Post-Cataract Surgery Vision Correction: Glasses vs. Contact Lenses

Post-cataract surgery vision correction => contact lenses, prescription glasses?

I have high myopia, with approximately -800 diopters in my left eye and -1200 diopters in my right eye.
I underwent laser surgery on my right eye over a decade ago, diagnosed with lattice degeneration of the retina.
I recently completed cataract surgery on my right eye, and the artificial lens was covered by health insurance, allowing me to see far but not near.
During my last follow-up appointment, the doctor mentioned that I could get glasses.
The disparity between my two eyes is about -800 diopters.
The vision test results are shown in the following link: https://imgur.com/a/yaISZAl.
I would like to ask two questions:
1.
Post-surgery, I am using -7 diopter contact lenses without astigmatism correction in my left eye.
The optical shop indicated that this is the best solution for the significant disparity between my eyes.
Since I will be reading documents and using a computer screen for extended periods, should I reduce the prescription (to -6.5?) and consider contact lenses with astigmatism correction? Additionally, with the left eye in contact lenses and the right eye unaided, I have to adjust the distance to read near objects like books and text.
In some situations, I cannot enlarge the text size on a computer screen, making it difficult to read small print, such as packaging instructions or notices on bulletin boards.
Would I need to use glasses for correction in this scenario?
2.
I would like to use contact lenses in my left eye as a backup, primarily relying on glasses for vision correction, with both options available for emergencies.
How should I adjust the prescriptions to address the disparity issue?

Chang, 40~49 year old female. Ask Date: 2020/08/10

Dr. Liang Ce reply Ophthalmology

It is recommended that you discuss the above situation further with your attending physician to determine if any additional examinations are necessary.
Thank you, and wishing you good health!

Reply Date: 2020/08/10

More Info

Post-cataract surgery vision correction can be a complex issue, especially for individuals with high myopia and significant differences in refractive error between the two eyes, as in your case. Here’s a detailed response to your questions based on the information provided and general medical knowledge.

1. Contact Lenses vs. Glasses for Near Vision: After your cataract surgery, it’s common to experience a need for different types of vision correction, particularly for near tasks. Since your left eye is currently fitted with a -7.00 diopter contact lens, and you are considering reducing the prescription to -6.50, this adjustment may help with comfort during prolonged reading or computer work. However, the decision to reduce the prescription should be made in consultation with your eye care professional, who can assess your visual needs and comfort level.

Regarding astigmatism, if you have significant astigmatism in your left eye, it would be beneficial to consider toric contact lenses, which are designed to correct astigmatism. These lenses can provide clearer vision for both distance and near tasks. If you find that reading small print or seeing details at varying distances is challenging, you may indeed need additional correction, such as reading glasses, to complement your contact lenses. This is particularly true for tasks that require precise focus, like reading packaging or notices that are not adjustable in size.

2. Combining Contact Lenses and Glasses: Using contact lenses in one eye and glasses in the other is a strategy known as "monovision." In your case, you could wear a contact lens in your left eye for distance vision while relying on your right eye’s natural vision for near tasks. However, this approach can lead to visual discomfort or difficulty in depth perception, especially if the difference in prescription is significant (as it is in your case).
To effectively manage the disparity between your two eyes, you might consider the following options:
- Customized Glasses: You can have a pair of glasses made specifically for your left eye's contact lens prescription, which can help balance the vision between the two eyes. This can be particularly useful for activities that require prolonged near vision, such as reading or working on a computer.

- Progressive Lenses: If you prefer glasses, progressive lenses can provide a seamless transition between different focal lengths, allowing you to see clearly at various distances without needing to switch glasses.

- Dual Prescription: If you choose to wear glasses primarily, you can have a dual prescription where one lens is optimized for distance (for your right eye) and the other for near vision (for your left eye). This can help mitigate the effects of the significant refractive difference.

In conclusion, the best approach to managing your vision post-cataract surgery involves a combination of professional advice from your eye care provider and your personal comfort with different vision correction methods. It’s essential to have a thorough discussion with your ophthalmologist or optometrist about your specific needs, lifestyle, and any visual challenges you face. They can help tailor a vision correction plan that works best for you, whether that involves glasses, contact lenses, or a combination of both.

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