Binocular Disparity: Key Considerations for Eye Surgery

Q: Binocular Disparity: Key Considerations for Eye Surgery

Hello： <br>1. <br>Should the degree of the right eye be preserved during surgery to avoid excessive binocular disparity, and what is the recommended degree? When considering whether to preserve the degree, you should follow the advice of your ophthalmologist. <br>Typically, after

Binocular disparity issue?

Thank you for the previous response, Doctor.
I have more questions to ask.
My right eye is scheduled for surgery on November 8, and my left eye has -500 diopters of myopia and mild cataracts (but does not require surgery).
Both eyes have +250 diopters of presbyopia.
I have discussed with the clinic about using an aspheric monofocal intraocular lens for my right eye since I ride a motorcycle to work.

1.
During the surgery, should I retain some degree of vision in my right eye to avoid excessive visual disparity between the two eyes? What degree do you recommend?
2.
After the surgery, should I go to an optical shop to replace the right eye lens in advance to avoid difficulties riding my motorcycle? However, I read online that the prescription may not be stable yet, and I shouldn't rush to get new glasses.
But wouldn’t that be dangerous for riding?
3.
I will rest for five days after the surgery on November 8 and return to work on November 13.
Since my left eye has a multifocal lens, what would happen if I replace the right eye lens with a plano (0 diopter) lens or retain the degree after surgery instead of using a multifocal lens?
Thank you for your prompt response to my previous questions, and I appreciate your help with today's inquiries!

Jingju, 50~59 year old female. Ask Date: 2023/11/04

Dr. Gao Pilin reply Ophthalmology

Hello:
1.
Should the degree of the right eye be preserved during surgery to avoid excessive binocular disparity, and what is the recommended degree? When considering whether to preserve the degree, you should follow the advice of your ophthalmologist.
Typically, after surgery with an aspheric monofocal intraocular lens, your right eye's degree will be corrected to your optimal prescription for the best visual outcome.
The ophthalmic specialist will determine the surgical prescription based on your eye condition and visual needs to minimize binocular disparity.
You should discuss this issue carefully before the surgery to ensure you receive the most suitable advice.
2.
After surgery, should I go to an optical shop to replace the right lens? Generally, the eyes need some time to stabilize after surgery to determine the final prescription.
During this stabilization period, it is not advisable to rush into replacing the lens.
The prescription may require multiple adjustments to ensure optimal visual performance.
Replacing the lens immediately after surgery may lead to discomfort and unstable vision.
For safety while driving, you should consider replacing the right lens only after your eyes have fully stabilized.
3.
If the left eye has a multifocal lens and the right eye is replaced with a plano lens or retains a non-multifocal prescription, what would be the outcome? If your left eye has a multifocal lens and the right eye is replaced with a plano lens, this may lead to visual imbalance, as the visual capabilities of your left and right eyes will differ.
This situation could cause visual discomfort and disturbances.
The best approach is to discuss with your ophthalmologist after the surgery to determine the most suitable method for your visual correction to avoid issues with visual coordination.

Reply Date: 2023/11/04

More Info

Understanding binocular disparity and its implications for eye surgery is crucial, especially when considering the unique challenges posed by conditions such as high myopia, cataracts, and the need for corrective lenses post-surgery. Let's address your questions one by one, while also providing some context about binocular disparity and its relevance to your situation.

1. Should I Preserve Some Degree of Myopia in My Right Eye to Avoid Excessive Binocular Disparity?
When planning for surgery, particularly in cases where one eye has a significantly different prescription than the other, it is essential to consider binocular disparity. Binocular disparity refers to the slight difference in images perceived by each eye, which is crucial for depth perception and overall visual comfort. If the difference in prescription between your two eyes is too great, it can lead to visual discomfort, difficulty focusing, and even headaches.

In your case, since your left eye has 500 degrees of myopia and the right eye will be corrected with a non-spherical single-focus intraocular lens, it may be advisable to retain some degree of myopia in the right eye. This can help minimize the disparity between the two eyes. The exact degree to retain should be discussed with your surgeon, as they will consider factors such as your lifestyle, the specific lens being used, and your visual needs. A common approach is to aim for a difference of no more than 1.00 to 1.50 diopters between the two eyes.

2. Should I Get My Right Eye Glasses Changed Before Surgery?
It's true that immediately after surgery, your vision may fluctuate as your eye heals and stabilizes. This is particularly important to consider if you rely on your vision for activities like riding a motorcycle. While it is generally advised to wait until your vision stabilizes before getting new glasses, you may need to have a temporary solution in place for safety reasons.

If your surgeon believes that your vision will be stable enough shortly after surgery, you might consider getting a pair of glasses that accommodate your expected post-operative vision. However, if your vision is likely to change significantly during the healing process, it may be better to wait. Discuss this with your eye care provider, as they can provide guidance based on your specific situation and the expected recovery timeline.

3. What Happens if I Use Different Types of Lenses Post-Surgery?
If you choose to use a plano (0.00 diopter) lens in your right eye after surgery, while your left eye remains myopic, you may experience significant visual disparity. This could lead to difficulties in focusing, especially for tasks requiring depth perception, such as driving or riding a motorcycle.
On the other hand, if you opt for multifocal lenses in your right eye, it may help in providing a more balanced visual experience, especially since both eyes would then be corrected for distance and near vision. However, this could also introduce some complexity in terms of visual clarity and comfort, particularly if the left eye remains uncorrected for distance.

Conclusion
In summary, the considerations surrounding binocular disparity are essential when planning for eye surgery, especially when dealing with significant differences in refractive error between the two eyes. It is crucial to have a thorough discussion with your ophthalmologist regarding the best approach for your specific needs, including the degree of correction to aim for in your right eye, the timing of new glasses, and the type of lenses to use post-surgery. Your safety and visual comfort should be the top priority, and your eye care team is there to help you navigate these decisions.

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