IF THIS TOPIC isn't applicable to you now, it may be a topic of discussion in your family, since everyone will need cataract surgery if they live long enough.

What I learned from this journey as a contact lens wearer with monovision will be particularly informative to anyone who has questions about the procedure or their vision options afterwards. Because I had so many questions and concerns myself, I'm sure I can put some of your concerns or fears about this surgery to rest.


"Surgeons are going back to monovision cataract surgery, and it's working."

In this article on Healio.com, Dr. John A. Hovanesian states, "Several colleagues have recently informed me how happy they and their cataract patients have been with monovision."


Several surgeons share their tips on how they evaluate patientsí eligibility for monovision, and take a look at what might be the next generation of monovision treatment.
Read article here.


Copyright © 2016 by Barbara Brabec. All Rights Reserved.

Now I See Clearly

An Authorís Personal Experience
with Monovision Cataract Surgery

by Barbara Brabec
Posted January 2016

This is a long article, so Iíve divided it up into helpful sections and spread it over three pages. The following T/C will link you to individual sections below and on the following pages, each of which has a link to bring you back to this page:

My Contact Lens Experiences
Vision Changes that Prompted Cataract Surgery
Selecting an Eye Surgeon
Switching from Hard to Soft Lenses
The Surgical Procedure and Prescription Costs
Eye-Drop Procedure Before and After Surgery
What My Cataract Surgery Was Like
Two Days After Surgery
The Glasses I Needed
Closing Thoughts and Statistics


My Contact Lens Experience

I STARTED WEARING glasses when I was in the sixth grade, and the first thing I did when I was on my own at eighteen was exchange them for the kind of hard contacts that are now considered old-fashioned and obsolete. They were a challenge to get used to, but those contact lenses changed my life for the better.

Soft lenses were introduced in 1971, but I had no interest in them. By then Iíd gotten so used to inserting and removing a hard lens that I refused to change. Besides, they were more affordable, because unless I lost a lens, I could wear one for years, or until my vision changed in either eye.

When gas permeable lenses were introduced in the late seventies, my eye doctor (an optometrist) suggested I switch to them, and I did so because these rigid lenses felt much like the ones Iíd become accustomed to and offered some advantages. They allowed the cornea to draw oxygen from the air (promoting eye health), couldnít tear or break unless they were stepped on, and gave me sharper vision than I could have gotten with soft lenses. The only real drawback I found was that because the rigid lenses move when you blink your eyes, specks of dust or a flying cat hair could easily end up under the lens, requiring prompt removal and cleaning to avoid damage to the cornea. (Not recommended for someone who works out of doors.)

I loved how easily I could "pop them out" and insert them in a second, and the cleaning process was a breeze. But I must admit that the pop-out procedure sometimes caused me to lose a lens, because they could easily go astray if you didnít catch them in your hand. Sometimes they would hit the edge of the sink and bounce, and it might take me an hour or more on my hands and knees trying to find them. Sometimes I never found them at all, and I had to order a new lens and wear an old backup lens until the new one came in.

I once lost a lens on a sparkly sidewalk in New York City and many kind New Yorkers joined me in the search, to no avail. I had to buy a temporary pair of glasses to get through that week.

To avoid a pair of supplemental glasses about thirty years ago, I switched to monovision to get better vision for both driving, reading, and computer work, and the vision I had then seemed like a miracle. I could hardly believe it possible to be able to use one eye for distance and another for near, but thanks to the neuroplasticity of our brain, we can train it to automatically and seamlessly switch between the eyes as we change our focus from near to far and vice versa.

Vision Changes That Prompted
Cataract Surgery

AS I GOT OLDER, my lenses had to be strengthened a bit in one eye or the other, and I had no trouble seeing everything clearly until a couple years ago, when I had to buy a neck-hung magnifying glass to do my needlework without glasses.

One day in late 2014 when I said I was having trouble with my near vision, my doctor told me he had tweaked my right eye lens (for reading) as far as he could go because the cataract was now causing me a problem that could only be fixed by its removal. I had cataracts in both eyes then, but the breaking point for me was when work on the computer became more difficult. I found myself continually blinking in an effort to see better and had to move the monitor closer too. I finally decided in August of last year to go ahead with the surgeries.

Something I didnít learn until then was that age is a factor in how long a person may be able to have monovision. My eye doctor told me that many seniors canít do this past sixty, but the fact that Iím still having no trouble with it suggests I may be able to see like this for many years to come. He told me not to worry about it because his oldest monovision patient is 89, and that if I should lose this ability in the future, I will have eyeglass options for moving forward.

Selecting an Eye Surgeon

A FRIEND CAUTIONED ME to be careful in choosing a cataract surgeon, offering tips on how to pick one. But this advice didnít apply to me because Iíve been seeing the same eye doctor for more than thirty years and I trusted his referral to a surgeon without question. He had ushered my late husband through this procedure about twenty years before (with a different surgeon then), and told me that the surgical procedure for cataract removal as well as the quality of lenses had changed dramatically since Harry had his eyes done. He had good vision afterwards with 20/20 in both eyes, perfect for ordinary use, but he didnít have monovision, so he ended up needing four pairs of glasses: one for driving, one for detailed desk work and newspaper reading, one for television, and a pair of half-glasses when he played concerts since he had to see both the conductor in the distance and the music on the stand.

I wanted to avoid glasses as much as possible, so I was assured that I could have monovision in the permanent lenses that would be implanted. When I finally called the eye surgeon in August to set up the initial appointment, I was surprised to find she was booking two months ahead. Turned out that I would need at least a monthís time to get ready for this appointment.

Switching from Hard to Soft Lenses

THIS PROVED TO BE VERY STRESSFUL for me. When I gave my eye doctor the date of my appointment with the surgeon, he told me something I wished I had known earlier: that I had to immediately stop wearing my gas permeable lenses and switch to soft lenses for a month. Why? Because the rigid contact lenses had changed the shape of my eyeballs—complicated by the fact that I also had astigmatism—and the eye surgeon couldnít come up with a prescription for the permanent lenses that would be implanted until my eyes had returned to their normal shape. I had no idea how stressful and difficult the next four weeks would be. In a September 29 email to my sisters, I wrote:

"Well, Iím not seeing well today. Got my first pair of soft lenses yesterday, and after spending more than an hour trying to learn how to get them out of my eyes with no success, I was an emotional wreck. This is totally different from 'popping out' the hard lenses Iíve worn all my life. These are such flimsy suckers! I was directed to put my thumb and forefinger on either side of the eye, and at the bottom pinch in from either side to break the suction and fold the lens like a taco shell to get it out. I simply could not make my fingers work like that and was very reluctant to literally 'pinch my eye' like this.

"I was supposed to wear the lenses from 4 p.m. to bedtime and then take them out, but I said Iíd be a nervous wreck all evening, convinced I wouldnít be able to remove them. So they had to change the plan and have me start wearing them at 10 a.m. this morning until 3:00, and after I return from my Bible study class this afternoon, Iíll try to take them out. Escape route: If I canít do it (again), Iíll have to go back to the doctorís office for another lesson. VERY stressful. Will repeat the process tomorrow, and then itís 'wear them all day' and come back in a week for a new prescription.

"I pray I can get the feel of how to do this. Sounds so easy, but I can't yet make the fingers work. Really hard to teach an old dog a new trick like this. It took me ten minutes this morning just trying to get one of these invisible lenses out of the container's solution and onto my finger. AARRRGGH!

"The doctor told me that the temporary lenses wouldnít give me the same vision Iíd had before, but would be good enough so that I could function and still drive. Thatís when I learned that all one had to do to pass a driving test was be able to read the third line on an eye chart. (I shudder to think about all the drivers out there with vision this poor!)

"Right now, the worst part for me is that the temporary lens prescription is about 75 percent of what I need to be able to read without putting something six inches from my face, so Iíve been advised to buy some 2-power magnifying glasses for reading. And my balance is terrible. I feel like the brain is asking why Iím sending it such strange messages now. Thankfully, I can enlarge the font size in Outlook and Word, but Iíll bet this is going to result in a doozey of a headache before the day is over."

Continued on page 2 ->

The Surgical Procedure and Prescription Costs * Eye-Drop Procedure Before and After Surgery

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