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Guest NEIL-D-WILLIAMS

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HI Rick

I wear soft, disposable - much simpler! spectacle Rx? I guess I might have to ask my optician about that - is this about astigmatism? mine is slight but there is some. 

 

To be honest, I haven't had a new pair of spectacles since I started wearing contact lenses, probably 15 years ago!

 

I really appreciate your getting involved - it's beyond the call of duty, but hopefully it will be of interest to lots of people. 

 

I've not yet consulted with a doctor about the impending cataracts - it would be great to be armed with all the information before I do!

 

all the best

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I've come late to this thread - really useful reading for anyone using a Leica - thanks, Rick.

 

I've been fortunate, and came to spectacles relatively late in age (40s) and to contacts a decade later. I now use daily disposable progressive contacts 6 days of the week and varifocal spectacles the 7th. Using contacts is by far the better experience with the M, but I can manage with the varifocals when I have to.

Progressive contacts, especially the dailies, are expensive, but they seem to work by magic - the brain is a wonderful thing when it comes to adapting. My only problem is I forget I'm wearing them - and I use them for reading, computer screens, musical scores and photography.

 

No one needs to know my personal optical history, but I'm posting just in case anyone of my vintage (60s) needs that little encouragement to try the progressives when offered by your optometrist.

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Hi There Paul

Never tried progressive contacts - so now I will - I have an appointment with my ever helpful and skilful optician next week and I'll give them a try (at which point I'll also post my prescription).

 

The monovision has worked really well for me - but I'm looking forward to trying these. 

 

What a useful thread - all I can say for any others who are still struggling with glasses or diopter lenses - think about contacts - it's a great solution for a rangefinder shooter.

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I've not yet consulted with a doctor about the impending cataracts - it would be great to be armed with all the information before I do!

 

I had cataract surgery last year and it made a dramatic improvement in my ability to manually focus.  The replacement lenses corrected my mild astigmatism, but the biggest difference was in contrast.  The first time I looked through my newly implanted  lens the difference in contrast was amazing.  An A/B comparison with my as yet uncorrected eye showed how much the cataract affected acuity, color, and especially contrast.  I find manual focus much easier now.

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Same here, I had extensive eye surgery in my left eye - typed Cornea transplant and lens. The colour balance in my left eye is considerably shifted to blue - or rather to yellow in my right eye.

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Hi There Paul

Never tried progressive contacts - so now I will - I have an appointment with my ever helpful and skilful optician next week and I'll give them a try (at which point I'll also post my prescription).

 

The monovision has worked really well for me - but I'm looking forward to trying these. 

 

What a useful thread - all I can say for any others who are still struggling with glasses or diopter lenses - think about contacts - it's a great solution for a rangefinder shooter.

Good luck, Jono!

Progressive contacts started out with the ability to make only a limited range of corrections, but I've been fortunate that the range has increased in recent years in line with changes in my eyes. The first generation I used were unwearable for driving at night - too much flare - but the current technology can handle car and street lights. 

My distance vision is still good enough to manage unaided; the near vision is set at +0.75 in one eye and +1.5 in the other, but I believe progressives can go over +2 at least these days.

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HI Rick

I wear soft, disposable - much simpler! spectacle Rx? I guess I might have to ask my optician about that - is this about astigmatism? mine is slight but there is some. 

 

To be honest, I haven't had a new pair of spectacles since I started wearing contact lenses, probably 15 years ago!

 

I really appreciate your getting involved - it's beyond the call of duty, but hopefully it will be of interest to lots of people. 

 

I've not yet consulted with a doctor about the impending cataracts - it would be great to be armed with all the information before I do!

 

all the best

 

 

Hi Jono,

 

I would stick with the monovision for both the cataract surgery and the contacts.  That is the simple and probably correct advice.  I'll write more about this below.

 

Rick

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I get an eye exam and a new prescription annually (since there are changes) and the last two years the examiner has told me there is some pre-cataract yellowing in one eye.  It hasn't bothered me.  The lines in the rangefinder still merge crisply.  I hope Jono's concern is no more than that.  I wore glasses from the age of 12 to about 25.  Then a girl friend convinced me to shift to contacts, which worked fine, without change in prescription, for about 40 years.  I considered the monovision idea of using two different contacts, one for reading distance and one for distant vision, but I really like the perception of stereo vision and was concerned about how it work when flying an airplane, for instance giving lopsided peripheral vision.  I've been back to progressive lenses for normal use, and distant prescription-only yellow glasses for outdoor use (polarized don't work with today's cameras) for a while now.  I have some degree of astigmatism.  I wonder if the soft disposable contacts would let me ditch the progressives and deal with the annual increase in reading glass strength separately.  My previous contact experience was with hard and then gas permeable, ending when I could no longer wear them all day.

 

Just one more example.  Vision is pretty important to all of us.

 

scott

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Monovision correction and multifocal contact lenses and cataract IOL (Inter Ocular Lenses).

 

MONOVISION:  This is the correction that works best for me.  When it works for a patient it can provide the best possible correction of all modalities.  I have tried many different versions of "bifocal" contact lenses and none provide vision even close to the mono vision correction I use.  

 

At this point in time, there would be no IOL that I would consider for myself and Jono other than a simple single vision IOL; one eye for distance and the other for near.  Jono and I are able to utilize this modality so there really isn't any reason at this point in time for us to switch to something that most likely would not work as well, for us.  This is advise for us only or others that find monovision correction to be pretty perfect.

 

MULTIFOCAL CONTACT LENSES:  This correction modality works for many patients that can not wear monovision.  For some it works even better than mono vision because, it offers a greater range of focus at near.  The trade off is that for some patients the distance or near vision is not as sharp as mono vision and some report glare problems.  For many this modality provides excellent vision.

 

IOL(cataract surgery implants):  Simple single vision IOL lenses are usually set for distance for both eyes.  For Jono and myself we would probably choose a monovision correction and for us this would continue to be a fantastic modality.

 

We now have IOLs that can focus.  They are a compound lens that utilize the eye's ability to focus.  In general, they do not provide large amounts of near power for most patients.  This can be really variable with some patients realizing large amounts and some very little.  Sometimes scarring can cause the compound lens to lose its ability to move and focus.  But, this can be a good choice for some patients.

 

The most commonly implanted multifocal IOLs are the type that have zones in the IOL that are a some combination refraction areas,  defraction zones, and apodization.  These lenses all give varying degrees of success but, patients often suffer from decreased VA, glare and halos.  For some, these lenses work very well.  Others can be disappointed by the results.

 

 

Patient selection is key to making decisions of which modality will work best for each individual.  This is a topic that is too large, complex, multifactorial and variable to discuss here.  I'll leave that up to your individual practitioner to discuss with you.  But, most importantly, one solution is not perfect for each individual.  Some of you will have great success with one type of correction and others will have better results with another.  There are no perfect choices.  

 

And, I can't stress enough that all individual postings here will be anecdotal and to some degree incorrect.  Talk to your doctor.

 

Rick

 

 

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Many thanks Rick

That's extremely helpful, it rings true to me with the idea that simplicity is often the best option. Monovision has been working well for me for some time, and I'll leave it like that until the cataracts need doing.

 

I'm sure others are really grateful for this information as well.

 

best

Jono

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I hope Jono's concern is no more than that.   I considered the monovision idea of using two different contacts, one for reading distance and one for distant vision, but I really like the perception of stereo vision and was concerned about how it work when flying an airplane, for instance giving lopsided peripheral vision.  I've been back to progressive lenses for normal use, and distant prescription-only yellow glasses for outdoor use (polarized don't work with today's cameras) for a while now.  I have some degree of astigmatism.  I wonder if the soft disposable contacts would let me ditch the progressives and deal with the annual increase in reading glass strength separately.  My previous contact experience was with hard and then gas permeable, ending when I could no longer wear them all day.

 

Just one more example.  Vision is pretty important to all of us.

 

scott

Hi There Scott

I don't think I'll need my cataracts doing for a few years - but I'm prepared to jump as soon as focusing my M becomes difficult :).

 

Well, if you haven't tried monovision I can only recommend it, and daily soft disposables make life so much simpler. 

WRT monovision - it doesn't significantly affect stereo vision - and certainly doesn't seem to have any affect on peripheral vision. 

I guess what Rick says is the case - that if you can manage it, then it's probably the best solution - I really recommend you try it (cheap to try if you use disposables too).

 

I've tried a number of different combinations, currently I use +2.75 in my left eye (about right for reading), and +1.5 in my right eye for distance (this is actually, theoretically, a bit too strong).

 

I've got some vari-focals sitting by the bed, but I only wear them if i get a text in the middle of the night!

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Hmmm.  I'm in a different category.  My basic corrections go the other way.  -0.25 on the left and -1.75 on the right.  (Far-sighted, I guess, with better vision on the left, although I use my right eye with a camera.)  Reading correction is age-appropriate:  +3.  But when I did more flying, trying to spot a small airplane at 5 miles and read panel steam gauges in turbulence at 18 inches got complicated.  And I gather the virtual image in a camera's EVF is at about six feet?

 

scott

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But when I did more flying, trying to spot a small airplane at 5 miles and read panel steam gauges in turbulence at 18 inches got complicated.  And I gather the virtual image in a camera's EVF is at about six feet?

 

scott

 

I wasn't suggesting it would work necessarily, just that if, as Rick suggests, mono vision is the best solution, then it would certainly be worth trying. Added to which, that scenario would seem to me to be one where it does work really well.

 

ie looking at your LCD for chimping from 18" and then looking at a subject nesr infinity.

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Hi Jono,

 

I would stick with the monovision for both the cataract surgery and the contacts.  That is the simple and probably correct advice.  I'll write more about this below.

 

Rick

 

Hi There Rick

Well, in the spirit of adventure, I'm trying out progressive contacts for a few days to see if I like them - 2 hours in and feeling slightly sick I think you're right and I'll stick to monovision!

 

My prescription is:

Eye       SPH    CYL   AXIS  ADD   INT ADD

Right   +1.25   -0.75   180  +2.25   +1.5

Left     +1.25          0      0   +2.25   +1.5

 

My normal squeeze is +2.75 in my left eye, and +1.5 in my right (soft disposable) - which is working pretty well.

 

Your information has been seriously useful, it's fine messing about with contacts to see what works and what doesn't . . . . not so good with implants!

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Jono,

 

When you go back, ask if you could try an astigmatic lens in your right eye.  Something like +1.50 - 0.75 X 180.  You might be surprised that your vision is a little better in the distance.  

 

If, the astigmatic contact looks better it might make it harder to see through the RF... then you would need the +0.50 diopter.  Which would be even better than what you are doing now with a purely spherical contact lens in the right eye.  

 

But first, you need to try and astigmatic contact to see if it is better than your spherical contact.

 

Worth a try,

 

Rick

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HI Rick

I'll be going back in 10 days or so after I've given the progressives a try . . . first impression isn't good, I seem to have a fairly hefty migraine flashing lights attack this evening!  The vision difference is interesting . . . the actual point of focus seems better than with monovision . . . but the impression over the whole field of view is less sharp - focusing isn't a problem either way (truth be told I can focus fairly well with my naked eye - practice is a great thing!

 

To be honest, I've had no problem with the monovision, even for distance - it just seems that now is a really good time to see if there is a better option (easier to change contact lenses than to change implants)

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My distance vision doesn't need correction, so I certainly notice that distance vision is less sharp with progressives - but it's good enough. Monovision wouldn't work for me - my left eye has other defects, so the right has to do most of the work, with a bit of stereo help from the left.

But I never had headaches or flashing lights :)

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My distance vision doesn't need correction, so I certainly notice that distance vision is less sharp with progressives - but it's good enough. Monovision wouldn't work for me - my left eye has other defects, so the right has to do most of the work, with a bit of stereo help from the left.

But I never had headaches or flashing lights :)

 

 

I don't get headaches - but I've often had the flashing lights - I can still remember how freaky it was the first time in a tube station in around 1975 - serious psychedelia, and for someone in my generation strangely familiar!

 

Usually they start in the middle and last for 20 minutes - these ones today were all over the place, but they still lasted 20 minutes

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