How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. Rick Your Own Question

Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7746
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
Type Your Eye Question Here...
Dr. Rick is online now
A new question is answered every 9 seconds

I am a 56 year-old female in excellent health. I have the

Customer Question

I am a 56 year-old female in excellent health. I have the beginnings of cataracts in both eyes (enough to have insurance cover a basic IOL implant). I also have recently discovered astigmatism (about 1.25-1.5D) in both eyes. I have mostly successfully worn monovision contacts for the last 12-15 years. My Rx is +2.50 (right eye, distance) and + 4.75 (left eye, close up). However, I am not totally satisfied w/ my distance vision--far ends of grocery aisles and far distance driving (in all conditions) are less than optimal. I desire to NOT wear contacts or glasses. I am considering a monovision toric lens implant (just like my contacts--one eye for close up; the other for distance). However, I'm also considering waiting for US/FDA approval of the toric multifocal lenses. What do you suggest?
Submitted: 1 year ago.
Category: Eye
Expert:  Dr. Rick replied 1 year ago.

Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

Since you have years of experience with monovision contact lenses I feel you would do just fine with monovision toric IOL's.

Dr. Rick :

Who knows how long it will take for the FDA to get around to approving the new toric mulitfocals and, since your cataracts are at the point that they are bothering you and are ready to come out, I do not see any reason to delay surgery.

Dr. Rick :

Also, should you have the monofocal/toric IOL's placed in your eyes in a monovision configeration after cataract surgery and, for whatever reason, do not like it, you can have IOL explanted and exchanged.

Dr. Rick :

Is there anything else you would like to discuss at this point or have all your questions been answered to your satisfaction?


 


I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. And please let me know if the rating system gives you any troubles.

Thanks in advance,

Dr. Rick MD FACS

Dr. Rick :

We have been experiencing problems with the chat system for the last few days. Our engineers are working on it. However, I'll switch over to the Q&A system. This system works a lot like 'text messaging' but an email is sent to each of us anytime something is posted to this thread. We can continue to work on your question there..... :)

Expert:  Dr. Rick replied 1 year ago.
Our chat has ended, but you can still continue to ask me questions here until you are satisfied with your answer. Come back to this page to view our conversation and any other new information.

What happens now?

If you haven’t already done so, please rate your answer above. Or, you can reply to me using the box below.
Expert:  Dr. Rick replied 1 year ago.
We have been experiencing technical difficulties with the chat system. Please allow me to retype my chat here for your review:


Dr. Rick : Hi. I'm online and happy to answer your question today.
Dr. Rick : Since you have years of experience with monovision contact lenses I feel you would do just fine with monovision toric IOL's.
Dr. Rick : Who knows how long it will take for the FDA to get around to approving the new toric mulitfocals and, since your cataracts are at the point that they are bothering you and are ready to come out, I do not see any reason to delay surgery.
Dr. Rick : Also, should you have the monofocal/toric IOL's placed in your eyes in a monovision configuration after cataract surgery and, for whatever reason, do not like it, you can have IOL explanted and exchanged.
Dr. Rick : Is there anything else you would like to discuss at this point or have all your questions been answered to your satisfaction?

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. And please let me know if the rating system gives you any troubles.

Thanks in advance,

Dr. Rick MD FACS

So. What is the take home message? I believe you will be fine proceeding with monovision/toric IOL implantation with one eye set up for near and the other for distance, just like you have been doing for years with your contact lenses.

Best of luck to you in your upcoming surgery. :)
Customer: replied 1 year ago.

What is the reason that my far distance vision is blurry right now (actually for quite a while--I really have to concentrate & tell my brain to focus on distance while driving). Is it the cataracts? Astigmatism? Or the monovision contacts? (My distance vision is much clearer when wearing my bifocals. . . )

Expert:  Dr. Rick replied 1 year ago.
Susan,

Monovision contacts will not, in and of themselves, cause a decrease in vision that the ophthalmologist can not make better in her office; this is also true for astigmatism.

From what you have posted, it sounds like the primary cause of your decreased vision are your cataracts.

I'm sure your doctor told you this, but as long as you can see well enough to do the things you need to do while wearing your contacts or glasses, there is no need to have cataract surgery. Waiting to have cataracts removed does not change your final visual outcome or make the surgery any more difficult or risky.

Does this make sense?

It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I don't go up in a puff of smoke -- I'll still be right here to continue helping you, but, as I do work for tips, I want to make sure you are happy before rating me.
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7746
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Customer: replied 1 year ago.

I am weighing cost (our insurance premiums continue to go up; benefits continue to go down). I can only expect more of the same in 2014. . .The fact that I've already invested time/money in 3 measurment visits (a 4th scheduled for Friday, 3/22--surgery scheduled for 4/16). I have an active lifestyle, and do not want to wear glasses. Also, the contacts generally work so well for me that I am tempted, too often, to sleep in them. I realize that this is a very dangerous practice. Just having a hard time making a decision. . .a friend/colleague in Ecuador just had toric multifocal implants, and she is begging me to wait for FDA approval--scheduled for 13-14 months from now. However, not sure I want to be one of the first patients implanted with this new lens.

Expert:  Dr. Rick replied 1 year ago.
Susan,

When the FDA gives a "date" for when the might approve something I would not put much stock on what they say...it might be years.

As you can tell from your friends experience in Ecuador, even if you had the lens implanted the very first day the FDA allows doctors in the USA to use it there would have been thousands of people around the world ahead of you. Also, implanting the "new" lens is not technically difficult for and experienced surgeon.

There are really no wrong answers for your issue....just decisions. I am glad that you are exploring all your options before making this important decision.

Let me know if there is anything I can do to help you in the future.

Dr. Rick MD FACS

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
< Last | Next >
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
  • Wonderful service, prompt, efficient, and accurate. Couldn't have asked for more. I cannot thank you enough for your help. Mary C. Freshfield, Liverpool, UK
  • This expert is wonderful. They truly know what they are talking about, and they actually care about you. They really helped put my nerves at ease. Thank you so much!!!! Alex Los Angeles, CA
  • Thank you for all your help. It is nice to know that this service is here for people like myself, who need answers fast and are not sure who to consult. GP Hesperia, CA
  • I couldn't be more satisfied! This is the site I will always come to when I need a second opinion. Justin Kernersville, NC
  • Just let me say that this encounter has been entirely professional and most helpful. I liked that I could ask additional questions and get answered in a very short turn around. Esther Woodstock, NY
  • Thank you so much for taking your time and knowledge to support my concerns. Not only did you answer my questions, you even took it a step further with replying with more pertinent information I needed to know. Robin Elkton, Maryland
 
 
 

Meet The Experts:

 
 
 
  • Dr. Dan B.

    Board Certified Ophthalmologist

    Satisfied Customers:

    2903
    Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
< Last | Next >
  • http://ww2.justanswer.com/uploads/DoctorDanB/2010-6-7_6228_just_answer_profile_picture_60_pixels.jpg Dr. Dan B.'s Avatar

    Dr. Dan B.

    Board Certified Ophthalmologist

    Satisfied Customers:

    2903
    Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
  • http://ww2.justanswer.com/uploads/anupamadesai/2010-04-13_122313_Dr._A.S.Desai_new_photo.jpg Dr. A.S. Desai's Avatar

    Dr. A.S. Desai

    Ophthalmologist

    Satisfied Customers:

    1903
    MS Ophthalmology with 11 years of surgical expereince
  • http://ww2.justanswer.com/uploads/gsokoye/2009-10-28_181751_Dr._Stan.JPG Dr. Stan's Avatar

    Dr. Stan

    Ophthalmologist

    Satisfied Customers:

    895
    Johns Hopkins Fellowship Trained, Certified and Licensed Medical Physician and Surgeon
  • http://ww2.justanswer.com/uploads/eyemd/2009-04-07_180315_pic.jpg Dr. Stevens's Avatar

    Dr. Stevens

    Ophthalmologist

    Satisfied Customers:

    629
    Board Certified Ophthalmologist
  • http://ww2.justanswer.com/uploads/CO/CorneaDoc/2012-2-18_0390_photo6.64x64.jpg Dr. Susan's Avatar

    Dr. Susan

    Ophthalmologist

    Satisfied Customers:

    217
    Board Certified & Fellowship trained eye surgeon.
  • http://ww2.justanswer.com/uploads/neuph94/2009-10-11_164729_gif_pic.GIF Dr. JP's Avatar

    Dr. JP

    Ophthalmology, Oculoplastic Surgery

    Satisfied Customers:

    28
    Harvard Medical School, Massachussetts Eye and Ear
  • http://ww2.justanswer.com/uploads/JA/JACUSTOMERjcufyksv/2012-3-13_44825_crop3.64x64.jpg Dr-Trace's Avatar

    Dr-Trace

    Board Certified Ophthalmologist

    Satisfied Customers:

    26
    Board Certified in General Ophthalmology