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Ask Dr. A.S. Desai Your Own Question
Dr. A.S. Desai
Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2437
Experience:  MS Ophthalmology with 13 years of surgical expereince
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I had cataract surgery in Oct 2009 & had IOLs implanted in

Resolved Question:

I had cataract surgery in Oct 2009 & had IOLs implanted in both eyes. I had astigmatism in both eyes, so the surgeon chose Toric lenses which corrected both the astigmatism & cataracts at the same time. My right eye, which is my dominant eye, was set for distance vision. My left eye was set for a little less distance to assist with working on the computer, which I do 6 hours a day at work. My surgeon called it modified monovision. My vision now is great & I can clearly see objects both near and far. However, pain in my right eye is a concern. When I look at objects less than 3 feet from me, I feel a tingling or sensation of pressure in my right eye. Soon thereafter, my right eye is sore and there also is discomfort in the back of my neck on the right side. My surgeon said he doesn't know what is happening in my right eye, but believes I will adjust to it over the next year or two. What are your thoughts on what is happening in my right eye & what are my options to fix it?
Submitted: 7 years ago.
Category: Eye
Expert:  Dr. A.S. Desai replied 7 years ago.

Since your right eye has been corrected for distance only and your left eye for intermediate distance too, what you might be experiencing is the strain on your right eye to visualise near objects. Usually there is no problem in such a situation(modified monovision) when both eyes are open and used together.

Pain in your right eye could be due to post operative iritis(uveitis) which can be treated with steriod eye drops(as you have already done in your case).

One suggestion to avoid closing your right eye when objects are close is to use spectacles with progressive additional lenses(your optometrist will be able to help you) which can take care of distance vision, intermediate vision and near vision with the help of same glass.

The whole idea of doing modified monovision surgery is to avoid glasses post operatively. But in your case if the right eye is bothering you too much then this is the simple solution. So if your post operativae inflammation has totally subsided then you can think of getting your glasses done.

Dr A.S.Desai

These answers are for information purpose only and cannot be substituted for a check-up and visit to an ophthalmologist.

Customer: replied 7 years ago.

Thank you, Doctor. Lets assume that the issue is strain on the right eye, when it is trying to visualize near objects. Based on your experience, is this something that my eye and brain might get used to over time?

If I get glasses, will that keep my eye and brain from adjusting?

Also, is it important to have both eyes open and used together? I have noticed that I have the most difficulty when talking to someone on my right side. In this situation my right eye is closest to the person's face and looking directly at it. My left eye is only glancingly viewing the persons face.

Expert:  Dr. A.S. Desai replied 7 years ago.

Wearing progressive additional glasses are fitted with powers to visualise objects at different distances so that there is no strain on your eyes. You will be able to adjust to them .
For good binocular vision both eyes should be open. You must avoid covering right eye to visualize near objects. I am sure glasses will be able to give relief in this regard.

A normal person needs to accommodate(with the help of natural lens) to see near objects. After cataract surgery this power to accommodate is lost as the natural lens is removed. To overcome this loss the following options are used. Either glasses are given for near vision or multi focal intraocular lenses are implanted or modified mono vision technique is used. In your case the last option was done, but you still need some more correction for near vision in your right eye.

Dr A.S.Desai

These answers are for information purpose only and cannot be substituted for a check-up and visit to an ophthalmologist.

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