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I'm 33. I have retinitis pigmentosa and I'm nearsighted. (-9.00 in right eye, -10.5 in left eye). I have to have cataract surgery in both eyes. I expressed to my surgeon that I wanted to keep my very near vision (right up to my face). I cherish the ability to bring something very close to my eye and read it. With my contacts in I can read the computer fine, drive (during the day), and function quite normally. After expressing my desire to maintain my near vision, my surgeon recommended not correcting anything, which would leave me nearsighted. This seems fine to me. They're doing my left eye first since it has the much larger cataract. My question is this: If the left eye surgery goes well, and my very near vision is razor sharp (again very near meaning right up to my face) as it is now, would it be possible to then just correct my right eye? Then I could just use a contact lens in my left eye. Would I basically be able to see as well as I do with contact lenses? Also, I believe they are going to leave me -10 in my left eye which is what I asked for so I could keep my razor sharp near vision. Another doctor on an Internet forum said that was a horrible idea and wouldn't do that if I were his patient. So I'm curious of your opinion.     

This is a confusing question and I will try to help you. First, too many cooks spoil the broth, or something like that. Our job as ophthalmologists includes providing our patients with the information they need to make an intelligent and informed decision, not telling them what choices to make. Sometimes it's hard for some of us to remain objective. If you want to keep your -10.00 diopter myopia in the left eye after cataract surgery, that is your right. And yes you can have your right eye surgery calculated to target a plano correction (needs no glasses at all to see distance). The problem is that the maximum difference in refraction (glasses measurement) between the two eyes that most people can tolerate without seeing double is about a 3.00 diopter difference.  Contact lenses can extend that difference greatly. So if you follow your plan, you will be obligated to wear a contact lens in the left eye almost 100  percent of the time in order not to see double. If that meets your needs and visual desire, you certainly should be able to have it. I suggest you contact the ophthalmologist (Eye M.D.) that is going to do your cataract surgery and ask him/her to go over all of this with you carefully, as what you plan to do will be "written in stone" and might not be subject to insurance coverage if you try to change your mind later.

Answered by: Wayne Bizer, DODr. Wayne Bizer

Categories: Cataracts, Eye Surgery, Vision Correction

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Answered: Feb 07, 2013

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