The 3 zones of vision

When we are young, vision is seamless at most distances and we do not have to even think about the 3 zones of vision. As we age, the lens deteriorates and vision at near and intermediate distance starts to fade. When cataract surgery is performed, it is critical the patient choose a lens implant and surgery type that is consist with the zones of vision that are important to them.

Typically, we think of the following 3 zones of vision:

• Far Vision: This is used for driving or watching tv.
• Intermediate Vision: This is used for viewing a computer, tablet, cellphone or dashboard.
• Near Vision: This is used for reading a paper book or looking at small near objects.

4 Cataract Surgery Packages:

The lens you select for your cataract surgery will determine how you see for the rest of your life. Thus, this is a very important decision.

The Cataract surgery packages below offer glasses free vision at 3 distances (3D), two distances (2D vs 2D+), 1 distance (1D) or none at all. (traditional surgery). It is important to keep in mind that the technologies are different and each has its pros and cons. At this time, “perfect vision’ at all times and in all circumstances” is not possible.

Full Range of Vision: 3D VISION:

Far, Computer and Reading distance. This can be achieved using most of the currently available Multifocal lenses.

• Multifocal lenses offer a full range of vision at far, intermediate and near vision, as well as maximum freedom from glasses..
• Each has its pros and cons.
• These lenses use diffractive technology. This means they have rings on their surface that break up light into different wavelengths to allow vision at far, intermediate and near vision.
• These rings can cause night vision and contrast quality issues. For most patients, these are mild and your brain neuro-adapts to them with time.
• IDEAL PATIENT:
  • Younger active patients.
  • Easy going patients.
  • Patients with intense near vision demands.
• OUT OF POCKET COST: $$$$

Extended Focus Vision: 2D vs 2D+ VISION:

For 2D+ vision, we have to include either monovision or blended vision in the picture. Monovision usually refers to having one eye targeted for far vision and the other targeted for near vision. Blended vision refers to having one eye targeted for far vision and the other targeted for intermediate vision. Of the two, blended vision is easier to adapt to than true monovision. While monovision and blended vision can take some adjusting to, with neuro-summation, the brain learns to bring the two different images together.

Some people may have a hard time adjusting to true monovision. Most people acclimate to blended vision well. The near/intermediate eye for monovision/blended vision will be more blurred in low light situations.

2D and 2D+ vision can be achieved using 2 different technologies:

• Extended Depth of Focus Lenses:
  • These lenses can be corrected for Far and Intermediate vision:
    • When both lenses are targeted for far distance, the patient is able to achieve function vision at far and intermediate distance: 2D Vision.
    • When one eye is targeted for far distance and the other is intentionally targeted to be slightly myopic (blended vision), we can achieve 2D+ vision.
• Light adjustable Lenses (LAL): True Customized vision.
  • The LAL offers truly customized vision because the prescription can be finetuned with a Light Delivery Device for a limited time after surgery. It comes in 2 versions, regular LAL and the LAL Plus that can be customized to your liking.
  • LAL, at its core, is a monofocal lens and thus the only way to achieve vision at near and far is monovision or blended vision.
• The regular LAL, and especially the LAL Plus, have some degree of Extended Depth of Focus ability. LAL Plus is more likely to achieve true 2.5D vision.
• LAL lenses can also both be aimed for distance but the result would be 1.5D VISION. This is ideal for patients with high night or low light vision demands.
• IDEAL PATIENT for 2D/2D+ Vision:
  • Patients with very “particular” personalities.
  • Patients with high night vision or low light demands.
  • Patients who have loved monovision with LASIK or contact lenses.
  • Patients with a prior history of LASIK/PRK with an enhancement. It is much harder to target these patients and the adjustability really helps.
• OUT OF POCKET COST: $$$$

Astigmatism Management: 1D VISION:

We offer a package for Astigmatism management.

• This option offers aiming vision for Far distance only.
• This is most easily achieved with:
  • Laser-assisted Cataract surgery with a standard monofocal lens.
  • TORIC lens with either Laser-assisted or traditional cataract surgery.
• Glasses are required for both reading and intermediate vision.
• NOTE: We do not offer monovision or blended vision with this option. This is because some people do not tolerate monovision or blended vision in a lens implant and this package does not allow customization. For monovision or blended vision, you should consider LAL or LAL plus.
• IDEAL PATIENT:
  • Budget minded patients.
  • Patients who do not use a computer or read a lot.
  • Inactive patients.
• OUT OF POCKET COST: $ to $$

Traditional (non-Laser) Cataract Surgery:

This option almost always requires glasses in the form of a trifocal or bifocal.

• Standard Monofocal lens

If you have questions about which option is best for you, please call 214-328-0444 and speak to one of our counselors.

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