Monovision Progressives?

Hello everyone,

I had an interesting troubleshoot today. The Pt was picking up their glasses and having trouble seeing out of their new progressive lenses. They were unable to read up close or see clearly far away.

They had recently had cataract surgery and had a new distance and reading Rx from their Dr. The optician who sold them their glasses (not me) put them in progressives, since they had both a far and near Rx.

After asking them some follow up questions, they either have multifocal IOLs or more probably the Dr has them set up for Monovision post surgery. They were really confused and unsure what the Dr had done, and they are going back for a follow up visit. I did not think you could use progressive lenses with Monovision or Multifoical IOL or contact lenses. I explained that we could do one pair for reading and a separate pair for driving, but they were adamant that they didn't want to have to switch back and forth between glasses.

Does anyone have any experience with situations like this?

Thanks for your help and advice.

Need more info on glasses Rx and type of IOLs to give anything other than a wild guess at 1,000’s of possibilities.

If they had mono vision implants they should not need glasses. If they had multi focal implants then a refraction will determine what they need for a spectacle Rx. You had to have an Rx to make progressives so something is very wrong if they can’t see in either distance or reading

As optical24/7 mentioned you will need to provide more info for any informed potential solutions. At the risk of sounding basic were the provided spectacle lenses checked against the provided Rx to make sure it was correct?

Bill(?)

If it's mono, you'll probably be dealing with a diopter or so of vertical imbalance at near, so add that to your pile o' trouble.

Robert

I honestly would tell them they need to discuss this with the prescribing doctor/surgeon. We do everything we can to talk patients out of monovision IOLs because there are almost always issues down the road. We pretty much never recommend it to patients and the doctor will only do them if a patient is absolutely dead set on it. And if they opted for monovision IOLs my assumption would be that they don't need glasses or else why would they have bothered with monovision implants in the first place?