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 Motorcycle Safety
 Aging and Disabilities
 Mono-vision
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D R
Advanced Member
1053 Posts
[Mentor]


Northern, Virginia
USA

BMW

R1200RT

Posted - 11/09/2013 :  9:47 PM                       Like
Mono-vision is the method of using one eye for distance vision and the other eye for near vision.

Back in March 2013, I wrote about how eye floaters could be a symptom of something worse; in my case it was a detached retina in my left eye.

See "Eye Floaters, Retinal Tears and Detached Retinas":

http://www.msgroup.org/forums/mtt/t...PIC_ID=14480

Back in 2001, I underwent PRK surgery to correct near-sightedness. Both eyes, uncorrected were close to 20/400. After the surgery I had 20/15 in my right eye and 20/25 in my left eye. I was also able to read up close and see clearly in the mid-range as well. About two and a half years ago, I had to admit I needed reading glasses. As the need for reading glasses progressed, I gradually lost my ability to focus clearly at the closer end of the middle range. Unfortunately, this meant the motorcycle instrument panel, car dash board, GPS, etc., where now within the range where I could not achieve a clear focus.

About the time I suffered the detached retina, I had begun looking into how much it would cost for prescription lenses I could wear under my motorcycle helmet. Having to undergo surgery to correct the detachment meant I would be putting off any prescription purchases until afterward, when my vision had stabilized. As my left eye recovered from the surgery, I noticed two things. First my far vision and slipped to around 20/35, so I had lost a little clarity in my left eye's distance vision. This didn't really matter much as I'm right eye dominate and with both eyes open, I saw no difference at far distances.

The second thing I noticed, surprisingly, was I could now see up close with my left eye. While the near vision is not perfectly clear I can read up close and the motorcycle instrument panel, car dash board, GPS, etc., were again readable. The need to obtain prescription glasses for wearing under my helmet was no longer necessary. The only downside to this was the left lens of my current reading glasses was now pretty much useless.

I went to my Optometrist to see about obtaining an updated prescription, however, my insurance wouldn't link the need to update my prescription to the detached retina surgery. My insurance only allows a covered eye exam for updating prescriptions once every two years. While annoying, I would only have to wait about three months for a covered exam and it wasn't worth the cost of paying between $300-$400 out of pocket, so I decided to wait. The decision to wait may well have proven to be a blessing in disguise.

While waiting for the three months to pass, I noticed the vision in my left eye was again starting to cloud over. As this was the first symptom I noticed with the detached retina, I was concerned the retina might be detaching again. At my last follow-up for the retinal surgery, the doctor informed me the retina was fine and still in place. He then told me any time an eye suffers an injury, to include corrective surgery like I had, there is always a chance of a cataract forming. That is what is now clouding my vision in my left eye. This meant I would now have to be seeing an Optometrist specializing in correcting cataracts.

Prior to my first appointment with the cataract specialist, I did research into what was involved. The simple answer is the clouded lens is removed and replaced with an Inter Ocular Lens (IOL). There are a variety of IOLs which can be used. The basic lens which gives a fixed point of focus, usually set for near vision or far vision. There is a multi-focal lens which offers a greater degree of vision from near to far, but doesn't truly guarantee clarity in any field of view. A down side to the multi-focal lens is the appearance of slight halos around lights at night (although the brain can learn to filter out the halos over time). A third IOL is called the Toric Lens. It is sort of like an implantable bi-focal. It can achieve good vision and clarity at both near and far distances. However, the clarity drops off in the mid-range where the instrument panel sits.

Of the three IOLs I mentioned, most insurance covers only the cost of the basic IOL. The multi-focal IOL would require $1,600.00 out of pocket. The Toric IOL would require about $2,400.00 out of pocket.

Having gathered this information, I set to thinking about my options. Ideally, I would like to be able view my instrument panel clearly. This would preclude having to shell out money to buy extra glasses for use while riding. Under my helmet I currently wear safety glasses of various shading (depending on lighting) which only cost me around $3.00 per pair. I prefer $3.00 over $300-$400. Also, if I lose or break a pair, it's only $3.00 to replace. This got me to thinking, could I get an IOL with a fixed focal length for the mid-range of vision? My right eye already gives me good clarity at distance and I already require reading glasses, which aren't needed while riding. I decided I would discuss this possibility with the cataract specialist and see if it was a possibility, or something they would even consider.

This now brings me back to mono-vision. The big question is would I be able to adapt to mono-vision way of seeing without an increase in danger while riding. Let me go back in time to 2001 when I had the PRK surgery to correct near-sightedness. As I previously stated, my pre-PRK uncorrected vision was around 20/400; one eye was more, the other was less. At 20/400, neither eye sees anything clearly. As such the brain has no clear image from either eye and doesn't need to learn how to resolve the difference in vision from each eye.

After my PRK surgery, I had 20/15 in my right eye and 20/25 in my left eye. One of the first things I noticed during my recovery was a slight blurriness around the extreme outer edge of my field of vision. The center of my field of vision was perfectly clear. If I closed one eye or the other, the blurriness around the outer edge would go away. This blurriness was a result of the brain now having to learn how to put two clear images, each with a slightly different focus, together into one coherent image. Over time the blurriness disappeared completely. This was a good sign I could adapt to mono-vision.

With the change in both the near and far vision in my left eye following my retinal surgery (and prior to the onset of the cataract), there was a slight increase in the difference between the vision in each eye. Once again these differences did not prove to be an issue as the brain again learned to adjust for the differences.

At my appointment with the cataract specialist, the technician tested various aspects of my eyes and vision and basically confirmed what I already suspected - for the past several years I have basically been seeing the world through mono-vision to one degree or another. The doctor also confirmed this as well. Having a fixed focal IOL insert set for the mid-range, which would allow greater clarity when looking at instrument panels, GPS etc., was perfectly do-able.

To achieve optimal results for the mid-range correction I'm looking for, requires the use of Optiwave Refractive Analysis (ORA). ORA is a procedure which uses a laser to shoot light through the IOL and measure the refraction off the retina. This measurement will allow them to determine the best focal power for the IOL to give the greatest clarity at the desired distance. The use of ORA is considered optional and is not covered by insurance, but at $400.00 is affordable, as compared to as much as $2,400.00 for one of the premium IOLs.

So while this year began with great concern regarding the state of my vision, in at least one eye, the issue of the detached retina may actually have had a silver lining. The best outcome of the surgery will be achieving clarity of the instrument panel. If it doesn't achieve clarity of the instrument panel, then I'm back to where I was before the detached retina - needing prescription glasses I can wear with my helmet. Either way, once post-cataract surgery vision stabilizes, I will still need new reading glasses. This truly looks like a situation with much to gain and little to lose. We'll see how it goes after the surgery in about ten days. Wish me luck.

(I thought about going for the night-vision IOL but it was WAY too expensive. )

(edited for typo)

Edited by - D R on 11/11/2013 6:18 AM

rayg50
Male Moderator
2082 Posts
[Mentor]


NYC, NY
USA

Honda

Shadow Spirit 750DC

Posted - 11/09/2013 :  11:03 PM
quote:
Wish me luck.
I definitely wish you luck on your surgery and want to thank you for a most excellent post.
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Axiom2000
Male Moderator
1761 Posts
[Mentor]


Georgetown, Delaware
USA

BMW

F 800 GT

Posted - 11/10/2013 :  4:46 AM
My wife just had that surgery completed for both eyes over a two week period, The prodecure only took 20 minutes and other than sleeping off the anesthesia there were very few restraints on normal activity right away. No pain and for the first time in a number of years she needs no glasses, good stuff I think, good luck.
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