Cataract in one eye - what lens?

[Rushie]

I'd like any feedback from everyone who has had cataract surgery. I finally went to the surgeon and am about to schedule it but want to be sure I'm doing the right thing.

I am nearsighted in both eyes, but only have a cataract in one eye. The other is clear, may never get one, may get one in the future.

So in deciding what lens to put in the bad eye, here are the options given by the doctor:

1.) Lens for distance. That way I will have "monovision" and need no glasses. The new lens eye will have distance vision and the other eye will have near vision like it does now because we will do nothing to it. In the future if the other eye gets a cataract, I can then decide whether to have it corrected for distance also, then need cheaters for close up, or put a near lens in that eye, and continue to have monovision. For me personally, cheaters for close is NOT AN OPTION. So I would have to go with a near focus lens if the other eye ever needs one, and I will be committing to monovision forever with this option.

2.) Lens for near. He will attempt to equate the focal distance to my other eye so they will be relatively equally corrected. That way I will need glasses for distance but unlike now, the lenses will be equally thick (right now they are many diopters apart). In the future if I get a cataract in the other eye, at that point I will have the option of putting a distance lens in that eye, and hence will have monovision from that point on, but then will not need glasses for anything.

I am going to go with option 2 because I am unsure about monovision. Don't know if I will like it and also it's an FAA certification problem if I ever go back to flying.

This doctor says for patients like me, he does recommend option 2. By patients like me, he means those who spend most of their time doing reading or close work and who adamantly do not want to wear glasses for close up. Also, since I've been wearing glasses for distance since I was a teen, it's not like they will bother me.

He also does not recommend any of the newfangled multiple focusing or torrid whatever they are called lenses. He says the standard tried and true has the greatest chance of making me happy. I agree.

He says he usually puts the focus about 1/3 meter. That's pretty much what my other eye is at. (The cataract eye is currently about 4 inches LOLZ!)

Here is my biggest question. Any of you had the new lens for closeup? If so, is the image sharp at exactly 1/3 meter and too blurry a little farther or closer, or do you find the image comfortably acceptable over a variation from that exact distance? Like can you read the airplane panel without additional lenses? 1/3 meter seems short (it's holding a book up) and things like reading products on a grocery shelf or looking at a computer screen while sitting back in your chair, is a bit farther than that.

 

[azure]

I have NOT had cataract surgery (but will probably need it in one or both eyes in a couple of years), so I'm not speaking from experience. But my choice would be to correct for distance but choose the correction to leave me slightly nearsighted, less than one diopter worth. At even -0.50 over contacts I find I can read most labels in the supermarket, even my MFD and GPS without cheaters, but still see 20/30 or better at a distance. So it's kind of the best of both worlds. OTOH for sustained close-up work I still require cheaters, something I'm personally okay with but it sounds like you probably wouldn't be. But there are many possible choices for this, and -1.00 might be your personal sweet spot.

All I'm saying is, don't assume it has to be one or the other unless you've tried some intermediate corrections. If you would be satisfied with *adequate* vision for both ranges without perfect vision in either, you might be able to find a best overall "average" vision correction that works for you.

 

[comanchepilot]

Monovision is an FAA no no. You will be grounded for significant stabilization period if you go for a medical certificate and disclose your monovision.

Only put in a distance vison IOL.

Last time I checked FAA would not approve any of the multi-focal lenses.

YMMV. I have had the non-eventful surgery/

 

[Clark1961]

I have not had cataract surgery. I do have IOLs. I lived with mono vision for a couple weeks since one eye was treated at a time. I did not adapt well to the mono vision and resorted to an eye patch so I could see well enough to work.

I guess monovision works for some folks.

 

[Rushie]

I have not had cataract surgery. I do have IOLs. I lived with mono vision for a couple weeks since one eye was treated at a time. I did not adapt well to the mono vision and resorted to an eye patch so I could see well enough to work.

I guess monovision works for some folks.

You haven't had cataract surgery but you do have IOLs? If you don't mind my asking, why?

I think I agree with you about monovision, I don't think I would like it.

 

[Clark1961]

You haven't had cataract surgery but you do have IOLs? If you don't mind my asking, why?

I think I agree with you about monovision, I don't think I would like it.

The IOLs correct high myopia. Although expensive the procedure is low risk and supposedly reversible. There is very little damage to the cornea unlike other refractive surgery options.

 

[Everskyward]

I am waiting patiently to get cataracts so I can get up in the morning and see the clock after surgery. Wait, I don't have a clock in the bedroom...

 

[Hank S]

I made IOLS for nine years. It gave me the opportunity to earn my license and buy a plane.

As above, avoid monovision to stay in the good graces of the FAA. Toric lenses correct for vision issues that you may not have (astigmatism), but if you need them, get it.

Many doctors strongly recommend single vision lenses to two groups of people: pilots and engineers. I'm both. Trouble is, we tend to be perfectionists, and have problems when things aren't exactly right . . . For the general population, multifocal lenses work well. Mom and dad each have one, and like them.

Ask about aspheric lenses. It helps to sharpen up the image, like better focus, and that tends to be the problem with multifocals (lack of sharpness). Most lenses anymore should be aspheric, since nobody's eye is very spherical anyway.

Make sure your surgeon is experienced not only with the surgery, but with the measurements to and calculations done to determine the lens power to be implanted. We made 57 different prescriptions of most lens models, and 41 prescriptions of most of the rest. Got to use the right one for you . . .

 

[Rushie]

Thanks for all your replies. Hank I too am a perfectionist and you are right. If it isn't perfect it will bother me if I think I let them put the wrong lens in. I know perfection isn't achievable but I need to know we got as close as possible. The doctor is highly experienced and has a careful and thorough way to calculate the lens but when I went for the exam the technician who did all the what do you call them - optics? was kind of curt. Also they read my last lens prescription from my glasses but I had broken the most recent so it was the glasses before. I don't feel warm and fuzzy about this. Should I make another appointment to discuss the exact lens choice with the doctor before scheduling the surgery?

 

[weilke]

The lens selection doesn't go off your prescription. The machine measures the length of your eye and the curvature of your cornea and calculates the lens strength that is required. The surgeon will look at the numbers, decide whether they make sense and select the appropriate lens.

 

[MassPilot]

The IOLs correct high myopia. Although expensive the procedure is low risk and supposedly reversible. There is very little damage to the cornea unlike other refractive surgery options.

I didn't know that was an option. I have high myopia too (very high, my contact lens prescription is -10.50 in each eye). I am not eligible for LASIK since I have lattice degeneration. I'll have to look into doing what you did.

 

[Clark1961]

I didn't know that was an option. I have high myopia too (very high, my contact lens prescription is -10.50 in each eye). I am not eligible for LASIK since I have lattice degeneration. I'll have to look into doing what you did.

IOLs have been used for myopia for many years (20+ I think) outside the US. They've only been approved in the US for about 10 years. I've had them for just about 10 years now and have no regrets.

 

[Rushie]

The lens selection doesn't go off your prescription. The machine measures the length of your eye and the curvature of your cornea and calculates the lens strength that is required. The surgeon will look at the numbers, decide whether they make sense and select the appropriate lens.

Thanks, not worth me trying to find the broken pair and bring it in then. I kept it for some reason in a box somewhere.

I think my problem is with the process. When he was doing the "is it more clear 1 or 2?" And I hesitated and said "I think 1 but they're both a mess." He yelled at me, "You think? You're not sure? Either it is or it isn't, which is it?" And I got upset. I understand you must get frustrated with patients being wishy washy about the 1 and 2 but here was a young guy who probably has no idea what it's like to look through a cloudy lens yelling at a old lady. We got through it and in the end he seemed contrite and took a lot of time to nicely talk to me (but didn't actually apologize). So I worry that the process was somehow contaminated. I was throwing out 1s and 2s to make him happy when they all looked like garbage.

This was the technician now not the surgeon, the actual doctor was wonderful. But if the calculations for the lens they are putting back in my eye that I'm going to have to live with for the rest of my life is based on that one encounter, I don't feel very warm and fuzzy.

It's not completely that, it's also where do I want the focal length to fall. I don't yet feel like I "grok" the whole thing. Being an engineer I am proabably one of those pain in the butt patients who won't just be a cattle in the line but insists on thoroughly understanding everything before I let them touch me.

 

[comanchepilot]

Thanks, not worth me trying to find the broken pair and bring it in then. I kept it for some reason in a box somewhere.

I think my problem is with the process. When he was doing the "is it more clear 1 or 2?" And I hesitated and said "I think 1 but they're both a mess." He yelled at me, "You think? You're not sure? Either it is or it isn't, which is it?" And I got upset. I understand you must get frustrated with patients being wishy washy about the 1 and 2 but here was a young guy who probably has no idea what it's like to look through a cloudy lens yelling at a old lady. We got through it and in the end he seemed contrite and took a lot of time to nicely talk to me (but didn't actually apologize). So I worry that the process was somehow contaminated. I was throwing out 1s and 2s to make him happy when they all looked like garbage.

This was the technician now not the surgeon, the actual doctor was wonderful. But if the calculations for the lens they are putting back in my eye that I'm going to have to live with for the rest of my life is based on that one encounter, I don't feel very warm and fuzzy.

It's not completely that, it's also where do I want the focal length to fall. I don't yet feel like I "grok" the whole thing. Being an engineer I am proabably one of those pain in the butt patients who won't just be a cattle in the line but insists on thoroughly understanding everything before I let them touch me.

\Maybe its time to find a different doctor . . .

 

[X3 Skier]

My wife had monovision lenses when she had cataract surgery for both eyes. Usually she was fine but for reading, she used cheaters. I have had mono vision contact lenses for almost 20 years and they work great. Since the FAA Rules require me to wear near or far lenses in both eyes, I do that but see considerably worse than with my contacts. But rules are rules.

BTW, I always pass my drivers eye test as well as my annual physical exams with the monovision lenses.

Cheers

 

[Rushie]

\Maybe its time to find a different doctor . . .

I am considering that but I'm finding all the doctors around here seem to have rude staff. Maybe I'm just too accustomed to the well mannered South.

 

[MassPilot]

I am considering that but I'm finding all the doctors around here seem to have rude staff. Maybe I'm just too accustomed to the well mannered South.

My ophthalmologist does all the tests himself. He doesn't have any techs. The 1 vs 2 thing can be hard. With some of them one is obviously better than the other, and some you really can't tell, but others you think one is a little better than the other but you're not sure. My ophthalmologist seems to understand this and is very polite the whole time.

 

[Rushie]

My ophthalmologist does all the tests himself. He doesn't have any techs. The 1 vs 2 thing can be hard. With some of them one is obviously better than the other, and some you really can't tell, but others you think one is a little better than the other but you're not sure. My ophthalmologist seems to understand this and is very polite the whole time.

My old ophthalmologist did it himself too. My retina doctor had his nurse/technician/whatever do it and she could only get me corrected to 20/70. This guy, jerk that he is, got me corrected to 20/40 so I suppose he knows what he's doing.

 

[MassPilot]

My old ophthalmologist did it himself too. My retina doctor had his nurse/technician/whatever do it and she could only get me corrected to 20/70. This guy, jerk that he is, got me corrected to 20/40 so I suppose he knows what he's doing.

Mine got me corrected to 20/20 and that's from uncorrected vision that's literally off the chart since I can't even read the "E" at the top.

 

[Rushie]

Mine got me corrected to 20/20 and that's from uncorrected vision that's literally off the chart since I can't even read the "E" at the top.

That's me. or even "what chart?"

 

[Rushie]

IOLs have been used for myopia for many years (20+ I think) outside the US. They've only been approved in the US for about 10 years. I've had them for just about 10 years now and have no regrets.

I did not even know about those. I just did some learning, so they place that lens in without removing your natural lens? Sounds like a better solution than LASIK imho. Glad it's going well for you!

 

[Rushie]

I've made a decision. I had a choice of August or October (due to my kid's wedding in September). August would have been in the city which complicates the next day followup visit, but October is in my home town. But with October I exceeded the 3 month exam window so will need to come in for the exam again. I felt pushed by my *cough* husband to go ahead and get it done in August. He didn't mind driving me into the city. But that's four total hours of travel. I mind that. The hometown hospital is 5 minutes from my house.

This way I will have to see the surgeon again anyway and so have a chance to talk to him about the lens calculations and let him do the measurements again if need be, to make sure I'm happy.

That also gives me more time to ask around and make sure this surgeon is the right guy. All I have right now is my retina guy's recommendation which is okay but it would be nice to get more data points.

I know I might be overthinking this but buying new carpet was bad enough knowing I had to live with it forever. But if it ends up TOO bad, I can always change the carpet again if I feel like spending $5000. I don't see ever going back and changing this lens so I want to get it right the first time.

 

[Clark1961]

I did not even know about those. I just did some learning, so they place that lens in without removing your natural lens? Sounds like a better solution than LASIK imho. Glad it's going well for you!

Much better than LASIK since only a few tiny incisions are made in the cornea rather than cutting a flap across the pupil. A needle is used to place the folded lense. You can see the lense unfold when it's happening if they don't zap you too hard with the happy juice. There are some potential problems and prevention of one of them is no fun at all. A laser is used to make holes in the iris so fluid doesn't get trapped in front of the lense. The procedure is "painless". I think painless means it doesn't hurt the doctor.

 

[Rushie]

Much better than LASIK since only a few tiny incisions are made in the cornea rather than cutting a flap across the pupil. A needle is used to place the folded lense. You can see the lense unfold when it's happening if they don't zap you too hard with the happy juice. There are some potential problems and prevention of one of them is no fun at all. A laser is used to make holes in the iris so fluid doesn't get trapped in front of the lense. The procedure is "painless". I think painless means it doesn't hurt the doctor.

HA HA HA!!! Ho boy, I know about the laser pain although they did not tell me it would be painless, and it was my retina not my iris. They told me to expect significant pain and they were right!

I don't know if it has been a proven causal link but I understand keratoconus is a possible late complication of LASIK due to the procedure permanently weakening the cornea. That was enough to put me off even considering that. But my brother did it many years ago (15?) and so far he is doing fine.

I found this hilarious article by a cataract surgeon when he had his own done. It is me to a T! I'm not a doctor but I am an engineer and I react exactly the way he does to stuff (overthinking it every step of the way). His panic thinking they had put in the wrong lens had me rolling on the floor. It makes me feel a lot better knowing I'm not the only one:

http://www.allaboutvision.com/conditions/cataract-surgery-experience.htm

 

[Clark1961]

The eye mapping systems are really good so maybe don't worry too much about getting the lense right. I still have the fantastic contrast but I'm not so amazed by it anymore. Now I'm in my mid 50s so presbyopia has ruined near vision. Oh well. Distance vision is still good.

 

[weilke]

I don't know if it has been a proven causal link but I understand keratoconus is a possible late complication of LASIK due to the procedure permanently weakening the cornea. That was enough to put me off even considering that. But my brother did it many years ago (15?) and so far he is doing fine.

Not really keratoconus but something called corneal ectasia where the cornea bulges out due to the reduced strength. Similar end result.
The boss does a corneal topography on all her cataract patients to catch subtle cases of keratoconus.

 

[John Elfstrom]

I'd like any feedback from everyone who has had cataract surgery. I finally went to the surgeon and am about to schedule it but want to be sure I'm doing the right thing.

I am nearsighted in both eyes, but only have a cataract in one eye. The other is clear, may never get one, may get one in the future.

So in deciding what lens to put in the bad eye, here are the options given by the doctor:

1.) Lens for distance. That way I will have "monovision" and need no glasses. The new lens eye will have distance vision and the other eye will have near vision like it does now because we will do nothing to it. In the future if the other eye gets a cataract, I can then decide whether to have it corrected for distance also, then need cheaters for close up, or put a near lens in that eye, and continue to have monovision. For me personally, cheaters for close is NOT AN OPTION. So I would have to go with a near focus lens if the other eye ever needs one, and I will be committing to monovision forever with this option.

2.) Lens for near. He will attempt to equate the focal distance to my other eye so they will be relatively equally corrected. That way I will need glasses for distance but unlike now, the lenses will be equally thick (right now they are many diopters apart). In the future if I get a cataract in the other eye, at that point I will have the option of putting a distance lens in that eye, and hence will have monovision from that point on, but then will not need glasses for anything.

I am going to go with option 2 because I am unsure about monovision. Don't know if I will like it and also it's an FAA certification problem if I ever go back to flying.

This doctor says for patients like me, he does recommend option 2. By patients like me, he means those who spend most of their time doing reading or close work and who adamantly do not want to wear glasses for close up. Also, since I've been wearing glasses for distance since I was a teen, it's not like they will bother me.

He also does not recommend any of the newfangled multiple focusing or torrid whatever they are called lenses. He says the standard tried and true has the greatest chance of making me happy. I agree.

He says he usually puts the focus about 1/3 meter. That's pretty much what my other eye is at. (The cataract eye is currently about 4 inches LOLZ!)

Here is my biggest question. Any of you had the new lens for closeup? If so, is the image sharp at exactly 1/3 meter and too blurry a little farther or closer, or do you find the image comfortably acceptable over a variation from that exact distance? Like can you read the airplane panel without additional lenses? 1/3 meter seems short (it's holding a book up) and things like reading products on a grocery shelf or looking at a computer screen while sitting back in your chair, is a bit farther than that.

 

[John Elfstrom]

I'd like any feedback from everyone who has had cataract surgery. I finally went to the surgeon and am about to schedule it but want to be sure I'm doing the right thing.]

I had option two about three four years ago (near vision lens replacement in one eye) for similar reasons to what you state. My thoughts are:

1. Definitely discuss all this with the surgeon before proceeding make sure you are both on the same page.

2. About your range of focus, I did not realize that any natural ability you have to adjust your focus will be lost with the new 'fixed' lens and was disappointed I was not told, maybe they thought I would not notice because of my age (You lose the ability to adjust focus with age I think).

Also realize that, well, in my case, right now, for my right (surgery) eye, my clear focus (extreme) range is from about 12" to 18" and my left (non-surgery eye) range is about 8" to 10". This is weird because trying to focus on something close up is difficult unless I consciously average the distance, or sometimes close one eye. I wear glasses for distance of course.

This brings up another thing, it may seem obvious, but as you age your vision changers but not necessarily in the same direction or amount between altered and unaltered eye.

3. Make sure you use the eye drops prescribed post surgery as the DR. instructs.

I don't mean to scare you, I definitely see much better now especially when night driving, but I may have chosen a different lens power option. In any case I would still need to wear glasses for distance and or near vision and really small items are getting difficult to see over time because neither eye can naturally adjust for distance any more.

Even now I don,t know which option I would prefer with out trying both out. but I do know it's a compromise. Maybe just toss a coin.

I hope this helps. Best wishes.

 

[John Elfstrom]

P.S. Might think about eye dominance In making your decision.

 

[Rushie]

I had option two about three four years ago (near vision lens replacement in one eye) for similar reasons to what you state. My thoughts are:

1. Definitely discuss all this with the surgeon before proceeding make sure you are both on the same page.

2. About your range of focus, I did not realize that any natural ability you have to adjust your focus will be lost with the new 'fixed' lens and was disappointed I was not told, maybe they thought I would not notice because of my age (You lose the ability to adjust focus with age I think).

Also realize that, well, in my case, right now, for my right (surgery) eye, my clear focus (extreme) range is from about 12" to 18" and my left (non-surgery eye) range is about 8" to 10". This is weird because trying to focus on something close up is difficult unless I consciously average the distance, or sometimes close one eye. I wear glasses for distance of course.

This brings up another thing, it may seem obvious, but as you age your vision changers but not necessarily in the same direction or amount between altered and unaltered eye.

3. Make sure you use the eye drops prescribed post surgery as the DR. instructs.

I don't mean to scare you, I definitely see much better now especially when night driving, but I may have chosen a different lens power option. In any case I would still need to wear glasses for distance and or near vision and really small items are getting difficult to see over time because neither eye can naturally adjust for distance any more.

Even now I don,t know which option I would prefer with out trying both out. but I do know it's a compromise. Maybe just toss a coin.

I hope this helps. Best wishes.

Thanks! That is exactly the kind of feedback I was hoping for!

You point out something I completely forgot.... the new lens is not adjustable like your natural lens. I knew that but I think I was assuming just like you say, because of my old age my natural lens was already "fixed". That's not entirely true though, now that I think about it. Likely the new lens will have a more limited range than I'm expecting.

No you're not scaring me, I want to know what I'm getting into. I do not have much need to drive at night but in recent months even my day driving is affected. The blurs from the cataract either interfere with reading highway signs for example, or my brain ignores that eye and I don't have good peripheral from the right, and/or not good depth perception. I'm hoping fixing this will make me a safer driver.

You say if you could do it over you may have chosen a different lens power option. Do you have a distance in mind you would have preferred? My surgeon says he puts in about 1/3 meter which is 13". Very good for say reading in bed. But at my desk computer it's about 28" and for close up work I like 4". Ideally I'd like all these distances to be clear, but maybe 13" is a good compromise.

 

[John Elfstrom]

Thanks! That is exactly the kind of feedback I was hoping for!

You point out something I completely forgot.... the new lens is not adjustable like your natural lens. I knew that but I think I was assuming just like you say, because of my old age my natural lens was already "fixed". That's not entirely true though, now that I think about it. Likely the new lens will have a more limited range than I'm expecting.

No you're not scaring me, I want to know what I'm getting into. I do not have much need to drive at night but in recent months even my day driving is affected. The blurs from the cataract either interfere with reading highway signs for example, or my brain ignores that eye and I don't have good peripheral from the right, and/or not good depth perception. I'm hoping fixing this will make me a safer driver.

You say if you could do it over you may have chosen a different lens power option. Do you have a distance in mind you would have preferred? My surgeon says he puts in about 1/3 meter which is 13". Very good for say reading in bed. But at my desk computer it's about 28" and for close up work I like 4". Ideally I'd like all these distances to be clear, but maybe 13" is a good compromise.

------------
Well for a couple of reasons I might of chosen far or infinite distance focus. I am right eye dominant and having far distance in that eye might be better for driving etc. also with an infinite focus the range of relatively clear vision would be from maybe 5 or ten feet (I think) to infinity, like with a camera.

Something I didn't mention is that I have always had excellent close vision, almost like a low power microscope so to speak, and wanted to keep that, but that is not working out as good as I had hoped because of the disappointing lack of ability to focus in close which partially defeats the reason I went with the close lens, seems I am going to need a magnifying glass or something to see very small detail.

About peripheral vision, I've always had extremely good peripheral vision seemingly more than 180 degrees if that is possible, it is less with the artificial lens than the natural one and I need to remember that when driving, but my depth perception is good.

As far as optional distances, as I am now, I prefer reading with my gasses off and the computer screen if I sit up close is good, but it's a bit fuzzy if I lean back in my chair. For close detail I have decided I need to have different glasses or maybe one of those desk magnifying lights or maybe different prescription glasses for different uses, I do have prescription safety glasses.

BTW. I am going to school to be an A&P, and after that I want to get a pilots license.

Again I encourage you to discuss these things with your eye surgeon, he may have more input he did not mention before.

 

[Rushie]

------------
Well for a couple of reasons I might of chosen far or infinite distance focus. I am right eye dominant and having far distance in that eye might be better for driving etc. also with an infinite focus the range of relatively clear vision would be from maybe 5 or ten feet (I think) to infinity, like with a camera.

An excellent point, but then you would need reading glasses for close up if you ever get your other eye done and also make it distance. But if you got the left eye done with close, you would be "monovision" and that might bother you when you want to use your dominant eye for the opposite of what the lens is? But you would never need glasses except the magnifying glass for very close.

I found a chart showing age and the natural lens loss of accommodation. According to this, I have already lost all I'm going to (I am 60). If your new lens allows you to accommodate between 12 to 18 inches, that's better than nothing. Well, it's a fixed lens I guess "accommodate" isn't the right term, but you find it functional between that range. My clearest focus on my left (non-surgical) eye is 14" and the surgeon says he's going to shoot for 1/3 meter (13"?) which should pretty much match it. I can't think of any reason to vary from that.

To answer your question, I think I am right eye dominant.

Something I didn't mention is that I have always had excellent close vision, almost like a low power microscope so to speak, and wanted to keep that, but that is not working out as good as I had hoped because of the disappointing lack of ability to focus in close which partially defeats the reason I went with the close lens, seems I am going to need a magnifying glass or something to see very small detail.

Me too exactly! My right eye currently focuses at 4" which is excellent for cleaning my hearing aids, dealing with tiny screws and mechanical things, identifying tiny insects, reading teeny tiny print, and so on. I know that I am going to lose that and is probably the biggest reason I have put this off as long as I have. But asking the surgeon to give me a 4" focus is out of the question, I don't think he would even do it. I'm not even sure they make a lens like that. But I am going to very dearly miss that ability.

As far as optional distances, as I am now, I prefer reading with my gasses off and the computer screen if I sit up close is good, but it's a bit fuzzy if I lean back in my chair.

Well this is me exactly now, using my left eye only. (My brain ignores the right eye at the computer.) I use no glasses at all around the house or at the computer. I either lean close to the screens or put up with a bit of fuzzy leaning back in the chair. But it sounds like after they do my right eye, if anything this situation will improve. I still won't use glasses but I'll have two "good" eyes instead of one with a focus 12-18 inches for the computer. This is very helpful to know it worked out that way for you.

For close detail I have decided I need to have different glasses or maybe one of those desk magnifying lights or maybe different prescription glasses for different uses, I do have prescription safety glasses.

BTW. I am going to school to be an A&P, and after that I want to get a pilots license.

I'm thinking I will have to go with magnifying glasses for the very close work but what a pain. But right now my right eyeball does me no good at all except the close 4" focus. Even with glasses it's useless and my brain tries to ignore the image from it. But since it can't completely ignore it, I suffer from the halos, the washout smudging, etc.

Wanting to keep that 4" focus is not worth the risk of leaving my eye alone. It will be harder for them to treat my retina through a cloudy lens should I ever need that, it is causing driving danger, indeed I cannot now drive at night at all, and causing loss of depth perception, I'm tripping on curbs and stuff. On balance I'm thinking I will be happier and safer having it done.

BTW. I am going to school to be an A&P, and after that I want to get a pilots license.

Pilots license alone is a good reason to avoid monovision. As for the A&P, I would think close focus would do you better than far for mechanical work. You probably made the right decision all in all.

Again I encourage you to discuss these things with your eye surgeon, he may have more input he did not mention before.

I will but there is no substitute for talking to actual patients with the exact same situation, unless the doctor himself has been in your shoes. But he's the one who knows what he's going to put back in you so yeah, I'm going to have another discussion with him.

 

[John Elfstrom]

An excellent point, but then you would need reading glasses for close up if you ever get your other eye done and also make it distance. But if you got the left eye done with close, you would be "monovision" and that might bother you when you want to use your dominant eye for the opposite of what the lens is? But you would never need glasses except the magnifying glass for very close.

I found a chart showing age and the natural lens loss of accommodation. According to this, I have already lost all I'm going to (I am 60). If your new lens allows you to accommodate between 12 to 18 inches, that's better than nothing. Well, it's a fixed lens I guess "accommodate" isn't the right term, but you find it functional between that range. My clearest focus on my left (non-surgical) eye is 14" and the surgeon says he's going to shoot for 1/3 meter (13"?) which should pretty much match it. I can't think of any reason to vary from that.

To answer your question, I think I am right eye dominant.View attachment 54699



Me too exactly! My right eye currently focuses at 4" which is excellent for cleaning my hearing aids, dealing with tiny screws and mechanical things, identifying tiny insects, reading teeny tiny print, and so on. I know that I am going to lose that and is probably the biggest reason I have put this off as long as I have. But asking the surgeon to give me a 4" focus is out of the question, I don't think he would even do it. I'm not even sure they make a lens like that. But I am going to very dearly miss that ability.



Well this is me exactly now, using my left eye only. (My brain ignores the right eye at the computer.) I use no glasses at all around the house or at the computer. I either lean close to the screens or put up with a bit of fuzzy leaning back in the chair. But it sounds like after they do my right eye, if anything this situation will improve. I still won't use glasses but I'll have two "good" eyes instead of one with a focus 12-18 inches for the computer. This is very helpful to know it worked out that way for you.



I'm thinking I will have to go with magnifying glasses for the very close work but what a pain. But right now my right eyeball does me no good at all except the close 4" focus. Even with glasses it's useless and my brain tries to ignore the image from it. But since it can't completely ignore it, I suffer from the halos, the washout smudging, etc.

Wanting to keep that 4" focus is not worth the risk of leaving my eye alone. It will be harder for them to treat my retina through a cloudy lens should I ever need that, it is causing driving danger, indeed I cannot now drive at night at all, and causing loss of depth perception, I'm tripping on curbs and stuff. On balance I'm thinking I will be happier and safer having it done.



Pilots license alone is a good reason to avoid monovision. As for the A&P, I would think close focus would do you better than far for mechanical work. You probably made the right decision all in all.




I will but there is no substitute for talking to actual patients with the exact same situation, unless the doctor himself has been in your shoes. But he's the one who knows what he's going to put back in you so yeah, I'm going to have another discussion with him.

--------
Rushie,
Thanks for the chart. That explains a lot, I think for me the curve is shifted to the right about ten years or so, yeah that's kind of typical for me (knock on wood). I am 66 now.
Best wishes with your eye surgery.

 

[Briar Rabbit]

I'd like any feedback from everyone who has had cataract surgery. I finally went to the surgeon and am about to schedule it but want to be sure I'm doing the right thing.

I am nearsighted in both eyes, but only have a cataract in one eye. The other is clear, may never get one, may get one in the future.

So in deciding what lens to put in the bad eye, here are the options given by the doctor:

1.) Lens for distance. That way I will have "monovision" and need no glasses. The new lens eye will have distance vision and the other eye will have near vision like it does now because we will do nothing to it. In the future if the other eye gets a cataract, I can then decide whether to have it corrected for distance also, then need cheaters for close up, or put a near lens in that eye, and continue to have monovision. For me personally, cheaters for close is NOT AN OPTION. So I would have to go with a near focus lens if the other eye ever needs one, and I will be committing to monovision forever with this option.

2.) Lens for near. He will attempt to equate the focal distance to my other eye so they will be relatively equally corrected. That way I will need glasses for distance but unlike now, the lenses will be equally thick (right now they are many diopters apart). In the future if I get a cataract in the other eye, at that point I will have the option of putting a distance lens in that eye, and hence will have monovision from that point on, but then will not need glasses for anything.

I am going to go with option 2 because I am unsure about monovision. Don't know if I will like it and also it's an FAA certification problem if I ever go back to flying.

This doctor says for patients like me, he does recommend option 2. By patients like me, he means those who spend most of their time doing reading or close work and who adamantly do not want to wear glasses for close up. Also, since I've been wearing glasses for distance since I was a teen, it's not like they will bother me.

He also does not recommend any of the newfangled multiple focusing or torrid whatever they are called lenses. He says the standard tried and true has the greatest chance of making me happy. I agree.

He says he usually puts the focus about 1/3 meter. That's pretty much what my other eye is at. (The cataract eye is currently about 4 inches LOLZ!)

Here is my biggest question. Any of you had the new lens for closeup? If so, is the image sharp at exactly 1/3 meter and too blurry a little farther or closer, or do you find the image comfortably acceptable over a variation from that exact distance? Like can you read the airplane panel without additional lenses? 1/3 meter seems short (it's holding a book up) and things like reading products on a grocery shelf or looking at a computer screen while sitting back in your chair, is a bit farther than that.

Lot of good feed back. Here is my two cents:
I am 66, active pilot, engineer and spend a lot of time driving day and night, spend a lot of time outdoors, also, I read a lot and then see a computer daily. I had cataracts in both eyes that really impacted my vision, made it difficult to see the airplane panel in certain light conditions. Had surgery two years ago. After consulting doctors I went to the Mayo Clinic for the eye test prior to surgery. If you are not comfortable with your pre surgery sight evaluation definitely go to another facility to have your eyes tested - it does make a difference and is a small price in time and money for what could affect a life long vision result. I had astigmatism in both eyes that they corrected during the cataract surgeries. I wanted good peripheral vision so the multi focus lenses were not an option. I selected distance correction in both eyes, and the result is 20/20 in both eyes without glasses. Would definitely do it again, better vision driving and flying than I have had most of my life! Can easily watch TV without glasses, and do not need to wear glasses when at sporting events or out in public. I can still read most print at full arms length but do need correction to read comfortably. If you go the other way with close vision corrected you will have to purchase prescription eye glasses for your distant vision and likely wear them the majority of the time. With good distant vision you can use inexpensive readers from WalMart or any discount chain that cost less than $10 a piece. I have multiple sets of these cheap glasses, next to my lounge chair, by my computer, in my car that I take into restaurants to read menus. I can get reader lenses in my safety glasses for next to nothing vs getting a prescription pair. And if I ruin a pair I don't have to get a doctors exam, spend several hundred bucks and wait several days - I just run to the store and in 30 minutes and $10 I can see just fine.
Also after your surgery you will likely find that colors are more brilliant. I did not realize that whites were actually being tinted with my original God provided lenses to yellow dirty white. And blues are now much more beautiful, very noticeable and a great improvement!

Good luck with your surgery and let us know the results.
Briar Rabbit

 

[Rushie]

Briar Rabbitt, I already know what you are talking about with the colors. There is a very dirty yellow haze all over everything with my right eye. My left sees colors much better. The doctor says I only have a "trace" of cataract in that eye, and it's no where near needing surgery yet. I do wonder if I will have that amazing reaction to colors you describe since I presume I'm already seeing them normally with my left eye.

I had this book lying around the house so I just read the chapter on cataracts:

https://www.amazon.com/OphthoBook-Dr-Timothy-Root/dp/1448638828

Here's a relevant to us paragraph!

Almost every ophthalmologist performs cataract surgery so there is a tendency to view this as a simple procedure that only takes a few minutes. Some cataract cowboys are able to perform an extraction in ten minutes and may even downplay the risk.

The reality is that cataract surgery is very difficult. The lens is mostly clear, floating in clear aqueous, supported by a microns-thin clear capsule that wants to tear. The patient is usually awake, so any small movement such as a cough or simple head adjustment looks like an earthquake under the microscope. Cataract extraction involves many steps, and early mishaps at the beginning of the case cascade and make the later steps that much more difficult.

Look at it this way: any surgery that takes over 100 operations to develop basic proficiency has got to be tough. Cataract surgery is like flying an airplane... it takes many years of training, screening, certification, accreditation to be an accomplished pilot, and most flights are uneventful. But you want a qualified person behind the wheel when you hit turbulence.

Fortunately, most of the time things go just fine.

 

[Rushie]

Not really keratoconus but something called corneal ectasia where the cornea bulges out due to the reduced strength. Similar end result.
The boss does a corneal topography on all her cataract patients to catch subtle cases of keratoconus.

I have very mild astigmatism in that eye. If I am not going to consider toric or any kind of advanced technology lens, is there any point in doing the corneal topography?

 

[Rushie]

I made the decision! I am going to travel back to NC and have it done at the hospital that fixed my detached retina - they know me and I love them. It will mean I will need to fly there for the consult, then go back for the surgery and stay about 5 weeks for followup. It's going to work out because I have business reasons to spend a few weeks in NC anyway.

I feel much better now, I was getting no warm fuzzies about the people here and I really trust my old ophthos back there. It will cost me a few hundred for plane tickets, hotels and probably insurance won't pay twice for the biometry for the power calculation but I don't care, it's worth it. It would be different if this was a hernia repair or something, but these are my EYES. I want to get this right.

 

[Rushie]

I did it! And with one of these Texas doctors (not the one with the rude technician). I decided flying back to NC was just silly. But I had to put some effort into getting with the right doctor.

weilke, this one DID do the cornea topography, unlike the other one. I am confident in their measurements and calculations, this doctor himself was involved with developing the latest programs for the lens biometrics.

I have a big fat pad on my eye right now and they say I'm still under the influence of drugs (I think I feel fine!) so I might not even remember making this post.

Anyway, I guess we'll see what we see in the morning when he takes the patch off.......

(Those visuals during the surgery must be what an acid trip looks like.)

 

[weilke]

Anyway, I guess we'll see what we see in the morning when he takes the patch off.......

(Those visuals during the surgery must be what an acid trip looks like.)

Lol, anesthesia is responsible for your acid trip. Dont expect miracles for your vision on post-op day one.

 

[Rushie]

Lol, anesthesia is responsible for your acid trip. Dont expect miracles for your vision on post-op day one.

Oh wow you couldn't have been more wrong. My vision is AMAZING. It IS miraculous. When she took off that patch, I looked around and actually started laughing with joy. Tears came. The nurse said, "What, did your husband do something funny?" (He was sitting across the room and I was staring at him.) No, I'm laughing because I can SEE. My blind right eye is no longer blind!! Furthermore it is SO good, my 20/20 corrected left eye now looks horrible. I was expecting at best the vision to equal my left eye but it is so very much better even. It tested at 20/12. The range is far more than I expected. I can see clearly from about 7 inches to arm's length (he was shooting for 16 inches to match my left.) With my old glasses the distance vision in that eye is improved I'd say 90% over what I was seeing before. Of course I'll have to get new glasses, but with all the glare, halos, yellow washout gone, my distance vision even with these wrong glasses is many times better than it was, I am already going to be much safer driving even before I get the new glasses.

This result is orders of magnitude better than my wildest imagination was expecting.