When I went in to get a new eyeglasses prescription, I'm told to get cataract surgery instead. Any thoughts on the pros, cons, what to ask, what to expect? Any effect on medical?
Cataract surgery
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Tom-D
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Tom-D
I did this, first eye was 8 years ago, like night and day. was back to 20/20 over night, with no problems for all this time, last year I had the other eye done. again 20/20 over night, no problems no more glasses.
I do use the store bought simple magnifiers 250 for the little print. Always did, still do.
easiest medical procedure I've ever had done. no knock out drugs, nothing but drops in the eye. hold still, Ok we are done.
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Matthew
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My only personal experience is when my dad did his. He kicked himself for not doing it sooner.
I think he got to choose his replacement lens vision setting. I can't remember if he got corrected for near in one eye and distant in the other, or distant in both. I'll have to ask him about that.
It sounds lke FAA medical is pretty lenient on it:
https://www.faa.gov/about/office_or...m/ame/guide/app_process/exam_tech/item31/amd/
I think he got to choose his replacement lens vision setting. I can't remember if he got corrected for near in one eye and distant in the other, or distant in both. I'll have to ask him about that.
It sounds lke FAA medical is pretty lenient on it:
https://www.faa.gov/about/office_or...m/ame/guide/app_process/exam_tech/item31/amd/
nddons
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Good luck, AP. 
BillTIZ
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Need to check, but FAA does not accept one eye near and one eye far (Monocular Vision). Get them both set to 20/20 distant and get the cheaters for in cockpit work.
PaulS
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My mom had both eyes done, now she sees every wrinkle in my shirt. 20/20 and she can read without cheaters. Process was straight forward and she didn't have any pain. Best of luck.
AlanM
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My experience was similar. I had both eyes done within a month of each other back in 2013. I felt the doc could have been in there for days as it was so easy and painless. For my subsequent medical, I brought a letter from my doc stating that my vision was 20/20 distant and that my eyes were completely healed. I too use +250 readers in the plane.
Good luck.
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azure
Final Approach
Might want to check on that, I'm pretty sure that applies only to contacts. Last I checked a permanent monovision correction is allowed, with a 6 month adaptation period and a SODA ride at the end. At least that's true for refractive surgery and I can't think of a reason it wouldn't also apply to cataract surgery.
Good luck, AP.
Thanks.
Matthew
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I thought that rule only applied to contacts, too. Lasik and other procedures that make a permanent change to a near/far situation can be OK because your brain makes the compensation and it's fixed. But with near/far contacts, that temporary difference doesn't give your vision processing wetware enough opportunity to get used to it.
But it is a good point and should be verified.
--
Getting back to my dad - he went to a guy that's done many of these. It was a simple job, and made immediate improvement. So much improvement that he really was wishing he had done it sooner.
Jimmy cooper
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I just had an eye exam last week. Doctor, a well respected eye surgeon at hopkins said that a lot of cataract surgery is not necessary but is very popular. Probably worth a second opinion. I wear glasses when flying, driving, etc. My dentist also saved my lower teeth for which I'm very greatful. Another dentist had said I should have them pulled and implants installed. Very expensive and painful. Glad I did not listen to him. It proved unnecessary. This was five years ago.
How would I judge whether the surgery is needed. Over the past year, my vision has deteriorated noticeably. Night driving is difficult. Daily driving is becoming difficult. Reading has become difficult. No matter how often I clean my glasses, they seem cloudy. Glare is distracting. The optician took a scan of my eyes and said he sees the shadows from cataracts. The optician cannot correct my vision to better than 20/40 in the scarred eye and 20/30 in the other, which is worse than I've ever had before.
In general, I don't object to a second opinion. A second opinion saved me from unnecessary wrist surgery many years ago. I've not gone under the knife since having my tonsils out nearly 70 years ago.
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Matthew
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You'll need to see an MD anyway, might as well make an appointment with an ophthamologist and get a better opinion.
Your last post said "optician", that's below OD. And neither is an MD. If it's more than what simple glasses can take care of, it really is worth getting it checked out thoroughly.
Your last post said "optician", that's below OD. And neither is an MD. If it's more than what simple glasses can take care of, it really is worth getting it checked out thoroughly.
He is an OD. His card says Optometric Physician. I'm old school and didn't make to effort to read his card. (Why would an eye doctor have a card that is skinny pale grey font on medium grey background?) I have an appointment for a pre-op interview with a surgeon who is also a DO. That is why I'm asking questions. I'd like to ask informed questions for this interview.
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Tom-D
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My Eye guy told me " you have a cataract" I said "Oh no I have a rincon"
It became difficult to drive at night, every light became a star burst of light. So I went in for an eye check and was referred to the surgeon
It became difficult to drive at night, every light became a star burst of light. So I went in for an eye check and was referred to the surgeon
Matthew
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OK, ODs are actually able to do some basic diagnoses, but it's probably not wise to make a surgical decision solely on that.
I would think the pre-op interview would start with a more thorough exam from a DO or MD?
nddons
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+1,000 for an MD (ophthalmologist.) You only have two eyes.
Matthew
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I found a couple of resources online that have some ideas for questions:
https://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000210.htm
http://umm.edu/health/medical/reports/articles/cataracts
https://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000210.htm
http://umm.edu/health/medical/reports/articles/cataracts
Matthew
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And the ophthalmologist could be either a MD or DO, but not an OD.
(My own doc is a DO, and my OD is also a pilot - it's an interesting world.)
Sheesh. I looked again at my notes. Surgeon is D.O. Eye guy is O.D. What's wrong with me? Going blind or something?
Optician: Skilled tradesperson who fits frames and grinds lenses based on a prescription.
Optometrist (OD): College trained professional trained to prescribe spectacles or contacts and to diagnose and treat a range of diseases of the eye. Treatment is usually medical using either eyedrops or in some states systemic meds.
Ophthalmologist: Doctor of medicine (MD) or doctor of osteopathy (DO) who holds a medical license and has finished a residency/fellowship in ophthalmology. Most ophthalmologists are board certified by the american board of ophthalmology. With the exception of Nebraska, only an ophthalmologist will provide surgical treatment of eye diseases.
Optometrist (OD): College trained professional trained to prescribe spectacles or contacts and to diagnose and treat a range of diseases of the eye. Treatment is usually medical using either eyedrops or in some states systemic meds.
Ophthalmologist: Doctor of medicine (MD) or doctor of osteopathy (DO) who holds a medical license and has finished a residency/fellowship in ophthalmology. Most ophthalmologists are board certified by the american board of ophthalmology. With the exception of Nebraska, only an ophthalmologist will provide surgical treatment of eye diseases.
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It is very common for an optometrist to be the first professional to recommend cataract surgery. One thing to be aware of is the concept of co-management. That is a setup where an optometrist provides pre- and post-op care for the cataract patient and receives 20% of the surgical fee as compensation. The surgeon only sees the patient the day of surgery. In some cases, this can lead to a conflict of interest with very aggressive recommendations for surgery. A tipoff that this may be happening is if you get the 'hard sell' for surgery with the admonition not to wait as terrible things will happen if the surgery is not done next week. While you shouldn't wait for 3 years (the surgery does get harder while you walk around with deteriorating vision), waiting a couple of months to look for a good surgeon or obtain a second opinion will do no harm.
I'm also wondering whether something can be done simultaneously about the scar on one eye. Probably no, huh?
How to go about getting another opinion? Don't know anybody here. Look on internet? Then what? Wouldn't know what to say/ask.
How to go about getting another opinion? Don't know anybody here. Look on internet? Then what? Wouldn't know what to say/ask.
Matthew
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You can get a referral from your regular PCP. Check your insurance co for ophthalmologists in your plan. Tell your doc your eye-guy suspects cataracts and you need another opinion and plan of action. Essentially, this has turned from a "glasses" issue into a "medical" issue, so your medical chain of command and insurance will come into play.
Clark1961
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The only thing to add are to get copies of your file from your optometrist and to show them to the opthalmologist when you see them. Tell'em you're seeking a second opinion when you make the appointment.
Where is the scar ? Cornea, retina ?
Ask your primary care provider. The second opinion could be from someone is not one of the high volume cataract surgeons. They tend to be lets say a bit focussed on one thing (if you have a hammer etc.). Any general or anterior segment ophthalmologist would be able to tell you whether he/she agrees that you need surgery. Where in OK are you ?
Cataract surgery won't fix that. A corneal transplant would fix it, but that is a major procedure with a prolonged recovery. You could see a cornea specialist to get an opinion whether he/she believes it would be worth going that route.
Dont know anyone in Tulsa. The academy of ophthalmology directory shows 10 comprehensive ophthalmologists, 1 anterior segment and 2 cornea specialists.
https://secure.aao.org/aao/Find-an-Eye-MD
The recommended surgeon is not listed by this organization. Should I be concerned?
Should I expect an eye surgeon to be associated with a hospital? I mean to have privileges with one?
I don't see a real need for a transplant. Seems like that would be asking for a lot of new problems. (rejection, anti-rejection drugs...)
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Matthew
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Here's one list of Tulsa board certified (American Board of Ophthalmology), cataract docs:
http://www.healthgrades.com/ophthal...rue&f.cond=PS606/C/Cataract|1781&pagenumber=1
I don't know all the different certifications, or which one is "better": American Board of Ophthalmology or American Academy of Ophthalmology.
http://abop.org/verify-a-physician/?fv=Location&c=tulsa&st=OK#physician-list-search-results
http://www.healthgrades.com/ophthal...rue&f.cond=PS606/C/Cataract|1781&pagenumber=1
I don't know all the different certifications, or which one is "better": American Board of Ophthalmology or American Academy of Ophthalmology.
http://abop.org/verify-a-physician/?fv=Location&c=tulsa&st=OK#physician-list-search-results
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PM me his name and the facility and I'll see what I can find. He may have chosen not to be listed.
Most cataract surgery is done at ambulatory surgery centers. This is for both patient and physician convenience (also in full disclosure, typically the physician owns a share of the ASC and is interested in financial success of the company). The ASC credentials the surgeon, iow checks his references, makes sure he has a medical license, has someone review his records etc. In addition, every ASC has a relationship with a nearby hospital in order to admit patients to that hospital if the need arises (anesthesia issues, surgical complications). Typically, the surgeon is required to hold privileges at that hospital, but at times he can have an 'admission agreement' with a physician who does. So yes, your surgeon should be affiliated with a hospital.
Interestingly, the way the cornea is installed in the human, it is fairly protected from rejection. If any anti-rejection treatment is required, it is usually steroid eye drops. But yes, a transplant is in a way a last resort and in cases where the scar is what keeps someone from seeing (e.g. they have very poor vision in the other eye).
The board is who oversees board certification. The academy is a membership organization that provides educational meetings, advocates on capitol hill etc.
Someone can be board certified yet not be a fellow of the academy. It's not cheap and some disagree with some of the positions the academy holds.
Rushie
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This. Don't assume that because your vision is getting blurry that it's a cataract and don't assume that because someone that looks into your eye can see cataracts in the lens, that that is the cause of your blurry vision. You may have a mild cataract and also something else going on.
Cataract surgery isn't zero risk. It might be low but it's not zero. Other things can cause similar symptoms and you want them ruled out before committing to surgery.
oldShar
Cleared for Takeoff
Worse outcome I heard was from my father when he said, "I didn't realize I had so many wrinkles in my face." (What do you expect from a nonagenerian?)
I had mine done 16 years ago (bllaterally). I can pass my class-3 in distant, intermediate, and near without glasses, but do carry some Walmart specials ($10) with me as a CYA. 20/15 distance otherwise. All vision exams, post-op are covered by MEDICAL insurance (you can throw away your vision insurance -- no longer need it). Prolly more advantages than disadvantages, except all future checkups should be done by your Opthalmologist rather than the local glasses practitioner.
Other downside is that the sac that holds your lenses usually begin crystallizing within a couple of years post-op and that crystallization has to be broken up with a laser. Again, that's the norm; but I'm 16 years post-op and my sac is still clear (examination of same is another reason to have an opthalmologist examining your eyes post-op vs an OD, who prolly doesn't have the equipment/training to examine for that nor the ability to practice medicine without a license).
As to the FAA, they have no problem with it -- except for the post-op recovery time. Don't remember the lag, but seem to think the corneal healing was a couple of days with no strenuous activity for a couple of weeks and I think the FAA required a follow-on exam and release by the AME before being cleared -- but it wasn't a major period of time.
I had mine done 16 years ago (bllaterally). I can pass my class-3 in distant, intermediate, and near without glasses, but do carry some Walmart specials ($10) with me as a CYA. 20/15 distance otherwise. All vision exams, post-op are covered by MEDICAL insurance (you can throw away your vision insurance -- no longer need it). Prolly more advantages than disadvantages, except all future checkups should be done by your Opthalmologist rather than the local glasses practitioner.
Other downside is that the sac that holds your lenses usually begin crystallizing within a couple of years post-op and that crystallization has to be broken up with a laser. Again, that's the norm; but I'm 16 years post-op and my sac is still clear (examination of same is another reason to have an opthalmologist examining your eyes post-op vs an OD, who prolly doesn't have the equipment/training to examine for that nor the ability to practice medicine without a license).
As to the FAA, they have no problem with it -- except for the post-op recovery time. Don't remember the lag, but seem to think the corneal healing was a couple of days with no strenuous activity for a couple of weeks and I think the FAA required a follow-on exam and release by the AME before being cleared -- but it wasn't a major period of time.
OK. I got the second opinion today -- or partially. He said that I have the start of cataracts on the back and side of my lenses, but probably don't need surgery at this time. Too early. Let it develop some more if it will. But... He wants me to come back so he can do some more tests. Doesn't like the look of my optic nerve in one eye. Doesn't like muscle weakness in one eye. Wants me to use drops for dry eyes.
oldShar
Cleared for Takeoff
Relax until you get something definitive.
The arguement about putting off surgery until the cataract ripens is very common.
You have to wait until such time that writing on paper appears to be done by some writer who has decided to be very stingy with the use of ink, or when the lettering on the big signs over interstates fade into a single background color. <sigh, BTDT>
Also, be careful that followups don't get coded in a way for the doctor to guarantee insurance payments to him (at your medical expense), but adversely affect your getting future Class-III's
Meanwhile, keep your head high and your thoughts positive
The arguement about putting off surgery until the cataract ripens is very common.
You have to wait until such time that writing on paper appears to be done by some writer who has decided to be very stingy with the use of ink, or when the lettering on the big signs over interstates fade into a single background color. <sigh, BTDT>
Also, be careful that followups don't get coded in a way for the doctor to guarantee insurance payments to him (at your medical expense), but adversely affect your getting future Class-III's
Meanwhile, keep your head high and your thoughts positive
RJM62
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Geek on the Hill
Unfortunately, probably the best eye doctor I know is in New York City. Dr. Wilson Ko. He's the eye doc that other eye doctors go to when they need their own eyeballs worked on. He's also my friend John's eye doctor -- and John already lost one eye, so he's very particular about the one he has left.
Dr. Ko also has a lot of pilots as patients and is familiar with FAA requirements. He even has a Farnsworth lantern that he keeps around strictly for FAA color vision tests. (Apparently no one other than the FAA still uses them.) But alas, he's in New York City (offices in Manhattan and Queens).
Best of luck with this, AP, in any event. I'm sure there are capable eye docs closer to home.
Rich
You better meet a professional in this matter. There are many clinics that specialize in cataract detection and surgery like that of See by Intravision in Oakville. Get confirmed and then start your treatment. Meet surgeon, he will review the symptoms of possible complications, eye protection, activities, medicines and required visits. There are certain test that is required before you go for a surgery like that of opthalmoscopy, measurement of visual activity etc. Nothing to worry much. Fewer people develop complications after surgery that might require further surgeries. Its important that you let your surgeon know all the medicines you are taking. That way your doctor can be prepared to handle any problems that might arise.
