Cataract surgery or stronger prescription?

Posted , 6 users are following.

Hello everybody,

I have scheduled my right eye cataract surgery, which is supposed to happen in about 2 weeks, but I am still having second thoughts, about possibly waiting some more.

I'd like to know whether a a stronger prescription can temporarily take care of cataract problems. My glasses prescriptions are -3.25 L and -4.0 R. Left eye has no cataract. Overall, my vision is not too bad at all, because my left eye carries most of the load. But if I cover it and look at the TV, for example, I can hardly read any text on the screen.

I haven't seen an optometrist, so now I'm questioning if my right eye prescription is correct. I have been seeing an ophthalmologist for the last 2 or 3 years, but, other than checking the development of the cataract, they never check the prescription.

So I experimented a bit, using some of my old glasses and may have found something interesting...or not, I don't know.

I've printed a copy of Snellen Eye Chart and placed it on the wall, and stood about 10 feet away. My left (no cataract) eye is perfect, as I can read everything on the chart with any problems (with glasses, of course). The right (cataract) eye, as expected, is a completely different story. I can't read even the biggest font. However, when I use my old glasses, and places them on top of the ones I'm wearing, I can read the top 4 lines, maybe even the 5th. By placing old lens on top of the existing, I am probably changing my -4.0 to something close to -7.0 (not quite sure what the old prescription was).

Does any of this make any sense? Could I possibly postpone the surgery by getting stronger prescription on my right eye? Even if I can, would I maybe run into a completely different problem, where the difference in prescriptions between my eyes would be almost 4 diopters, whereas now it is only 0.75?

I'd really appreciate any feedback, especially if anybody had successfully "cheated" on their cataract by stronger prescription. Of course, "cheating" would be only temporary, until my left eye develops a cataract as well (might take a few years, nobody knows), and then I do them both.

Thanks!

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20 Replies

  • Posted

    You would have to go to an eye doctor for a full eye test to be sure.

    Often a cataract initially can cause the eye to be near sighted and stronger eyeglasses may correct for that for awhile until the cataract gets worse enough it no longer helps.

    That was the case for me, I got stronger eyeglasses Rx for my right eye for a couple years until it could no longer to correct distance vision better than 20/40 since thats the limit for driving tests, also thats the point when insurance will cover cataract surgery.

    Get an eye exam at least once a year, and the doctor will be sure to let you know when you are at that point.

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  • Posted

    If your eye's Rx difference gets bigger than about 2D or so, yes that would also be a reason to get the cataract surgery and insurance would cover it at that point I was told. I didn't quite get to that much Rx difference between my eyes before my right eye was worse than 20/40 best corrected. I was also told that after cataract surgery on one eye, that if both eyes won't work together with glasses due to too much Rx difference that would allow insurance to cover cataract surgery for the other eye as well. But I ended up after surgery in one eye with <1.5D difference between the eyes so didn't need to do the other eye yet since it has only an early stage cataract not affecting that eye's vision so far - will probably take several more years for that eye.

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    • Posted

      I'm in Ontario, Canada, and cataract surgery is covered by the provincial health plan (OHIP). So that wouldn't be my worry. However, based on this little "experiment" I did, using additional lenses from my old pair of glasses, it appears that, if even possible, I would have to increase my right eye prescription from -4.0 to probably -7.0, maybe higher. With my left eye at -3.25, that may be too much of a difference between the eyes.

      If I go for the planned surgery, and looks like that is the right move, the IOL will bring my right eye to -2.0D, and the difference between the eyes will be only 1.25D.

      Thank you for your input. Much appreciated!

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    • Posted

      Hi again, in glasses a -3.25 to -7.00 is a big difference and you might have double vision. I'd still get sn eye exam and see if you can maybe get by with a lesser rx in your cataract eye. If you go for an IOL OF -2.0 in your right eye you should be ok as far as balance. If you go for plano you could be like me and have some imbalance. No one explained this to me prior to surgery. I am now -4.50 in left eye and -.50 in right surgery eye. I cannot wear glasses at all due to double vision and am getting the ghosting even with contacts. seeing doc again next week.

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  • Posted

    I cheated on my cataract with pinhole glasses They work well up to a point

    After 20/100 they are not helping much but at 20/60 they are still usable

    For me this was without glasses so I am not sure if it would work for you if you need prescription glasses

    According to Wikipedia it's not recommended for people with more than 6 diopters

    It may be better if you get the optometrist to get a real measurement instead of using the printed form at 10 ft and trying to translate that number into reality

    Not sure how much prescription glasses cost but you could buy a pair of pinhole glasses on Ebay for less than $5 so it wouldn't hurt to try it as an experiment

    On the other hand if it's that bad and you are relatively young than you may want to go ahead with the surgery in the bad eye only so at least the vision will be clear than worry about the glasses later You know it's not going to get any better you are just postponing the inevitable

    I just did my left eye a few days ago and went from 20/100 to 20/30 and while the other eye is still at 20/60 I can see very well without any glasses there is just some light interference on the right side but it's mostly in the peripheral vision

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  • Posted

    Hi P93570

    I am also Canadian. Night Hawk has provided very good advice/info.

    You don't say how old you are but the younger one is the more possibility of other issues like pupil dilation come into play and affect vision. IOLs are all pretty much same diameter at 6mm.

    My own opinion is if glasses or contacts correct your vision then hold off on surgery. In that interim perhaps a better lens becomes available. Read up on the surgery and lens options - pros and cons to them all. I was blindsided with cataract diagnosis in both eyes bad enough that best corrected vision I could get with glasses was 20/60 RE and 20/50 LE. Without the surgery I wouldn't be able to keep driver's license which requires 20/40 or better.

    I am thankful Canada covers the surgery no matter which lens you choose. I paid just for my IOL $900 per eye for Symfony lenses.

    Hopefully you have a good surgeon that will dialog with you about your options and the trade-offs if the various IOLs.

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  • Posted

    yes, you can postpone. but the higher prescription in your cataract eye will only buy you 6 months or so of better vision. i did exactly what you are suggesting. Then i felt pushed into surgery and my outcome is difficult having only one eye done. I am having imbalance issues causing ghosting/double vision. My advice, go as long as you can before surgery, especially if you are only getting one eye done.

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    • Posted

      I just had my surgery today. In the meantime, I did go to see an optometrist, and my cataract eye would have to go to about -6.5D, to be able to read just 3 or 4 top lines on the chart. Even then, it is still pretty blurry, and the difference between the two eyes would be too much anyway.

      So, I went with the original plan and had surgery today. The procedure itself went well, maybe only about 5 minutes long. The target was -2.0, so eventually I'll have -3.25D left, and -2.0D right, for my glasses. That should be easy to get used to. I'm planning to have progressive lenses, since that's what I've doing for the last 15-20 years. Down the road, when my left eye is ready (it may take a long time, the way it is now), I may have that one targeted at -1.0D or -2.0D.

      Since right now everything is still blurry (not too bad though), it is too early for me to judge the IOL. It is a single vision lens (if that is the correct term), so theoretically it should be fine...at least I hope so. I am going to see the surgeon tomorrow.

      Right now, my main problem are all these damn eye drops. Struggling to hit the eye every time, but I think I'm getting better at it.

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    • Posted

      The correct term would be monofocal if that's what you got

      Was that set for distance ?

      Do you have to wear glasses in order to see the drops ?

      I never tried to hit the eye even when I was having cataracts since it was difficult to see the drop if it was too far from the eye

      I just pulled down the lower eye lid and layed the drop in there

      It worked for me

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    • Posted

      Yes, it is a monofocal IOL, set for distance.

      As for the drops, pulling down the lower eye lid is what I'm doing. In most cases I'm successful, but sometimes the drop lands on the cheek instead.

      I've read about an alternate technique, where you place a drop at the inner corner of your eye, with the eye closed, and then slowly open the eye. The drop is then supposed to roll into the eye. I haven't tried it yet. Wonder if that works.

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    • Posted

      I understand what you are saying

      I had a few drops missed the eye at the beginning

      That was with the more liquid one but I adjusted to get a little closer to the eye

      About the other technique that may work with the liquid one but it will probably not work with the other 2 that have a more thicker consistency

      Also with this technique you will probably have to lay down or tilt your head way back to keep the drop in place otherwise it will roll down and also have to keep the area clean so it will not carry any germs or microbes into the eye That's the last thing you want after the surgery

      I would stick with the eye lid method and just adjust the way it's applied and it should work fine

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  • Posted

    Today, during the regular check-up, 24 hours after the surgery, the doctor mentioned that I should have a "laser treatment" on the operated eye, in about 2-3 months. Since this was completely new to me, and you never have enough time to ask all the questions in the doctor's office, I am now a bit confused. It is supposed to improve my vision, and I read a little bit about it today. Is this something that is commonly done? Once my eye completely stabilizes and I get my new prescription glasses, I hope that my vision will be good, certainly much better than before the cataract surgery. So, what is the point of having this treatment, especially if everything will be okay without it, which I hope will be the case? Anybody had this laser treatment and what did it do for you?

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    • Posted

      I honestly fond it a little odd your doctor would recommend laser tweaking 24 hours after surgery. if I remember correctly you opted for a monofocal lens (not multifocal or EDOF). Majority of people opting for monofocsl lens understand they will gave clear vision for one focal point. If distance you should see clearly for distance and need glasses for intermediate / near. So why if the understanding was you'd need glasses would doc suggest laser - and that would do nothing to help other distances anyways unless you are over corrected? Did doc provide explanation? Your eye is only just starting to heal!

      Most laser tweaking happens for patients that paid a lit for a premium lens - and they want to be as glasses free as possible.

      Trying to see the benefit of that for someone with a monofocal lens.

      Suggest you wait 6 weeks for healing and drop regiment ends and you then see a regular optometrist to see where vision is. Don't make any fast decisions and if not happy after 6 weeks maybe see another specialist.

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    • Posted

      Yes, my IOL is monofocal, so definitely not clear to me what this tweaking should be about, especially being brought up only a day after the surgery. Among other things, the doctor did a quick check of how clear I could read the chart and, as a matter of fact, I did great. Whatever he asked me to read was very clear.

      I will see him again in 6 weeks, but prior to that I'm planning to see an optometrist 4 weeks from now (most people say 4 weeks is more than enough), to get new prescription and new glasses. That way I should have at least a week, maybe two, with new glasses, before I see my ophthalmologist again. If I feel that everything is okay with my new prescription (good vision, no glare etc.) I don't think I am going to go for any laser "tweaking". In case I have issues after I get my new glasses, then it's a different story.

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    • Posted

      That sounds good - no clue why laser tweaking even mentioned. Complete healing takes place at 6 weeks if no other issues encountered. I assume you would have been told if opting for monofocal lenses that you would need glasses for near (if target was for distance). Your optometrist will he able to give you a prescription then. If you have another appointment with surgeon perhaps and why he thinks a tweaking is needed.

      when 2nd surgery is needed you can opt for mini monovision where that eye is targeted for .50 diopter nearer to get better reading distance.

      Good luck - if you are seeing this well now things will only improve. Good luck.

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    • Posted

      I will still need glasses for both near and distance. My operated eye was -4.0D, while the left is still at -3.25D. Since my left eye practically does not have any cataract (very mild one only perhaps), I decided to operate only the right eye. Target was -2.0D, so I will still need -2.0D-ish prescription on it. My new glasses will be with progressive lenses (same as now), with the difference of 1.25D between them, which should be easy to adjust to. Right now I am wearing my existing glasses, and obviously they are not very comfortable, since the right lens is -4.0D, and I only need about -2.0D. I guess I'll just have to struggle a bit, until I get my new prescription. I tried removing the lens out, but it was even worse.

      If and when my left eye develops cataract, I'll probably target the IOL for anything between -1.0D and -2.0D, wearing the glasses for the rest of my life, which is not a problem for me as I started wearing them at the age of 17 or 18 (I am 64 now).

      I did not want to target my right eye to zero, as that would require cataract surgery on the "good" left eye too, and I just didn't feel that it was the right move. Even with both eyes at zero, I'd still need reading glasses anyway.

      The good thing right now, only 2 days after the surgery, is that when I look through the bottom of my -4.0D progressive lens, I see perfect in the distance. Since the bottom of the -4.0D progressive lens is, I assume, somewhere around -2.0D, I guess that proves that my eye is now set to what the target was supposed to be.

      Apologies for a very long reply, more like a short novel. 😃

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    • Posted

      Yes can understand why you didn't want to target plano. Especially if other eye may not need doing for some time.

      Have you considered a contact lens for that unoperated eye? That might be easier to balance with the other eye.

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    • Posted

      Yeah, the main reason I decided to go this way is the fact that it may take a long time before my other eye needs surgery. Of course, with my luck, it won't surprise me if it starts changing rapidly, now that I went this route. 😃 But hopefully it won't be for a while.

      No, I haven't considered contact lenses. I know that was another possibility, but I never had them in my life, so I decided to skip that option.

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    • Posted

      many optometrists will let you try multiple contact lenses to get right fit. no harm trying them out. You get much better vision with them. They also have multofocal ones too.

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