Confused after cataract surgery

Posted , 4 users are following.

This discussion has been locked due to a period of inactivity. Start a new discussion

I have high myopia and had cataract removed from right eye earlier this week, ostensibly that it was the cause of blurred near-sight vision (was unable to read anything with right eye). Have early cat in left eye but not affecting vision at mo. Surgeon has implanted an IOL with no power, meaning that I carry on wearing my existing glasses - and in fact, distance vision is already fine.  I realise that it is very early days and my right eye is yet fully to recover, but I suspect the near focus problem is still there!  Confused and somewhat anxious....

1 like, 8 replies

Report

8 Replies

  • Posted

    I didn't get the regular lens, but it is my understanding that you chose to have near or far sight when they replace the lens.  Which means you can see far with no assistance from glasses but will need the glasses for reading.  

    I went with the multifocal lens which allows me to see without glasses at certain distances , I haven't touched glasses since May 2, 2016 my first lens.  I suspect you have a far sight lens and will need glasses for your reading vision. 

    Report
    • Posted

      The replacement lens has no power, so my existing glasses are still effective.  What worries me is that the lack of close focus in the right eye that I had prior to surgery has not been remedied by the procedure.
      Report
  • Posted

    I would check on that , never heard of a now power lens for cataract, it is a monofocal , which there is power for either far or near.  So I don't think I can offer any advice other than check with the doctor.  I wish you luck

     

    Report
  • Posted

    A cataract's impact is usually mostly to   blur vision at all distances, though there is some chance it can reduce accommodation (the ability of the natural lens to change shape  to focus near) which might be what happened in your case to reduce near vision. I don't know if you are old enough to have had presbyopia before this, the reduction in accommodation that leads people as they get older to need to wear  correction in order to read. If you just got a standard monofocal IOL (which is what the overwhelming majority of patients get, partly since is covered by insurance or government payment plans), the artificial lens can't change shape to accommodate to see near, it is essentially like the level of presbyopia of an elderly patient with the maximum reading add.

    When you wear distance correction with a monofocal IOL, the general guideline I'd heard is that things 6 feet and inward start to get blurry. People's eyes vary in their natural "depth of focus" (how much they can see near even without their eye changing focus) so a very tiny  lucky minority can do some reading with a monofocal IOL set for distance, but most people shouldn't expect that. With a monofocal IOL, that eye will need correction to see near (e.g. either reading glasses, bifocals, progressive/varifocal glasses, multifocal contact lenses, or contact lenses set for monovision).

    They should have explained to you the issue of losing the ability to focus near with a monofocal IOL.  There are premium IOLs (which usually require out of pocket payment) which give people better closer in vision, like multifocals,  accommodating lenses, or extended depth of focus lenses (they use   different methods for trying to give people a wider range of vision). People with monofocal IOLs sometimes get them set for monovision, where one eye is set for distance and the other eye is set for vision closer in. 

     

    Although this issue doesn't related to your concerns, I'll note It is incredibly unlikely the IOL has no power. Someone who doesn't need vision correction before surgery might need an IOL power in say the low 20s.  To correct someone for perfect distance vision who is highly myopic, a low power IOL is required, which potentially might be as low as 0 diopters or lower (though usually its > 0  even for most high myopes). You say you weren't corrected for perfect distance vision, but instead were left highly myopic so your old glasses work (which is  rare to do, and a questionable approach). If someone wishes to be left as myopic as they were before surgery, then a *higher* lens power is required than what would be needed for what would correct them for perfect distance vision, e.g. likely more on the order of 20 diopters or more. 

    Report
    • Posted

      I'll add that they should have given you a little wallet size card for the IOL implant you got which gives the model number and power of the lens, though many people don't  bother saving those or looking at them. Some may not realize they got it since they were too distracted recovering from the surgery and perhaps being on a sedative from the surgery when they get the card.
      Report
    • Posted

      Thanks so much for your helpful and considered comments.  It would have been more accurate had I said that the replacement lens has the effect of having no power, but you are quite right: the "card" indicates a value of +21 D.  And yes, I still have high myopia post surgery and the same near focus problem in the operated eye that I had pre-surgery.  I'm beginning to think that the cataract was not, in fact, the issue, as my overall acuity is unchanged.  I wear varifocals, BTW.

       

      Report
    • Posted

      If you do wear varifocals (in the US we call those progressives), then it may be that you need a higher reading add for the operated eye. It may be that the cataract was reducing near vision, but the monofocal IOL has less near vision than younger presbyopes stil retain so it didn't help directly with that. 

      You would still have needed cataract surgery eventually anyway since cataracts get worse over time and it would have eventually blurred vision at all distances until eventually you were blind in that eye. Usually cataracts develop slowly over many years before they get bad enough to need to be operated on, but some get bad quickly (mine reduced my best corrected vision in that eye in about  3.5 months from 20/25 to 20/60).

       

      Report
  • Posted

    Two months after surgery and a (slight) change in prescription, my right eye is still not functioning properly.  I saw another optician this week, who baased on the results of a field of vision test, is referring me back to hospital.  As I suspected, removal of the cataract was unnecessary at this stage - and is not the cause of my problem.
    Report

Join this discussion or start a new one?

New discussion

Report as inappropriate

Thanks for your help!

We want the forums to be a useful resource for our users but it is important to remember that the forums are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the forums is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.

newnav-down newnav-up