Inevitable cataract surgery, scared of different possibilities
Posted , 12 users are following.
Before I begin with my long story, I want to thank this group and amazing people who have been sharing their experiences to make my horrors a bit less scarier.
History
I have been high myopic from the very childhood. Glasses have been my companion since I was 8. -10D in each eye. Got LASIK done to enjoy glass free vision. Or so i thought. They couldn't correct it completely because my cornea wasn't very thick. I ended up with less thicker glasses, -4.5D in each eye.
Things were going pretty well. Vision was 20/25 in both eyes. Life took an unfortunate turn when I had macula-off RD in left eye 4 years ago. The vision in the affected eye is very bad. I can see big objects, cars, people crossing the street and can read big letters on buses. Can't read books or read texts on mobile. Due to this, I am living my life with double vision. My brain has adapted to a great extent. However, while I was recovering from the surgery, I took a lot of steroids to control inflammation. It formed cataract in my good eye. Vision in left eye is 20/200 and it has deteriorated to 20/40 in right because of cataract.
In my last appointment with doctor, I discussed the problem I am having lately -- reduced contrast sensitivity, glare and halos at night around street lights and car headlights. I explained how reading blue letters on black background has been difficult lately. I have stopped driving after dusk as it's better safe than sorry. Big blasts of light from car headlights. I am able to do all of the day tasks. My doctor has suggested me to go through Cataract surgery to improve quality of life.
Given how complicated my eye history is, he has suggested to get basic lens implanted to avoid complications in long run and wear progressive glasses for near, mid and distant vision post cataract surgery. So far, I am able to use mobile and read labels on shampoo bottle while taking shower without glasses. I spend most of my day (10 - 12 hours) sitting on a computer and use my distant glasses for that. After surgery, my life would be fully dependent on glasses. It scares me to hell that I won't be able to brush my teeth without wearing glasses.
Multifocal isn't an option for me. Even if it were, I think I would have not opted for it after reading not-so-good results from it -- halos and glare.
How have your experiences with progressive glasses been? Does it take too much time to adapt? I also learned that there is peripheral distortion or swim effect? Is it too bad? How much out-of-focus the vision is if looked through the wrong segment? Can you please post some picture? I am worried if I would be able to do anything at all without glasses. Also, can other person easily make out that it's a progressive lens I am wearing? Will there be any cosmetic change? I am still in early 30s.
I have consulted only one doctor so far. Do you recommend getting a second opinion? Not sure if it would change anything.
Looking forward to your help!
0 likes, 29 replies
Bookwoman dan26032
Posted
Hi Dan,
People who are highly myopic generally have a pretty easy time adapting to progressive lenses. It took me all of 48 hours when I first started wearing them about 10 years ago. And no one can tell you have them - the transitions between the different parts don't have a line between them, unlike old-style bi- or tri-focals. You can choose pretty much any frame you like, so long as they're not too small top-to-bottom. Fortunately for you, slightly larger glasses are trendy right now. 😃
And yes, you should definitely get a second opinion, preferably at a major teaching hospital with a good ophthalmology department, or a dedicated eye hospital. With a near-distance monofocal lens you'll be able to brush your teeth just fine. What will be most important to determine is the power of that lens, given that you'll remain -4.5 in your non-operated eye. Best wishes to you!
dan26032 Bookwoman
Posted
Thanks a lot @Bookwoman!
I think my doctor said to get the basic IOL. Is it different from monofocal?
If you don't mind me asking, how does the out of focus things seem when seen through the wrong part of the lens (looking near objects through middle part of lens)? Is it like DSLRs where things not in focus are completely blurred out?
Another question popped up in my mind today while using mobile, have you ever tried taking selfie with phone wearing progressive lens? Given phone will be at near distance and we look through middle part of lens, it would be blurry, right?
Bookwoman dan26032
Posted
dan26032 Bookwoman
Posted
Thank you so much! 😃
I am really scared. I have booked appointment for second opinion. Let's see how it goes.
Guest dan26032
Posted
Hi Dan
I have no experience with glasses with progressive lenses, but the problems you are having with your cataracts eye is something I can relate to fully, I was also under 20/40 in my best eye, and had all the same problems you are mentioning, contrast loss was my biggest problem.
I have premium lenses both eyes, but to be honest, if I was in your situation, I don´t think I would chose premium lens either, I think monofocal lens is your best option.
But that said, I am quite sure you will get more range of vision with a monofocal than you expect, simply because your vision is so poor now, that even a monofocal lens out of focus, will be an improvement.
There are multifocal contact lenses on the marked as well, these could maybe be an option after iol implant. That is the good thing about monofocals, all other options are still open with these.
dan26032 Guest
Posted
Thanks Danish!
How is your experience with multifocal so far, especially the night vision?
One question I have is that if I go with monofocal, my vision will be corrected for either near or far. Does that mean my progressive lens will be for two distances -- intermediate and near/far?
I am actually able to do all the day activities. It's the night things that bother me. Can you please tell me how out of focus objects seem? Is it like the DSLR pictures that are completely blurred out?
Problem with contact lenses is that I will have to wear and take off daily, right? Not sure how much I would be going to like it.
Guest dan26032
Posted
I do have side effects in night vision, halos and sturburst, but compared to before the surgery, I feel I have very good night vision. Right after surgery I felt like had been given the eyes from a cat or something, I could see things in the dark I have never been able to see before.
Even a monofocal lens have a little bit of range, I have no experience in progressive glasses, but my guess is, that you could hit some strength in the lens that will cover what you need to see both intermediate and near.
If you monofocal hits target well and set for far, you will get some intermediate range as well, especially in good lighting.
It is kind of funny about the out of focus image, because for me this have changed. One of my eyes I have edof, that have hit a little bit over the target, so it does not give me that good vision up close, food on my plate was very blurry and stuff like. But after some time the brain adapted, now things up close does not look blurry, I just don´t see much details, but image is not blurred out. Difficult to explain.
Anyway, just to add a little bit to the confusion, there is a bifocal lens on the marked, that does not have all these rings on the surface like other premium lenses, so it uses 95% of the light, like a good monofocal, and should give less side effects because the rings are the reason for some of the side effects.
One of these could give you both far and intermediate, I believe enough to get you by on a daily basis without glasses, only for reading and fine stuff. Sometimes I still think I maybe should have gotten these myself, even that I am satisfied with my vision.
Forum usually don´t allow links, but you can search Oculentis mf20, or the other Oculentis lenses.
dan26032 Guest
Posted
Thanks Danish!
That's the thing about brains. It learns to adjust sooner or later. I will take a second opinion and ask questions.
mjcg dan26032
Posted
It should take zero time to adjust to progressive glasses. Once you put them on, you should be able to see far and close. I hate it when they say give it time... if the glasses are fitted properly you will be able to see well immediately. I would definitely recommend you get cataract surgery and go the conservative route. This is what I did when I had my cataract removed (my cataract developed a result of the vitrectomy surgery I had for a retinal detachment). I went with a close lens so the IOL would be compatible between both eyes.I'd also been nearsighted all my life. Keep us posted on your decision!
dan26032 mjcg
Posted
Glad to hear that you are happy with the result!
Does your progressive glasses have correction for intermediate and distant vision, since you have close IOL in eye?
mjcg dan26032
Posted
Progressive glasses are made to do exactly what you mention - correct near, intermediate, and distant vision. I always get a high index, thin, progressive lens. This costs a bit more, but I don't mind the extra expense in order to get the best vision I can. Go somewhere that they have a 30-day return policy if you don't like your frames or your not happy with your vision (most places do this now).
Now giving all this praise about progressive lenses let me add this - since the vitreous has completed separated from my retina (PVD) in my "good" eye, my vision isn't perfect. Depending on lighting I, unfortunately, can sometimes see a glob floating around. It's annoying but I've gotten used to it. I can see better out of the eye that had the vitrectomy and cataract surgery - go figure!
dan26032 mjcg
Posted
Thank you!
diane48177 dan26032
Posted
I had Lasik 20 + years ago and at the ripe young age of 53 I had cataract surgery for posterior polar cataracts (very rare) that I was born with. I had basic iol's put in abd one is set to intermediate distance, the other is set for distance. The distance eye is about 20/30 so i wear glasses to drive to give me crisper vision.
Is this an option for you? Having one set for near and the other for far?
dan26032 diane48177
Posted
I have very poor vision in one eye because of RD, which rules out the possibility.
Do you use progressive glasses?
Boston_Oat dan26032
Posted
Dan,
Just had my second eye done for congenital cataracts at the age of 36. I had never seen better than 20/35 in either eye. I did monofocal lenses in both of my eyes as I wasn't a good candidate for multi-focal lenses (I'd be ambloptic my whole life, and congenital cataracts meant a high possibility of a post-capsular tear during surgery, which ended up happening to my RE which meant I could only get a monofocal as it has to be implanted outside the capsular bag where implants usually go). I can now see 20/20 in my LE and 20/25 in my right (which is easily correctable to 20/20).
Overall my distance vision is phenominal and is better than my natural vision had been for a long time. I'd never had to wear glasses as I had full focal range, but I'm adjusting to the things I now need it for. My RE came out slightly farsighted, so we targeted my LE to be slightly closer than plano. I'm honestly still somewhat dilated from my surgery, but I can read a cellphone and most labels on things now. I too thought I'd lose a lot of my ability to do things after surgery, but it's mostly an adjustment to the distance I need to hold things to read them (and I have a pair of 1.5D readers for now until my eyes settle in and I can get progressives or contacts).
I'd say don't be afraid of the possible outcomes (I know I was) because likely you'll see better in that eye than you ever have in your life. I think the big question is how do you want them to focus your eye - for distance, intermediate or near? If you've always worn glasses, you won't have as much to adjust to. I already see lots of people chiming in with their experience with progressives, and since I haven't gotten there yet, I don't have much to add. But don't be afraid.
Would second the idea of getting a second opinion and possibly getting seen at an eye hospital or teaching hospital. I did deal with just my primary ophthamologist through my ordeal, but she was a cataract specialist and I felt very at ease with her (though anxious about the outcomes).
Best of luck!
dan26032 Boston_Oat
Posted
Glad to know that things worked out well for you.
My problem is that my vision in one eye is very poor. I will go through cataract surgery in the other. So, I can't have close IOS in one eye and distance in other.
Keep us posted about progressive/contacts work out for you.