need feedback re: cataract surgery & correcting for near vs far vision
Posted , 63 users are following.
I'm facing cataract surgery & am wondering if anybody can help, particularly if you were myopic (nearsighted) prior to surgery & chose to remain slightly myopic afterwards? I am approx -4 in both eyes with approx. +1 astigmatism in both. I've worn glasses since early childhood, so I'm used to seeing things clearly without glasses (being able to read, remove a foreign object from my eye, apply mascara, etc) , as long as those things are within about 1-foot of my eyes. It seems that the majority of cataract patients get corrected for far vision, in which case they no longer see things that are up close clearly without glasses (the exact opposite of what I am used to). Since I'm not interested in "multi-focasl" (apparently not as crisp vision as "standard" lenses), & also probably not interested in setting 1 eye for distance & 1 for near (I'd probably stay dizzy all the time), I'm wondering how those in my situation have delt with suddenly not having clear close vision (such as if you needed to remove a foreign object from your eye) if both eyes are set for distance vision? Also, I've read reports of people who have gone that route saying they end up having to get reading glasses in several different strengths, since different "near" tasks are performed at different distances...for instance 1 pair/strength for reading a book, a different pair/strength for knitting, ditto for working at the computer, & so on. Although being able to drive without glasses is very appealing, I'm not sure I want to deal with all of the issues that it sounds like I would be faced with by having both eyes set for distance. Can anybody who has gone from being nearsighted to being corrected in both eyes for distance comment on the issues I've raised (particularly if your nearsightedness was around -4 or worse)? Are these valid concerns? SO, due to those concerns, I'm currently considering staying slightly myopic (nearsighted) in both eyes...anybody out there have this esperience??? My concerns about this choice include not knowing at what distance from my face I would be able to see clearly without glasses...will I be able to see my computer screen clearly enough to not get horrible headaches due to the "fuzziness"? Will I only be able to see about 1-ft from my face clearly (like now)? I spend a LOT of time reading books & also on my computer (so it terrifies me to think of losing my near vision if both eyes are set for distance!)...it would be REALLY nice to be able to see well enough to perform tasks from the distance of my computer screen in...is this even possible??? Right now, the WORST distance for me is the computer screen...it's not clear AT ALL without my glasses or with them (I have progressive bifocals & can't find ANY spot where the computer screen is in good focus). I really hope somebody out there has been in the same boat as me & can provide some insight! I am particularly interested in hearing from anybody who was in my situation & chose to stay slightly myopic, but any comments/points are welcome! Thanks in advance! 
4 likes, 1063 replies
lindagary1960 xyzxyzxyz
Posted
The things they don't say before surgery
And I have a friend she decided to do contacts one with reading and one long distance for 6 months before surgery
She has now put off cataract surgery for as long as she can. And keeps wearing the contacts one close and one far away. And she wears glasses to correct the contacts
Carolyn7171 lindagary1960
Posted
xyzxyzxyz lindagary1960
Posted
Guest Carolyn7171
Posted
Carolyn, and I am in your boat! What did you end up doing? If you'd be willing to post again about what your other referrals yielded, it would be hugely helpful. I just had right eye done for distance not realizing I would be LOSING my near reading vision. Docs assume you realize that. It's been a shock, to say the least. Can't read, can't see iphone or computer. In a tizzy about what to do now. Am told by current surgeon it is not safe to replace the new lens for near vision. Also, i'm told that having each eye set differently has a drawback re field of vision --something that matters a lot as you age. All to say, eagerly awaiting your developments/decisions. Thanks.
alexandra47598 Carolyn7171
Posted
alexandra47598 Guest
Posted
Make sure they don't assume you will tolerate monovision I could not get my eye to see near , spent three months trying the most uncomfortable glasses even reverse vision until I gave up
in your boat is awe full not to be able to read !!!
i can't imagine both eyes for distance
try the contact lenses in the other eye
I got replacement 10 days ago , 4 weeks after my first surgery
with the same surgeon as every other told me it was too risky unfortunately symphony is not working as expected for me
SimonEye xyzxyzxyz
Posted
Dear Mario1dog
This is a fascinating discussion.
I do hope you get a good result from your cataract surgery and look forward to hearing the outcome
As a cataract surgeon in UK my experience has been to consider monovision or low myopia post-operative target for NHS cataract patients of presbyopic age group with pre-existing myopia and who have needed spectacles or contacts for myopia since youth.
Such folk will be happy being less spectacle dependent than pre-operatively and will have much thinner distance spectacle lenses postoperatively.
Emmetropia for distance viewing is good for folk who were used to wearing reading glasses without problems after they developed prebysopia
Yes there are evolving alternatives with use of multifocal or 'premium' intraocular lens implants in the private/self-pay sector but these are not without issues
A key factor in selection of the post-operative refractive target following cataract surgery is for the ophthalmic surgeon to understand the patients visual needs, visual goals and past optical history and have a good discussion on all these matters in advance of surgery. By doing such talking beforehand shared decisions and realistic expectations can be arrived at by patient and surgeon. It is wise to set some time aside to do this talking in advance of planned cataract surgery and not just do it on the day of surgery. All too often these matters are rushed as the doctors often lack the time to undertake the discussions to arrive at bespoke decisions
xyzxyzxyz SimonEye
Posted
I ended up going with the "regular" lenses, Acrysoft brand, & had the first eye done on 5/31, 2nd eye on 6/14. The goal was to leave me only slightly myopic, so my need for glasses would be less than it was before surgery (I was told I would probably be able to perform most indoor tasks without glasses post-op) & also so my glasses would be much thinner & lighter than they were pre-op (I've been significantly myopic & had thick, heavy eyeglass lenses since 3rd or 4th grade). However, a "calaculation error" (that's what they called it, in an effort to make it not sound quite so bad) was made when determining my IOL strength & my post-op prescription ended up being IDENTICAL (that's right, identical) to what it was pre-op in BOTH eyes...in other words, they screwed up big-time! So, the lenses in my glasses are just as thick & heavy as they were pre-op...& I am NOT happy about that at all! To make matters worse, I suffered Sudden Posterior Vitreal Detatchment (sudden PVD) in BOTH eyes approximately 3-weeks after the 2nd surgery. I have been dealing with complications from that for almost a month now, with large numbers of HUGE floaters & extremely blurry vision in both eyes at times. At the very least, I feel as if I am looking through a milky film almost all the time. The guy who did my surgery has a good reputation & came highly recommended, but I have been pretty disappointed in the outcome, especially the "calculation error", which has left me with thick, heavy eyeglass lenses. Oh well, nothing I can do about it now...
SimonEye xyzxyzxyz
Posted
If you ended up with the same post-operative refractive error as you had pre-operative it sounds like a case of insertion of a wrong powered intraocular lens implant for whatever reason.
I provided a report on such matters some years ago and which can be read open acess at [b]http://www.nature.com/eye/journal/v25/n6/abs/eye201189a[b].html
These 'wrong implant' episodes and not supposed to happen and are thus sometimes called 'never events'
alexandra47598 SimonEye
Posted
xyzxyzxyz
Posted
I might also add that the guy who fitted me for my eyeglasses post-op asked me why, with the problems I've ALWAYS had focusing on my computer screen (I've never been able to read it clearly with OR without my glasses), I'd never been fitted with eyeglasses JUST for computer distance. I'd never heard of that & didn't know it was a possibility. So I had him do me a pair of "computer glasses", which he said he felt would benefit me a great deal. Boy, do they EVER! For the first time, I can clearly see my computer screen! I have complained repeatedly through the decades about the HORRIBLE headaches I suffer due to eye strain from not being able to focus on the computer screen (my job involved extensive computer work, plus the time I spend on my computer at home), so WHY has nobody ever mentioned doing a pair of eyeglasses just for "computer distance" to me before??? They were only about $100 & well worth it! I got them (& my "regular" eyeglasses too) from ReplaceALens in Denver, CO. Ordering was very easy (online or over the phone) & turn-around time very fast (mailed to my door). I will definitely use them from now on & wish I'd found them sooner. If anybody else out there has problems focusing on their computer screen, I most definitely recommend trying a pair of eyeglasses set for computer distance!!!
GretaGarbo xyzxyzxyz
Posted
xyzxyzxyz GretaGarbo
Posted
xyzxyzxyz
Posted
Greta, I've also been in glasses since 3rd or 4th grade, so I understand what your fears & questions mean! I had both eyes set for near (so, "near-near"
, so as to approximate what I've been accustomed to pretty much my entire life. I was afraid (so was my doc) that it would be really hard for me to adjust to suddenly being farsighted, which is how most people end up after surgery, since I've been SO nearsighted SO long. The brand of my IOL's is AcrySof, & I have no issue with the brand at all. They're the "regular", NOT multi-focal. What I have issue with is that the doc "accidentally" left me just as nearsighted as I was prior to surgery ("calculation error"
, which was quite a lot, so the lenses of my eyeglasses after surgery are just as thick/heavy as they were prior to surgery & I still have to wear glasses all the time to see, just like I did prior to surgery. The goal was to leave me only BARELY nearsighted, so my lenses would be a lot thinner/lighter, but that didn't happen because he didn't double-check his calculation of my lens strength. Yes, since I am still nearsighted to a significant degree, I can still see AT A CERTAIN CLOSE-UP DISTANCE without my glasses...so I can see to put makeup on, fix my hair, etc...I just have to have my face that certain distance from the mirror to do those things. Once you have IOL's implanted, they don't "flex" like your normal lens does, so the certain "sweet spot" distance where us significantly nearsighted folks can see clearly without glasses is fairly narrow...but it's still there. I hope that makes sense. But as we age, our natural lens loses its ability to flex (presbyopia), so you may have already experienced that aspect with your natural lens & not even notice a difference in that after surgery. I can read a book without my glasses, but it has to be held at that certain distance. If you read my last post (prior to your post), you will see what I said about having a pair of computer-distance eyeglasses done. These have been extremely helpful to me for computer work! I just told them (ReplaceALens in Denver, CO is where I ordered them from; they made them & mailed them to me) about how far my computer screen is from my face when I'm sitting at my computer desk & they figured it all out. That set of eyeglasses is only good at that particular distance (things closer in or farther out are blurry), so they only work for my computer work (or anything else at that particular distance)...but that's what I needed them for, as I've NEVER been able to see my computer screen clearly with or without glasses & experienced BAD headaches when sitting at my computer...until now, so I love them! The hassle is that I use a laptop downstairs & have my PC upstairs, so I have to remember to carry them upstairs/downstairs with me! The only thing I really WISH had happened is for my doc to have double-checked the calculation of my IOL strength, so I would have ended up BARELY nearsighted, as opposed to REALLY nearsighted. I hope this helps you!
GretaGarbo xyzxyzxyz
Posted
Thank you so much. I can't stand the thought of needing glasses to read my books. It's driving me crazy now since the cataracts cause me to need them for reading and the vision is not ideal. The last doctor I visited told me there was no such thing as lenses for close up. I knew he was lying. They all tell you that you won't be satisfied with the near vision lenses. I disagree.
There's an old Twilight Zone that always upsets me. This man's wife nags him because she hates him reading books. He works at a bank and sits in the vault to read at lunch. When he comes out, evryone is dead from a bombing. He finds the NY public library and lays out all the books he's going to read for the rest of his life. Then he bends down and his glasses fall off and break. That would be my worst nightmare.
xyzxyzxyz GretaGarbo
Posted
Greta, what happened to that man was my worst fear & was why I stressed SO much over the option of being set "far-far" (both eyes set to see clearly at far distances). If you go that route, you WILL NOT be able to see up close (read, etc) without glasses!!! You will have to, at the very least, have reading glasses. If you are set to be BARELY nearsighted, you will still be able to read without glasses (like you've been accustomed to) & will most likely be able to perform other close-up tasks without glasses (but would need glasses to see at a distance). If I'd ended up BARELY nearsighted, I'd be tickled to death!