need feedback re: cataract surgery & correcting for near vs far vision

I mean choosing the power of the lens. I chose monofocal set for distance. Should I be allowed the opportunity to make any other choices?

The measurements are mainly about the power of the lens. They are measuring the distance from your natural lens to the retna. From that they figure out the power.

I am not sure how the torx comes into play. Not sure if that occurs at the same time or is based on your regular exam. Either way, torx are considered a premium lens, so they cost more. Insurance doesn't pay for the extra cost. So if a torx is suggested, they should have discussed that with you because the cost delta is on you.

The same cost thing is true for other lens (e.g. Symphony). Most people do not even those exists (I didn't when I started all of this over a year ago).

So you are probably getting just a plain old normal monofocal; like most people (myself included) get.

And yes, the power should be based on what you and toe doctor talk about.

Hi Mark: Have you had any experience with multifocal rgps? I've got the 20/20 correction in my left eye and am dealing with -6.5 in the right and alternating between several rgps (one for 20/20, one for walking around and being able to read most things except small print but not being able to read a book comfortably). Wondering if one would be a better solution and also what the price range is for them.

No, I don't have any experience with any multifocal things.

All I know about them is I heard someone say they have rings of different power in them. I am not sure how that could work, but I guess it does somehow.

 

Oh yes I told him I want a monofocal lens set for distance. I haven't had a chance to read all the posts, so I wasn't 100% sure what all the numbers mean exactly. Also, my having had lasik makes things more complicated unfortunately. Thanks for clearing that up for me!

This question is for mark (and anyone else who's reading). Did your primary care physician/general practitioner require you to have bloodwork and/or other tests before they would clear you for the surgery?

As for me I was not required or asked to have any blood work prior to cataract surgery. When I checked in at the hospital morning of the surgery they didn't even ask me if I was allergic to anything. As I am allergic to penicillin I brought that up to hospital staff as I have always in the past been given a red bracelet to wear indicating that allergy.

Nope. He didn't even know I was having cataracts surgery.

My regular eye doctor didn't ask me to either, nor the surgeon.

 

Nope. My GP doesn't know I don't think. Pre op which was cancelled they asked abt regular meds, allergies and general health.

Hi Sue.  Wondering if you have time to give us another update on how you're getting on?  I have received an appt for a last minute eye 'A' scan, whatever that is, tomorrow back at the hospital. I wasn't expecting any more appts before Monday's surgery.  I guess the new surgeon just wants to get absolutely sure what's the status quo is.  I have to collect a new contact lens and new specs on saturday from the opticians.  All this running around, with the kids in tow!  I'll be glad when it's done and I can just sit in a chair and they can run around me!

Maybe it was my age (69 at the time) but they wanted me to see my GP, but I'd had my annual physical a few weeks before (same hospital/network) so it was waived as long as the surgery was w/in a certain period (30 or 60 days). One of the keys here is that opthamologists can tell a ton about your general health by looking at your retina (high blood pressure, diabetes etc)....

Too funny. That's a lot of scans. I had one scan back in April and a 2nd one done when I decided on Symfony lenses. But then 2 1/2 month wait till surgery - no other scans but I didn't change surgeons so likely understandable each would want their own.

Update: I am doing well. Feeling a lot better end of week 2 than week one. I had no complications so guessing my healing normal. When I am tired (with kids unavoidable) and went back to work after 1 week off (not enough in my opinion). Reading for any length of time I feel it. Can sense something in my eye like eyelash (but don't rub it as I pretty sure it's the lens). Also in evenings feel like there is a bruise feeling or slight pressure in the eye (told this was normal too). After a good night's sleep it goes away.

Eyesight is good. I have been seeing distance and intermediate since 24 hours after surgery. Near vision I have to hold out my iPhone further than before. I'd say I hold it out 16 to 18 inches. After 2nd eye done may want readers for reading unless this is something you get used to. With just one eye done popped out lens on operated eye so haven't really experienced freedom from glasses but if all goes as well with 2nd eye that will soon be a reality I look forward to.

Night vision. To be honest haven't driven at night yet (I do drive during day - wonderful to read road signs again). Operated eye takes over so. I issues there. At night I still do not see the concentric circles. Car headlights and streetlights do have a glare or halo around them (not sure diff between glare or halo). This looks to be about 2 feet around each light - hard to tell. It's like they are fuzzy - no definition. If other eye turns out the same I believe I will be able to drive without being bothered by that. The only other thing I have noticed is white lettering on a black screen (PVR click TV). It looks like there is a slight highlight around them. I read the lettering no problem.- it's not blurry however it is like there is a slight glow around it. Could be eye still healing or part of night vision issue. But all other lettering is sharp/clear. No blurr.

Overall I am very pleased with the way I see. Best I have seen in a very long time. Last week was so great to watch my daughter play soccer at night (floodlights didn't obstruct my view) and I could read the girl's jersey numbers and distinguish one player from another. Almost made me cry. It is truly amazing what a gift sight is. If I lived 20 years ago life would have had far more consequences for me at this age. So I am very thankful.

When is your surgery date Jenny - will pray for you that all goes well. I did not see well after surgery. They dialate your eye so blurring occurs from that. When I woke up next morning could read my clock and I knew there had been a big change. That dialation can last several days though for some people.

Op is on Monday the 31st July.  Sounds like you are adapting very well, Sue, and it is an adaptation, not just a cataract op like my elderly mum had. Like me, you are young, so you and I are going to get years and years of benefitting from eyesight that's better than we've had before.  Of course, given the choice I would prefer not to have cataracts and just carry on as before, but I am beginning to see that this is an opportunity to have better vision. I am so glad you are happy with the lens you chose - I think we have both done a lot of research before making our decisions.  I have always found that research is the key for any big decision - shame I didn't do more on my ex mother in law before I married her son!!

Too funny Jenny. I moved away from my MIL. But now she has dementia and do feel bad we can't be there more to help out. Guess the heart softens with time and find God works on my attitude too.

Yes would rather not have cataracts at all. But since I do and no choice am seeing benefits of seeing distance something I haven't had since teen years.

Yes research if nothing else prepares you. I wasn't shocked to see some glare at night and perhaps would have been more bothered or shocked even if I wasn't expecting any.

Hoping you have prescriptions for antibiotic and steroid drops and starting these min 2 days prior to 31st. Helps with preventing infection and helps the healing.

It was amazing to me chatting with the other patients in waiting room prior to going into surgery the different levels of understanding we all had. One lady had. I idea a lens was removed from her eye! Post op visit day after we all had to have an eye test prior to seeing surgeon (open area) and I was asked why u could see near and far out of one eye. I guess

Lenses weren't discussed. When I think back to my first consult it was me that asked about lenses.

Anyways I wish you all the best. When you get home sleep as much as you can. Let us know when u can how you are doing. Sounds like you have a more caring and vigilant surgeon this time.

We don't get given the drops until the day of the op, Sue.  Nothing beforehand.  And it's a 4 week check-up with the hospital opticians, not the surgeon apparently.   Thank you for your advice re light and sleeping.  I plan to have 2 weeks off work - the surgeon will give me a sick note apparently.

Thanks wgriff, Jenny, Mark & Sue - my eye doctor told me the testing isn't required, but they need my PCP to send a surgery release form to the place where I'm having the surgery done and my PCP is the one who can require me to have any tests he wants me to have. I have no ongoing health issues, so I was curious as to what others have done so I can argue against any testing that my PCP might require (I'm getting ready to call his office within the next few days to ask about the release form which my eye doctor faxed over to their office a few weeks ago).

You get to go 2 weeks before me Jenny! Here is what an a-scan is (copied from a doctor's website - probably not all doctors use the Zeiss IOL Master to do A scans):

An “A” Scan is a highly precise measurement of the eye used to help us choose the correct lens implant power before cataract surgery. Our office uses state of the art technology with the Zeiss IOL Master, a totally noncontact instrument. This “A” Scan device measures the length of the eye in addition to the shape of the surface of the eye, and the dimensions of other structures in the eye. It then runs calculations using multiple different formulas to help us predict which intraocular lens implant power will provide the best outcome for the patient.

So they use the A-scan to determine IOL power. I'm not sure how that comes into play with people requesting certain IOL powers according to research done on the internet.

Happy to hear you're doing well Sue.An!

Doesn't seem right that they don't get you to start drops prior to surgery. Are you able to inquire/request?

Best wishes Nina. Find it all so interesting how different places do very different things.

Makes me now curious as to what my 2nd scan was that I went for once I had decided on Symfony lenses.

I shall ask today at the A scan ... I know a few elderly people who've had it done and there were definitely no drops beforehand; you have to do them 4 times a week in week 1, 3 times/week in week 2 etc up to 4 weeks.

Nina, thank you for the A scan info.  I wonder if that's the same as the biometry check I had done half an hour before the aborted surgery on 10th July.  Maybe the new surgeon wants it done as I have requested a -2 lens and not a 0 lens.  I will know later on if it's the same thing.  Where are you in the world Nina?  (sorry if you have already said)

Good luck Jenny. Yes ask about the drops. I started 2 days prior with 2 types of drops (antibiotic and steroid) and continued both for 10 days and then stopped antibiotic and continue with steroid one for 5 weeks. all cataract surgeries in Canada require you to start prior - some 3 days and some 2 days prior.

Just to give you an update. We (husband driving) home late last night from an away soccer game and for first time noticed the concentric circles - so yes thinking it must be a design then with lens. Noticed them on red lights (car taillights). Noticeable on dark highway where there is no

Overhead streetlights. Likely why I have not noticed them before. Oncoming car Headlights have this glare but no circles. Wonder if too bright that I cannot notice the circles whereas the red is softer. Anyways looks as if I haven't escaped them after all. Maybe mine milder or way brain sees them or due to only one eye done. Not sure. Will have to post on a201's posting about 'anyone notice unusual visuals...'. As I

had been expecting those due to the forums not freaked out.

PS have you seen any of James's posts? I believe he mentioned he wish he had known about the pre-op and post op drops - he ended up with an infection after surgery that took a while to clear up. He mentioned if it was a matter of what NHS covered he would have paid out of pocket vs what happened. Not to worry you but thinking you may want to push the question of when to start drops and ask their reasoning why. In James' case they didn't think he was high risk. But since they put you on drops after surgery why wouldn't they have you start earlier?

Glad things are still going well.

I found that things continued to change (althought slighty) until after the drops are done.

It is odd that doctors things so much different.

My guess is that the before surgery drops are just to help make sure nothing gets into the eye beforehand (i.e. clear up anything that might be there).

I would think the after surgery drops are much more important because the eye now has its cut and you want to keep it clean and clear of anything.

I only do drops for 2 weeks after; no tappering.

Maybe behind the scenes that asked my PCP, but I doubt it. I do not need any referrals. Plus if I did, I would suspect it would have been from the regualr eye doc anyway.

It really matters what the health of your eye is.

Me thinks you are right. I went on several Canadian hospital sites for cataract after care - following most conservative one (not for medications just what to do not to do). most sites say 5 or 6 weeks to completely heal and my drops tapered off after 2nd week and now I use 2 drops per day of steroid one till 5th week. Visual symptoms I guess will change for awhile. Glad I knew in advanced

Mark did you eye feel a slight pressure end of day especially? Almost like a bruise or someone pressing your eye? After night's sleep goes away. I suffer from migraines and had a 3 day one starting last Friday. Monday I was good and headache back. Not sure if headaches are related to eye surgery or since prone to them due to changes in weather might be related?

Hospital just rang - they don't think I need the A scan as I had the biometry done on the 10th (aborted op day) and the lady thinks they will get all the information they need from that and she can set the lens for -2. So I am not going now.  In the rush to get off the phone and ring my lift to stop her coming I forgot to ask about pre-op eye drops.  It's never been mentioned to me or anyone else I know of.

I am sure Mark is right that as long as drops started day of op you'll be fine. Different countries have different protocol.

Re: lens power preference- won't hurt to mention to surgeon prior to

Him operating on your eye

Occasionally I would get a twing feeling (like when a cut on your skin is healing). That lasted for a few weeks.

I would also see this bubble of white move along the outer edge from middle to bottom. Based on what I gathered from the eye doc, that is probably the nerves in the eye healing. Realize, I am not talking about flashes for light; which the the retna detaching.

For my right eye it would seem to feel like it had extra pressue, and when I slightly rubbed by eye I swear I could feeling pushing on the side. I don't seem to notice that anymore.

So prior to the IOL, even though I needed reading glass, I am sure there was still some accomadation (i.e. eye muscle pushes on lens to bent it to focus near). Of course, that is why people need reading glasses; because the lens starts to harden and no longer bends as much. I always wondered if the eye is adjusting to the fact that the IOL is in there and doesn't budge at all.

I don't know about migranes. But I would think the fact tha your eyes are two different powers isn't helping; especially if you are trying to read. I do recall having some type of eye strain in between.

I would say that if you have any concerned you should all the doctor.

That makes sense to me.

Realize the measurement is to get the distance from your lens to the back of you eye. With that, they can figure out any power that you want.

Thinking everything I am experiencing is normal. Eye doc on vacation so would need to go to hospital if felt it was worsening. My eye itself looks normal. Realized the incision was under the eyelid when I went to wash my face - quite sore there. Since I suffer regularly from migraines and we've had some extreme weather - not unusual for me. The eye pressure sensation likely from using eyes to read too much at work. Seems to feel better after night's sleep. 2 more days of work then vacation 2 weeks. So can relax more then. Have not had any sharp pain so far just gritty feeling like something in my eye. Eye drops are soothing but don't necessarily take away that sensation which also comes and goes. Vision has been constant - it's good. If that were to fluctuate I'd be more concerned. Guess everyone's tolerance of discomfort is different.

Maybe they needed to double check your measurements after you decided not to have a monofocal lens.

I'm in the United States, Jenny.

The surgical center wants clearance from my PCP, but they don't require me to have any tests. The PCP is going to try to make me have unnecessary tests but I plan on calling tomorrow to talk them out of it. I'm in perfect health.

I was only told to use one type of drop after surgery, Prednisolone and to use the Gatifloxicin and Prolensa starting 3 days before. I have to call to ask if I'm also using the drops I start before after the surgery and if I will need more than one bottle. Did anyone here need more than one bottle of drops for the time after the surgery?

And I'm only 58 (only meaning also relatively young to be having cataract surgery).

makes sense

I had mine at 51 (last year); so I am young for getting it :-)

I read someplace online that after cataract surgery it could feel like there's an eyelash in your eye. Not sure how long it takes to go away though. I get migraines too...I'm also a little worried about that after. I can't wait until this is over!

That's for sure! In my case, I think the Lasik caused them but there's no proof of that.

I'm pretty sure an A scan is the same thing as biometry.

Yeah I am 53 so young as well for cataracts. Been reading about causes for that and I will likely never know why. Some of the issues are atopic eczema, skin cancer menopause - I can take my pick as I have all 3. Oh well a sense of humour gets you through most things. Seriously though I do think in next 10 years there will be some major breakthroughs with IOLs. With so many baby boomers having gotten lasik they will be more demanding for perfect vision. I wish I didn't have cataracts in both eyes. Even my parents who are well into their 70's don't have them.

I was on Prednisolone too and Zymar 2 days prior to surgery. Both drops for 7 days following surgery and Prednisolone now 2 times per day for 4 additional weeks. My prescriptions were with 2 refills as I am certain will need more for eye #2

Possibly but they said it was specifically for Symfony lens.

Was very thankful I did not get a migraine during first week or a bad cold. We had violent thunder storms last Friday - had a 3 day migraine. Mine are caused by changes in weather pressure so nothing I can do to prevent them. Would love to live in Arizona or someplace where it is drier and sunny. Would help with my eczema and migraines.

Like anything else, many people are different.

?My dad just did is eye's last year and my brother (1 yr younger than me) doesn't have them.

?I never wear sunglasses, so that could be the cause for me. I know my eye doc said to stare at the sun to help them along :-)

I could be impact related as well. Who knows.

?And yes, there will be break throughs. I know of a guy that works on them and he says there are things in the works. More along the line of inserts (in front of the lens).

 

Cool sounds interesting. Would those inserts help those of us with lens already implanted or just a different kind of surgery altogether. I need to remember not that long ago there weren't many options and vision not great after cataract surgery which is why they waited till you were almost blind

Right that's what I meant by "maybe they needed to double check your measurements after you decided not to have a monofocal lens."

You said:

"Possibly but they said it was specifically for Symfony lens."

Is one bottle of each eye drop enough for one eye both before and after?

Yes one bottle of each will do one eye and likely there still will be some left. I have finished taking the antibiotic drops and there is half a bottle left. Since I have refills going to get 2 new bottles for other eye.

OK thanks Sue!

It's morning here now and I didn't sleep very well.  Worrying about my eyes, not so much the op but how I will be left afterwards.  I know I told the surgeon I should be able to wear a lens in my right eye to balance things up but thinking about it that is going to be a pain ... I can see myself having to put it in and out more than once a day for things like washing, taking make up off,having a bath etc.  I know the surgeon said it would be great if I didn't have the 2nd eye done as the cataract on that isn't too bad but I can see that's the way I will probably go.  

I too am perimenopausal or whatever they call it, have been for a few years.  I have always totally healthy and have never had any sort of operation before.  Interesting comment about the sunglasses - I haven't worn them for a few years cos I wear my specs all the time and prescription sunglasses would be too thick.  On the other hand I live in the UK - how many really sunny days do we get a year?!!!

Yes from my conversation yesterday I think it is.  I will be checking on Monday that they are using the most up to date measurements. I am quite anxious about how I will feel after but I keep telling myself so this op is done millions of times a year and it just can't be that bad and the results unsatisfactory or people would not choose to have it done.  From what I've read on here and other Forums I think it might be a case of training our brain to not focus on or acknowledge that something is different/annoying.  A bit like my impending 50th birthday!  Is yours on the 14th Nina?

The lens goes in front of the natural lens or IOL. I know they do such a thing today for people with IOLs, just not sure all the reasons why ot what types.

If you have any catract OR your eyes will be too different, you should be able to get the other one done without issue. The one in my right eye was on the side and not too bad, but because it was there and because I was -12D, there was never a question about doing both.

Hi Jenny - it's morning here in Canada.   Can so relate to the worry.   Not just about the surgery itself (bad enough to have someone operate on an eye) but I worried more too about the outcome:  what will life look like for my family, child, work, community.   Eyesight so vital to all of who we are and what we do.  I broke down a couple of times and just cried.   Can't say I am any less worried for 2nd eye after having gone through it once.   I found comfort in my faith and memorized a few verses that helped me focus and take my mind off myself.  I prayed too and I was thinking of you last night and praying things will go well for you.

?I haven't worn contacts for years (last time I tried was right after I had my daughter) and find my eyes drier and didn't try again.  Wish I had or I had tried the mini monovision thing.  Might have opted then for monofocals if I knew I could tolerate it.  I think all opticians should now recommend that to their patients prior to them getting cataracts.

Even though England doesn't get as much sunshine as other places you will still find the world so much brighter after the surgery.  I even wear sunglasses inside.   I am glad I kept the original lenses the optical place gave me when I got presciption eye glasses.  I just popped out the prescription side and put in the regular lens.  I use these regularly - especially driving and as mentioned even inside my house.    I do have the last prescription eye glasses too and went over to optician prior to surgery and they took out the lens.  Looks a little odd but for work I couldn't read the computer well with sunglasses on so had to turn down contrast on computer (even at work things very bright).  So I am managing.  

?If you have eye glasses you may want to do same prior to surgery in case putting in contact lenses might not be easy to work with.   

?Thinking of you - I know this weekend will be hard to get through.  Keep yourself busy - don't give yourself too much time to think about it.   I felt like groceries on a conveyor belt - no choice move forward.   But my cataracts are bad - I realize now driving how much more I can see.  Thankful nothing bad happened but I really was missing a lot.  

?If you find you can wait another 5 years for other eye - there may be better advances in lens selection.  I know I wish I could have waited another 20years.  Feel cheated out of my natural vision getting cataracts so young.  But there is a reason for everything.  Life is like a quilt - from the inside it is a mess of thread - the beauty of it when looking on the outer side once finished will make sense of the mess.

Take care Jenny.  We are routing for you.

 

Hi Jenny:  I'm typing this 9 months after cataract surgery on my left eye (20/20 for distance) and a severely nearsighted right eye that doesn't require surgery. On my first followup after surgery, the surgeon shocked me by saying she didn't like to operate on a healthy eye; however, at a 6-month followup, she said "balancing vision" is a sound reason for surgery.

   But by that point my brain had adapted.

   I use 2 rigid gas permeable contact lenses during the day.

   1. Corrects right eye to a -2 or so. Balances vision nicely so I can read menus, drive and see dashboard clearly. I usually use this "solution" all day.

    2. Have a lens that corrects right eye to 20/20. I thought it would be good for driving but the opposite proved true. I use that lens, with a pair of drugstore cheaters for long stints reading or writing on the computer.

   3. Go w/o a lens in the right eye. It's fine for walking and jogging. Also, works fine at night for watching TV (w/left eye) and reading texts/tweets with the right eye.

   4. I also got 2 new lenses for my old glasses (expensive frames). A -2.0 in left eye (for reading computer) and just plain glass in the right. I'm using those (w/o a contact) in typing right now.

   I know this sounds complicated, but I basically do well w/o a contact in the morning and night, wear the weaker lens all day, and the stronger one for a long day at the computer.

   I kind of like the "freedom" to choose my vision options and am leaning strongly towards NOT having the right eye "fixed" and locking me into either monovision (my likely choice) or having to use cheaters for all close work and reading.

   I'm able to shave and see close (find an eyelash in my eye for instance) this way.

   We're all looking for a "perfect" solution to our vision and, if one thing is obvious from reading this site, there is no "one fix solves all situations." 

   I'm tempted to try a multifocus rgp in my right eye to see how that would work, but am pretty frugal and hesitate at the $340 fitting fee before dealing with the special order lens.

   FWIW, my left (fixed) eye seemed perfect as soon as the eye un-dilated later in the day after surgery. It may have felt a tad scratchy for a day or so but I didn't really notice it.  The drops feel good.

   Anyway, my reason for writing was to say that the surgery is close to 100% successful so you'll have one problem-free eye and choices for the other.  Take some time and see what works for you. We're all different and have different priorities and tolerances for dealing with things like changing a lens (30 seconds?).

    

Agree take time Jenny. I don't have that luxury as I have cataracts in both. Explore your options and by time you need 2nd eye done there may be better IOL options.

Hi all - Sue, Mark, Nina and Griff (?)

Really appreciate your posts on here today.  Very interesting info from Griff - as you say, you have options which I guess could be a good thing.  I also have a 1 and 2 lens. Im surprised you can function without a lens (no. 3) as I thought I would get an instant headache and double vision if I don't correct the right eye (-12).   Also interested to read about no. 4.   My current glasses were expensive so that is an interesting option for me to consider.  Again I didn't think you could manage with a -2 in one eye and plain or -12 in the other - perhaps it's just the latter that isn't do-able.

I do have the beginnings of a cataract on the other eye but surgeon no. 4 said it wouldn't quality for NHS surgery and he would rather not operate on it privately as it's pretty good at the mo.  However if the cataract grows as quickly as the left one has (picked up a year ago exactly) then I will have to have it done anyway.

Sue, you are very sweet to write such a caring message and it really helps to know that people are thinking of me, although loads of my friends are going on holiday so I do feel slightly abandoned.  Like you I feel frustrated and quite frankly annoyed that I have cataracts at such a young age.  I know there are far worse 'illnesses' to have and I remind myself of that a lot.  I am thankful the c. can be sorted, and for free too, but I never CHOSE to have corrective surgery as I didn't want to mess around with my eyes.  They've always been awful but I've never complained, I just get on with it.  I have an old pair of specs I wear if I take the children swimming and I don't care if people think oh she looks weird.  I would have happily carried on with specs/varifocals whatever I needed for the next 20 years.  If it isn't broken why fix it?  I am so thankful my children have perfect vision; another worry is I live alone with them (the mother in law had to go!) so if I can't drive at night that will curtail a lot of their activities and my non-existent social life!

My confidence for Monday has taken another dip.  Someone from the hospital just rang to check that I haven't worn my contacts recently - I must have told 4 people that - no, I havent worn them since January.  By chance she mentioned they were going to do a +9 lens ... that doesn't add up, I said.  My eye is -12.5 so surely I need a +10.5 lens.  Oh!  Have you got a more up to date prescription than February?  Yes, I said.  And you did an eye check last week when I met the (nice) new consultant ... Honestly, don't they have access to that information?  I checked she was working to the biometry from the 10th July (aborted op) ... no, they were working to the biometry on the 26th July.  Yesterday.  Erm, no that appt was cancelled.  What a muddle they are in.  I feel that I am having to double check everything with them even though they have all the information they need.  I have a list of things to double-check with them on Monday and it wouldn't surprise me if something is awry and the op can't go ahead.  In which case I think I might postpone surgery as I am getting a bad vibe about all of this ...

 

If they said -9, that would make sense. While glases would be a -10.5D, to get you to a -2D, the number gets less for a contact and for IOL.

As I had mentioned, I wore a contact in the unoperated eye between surgries. My glasses were around -12D, and he had be wear a -10D contact to be at 0D. So there was around a 2D difference between glasses and contacts; at out power.

So if you are -12.5, then a -10.5 contact would give you 0D. So since you want -2D, that would be a -8.5 contact. Since I believe IOLs, at our power, only come in 1D increments, it would make sense if he picked -9D. That would put you on the 'closer to 0' side of -2D that you wanted.

What is odd is that they said 'plus'. Maybe there power is reversedfor IOLs? Or they read it wrong.

I believe wgriff's unoperated eye is around -6 (or maybe -4). So that is why he would be 'ok' with nothing in that eye.

Me, I could not stand wearing my -12D glasses over my unoperated eye. Way too much double vision. The contact was the only way I made it through those two weeks.

Yes, i remember you saying i would REALLY need the contact in the right eye, instant headache and double vision without it, which is what is really worrying me.  No. 3 surgeon himself told me it will be horrible for me 'between surgeries'.  And now no. 4 surgeon says he won't recommend operating on a healthy eye despite the massive dioptre difference I'll end up with.  That's the problem with seeing so many surgeons; they all have a different opinion.

Your calculations re the lens make sense.  She definitely said a +9 lens cos I was mentally thinking -12.5 + 9 equals -3.5 not  -2.  The lady asked what my latest prescripition was (glasses), I told her, and she said bring it with you on Monday too.  She didn't seem concerned that they were working to an out of date prescription. I got the impression they prepare the lens on the day, do you think?  She said they had the sort of lens required, so they must have different lenses for different prescriptions and then just configure them using Medisoft software on the day or just before.

I'm best described as feeling resigned now.  I believe in fate, what will be will be.  I will double check everything on Monday before anyone touches me and then it will be in fate's hands what happens.   I will try both distance and -2 contact (with specs on top) but I don't believe it will be possible to wear specs without a contact in unoperated eye.  I will be pleasantly surprised if I can function without anything on the unoperated eye.

Jenny do you have someone to drive you Monday? If op goes ahead you'll not be able to drive yourself .even if they don't do an IV for nerves eyesight will be too blurry.

Sounds like your file has too many hands on it. Be sure to confirm everything.

I too would never have opted for surgery on eyes if not absolutely necessary. Would gladly have worn specs.

I felt exactly the same way Jenny on day of operation. Made my daughter's lunch box drive her to her summer job then we went to the hospital. Tolls my husband I felt like a grocery order on a conveyor belt no way of getting off. Waiting in the waiting room everyone except one young woman there like me who mentioned she was curious to

be there and if it wasn't for her driver's license being revoked if she didn't have this surgery she wouldn't be there. Rest of the waiting crew much older mostly women were joking around and apparently think our surgeon was good looking. Honestly was very surreal.

Yes a lovely lady from church is taking me and will wait for me.  The girls' dad is looking after them at my house for a few days so there will be someone around in an emergency.

You are absolutely right - too many people getting involved in it now.

On the aborted op day 3 weeks ago I was by far the youngest in the w/room - I decided to tackle the elephant in the room by telling the old chap next to me I looked good for 69!  I just want in and out on Monday, pray I'll be first on the list - I so do not need to be sitting there for hours waiting ...

Too funny. Might try that line in the waiting room too. I was about the middle person taken to OR room from waiting area. Nurse would come in every 30 mins to put more drops in our eyes to dialate them.

ive got a logistical question for you Mark.  On your op day did you wear your specs and then just take them off prior to surgery and put them in your bag and then manage to get back to the car with one eye covered up and the other eye with -12?    

Or did you have surgery done with the c/lens already in place in your right eye so that you could see?  And what did you do that evening/next day until you took the patch off?  Cos you couldn't wear your glasses ...?

Where I go, I got the impression that they have a stock of lens at the surgical center. I overhead one guy who was putting drops in the wrong eye, so they have to get him the lens for that eye; he went in as scheduled.

I too, obviously, was the youngest when I had mine done. It was interesting.

Yup, as some point, got to let it go. But it is worth just making sure, they are sure :-)

I call the day before (which would be Friday for a Monday surgery) and they tell me the time to arrive.

No.  As Mark says my pcp did not know

Eye clinic did not ask for any blood tests to be done

Thanks veepee. I called my eye doctor, the outpatient surgical center and my pcp. What it seems I need is an "exam" from my primary care physician for clearance to give to the surgical center and to my eye doctor. No blood tests or anything else is required, just an "exam". I tried arguing that I'm in good health and relatively young, but that didn't work. I see my pcp on Tuesday and I guess he'll take my blood pressure and listen to my heart (still beating!) and will sign the clearance form and fax it to my eye doctor and the surgical center. A total waste of time (but it's not costing me anything to see my pcp, so it's okay I guess).

Tell them your heart is actually beating fastet since you got on to these forums. I know mine is🙄. Been learning a lot.

Yea, I know what you're talking about. Yo sit in the waiting room for 2 hours after which you're called in etc and then you wait another hour to actually see the doctor.

Consolation - you're not paying for it. Good luck with your surgery. Two weeks?

My pcp hardly ever has a long wait thankfully. Ever since I have started researching this, I have nightmares of diopters chasing me lol. My surgery is on August 15, thanks veepee!

Best of luck for Monday. Prayers and good vibes coming your way.

Jenny, just saw your logistical question.

I went with my glasses. Gave them to my qife while I was in there.

I did leave with the 'fancy' sunglasses on, but not sure if I had my glasses on under them or not; I probably did as I don't remember the car ride being blurry.

In any event, never had the contact on until a day or two after the surgery, when the op eye starts to clear up.

Hi all. The hospital rang today. They've cancelled my ooperation on Monday due to an emergency!I give up!

What a mess. Hard to keep to keep preparing yourself like this. At least you aren't starting the drops each time ...

Have they given you a new date? Time to go enjoy a glass of wine!

I second the recommendation for a glass of wine--a large one. Sorry you got this upsetting news.

No way!  Maybe there's a reason you're prevented from going to this particular clinic.  Can you have it done somewhere else?

Glass of wine,  yes!

Oh no Jenny! Sorry to hear that - so stressful!

Me again.  It's 7am here in the Uk and I can't sleep even though it's a Saturday.  Anyway, yes, they offered me surgery 2 days later (Wednesday) BUT with a different surgeon, one I've never met before which isn't great and my biggest problem is that the 'responsible adult' who arrived yesterday is leaving on Weds evening!  That leaves me on my own with my children aged 9 and 12 and having to rely on friends, a lot of whom are away on holiday, in an emergency and for childcare if I'm not up to much.  

The woman who rang at 3.15 yesterday to tell me the surgeon had an emergency on Monday (how does that work then?!) was not interested in any of the details of my situation.  She said if I didn't accept the appt I would have to ring next week to see when another appt might be available.  Oh, and she was leaving the office in half an hour so I had to accept or decline it right there on the phone.  I was speechless.  In the end I said Yes but I really don't know what to do now.  Interestly the surgeon I liked (no. 4) and who was going to do it on Monday has 2 weeks leave in August and Sept and he is the retinal specialist which is why he's got the emergency job, so if anything went wrong with my eye there's a good chance he wouldn't be around to sort it out. 

I spoke to his private practice secretary (in the UK these surgeons all seem to do private work and nhs work) and she said to go private he is booking into October and the cost is around £2,600 because you pay for everything - you can't top up the nhs contribution or anything like that.  I said I'd ring her back on Monday for a longer conversation.

To be honest I was having concerns about having to wear a contact lens in the unoperated eye ALL THE TIME.  What about swimming?  What about if my eye feels dry and gritty after wearing it from the minute I get up until 6pm but I am going out in the evening as well, even if it's just a taxi run?  The surgeon said don't operate on the right eye yet as the cataract isn't too bad at all and leave it for now but the catch is I have to somehow manage with one corrected eye and a -10 dioptre difference.

Question - can I not just have a plain lens inserted in the bad eye?  Surgeon no. 3 said it wasn't possible but didn't say why; the optician felt the lens would be "too thick" - anyone any thoughts on that?  I think no. 4 said I could but why would I want that, given that I have an opportunity to correct my high myopia.  No one has suggsted I go down this route.  When pressed, no. 3 said I could possibly get away with a -7 lens which would be the point where the dioptre difference wouldn't be that noticable.  Mark and Griff - you seem to be pretty good on the technicalities of this - any thoughts?  

Right now one of my eyes is 20/200 (the one I'm having surgery on first even though it's my non-dominant eye) and the other eye is 20/60. The difference doesn't really bother me (and this has been going on for 3 years although they're both worse now). I wouldn't like it like this forever of course, plus I know everyone is different.

Do you know what that translates to in dioptres Nina?

I have Googled the alternative surgeon and am not taken as there are no areas of expertise listed and only one qualification.  One decision made - to stick with surgeon no. 4 even if I have to wait.

Sorry this happened Jenny.

When you say a 'plain lens in the bad eye', do you mean to put in an IOL with no correction and stick with the current distance vision you have in that eye today?

If so, that doesn't make sense to me; however I don't recall what you current power is.

If you are going through the trouble of getting the IOL, get the power that you really want (i.e. 0D for far, or -2D if that was your plan).

I would definitely push to have both eyes done. Who cares if the other eye isn't bad yet. You need 'balanced' vision for your health. Yes, surgeons always say they perfer to not operate on an eye that isn't ready; everything has risk and of course you want to avoid it when possible. IMO - having two eyes too far apart negates the risk discussion. So if that is how you feel, you should be able to discuss those concerns with the surgeon and he should take that into consideration.

There is no doubt that you want to stick with the surgeon you like. Maybe take this time to re-talk with him about doing both and finding a time to get them scheduled closer together. Maybe you can think of that as the reason for the cancellation; think of the positive not the negative.

Wow that's a lot to consider and you are pressured into making a fast decision.

I will Mark and a201 weigh in on the unoperated eye. For myself now 3 weeks past often I manage without glasses (except in bright conditions - need sunglasses with one prescription lens and one non prescription lens). I even forgot to put them in on my trip from work yesterday (cloudy day). My operated eye takes over. I am sure I lose a little depth perception but seem to read road signs etc and manage better than prior to surgery. If I didn't have a cataract in other eye I would definitely wait to see if better lenses would become available down the road.

For me confidence in surgeon played a role. Also want to ensure it isn't their first rodeo- lol. Is Wednesday's surgeon done lots of these surgeries? Any way they could give you some info on him or her? To be a NHS surgeon do they have to be seasoned with many surgeries?

No Jenny, because I got different answers when I tried to research what that equals in diopters but I don't think it's over 2 diopters (the cutoff point that I read should be the maximum difference). Some people are basically blind in one eye though (uncorrectable) and they are able to live like that, but I guess if you have vision in both eyes with a huge discrepancy some people can't tolerate it.

Also maybe because my dominant eye is the better one is the reason I don't have much of a problem. I just hope I'm ok after the surgery.

Hi All ... Here's the funny thing ... I don't mind the vision I've got!  I don't particularly want it corrected.  But of course none of the surgeons I have spoken to think it's a good idea to keep the terrible vision I've got.  But they're not the ones living with a 10 dioptre difference are they.  I don't actually know what my 'normal' vision is anymore.  Since 2014 my eyes have deteriorated by -1 in one eye and -2.5 in the worst eye (ready for op).  Since both have cataracts I don't know what my cataract-free vision would be normally now.

I feel I am back to square one.  At work this week I will see if they can get me a bigger monitor as I can see surgery won't be done in the near future now, not with preferred surgeon's holidays.  I am fed up of the whole thing and don't know what to do anymore anyway.

Sue - enjoy your 2 weeks off.  

Nina - enjoy the time pre-op and keep busy.

 

Hi Jenny - sorry about the frustration of it all. Can relate . I was feeling like I would prefer to go on with what I had st 20/70 in right eye and 20/60 in other. The truth now I cannot believe how well I see with just one eye done. If a solution cannot be found for your 2nd eye that balances out your vision I would think this is good cause for NHS to cover 2nd eye.

Sorry this whole process had gotten you down.

However, the lens is only going to get worst with time. So you will have to get it fixed at some point. The sooner the better, IMO.

Not saying you need to get it done 'next week', but you should continue to persue it and get everything worked out.

If the surgeon is good (and sounds like it since you like him), then have a conversation with him before deciding anything.

Hi Jenny - did you end up having the surgery today or have you got a new date?  Hoping all is well.

Hi y'all.  I didn't have surgery yesterday, no.  I want to stick with the surgeon I have met and feel I can trust.   I have an NHS appt with him now on 11th September but in the meantime I am seeing him as a private patient this Saturday.  I am hoping he will allow me to book an appt with him for surgery in October so that ifthe September date is cancelled again I know for sure it will be done in October.  I will also discuss lens options with him, as there will be option; withe NHS there are no options - monofocal is the only option.  I will also discuss the option of him doing the second eye privately so it may be that I have one done on the NHS and the other I pay for (around £3,000).  An awful lot of money if I have to pay to have both done, and galling given that I qualify for it on the NHS.

How are things with you, Sue?  3 weeks in  - how's things looking?

Nina, not long to go now.  This time next week you'll be counting down the days.

Mark - you have a voice of calm and reason.

Hi Jenny - late here.  My sister is visiting from Quebec and we've been catching up and sightseeing.  This had been first time I have driving for any length of time.  (Daytime since surgery).  And drive at night this evening locally for first time tonight.  Wasn't too bad - only faced 2 cars.  If I look away to side of road I can manage.  At least streetlights don't have the circles that cars do.  Just a bit of fuzzy glare from them.  Although a number of years ago city put in new type of streetlights (more energy efficient but not as bright) so that may be one reason I don't see the concentric circles around them.

This is first week I have had no eye discomfort - so I am guessing healing is progressing.  Find it odd that only had post op visit and nothing else.  Not sure what I would do if anything went awry.

Wow £3,000 per eye.  Even if in Canada I had to pay out of pocket for cataract surgery it would be $3,000CDN  per eye.  Not sure what exchange rate is today but you could almost get both eyes done here.  Maybe you should take a trip across the pond.

Sounds though this surgeon you like has plenty of experience even outside of NHS and your plan sounds good.  Are you ok to manage though with your job that long?  With 20/70 in one eye and 20/60 in other so was struggling.  Had to increase font on my computer to read emails and docs.

Even though it hasn't been ideal with managing with one eye done sort of glad that first eye has had chance to heal.  One week apart in my opinion would have been harder.  I think 3 weeks is the soonest they should leave between operations.

In Ontario, Canada, the surgery and basic IOL is free but you can upgrade testing and IOLs for a fee. I believe not all provinces organize things the same way - or didn't. 

Waiting for my measurements - I believe there is a 3-4 month waitlist in Toronto. I have met the surgeon and and will have the procedure at a specialized eye hospital which is funded by the public medical system. 

So glad to be able to get all this info!

Like others have said on here, I think we have to train ourselves not to focus on something we don't really like, like the car's headlights.  I look to the side because of the glare even now, and those bright blue ones are the worst.  I am hoping after surgery this wil be a lot better as the nights are starting to draw in.  You sound like a very resiliant person, Sue, and you know how to adapt to what life throws at us!  I wonder how things will look when you've had them both done.  

I thought a 5 week gap might be good to give the 1st eye time to heal and settle as sometimes they don't get what they aimed for and I want the 2nd eye to match as near as possible.  I will ask surgeon tmr about this.  Maybe 3 weeks would be enough time.  

On the NHS you don't get ANY post check-up at all, you simply go back 4 to 6 weeks later and even though you don't see the surgeon.  You see the hospital optical dept and I think all they really do is check your vision.  Maybe I should do the lot private so that I get the extra care; need to find out if the surgeon is 'on tap' so to speak if I go private should there be any problems.  I know he's away in Sept so I have to ask about post-op care there (Nhs).

Bet ops I plan to use the 1 lens in the right eye and specs on top which I already have here.

Got a bigger screen at work yesterday - everything's bigger ... and still blurred!

 

My surgeon does a follow-up the next day, and 1 week from the surgery. I then followed up with my regular eye doc 1 month after.

Based on my experiance, and have heard from others, it seems 1 month is the soonest one should get glasses.

How long to wait if they want to re-calc the power? Yes, the longer the better, but 3 weeks is probably more than enough; 2 should be ok. They did mine at 2 weeks (they re-checked my first eye the day before my 2nd eye was getting done). There are just so many variables. For me, being -12D, makes it harder because the calc 'error' increases for stronger scripts; and at a certain point, the IOLs only come in increments of 1D vs 0.5D. I don't know where that cut over point is, but since a lot of people are in the -7D/-8D range, I would think 0.5D covers at least that range; just a guess though.

Glad you have those appts setup. You should have a good appt, and have a plan that you will be happy with. I would think NHS should cover the 2nd eye, the surgeon should be able to explain the reasons to NHS and get it approved. If you were going to be within a 2D difference between the eyes, I could see why they might not; but you will have such a bigger delta.

Not surprised things are still blurry with the bigger screen. The cataract is blurring everything entering your eye, doesn't matter how big or small it is. About all you could hope for is that by being bigger, the characters 'center' is large enough to minimize the blurr.

We have same system in NB.  All upgrades for IOL selection done through hospital not surgeon's office.  Surgeon is paid same amount through Medicare regardless of IOL selection.  Different if you opt for this surgery (clear lens exchange or your cataract isn't bad enough to be covered).  In that case patient pays for everything.  Although I know of some one here who only had one eye that was bad enough for cataract covered surgery that Medicare covered for 2nd eye due to too much difference between eyes.  

Yes that is exactly what I have been doing when driving at dusk or night.  Looked to side of road.  Honestly not sure if having 2nd eye done will make this better worse or same.  One thing I can say as the headlight glare with cataracts in both eyes was still blinding.  And it would wash out everything.  If a person was walking or something was right in front there was almost no contrast between dark shapes.  With one eye done I can make out shapes and signage better.  Perhaps if I went with standard monofocal lens I wouldn't have any night issues.  I do like the daytime vision and once other eye is done will enjoy life for first time since a teen glasses free.  Even prior to cataract surgery around the house I did not wear glasses (near vision was good).  Now that I have to wear a pair of sunglasses or glasses with one lens poked out all my waking hours.  Ears are sore / nose is sore.  but I have learned to function and now can appreciate one eye will be healed nicely before other eye is operated on.  A blessing in disguise.   also having "fun" comparing 2 eyes.  Last night moon is blurry with non operated eye but has a halo with operated eye but I can distinguish dark shaded parts on it.  Once I lose my last natural lens I will wonder if what I see is 'normal' or part of what the lens does to the view.

Yes one does have to be resilient and have a sense of humour to get through life.

I know this seems long Jenny (much longer than it should) but this too will pass and I hope you end up with good vision .  I figure if one can still enjoy everything they used to it is a success.  I recall feeling frustrated about a movie I went to see last May and my daughter's soccer matches.  Really was frustrated.  Not one day went by that I didn't think about my vision.  I am still healing but there are large chunks of time that hobby where I dont think about my eyes. (Lol first few days there are no drops to put in - yeah).   You WILL get there.

Yes agree Mark - with a cataract you never get anything clear.  Computer etc.  You can get bigger monitor or enlarge font - still blurry.  Went to a movie and there were a lot of scenes of text messages which although on big movie screen I could not read.  I was so down after the film I said I would not go see a movie until eyes were fixed.   Still haven't been (and I like movies).  Likely I would be fine with one eye.  Driving during day I find it amazing that operated eye takes over.

Just a quickie ... I am thinking tomorrow of booking one appt in October which is when the surgeon is booking for now as hes got leave booked in August & September apparently, and book in to have the second eye done 3 to 4 weeks after.  That way I KNOW that both will be done this year.  If I stick with the NHS neither may be done and like you I am feeling depressed and frustrated.  Maybe I should have made this decision months and months ago ...

So glad to read your lovely long message.  Have a lovely weekend y'all.

That sounds like a good plan.   At 3 weeks my eye was feeling a lot better.  Read online that at 3 week mark half the healing is completed.  It's also when I finished with the drops.

If you had both eyes done this way will NHS cover any of the expenses?  hard to make this decision based solely on what it costs - except in situations where if one just can't afford it.  I spend that kind of money on a vacation and told myself my eyesight worth my cancelling a vacation or two.  As important trust/confidence in surgeon.  This isn't something easily undone.  And even a financially covered surgery  if not done right could cost you funds to correct (and not without additional risk).

Being younger Jenny divide the number of expected years you'll live with this with total expense (that is what I did).  If I were in my late 70s I may have decided differently.  I have an uncle in England that I spoke to prior to my surgery.  He did his privately and is in his 70's.  

Do whatever is best for you.  Waiting indefinitely is no fun either.  

Yes I plan on picking up my eye drops on Sunday. Trying not to think about it too much yet.

Best of luck Nina.  I assume your surgery is soon.  Let us know how it goes.

Thanks Sue, I will!

Hi Sue/Mark/Nina

Update.  Private surgery scheduled for 5 weeks today (9th Sept).  The consultant was so nice again this morning; he didnt rush me, we discussed different types of lenses/power/post op check-up ... the lot.  Both agreed for -2 in bad eye and see how it goes for a couple of months using lens & new specs on better eye and review before Xmas.  He will do the second eye if I want it done, even though it is pretty good.  He will be using an Alcon lense, he gave me the exact specification so I can Google it!  It will cost £2,500 but going private is the only way to take control of this situation.  Then I can get on with my life!

Happy days ... it's raining here ...

Sounds as if you are far more confident with this.  The whole procedure is stressful enough without the added worry of cancellations, different surgeons, making arrangements for your kids etc.  

You can now at least put your mind at ease and enjoy rest of your summer.

Agree with Sue, soudns like you have a plan that you are happy with. That is great!

Yes, good luck. Keep us posted.

Thanks! I'm sure I'll be posting again before I have to go (stress level is starting to go up - once again, I'm trying not to think about it - it's in 10 days).

That's good Jenny - looks like I'm going first

Yes, the unknown can be stressful. Just realize they do them all the time, and if there are any issues, there are multiple ways to address it.

Trying to keep reminding myself of that - I picked up the drops today, $180 for 3 tiny bottles WITH insurance.

And I had a coupon for the Prolensa to "only" pay $60, otherwise it would have been at least $200, maybe $250 - again with my insurance.

Wow seems excessive.  My private insurance through employer covered the expense of drops but total expense of 2 bottles was less than $50.

Did you have any less expensive generics? I don't recall what you said you were using for drops. Anyway, if you had the same drops as me, it's because it's apparently cheaper in Canada than the US.

I used Prolesna, but my surgeon gave me free samples; maybe he has some relationship with B&L. The others were probably around $50; but I got them a year ago so not sure.

I know Prolesna is expensive, so I am not at all surprised by your costs.

There are currently no generic drops in Canada for Prednisolone or Zymar.

I wasn't prescribed a NSAID.  I asked about these drops but my eye surgery said each surgeon will have his preferred and his were a steroid drop Prednisolone and antibiotic Zymar

Mark would you know if the drops can cause a sore throat?  I have been thinking I was coming down with a cold.  Had sore throats since last Friday but no fever or cold - wondering if the drops can give you a sore throat?

I do not know.

I do know that this time around, after taking drops, I can 'taste' them in my throat. So they probably are draining via the tear ducts into the throat.

So I guess it is possible, but do not know.

Yes I can taste them as well.  I was at the pharmacy last night to refill prescriptions for drops and asked the pharmacist about side affects.  She didn't think they could cause a sore throat but did say they do drain through tear ducts.

For first morning in 5 days sore throats is less .  So hoping whatever it is goes away.  If it turned into anything was going to halt the surgery.  Last thing I need is a cold or cough that first week

after surgery.  It was hard enough holding a sneeze back first time around.  And here we are entering ragweed season!  Not typically a good for me with allergies. Always something!

My post surgery drops are Prolensa (the NSAID) and Prednisolone Acetate (the steroid for swelling).

My pre surgery was Prolensa and Polymyxin (ant-biotic).

It is odd that I only do anti-biotic before, but not after. I can only guess it is before to make sure the eye is clean from any infection. And then maybe the cut closes completely right way (like a LASIK flap), so maybe all the stuff they put in your eye during surgey is enough to worry about infection for some surgeons.

It is very odd, that the type and schedule of drops is so different. Kind of tells you that most of it is probably overkill :-)

 

Yes very strange.  I am on an antibiotic drop 2 days prior to surgery and for a week after surgery.  Steroid drops 2 days prior and for 4 weeks after.  No NSAID drop.

Eye incision takes a while to heal - guessing at least a week which is why they do not want you to put any water (from shower on it).  I remember putting a face cloth on my face and eyelid was very sore .   I went to hairdressers to have my hair washed just to keep water off my face.  Thinking incision is made under your eyelid which would make sense.  Had a bruise under my eye that came out 2 weeks after surgery.  When I googled healing for this surgery found out have the healing is st 3 week mark.  

I could have asked for samples but I didn't ask. I think most of them probably have samples.

Prednisolone is the generic name. I think in the US most people get Pred Forte if they don't get the generic prednisolone.

Sue and Mark - do any of the drops burn your eyes?

I won't know what drops I have to use after until next week.

Yes slight stinging.

Hospital have me a schedule for post op drops with dates on it and boxes to check off.  Great for an OCD person like me.  Never missed a scheduled drop - lol

Oh I hope I get that too.

Do all of them sting and if not, which ones? The prednisolone?

First couple of days both sting.  As incision heals they sting less.   

Pred Forte and Pred Mild are listed as a 'commond brands' on my Prednisolone Acetate.

The only drop 'pain' I had was for a few days in one eye. It was like the drop (when between the lid and eye) was adding pressure. It lasted less than a minute.

I wouldn't be surprised that some people feel a sting, people have different tolerances and drops are different.

I didn't ask for samples, they just gave them to me. I know my father asked (he is a different state) and they gave him some, but he had to buy one of them.

I thought the cut was on the side, at least that is what it felt like to me whe nhe was doing it. But maybe not.

They only had me skip a shower until the 1 day post-op. After that they said I could shower, just keep water out. I just bad sure eye was shut tight, then put hand just above it to help divert shampoo and soap away from it; and turned around to do the back (instead of bending over like I usually do). Of course, much easier for a male with short hair :-)

Yes hard to shampo long hair and not get water in your eyes.  First 2 weeks I just went to hairdresser.  No big deal.  

Drops did sting first few days but lasted less than 30 seconds.  

Not really sure where incision is.  My eyelid was very sore 2 weeks.  But I did get a bruise under my eye.   All is better now till round two.

You can't see the incision in the eye at all?

I've heard its in the colored part of the eye (iris), perhaps near the top?

I should have asked but probably they didn't have samples since I mentioned how expensive they are and I didn't get offered samples Thanks Sue & Mark for info on possible stinging. Oh and I found an interesting article that's giving me more to worry about now that I see how much is really involved lol - google 25 Ways to Maximize Your Cataract Outcomes - thankfully 2 of the surgeons in the article practice near where I live in case something goes wrong!

Google 2 articles - Incision Complications and Management and Which is better: superior or temporal incisions? for articles on incisions. Mine has to be done to avoid my lasik flap - more fun NOT! From "Incision Complications":

"Incisions play an important role in cataract surgery. Whether placed on the cornea, the limbus, or the sclera, the incision is the gate to reaching the capsular bag—where the main surgical event takes place. No surgeon wants to see the iris prolapse following the first incision, but it can happen. Because incision complications are quite common, surgeons should pinpoint strategies to manage such situations.

Depending on size and function, a cataract incision is referred to as either a main phaco incision or a sideport incision. In this article, we discuss how to avoid and manage cataract surgery incision complications. As scleral incisions are less common in the phaco era, this article focuses on clear corneal incisions."

So according to articles, the location of the incision can vary.

Plus I think the incision is very tiny, not sure how someone would be able to see it....

Thanks - I really could not see where incision was.  Just know where eye was more sensuyfolliwung surgery.  Guess it really doesn't matter.  Except I wish day 3 I had not put a face cloth over that eyelid.  Boy did it hurt!

The more I t hink about it, mine has to be on the side. Like I said, that is where I seemed to feel it while he was doing it. Also, while healing, that is where I get an occasional 'bubble' of light; which they told be is just healing. I think is it he nerves healing/reconnecting.

What do you mean by you could feel it Mark? I hope I can't feel a thing!

I just found out I'm getting an "aberration-free" SofPort AO IOL (LI61-AO) by Bausch & Lomb.

How does that compare with Technis monofocal one or are they about the same.  If one is a5mm vs a 6 mm - choose the 6 mm.   

FWIW ... I never felt a bit of discomfort after the operation and the drops felt fine, just like a bit of Visine or rewetting drops on a contact lens. I remember being a bit groggy (and wearing the big sunglasses on the train ride home), taking a long nap (had to be up early that morning), and being amazed at how clearly I could see that evening.  

     My problem was dealing with 20/20 in the repaired eye and extreme nearsightedness in my "other" eye. I'm doing OK with a couple of RGP contacts, one that gives me 20/20 (good with cheaters for long stints on the computer) or one that gives me monovision (surprisingly good for walking around w/o glasses).

I don't know but here's an article on it even though it's from 2006

"Why I Use the Sofport AO" plus I also had lasik so I'm sure he had to take that into consideration (I just skimmed the article so far and it goes into the problem with people who had lasik and how this lens helps with that). I'm going to leave it up to his discretion at this point, but what is the reason for 6mm instead of 5mm?

From the article:

"I use the Sofport AO lens because it "does no harm." Unlike a spherical IOL, the Sofport AO lens does not add positive spherical aberration to the optical system. Because the lens is spherically neutral and aberration free, it is immune to the deleterious effects on acuity that occur when an IOL with spherical aberration tilts or decenters in the capsular bag. The Sofport AO lens offers visual benefits to all of my cataract patients."

Thanks for your input Griff!

I found an article called "Managing Decentered Aspheric IOLs" and one of the doctors in the article says:

JEFFREY WHITMAN, MD

Aspheric IOLs are fairly user friendly in terms of decentration. As a general rule, decentration is less of an issue with a neutral aspheric such as the Sofport LI61AO IOL (Bausch & Lomb, Rochester, NY). Aspheric IOLs have the advantage of matching the appropriate negative or neutral spherical aberration to the patient's wavefront measurement when needed. Decentration is more touchy with an aspheric IOL that adds negative spherical aberration, such as the Acrysof IQ monofocal aspheric IOL (SN60WF; Alcon Laboratories, Inc.) and the Tecnis IOL. Decentered spherical IOLs can also cause significant problems, because the power at the center is different than the power in the intermediate and peripheral areas. I base my intervention on the patient's symptoms. I reposition the IOL if the patient is experiencing optical distortion or sees halos and glare.

The feeling is not pain. Just a feeling of someone touching you. Like when you are numb and you touch that area; you don't feel it at that spot, but can sense it in the area next to it.

Nothing to worry about.

I know nothing about lens types. I kind of wish I did, but now that I have what I have, I am afraid to learn about them :-)

Reason for 6mm vs 5mm - is for pupil size and dialation.  Most IOLs are 6mm but there are a few that are 5mm .  If pupil dialates beyond 5mm some see edge of lens and find it annoying.

OK thanks for clarifying Mark!

Thanks for the info, Sue. I found this info about my lens in an article from 2015 called "Understanding Intraocular Lenses: The Basics of Design and Material" by Steven Dewey, MD. I'll also try to find out how many mm's it is.

"The SofPort AO lens (Bausch + Lomb) is designed to be simply aspheric, thus neither correcting nor worsening spherical aberration attributable to the IOL. The advantage of a neutral aspheric lens is the lack of visual degradation associated with IOL decentration or tilt. Decentered IOLs with an aspheric correction will induce coma to varying degrees. Neutral aspheric IOLs can be decentered without degrading contrast sensitivity. These

lenses are suitable in cases of previous refractive surgery in which the corneal correction was off-center, or if the patient has a naturally neutrally aspheric cornea."

In any event, apparently my doctor chose this specific lens due to my having had lasik, so I am going to trust his choice.

Yes best to follow that.  They are the experts.

It's 6mm and made of silicone. I'm going to trust my doctor on this one. All I can do is hope for the best. I found this from "Does IOL Material Matter?" for what it's worth:

"Silicone IOLs, if they have a truncated edge, can be associated with an excellent and possibly even superior PCO-prevention profile. Some of the latest silicone materials have been associated with no more inflammation than hydrophobic acrylic IOL materials and no greater anterior capsular contracture.

Unique problems are associated with silicone IOLs. Silicone oil tends to obscure the view of the posterior segment with all silicone IOLs; this continues to be a consideration for why such lenses should not be used in some patients. Silicone IOLs also have been uniquely associated with calcification in any eye with asteroid hyalosis (Figure 2). Although this is an uncommon problem, it is a relative contraindication to use of silicone IOLs. In addition, due most likely to the material’s lower refractive index, silicone IOLs seem to be more forgiving in regard to pseudophakic dysphotopsia than many acrylic IOLs."

I think the IOL I'm getting is 3 pieces. One of the doctors in the article I posted about 25 things cataract surgeons should watch out for is located right near where I live and is one of the top eye surgeons and cornea specialists in the world. I found an article from December 2014 called "Shedding Light on Pseudophakic Dysphotopsia" where he said in the part that says "Web Extra: Clinical Update" that he uses the IOL I'm getting in most of his cataract surgeries that are monofocal IOLs and also uses that IOL when he has to do a lens exchange due to dysphotopsias. I'm so glad I asked which IOL I'm getting today. Now hopefully all will go well!

And the reason why it's so tiny (3mm) is because of the newer IOLs that can be folded before inserting.

Wishing you all the best Nina.  Really hope your results are excellent!  Let us know how you make out.

Thanks Sue, I will!

I read the best way to do the drops is after you put them in, take your pointer finger and gently press on the inner lower corner of your eye. This helps keep the drops from draining into your lacrimal glands and out of your nose and throat. My doctor also told me to use a warm compress for 3 to 5 minutes before putting in the drops, but not sure that would help with your problem. The finger thing works though because I tried it.

Correction - don't put warm compresses on your eyes after cataract surgery, only before surgery. My doctor told me yesterday to stop putting them on after the surgery.

Warm compresses?    That wasn't mentioned to me - is it a prep thing we should be doing?

I never heard of doing warm compresses. So I never did that for my surgeries.

I checked the sheet of instructions and no mention of that.  Just start 2 kinds of drops 2 days prior to surgery.  My second eye being done Monday so starting that soon enough.   

Anyone more nervous 2nd time around?   I would think I'd be calmer but not.

Hi Sue

How is life looking with both eyes done now?  I hope the problems you were having have gone and you have two perfectly matched eyes?

Do update us when you can.

Jenny

Hi Jenny - had 2nd surgery last week and doing fine.  Went back to work today but eyes got tired (hadn't looked much at a screen since surgery) so looks like I have to ease into reading.  Bit off more than I could handle.  However my daytime vision is really good .  Can see well from 14 inches out. Not wearing any glasses first time since I was a teen.  I do have nighttime glare and halos and concentric circles.  I manage to drive locally with overhead streetlights.  It is more of a concern on darkened highways.  Whether that improves with time I don't know.  

How about you - I think your surgery is coming up next month?   If you are going with national health and getting these covered you should reach out to Nina.  She had one surgery done with an aspheric monofocal lens and sees well (distance and intermediate).  Quite a surprise for a lot of us here on the forums as I didn't think you got much intermediate with a monofocal lens.

Hi Jenny thought I would check in with you.   Wondering if you ever got that September appointment or if you are now going with doing the surgery with private company.

I had my 2nd surgery 2 weeks ago tomorrow and am doing fine.  Glad to have this behind me (or at least a spell of smooth sailing where I have days I don't have to think about my eyes.). Still on the prescribed eyedrops for another week.  So far no complications.  Have my next visit with surgeon at his office late September so I will know more about my results then.  Haven't had to wear glasses in 2 weeks.  There are times I still reach for the ones with one eye poked out at night as I like to watch the telly a bit before bedtime.  Guess old habits and all.  But it is so awesome to not have to wear them.  Although Ibwas so used to them - it's amazing now to see several pairs (6 in all) lined up on my counter.  Still haven't thrown them out!  

Hi Sue.  I've been wondering how you've been getting on these past 2 weeks, with both eyes done.  Sounds like you can call it a success which is wonderful.  Yes, I can imagine it must be very strange not to have to wear specs after so many years of wearing them.  Do your eyes feel 'perfect' now or are you aware of the lenses in them?

My op, private, is on Saturday morning.  I am not so worried about the op itself, more concerned about how life will look afterwards.  I am being positive and looking at it as a life changing event - if I don't like having to wear the contact in the other eye the surgeon will do it, he said, even though it's healthy with just a slight cataract.  I have 2 weeks off work to give me time to adjust but I hope I can drive and function normally after just a day or two.  I will keep you posted.

One thing - how is the night time vision now?  Do you think your brain is learning to tune out the stuff you don't want to see now?

 

So private appointment is soon.   Yes it will be life changing.  My daytime vision does feel normal - panoramic.  Very clear.  It was like that 24 hours after each surgery.  First eye can still get a sensation once in awhile something is in there like an eyeladh.  I assume that's dry eye ( will have to ask next visit).  2nd eye just done had a bit more pain for 2 days but not since then and no sensation something in eye at all.  It also took a full 24 hours to clear up (things out of focus that first day).  I read some people who had good vision except for a cataract t in one eye say colours with Symfony or writing are lighter than

Their unoperated eye.  I can't compare as both eyes had cataracts.  But I have no complaints about day vision.

Unfortunately night vision isn't what I would prefer.  I did anticipate that from these forums and my surgeon said that would be the compromise going with premiums lens.  In reading the stats perhaps I didn't fully take in it is 100% of people - they make it sound 13% found it bothersome but I am not sure about all that.  My surgeon seems to think people's brains adjust but not to point it disappears.  Also due to my age pupils dialate more in dark making it more of an issue.  I can manage to drive in areas well lit by streetlights - more troublesome in areas where there are no streetlights.

If you are going with monofocals check out Nina's post .  She got an aspheric monofocal lens in eye set for distance and sees well from 2 feet out.  No nighttime issues.  She is waiting to do other eye to figure out what she wants.  If you can wait too it would be better. 

Wishing you well Sat.  Let me know how it turns out.  Surgery itself is not painful- just unnerving to have someone work on your eyes.

Good luck on Saturday

Glad things are going well for you.

?My re-done eye is doing well. I went for my 1 month and it was still swollen, so back on drops for 10 days. The same thing with my right eye, so wasn't surprised at all.

?The dilating eyes, at our age, is a problem. I get interior reflections from the light bouncing off the edges. Mainly when the light source is above me. I got some drops to try, but haven't used them just yet. My eyes dilate very easily, and with just a little light being gone.

?I get some other reflections too, but it isn't the lens. It has something to do with the tear layer or something. Because if I pull my upper eye lid up, or my lower lid down, it goes away.

?The other thing I haven't trained my brain on yet, is floaters. I have a lot of them. More so in my right, the one with the astigmatism; so it might be related to them being in more focus than the outside world.

?He said the re-op'd left was measuring -0.25 and no astig. However, I couldn't get it to come in clear; he thinks that is because it is still swollen. I go back in another month.

Hi Everyone.  Have a question about post-op glasses for the group (see below as it'll take me a few paragraphs to get to my point.

      I've been OK with monovision for the past year (had left eye done for distance with toric lens to fix astigmatism). Right eye remained -6.5 and I have 2 gas perm contacts, one for 20/20 and another that lets me read most things except for fine print. Of course, I often go w/o a lens around the house, seeing TV just fine with left eye and trying to read phone right next to my face.

    I've decided to get right eye fixed for distance, too, to balance vision and depth perception.

   .  Because I've worn glasses forever and no solution for cataracts is 100% perfect, I plan to inquire about a good pair of Rx glasses with progressive lenses (clear top, computer distance mid, and reading low).  Also want to make them transitions to serve as sunglasses.

     Has anyone gone this route? I'd love your feedback or input from folks who see drawbacks.

   Many thanks...BillG

Mark - is the swollen eyes due to lens replacement surgery?  I am thinking it is a bigger incision to remove an IOL and replace.   Hopefully all will be ok and it just takes longer for healing to take place but once that happens results will be great.  Was it a Symfony lens you had replaced?

I get what you are saying g about lights inside and reflection.  Our church has some powerful lighting - ceiling is industrial looking (modern left look) and ceiling with large piping painted black.  Ceiling is high and light scatters and flares with that lighting.  First time I have ever had an issue with inside lighting.  In my home and stores or at work no issues at all.  But in all honesty it could be 15 years to wait before my eyes would dialate less due to aging process.  

I don't regret my decision - likely as I have no experience with what the other would produce (monofocals) and if I wound up with night issues with those (and I have met people that do - both golfers that want both eyes set for distance due to their love of golf).  They are in their 50s as well - so maybe it is an age thing too.  But if I had traded my opportunity for good all distance vision only to still have night issues I would be sorely disappointed.  

Not giving up on finding a solution though for night driving and very relieved to be able to drive to and from work and around the city- everywhere streetlights can be found.  

Even the moon has a glare around it now - I wonder in time will I forget what it used to look like?  Guess I spend too much time thinking about all this.  I hate Lisa - mourn things too much.

Glad your surgery went well - I am certain the swelling is what is causing the focus to be out.  

Also floaters - I have always had many too especially in right eye prior to cataracts - so not induced by surgery.  They are more noticeable due to my better vision.  Thinking brain will tune these out in time.  I notice them more when I am conscious of them.

Keep in touch - hoping things turn around for you soon.

Can't comment back much as I haven't gone that route but prior to cataracts had transition glasses.  Only thing I didn't like about them is they don't work (turn dark) when driving.  Great for outside.  Had to have separate prescription eyeglasses for just daytime driving.  

Now I can buy regular sunglasses for that - great savings for the future.

Hi.  Just a quick reply as tea is almost ready ... several consultants told me I have lot of floaters which I don't see so I am concerned I will see them after surgery.  Need to consciously not look at them I think.

As you say, Sue, nothing is perfect.  Without the cataracts we would have carried on as we were.  We had an opportunity to have something different, but I don't suppose anything will cover all bases.  Pros and cons with every option.  You are very early days - I can imagine it will take a good few months for our eyes to completely settle down.  As long as we can manage, that's the main thing.

Mark, I can't comment on specs as I have only ever had single vision glasses.  Didn't get old enough to need varifocals or bifocals before the cataracts arrived.

Bill,

?Interesting that you settled on getting it fixed for distance, you seemed to like that mono so much.

?You may recall, after my first round of cataracts, I was -1.5 in L and 0 in R. With the Left changed, it is somewhere around -0.25 (still waiting for it to heal). Before all of this I was -12 in both.

?So I basically had monovision for 1 yr. I understand the pros of mono, just didn't out way the cons for me. Now that I am completely distance, I am still getting used to it; after being mono for so long. Of course, I miss the pros of mono, but having clear distance is so good. Will be better once I get the astig in my R addressed.

?When I was -12 I had progressives. I sit in front of a computer all day. I could do the PC without a problem. After the surgery, with glasses, I found mid-range (like standing in front of a RedBox to get a DVD) was a problem. Not sure if it was because no accommodation left in the eyes, or glasses trying to compensate for the monovision. I also found I had tilt my head more to see the PC. I didn't like that at all. IMO - monovision was impacting the mid-range, and lose of accommodation caused the head tilt.

So I got a pair of +1.5 readers and took out the left lens; for the PC. Now that I am ~0 in both, I put the lens back in and use +1.5 readers. But now that I no longer have the mono, I have to find the readers much more often. For around the house I find I have the readers slid down my nose. In the car I can drive fine, but the dash is blurry. For that, I found +1 is what I needed for that; depends on how far you sit in your car.

?I am not sure if I will get progressives or not. I have to wait for the new Left to settle. It is nice to just buy readers. I did but a pair of safety glasses with readers, and sunglass with readers. If I try progressives, I might buy then on-line; much cheaper way to play around.

Just the normal swollen from surgery. Not sure it is 'worse' because it was an IOL exchange. My right did the same it was a one time IOL. I have been a slow healer as well, so nothing surprising.

?I do not believe the cut is any larger, as they cut up the old IOL before taking it out (I heard them put the pieces on the table to make sure they had all of it). However, he was in there a while trying to get the old one lose; so I am sure they didn't make the eye too happy.

?I just have a plain monofocal; as far as I know.

?Yes, had floaters too, just not this many as now. The sack of stuff in your eye starts to pull away as you age, so that causes floaters as well. That was just starting to happen to me before the surgery, so I am sure that is contributing. When I say the doc last week, he didn't see anything that concerned him.

?The brain should tune them out. They says they also will sometimes settle to the bottom of the eye. My engineering brain sees everything and doesn't like to tune it out :-)

?As far as glares, that is something else the brain should tune. So yes, you probably will forget in time what things looked like. That would be a good thing; the brain is tuning and life will be just life.

?And yeah, we are probably looking at ~15 years before the eye stop dilating. That will be a different set of pros and cons, but at least it will happen slowly so we can get used to it :-)

Mark was the monofocal lens you had an aspheric one?  Seems Nina was able to see 2 feet and beyond with hers (set for distance. )  she sees car dashboard w/o glasses.

Your reaction to monovision was my concerns for going that route with monofocals.  Symfony in both eyes targeted for 0D was best for me.  I was pleasantly surprised by the near vision I got .  Thought I would need readers more.

Yup, you will see them. VERY common after cataracts. Just don't look at white walls; that will show all of them. It is a little freaky at first, but knowing they are 'supposed' to be there helps you get over it. Just would be nice to not see them.

?Someday, maybe they will have a way to replace the sack of stuff in your eye. You know, suck it out and fill it with a some type of saline like solution. :-)

?I did find a video of a doc that zaps them with a laser, but that is so new; would only consider that if there was some big one right in the field of view.

I do not think it is aspheric, I thought I read those had some issues. I didn't get any type of card saying what it was. All I know is that I didn't pay for anything fancy.

I will have ask when I go back later this month. I never wanted to know before because they ware what they are; but know I need to know.

Surprised I was not given a card with name/make of my lenses with power on them etc.  I asked after 2nd eye done and surgeon said they no longer do that.  Only if I was having g one eye done so that when it came time to do the other eye and you moved or chose different surgeon they could match or select complementary IOL.  

Not sure Nina paid anything extra for her aspheric lens. She had prior lasik surgery so this was one her surgeon chose for her.  She researched it after knowing what lens was selected and discovered it gave distance and intermediate vision (from 2 feet) and is a monofocal.  Was surprised as I didn't think monofocal set for distance gave intermediate vision.  

How long did exchange take?  I would imagine the longer the surgery more aggravation to eye.  The steroid drop will help with swelling.  

From my own experience, progressive eyeglasses cover distance and near (reading) well but the intermediate range is too small and narrow to be useful for computer work from about 2-3feet away from the monitor.  I have to use a separate cheap +1D pair just for computer/intermediate distance viewing that makes that much easier.

Thats why my plan for cataract surgery is to get good distance and intermediate vision either with mini-monovision using toric monofocal IOLS or one eye with a Symfony IOL and the other with a toric monofocal.  Then I wouldn't need eyeglasses for either distance or computer/intermedate range, only for near/reading.

Thx.  Congrats on having a plan.  I do a lot of writing and want to be able to read notes (often printed out) as I switch from viewing computer & reading distance. I thought monovision would be answer but now find I've got a back/hip situation from hunching forward sitting at computer, kitchen table (morning paper's puzzles), and driving. That's why I'm leaning towards getting my 2d eye done for distance w/astigmatism fix.  Will try a pair of the over-the-counter progressives this month to check that solution. Know I won't like having to carry cheaters though, but I'm also tired of having an RGP in my eye all day at age 70. 

Thx for your input on this. Wearing an RGP all day has become tiresome. Thinking if I'm done for distance, I could have RX or on-line progressives. I find I've been leaning way forward to read computer, drive, read and write at the table. Not sure but think it's been causing an increasingly serious hip pain.    Using my "20/20" RGP and a pair of +1.75 cheaters I'm comfortable using a laptop on a couch or recliner--that's what pushed the distance correction for the 2d eye. There's always a drawback. Carrying cheaters will be that for me--thus the thought of Rx progressives w/transition, is, a full-time pair of specs. The nice thing is they'll be much lighter than what I've worn for almost 60 years. 

My understanding is that mini monovision is not the same with IOL as it is with contact lenses.  It is much superior and won't be as problematic.  If your first surgery iol was set for distance and you set the 2nd one for intermediate you'll achieve spectacle independence and need readers for only the fine print.   There are a number in these forums who gave that arrangement and do fine.   

In the realm of "what-ifs," is one able to wear an RGP postsurgery? If so, that would be an option to go monovision at times. I don't seem to have any problem switching back and forth to monovision with 2 different strength RGPs for my right eye. Also it will be interesting to see which is my dominant eye.  It was my left but the right seemed to take over as the left eye cataract became a problem. Wonder if they switched again and if I could use an RGP in the non-dominant eye.  Questions. Always questions  😊 

Not really that much longer. Most of the extra time was getting the old lens to break free. Maybe an extra 5 minutes.

Yeah, leaning forward is not good posture, so probably is part (or all) of your hip issue.

The do make glasses called computer progressives. Where the middle area is for the computer and then the lower part is for reading. This gives a very large computer distance; thus solving the mid-range area being narrow. Google them.

There are also different kinds of progressives, some give a wider mid-range.

Yes, whatever you get will me thinner; you will like that.

I am starting to get use to carrying the cheaters around. Once things settle, I know what I want for want, I will probably by a bunch at the dollar store.

Yes, but there are those (i.e. me) where that just didn't work well at all. They do say up to a 2D difference is doable, just wasn't for me.

Not sure how IOL mono-vision would be that much better than with contacts. Contacts are very close to where the IOL will sit.

Even so, they do say one should only do it if they like it with contacts.

 

Yeah, there are too many questions and options.

I would think you could do that. I see no reason why an IOL would prevent wearing a contact. I believe there are people that do that when the eyes are not equal.

But why put in a contact when you can just grab cheaters?

 I was thinking a contact could put me back in MonovisionLand for a while, but you're right, grabbing a pair of cheaters is easier.  I can see they'll change my wardrobe: I'll be buying T-shirts and polos with a pocket!  After reading as we all go in circles, I understand why the surgeons don't want to even enter these discussions in many cases. Mine simply says that distance correction has the greatest chance of the best outcome and balances your vision.  Dealing with the pain in my hip makes me realize there's a huge difference between real pain (hip) and the "pain" of inconvenience (cheaters)....

Mark if you have a Costco membership you can get 3 pairs of cheaters for $19.99 Cdn (likely cheaper in USA.  Nice thing about Costco is they have a

Viewer there that help you select power needed.  Lowest power they have is +1.25 which for me was too strong.  I could read the paragraph with no added power in viewer.  When I moved it to +1.25 text blurred slightly.  Not sure I will need any - certainly functioning last 2 weeks without any difficulty since 2nd eye done.  WIting to see at 1 month post op visit later this month.

Agree.  Due to my cataracts couldn't test it out with contacts.  I decided not to try monovision (they say everyone does fine with mini monovision) however I get very severe migraines, seasick on cruise ships dizzy driving backwards in a car so I decided to have both eyes balanced for 0D.    I have had one severe migraine 1 week after 2nd eye done - didn't even recognize it as a migraine.  It started right behind my eye (first operated eye done July10).  I thought something was wrong with the eye - so much pressure.  Veey painful.   Took me a few hours to learn it was a migraine - by then auras came (whole different kind of halos - lol).  Anyways not pleasant.

No need to new wardrobe. I just put them on the collar of my t-shirt or the V at the button area on a polo. That is where the fancy/actors/hipsters/etc. put their sunglass :-)

Anyway, it works for me.

My dad did start to buy shirts with pockets. I am too cheap :-)

We have Costco and other warehouse type stores.

Not sure if they are any better than dollar store ones.

I got a pair of +1.0 at Walmart. I have seen +1.0 at other stores as well.

So you should be able to find a pair. Could also check Amazon.

It is wo interesting that you can read it with no power; that is nice.

You made me chuckle.  Just spent 2 days walking around with the 20/20 lens in my right eye. Definitely prefer the monovision version.  The downside is what to get (glasses) for reading a book or long stints on the computer.  As we keep saying there's always a downside. For example, with the monovision contact, we went out this evening, picking up my old El Camino, and driving 10 miles in twilight to go food shopping   No problem with labels (I let Mrs G deal with the tiny print on ingredients) and prices. Then drove home in the dark with no difficulty.  A great solution for Day-to-day life, but not so good for computer/reading. Thus, maybe a complicated set of progressive lenses. Thanks in advance for poking holes in this premise. . 

Really haven't seen a need for readers at all at this point.  My plan B as I just got rejection notice from my private health insurance to pay for a portion of my Symfony lenses is to stick them with the bill for my readers once I get my prescription at my 6 week post op visit. Pretty annoyed with them as they would cover lasik if I had that up to cost of pair of glasses.  Have no idea why they cover that (cosmetic) whereas my IOLs I do not consider cosmetic.  When I feel up to it going to call and argue that case with them.   I used to live in the province of Quebec and they are 1st province in Canada to now include premium lenses under Medicare.  Wish I still lived there.  Was talking to family and friends that live there and they told me as of July premium lenses now covered.  I am sure other provinces will follow suit.

Anyways I will get a nice pair of frames and get my +0.75 cheaters and send bill to Sunlife - may even tell them that when I call.

I would say that 2 days is not enough time to try it. As I mentioned, I had it for about 1 yr. It has one month since I am now 0D in both, and I am still getting use to the things I 'lost' from when I was mono. I can only imagine it would take you longer.

Yeah, you really need to figure out which one is better overall. For me, when I had monovision and had glasses on, I could tell the difference in the size that things looked; it drove me nuts.

My suggestion is to go online and order a cheaper pair of glass. So with your contact in to get you your mono, then get glasses to correct you for reading. So pair of glasses with +2D in the Left and 0D in the Right; and wear your RGP in the Right that gets you your reading.

Without getting off topic too long, what year El Camino? I am a car guy.

Hi Nina - have you made a decision on your 2nd surgery?  How are you making out.  Hope all is well.

Wow, premium lens covered. I wonder which kind. Maybe it is just the torx ones, for people with astig. That would make sense because it avoid glasses/lasik. I could see it not covering getting a 'better' lens, since the 'regular' ones do work.

Here, I would have had to pay the difference. The only things we talked about where torx and multifocals. I wasn't going to need torx (they figure they could get the little I had out with the cut). I had no interest in mutilfocals, so didn't want to pay for those. I didn't recall any talk about a 'better' version; so never became an option for me :-(

 

No it is all premium lenses covered in Quebec if you are a Quebec resident.  Canadian Medicare covers surgery for cataracts (total cost) plus value of monofocal $300 per eye.  If you upgrade to premium lens you pay the difference - in my case $900 per IOL.  Now province of Quebec will cover the premium lens too.  i can see other provinces following suit in next year.  

I was having a hard time with Amoy of money people paid for premium lenses in U.K. And USA but then I realized in reading these forums people also have to pay for the surgery as national health only covers monofocal lenses - you cannot upgrade.

I think all people should have access to premium lenses regardless of their income (provided of course if they want them).  

Hi Mark:  Eyes 1st, Cars 2d.

1. Not sure how to figure the lens for right eye in ordering glasses.  Left would be 0 on top, +1.50 middle, +2.50 bottom.  If right is fixed fixed for mono, not sure of the starting point --would need a -rx on top for 20/20 distance and a pair of + in the progressive middle and reading slots.

2. Car is a '78 GMC Caballero (El Camino).  Runs great with the 350-350 powertrain and an old cruising gear posi rear.  Have to decide between tackling looming rust issues or leave them for next owner and find one that's been "done" during our winter trip to Florida.

Not sure they make trifocals in glasses - maybe I am wrong.  Something I considered when thinking of monofocal lenses would be to get a pair of computer glasses (so that mid distance you need at +1.50.). I work all day with spreadsheets and computers and would have found it annoying to find that sweet spot for computer distance.  Then you could just get a pair of readers for fine print.

Hi Mark and anyone else following this “case”:  So, if I were to order an on-line pair of progressives (assuming you can do that)…. sorry for the goofy spacing

 

1.     Left eye now 20/20 for distance.   Assume I’d want a +2.50 in the “reader” spot progressing through a +1.25/+1.50 in the middle for computer work and 0 on top in the distance spot.  (This is like setting the batting order for a baseball game).

 

 

2.     Now, for the right eye. Numbers are all over the place.

Last spectacle Rx was -4.75 however, last contact RX for distance was -6.50 (that’s the one I was using the past 2 days)

         

Last contact RX (for computer distance) was -4.50 (doesn’t really work for computer…think he did it just to balance  vision for some monovision…assuming I had an IOL for that -4.50, would I do a top part of a progressive as a -2, but something much less as a reader, like a +1 and +.50?). You can see (pun intended) that I’m not a numbers guy and wonder whether such a combination would literally make my head spin—if they even can build a progressive with both + & - elements.

 

Speaking of spinning heads, it’s almost time to get ready for the opening night of candlepin bowling season.

 

Thx,BG

From my experience, progressive eyeglasses are not useful for computer work in the intermediate area its way too narrow and you have to keep moving your head all around to view clearly a small region of the computer monitor screen.  You get a wider view only in the distance (top) area and a less narrow view in the near/reading (bottom) area.

Thats why for the last few years in addition to a progressive eyeglasses pair for regular use, I also have a separate pair just for computer work, set +1.0D over my distance Rx for good 2-3foot focus with full view.

Thx. Advice like that is golden. 

For testing, I would just get single vision glasses for what you want try. They are only $10-20.

If you want progressives (or bifocals), then you do Left as 0D with +2.5 add. For the Right you do -2D with +2.5 add. The number for the bottom is an adder, not the actual value. They care of it really meaning the bottom is +0.5; you don't worry about that. So the lens is chosen for the top being the 20/20, then they add +2.5 to each.

With the measurements for eye distance and height, in relationship to the frames, online might not be the most accurate, so just do it as test.

Candelpin? You must be the new England area; very popular there. I haven't tried that in years.

'78, nice. My dad had an '84 El Camino for a few years. And yeah, rust makes it hard to decide whether to keep or not.

I don't think he was saying tri-focals, but they do make them. I know a guy at work that has them.

Prior to cataracts, progressives actually worked ok for me, and I was -12D. However, I stayed with CR-39 (plain plastic material) which helped.

After, with the monovision and lost of accommodation, I could not.

This is part of the reason that I feel Bill should just try single vision lens for now. One option was him to get one eye 0D with the other at -2D (instead of both at 0D). With that, one eye 'wins' over the other. Once he puts on glasses, to correct the -2D to be 0D, both eyes with see distance; however, the image the eyes see will be different sizes. He should experience that before deciding if 2nd eye should be -2D; and then have glasses for reading, or have 2nd eye be 0D and deal with cheaters.

Ok wasn't aware.  Would be difficult to get used to trifocals glasses.  You'd be moving your head all around trying to focus - lol

A progressive is a trifocal isn't it?  Works pretty well for me now.  That's what I'm wearing right now cos that's what I wore (prior to my excellent results with the Tecnis Symfony as you are aware).  The only con is that one can't see sideways clearly.  Otherwise I love the ease.  But of course I have no idea what will happen once the symfony lens is replaced.

Have you found a surgeon to do lens replacement?   I assume you are replacing with a monofocal?  Wishing all the best!

Progressives and trifocals are different things.

Progressives have no line and are a gradual transition from 20/20 to reading.

Trifocals have visible lines have two extra areas (one for mid and one for reading), versus bifocals that have just one extra area (for reading).

The advantage of trifocals is it make the mid area wider and, like bifocals, more blurry sides.

I have not see many trifocals.

I haven't seen trifocals or had them discussed at any optometrist appointment .  Then again my eyes really just needed distance and 2 years ago optometrist put a small prescription in my progressives to get me accustomed to them.  Never liked them and kept taking them off to read.   Heard of trifocals IOLS though.

Good advice.  After having left eye "fixed" for 20/20, we took the left lens out of my progressives.  It didn't work.  Things WERE a different size and I saw a ghost image on the right side of things. Out of desperation I tried a 30-year-old RGP (used to wear them for running in my marathoning days).   It worked, an optician told me, because the lens was much closer to my eye than the lens in my glasses.  It also was a 30-year-old Rx and gave me the monovision that I seemed to adapt to immediately.  

     The simplest solution would be to have the same fix for my right eye and deal with the cheaters.  Monovision would be great most of the time, but more difficult to adjust to have both eyes "on duty" for long stints of reading or computer work.

    In theory it would be nice to have a set of progressive glasses with significantly different RXs that would solve all situations, but as Mark points out: Reality might not be the same as the theoretical.

    I had a good day yesterday going with monovision; today, I'm going with the 20/20 contact lens and give that another test.  

     I know my surgeon will recommend the 20/20 solution w/astigmatism fix, citing the terrific result in my left eye. She's one of the senior docs at a Harvard-affiliated eye center here and doesn't make time for lots of what-ifs in conversation.  I can see why after reading and contributing to all the torment we share here.

     In short, I will make here have the monovision discussion when I'm there for the pre-op testing and meeting, but won't fight if she feels strongly about the 20/20 distance solution. With one eye corrected for 20/20 I already see better at distance than at any time in my life.

    Again, as an optician friend who regularly adjusted my glasses said, "Your Rx was so strong that you only got perfect vision when your glasses were both adjusted exactly, they hadn't slid down your nose, AND your astigmatism axis hadn't shifted....

    Of course, assuming the procedure is a success, I know I'll adapt to the outcome.   I haven't had great vision my whole life and got along fine.

    FYI:  Annual physical is next week, visit with surgeon late this month, and if all goes well, surgery on Oct. 4.  I promise a post-op update as thanks to all who post here.

Thanks will be waiting to hear how it all turns out.  Wishing you success!!!!

Yes can relate my surgeon didn't entertain a lot of discussion on various scenarios either.  Mostly due probably to how busy he is.  2 full days a week at hospital with back to back surgeries and then 24 he follow up with each patient.  That's the Medicare system here in Canada.  However if you know your surgeon is good sometimes I think you have to trust they know what they are doing and what would be best.  Forcing your own wishes may not be best.  Again you'd have to have confidence in the surgeon selected.  Since my surgery I have run into so many others who have had surgery done by his office.  Not heard a bad word yet although I am sure there are a few.

Good luck.

Thx. Having a year between surgeries really drove home the point that there's no one-solution-fits-all so we adapt.  I'm grateful I wasn't facing this 30 years ago!

 

Guess that was my primary issues at 53 will have to live with this 30+ years.  

No one solution for sure and wish there was more discussion/consult offered.  

it was a whirlwind decision after diagnosis.  I was really struggling at work to read computer with cataracts.  

  Walking around with a 20-20 contact lens in my "bad" eye today.  Distancevision  and walking around is great.  I have no problem with a pair of "cheaters" at the computer, but I go nuts having to reach for the cheaters to read mail or a label or the newspaper when I'm "on the go."

  So, today, I'm leaning back to asking for monovision and working on a more-complicated glasses solution for reading/computer.  Will see what The Big Fish--The Sturgeon--says. 

  Whatever the new IOL's power, I'll opt for the higher-cost toric to fix astigmatism.

Yep agree - for everyday stuff so glad to be glasses free.  I even get less headaches now and had permanent skin irritation on bridge of nose which is now getting relief.  

Bill,

I REALLY suggest you try it longer.

The first week after getting my Left re-done, to be 0D in both, I was having buyers remorse.

I took a couple weeks to get used to grabbing for the cheaters. Still getting used to it.

So I would say you haven't tried enough.

Also, the contact might not be giving you 'perfect' vision in the Right. With both eyes 'perfect' they can work together to see closer than by themselves; not reading closer, but maybe the car dash.

If you get 20/20 and really cannot get used to grabbing cheaters, then get a pair of bifocals to were for "on the go".

You need to think about how much time you want balanced vision. And for those times, how will you do that; post-op. I believe today you are popping out the contact; that will not be an option post-op. Post-op you will need to wear glasses. This is what I wanted you to test. Get a pair of cheap +2 readers, then pop out the lens in the Right. Put the RGP in the Right that gets you to -2D, so you have your monovision. Then put on the readers glasses to see how you like that for long stints of reading/computer.

You have only tested half of what you will end up. I really suggest you try the other.

Hi Mark:

    As usual, you're right on the money.  I had my old progressives converted to computer glasses right after the first surgery.  A +2 in the left eye, clear glass in the right.   It works OK, not quite as clear as the balanced 20/20 vision with a lesser (+1.50 or +1.75) pair of cheaters.  Two solutions that work.  The one thing that I'd need to get used to is reaching for the cheaters all day long of (gasp) wearing them on a string around my neck.  Going back to mono this morning for bowling league. :-)

 

Glad you have something to try.

Now try each a few times to help pick what you want.

If you go 20/20 in both, and after a few months you truly miss mono at times (I don't think you will), then you could get daily contacts to wear for the times you like mono.

If you get monovision, and you find the +2/0 glasses are not working, then you would need a contact for reading/computer.

For me, I sit in front of the computer all day. I need the balanced vision. I much prefer having them balanced and then 'adjusting' from there.

  

Hi Sue, Mark and others.  The op went perfectly yesterday.  All the staff were brilliant and the surgeon even more so.  No pain at all.  I literally froze with fear on the operating table which I guess was a good thing as I didn't move a muscle!  I was very cold afterwards - shock I think.  I have never had a surgical procedure before.

So, what can I see with my (aimed for) -2 new eye?   The answer is everything!  I am typing now with no glasses on.  I can read a piece of paper next to my computer and see into the hall.  I got a fright when I looked in the mirror and could see my face!  Last night I could see the TV through the plastic shield with the new eye.  My brain is totally disregarding my right eye (-12).  I am so happy that I can operate with the new eye doing all the work.  No double vision.  No headache.  

Later on I will put the -2 contact in the un-operated eye and see how the eyes works together.  That will be more telling I think.  My gut feeling is the surgeon got nearer to 0 than -2 but I go back Friday for a check-up so I suppose he will be able to tell me then.

Last night I looked at street lights quite some distance away.  With the bad eye there were ENORMOUS patterns around them, like looking through a microscope at some cells; with the new eye there were none at all.  I so hope that doesn't change as we change the clocks in a few weeks and it will be dark here at 5pm.

One last thing - when I close the new eye and look through the bad eye, boy, was it bad!  I can't see anything!!

 

Great results so far!

What type of IOL did you get? Monofocal or Symfony or ?

 

A monofocal.  Which is why I am surprised I can see such a range of things.  I was expecting to see clearly to arm's length and nearer only.  I am sure the surgeon said I'd need to pop my new -2 specs on top for TV and driving.  Maybe I will when it settles down.  

I would say I am more aware of the floaters than before but I will ignore them!

The floaters - yes.  I used to notice the floaters in my right eye before the cataract made that eye more blurry, so can't see them now.  After the surgery, will probably see them again?

I'm finally getting close to scheduling cataract surgery for my right eye (dominant, worse cataract) - tentatively reserved a spot for Oct 24 with the 3rd eye surgeon I got consultations with the past few months. He goes between two offices, one is down the hill from me under 2 miles so the post op checks will be a short drive.  But the surgery and the pre-op measurements are at other clinic locations about 15-20 miles away from me.  I'm planning for a Tecnis toric monofocal for my right eye first set for good distance vision, -0.25D target.  I think I used to get 20/15 vision in that eye before the cataract effects with a RGP contact lens or eyeglasses for best distance vision, so might still get 20/20 even with a little nearsighted target which he does to try to avoid overshooting to farsighted. This surgeon also reduces significantly or eliminates the eyedrops normally taken for weeks after surgery, instead he injects the drugs into the eye at the time of surgery and it lasts for a few weeks.

I'm in the USA, southern California, but my grandmother came from Walsall Wood, England - a little north of Birmingham. I found lots of old postcards her older sister sent her from there 100 years ago. I have found lots of cousins on Facebook still living in that area today.  I guess thats about 60+miles north from you?

So so pleased for you Jenny.  Yes it's a strange procedure and I was paralyzed with fear too having it done.  But it teuly is amazing afterwards to finally see.  I still can't help looking at things in a whole new way.

What type of lens did you choose and Inasdume this was done by the surgeon you liked at NHS?

Yes I too notice floaters more butnknew I had them for years as my optometrist would mention them.  Thinking cataracts kind of blocked them too.  Your eyes /brain will adjust and ignore them again

Congratulations on a successful outcome. I always had floaters that I had to work at noticing but a year ago, something broke loose in my left (repaired eye).  Doc said it wasn't serious but I'd notice floaters for quite a while.  That was the case.  When big pieces would appear, I'd flinch.    Gradually they broke up but I still notice 'em occasionally.  

i just typed a long reply but it's all disappeared!  In a nutshell I feel great.  An Alcon monofocal 10D lens, paid £2,500 for the surgery, preferred consultant, no probs.  Today balancing my vision using -2 contact in the bad eye.  Feels very good.  Eyes a bit tired so will update more later.

Take care Jenny - chat later.   I slept a lot first 2 days.

Hey Sue.An, once again did not realise I had not replied.  Yes, a cornea specialist would be performing the surgery this time - on the 18th.  Have to admit am pretty nervous.  Yes, definitely going with the monofocal.  Having left eye done then wait for healing and results before I touch right eye that had the YAG.

Thank you Mark.  Learn things on here that I would never have thought would be of interest to me.  I can't keep up (cos I don't understand) the numbers parts of most of the posts - I do know what 20/20 is though.  All of you seem to be doing lots of research.  Hope my replacement will be successful

Lots of luck.  Many good reviews posted with replacement lenses.   Keep us updated.  Glad you have a good specialist.

Jenny,

So glad everything is work out well for you!

Since you can read and such, you are probably closes to -2 and not 0D. As the eye recovers, it will change a little.

Glad to help.

This was such a learning process. I have been learning about glasses and such for years, being an anal engineer with -12D :-)

20/20 and 0D are the basically the same thing.

A negative D means you are nearsighted and a positive D means you are farsighted.

As we age the reading goes away because the natural lens stops flexing so we cannot see near things. That is why readers a positive numbers; you are 'farsighted' for the close things.

Hi all.  So, into day 3 post surgery.  Day 1 I felt great.  Yesterday not so great.  The eye was really itchy and quite red.  I rang to check this was ok - nurse said itchiness was fine and to get some dry eye drops.  v important to keep on with the Trubudex or whatever it is 4 times a day.  It was very windy yesterday which bothered me a lot even with my specs on top.  Today the eye feels much better and the redness has gone down.  Still not driving.  I might try later but its very sunny and I don't have a prescription sunglasses ... can still see to arm's length and nearer.  I can see further with operated eye and no lens in the bad eye but to make everything super clear I put the specs on top.  It's weird having to move the specs on and off cos before I wore them all the time and just pulled them down to read.

So you think the surgeon got close to -2 Mark?  Well done him if he has.  I wear the right lens without problem so far.  I cannot say yet if I would want the bad eye done to balance. I did find the op a bit traumatic really so I guess if I can manage as I am I won't be opting for it in a hurry.  I am interested in the night time vision and will pop out tonight to test this.

What news from you Sue, Mark and Griff?  Must say this forum has been great as people don't understand what I am talking about !

So glad eyesight has turned out well.  Yes very important to stick to eyedrops schedule.  Mine was 2 weeks 4 times a day for both antibiotic and steroid drops and then 2 weeks 2 times a day with steroid drops.  You should notice a difference in itchiness in a couple more days.  I didn't experience any redness in my eye but had sensation of something in my eye for a long time in first op (and still occasionally do).  2nd op didn't have any of that.

Yes great to have these forums as family and friends don't want to listen to it all (just wait till it's their turn).

If you are able to manage for 6 weeks - will you be able to get a prescription for a contact lens in your other eye?  I was fortunate I had prescription sunglasses where I had original lenses - wore those a lot.  Even inside house first week or so as everything was so bright.  It does get better in a few weeks.  I have always wore sunglasses prior to surgery on sunny days and driving.  Had 2 prescription sunglasses - one for just the car.  

It is so great you got excellent vision with one eye one.  I know you must be so relieved to have the op behind you.

Yes let us know what night vision is like.  I would imagine you'll be driving soon enough.  were you able to take some time off work?  

Hi Jenny:  Sounds like everything is progressing.  My biggest problem was adjusting to the gap between my left eye (0) and right (-6.5 or -7).  Saw double with one lens removed from my old specs.  That's when I tried the old RGP which got that eye to (guessing here) -2 or so.  Got 2 new RGPs, one for the -2 and one for 0 and find I like the monovision solution most of the time but both work and I'm going to run the monovision option past my surgeon later this month and will go with her recommendation for surgery in Oct if all goes well. Neither solution is right for all situations but at least I know I'll be comfortable adaption to either.  Mark is in favor of the 20/20 and it's hard to believe anyone has studied our (patients' side of this more than he has.  Although I was alarmed when he said he was an anal engineer.  Was he designing the perfect rectum? (Lame attempt at humor here). His advice has been right on and makes me more comfortable with the 20/20 solution that I'm sure my surgeon will recommend. I guess this is a long way of saying I'm thrilled your procedure seems to have come out the way you hoped. Now the challenge is to adapt to this new reality in a way that's most comfortable for your lifestyle. I'm sure I could have phrased this all more succinctly but that's what you get from me at 6:30 a.m. Here's hoping Day 4 gets you settled in even better.

Hi Sue and Griff ...I tried monovision with contacts and didn't like it so I've opted to have -2 in each eye - one with the op and the other with a contact to -2.  Specs on top (-2) for sharper vision.  Defo the right decision.  Yesterday in the supermarket I had my glasses on for walking around, then pushed them onto my head to read the price of things, then back down to move onto the next aisle.  Different but quite do-able.  If i stood 2 feet from the shelf I think I wouldn't have to move the specs.  I will experiment more.

Sunny and windy today so defo staying in.

So glad I got the -2 lens prior to surgery so I can choose to stay balanced, although all is ok without it to which I am very relieved about - no double vision, no headache - probably because the sight in the unoperated eye is so poor my brain doesn't even register the image!

Lol yes hard to think straight so early in morning.  Jenny it just keeps getting better.  Can't believe all the details I see now!  And bright colours.  I kept closing the ne eye then the other to compare difference.  

Have you considered making the specs progressives?  Would less of a correction (tapering to 0 at the bottom?) make the specs a one solution fits all? 

Actually it sounds as if we have a similar situation right now except I'm 0 in the left eye and -2 with the contact in the right.

  For me it works great for everything but fine print in everyday situations and better in daylight or backlit iPhone than in dim light.

   I'm just wondering how long a 70yo should be wearing a RGP!  

I get that reaction a lot :-)

The point was that I have been studying glasses for a while and have been reading and asking a lot of question; the curse of an engineer.

Makes me look at things from too many angles.

I had struggled a lot with all of this. But I kept coming back to same thing: balanced vision. Once I had the YAG in the right, that meant I was 'stuck' with the 0D in that eye.

I actually considered having it Lasik to a -1D; since that was our original goal. That would mean Lasiking the -1.5D as well. That just seemed all sorts of wrong.

But with the -1.5D, and playing with readers, I realized the distance was never going to be clear enough for me to drive without glasses (or to see the TV); unless it was 0D.

I already knew I would need glasses for computer and reading. So with -1D, that meant I would need glasses all the time; that just made no sense for me.

So since I needed glasses for reading, I picked having clear distance for driving and TV.

Cheap readers are everywhere, so not concerned about being 'stranded' without being able read (for times when I forget them while I get used to needing them with me).

And with my friend (my age) and my dad just got theirs done with 0D (and they were happy with it); that helped drive it home for me to do 0D.

But all of that was picking 0D for me. Jenny went for -2D for her, which sounds like a great choice for her.

However, the big key has been that all of us wanted balanced vision; expect for you Bill. That might be the right solution for you, but I heard some things in what you typed that made me think maybe not. So I just wanted to make sure you are giving it an accurate trial before taking that final plunge.

I recall same thing.  Operated eye took over.  Except near vision - unoperated eye could see nearer and took over.  Now things are balanced and I definitively prefer it.

Mine are balanced at OD and I like it.  With Symfony providing that reading range.  I had to read numbers for contact info off back of credit card this morning and had no trouble doing that. I will be curious to see if I will need a prescription for specs on sept 28 at next appointment with surgeon.  I haven't struggled at all with anything (except driving on dark roads).  But that is trade off and since so far haven't had to do that many times va reading I am quite happy.  My private insurance refused my claim last week for IOLs (although they cover lasik up to what they would reimburse for glasses) so I am going to stick them with at least one fancy frame glasses even if for +0.50 readers!!!   I will chose a nice Coach frame I have been looking at.  Their logic made no sense.  I was refused due to these being cosmetic (I suppose lasik isn't????).

Hi all.  Things are good here today.  I've done some computer stuff and the eye feels ok but I wouldn't want to be looking at the screen for hours on end.  Luckily I have 2 weeks off work, more if I need it.  The screen looks brighter (more glare) with the operated eye, which makes perfect sense.  The cat. on the right eye is making it more yellow I believe.

I have struggled this week with bright sun - after I see the cons. today I will book in with opticians to order some prescription sunglasses.  3 times I have had awful stinging in the operated eye, it just comes on.  The antibiotic drops relieve it.  I've also been sent some good lubricating drops in the post by the hospital.

I am happy that I chose to keep my near vision,although I am having to off and o the +2 glasses depending what I am doing.  Yes, Mark, I will look into varifocals (progressives) when eye is settled.  I feel the contact in my un-operated eye could do with tweaking too - probably slightly off cos the cat. there keeps changing my vision.

One thing - my left arm (same side as operated) is achy from shoulder down to fingertips.  2 fingertips feel tingly like pins and needles.  Anyone think it could be more serious that just sleeping differently as not lying on left side yet?  Surely the drops (Tobradex) couldn't cause that?

Hi Jenny - yes everything is so bright afterwards - you do get used to the 'new' view but it takes 2 weeks or so.  I wore sunglasses inside even.  I am fine now with the brightness.  I between surgeries it was very difficult.  I had the lens poked out of one side and although that was ok - not do much at work with computer.  I took a week off work after first eye - worked for 2 weeks then had 2 week vacation.  

I had a bit of tingling too but figured it was sleeping always in my side (had that in pregnancy too).  It goes away after I am up for a bit.  Sleeping with eyeshield and just on one side didn't make for a restful night!

Glad to hear you are managing.  When is 2nd surgery scheduled.

The burning or sensation of something in your eye goes away with time and drops do help with that.

Hi Jenny:  Thanks for the update. I don't have anything more meaningful to add.  My cataract was small but blocking the line of fine vision so I didn't have the brightness issue (things hadn't gone dim).  After the first day (I came home an slept that day) the worst I ever felt was a bit of scratchiness as if an RGP needed to be removed and cleaned. 

      My primary cleared me for 2d surgery but I'm still on the fence (20/20 or monovision).  There's something to be said for continuing w/o surgery because it's just to balance my vision.  Wore the 20/20 contact the last 2 days and it got tiresome having to reach for cheaters just to read my phone--many texts coming in from editor and friends and neighbors hit by Irma in Florida.  

       The one thing I know is that we adapt to our visual situation and you'll be fine 'n comfortable in a few days.

 

All of that, expect the arm thing, sounds all normal. Sounds like Sue had the same arm issues, so glad to hear that is kind of 'normal' for some.

I found I needed sunglasses first couple weeks, then I didn't need them anymore. I wondered it if has something to do with the drops. Seems odd it just goes away after a couple weeks, right around when the drops end. I guess it could just be the eye being swollen.

I was driving home last night and realized one more thing I wanted to mention to you.

With monovision, it impacts depth perception.

So think about the times you wanted balanced vision and if that was really the cause.

Anyway, just another reason I prefer balanced vision.

So now you are up to 5 days total with the 20/20; but they are not 5 in a row. And yes, I can see it still being a pain to get used to.

Sometimes I keep mine on with them slide down the nose.

And I can understand being on the fence. I was there for so long myself. It was a hard decision.

Hi Mark:  We went to the Bob Seger concert at Boston Garden last night.  I went with the 20/20 option.  I could see the stage wonderfully but also could with my right eye closed, just using the surgically fixed eye.  Actually, it almost felt like too much firepower with slightly different vision in each eye at first. Interestingly, my brain compensated for it after a couple of hours and distances seemed equal in each eye. Those of us facing these decisions do stuff like that.

       I'd also had three major text discussions going on--1. with an editor; 2. queries on a Craigslist item; 3. chitchat about power (lack of) after Irma in our Florida condo complex.

   It was a monumental p-i-t-a putting cheaters on and off all night.

    As for depth perception, it's always been a minor issue that I'm used to dealing with.  I started wearing bifocals at age 10 and got used to fielding ground balls and playing other sports with balls and pucks crossing the bifocal line.  Plus my vision always was changing--glasses out of whack, astigmatism axis moving, Rx changing--so I got used to it.

   Occasionally with the monovision now I'll hesitate before taking a step down, just to make sure, but driving and parking a car isn't a problem, nor is bowling, walking, cycling.

    I'm pretty sure I'm going to pursue mono unless surgeon really pushes back.

    I picked up a pair of Foster Grant multifocals today.  Will try them next.

     

Yup, it is a PITA until it becomes second nature. It does take a while, since we have so many years under our belt without them.

There are people that like the monovision, so you could be one of them.

One thing to do it with contacts, but not so sure about doing it permanently with IOLs.

Since you could do 20/20 in both and wear a contact for monovision (like you have been doing), you could keep doing that. That is, get 20/20 in both, then wear a contact the times you would like mono, and then cheaters for long term reading/computer. Not sure if your activities are 'structured' enough for that work.

Glad you are still experimenting. No matter what you do, you need to be comfortable with your decision.

Not sure I could have done mini monovision or not.  Since cataracts affect both eyes - hard to try with contacts and I didn't want to chance it giving me more headaches than I suffer.  Weather changes can bring on severe migraines which is bad enough.  I think that played into my decision to have 0D targeted for both eyes and to do Symfony lenses.  With mini monovision I could have gone with monofocals and eliminated night vision issues.

You are right better make sure you can live with your decisions.

Or if I did monovision, I theoretically could use a contact  (a soft one in this case) to bring that eye to 20-20. Either way, I'll opt for a Toric lens to fix the astigmatism.  I'm sure if I went for 20/20 in the 2d eye, I'd just stay with cheaters..

Absolutely.  The more I think about it, the more I become paralyzed by indecision. 

I can do relate- surgery date was looming over my head and depending on day and what I had read I would change my decision.

In Canada where I live anyways when you want another consult it takes a month to get that appointment and then that pushes out your surgery date.  I was originally scheduled for 1st surgery end of May and then had another consult at my request and ended up with a surgery date July 15.  The one thing my surgeon told me is I cannot change my mind say of surgery or it would be cancelled and rescheduled.  There is someone on these forums whose surgeon is willing to have 3 lenses and eye readings ready for decision day of surgery! Good and hopefully doesn't mix files.  My surgery day I am with at least 15 other people all with same eye needed doing (guess operating room ready for all right eyes or left eyes and surgeon easily does 20 or more in a day.

On surgery day just went with it.  I figured more time would not on my case make decision easier. Only if time meant years to wait for better options.  Hate buyers remorse!!!!

"more I become paralyzed by indecision"

?Totally been there!

?Talking with my friend and my dad (who just had it done with 20/20) helped get me close to doing 20/20. But I did question myself all the way up to the day.

?In the end, balanced vision always won for me. I knew I could always tweak from there as needed (cheaters or contacts or etc.). It is just better optically for me and my engineering brain.

?Don't worry, something will help you 'pick' by the time you need to.

Hi all.  Saw the consultant yesterday for the 6 day check up.  He was very pleased with my eye - he was aiming for -2 and got -1.75.  He said it's healing nicely - the arm ache would be to do with sleeping position and defo not linked to the drops as it is such a small dose.  I can dispense with the night shield now and can sleep on the operated side, wash my hair and go back to the gym!  Right!  (I am not a gym-goer).

Am still adjusting to having different sight.  He said it will take a while.  Today it was sunny - I went for a walk and chose to wear my sunglasses over the +2 specs.  I can see perfectly well without the +2 on top, just need the extra sharpness for driving and telly.

We have no plans to meet again just yet - he said ring when I am ready for the other eye, if and when the cat. gets to the point I want it done.  I don't feel I want it done for balance now.  While I can manage ok with a contact lense I won't rush into surgery.

Am very happy with my decision to opt to keep my near vision.  I am driving fine but must go out at night to see how things look.

I was lucky - I had been given monovision with the contacts and didn't like it so I knew I wanted balanced eyes.  My quandry was whether to go for 0 or -2 and this forum definitely helped.

So glad for you Jenny and happy it was just sleeping position that caused arm pain.  Sleeping on one side did that to me too.  Also didn't sleep well as long as I had eye shield on.  Life will just get better and better for you.

Very nice outcome for you, congratulations!

How long has it been since your cataract operation until you didn't have to use the eye shield at night?

What distance visual accuity did you end up with the -1.75D? 20/50 or higher?

So glad you are doing so well Jenny.

Told you it had to be close to -2D :-)

With the increments the lens come in, that is probably the closest he could have gotten; so that is very good!

I was told to wear mine for the 1 week. At 1 week they checked my progress and remove restrictions.

I could shower the 1 day after.

Are there still any restrictions after one week from surgery?

Like limits to lifting a heavy object or bending down?

I think lifting could be an issue.  Likely light weights but don't try lifting appliances - lol

I was looking into this as I like to run.  I found a site that indicated half the healing takes place at 3 weeks so after a week eyes still healing.  As most patients are older their normal daily activities are different than someone younger whose activities may be much more strenuous.  Surgeons may not have that many younger patients to base their response on.  Was on a diving forum - someone was asking how soon they could dive after cataract surgery.  No one had a response.

Anyways not worth it to me to do anything that would strain my eyes.  I am walking - but will wait likely 3 months to start running again.  

My usual exercise routine is fast walking on a treadmill and using light weights, so I'm thinking that will still be OK maybe after a few weeks rest. I would think 1 week isn't long enough for healing, since the antibiotics and steroids eyedrops continue for 2+ weeks, so I'd think at least wait until after that period.

I'd like to know if there are any things we should do (or avoid) that might reduce the chance of the IOL rotating (important for a toric IOL) or decentering during the critical first month period. Reportedly after the first month, the IOL tends to be locked into place.

Hi there.  I had to wear the night shield for 7 nights.  Now I can have a shower and sleep as I wish but as I still have another week off work I am not going to over do it.  e.g. the gardening can wait.

Re the 20/50 thing, I don't know.  Mark will be able to answer that.  Operated eye has been corrected from -12 to -1.75.  Unoperated eye is still -12 but rather than having surgery straight away on it to balance, as the cat. is only slight at present, I am wearing a contact to bring right eye to around -2,to balance my vision.  Today I started walking downstairs with my -2 eyes and thought Oh, I've forgotten my glasses!  Now that's a first!

Morning Sue.  I am interested in how bright you are finding things and if you have found that to settle down now?  I am at the desktop with sunglasses on as I do find the screen rather bright.  I shall look strange at work if it doesn't settle!  Should I ask them to get me a screen filter maybe?

I really must go out tonight to see how things look.   How are you getting on?  Do you think as time goes on your eyes are adjusting to the night driving or is the situation pretty static?

One more thing - when did you start wearing foundation and mascara again?  

Lol Jenny - I still sometimes forget and reach for my glasses at night.  I like to watch the TV for a bit before drifting off to sleep and on more than one occasion I reached for glasses and suddenly remember I don't need them.  Too many years wearing glasses I guess and old habits die hard.

Yes things settled down for brightness but took about 3 weeks or do after each surgery.  With a 6 week wait between surgeries seemed it was just starting to get better and I had 2nd surgery.  Now 4 weeks tomorrow I am ok inside without glasses.  Never thought about getting a filter for computer but I did wear sunglasses at work - didn't care if that looked odd.  I have 2 walls of windows around my desk so it was too bright even after turning brightness down on monitor.  I do still wear sunglasses to drive orbwhen I am outside.  Had that before cataract surgery - always thought that was curse of blue eyes.   Even in winter I will wear sunglasses outside.

As far as night vision it seems to be getting a little better or I am just coping better.  I drive around the city after dark and with streetlights I do better than before surgery with cataracts.  Only situation where I find it difficult is night driving on dark roads.  Glare from oncoming cars very bright.  When I have a left turn to make judging distance of oncoming car a little hard .  Can't tell how far car is and if I have enough time to make the turn.  I just wait till car passes if I am unsure.

How is driving for you with monofocal lens? Do you see glare or is it fine?

I was reaching for my glasses every morning for a month or so after free agency. 

   With monofocal setup, I don't find glare or night driving much different except that I see better at distance with one IOL that I did in a lifetime with glasses. 

    Likewise, after adapting to bifocals as a kid and progressives later, depth perception is OK, too. 

    But I always have hated taking left turns into dark streets or driveways at night. Part of it is the way headlights are set up to avoid blinding incoming drivers. 

    Still unsure how I'll have second surgery. Emotionally, Insant to keep the monovision, just w/o an RGP lens in my eye. Logically, having a 20/20 or 0D fix makes sense, but reaching for cheaters all the time will bother me (maybe I'll be that guy wearing them on a string around my neck). . 

When do you have to have 2nd surgery?  Or is cataractb out so bad that it can be put off?

Not sure when my thinking started to change.  Rather than focusing on things I would miss started to dwell more on things I will be able to.   Things like running and walking without glasses - especially running - having to wear s band to keep them from slipping down.  Looking forward to going snorkelling and being able to see - not just watching playback on GoPro.  

The new normal for night driving is already improving bit by bit.  And one day when I am retired I will chhosevto drive more in daylight anyways.  

Perhaps think about what you'd prefer rather than what you'd put up with.  

If you have a great monofocal and get good distance with that eye you might want to consider a multifocal to give you near vision without doing a monovision.  The monofocal lens will minimize the night time glare and halo from the multifocal as well.  

Anyways just food for thought.

Hi Sue.An   When I broached multifocals before, surgeon said she didn't do them because she didn't get her ideal result (20/20).  Thus I forgot about them.  I'll bring it up again.  Have pre-op on Thursday, just about a year after the first surgery.  

     I like your optimist's approach: "Think about what you'd prefer (glass half full)."

     I like not even thinking about glasses all day (w/monovision) unless it comes time to do computer work (prefer that).

     I prefer putting glasses on for a long computer session (once or twice a day) to bring down my 20-20 eye to having to put on cheaters 40-50 times a day to read papers, check phone, read labels in stores, etc.).

     Maybe it's because it's what I'm used to.  Night driving, surprisingly at my age, is no tougher than it ever was.   Dark/rainy nights are tough, but most roads are fine.

 

Hi - sounds as though your  surgeon doesn't have a lot of experience implanting multifocals (does that include Symfony too as they aren't classified as a MF but many surgeons lump them in that category).  If you are comfortable with this surgeon it is likely better staying within their comfort level and what they have confidence in).  If you were convinced a Symfony or multifocal is the answer for you perhaps a consult with another surgeon that does a lot of these would be best.  Can't stress enough that the surgeon's skill is key to a great outcome.

If your goal is to rid yourself of glasses most of the time mini monovision would certainly accomplish that and give you better odds against any nighttime glare and halos.  If you're OK with a bit of that for the opportunity to rid yourself of glasses then find a really good surgeon who is confident in implanting these.

I have to say my surgeon was confident in his skill. I never really felt though he helped me make a decision.  He just explained what outcome would be with monofocals and multifocals (and he was spot on in his description).

It was only at my 2nd post op that he said he sympathized with how how hard this decision was for me but didn't want to influence me.  He did say he was in his 50's too and personally if he had to make this decision for himself he would go with Symfony lenses as in his opinion they are the best that he has seen on the market and patient satisfaction with them if they know in advance what outcome to expect . I asked if there were any better in the pipeline in Europe and his response was there isn't the real breakthrough yet.  There was hope with the LAL(light adjustable lenses) but so far in trials they haven't lived up to hype.

I am confident no matter which way you decide you'll be pleased.  It will be a relief to have it behind you - you'll get on with everything you enjoy without constantly weighing pros and cons.

I expect we may have to recalibrate our computer monitors and TV sets after cataract surgery, since the eyes become more light sensitive and you also get more intense blue end of the color spectrum.

Most computer monitors and TVs can be adjusted to reduce the brightness/contrast and color balance to reduce the blue level.

Question for you, Mark & Hawk:   If I were to opt for a Symfony/monovision/Toric  solution in my right eye, would I still have the option to wear a contact lens down the road if I needed to tweak distance vision?

I believe you can wear contact lens should you wish to correct/tweak for distance once eye has healed from cataract surgery - barring some other eye aliment that would prevent you from wearing contact lens - in which case you'd need glasses.

In my research on that I came across contact lens use for cataract patients where  an IOL was not inserted.  These are predominantly used for babies and young children but also for adults.   Wonder why an adult would go that route and if the person changed their mind can they have an IOL implanted later?

Today I finally got the entire sequence of appointments setup for my right eye cataract surgery!

The surgery date is 10/24 @11am and was told the surgery takes under 30min, and then rest for up to 60min before going home.

I have the cornea measurements pre-surgery office appointment a week before the surgery and a pre-op mini-physical exam by a nurse practioner next week which is under 30days before the surgery.

Only two post-op followup office checks scheduled, 1day after surgery and 2weeks after.

They are also sending a Rx to my local drugstore for the two non-generic eyedrops that only require 1drop each per day for the 4weeks after surgery. The reason the does is so low is the doctor also does a one-time eye injection at the time of surgery as well. 

They told me if the copay total for the eyedrops is over $100 to cancel the Rx order and call them to get them at lower price.

The names of the Rx eyedrops are:  Durezol (steroid) and Ilevro (NSAID)

 

Be good to have this all behind you.  Like the drop regiment.  I finished my last ones last week and sure glad that is over with as I had many more per day.  Yours sounds much easier.

So the big question- have you decided on a lens?

I know what lens I want for the right (dominant) eye: target for good distance vision with a Tecnis toric monofocal since that eye has almost -3D cylinder astigmatism plus only a little nearsighted about -1D.

However the final IOL decision won't be made until after the cornea measurement procedure 1week before surgery, thats about one month from today.

Yes, unless something odd happens with your eye.

?The only thing on the outside of your eye is the cut to put the eye in. So unless you eye isn't happy, a contact should be just fine.

?The eye should heal just fine. When I had my IOL replaced, it was a year later, and he couldn't find the previous cut; so the eye heals up well.

?So just like glasses correct vision after a IOL, so can a contact.

 

I'm finding Sue.An's suggestion of a multifocal for the right eye pretty interesting. Any thoughts on drawbacks?

I have heard those can be tricky.

​They said to try a multifocal contact first. If you cannot tolerate that, then No for IOL. If you can tolerate it, then maybe yes for IOL.

​

​Not sure if would be good to mix IOL types.

​Have you had your measurements for the 2nd eye done yet? If not, they say you must not wear a contact in that eye for 2 weeks before measurements.

I've worn an RGP every day for a year. Have no other vision solution. Couldn't go 2 weeks with that imbalance.  I guess I'd better call the office tomorrow and see what happens. This could delay/pp/cancel things. 

Hi - just to weigh in - yes true you shouldn't wear contact lens a good 2 weeks prior to measurements.

However multifocal IOLs not same as contact lenses.  I couldn't get used to multifocal contacts but have had no issues adapting to Symfony.  Going to do a search - but thought I read someone saying on these forums that it isn't the same comparison.  I think you can try out monovision with contacts but even that it is tougher than with IOLs.  Perhaps it is placement.  As I am not 100% sure going to research that.

Hi with a simple google search there are many sites that confirm multifocal contact lenses is not a trial for multifocal IOLs - here is one cut and paste.  Not sure that helps you in your decision or not. lol 

Eye care professionals often mistakenly believe that a multifocal contact lens trial can indicate whether a cataract patient is a good candidate for a multifocal intraocular lens. For many reasons, this is simply not true. For example, if a patient has a cataract, their vision is going to be blurred no matter how well the contact lens is fit. Also, elderly patients are more likely to have ocular surface disease, which can cause fluctuations in vision with multifocal contact lens use.1,2 This also occurs with IOLs, but to a lesser extent. 

Keep in mind that multifocal IOLs have different optics than the multifocal contact lenses we have available today. Also, multifocal contact lens wearers can be plagued by other fitting problems. Multifocal contact lenses, for example, can decenter and flex while on the eye affecting visual acuity. 

Thanks. Tomorrow (call to office) and Thursday (pre-op) are going to be interesting. So would bowling w/o a contact!

Haha - it sure would!  Best of luck to you.  We'll all be waiting to hear how that discussions goes seeing we can't be a fly on the wall.

Bet you'll be glad when all this is done with.

If I have real misgivings, I'll renege on surgery for now.  Of course, they may postpone me when they find out I've been wearing a contact. But there's no other option.  I can't walk around with a -7 uncorrected right eye.  I'm doing OK--better with the monovision contact than the 20/20. 

With surgery date not till October they can take measurements later.  This can be a fact finding mission for you tomorrow and get real expert advice other than from all of us wannabes!!!

But folks here at least give their opinions. Hard to get surgeons to open up.  Meanwhile, we're on hurricane watch here in Boston with Jose and maybe Maria to follow. 

I know watching news now.  Jose will likely have an impact here too in Atlantic Canada.  Also concerned about Hurricane Maria - looking like a direct hit in Puerto Rico.  I have cruise planned for Jan out of San Juan.  Hoping hurricane takes a turn but not looking good.  All those poor islands that were hit with Irma are bracing for round 2.

Time to be a dentist tomorrow and start pulling teeth for info - lol.  They don't like to influence decision - at least mine didn't.  so I started asking questions like is there any hint of an issue with my eyes that would indicate I am not a candidate for Symfony lenses.  I told him I was ok to go on wearing glasses as I had been wearing them most of my life.   It would be nice to be glasses free but not mandatory and certainly not worth risking if there was anything in my test results.

Not only San Juan, but have the other islands on your itinerary survived in shape to be cruise stops?  We took a cruise each year with friends until ships got so huge, then opted for a small condo in FL and warm winters😏 One of the good/bad things about cruises is that you think they'll last forever about 3 days in, then find yourself back in a warehouse filled with luggage and a ticket back to Frostville in a rude return. But they do help take the sting out of a long winter. Hope you have a great one. 

Fingers crossed the other islands look ok Bonaire Aruba St Lucia and Antigua (which was hit by Irma but didn't sustain a lot of damage and port is open).  Hoping San Juan is spared this time.

I know what you mean by mega ships.  Did one on NCL escape last March - not for me.  Jan one is on smaller ship.

Can't wait to escape winter even if it's only for 10 days.

Hi all.  My surgeon said I could try bifocal contact lenses after surgery although I am not sure they will suit as I still have astigmatism in the right eye (unoperated) and the bifocals are soft lenses (I wear RGP).  I will know a lot more in a few weeks when I go to the optician.

I am struggling in the supermarket with these single vision glasses.  Much off and on-ing as I go round.  I defo need bifocals or varifocals or something in the long term.

Otherwise very happy - the eye feels good.  3 drops/day now.  Sunlight not as bothersome but when I go walking on a sunny day I have to choose between the +2 specs and sunglasses.  This too can be fixed when I get 'proper' glasses.

I was told not to wear a contact for 4 weeks prior to surgery.  My surgeon has taken the measurements for the right eye so they are ready for surgery whenever it happens, thus allowing me to balance out with the contact now.

Hi Jenny - hoping a good solution between glasses and contacts can be found so that you don't have to have 2nd eye done.  I had no choice due to cataracts in both but during that 6 weeks having to wear glasses full time just to balance eyes was enough for me to stick with goungbfor a Symfony in 2nd eye vs a monofocal to help balance out the night time glare and halos.  Sunis setting earlier now and doing a fair amount of driving in the dark and finding it ok - not sure if I am just adjusting to it or glare is less - likely but if both.  But glad I can drive at least!

I really think it is harder on those younger and still working full time. Can't choose when you are going out.

If you find this interim time hard managing with glasses or contacts you might want to take another look at the premium lenses.  

Off to work now - have a good day Jenny!

Correct, not exactly the same.

The problem is, a multifocal is not like anything else. So the closest is to try a contact.

Of course, the cataract will impact the trial. However, not all cataracts are in the middle and not all cataracts are large. I believe Bill's isn't too bad yet; so it is worth trying.

And yes, a contact moving around impacts the trial. But that should be taken into account and discussed as part of the trial.

Also realize, the same thing can be said about monovision as well. If the cataract is bad, it impacts trying that as well. The 'blurry' eye will impact the brains ability to 'switch' to it.

What eye doctors should be doing, is that once a cataract is forming, they should be talking with their patients about IOL options, and having people try stuff before the cataract impacts trying things. Of course, not many want to talk about IOL options when it is time for surgery, so we know this will never happen :-)

It is hard enough trying to decided between monovision and both at 20/20, how does one throw a multifocal into the mix?

I still wonder about mixing a multifocal with the monofocal; not sure that is a good path or not.

Trying a multifocal contact is something I should have thought of and tried 6 months ago.  I know it's expensive ($350 fitting fee), but possible for me. My right eye surgery would be to balance vision.  Cataract is small and off to side. No issues with halos, and colors seem about as bright as in corrected eye.  

On your last point, Mark, my surgeon said categorically he does not do multifocals so if I wanted him to do the 2nd eye it would have to be a monotfocal or an extended range lense (if he would do that).  I think he sticks with monofocals as he gets the best results and less dissatisfaction.

Question - I have a voucher for my opticians for 50% off glasses.  It runs out on 27/9 which is only 18 days since surgery.  Do you think my operated eye will be settled enough by then to order new specs and get the discount or could it be a false economy if prescription then changes?  (Surgeon said to go 4 weeks post op).  50% off varifocals could be about £150 - 200 I think.

Interesting similarities.  I got the same response/reasoning from my surgeon a year ago.  It will be interesting to see what she says this time around especially where I'm also happy with monovision.   

     As for the optician's voucher, I'd visit the shop and explain the situation and offer to pay in advance, if necessary.  That being said, my vision was 20/20 in the corrected eye on the first followup visit (the next day? or next week?) and didn't really change.

    I hope you find a solution that makes life a lot easier.

Do agree / wish optometrists were part of this discussion as it won't happen (at least here in Canada with our surgeons spending 3 days a week in hospitals doing surgeries and no time for consultations).  

Optometrists on other hand see you at least every 2 years if not yearly and should be ones to mention trials when you are a certain age cataracts forming or not.   My cataracts were in middle and affected my vision right away.  My optometrist that diagnosed these in Jan was one I had been seeing for 8 years and when she saw

Look on my face she said you'll recall I said your pics were a little cloudy (I had no clue it was cataracts) since that word wasn't mentioned).  Water under bridge now.

Yes hard to know who will adapt and who won't to monovision or multifocals.

I do know with Symfony - was told by my opthamologist there is no learning curve for brain to get used to these lenses like multifocals- likely reason I went with these bs a multifocal.   I recall year when optometrist put a low prescription in my glasses (progressives) to help me get used to them and I didn't like these.  Ground seemed to be wavy like the sea when I looked down.  

Contacts usually covered by insurance - at least my private insurance would cover those (just not my Symfony lens - which is whole other story).  If your cataract isn't bothersome- there is something to be said about holding out for a better lens to come along.

That being said I am not sure a multifocal IOL is as hard adjusting to as a multifocal contact.  For Symfony my opthamologist said there is no learning curve.  

Progess!  Spoke to the optician who was most helpful.  He will extend the voucher to end October and has booked me in for my post-op check up mid-October.  He suggested I have the other eye done to balance sooner rather than later - his reasons were being younger and healthier, and being the begs of a cat. it would be easier to do.  He said he didn't rate varifocal contacts much and anyway being a soft lens I couldn't have them because of some astig. in the unoperated eye.  I have a friend who wears them and loves them so to give myself the chance to try them I would have to have the second eye done.  He was surprised I didn't get it done on the NHS - sympathised with the cancellations.

I have to say that I have found my optician(s) are the ones who will give me the most time and have a real depth of knowledge about how to live with different vision on a practical level in every day life, and what will work with glasses/contacts etc.  My optician was the one who said you need to get a c/lens and +2 specs ready prior to surgery.  Neither of the 2 consultants I saw prior to July mentioned this.

 I was going to say "Score 1 for the optician," but it's more like "Score 3."  Nice work.  I, too, have found the opticians give the best advice.  I think I'll take my spex down to be adjusted just to talk to the techs (opticians)....

 

That's good news.  Will you go through NHS to see about your other eye?   Wasn't the surgeon who did your first eye also work for NHS?  Hoping you can save yourself some funds.

Glad you'll be able to use your voucher To get a discount on some glasses.  Are you taking some sick leave to work through all this?   I took a week sick leave and 2 weeks vacation.  Found it hard to go back looking at a screen and spreadsheets with just one eye done.

What sequence of events happened on the day of your cataract surgery?

I was told first you wait with others until its your turn for the surgery, during this time you talk with the anathesiologist.

Then the surgery takes place, typically takes under 30min.

Then you rest there for up to an hour before you are discharged to go home.

I know they put an eye shield on at the end of the surgery. But how long do you have to leave it on?

I know you are supposed to have it on while sleeping for a week or more, but what about when you are up and not sleeping, can it be taken off at those times even the first day or week?

How about the next day checkup at the eye doctor's office - do you wear the eye shield there or is it ok to be off?

Sequence of events was same both surgeries.  Both done at hospital.  I was given a check in time.  There I registered- they took my Medicare card and had me sign a bunch of paperwork (waivers) and put a hospital bracelet on my wrist and then I went to another part of the hospital near the operating rooms for cataract surgery.  Down that hallway there was a waiting room where I sat with 8 others.  Nurse comes into waiting room and puts dialation drops in your eye- 3 separate times about 15 or 20 mins apart.  After 2nd drops she lets me know I can take my Ativan.  Most of the others didn't bother with Ativan.

Nurse fetches us when it's time and takes you to operating room.  Prep time is about 10 mins.  They got me to lie on a very low to ground table.  Surgeon  anathesiologist are there. Although no needle or anything placed in your arm.  A monitor for heart rate is placed on your finger and then you are covered with these surgical drapes with section that is a plastic window over your eye that is sticky.  Nurse peals back the plastic .  Under drapes is a pipe with oxygen to help you breathe better.  And then nurse pours 2 vials of liquid on your eye to freeze it.  Eye is dialated so already blurry so didn't feel or see spring to keep eye propped open placed in my eye.  A big machine rolls over your head and surgery begins - about 8 mins and it's over.  Feel slight pressure that is all.  i could see the whole time 3 circles within a pink reddish light.   I kept focusing on circles like surgeon told me to.  He chatted with me which helped.  I could see the rings of the Symfony lens as it was unfolding in my eye (a little freaky) and asked him if that's what I was seeing and he confirmed it was.  

When lens was implanted nurse removed drapes and taped an eye shield on my eye.  Handed me a list of instructions which included to wear eyeshield for 2 hours after surgery and every night (or nap) for a week.  No waiting at the hospital - just head home (with a driver).  Perhaps because no one is on an IV - not sure but no one stays for any period of time for observation after surgery.

Next day it's back to hospital with same group of people as previous day in another waiting area (same group of people 2nd surgery too.) Guess they set up equipment for all right eyes one day and next it's left eye.)

At 24 post op they test distance vision first then more waiting.   Then  see surgeon who examines your eye, answers questions and off you go home again.

Only difference at 2nd post op is my reading distance was also tested as surgeon said Symfony lenses work better for reading after 2nd eye done.

At 6 weeks which is next week I will have another checkup at opthamologist office where again he will test my vision then dialate  my eyes and examine them.

I am sure process my be different in a clinic.  Here it's like a big processing line.  Our surgeons are very busy.  I know that is why they can't devote much time to consultations.  I am pretty sure mynsurgeon spends min 3 days a week in operating room doing cataract surgery.

Hey I'm a little curious this quick question is for everybody, Do you guys do any special ORA or laser cataract surgery? I'm pretty sure the place I'm eventually gonna get mine @Kaiser Permanente is just the traditional method done by the hands of the surgeon. It seems that most people from what I read online seem to prefer just the standard operation as well with no extra bellls or whistles. Seems to be cheaper cost and some say laser isn't much of a difference anyways? IMO Might have an edge to the outcome butI'm not sure Is it even worth it to try to go to a place that offers all the lastest state of the art equipment (ORA, laser,)? 

Thanks very much for that very detailed report, helps a lot to know what to expect!

Yeah sounds like your eye surgeons do a lot more cataract surgeries per week - the ones I got consultations with all had the same schedule, only one day just for surgeries per week and the other days were in the office. The post op checks are done at the doctor's clinic office and I got those scheduled only a couple miles from my house. The surgery clinic is at a different location almost 20miles away, as is his other office where I have to go for the pre-op measurements since the clinic close to me doesn't have all the equipment for that I was told.  This surgeon also does some cataract surgeries at a separate hospital as well I think he is only there once a month and thats where they have the femtolaser for the extra cost laser assisted surgery, at the clinic once/week he does the standard (blade) cataract surgery but does have ORA there as well.

I got 3 consultations the last few months with top local eye surgeons.

The first one had all the "bells and whistles" with all the latest most advanced equipment (femtolaser, ORA, all premium IOLs, and more) plus lots of LASIK experience too.  That place was clearly the premium clinic with good reviews, but the highest prices requiring a "premium package" over $2700 extra on top of the premium IOL and other costs.

The second one was at a highly rated clinic associated with a local university but they only did standard (blade) cataract surgery but had ORA as an option, as well as various premium IOLs.  Their prices were more reasonable than the first due to no femotolaser.

The third one was kind of in the middle of the other two, femtolaser was an option but standard (blade) surgery was available and more common, as well as ORA available with either. This surgeon had extensive experience in all the premium IOLs I was interested in especially the Tecnis toric and Symfony IOLs as well as the accomodating IOLs (Crystalens, Trulign).  His prices were reasonable except for the extra cost for femtolaser, that alone costs as much or more than the premium IOL price. So I am going without femtolaser but with a premium IOL, also ORA since that only adds a reasonable $300 extra cost that allows the surgeon to confirm the refraction result at the time of surgery when he can make any adjustments if needed.

Femtolaser is claimed to produce less trauma during the process when the natural lens is broken up with ultrasonic energy I believe, also can make possibly more accurate and smaller corneal incision(s) that don't depend on the surgeon's skill with a blade.  But a highly skilled  and experienced surgeon is reportedly as good, so the high added cost of femtolaser is not considered worth it in most cases. But that all depends on the surgeon and the IOL being used too.

You're welcome.  I had watched the surgery online prior to mine - some aren't draped like I was.  That kind of surprised me and I felt a little claustrophobic.  

  Yes my surgeon is very busy / and why I couldn't get many consults and if I did want them had to wait and push out surgery date.  I am sometimes envious of you guys in USA.  Lots of options although it comes at a cost .  Our local hospital I researched online was fundraising in 2015 and 2016 for ORA equipment.  The article about it had quotes from my surgeon.  Makes me wonder whether they now have and use that equipment.  Can it be used with phaco and laser assisted surgery I wonder?    Or is it for pre surgery measurements only?

Sounds as if you have some good options to consider.

Hi - in Canada I don't think too many provinces have that kind of equipment for cataract surgery except in the larger cities Vancouver Toronto Montreal.

 There are plenty of articles online about the added cost and for now it is not covered under Medicare.  At one point prior to 2012 even premium lenses were costing people various prices depending on where you live.  Now these are bought through the hospitals and no mater where you live price is same to stop price gouging.  The added benefit is they are discounted for cost of a monofocal lens which would have been covered and because hospitals buy in bulk overall savings realized too.  

Guess when you have more options (a good thing) available choice becomes more difficult.

For me knowing surgery would be traditional it was important to find a skilled surgeon.

Sue.An nailed this except my fellow patients all were separated a bit. It was a good reminder about what awaits me in a few weeks.  The eye shield is so you won't poke yourself in the eye while sleeping.

Sue covered the day pretty well. Mine was slightly different.

Given a time to show up; they take my money, sign a couple forms, get wrist band.

Sit anywhere from 15min to 1hr before being called back and put on a gurney

They confirm which eye is being done (put a black dot over that eye); do all the drops and goop at that time; put in thing for an IV line (although no IV is connected, they put the anesthetic in there and for pre-caution in case they need to add more later during the op); place oxygen tube.

My lens was put at the foot of the gurney.

Surgeon also confirms the eye (another dot on your forehead) and he looks at the lens box.

I'd say all of that took from 15min to 30min.

Then they wheel you into the room and do final prep (lay the blue clothes over you, etc.).

Then the surgeon comes in; haves you look at the 3 lights (sometimes looks like 1).

Mine talked with me; then he got to a point where he said to be quiet.

That part was 15min.

Then they wheel you into recovery, where I got juice, cookies/crackers. My driver was given the post-op instructions. They you go home. Maybe 15min in recovery.

I did not leave with an eye shield; only had to where it when sleeping.

I just got a plan monofocal, so no toric. So not sure ORA is even needed in that case. I when eye being so blurry no way for me to know if he used one or not.

I just got the normal slit incision, didn't even know there were other options.

My surgeon does it 3 days a week. He typically does 20 eyes a day, for 2 days, and works a half day the other day.

Glad you continue to have good progress on all fronts.

My optometrist is very good, and takes time to talk about options. He was the one that suggested I target -1D. He said a lot of near-sighted people wished they had some near-sightedness afterwards. But the bigger concern is with me being -12D, because of all the errors, you want to aim nearsighted otherwise you might end up farsighted; which I did not want at all. Of course, I later learned that the IOLs only come in certain powers and that is where most of the error is; plus some variation in how the IOL ends up sitting in the capsule.

We skipped over toric because my astig was so low and he expected it to be gone post-op (the incision can 'fix' small ones). I suspect, my high power also was a reason.

He also knew how picky I am about my vision, so that took multi-focals off the list.

My surgeon was also great and would talk. He too use to be around -14D, so it was great to get his perspective. 

Or rub your eyes.  I am bad for that!

The patients all get chatting in the waiting room (it can be for over 2 hours) and I was with same group of people for 2nd eye done - it's like old home week- ha ha

Like the juice and cookies - could have used that.  I was awfully hungry by time I got home!  Had to check into hospital at 5:45am and only got out of there at 11

I am bad with rubbing my eyes too.

For my first eye, after the one week mark, I slept without the shield. I woke up that night and was pretty sure I rubbed my eye, or at least dreamed I did. So I wore the patch for an entire 2nd week to be safe :-)

 

Did the same thing - wore shield at night 2 weeks.  Doesn't help I am a sound sleeper so I don't always know I if I rubbed the eye.  Bad for scratching eczema too.  

Hi Folks:

      I've now had 2 updates "vaporize" before I could post them.   Surprise ending to today's saga was surgeon saying:

     1. She'd correct right eye for either monovision or distance but wouldn't mix a multifocal with the monofocal (distance) IOL in my left eye.

     2. Then she surprised me by saying, "You've adapted so well to monovision with the RGP that I don't recommend surgery at all.    That eye hasn't changed in 3 years, the cataract is small and off to the side, and your vision is correctable."

     3. When I brought up her prior statement that balancing vision is a valid reason for surgery, she said, "You've accomplished that on your own."

      4. Her finishing shot was "Very few people leave this office without either a date for surgery or a glaucoma treatment regimen.  So be happy and come back to see me in 6 months."

     5. Meanwhile, I'd decided to go with a distance monofocal IOL to balance things after sitting down with 2 trusted opticians yesterday. One said, "Then, if you want monovision, you could even use an extended wear soft contact."

    So my status is quo, so to speak.

Well that's a surprise.  Can't tell if you're pleased or not.  does this mean you'll wait another 6 months?

     Still trying to absorb this one. Last spring, she told me that "balancing vision" is a valid medical decision; however, for some reason, she is reluctant to operate on this eye. It was this mixed message that led to today's surprise.  I was there for a pre-op with the procedure scheduled for Oct. 4.

      The flip side is that it's nice to know all's OK with  the eye.  I don't have any issues with night driving or faded colors.

     My biggest issue is that the RGPs get "scratchy" in my eye when I spent a lot of time at the computer or reading, but I can go along with it for a while longer.

     I made the next appointment for next June, after we get back from Florida.

      I've got plenty of lenses so I'll need some Boston cleaning/storage solution instead of new cheaters.

     So, for now, I'm on hold and OK with it.

Yes and also give more time to think.  Always a roller coaster ride with adjustments.  

Keep in touch - wishing you the best.

The way I read what she said is that since you are happy with monovision, why bother getting the surgery. So if monovision is your goal, then she probably wants you to wait.

Now that you have talked with opticians and decided you would want balanced vision, and fall back to a contact if you really want mono (which I believe I had said :-) ). So that sounds like a decision, which is good.

She probably could sense your uncertainty about what to do. So of course she is going to say you should do nothing, they do not like to operate if it can be avoided; they must all be trained to do that. But if you go back and know exactly what you want, I am sure she will do it.

But I would say it sounds like you had a good day. Now you can think about what you really want to do. And you will probably know by the next appt. It kind of sounds like you are disappointed that she said to not do the op. So if you continue to think that way, then that might be just the push you needed to convince yourself that you do want the surgery.