Normal 42 year old one week to Posterior Subcapsular Cataract next week.
Posted , 12 users are following.
My wife is 42 and one week ago on waking up she saw blurry (more in left eye). We thought oily gland or something but it would not go away for almost the entire day.
We thought she needed glasses so headed to eye doctor and she was diagnosed with cataract "Posterior Subcapsular Cataract" in BOTH eyes 😦
Now here vision is back to almost normal but if she covers the right eye there is still slight blur but not like the days this all started one week ago.
She is not diabetic, nor a smoker, cortisol taker or alcohol drinker. Actually she is very sporty and healthy person. It seems it is genetic as her mum got it at 40 something too and grandfather too.
We have initial appointment with eye surgeon in 2 weeks time and I am trying to get as much info as I can for this meeting and to make the right decisions for her. Hence I am here and have some questions-
I am Europe if that is relevant and she does not drive-
- Is "Posterior Subcapsular Cataract" hard to treat on a relatively young person?
- Who makes the best IOLs that are reliable and excellent quality?
- Definitely go for Femto laser for the cut or not stress over it?
- Wife is group fitness instructor and also works in office. Would long distance mono IOLs in both eyes be the best and safest option?
- Mulitfocal IOLs too risky?
- Does long distance cover distance to computer screen?
- How come she is seeing relatively good right now compared to last week when it all started? Is the better eye and brain compensating?
I will have more questions probably but THANKS YOU FOR ANY ADVICE!
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0 likes, 119 replies
tamarinda W-H
Posted
Hi Husband!
Just seeing your first post now. Have a few thoughts. Firstly, that the suddenness must be so upsetting. I was upset with my first diagnosis too, when I was about 47. Alas, even though I knew the fix wasn't so hard, it still felt like extreme premature aging. Apparently while cataracts are mostly age related, truly that age begins in one's 40s. Except for those who are born with cataracts or who get traumatic cataracts. At any rate, the shock is understandable.
Why proceed with surgery right away if her vision is actually better? I was told there is little downside to waiting with cataracts (although not waiting forever...as they get thicker they do get harder to remove...mine was a "third world cataract" and I was lucky to have found a surgeon who had experience working in the U.S. with immigrant populations from Latin America, so he could handle the ultrasound carefully.) I don't know the natural course of her particular kind of cataract...but usually we aim to treat the patient, not a clinical finding, unless it's likely to worsen outcome by waiting.
I was told by my mother's ophthalmologist that laser incision was worse than standard and should be avoided. My own ophtho confirmed that. I'm surprised to read on this forum that so many people are getting laser. I thought outcomes were a bit worse.
I need to check with my mother who got monovision many years ago, as to what distances they chose for her. She may not know. She has zero complaints, although she's less OCD than I am for sure. Never checked the differences between her eyes, and says she only needs glasses in poor light conditions sometimes. Drives, sees the dashboard fine, reads, all without glasses. She does have some astygmatism, though (always wore hard, then semi-permeable, contacts), so maybe that's helping her near vision as I've heard it does. There was no LASIK at that time so it's almost surely not corrected. She does note that she "can't thread a needle", so clearly the binocular vision is more important up close for us than it is at distance.
PS: I just heard from a former classmate who said she was just diagnosed with early cataracts. She's a landscape painter, age 50.
tamarinda
Posted
Aw, shucks, posted before I read your updates, sorry...
I understand why proceeding now, so don't answer that.
Glad she's happy with the monovision idea.
Re: the two surgeons. sounds like one is a resident and the other is the attending,. A resident would of course want to be present for a case, as she is still learning. Doesn't mean she would be worse, just means less experience. Ophthalmology residency is four years total, one year of internship somewhere (one can choose surgical or medical internship as they wish) and then three years of ophtho. She's likely at least a second-year optho resident. You should feel free to ask exactly what her training is.
I personally chose a community doctor because I figure cataracts are pretty bread and butter and didn't want a resident operating on me. But of course maybe they're not so simple for younger folks like us where we demand a lot of life and want it all.
W-H tamarinda
Posted
I would not say that she is happy with mini-monovision idea. She panics about making the wrong choice. She goes through ups and downs.
She was reading some of the procedure and risks paperwork from the second surgeon and it made her super sad.
janus381 tamarinda
Posted
Regarding laser vs manual cataract surgery, I don't think it is fair at all to say laser is worse, and large studies do not support that statement at all.
Search
For excellent summary search: "A Review of Laser-Assisted Versus Traditional Phacoemulsification Cataract Surgery"
"According to a number of studies femtosecond laser surgery has the potential to improve the precision and reproducibility of corneal incisions and the capsular opening. It has been documented that LCS reduces the amount of ultrasound energy required for lens removal. The reported rate of complications is low and there are limited contraindications. Visual recovery and refractive results are promising. There are, however, a couple of challenges facing wider acceptance of the femtosecond laser in cataract surgery. The economic aspect is of importance. The higher costs are a barrier to wider acceptance by surgeons and clinical centers. "
For a good review of opposing sides of the argument search "Surgeons hold strong opinions for and against FLACS vs. manual cataract surgery"
The argument against laser economic.Added cost for clinic/hospital to install and maintain equipment. and added out-of-pocket cost for patient. From a cost-benefit perspective, there is no benefit to the patient. But if cost is not a concern, there are incremental benefits, particularly for difficult cases. If you ask any surgeon who does both laser and manual which they would choose for their own eyes, they would all say laser.
W-H janus381
Posted
I agree with the above but I do hear quiet a few very experienced surgeons prefer non laser option for some reason. Maybe habit?
soks janus381
Posted
hand drawn circle of 5.5mm or machine drawn circle of 5.5mm.
tamarinda W-H
Posted
That paperwork has to list even the slightest risk, so take heart. For example, "infection" is listed as a risk of anything where skin (or cornea in this case) gets entered. Even putting in an intravenous line has a risk of infection but the only place Ive seen ti was a filthy disaster zone. Surgery is very advanced now. THAT part will be fine.
I took heart in knowing a lens can be exchanged. She can get "divorced" once.
in a sense, (and I say this for my self reassurance too!) there is no such thing as a wrong choice. Just like you can't "be in the wrong place at the wrong time." Life unfolds and we go along for the ride, doing the best we can to steer the canoe in the river.
This whole thing has had me reconnecting with a meditative practice, which is a nice side benefit. PM me if you'd like suggestions for audio tracks and techniques that work quickly and without a doctrinal religious bent.
Deb03 W-H
Posted
With laser surgery, it's not just the equipment cost, but the procedure takes longer which cuts down on the number of surgeries that can be performed in a day; therefore the surgeons make less money unless they charge extra for it. I was between 2 doctors (one offered laser and one didn't). I asked my retinal specialist for his opinion, and he said either was a good choice. When I asked about the laser vs blade, he said either was fine. I chose the surgeon who used the laser only because it made me feel more at ease. The important thing is to have a skilled surgeon.
Regarding risks, I try to gloss over that stuff or I'd never get any procedure done 😃. Many of them are rare and they have to include them in the paperwork. Be sure to follow the instructions on the drops and do them as long as they recommend.
Regarding making the wrong choice - It is stressful. Lens exchange was also in the back of my mind as an option if I was unhappy, as was wearing a contact and/or getting lasik for mini-mono or monovision.
Guest Deb03
Posted
Nice to know, good info.
My surgeon also said that both options are just as good, so I chosed the old fasion way 😃
AndiPandi W-H
Posted
Hi how did your wifes surgery go?