Should I wait on the 2nd Eye?
Posted , 6 users are following.
Hello everyone,
First, thank you for being so helpful to me as I continue down this path with my cataracts. It's been overwhelming and a lot to try and understand in a short period of time ....and I am grateful for all of the wonderful advice here.
Soooo, I am starting to re-think my 2nd eye for now. I went for my one-week follow-up and asked more questions about my specific type of cataract and the severity of each. The type of cataract is an anterior subcapsular cataract. Everything I read today aligns with what the retinologist told me - that it can be fast growing. I also now know there are two main issues that can cause this type - steroids or skin issues related to dermatitis. I've had both since 2019 when I had blepharitis and a small skin outbreak on my body. That was the very first time I ever had something like that happen and I don't know what caused those issues. But I do think that these cataracts were either caused by the steroids or the underlying skin condition (the cataract I believe is just another form of this condition which affects the eye).
So the cataract that just got removed was a 3+ - and I know it was bad as I could not see the E on the chart with my glasses on! I asked today and was told that the other one is a 2+. The scale only goes to 4 . So, my vision with the 2+ cataract is corrected to 20/20 with my new lens. Reading is 20/25. So I told the optometrist today that I was thinking about waiting on the 2nd eye. Here are my reasons:
- I am afraid of night driving after getting the Synergy next week! I drove home from work tonight and believe I only managed to do with my actual lens in the right eye. The glares/halo are very distracting. I cannot imagine it being the same or even worse with the Symfony.
- Call me crazy, but I am afraid of having two man-made lenses - I keep thinking what if they stop working one day or degrade in some way not anticipated? I'd be blind. I know this is likely irrational, but my mind keeps going back to this.
- Although my sight has tremendously improved - it's still a bit blurry (actually, I think what I am perceiving as blurry is the halos around any lights in the room catching in my peripheral vision) - so not too excited about having two somewhat blurry eyes.
The optometrist noted that it's best to get them soon together so that the brain can adapt with them together. She also said that I am going to have to have it done - so now or later and she could not tell me when. As it is a fast-growing kind, maybe much sooner than I would like.
Sigh....I don't know what to do. I know I will likely go ahead with the surgery next week, but I am quite hesitant at this point. Fear is a very strong emotion!
0 likes, 19 replies
rwbil Jennifer_Guess
Edited
As I always say everyone is different. I am a procrastinator. My eye doctor kept asking me when I was going to get my 2nd eye done. I could not even see the Big E and basically only saw out of the one eye. I was waiting for a new and better IOL to come out. I really could not wait any longer so had to choice what IOL I thought would be best for me.
If you can correct to 20/20 distance in your cataract eye then take your time. For one think Synergy is relatively new in the US and with more time there will be more real-world results. Plus gives you more time to evaluate night time driving. If you are not happy with night driving with Symfony and a natural lens combo, I think you will be less happy with a Symfony and Synergy combo.
Also maybe some new trifocal options will become available. There is also the revolutionary Juvene IOL that is supposed to go into clinical trials, but that one might still be a bit in the future.
As far as having 2 man-made lens, unless they come up with some stem cell approach that will probably be the only option for a long long time. And I would add that the future more complicated IOLs like the Juvene are even more likely to break down and stop fully working.
Jennifer_Guess rwbil
Posted
Thanks @rwbil - always helpful 😃 I think I misreported above - the right eye can be corrected to 20/30 and the new eye is 20/20 - although it was 20/15 last week right after surgery, which is weird! Given the type of cataract that I have, I don't know that I'll be able to wait for any new ones to come on the market, unfortunately. I guess I just have to think about it in terms of waiting a few more months and know that my vision will likely just keep declining in that eye if I do postpone. It's already quite fuzzy in general so it's on its way for sure.
Thanks again for your thoughts/ideas - always very helpful 😃
rwbil Jennifer_Guess
Posted
You don’t have to procrastinate as long as I did, but I would give your eye some time to heal and experience your vision in various real world environments. I say the perfect office setting is not real life. See how our vision is at an indoor basketball game, movie theater, concert, at a restaurant in dim lighting, out on the pickleball court, like me or golf course or skiing on the mountain or whatever activities you participate in, and of course in many night time environments.
Then use those experiences and your knowledge to make the best choice for yourself.
My advice is don’t be rushed by anyone and at the risk of burning in HE….. that includes mom, as most people really only know high level information regarding cataract surgery and have no idea about diffractive IOLs especially Synergy which you are thinking about.
One other note. As far as the 2 eyes not adjusting later I was 5 years between cataract surgery and yes I had cataract in the non-operated eye the whole time. I don’t think a few months will make any difference.
Jennifer_Guess rwbil
Posted
Thanks @rwbil - these are great suggestions. I cannot believe I am 48 years old and still listen to my mother LOL.
RonAKA Jennifer_Guess
Edited
It takes about 6 weeks for the eye to fully recover from cataract surgery and show you what it will be like for the longer term. My thoughts would be to postpone the second eye for two months and use the time to think about what you really want to do with the second eye. The extra time can be used to fully research the options available, and also evaluate the outcome of the first eye. I am likely to go two years between eyes, so I don't think the time between eyes is a big factor. That said it sounds like the second eye is getting bad and probably should be done sooner rather than later. I would not consider putting it off for more than a couple of months.
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I can't remember the situation with your eyes. Was the surgery done on the dominant eye or non-dominant?
Jennifer_Guess RonAKA
Posted
Thanks @RonAKA 😃
The dominant eye, which was also the worst, was done first. Yeah, I think if I had one of the regular cataracts, I would not bother doing the 2nd one as growth would be slow. It's really weird b/c it seemed so much happened in a short space of time with regard to these cataracts, having allergies for the first time in my life, eye skin condition (blepharitis) and small patches of dermatitis - also for the first time in my life. I have to think it's connected somehow! But, I am not that kind of Doctor and just have to move on and do the best I can (I am telling myself this).
I have a couple of days to think about it. Hubby thinks I should just get it done and so does my mother. If it is anything like the other eye and suddenly I cannot see, then the choice will inevitably be made for me. So, it is definitely a case of when not if, unfortunately.
RonAKA Jennifer_Guess
Edited
If you were to change your plan for the second eye, these would be the options if you stick with the J&J product:
Synergy - As is your current plan. The halos and flare at night are likely to be worse. However, as it is not your dominant eye, perhaps they would be more likely to be ignored or moderated? Don't know.
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Symfony - As you currently have in the dominant eye. Halos and flare are likely to be the same, but again perhaps as the non dominant eye, they will not be additive to your dominant eye. However, you are not likely to gain much reading from what you got with the first eye. But if that is OK, then it may be a reasonable option. It could be under correct by a bit if you wanted to gain some extra reading.
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Eyhance - This should give you a significant reduction in the halos and glare in this eye only of course. Will it reduce the overall issue? I don't know. Again it could be under corrected to give better reading as the Eyhance is marginal for reading.
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Tecnis Monofocal - This should virtually eliminate the halos and glare but again with this eye only. It should give you the maximum distance vision, but no reading vision. Usually they are good down to 2-3 feet. And again it could be under corrected to improve reading but it would be at the cost of reduced distance vision in that eye.
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Tough choices. But, as the Brit saying goes "in for a penny, in for a pound", and staying the course may be the best for you. It may involve avoidance of night driving. My thoughts would be to give yourself 2 months to consider the options and get more experience with the lens you have after it fully heals and then make a decision.
Jennifer_Guess RonAKA
Posted
Hi @RonAKA,
Many thanks for the helpful overview. I'll probably just get the Synergy as prescribed. I think I am going to have to accept that night driving might be out for a while until my eyes adjust and then maybe not at all. Due to my job as a Professor, I really need to read up close and a computer a lot - so I will probably want to stay away from anything that will not improve or detract from that ability. I am so overwhelmed and will likely just stay the course and avoid night driving.
NeluG Jennifer_Guess
Posted
I think you should get a monofocal lens set for distance vision.
This way is guaranteed you won't have issues with dysphotopsia at night and your distance vision will be the best you can get nowadays at the current technological level.
Sure, you'll need glasses for reading but you can't have them all, you have to compromise.
Good luck with your decision, Jennifer!
Jennifer_Guess NeluG
Posted
Thank you 😃 I think, however, even if I went with a monofocal in the other eye, the dysphotopsia would still be there in the Symfony eye?
soks Jennifer_Guess
Posted
with two eyes open it will be canceled out 70%
soks Jennifer_Guess
Posted
Hi Jennifer, when you say blurry do you think there is a constant haze from light sources?
Also do you mean posterior sub capsular cataract? That is what I have.
A monofocal will give good night time vision but should probably be combined with trifocal so as to get near as well.
1 week post op I did not notice halos as much. The lens edge is what made it worse which I avoided by installing light in my car.
good luck.
Jennifer_Guess soks
Posted
Hi @soks - yes and no - yes, blurry/haze around light sources in the day (very clear for example if I look at something like the TV, but if there is light bulb anywhere there is haze around those - this seems to be reducing now however). No, it's an anterior sub capsular cataract - i think the anterior and posterior delineation has something to do with location in the eye.
Can you tell me more about the light in the car? What does this mean?
Thank you 😃
Sue.An2 Jennifer_Guess
Edited
I feel your anxiety about it as I felt much the same. Had same type of cataracts both eyes as you and they do grow fast - at least they did with me. I could not read big E or the lic plate on car in front of me when stopped at a light. I was 53. Vision could no longer be corrected with glasses. I was about to have my driver's lic suspended so knew there was no option. I have had atopic eczema my whole life - no one told me side effects could be cataracts from steriods.
Only you know your risk tolerance and I won't encourage you with one lens or another but will share my story knowing this doesn't happen to everyone.
I chose 2 Symfony lenses due primarily bc I am on a computer all day for work and looking at spreadsheets. So I was primarily concerned with seeing close and intermediate. I figured bight vision would be a concern in Canada 4 months of the year and as I aged night driving wouldn't be my thing anyways. I do to this day still see concentric circles and they are just part of my new normal. Not for everyone I know.
Fast forward to 2 years ago. Was lying down watching TV on my right side and realized I saw images blurry and could not read anything. Sat up and all was right with my vision but I closed one eye then the other and Left eye was seeing straight lines curvy - couldn't read either. Thought it was that PCO I read about here and thinking I would likely need a YAG. Made an appointment with my optometrist and found out I have epiretinal membrane. She referred me to a retina specialist - covid times took 19 months to see her but now she will see me every year. Surgery is too risky or at least that risk won't outweigh benefits in current condition. Apparently epiretinal membrane can be caused by the cataract surgery itself which is what retina specialist feels was likely source of mine. Given I have excellent vision with right eye with both eyes open I do not see the effects I see when I close my right eye and use left eye to see.
So given my current circumstances I am glad I have Symfony to be able to see this well with one eye. If I had a monofocal lens and did any sort of monovision I feel my vision would be more compromised. I had no idea I would live through all this. but one does adapt to life's changes.
Make the best decision you can for at this time. I would wait min of 4 weeks (preferably 6) to allow eye to heal and IOL to settle - especially important if you go with a monofocal and need to coordinate with other eye.
When you are young facing cataract surgery it is about compromise. Those of usual cataract are generally happy as they gain something they lost.
Wishing you the best Jennifer
Jennifer_Guess Sue.An2
Edited
Hi @Sue.An2,
Thank you for sharing your story. How very frightening! I was reading up on the risk of retina detachment already as this has me worried. But, I was not even thinking of other side effects. I am glad you are okay.
As noted on another thread, I decided to just get it done yesterday. So far, so good. Some unsettling aspects overall with regard to how I felt, but the vision is outstanding in both eyes as of today. I am now trying to read up on any literature on how to prevent issues - but I am not sure that's possible! I have a follow-up with my retinologist in a few weeks who will check things again - and ask him a few questions. I did read that the average time of a retinal detachment after surgery is at six months - but is also known to happen 2-3.5 years from surgery (luckily in less than 1% of people - but you know, now I know what's it's like to be in that low % in terms of getting cataracts in the first place, so I have a new appreciation for those in the low %!).
Sue.An2 Jennifer_Guess
Edited
I had no idea of the other side effects and risks for other eye conditions due to cataract surgery - Also concerned how long these lenses last.Main reason for my being not such a fan of clear lens exchange as they are all younger patients - most who did lasik to correct distant vision. My brother in law recently had clear lens exchange and did not understand they removed his natural lens - said it was not like cataract surgery. Unsettling that surgeons who perform this don't inform their clients of what the procedure is all the other health risks it could bring on.
Percentages are on your side. I just didn't land in right side of them. However I really had no choice as cataracts really impacted my vision. I recall how miserable I was waiting for surgery. My daughter played soccer and I could not even read the numbers on their jersey or distinguish her from other players. I see much better now with the condition I have than when I had cataracts.
Happy you see very well with set up you have. Hoping you adjust to the night vision issues. For me it was s process but it is now 4 years since surgeries and I don't think twice about driving at night. Most of the driving I do though is in familiar areas. I don't do long trips after dark.
Jennifer_Guess Sue.An2
Edited
@Sue.An2 - that's wonderful about the night driving. And, I also have an appreciation for seeing better than before the cataracts - and really sight in general now! God, one tends to obsess over the stupidest things, when life just decides to smack one up side the head with something else entirely. I am going to work on that - taking each day for what it brings and trying to stop obsessing over the 'what ifs'. I had a wake up call when I was 35 and living in the UK. Long story short, I got a kidney infection (silent and deadly as I really did not have hardly any symptoms - just a general feeling of unwell for a few days in advance) that turned into sepsis and then a heart attack from that sepsis. I was alone and working onsite on a project away from where I lived and was in the hospital all by myself (family in the US and friends around 3 hours away by train). It took me over a year to recover from that experience - well more than that as they cracked my sternum when doing CPR. I changed my life after that - starting eating healthier, working less, etc.
I have been extremely reflective since this cataract diagnosis! Because of the pandemic, and other stresses, I have again slipped into working like a maniac, being stressed out, etc. I cannot let go that I just somehow got a fast-growing form of cataract as this does not run in my family, etc./don't have diabetes or other known causal factors. I do think it was from some topical steroid cream I used on my eye - but I think that eye condition could have been brought on by dry eye and working too much on my computer - so work related. Of course, I'll never truly know (there is more money to be made by making better implants than actually preventing) the answer, but am treating this as another wake-up call to do better and live my life each day for the wonderful that it can bring instead of being chained to my computer working 7 days a week - which is what it has been for a few years now on the tenure track!
Sue.An2 Jennifer_Guess
Posted
Wow that is quite a smack on the head. Sorry for that experience especially alone. Although I bet you had better care in UK vs here in Canada. Shattered my humerus a year ago - took 3 days to get surgery. Covid time do no visitors allowed. Felt very alone.
Yes I too suffer from atopic eczema and believe all the creams source if early cataracts for me too. Creams that didn't help much at all. with help of a new cream on the market that doesn't contain cortisone it is much better. I also use a blend of essential oils mixed with coconut oil to help. When I first see the blister and it itches I put salt in a steel fish of boiling water - drape towel over - within minutes itch is gone.
Jennifer_Guess Sue.An2
Posted
@Sue.An2 - oh, that sound awful and painful! 3 days is a long time! Hmm, not sure I'd say the UK was better. Actually, it was pretty horrific if I am honest. Because I was in a city that was not where I lived, I had no idea where to go when I finally did develop substantial symptoms (could not see or walk straight and felt very unwell). So, I called the NHS helpline. They sent me to a GP who should have sent me to the hospital as I already had a 39-C degree fever (102) after taking paracetemol. Instead, he sent me back to my accomodation with antibiotic tablets. I am only sitting here today b/c my parents in the US kept calling me to tell me to go to the hospital (I passed out in a bathtub for two hours as I got in from shivering so bad). My stepfather finally got fed up and yelled/cursed at me to go to the hospital and that did it. I took a taxi there and went into cardiac arrest within 2 hours of arrival. I would have not survived if not for them. Then, for months after the hospital stay, I kept complaining to my GP of chest pain and just being unwell. When I went home to the US, it took a doc there 5 minutes to guess that I had a fractured sternum and then to confirm. Also, I had a colleague in London on a video shoot who broke her ankle. Upon going to A&E, there were no crutches or wheel chairs. She literally had to hop on one foot between the reception bay to Xray and back. So, the NHS, is not perfect by any means. They did save my life though when things really went bad, so I will always be grateful to the staff there for that (angels).