What to expect ?
Posted , 5 users are following.
My vision with glasses is about 20/50 and has been for most of my life. My prescription is CYL -1.75 & -2.25 AX-030 & 120. I'm a -625 & -500 with +2.50 add and Prism 5 up 5 down
I have a astigmatism and my script has prism in it. So I know I'll still need to wear glasses after surgery.
Wondering when it's all said and done what can I expect will I be able to get 20/20 or close to it than glasses alone ever gave me ?
0 likes, 15 replies
Sue.An2 markee
Edited
Do you have cataracts? Is that why you are have cataract surgery? My vision deteriorated to 20/50 in one eye and 20/60 in the other and after cataract surgery I experienced 20/20 in one eye and 20/25 in the other.
Expectations with this surgery don't always match up to reality.
If your vision is poor due other reasons as you mention it has been 20/50 with glasses all your life it will be difficult for any of us who are patients like you to set your expectations and most here have this surgery due to cataracts.
Best see several surgeons for their expert opinions. Know if you are a younger person (than normal cataract age) you likely will experience added visual disturbances like seeing the edge of the IOL. Younger pupils dialate more than someone in their 70s. Pretty much all lens options are 6mm. So this is something to factor in.
Sorry you are experiencing this - must be frustrating. Take your time in coming to a decision as it is permanent and most people live with it vs doing a lens exchange because that comes with added risk. There is lots of good info on the internet so read up on the lenses. No one perfect fit all solution. Each comes with pros and cons and tradeoffs.
Best wishes to you.
RonAKA markee
Edited
I assume you are here because you have cataracts and will have cataract surgery? If so, the surgery will certainly help with any loss of focus and double images you may be seeing due to the cataract. However, since you say you have had vision problems all your life it may or may not help with those issues. In cataract surgery the natural lens is removed and replaced with a flexible plastic lens. Any visual issues you have that are caused by the natural lens may go away. For example if the astigmatism you have is caused by your lens and not the cornea of the eye, then astigmatism may go away as well. To my knowledge prism is not correctable with an IOL, so you may need glasses for that after the surgery. When you go to have your eyes measured and have the consultation with the surgeon you should ask what can be corrected and what cannot, and your potential vision outcomes. One thing to think about is astigmatism correction. While it may not even be an issue, if it is in your cornea and is significant enough there are IOL lenses that correct for astigmatism. However, they will cost more, and are a little more difficult to position correctly. And if you are going to need glasses anyway, it can be corrected with glasses. All things to think about, but the surgeon will be the best one to ask about vision expectations.
markee
Edited
Thanks for the replies I'm 61 so not that old yet and yes I do have cataracts just not so bad yet their just at the point where my insurance will pay but not at the point where its affecting my vision badly enough to make surgery urgent yet.
I happen to have this Opthamologist friend that keeps telling me I should go for the surgery that i would really benefit from it. So I went on to a couple of cataract doctors both confirmed I do have cataracts one place was ready to book me for surgery but the other said that there still pretty minimal at this point and felt i have time to wait for more better options before surgery becomes more mandatory. He went on to tell me which I didn't know back then that I would loose the one area of my vision that works best for me my almost perfect near vision from about 5 inches out to about 12 inches i can see great without glasses.
Anyways I was just curious and don't really know what to expect as far as vision improvement goes
wondering if in the end I'll be able to see better then the 20/50 I been living with most of my life is all ?
RonAKA markee
Edited
You actually do have an option to retain close reading vision without glasses. It is an option that not many people choose, but if they use an IOL that leaves you with something around -4.0 D in both eyes you should have excellent close vision. That is fairly near sighted (myopic) so of course you will need glasses to see in the distance. The same glasses could correct astigmatism and prism.
markee RonAKA
Edited
I'm not really sure what -4.0 D means but what about my intermediate vision would i need to wear some kind of progressive for distance and intermediate vision with clear lens on the bottom for reading ?
soks markee
Edited
keep your great vision from 5 to 12 inches. has 20/50 caused you amblyopia? even with surgery your distance vision may never get 20/20?
soks markee
Posted
-4 means they will use the lens so that u require -4 glasses for distance. for near you wont need glasses but i think the range of near you would get would be smaller than your current 5 to 12 range. i suspec5nit would be more like 7 to 10 inches. more diopter are needed for smaller range for near vision.
RonAKA markee
Edited
Yes, essentially that would be it. You would need progressive glasses with a -4.0 D correction for distance. You should see pretty well up close with no glasses. If you have significant astigmatism to correct (with the natural lens removed) you may benefit from an toric IOL which would correct it as well without glasses. You would want to discuss with your optometrist what degree of myopia would be best.
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But, not many choose this option because they want to see in the distance with no glasses instead of up close. They of course need reading glasses for up close.
Sue.An2 RonAKA
Posted
I may be wrong but i think many don't chose near vision not only because of distance preference (or distance assumed by surgeon if options not discussed) but the margin of error is greater too. going intermediate would be better than selecting near. Again I may be wrong on that
RonAKA Sue.An2
Posted
I can't think of any reason why a near vision correction would be any less accurate, and in fact I think the acceptable "landing area" is probably a lot wider. Suspect anywhere between -3.0 to -4.0 is ok. But, I am not a cataract surgeon, and it would be best to discuss this option with a cataract surgeon when the initial pre op is done.
Sue.An2 markee
Posted
markee if I were in your shoes I would wait till you needed cataract surgery ie vision deteriorates where it cannot be corrected with glasses or contact lenses. Here in canada that benchmark is 20/40. At that vision one cannot pass driving vision test. Insurance or in case if Canada mecicare system the cataract surgery is covered. It is very expensive otherwise. Perhaps that isnt an issue for you but would be a consideration for many.
Cataract surgery will correct many things where vision is affected by cataracts or your natural lens but does create some new issues - younger you are the worse those could be.
I would though encourage you to simulate with contact lenses various degrees of mono vision to see how you tolerate that. My vision deteriorated rapidly so could not try that. monofocal lenses typically have less night vision issues but wont grant you as much range of vision so if you know you can tolerate a diopter between your eyes this would give you a wider range if vision where one eye is targeted for distance and the other 1.0 diopter nearer.
Wish you well - good news is you have time to search for your options and experiment with contact lenses
markee
Edited
I don't think I have any amblyopia. I really didn't expect to get 20/20 but maybe 20/30 ?
I'm in no rush to get this done hopefully by the time I'm ready there will be some better options available for me ?
I never realized how complicated lens choices can be. I remember must be like over 40 yrs ago both my parents had the surgery done and it was no big deal it was just a easy fix
RonAKA markee
Posted
Not sure if it was 40 years ago, but at one point cataract surgery meant that they just removed the natural lens and didn't put any new artificial lens in at all. That meant that all the correction that the lens needs to provide has to be provided a super strong eyeglass prescription. I am glad those days are long gone!
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Yes, the options for IOLs are extensive now. The big change was making them flexible so the surgery could be less invasive.
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Without getting into all the detail there are monofocal lenses which only correct for one distance, usually far, but it could be near. Then there are toric versions which correct for astigmatism also. Sometimes one eye is corrected for distance and the other eye is undercorrected a small amount so you retain some near visions - monovision. And last there are a wide range of presbyopia correcting lenses which use various strategies to give a wide range of vision. Unfortunately they do have other vision issues associated with them, which some will find are a good tradeoff for not wearing glasses at all, and others don't tolerate them so much.
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It seems to me that you are going to need glasses anyway with the prism so I would not go down the road of presbyopia correcting lenses and just focus on what distance of monofocal you want and whether or not toric versions are needed.
Quandryite markee
Posted
You might, understandably, be through with this page and your question. Faced with rapidly-worsening vision, and other worsening health problems, somehow, I don't think I can get a degree in ophthalmology any too soon, and must comment that I believe that over 40 years ago your parents had the surgery done as an "easy fix." I am terrified. What do you suppose was the difference 40 years ago. Any hypotheses?
RonAKA Quandryite
Posted
In the first cataract surgeries the cataract clouded lens was simply removed. With no lens in the eye you only have the cornea to provide vision correction. It is not nearly enough, so the end result was that you had to wear very thick glasses to provide the correction lost by the lens. The next improvement was to implant an artificial hard lens after the cataract lens was removed. Because the lens was hard the incision to implant it had to be quite large, and it took a long time to heal. Next came soft foldable lenses which could be inserted through a much smaller hole. Healing time became much shorter.
Today cataract surgery has advanced to the point it has become a painless 10-15 minute procedure. The preparation time to put drops in your eyes takes longer, but the operation itself is very short and painless.