Thread: Cataract surgery; which IOL?

Originally Posted by Chris Parks

I don't get this at all. If the cataract has started and will need surgery to correct it and during the five years your sight will deteriorate why not do it earlier rather than later and you can benefit from a corrective lens if that is appropriate and needed. Mrs P. is in the same boat, I was told the same thing on my last one and talked him into it as I wanted the permanent correction asap. Once the lens is in place their is no more expenditure on scripts and glasses either.

No idea why Chris, apparently they don't like doing them early, that's all I know, but I will ask him in December.
Crocy.

Good thread read for me, my optometrist a couple of years ago warned me of cataracts forming and after a visit last Friday suggested I should do something sooner than later as they had worsened. Now that I have read this I’m more aware of options when I see the specialist. I’m also on prostate medication which can add a complication to the procedure.

Originally Posted by Old Croc

No idea why Chris, apparently they don't like doing them early, that's all I know, but I will ask him in December.
Crocy.

It wouldn't occur to doctors to delay the procedure because they get more money from the visits you make in that time.....no, they would never do that would they. Call me cynical but I can't see any other reason.

The main reason for delay is that the new lens is inflexible, so you will loose any accomodation you have. Accomodation is the ability to change your focal length - you can focus on things at 30cm, 50cm, 1m, 20m etc because your natural lens can change shape to adjust focus. You gradually lose this as you age - which is why you end up with reading glasses for near stuff - but you still have some accomodation.
Replacement lenses are a fixed focal distance. They only focus sharply at one distance, and anything outside of that distance becomes increasingly blurred. Multifocal IOLs are an attempt to get around this, but they're a long way from perfect. Artificial lenses that can accomodate are in the pipeline, but again, they're some way away.

'Blended' vision is another attempt to get around this limitation - usually your dominant eye is corrected for far sight, and your non-dominant is correct for near, so you can drive (your dominant eye will take care of this), and you can read your book at night (the non-dominant will take care of this). It's also not perfect as you still have two fixed focal lengths - eg. anything nearer than your 'near sight' focal length will become increasingly blurred - so you may struggle to thread the sewing needle. A pair of multifocal glasses for close work usually solves this.

So advice is always to hang on to your natural bits for as long as possible. You'll seldom have IOL's recommended before age 50 (unless there's an issue with your natural lens), and even then you'll notice that loss of accomodation. The older you get, the stiffer your lens gets, and the less you'll notice the loss of accommodation as it becomes increasingly fixed.

And safe as it is, there's always a risk of complications. Slightly dodgy vision is a whole lot better than SFA.

forgot to mention: won't you be happy as a pig in poo if, in 5 years when that money-grabbing doc finally lets you have the butchery, and the new flexible lenses are finally available, and you end up with almost completely natural vision...

My experience is that my lens implants have not proven an issue at all and one was done before I was 50 and one not long after. I can only say what happened to me from experience and I am now over 70 with no problems from the lenses and no prescription change needed. How is blended vision different from mono vision which is the term given to my eyes?

mono is the same as blended but doesn't sound as posh - each lens has a different focal length so you get near and far vision

Originally Posted by Chris Parks

It wouldn't occur to doctors to delay the procedure because they get more money from the visits you make in that time.....no, they would never do that would they. Call me cynical but I can't see any other reason.

My guy bulk bills me😃
Rgds,
Crocy.

Thought I might add a bit re focal length and cataract surgery to the discussion if that’s ok.
I had mine done a couple of years back.
I was short sighted, had glasses since 5.
My regular eye guy picked it up in my right eye after I’d collected an island at night due to oncoming headlight glare.
He was about my age and he said to figure out the focal length I wanted and to be wary of younger surgeons who want to do away with your glasses for long vision but wreck your close up.
He said ‘do you read in bed without your glasses if you get your focal point set for driving you will no longer be able to do this’.
Id already figured out my welding was rs because I couldn’t get my head in the right place to see with the multi focal glasses and small helmet window.
I was also finding reading/marking out from a steel rule almost impossible.
So I got my focal length set to bench height and it works for me.
I now still wear glasses for driving and it doesn’t worry me after nearly 70 years I’m used to them. I can get around the house without specs which I couldn’t before.
But I now occasionally need reading specs and have a few elcheapos where I’ll need them.
I used to be able to read the markings on a dirty 1/4” drill but now have to put on the readers for that. I have to hold a book or iPad about 400mm away but that’s ok.
I take my glasses off to weld and bought a helmet with a bigger window.
H.

My eye story starts out with needing glasses to see the blackboard in high school. By the time I was 40 I had some astigmatism in my right eye and increasingly found close up detail hard to see so got multifocals.

When I finally came out of denial that I was diabetic and went onto diabetic meds my vision went all wobbly - glasses didn't work at all - An optometrist friend said I should wait until thing settle. I bought some cheap magnifiers to help me in the shed and to read the computer screens. Over a period of about 3 months I found my distance and mid range vision improved to the point where I no longer needed to wear glasses. My close up vision also improved in one eye but got slightly worse in the other - still need glasses for computer screens though

I now wear mulitfocals with no correction in the top half and close up corrections in the bottom half but I also have a pair of reading glasses for when I'm sitting at the electronic bench or doing fine work in the shed.

My main problem these days is "not enough light". Even with glasses and all my shed lights on I find myself more often going outside to read the markings on small drill bits etc.

Originally Posted by clear out

Thought I might add a bit re focal length and cataract surgery to the discussion if that’s ok.

Id already figured out my welding was rs because I couldn’t get my head in the right place to see with the multi focal glasses and small helmet window.

I take my glasses off to weld and bought a helmet with a bigger window.
H.

This was all good info👍
I have perfect vision up to about 400mm so I wear multifocal glasses to be able to do everything else. The guys at my local welding shop fitted me up with a corrective lens that fits into my helmet so I can see with my distance correction glasses on. The only problem I now have is when I can't get my head close enough to the point of welding, like under a truck, so for that I just remove the lens.
Rgds,
Crocy.

Originally Posted by BobL

My eye story starts out with needing glasses to see the blackboard in high school.

I now wear mulitfocals with no correction in the top half and close up corrections in the bottom half but I also have a pair of reading glasses for when I'm sitting at the electronic bench or doing fine work in the shed.

My main problem these days is "not enough light". Even with glasses and all my shed lights on I find myself more often going outside to read the markings on small drill bits etc.

Very similar to me Bob. I have always had an issue with not enough light, so my latest iteration for a work light was ripping out the 240V workings of a swing arm desk light, you know one of those ones with the external springs and installing a 22W 6K LED downlight on it. I had to retension the springs a bit for the extra weight, but the output is as close to real daylight in the shed as you can get.
Rgds,
Crocy.

Well; since I started this thread there have been a few developments. Firstly the lens I had settled on (Vivity EDOF) took a very long time to finally be released in Australia in the size that I need. In fact it has only been available for less than 2 months.
Secondly; I have changed my mind regarding having two different strength lenses inserted in order to improve my focal range. I stopped trying to use mutlifocal contact lenses and changed to simply wearing one that is 1/2 diopter weaker in my non-dominant eye. It was weird at first but my brain figured it out a lot quicker than I expected it to do and now I have to concentrate to differentiate between the two. I cope so well in fact that except for very fine work I am glasses free, so my IOL’s will be mimicking this setup.

And the first eye is getting done tomorrow with the second eye on Wednesday. So wish me luck guys!

Good luck CT - hope it works out for you.

I'm on my second pair of (multifocal) glasses in 6 months. The previous pair had my usual "no correction" on the top and the minor corrections for close up work at the bottom, plus a bit of astigmatism. 6 months ago the optometrist also picked up a small cataract in my right eye but recommended I not do anything about it at that stage

During the last six months my distance vision deteriorated slightly to the point where I felt it needed correction, and found I could not read the computer very clearly so resorted to my old reading glasses

So off to the optometrist expecting to hear that the cataract had grown and was to blame but not so - it was more or less the same. Anyway test showed a significant change in prescription so I got new glasses and can at last read the computer again. But now every middle and close up vertical line looks curved. Doorways look narrower at eye height and splay out at top and bottom, eyeballing stuff for straightness is out - it's weird when I check with a straight edge to see the straight edge as curved. Does my head in.

Optometrist reckons it could be all the meds I'm taking.