Managing after cataract surgery.

John Kielly

John Kielly

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On Thursday, I took the first step to upgrade my vision. The cartaracted lens in my master eye was removed & replaced with one to give me perfect distance vision - if the measurements were taken correctly & so far, that seems highly likely, as I was reading 20/30 Friday morning at surgery follow up & most of the 20/20 line & my vision has sharpened up even more since the stuff they dropped in my eye to dilate it wore off. When this procedure has settled down, my ophthalmologic surgeon proposes to replace the lens of my off eye with one better suited to the needs of day-to-day living.

At the moment that eye is somewhat short sighted, focussing at around 12 inches. Without any correction, it's great for reading but not quite up to using a computer screen, hammering a nail or measuring a plank.

My doctor's suggestion is to have a lens fitted to correct for short/intermediate distance, something along the lines of what I have achieved with my computer glasses, but knowing I'm a target shooter, hasn't completely discounted fitting a second long distance lens. In any case, he believes that the so called necessity of binocular vision of normal day to day function is greatly overemphasised, something I'm already coming to agree with, as I'm not wearing correction for distance on my off eye at the moment.

I drive long distances between events & prudence suggests that it would be appropriate to be able to read the speedometer & my GPS whilst driving, as well as using hand tools etc. As it turns out, now my eye has settled to something close to its new normal, I’ve found that I can easily acquire the instruments with the new lens. Its accommodation is far better than I expected - in good sunlight anyway.

Advice I’ve has so far is split down the middle. There are supporters of either option (fitting a second distance lens or one more suited to close/intermediate distance).

At the moment, I’m inclined to favour the first option. With what nature gave me, I used close up glasses both for administrative chores & as safety glasses when I was using my power tools, so there would be no change there. At the other extreme, I could maybe pick myself up a nice used set of real Ray Ban Aviators & use off the shelf shooting glasses for a change.

If I opt for different lenses, then I’m going to be messing with some strange prescription glass, for example, safety glasses with one prescription lens & one plain, or the reverse if I want to boost my left eye to read the wind at 1000 yards.

Anybody handled this one before?

John
 
Horses for courses

As an optical engineer I worked in the ophthalmic section of the company as the last port of call and worked with ophthalomoligsts on a daily basis. Whether to fit two long distance lenses and use corrective lenses for intermediate or near vision or split the field and fit one for long sight and another for near essentially creating monocoluar vision is debatable. But you do have to get the balance correct for yourself as it isn't easy to correct without more surgery. Trouble is you can't trial various options first.

Here is another option that has been done a lot recently. Fit long lenses for both eyes. Then get a pair of progressive lenses fitted to your spectacle frames that have no power in the distance. There are many different types of progressive lenses these days and all have different field parameters. You are sure to find a type that suits. Try out one such lens in your specs on the eye you have had a replacement lens for long vision done. If you like it then get both done that way.
Andy
 
John,
I was very near-sighted in both eyes before I had laser keratotomy to mono-vision. It was really strange at first. It took at least six months for my brain to accept the different images from each eye as the new normal, but it seems OK now. Since you already have mono-vision of sorts, you know what it is like to have each eye seeing something different. That should make the decision easier. Mono-vision doesn't entirely compensate for the fact that eyes lose the ability to adjust focus as we age. (Your hard lenses won't adjust at all.) I now need reading glasses. I bought two pair with different diopter and made one pair by putting the higher diopter on the side of the far-sighted eye. This brings binocular vision back for working closeup.

Best of luck with your decision,
Keith
 
There is another option called "Crystalens" where the new lens has little flaps that tie into the muscles that cause changes in focus. I have two friends with that. One likes it a lot and one had it done before it was fully perfected and has a few issues with night driving. We had a local doctor who was the world expert on these things but unfortunately he died before I could get mine. I don't know of another practitioner that I trust, and there are some reports of unhappy results on the web. I am nearly 62 and I am told I have slow growing cataracts. I am thinking of going with both lenses fitted for distance. I would be happy just to sharpen distance vision and get rid of my astigmatism. I would like to get glasses off my nose for part of the day. Now I use bifocals for out-and-about and single-vision lenses for computer work (8 hours per day at least). I am thinking that after surgery I would have a similar arrangement, but the top lens in my bifocals would be clear. The main difference would be that I wouldn't wear the bifocals near as often. For driving and TV watching I wouldn't need them. I might also be able to wear drug-store glasses for the closer work. Fitting two distance lenses would be good for hunting where I use a binocular frequently and don't often need close focusing. I talked to a bench rest shooter about 70 that had distance lenses done and wears trifocals. He was very happy. He said if you have any cataracts at all, fuss until your opthomologist agrees to do it. Tell him it's impacting your lifestyle negatively (ie: shooting). Incidentally, I and several friends use the Stallings SR Microsight for service rifle shooting and it is quite helpful, cataract lenses or not.
 
vtmarmot said:
There is another option called "Crystalens" where the new lens has little flaps that tie into the muscles that cause changes in focus. I have two friends with that. One likes it a lot and one had it done before it was fully perfected and has a few issues with night driving. We had a local doctor who was the world expert on these things but unfortunately he died before I could get mine. I don't know of another practitioner that I trust, and there are some reports of unhappy results on the web. I am nearly 62 and I am told I have slow growing cataracts. I am thinking of going with both lenses fitted for distance. I would be happy just to sharpen distance vision and get rid of my astigmatism. I would like to get glasses off my nose for part of the day. Now I use bifocals for out-and-about and single-vision lenses for computer work (8 hours per day at least). I am thinking that after surgery I would have a similar arrangement, but the top lens in my bifocals would be clear. The main difference would be that I wouldn't wear the bifocals near as often. For driving and TV watching I wouldn't need them. I might also be able to wear drug-store glasses for the closer work. Fitting two distance lenses would be good for hunting where I use a binocular frequently and don't often need close focusing. I talked to a bench rest shooter about 70 that had distance lenses done and wears trifocals. He was very happy. He said if you have any cataracts at all, fuss until your opthomologist agrees to do it. Tell him it's impacting your lifestyle negatively (ie: shooting). Incidentally, I and several friends use the Stallings SR Microsight for service rifle shooting and it is quite helpful, cataract lenses or not.
Click to expand...
This is the info gleaned on the web concerning Crystalens:
http://www.crystalens.com/us/

I'll keep on reading as my eyesight is a little wonky.

Phil aka tazzman
 
I am 71 now and still shoot both short and long range, I had both eyes done two years ago and followed my doctors advice and opted for both eyes in long range. At first I never used any lens correction to shoot either and then as time went on I find I now have to use bifocals again with very little correction for distance but a little magnification for seeing all of the close up stuff, it is a lot like it used to be but I still can see well without glasses for driving and for anything other than working with something up close.
For me I think the decision was a good one to go with both eyes in long distance, but that was me.
Denton
 
Andy's got it

There is a 50% chance of needing reading glasses with the Crystalens. Save a bunch of money and get the long range lens coupled with a good pair of progressive lens glasses.
 
More than a little wonky

tazzman said:
This is the info gleaned on the web concerning Crystalens:
http://www.crystalens.com/us/

I'll keep on reading as my eyesight is a little wonky.

Phil aka tazzman
Click to expand...

Were my eyes after one catarac was removed and the other one not. That experience alone makes me glad that I got both lenses set for long and use reading glasses. I do not know how the "bionic eye thing will work with presbyopia. As we age it is as sure as anything else. My eyes corrected from needing coke bottle lenses most of my life to 20/15. After two or three years they settled at 20/20. No worries. What's not to like? 20/20 with reading glasses for close work? I would wear out my doctor with what if's re the non-matching option. I personally buy into the binocular thing. Fifty years ago my grandad told me to use both eyes when shooting. "you can see better with two eyes than you can with one". I seem to remember reading that visual acuity suffers when one eye is shut. Gooed Luck.
Tim Thompson
Hanover PA
 
New technologies

virg said:
There is a 50% chance of needing reading glasses with the Crystalens. Save a bunch of money and get the long range lens coupled with a good pair of progressive lens glasses.
Click to expand...

I was going to mention crystalens but elected not to comment on it. This technology has by no means been perfected. If a young person gets damaged eyes and replacement lenses are required the crystalens technology will probably work fine. The ciliary mussels are in good condition and will heal properly. In an aged eye the failure rate goes up. Often working correctly for a couple of years then failing. For shooting I would opt for binocular vision for distance and use progressive spectacles for intermediate and near. Multi coated transition photochromatic lenses might also be a help regulating glare which causes flare in synthetic implants. This isn't as much of a problem with the natural multi layered construction of the human eye lens.
Andy
 
Andy,

Can you define intermediate & near? My accommodation is surprising me at the moment, though maybe it will regress as things settle down, but right now, I can read my mobile phone 3-6 inches out from my extended arm, which suggests that on a day to day basis, I don't need intermediate correction, only when settling down for the hard slog in front of the computer screen.

Thanks, John
 
Reccommendation on suppliers for Safety glasses

Andy Cross said:
As an optical engineer I worked in the ophthalmic section of the company as the last port of call and worked with ophthalomoligsts on a daily basis. Whether to fit two long distance lenses and use corrective lenses for intermediate or near vision or split the field and fit one for long sight and another for near essentially creating monocoluar vision is debatable. But you do have to get the balance correct for yourself as it isn't easy to correct without more surgery. Trouble is you can't trial various options first.

Here is another option that has been done a lot recently. Fit long lenses for both eyes. Then get a pair of progressive lenses fitted to your spectacle frames that have no power in the distance. There are many different types of progressive lenses these days and all have different field parameters. You are sure to find a type that suits. Try out one such lens in your specs on the eye you have had a replacement lens for long vision done. If you like it then get both done that way.
Andy
Click to expand...

Andy:
I also have had cateract surgery and now contemplating a supplier for shooting/safety glasses.
Also which product should the glasses be made from (Glass/Plastic/Polycarbonate/Lexan)
My distant vision now is fine but need correction for reading.
Requesting your learned opinion.

All other opinions or experiences welcome.
Thanks in advance!
CLP
 
Last edited:
i had distance done in dominate left eye and near done to right eye...
computer glasses some times...reading glassed for sure,
but i have an issue with iron sight rifles...left eye does not seem to focus short enough...
so iron sight shooting is no longer much of an option.
sort range pistol shooting...right eye is not in focus...so pistol shooting mostly sucs except for true self defense
as in body sized targets and iron sights..( i can shoot a bit better than that.....)

far/near was my docs recommendation....but while i can live with it( a bunch better than blind) i'm not sure what the answer is.
i wear reading glasses for lathe work.....

mike in co
 
John, I had cataracts removed about 5 years ago. I asked for implants that will allow me to see the frickles on a pretty girls nose at 50 yards. I'm almost there with distance in both eyes(25/20 & 30/20). I shoot short-range benchrest with both eyes open. I did have to adjust the scope (right eye) slightly.

I do use dollar store glasses for reading.. 2 1/2+ .
 
Intermediate

John Kielly said:
Andy,

Can you define intermediate & near? My accommodation is surprising me at the moment, though maybe it will regress as things settle down, but right now, I can read my mobile phone 3-6 inches out from my extended arm, which suggests that on a day to day basis, I don't need intermediate correction, only when settling down for the hard slog in front of the computer screen.

Thanks, John
Click to expand...

Well intermediate distance can vary quite a bit from person to person. But as a rule of thumb reading can be described as being just short of arms length up to as close as your eye can focus. Intermediate from about arms length out to the point of where distance glasses become effective. The idea behind tri-focals was another segment containing power half way between distance and reading. Progressives have virtually made tri-focals redundant but you can still get them.
Andy
 
Safety glasses

C.L. Peterson said:
Andy:
I also have had cateract surgery and now contemplating a supplier for shooting/safety glasses.
Also which product should the glasses be made from (Glass/Plastic/Polycarbonate/Lexan)
My distant vision now is fine but need correction for reading.
Requesting your learned opinion.

All other opinions or experiences welcome.
Thanks in advance!
CLP
Click to expand...

From a pure safety perspective polycarbonate material is without question the way to go. But they will be more susceptible to scratching than even CR-39 material. So plan on replacing the lenses yearly. CR-39 although not as impact resistant can have various scratch resistant coatings applied to them which extend theit life. Glass ( even chemically ot thermally hardened ) doen't have a therapeutic goods administration or TGA safety rating in Oz so I doubt if it has in the uS either.
Andy
 
A word of advice

Charles Curry said:
John, I had cataracts removed about 5 years ago. I asked for implants that will allow me to see the frickles on a pretty girls nose at 50 yards. I'm almost there with distance in both eyes(25/20 & 30/20). I shoot short-range benchrest with both eyes open. I did have to adjust the scope (right eye) slightly.

I do use dollar store glasses for reading.. 2 1/2+ .
Click to expand...

With dollar store glasses there are a couple of things to watch out for. First they only offer shperical correction. If you need toric correction you would be better off getting the right prescription. Second for best eye comfort the optical centres of the lenses need to match your pupilary distance or PD. Depending on the power of the lenses the more out of alignment they are the more prismatic eye strain they create. This goes for vetical displacement between lenses also. Personally I don't think they are worth it.
Andy.
 
I can relate to that, Andy. If my eyes were any closer together, they would both be on the same side of my nose.
 
my eye doc suggested cheap reading glasses over prescription...........
just goes to show ya...
mike in co
Andy Cross said:
With dollar store glasses there are a couple of things to watch out for. First they only offer shperical correction. If you need toric correction you would be better off getting the right prescription. Second for best eye comfort the optical centres of the lenses need to match your pupilary distance or PD. Depending on the power of the lenses the more out of alignment they are the more prismatic eye strain they create. This goes for vetical displacement between lenses also. Personally I don't think they are worth it.
Andy.
Click to expand...
 
Why

I bet you didn't bother to ask why ? Most people don't. The reason for saying something like that would be more important than the suggestion itself.
Andy.
 
I've got macular edema, similar to macular degeneration but different, and have been getting shots in both eyes for the past year and a half or so which I guess complicates things some. The right eye has a cataract that's like having a greasy thumbprint in my line of vision which is really distracting and cuts my not too hot vision considerably. I go see the retina specialist tomorrow and will try to get an answer out of her. Wish me luck.
 
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