Cataracts - Which lens?

[MissMolly]

Good evening all - I was diagnosed a couple of years ago with cataracts and really didn't give it much thought. In the past month I have noticed I am having a lot of problems seeing clearly and went to the eye doctor for a new prescription for glasses. The doctor told me my prescription is fine - no change needed - and that my problem was with my cataracts.

I read all the old threads here on the forum and have done a lot of Googling for information. I know the procedure is virtually painless and everyone seems to be thrilled with the outcome. My question is, how do you choose what sort of vision to have? How do you know if you want near/near or near/far or far/far? This is a once in a life decision - whatever I choose I am stuck with it for life.

I am very near-sighted as I have been all my life. I've worn glasses since I was six years old. Since I've always been near-sighted do I stick with that? Or go with far-sighted and readers? Or one of each? How does one decide this? My ophthalmologist seems to feel that in any event, I will still require glasses no matter what due to astigmatism (although the astigmatism is not severe enough to require the special Toric lens).

As much as I would prefer not to have to deal with this (I have fears of people cutting on my eyes) I know I will have to make a decision in the upcoming months. But if I am going to be forced to do this in order to see at all, how do I make the wisest choice? What criteria do I use to make this decision?

I appreciate any insight you might share.

 

[BrianB]

I had cataracts in both eyes within a 5 year span, over a decade ago. I opted for good distance vision and need readers for anything close up. Those were the choices then.

I do not regret the decision but my understanding is that there are now multi-focal lenses that may require some time to adjust to but ultimately give acceptable near & far vision.

If I was making the decision now I would give the multi-focal option some serious consideration. Readers are a PITA.

Brian B

 

[Blue Collar Guy]

I took my mother about 15 years ago i dont remember them asking her what she wanted. after the procedure she wore reading glasses. i didnt know we had a choice.

 

[Likes_to_Lurk]

I had cataract surgery 3 years ago, after being near sighted since my teens. I opted to have both eyes set to distance and now have amazing distance vision without glasses. I have both readers and bifocals to read.

I researched the multifocal lens and decided not to use them. Some types don't always give good close vision, so you might still need reading glasses.

Both of my procedures went very well. You will be mildly sedated and the surgery is very brief.

I am happy with my decision and thrilled with my vision!

 

[MissMolly]

Yep, all sorts of choices. I have read the multi-focal are not universally loved. It's my understanding there is quite a bit of glare when you have those, but I will still consider it. I have worn glasses all my life - almost 60 years, so wearing readers would not be a problem for me (I don't think). What worries me is losing my near nearsightedness. If I have a splinter or need to thread a needle I take my glasses off to see what I'm doing. Other than things like that, my glasses are on my face 24/7. I'm not sure how well I will be able to see really close up if I lose my nearsightedness. But if I could go 90% of the time with no glasses and only need readers for reading and whatnot (assuming I choose to set both eyes for distance) then I think I would love that. So I just can't decide....

For those who have set both eyes for distance, how do you thread a needle or pick out a splinter, or other types of close work? Different readers for different tasks or what? And how does it work when you're on the computer if your eyes are set for distance? Yet still another pair of readers?

 

[Likes_to_Lurk]

I appeciate your question re: threading a needle, etc, as I used to do take my glasses off, too!!

I now have to use my reading glasses or bifocals. I also use magnifiers. I have a 10x mirror to fish out eyelashes and such.

 

[Moemg]

I had cataract surgery over 10 years ago . I have mono vision lenses . One eye for distance and one eye for close . My vision has been perfect . The only time I wear readers is if I am reading for a long period . I do not need them for daily chores or reading menus.

 

[W2R]

It was easy for me.

Years ago I had contacts which corrected my moderate nearsightedness so that I didn't need glasses to drive, and all I needed was readers. I absolutely LOVED the wide field of vision that I had with no glasses when walking around, driving, and so on. Also didn't mind wearing readers when doing close up work at all.

So, I was pretty excited about that option.

Despite the fact that I had significant astigmatism, they did not offer me the option of Toric lenses. They said the astigmatism was actually due to the cataracts themselves, and not due to the shape of my corneas. So, I just got the "plain jane" contacts that made me far sighted, with readers.

The surgery itself is a piece o' cake - - wish I could remove your worries. I was scared to death of it too. But, they gave me Versed which acted as a local anesthetic and I guess it calmed me tremendously during the procedure because I felt very relaxed. It only took about 5 minutes, give or take a minute I guess, and the whole time the surgeon was saying "look here, look there" or whatever, and talking to me. So it was all over before I was able to get scared. When I came back a week later for surgery on the second eye, I wasn't worried at all.

MissMolly, I can see perfectly on the computer for some reason, using my readers. I can read perfectly well with the same readers, too. I'm not sure how that can be, since I had trifocals before the surgery; nevertheless, I can see both distances very nicely.


For extra tiny things like threading a needle or doing very tiny, fine work, I use a bright light and that is good enough for me. If it wasn't, I'd get a good magnifying glass and use that. I got two types of readers (magnification +2.00 and +1.75) but only use the +2.00 readers.

 

[folivier]

Interesting thread. In my case I only started wearing glasses in my mid 40's for close work and reading, always had 20/20. Now have a slight correction also for distance. So what will I choose when my cataracts are "ripe"?

 

[kaneohe]

The choice was easy when I had mine 20+yrs. No multi-focal things existed so it was either lenses for close vision or distance vision. Since I was still working at the time and most of the work involved stuff like reading/microscope/using computer and other close work, I opted for the close vision so that I would not need glasses most of the time at work. That had the side benefit that I could look gorgeous most of the time . I also was very near-sighted for a long time so this seemed more natural since no major changes were involved. I used to delight in copying things smaller N times and challenge others to read the small print.

Of course I need the glasses for driving, watching performances, etc.but that is a minority of the time.

 

[Koolau]

After 15 years, I'm still PO'd as the doc who did my first surgery. He kept trying to talk me into a lens which would be good for reading. I kept telling him I read a heck of a lot less than I drive. I DO NOT WANT THE READING LENS. The guy put in the reading lens and then claimed it's not an exact science. My next surgery was handled by another doc and I got the 20:20 (driving) lens I wanted - near perfect. SO, now I need glasses to drive AND to read because I can't make one lens work for reading and the other for driving (as the first doc assured me I would be able to do.) I actually considered a law suit, but I'm sure the first doc covered his tracks too well. I wouldn't think so much about it, but I told the guy at least 3 times exactly what I wanted. He knew better I guess! NOT!! YMMV

 

[MRG]

I was very near slighted my whole life and did mono-vision. I have a pair of bifocals and use them only to read. Yes you lose some depth perception but 90%+ glasses free is pretty awesome.

Like said surgery is easy.

 

[Blue Collar Guy]

After 15 years, I'm still PO'd as the doc who did my first surgery. He kept trying to talk me into a lens which would be good for reading. I kept telling him I read a heck of a lot less than I drive. I DO NOT WANT THE READING LENS. The guy put in the reading lens and then claimed it's not an exact science. My next surgery was handled by another doc and I got the 20:20 (driving) lens I wanted - near perfect. SO, now I need glasses to drive AND to read because I can't make one lens work for reading and the other for driving (as the first doc assured me I would be able to do.) I actually considered a law suit, but I'm sure the first doc covered his tracks too well. I wouldn't think so much about it, but I told the guy at least 3 times exactly what I wanted. He knew better I guess! NOT!! YMMV

im sure this will happen to me

 

[Rambler]

I had cataract surgery 12 years ago this month at age 43. I had worn corrective lenses for 33 years.

I had the ReStor multifocal lens implants. Overall, I'm very happy. One thing to be aware of: you will have great distance vision. You will also have great reading distance vision. Now, extend your arm fully in front of you...from the tip of your fingers, out to 6-8 feet, you will have problems reading things in this range. Think shopping, the GPS in your car, etc. You will also have trouble reading in dim light, like in a dark restaurant. This is because of the way the multifocals refract the light onto your retina thru the pupil that dilates in the dark. You'll possibly/likely need a set of progressive lens glasses to cover this deficiency. I have a couple pairs of them. I keep a pair in each car, in case I have to rely on the gps to get me where I'm going. This will depend on the GPS unit in your vehicle...I can see the GPS on its massive screen in my 2017 Honda Ridgeline just fine, because the letters are large enough and with proper contrast. My 2014 Honda CR-V is not as good, but let me tell you, in my 2012 Ford F-350, the contrast was odd and the screen was small, so without the progressive lens glasses, the gps was useless. You may have this issue with standard single vision lens implants, or maybe not. One think I like about the ReStor Multifocals is that I can wear any sunglasses that I like, such as my favorite Maui Jim polarized sunglasses. If you have to wear glasses post op (like my mom who had hers done 30 years ago, and my dad who had his done 7 years ago, both with single vision lens implants) then you are stuck buying prescription sunglasses, or those big weird old people sunglasses that go over your prescription glasses. They are a bit more expensive. I think I had to pay $500 extra per eye, because the insurance would cover single vision but not multi focal, at the time. These had just come out not too long before I had my surgery so they were relatively new and still not covered by insurance. As far as I'm concerned, though, this was the best thousand bucks I could have ever spent. I do wear glasses occasionally, for the gps and for seeing the prices on the shelf while shopping, and on the rare occasion that we go out to eat in a dark restaurant, but not every day by any stretch of the imagination. Hope this helps.

 

[gcgang]

Molly, I'm in the same boat. Right eye is totally clouded, have worn glasses for nearsightedness since I was 7, often take my progressive lense glasses off for up close stuff. Was told my astigmatism is in the lense not cornea. While I understand this is now routine,I freak thinking about having my eyes cut on, and worry about which type of lense is best. My Surgery is scheduled for July 20.

I am going thru same thoughts - it would be awesome to be able to see far without glasses. But it would suck to have to find a pair of glasses every time I needed to look at my phone.

I'm thinking of the multi focal Toric in one eye, and a distance mono in the other. But will rely heavily on rec of current Doc. Will have met with three ophthalmology groups by the time I get done. Amazed at how much the conclusions of the first two differed.

Keep us updated on what you're thinking. I'll do the same.

 

[Lakewood90712]

I may need one eye done in a few years. Ok for now but getting worse.

I was told that intraocular lenses are a one shot thing, and if major complications happen (very rare) a person then needs a cadaver donor cornea to do a new lens. I have been told this by several people, including someone who had a bad outcome on the first.

Have things changed in the last 10 years on this ? I sure hope so.

 

[Amethyst]

This topic is very important to me, as my cataracts are getting worse and I now hate to drive at night due to the glare of oncoming headlights. Moderately nearsighted; currently use readers over the naked eye to do very detailed work. When wearing contact lenses, I have to pull out my grandma glasses (drugstore readers) to use a smartphone.

Fine, close-up work is my passion, and I've heard horror stories from other women who lost the ability to do truly fine needlework after cataract surgery. (Delicate fly-tying and circuit board soldering are probably the closest "male"-hobby equivalent).

I'm worried that even "grandma lamps" (lamps where you look through a big magnifier) and grandma glasses won't be enough to allow the level of fine work I demand of myself.

 

[Amethyst]

I've been wearing those for years. I didn't think they look weird or (perish the thought!) "old-people."

https://www.amazon.com/LensCovers-S...-4&keywords=sunglasses+over+glasses+for+women

i those big weird old people sunglasses that go over your prescription glasses. .

 

[Bestwifeever]

Extremely nearsighted here, like the OP from an early age. Even though I successfullyy wore the near/far contact lens combo, I knew I wanted both eyes corrected to 20/20. My surgeon left the choice completely up to me but said she was glad I picked that. I have the Crystalens implants (you can google it for more info) and can easily make out a menu in good light or a phone screen if need be but wear reading glasses for most closeup (I keep them scattered all over my house and a pair in my car, just the drugstore readers that my surgeon suggested).

I read, sew, and knit with the same pair of readers--I used to be able to thread a needle holding it so close to my hypermyopic eyes that DH thought I was going to stab myself in the eye. The readers are soooo much better for closeup work than my naked eyes used to be but if that ability was a priority I would survey a quilting group with members who had had the surgery and then ask the surgeon. For me it wasn't even a possibility that I would want to stay nearsighted.

Good luck! I hope your results make you as happy as mine have!!

 

[Bestwifeever]

I've been wearing those for years. I didn't think they look weird or (perish the thought!) "old-people."

https://www.amazon.com/LensCovers-S...-4&keywords=sunglasses+over+glasses+for+women

No worries, we're all invisible at our age anyway!

 

[savory]

Daughter had multi-purpose lens put in (inherited cataracts). She has a kind of mid-vision problem. Reading a computer screen requires glasses but a book and distance is mostly OK. We were coincidentally discussing this a few days ago. If she were to do it again, she would not select the same lens. However, what created the conversation was some new lenses. Not really sure what she would ultimately decide but I think it would not be the multi-vision.

I did watch my wife's surgery at the teaching hospital in Charleston, SC many years ago. Her eye basically took up the full TV screen so it had no real definition. No blood or gore. Appeared to be a very straight forward operation.

 

[Amethyst]

So I've heard, but if a garment or accessory is deemed "only for old people" then somebody must have been able to see the old people wearing it.

No worries, we're all invisible at our age anyway!

 

[Bestwifeever]

So I've heard, but if a garment or accessory is deemed "only for old people" then somebody must have been able to see the old people wearing it.

Only other old people can see the invisible old people. With their cataract-free eyes

 

[Silver]

I had cataract surgery over 10 years ago . I have mono vision lenses . One eye for distance and one eye for close . My vision has been perfect . The only time I wear readers is if I am reading for a long period . I do not need them for daily chores or reading menus.

This is my exact experience as well. Mono vision lenses, no issues with vision at all.

One thing to mention with severe near sightedness and cataract surgery; the likelihood of having a detached retina increases with the surgery because of the natural elongation of the eyeball due to near sightedness, and then the addition of the lens. I had a detached retina six years ago that was corrected with an in-office surgical procedure, and my vision is great. Just something to be aware of, and when you realize you are seeing a grey colored half moon in one eye, get to your retina specialist within 24 hours.

 

[MissMolly]

This is my exact experience as well. Mono vision lenses, no issues with vision at all.

One thing to mention with severe near sightedness and cataract surgery; the likelihood of having a detached retina increases with the surgery because of the natural elongation of the eyeball due to near sightedness, and then the addition of the lens. I had a detached retina six years ago that was corrected with an in-office surgical procedure, and my vision is great. Just something to be aware of, and when you realize you are seeing a grey colored half moon in one eye, get to your retina specialist within 24 hours.

Thanks. I've read this while researching all the options. I will just have to keep my fingers crossed that this doesn't happen. I know this is serious if not caught timely.

Much as I expected (but not hoped for) the responses are all over the place. *sigh* What to do, what to do