jim miller

Hi all,

I'm 38 and I've been having bad halo/starburst problems at night.
Several doctors have noticed the beginning of nuclear cataract, and a
surgeon I've been working with, very experienced, has offered to
perform cataract surgery, on my right eye at first. I have a couple
questions.

Since I'm only 38, I haven't lost my near vision much yet and I pretty
much enjoy focusing at any distance. After the surgery, of course, I
will completely lose near accommodation in the first eye. Is this
typically a traumatic thing for younger people who have the surgery,
for it to happen suddenly, all at once? Does adjustment take a long
time?

Secondly, for the time period, unknown how long, between having the
first and second eye done, the doctor said my eyes will be
"unbalanced", especially because one eye will be accommodating still,
but the operated-on one won't be. I already wear glasses, and for
surgical reasons, the doctor will implant a lens in the first eye to
adjust it to -2 (so as not to be too different from my other eye,
-3.75). What will be my options as far as "balancing" my vision goes?
It sounds like graduated lenses in my glasses will be out of the
question until both eyes are done? The doctor also said that I will
tend to favor one eye for different tasks, such as reading or far
vision?

In general, what is life like after cataract surgery, or after
naturally losing the ability to accommodate? The prospect seems scary
right now, because it sounds like it's a constant battle to find the
right focus for different close-up tasks, such as reading or using the
computer or looking at something across the room. Do most people
perceive this as a big handicap, or a handicap at all?

Thanks for reading,
Jim

robert kopp

I was about 30 when I began wearing hard contact lenses, and found that
this greatly reduced accommodation. I began to wear reading glasses, but
did not regard the experience as particularly traumatic. If your
cataract continues to progress, you may not be able to postpone surgery
very long in any case.


Now 55, I have had cataract surgery in one eye and the other is -11 D. I
wear a contact lens on the unoperated eye and this arrangement causes no
trouble, except that vision is deteriorating in the unoperated eye.
Unlike you, though, I had no or very little accommodation before surgery.


Before lenses were invented, loss of accommodation was a disaster for
those in many professions, with only myopes being able to continue. I
don't think it's much of a problem at the present time, however.


--
Robert "Tim" Kopp
http://****ytic.tripod.com/

richard schumacher

I was in much the same situation. The lack of accomodation in one eye never
bothered me. I would suggest that you wait until you find that eye longer
useful. Then the surgery will provide a large relative improvement despite
the loss of accomodation. And at your age you will probably start to lose
accomodation in both eyes soon anyway :_>

You should consider experimenting now with disposable contact lenses to see
what focus distance will work best rather than letting your surgeon pick
something for you. You may want to do exactly what he suggested, or you may
find that the different focus distances drives you nuts. In my case it was
three years between surgeries. The operated eye was -3 and the unoperated
eye was -11. The difference was made up with a contact lens in the
un-operated eye with a pair of glasses over both. This worked great for me:
I took off the glasses or peeked under the lenses for reading, and wore them
for driving. The glasses also corrected the astigmatism induced by the
surgery, which is common. Very occasionally I'd remove the contact lens for
close work.

I've just had my second surgery and so, as anticipated, now need a magnifier
for close work. It's a bother but this still seems the best overall
compromise.

jim miller

Hi all,

I'm 38 and I've been having bad halo/starburst problems at night.
Several doctors have noticed the beginning of nuclear cataract, and a
surgeon I've been working with, very experienced, has offered to
perform cataract surgery, on my right eye at first. I have a couple
questions.

Since I'm only 38, I haven't lost my near vision much yet and I pretty
much enjoy focusing at any distance. After the surgery, of course, I
will completely lose near accommodation in the first eye. Is this
typically a traumatic thing for younger people who have the surgery,
for it to happen suddenly, all at once? Does adjustment take a long
time?

Secondly, for the time period, unknown how long, between having the
first and second eye done, the doctor said my eyes will be
"unbalanced", especially because one eye will be accommodating still,
but the operated-on one won't be. I already wear glasses, and for
surgical reasons, the doctor will implant a lens in the first eye to
adjust it to -2 (so as not to be too different from my other eye,
-3.75). What will be my options as far as "balancing" my vision goes?
It sounds like graduated lenses in my glasses will be out of the
question until both eyes are done? The doctor also said that I will
tend to favor one eye for different tasks, such as reading or far
vision?

In general, what is life like after cataract surgery, or after
naturally losing the ability to accommodate? The prospect seems scary
right now, because it sounds like it's a constant battle to find the
right focus for different close-up tasks, such as reading or using the
computer or looking at something across the room. Do most people
perceive this as a big handicap, or a handicap at all?

Thanks for reading,
Jim

tomkopan

You may wish to try something like the new Acuvue Bifocal Lens on the operated
eye. This will in some ways mimic the effect of accomodation. Otherwise, what
is likely to happen, and you have given no indication as to what kind of vision
you now have as far as clarity goes, that the newly operated eye will become
your dominant eye, causing the now worse eye to follow along and possibly
either try and focus along with the other or it may learn to supress vision
until it is done also.

Dr. Tom Kopan - Dana Point, CA

robert kopp

I was about 30 when I began wearing hard contact lenses, and found that
this greatly reduced accommodation. I began to wear reading glasses, but
did not regard the experience as particularly traumatic. If your
cataract continues to progress, you may not be able to postpone surgery
very long in any case.


Now 55, I have had cataract surgery in one eye and the other is -11 D. I
wear a contact lens on the unoperated eye and this arrangement causes no
trouble, except that vision is deteriorating in the unoperated eye.
Unlike you, though, I had no or very little accommodation before surgery.


Before lenses were invented, loss of accommodation was a disaster for
those in many professions, with only myopes being able to continue. I
don't think it's much of a problem at the present time, however.


--
Robert "Tim" Kopp
http://****ytic.tripod.com/

richard schumacher

I was in much the same situation. The lack of accomodation in one eye never
bothered me. I would suggest that you wait until you find that eye longer
useful. Then the surgery will provide a large relative improvement despite
the loss of accomodation. And at your age you will probably start to lose
accomodation in both eyes soon anyway :_>

You should consider experimenting now with disposable contact lenses to see
what focus distance will work best rather than letting your surgeon pick
something for you. You may want to do exactly what he suggested, or you may
find that the different focus distances drives you nuts. In my case it was
three years between surgeries. The operated eye was -3 and the unoperated
eye was -11. The difference was made up with a contact lens in the
un-operated eye with a pair of glasses over both. This worked great for me:
I took off the glasses or peeked under the lenses for reading, and wore them
for driving. The glasses also corrected the astigmatism induced by the
surgery, which is common. Very occasionally I'd remove the contact lens for
close work.

I've just had my second surgery and so, as anticipated, now need a magnifier
for close work. It's a bother but this still seems the best overall
compromise.

jimlawton

I read recently, I think in New Scientist, that a new flexible IOL is in
development, which, it is hoped will allow accommodation - might be worth
checking if it's close enough for you to wait....

J

robert kopp

There's some kind of multifocal IOL already available, using another
principle. But you have to use this kind of lens in both eyes, and a few
patients (about 1%) have been so dissatisfied with it that they wanted
it removed.


--
Robert "Tim" Kopp
http://****ytic.tripod.com/

tomkopan

You may wish to try something like the new Acuvue Bifocal Lens on the operated
eye. This will in some ways mimic the effect of accomodation. Otherwise, what
is likely to happen, and you have given no indication as to what kind of vision
you now have as far as clarity goes, that the newly operated eye will become
your dominant eye, causing the now worse eye to follow along and possibly
either try and focus along with the other or it may learn to supress vision
until it is done also.

Dr. Tom Kopan - Dana Point, CA