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Cataract surgery, how to chose focal distance

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Cataract surgery, how to chose focal distance

Old 09-03-19, 11:53 AM
  #1  
teacherlady
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Cataract surgery, how to chose focal distance

I'm having cataract surgery in a few weeks, and am having trouble choosing a focal distance for the new lenses. I think I want monofocal lenses, because I have read that they have fewer complications.

Factors affecting my decision:
I've worn glasses since I was 7 years old. I don't mind wearing them; they are part of my identity.
I bicycle a lot. I'd like to be able to get not-too-expensive biking eyewear for protection against sun and wind.
I'm a text-based life form. I read a lot. I prefer paper, but I read on my desk-top, my phone, and my Kindle as well.
I knit and sew, and when I make mistakes, (which is often) I have to do very close work.
I travel, including bike touring for several months a year, and would like to keep the fuss and weight of extra glasses to a minimum. However, I need to read maps, including paper maps.

I'd love to hear what others decided, and particularly would like to hear from people who have regrets about what lenses they chose. I'd also like to hear how you manage juggling glasses during recovery and after.

I've read the discussion on focal distance from a few years ago, but I imagine there are new thoughts and experiences since then.

Thank you!
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Old 09-03-19, 02:15 PM
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I haven't had it done yet but definitely is on the radar. When I visited the DMV recently for a drivers license renewal the lady who handled the paperwork suggested I return to the DMV and update the restrictions on my drivers license once the surgery was done. I would then be able to drive without using glasses if I got the version that corrects for distance. It sure would be nice to go back to single-vision glasses for reading and be able to ditch the glasses for driving. She also told me I could be cited for not using glasses if I had the correction and didn't notify DMV of the change.
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Old 09-03-19, 02:56 PM
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Thank you!

Thank you! I hadn't thought of that.
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Old 09-03-19, 04:14 PM
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Originally Posted by VegasTriker View Post
I haven't had it done yet but definitely is on the radar. When I visited the DMV recently for a drivers license renewal the lady who handled the paperwork suggested I return to the DMV and update the restrictions on my drivers license once the surgery was done. I would then be able to drive without using glasses if I got the version that corrects for distance. It sure would be nice to go back to single-vision glasses for reading and be able to ditch the glasses for driving. She also told me I could be cited for not using glasses if I had the correction and didn't notify DMV of the change.
What does your DMV say about contact lenses? That’s what I wear for “corrective lenses.” How would they know you’re not wearing contacts?
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Old 09-03-19, 05:30 PM
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Long story shortened but a vitrectomy in my left eye hastened the development of a cataract by years... the right eye is several years off. I've decided that I want distance vision and can wear readers for everything else. Currently I do need some correction for slight nearsightedness in my right eye and even less in my left. So I do have two pairs of progressive lenses, one clear one sunglasses. They're mainly for use in the car so I can clearly see things on the dash... and on my bike so I can see the bike app on my android. That and I have readers scattered all over the house. Having said that, my decision that monovision wasn't for me is a personal one and may not work for you. Also part of my decision revolved around if I ended up not liking monovision there wasn't much I could do about it post surgery but distance only vision could be easily corrected with readers or progressive lenses.

Also may I suggest that you consider or at least research Laser cataract surgery or sometimes called Refractive laser assisted cataract surgery. Conventional surgery uses a handheld "cutter". The skill of the surgeon, at least for making the cut, is taken out of the equation. The laser also breaks up the old lens. I went that route with the big downside being insurance doesn't usually cover it. With the vitrectomy in that left eye they told me if I ended up with 20/30 or 20/35 corrected vision I'd be lucky. Well I'm either very lucky or perhaps the laser decision helped but my corrected vision in that eye is 20/20. If you decide laser is for you they may tell you that you're not eligible... that's what they told me because I don't have astigmatism or something like that and so it wasn't FDA approved for me. Anyway, I insisted so there are ways around the restriction.
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Old 09-03-19, 06:16 PM
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Originally Posted by horatio View Post
What does your DMV say about contact lenses? That’s what I wear for “corrective lenses.” How would they know you’re not wearing contacts?
My surgeon gave me a wallet card that states 'Interocular Lens'.
I went with distant focus and my wife went with reading.
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Old 09-03-19, 06:41 PM
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Why not multifocal? Function similar to the eyeglasses and cover all focal lengths.

I had multifocal lenses inserted about 7 years ago. Have always considered that one of my better life decisions.

At that time Medicare would only pay for fixed focal length lenses. So I had to pay the difference. Not an easy thing. But it was the right choice. Financially not having to buy glasses has paid for the multifocal implants.
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Old 09-03-19, 07:51 PM
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Moved from 50+ to Pills and Ills.
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Old 09-04-19, 05:52 AM
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I went through the same process a year and a half ago! I went mono and I still wear glasses with a progressive lense. But it is basically clear with only magnification at the bottom for reading. I bought cycling sunglasses with readers in the lense. As we do a lot of touring this works great for map reading!
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Old 09-04-19, 07:02 AM
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I went with distance vision, need glasses for reading, for the following reasons.
My doc favored it, though he offered all other choices. It seems to be the most commonly chosen. So it is likely to be the best understood and supported. You can get reading glasses at the drug store, not distance glasses.

I still wear prescription progressives, though in theory I could drive w/o them and get cheaters to read. But that is a bother, it's easier to just wear glasses all the time.

I didn't need glasses to read previously. One eye was distant, the other near. So it was a bother at first. But a friend choose that bi-optical option and has had problems, some blurring. I occasionally wish I had chosen close vision, but that would just flip the problem to the other side.

One thing I noticed after the surgery, which was over the winter: I'm a birder and commented to my wife in the spring how much brighter some of the plumage seemed on the warblers that year. She reminded me that the cateracts had dimmed my vision and I was noticing the difference.

By the way, check your insurance, they will probably cover a new pair of glasses after the surgery.

Last edited by bargeon; 09-04-19 at 07:05 AM.
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Old 09-04-19, 09:54 AM
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My experience transitioning from myopia with -11diopter glasses pre cataract and good vision from 1" to ~6" from
the eye surface was a bad week between one surgery and the next as one eye was now 20/20 from ~3'and the other blurred
from 6" out. After the 2d eye was done both were corrected to 20/20 from 3' out and only 2.75 diopter reading glasses
needed. Over the next 2 yrs the vision drifted to 20/20 at 6' then ~10' out with adequate vision closer in but reading
glasses at 2.75 diopters and computer use 1.75 diopters. I can read my bike computer with uncorrected vision but
generally I wear a set of Rx progressives nominally 0 at top 1.75 in mid and 2.75 at bottom about 90% of the time now.
When looking at TV/movies/concerts/driving/conversation with small group I really don't need glasses and frequently
take them off. I have reading glasses all over the house. Rx glasses pre-cataract were ~$400-600, now they are ~$100.
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Old 09-04-19, 10:16 AM
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After the surgery, the Left eye is 20/15 at 20 feet to infinity.
The Right eye is almost 20/20 at infinity and beyond.
So I have bifocals setup with the top section for 2 to 8 feet and the lower section at 17 inches.
In both sections, the Right eye is +1/2 diopter stronger than the left.
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Old 09-04-19, 08:12 PM
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I had high myopia both eyes(-12 diopter) and decided to get both eyes corrected for distance. From 50 years on however, I wore contact lenses with mono vision. Meaning, right eye could see far and left eye could be used for reading. I was a big fan of mono vision. So, after the cataract surgery I ask my eye doctor if I could get a contact lens for reading for my left eye and not have to get progressive glasses. He loaned me one for my left eye and the immediate problem is that you cannot change focus. So, I had a fixed reading distance and it was quite limiting. Meaning I was used to being able to see a computer screen and read a book with no problems. With the contact I could read a book, but I could not focus on a computer screen because I sat further back. Lots of things you do close up, require some kind of change in focus. So, I ended up with progressive glasses that allow me focus on things that are within arms reach. Since I had high myopia I was also more prone to retinal detachment, my doctor felt far vision in both eyes left me with the ability to see far if an eye had retinal problems in the future. In terms of the lense replacement type, I also had lenses with blue light blocking. Not sure if it helps, but my doctor felt I needed it.


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3496098/

I have settled in to using reading glasses for the computer(+1.5). The progressive glasses are not the best for scanning a large computer screen, I play computer games. For close work, I purchased these:

https://www.amazon.com/Donegan-OptiVISOR-Headband-Magnifier-Magnification/dp/B0015IS6K2/ref=sr_1_1?keywords=donegan+optivisor+glass+lense&qid=1567650080&s=gateway&sr=8-1

I have a DA-5 and a DA-7. The DA-5 I use for cutting finger nails, and such. The DA-7 I use for antique clock repair. The DA-7 was based on what I could focus on before cataract surgery. As a high myopia I could see down to an inch in front of my eyes. I could take out splinters no sweat. Make sure you get the glass lens version, they are very good optically.

For riding a bicycle, I use sunglasses with a +1.5 bifocal, that I purchased at Walmart(under ten dollars). It lets me see the handle bars clearly and that is all I need riding. I got a clear pair also for riding at night with my bicycle light. I thought I would like not wearing glasses, but found that the progressive lenses let me do everything I used to be able to do. When driving I want to be able to see the dashboard and what is happening on the road. My wife on the other hand has had perfect eyes all her life and now that she needs reading glasses will not go with progressives. My older neighbors are like this also, they are always looking for their reading glasses when they need to do close work.

Finally, at 3 years out I had to have YAG surgery as I got 'second cataracts'. I was not aware of this condition until after the cataract surgery, when my optometrist brought up the procedure. I hemmed and hawed on getting this done, but in the end it was totally worth it.

Last edited by themp; 09-04-19 at 08:46 PM.
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