Cataracts [ocular, not Hardinge]

[Neil WyattModerator @neilwyatt]

Someone I know has been offered the choice of one long-sighted and one short-sighted eye.

Edited By Neil Wyatt on 29/11/2016 22:28:48

[Michael GilliganParticipant @michaelgilligan61133]

Posted by Neil Wyatt on 29/11/2016 22:28:32:

Someone I know has been offered the choice of one long-sighted and one short-sighted eye..

.

That's one option that really does not appeal.

MichaelG.

[Phil WhitleyParticipant @philwhitley94135]

I had cataracts in both eyes in my early forties, and also Keratoconus,and later a detached retina, having been short sighted all my life, today at 64 I take my glasses off in the workshop, especially when welding, I think today my eyesight is really better than it has ever been! Go for it!

Phil.

[John ReeseParticipant @johnreese12848]

I had cataract surgery in the mid 80's. The original intent was to have one eye corrected for far distance and the other corrected for mid distance. It did not quite work out that way. My right eye focuses perfectly at about 30" and the left at around 12". It worked out OK. I can read and do close work without glasses. I have single vision lenses for work at the computer. I have bifocals for driving and normal wear. When working full time in the machine shop I had occupational bifocal ssafety glasses made. Those lenses are near vision top and bottom and mid distance in the middle. My opthalmologist was great. She helped me optimize the lenses for the distances at which I was working. I tried trifocals at one time but scrapped that idea. I did not like being a bobble head trying to find the right lens segment for the distance at which I was working. I can go without glasses when welding. I tried it with bifocals but had trouble finding the right part of the lens to look through. If the surgery leaves you far sighted you can get "cheater" lenses to put in the welding helmet.

You can have excellent vision after the cataract surgery but may need more than one pair glasses, depending on your activities.

[Geoff TheasbyParticipant @geofftheasby]

My current situation is, Left – short sighted, natural focus at about 300 mm or less; Right – very short, natural focus about 100 mm in a good light, with contrasty subject, otherwise forget it. It's unsettling, wearying, frustrating, affects my balance, I can't do even close-up work like soldering printed circuit boards, and reading is difficult. So, I don't recommend 'one of each'. I also need new specs every few months…

Regards

Geoff

[michael howarth 1Participant @michaelhowarth1]

Michael…..the very best of luck and I am sure that you will make the right choice. As a beneficiary of your excellent advice in the past, just make sure that you can keep tapping it out on the keyboard.

Mick

[MikeParticipant @mike89748]

As a person who has recently been told I have the beginnings of cataracts in both eyes, I find all of the above most useful information, and in some ways quite comforting – so thanks to everyone who has contributed. I became short-sighted at the ae of 20, and not long afterwards I developed astigmatism. I need specs for driving and for reading, and I just can't get on with varifocals. I find them particularly annoying when driving – they were fine when watching the road, but when glancing at the instruments I was looking through the close reading part of the lenses and everything was blurry. Anyone have the same problem?

[The Novice EngineerParticipant @thenoviceengineer]

I've had cataract operations on both eyes and on recommendation from the surgeon I have one lens set to long distance [ miles] and the other set for close [arms length].

It didn't take long [hours] to get use to the set up and find it very easy to do just about anything, Driving, games , using computer, shopping , reading etc… the only issue is in the workshop I need a bit more clarity to see what I'm working on in the vice and machines and to check things close up, for this I have a pair of Intermediate/Reading Glasses [ . I'm thinking of getting Vari-focals so I don't have to push up or look over the glasses when away from the bench].

I've been short-sighted and wearing glasses or contact lenses since I was 10 [Varifocals for last 15 years] so the freedom to see clearly with out them has been great, especially in the morning …. no groping around to find the glasses!

One issue I did have [with both eyes] about 6 months after the cataract operations the vision started to blurr … this was due to a membrane in the eye growing over the lens. This was cut away by YAG laser in about 30 seconds at the Eye clinic with full vision restored after the eye drops had worn off [hours]

Steve

[martin perman 1Participant @martinperman1]

Mike,
I had a similar issue when driving until I learned to move my head instead of my eyes, re cataracts, I was told a year ago I had the begg?nings of cataracts but this year they mysterious disappeared and as a diabetic the hospital checks my eyes annually with no mention.

[Michael GilliganParticipant @michaelgilligan61133]

Thanks for the continuing input and encouragement

• As good stereoscopic vision is important to me, I am most unlikely to opt for a 'one of each' solution … although that may well suit the needs of others.
• Like Michael Poole, I used to be comfortable working very close without my glasses; but those days are long gone. [note: this thread might become a useful reference point, so here is a link to the Wikipedia page about Presbyopia]
• There are good arguments in support of both the long-sighted and the short-sighted solutions, but I am currently tending to favour the long-sighted:

1. Wide angle of vision is more relevant to driving and walking about, and it would be good to have this, unconstrained by glasses. [whereas close work is generally concentrated within a fairly narrow angle of view]
2. Depth of Field is a non-linear phenomenen; so it is perhaps 'better value' to have the distant portion. [still guessing numbers here, but; the trade-off might be something like '6ft to infinity' vs '2ft to 6ft']
3. Whichever solution I choose; there will be some close work that requires the use of optical aids, so I might be best to just accept that all close work requires something … i.e. Reading Glasses > Loupes > Optivisor > StereoMicroscope.

Please keep the comments coming: Many of us are of an age that makes this discussion relevant, and the pool of combined experience must be wide and deep.

MichaelG.

[John Stevenson 1Participant @johnstevenson1]

Just had new lenses fitted to both eyes within the last month.

Have gone from very, very short sighted to long sighted, Can walk round OK and drive the truck with good vision but close up work is a bit harder at the moment as relying on two pairs of cheap reading glasses and eye test isn't until late December.

Edited By John Stevenson on 30/11/2016 10:33:08

[Michael GilliganParticipant @michaelgilligan61133]

Posted by John Stevenson on 30/11/2016 10:32:31:

Just had new lenses fitted to both eyes within the last month.

Have gone from very, very short sighted to long sighted, Can walk round OK and drive the truck with good vision but close up work is a bit harder at the moment as relying on two pairs of cheap reading glasses and eye test isn't until late December.

Edited By John Stevenson on 30/11/2016 10:33:08

.

Thanks, John … Glad it went well for you

My first is 'pencilled-in' for mid-January, so hopefully I will not be far behind you.

MichaelG.

[Clive FosterParticipant @clivefoster55965]

I was naturally one long / one short sighted with no overlap and had no issues with stereoscopic vision, using optical devices et al. Left eye was long sighted so that became the master eye but I'm naturally strongly right handed so there were a few issues when I was very young and didn't understand things. With left eye being master there was a tendency to try to be left handed, or at least ambidextrous for certian things which conflicted with beign wired right handed. Odd balance issued worked out by the time I was 10 or so and no way can I shoot a rifle. Limited abilites for dancing gymnastics and anything else requiring fast precise control but how much of that was vision and how much me I know not.

No doubt the vision processing bit of the brain has to work harder with one long / one short so there will be limits at the top end. Had a graphic illustration of just how adaptable the vision processors are about 15 years ago when I had to have a corneal graft in the right, non master, eye due to a herpes infection causing a cloudy cornea. Operation left me with considerable astigmatism, a double focus and a bent visual field on that side. Bend is a hard vertical line at about 2 on the clock. Took about 6 months to adapt but I don't notice the problems now. Still there tho' as adaption fails sometimes. Looking round to reverse the car is the usual thing that will do it and the bend comes back briefly. Interestingly the adaptaion fails if I try to reverse using mirrors only as the mirrored veiwpoint effectively doubles the error.

Clive.

[MikeParticipant @mike89748]

That's interesting, Clive, because after 60 years in the target shooting sports I've come across a few right-handed men who have a left master eye, and this may be the reason why. I've always been lucky in that I'm right-handed with a right master eye – so strongly so that at one time I could shoot a rifle with iron sights with both eyes wide open. The unexplained statistic in this business is that very many more women than men have a right-handed/left master eye problem. That's not a sexist remark, just a fact – as any shooting coach will tell you.

[Dan CarterParticipant @dancarter89683]

I've been very short sighted since about 7, then lost focus ability 10 years ago. Couldn't get on with vari/multifocals so moved to monovision – one corrected fully for distance, one undercorrected for short, in both glasses and contact lenses. Works for some people, not others – as well as workshop, I play a lot of tennis and have no problem with stereo vision.

You could consider a cheap pair of specs from tesco etc with the monovision approach to see if it might work for you before choosing your permanent solution

[simon Hewitt 1Participant @simonhewitt1]

I had the op about 5 years ago, both eyes (1 week apart) Best thing I ever did. Before that I needed glasses to find my glasses, and had to use a strong headband magnifier on top of my glasses in the workshop. Now I work with computers every day without glasses, just using reading glasses for fine work.

The op is a bit scary, but for me anyway, the so called local anaesthetic was more like a general, I was vaguely aware of people moving around but not much more. Recovery was a few weeks – could see OK after a week, just take lots of care against infection.

Driving is better and easier. I do see some sort of light circles, looking at bright lights at night, at the edge of my vision, does not cause any problems. Plus you have built in UV filters, no more arc eye!

So at 58 I have perfect distance vision, pretty good reading, and +3 reading glasses for very fine work up to 12 inches away.,

Simon

[KWILParticipant @kwil]

Mike,

I am predominately right handed with a left master eye, I have shot rifle and pistol right handed but left handed shotgun.

Varifocals for me, distance and car instruments all clearly available, but I would like what they used to call "pilot" lens with an upper reading element, for when my head is in milling machine mode.

Edited By KWIL on 30/11/2016 21:56:47

[PaulRParticipant @paulr]

Bet you can't guess what I do for a living?

@KWIL and others: So much for progress. Time was you could order whatever combination of lenses you fancied in the same pair of glasses. This form of lens, the 'Franklin Split Bifocal' (bet you can't guess who invented them? ) consisted of two pairs of lenses of the required prescription cut in half, or thereabouts, and cemented with Canada Balsam to create what was in effect a pair of straight line bifocals (similar to the 'executive bifocal&#39. So you could have distance at top, reading at bottom or any other combination of distance/reading/intermediate/custom range. If you ask your optician for a pair today, he or she will either look at you blankly or tell you they can be obtained but are very expensive (which they are because someone has to actually make them by hand rather than pressing a few buttons). These lenses had a few disadvantages but served their purpose for particular applications, such as ours.

[VersabossParticipant @versaboss]

Hi all,

it's a bit depressing to read about all that successful cataract operations. So I can keep the balance to show one which went belly-up.

About 5 years ago my eye doc found it necessary to talk me into a cataract surgery. I had the usual fears, but finally succumbed and went ahead. But afterwards I had the feeling that something was wrong. Straight lines were not straight, circles were more like eggs, all persons on TV had flat head sides etc. etc. Naturally I immediately cancelled the second surgery date. A long series of tests followed, culminating in a second surgery in which the glass body in my eye was removed. Unfortunately the success was almost nil.
One of the tests was a laser scan of my retina. This is what it looks now:

The upper wavy line is the retina surface. Maybe you can understand a bit what kind of 'picture quality' results from that. A further problem is that part of my short-sightedness was corrected with the artificial lens, so I have now two very different apparent picture sizes in my eyes, which somehow the brain tries to overlay. Estimating distances is quite difficult now.

I don't want to bring panic an all those who stand for that decision, but unfortunately the docs never tell what can go wrong. 999 out of 1000 come out well, but if you happen to be the one…

Kind regards,

HansR.

[Michael GilliganParticipant @michaelgilligan61133]

Thanks for the 'reality check' Hans … and very sorry to hear of your problems.

My vision has deteriorated so much in the last six months that the operations are probably mandatory.

Retinal scans, Fields Test, and pressures are all good [despite my 'Iris Pigment Shedding'], so I have to trust in the Consultant's opinion that I have no other choice.

MichaelG.

[John McNamaraParticipant @johnmcnamara74883]

Hi

While I do have the beginnings of cataracts they are not "ready" according to my opthomoligist. I do wear glasses for long sightedness, from age 50 I needed them. Now I need glasses for all distances. I wear them nearly all the time.

I switched to continuous varifocals a few years ago. The standard type are heavy. Thinner lighter types are available at higher cost the refractive index of the is different making them thinner and lighter. The benefit is my nose can cope with the weight better, as your prescription changes and if your glasses are getting thicker worth looking into.

Yes the days of levelling work by eye are gone…. varifocals put paid to that, there is too much distortion. You get used to the distortion within a week or two, the human brain is a wonderful thing it adjusts to them. I would never switch back to separate reading and distance glasses.

As you can see from my photo I prefer aviator style glasses with wire frames, better protection and a wider field of view. They also tend to stay on when I am looking down into a piece of machinery, they don't fall off. They are sturdy. I also look for big softish nose pads for wearing comfort and request they be fitted no charge when I order a new pair.

My worst experience with glasses was when a pair was fitted too high.
When you order your glasses they will ask you to look into a device that looks a bit like a pair of binoculars or alternatively they will put the glasses style you are ordering on and mark the dummy plain glass lenses that are fitted to the shop samples with a felt pen. What they are actually doing is measuring your eye height relative to your nose and the lens.
They got the measurement wrong; they did not fit properly, now I pay particular attention when they take the measurement. Ideally you want an experienced specialist fitter.
For something you wear 16 hours a day it is important to get it right.
The same applies for the eye test, repeat each step until you are sure that A or B is better, don't let them hurry you.

Regards
John

Edited By John McNamara on 01/12/2016 11:09:49

[Mike PooleParticipant @mikepoole82104]

Posted by John McNamara on 01/12/2016 11:09:09:

Hi

While I do have the beginnings of cataracts they are not "ready" according to my opthomoligist. I do wear glasses for long sightedness, from age 50 I needed them.

My mother was strung along with this not ready thing, her quality of life was seriously impaired before she finally joined the waiting list which added another six months to her not being able to read or see that she had missed things when cleaning. Is this ready thing just a delaying tactic to keep the waiting list down? The treatment when she finally got it was absolutely first class but with the benefit of hindsight I think she could have had a much more enjoyable couple of years if she had gone private and got it sorted quickly instead of soldiering on with seriously impaired eyesight, being from the generation who don't complain and just get on with things doesn't always serve you well as we live in a world where the people who make the most noise get the most attention.

Mike

[Clive FosterParticipant @clivefoster55965]

Mike

Cataracts become more brittle as they get older so removal methods involve breaking them up in situ and removing the pieces. According to this link :- **LINK** ultrasound is the most common way but there are several others. Bringing the cataract out in pieces minimises the size of the cut made in the eye to get the cataract out which is clearly a good thing. Modern replacement lenses can be folded for insertion which further reduces the size of cut needed.

Flip side of this is that you have to be sure that the cataract is brittle enough to break up cleanly so all the parts can easily be removed. I imagine there is a considerable judgement call as to when the cataract is old enough and brittle enough to break up properly with the equipment the surgeon will be using. Better to err on the side of caution and wait a bit longer until the thing is certain to break up than having to make larger cuts to get the bits out. Being biological catarcts are unlikely to be homogeneous so its easy to imagine a situation where part of the cataract is less brittle than the rest so a longer wait is needed to ensure that it will all break up properly.

Clive.

[Colin BishopModerator @colinbishop34627]

The NHS are indeed putting off treatment as long as possible for budgetary reasons. Also they may only treat one eye 'to keep you going'.

I had both eyes done privately four years ago, one was more urgent than the other and treated in January, the other in November. The actual procedure is painless and straightforward, no worse than a visit to the dentist.

With regard to the distance setting, I have worn varifocal glasses for many years very successfully and after discussion with my consultant I opted for the implants to give a similar focus to that already existing which mean that there should be less likelihood of any adjustment complications. This seemed to work out pretty well for most situations but if I really want close up focus then I can get this by removing my glasses. You will never get everything perfect and everybody is different. Earlier this year I did get some regrowth over one of the new lenses but the YAG laser treatment treated it in just a few minutes.

The other huge bonus of the new implants was the restoration of colour. As cataracts are gradual you don't realise just how much they are dulling your vision. Afterwards it was a revelation with everything bright and vibrant. Just in time for our holiday to New Zealand!

At the time it cost me about £2,300 per eye but was money well spent. If you have set aside money for a rainy day then this is it!

Colin

[Richard S2Participant @richards2]

I consider myself lucky in consideration to many of you here with various eye problems etc. I can only endorse the use of Vari-focals from my perspective.

I've had to wear glasses since I was Forty. Possibly hereditary, more probably due to the Eye strain from spending 8 hours + in front of flickering 50Hz Monitor Screens and early VDU screens. One day at work, my eyesight just went out of focus for short-middle distance. Started with a plain lense for PC work etc. 10 years later, I was on the 'Varies' and after getting used to them, really suited my needs.

The last 2 sets I've had, I specified Premium grade Lenses with Close Focus (25 cm min) on the bottom. I actually took my Depth Gauge to the Test, so I could be sure to read the 1/64th graduations ok. Top end is infinity and I can adapt instantly to all distances in focus with very little head adjustment.

Had 2 pairs made, 1 of them with Reactive Glass for outdoors (bright light phyiscally hurts my eyes).

I know these are not for everyone, but it is possible to adapt

I also use a 4 dioptre Jeweller's Loupe direct for the really small stuff.

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