Advice on cataract surgery

[MarkWalberg]

Vision is losing contrast, getting halos around bright lights, hard to drive at night, harder to read, harder to focus cameras.
I've worn glasses for astigmatism for decades. This is more than astigmatism.
So, I'm going to see the cataract surgeon in April.

I'm interested to hear about how your cataract surgery affected your photography.
Did it make it easier?
Did any new problems arise?
I read about different lenses that can be placed, single vision, triple vision, etc. Any advice on these?

I found a post here from Ranger9 that says that my Canon VI rangefinder will clear up. That sounds promising!
"This isn't going to be what you want to hear, but the viewfinder in my VI-T (and my P) improved dramatically after I had cataract surgery :-/" -Ranger 9

Actually, I cleaned it last week and it is pretty good now. Love those Canon RFs.
-Mark Walberg

 

[rhl-oregon]

Did it in June 2020, age 67.5. Easy surgeries. Takes about a week for new vision to resolve. I chose distance vision so must now use readers, and adjust EVFs (M10M, SL2, CL, RX1Rii) and OVF (Minolta A7, OM-4Ti) for glasses-free focusing. (I also now wear bifocals to correct double vision @ distance.)

I photographed George Floyd’s funeral in Raeford NC the day after the first surgery using my uncorrected eye with a GR/Hoodman loupe and RX1.

You should enjoy your RF patch and all round clarity soon.

 

[Dogman]

I had it last summer. Was planning it for earlier in the year but I got shingles (get the freakin' vaccine, otherwise...). Had both eyes done the same week and it was a breeze. I did develop the secondary cataract I had read about and had to get those zapped by my regular ophthalmologist with his nifty laser pistol.

Distance vision is improved. My left eye, which has been my weakest, is now sharper than my right. Still need a bit of correction, however. That's fine with me. I've worn progressives for over 40 years and having readers dangling around my neck is driving me crazy. I can see well enough to drive and function so I've procrastinated in filling the eyeglasses prescription. I go this week to get a new pair of progressive eyeglasses which should make life better, especially when it comes to seeing the settings on my cameras as well as seeing what I'm photographing.

The biggest difference I noticed was how bright everything became following the surgery. Also white. I did not notice it but everything white was tinted a yellowish brown.

Best of luck with your cataract surgery. I highly recommend it.

 

[kshapero]

Got the double surgery about 2 weeks ago. Took about a week to get things in good focus. Had cataract and lens implants (progressive tri focal, amazing). Photography is awesome. Of course, no more glasses. All in all it's going great especially since I was really suffering poor eyesight before the surgery. YEEHAA!!

 

[maddoc]

Got the surgery for my right eye in December 2020 briefly after retinal detachment was diagnosed. The surgery was quick, about 45 minutes, and local anesthesia only. The doc decided to adapt the replacement lens to my left eye, which is farsighted. Recovery was quick, after about 2 weeks the sulphur hexafluoride gas, which is used to keep the retina in place, had diffused out of the eye ball. Visibility has largely improved, especially at night. Focusing a M Leica with diopter lens attached is better than before the surgery (I use my right eye to focus/compose) but modern cameras with variable diopter setting are easier to use. One thing to consider, since the pupil is removed, the eye can no longer adapt to changes in brightness, which forces me to use sun glasses in bright conditions.

 

[CMur12]

I had both eyes done last spring, at 70. Surgery and healing went smoothly.

The disappointment in my case has been that implants expected to correct my myopia (and some of my astigmatism) to 20/20, only actually corrected it to 20/50. It worked out this way with both of my eyes, so that bit of my anatomy is different from that of most others. I'm glad I didn't have graduated/trifocal implants, as the correction would have been all off.

I still have to wear glasses. I haven't actually taken any photos since my surgeries, but I think I can see the focusing screen in eye-level finders well enough to focus without glasses now, which I couldn't do before. I still have two diopters of corneal astigmatism however, so that is my greatest drawback in this pursuit.

- Murray

 

[newst]

I had a cataract removed early in 2020, just before the shutdown on elective surgery. It was a mild cataract that was being watched for years but it suddenly got much worse over the course of one year, where I was no longer able to use my right eye to focus a camera.

The surgery itself was short, painless, and totally non-dramatic. My recovery was quick and uneventful.

I am mildly myopic, and generally don't use my glasses while in the house (which leads to searching for where I last left my glasses far too often), When given the choice of what kind of correction the new cornea should provide I opted to match what I already had. There was absolutely no issue with adjusting to the new vision. The only long-term adjustment I have made was to return to focusing a camera with my right eye.

 

[MarkWalberg]

Thanks to all for the very useful advice.

I had not thought about changes in the pupil. I read that pupil response to light sometimes returns to normal and sometimes not. The people I've asked locally have not been bothered by this after their cataract surgery.

I am certainly looking forward to seeing more clearly, particularly at night.

The comment about how whites went from a bit yellow/brown back to white is interesting.
One of the things I notice most about my vision now is loss of contrast. Blacks are no longer as black, particularly for small things like type.

If one gets monovision lenses (I presume these give good far vision), then I'd guess that reading glasses would be needed to set the shutter speed and aperture. If I still need correction at all distances (clearly some do after cataract surgery, like CMur12) then using progressives would work for this, like I've been doing for decades.

Mr. Long's comments about using the various finders is one of the main things I have been wondering about. I'm hoping to avoid the need for glasses up, glasses down iterations for running a camera. I recall one of our old lecturers in school, Eugene Robin, who lectured with three pairs of glasses on his head. He would be switching pairs of glasses during his lectures.

 

[davidswiss]

Recently had mine done and, like most, have distance lenses installed now. This is a pain for any adjustments on the camera itself as I then need to slap on readers. The view at the camera, now without specs, is great though. Much brighter and easier to focus. I'll have to see what the results are as I've not used a complete film yet.

 

[571514m3]

It's been 8 years now since I had it done on both eyes. After needing bifocals for 30 years. After stumbling when hiking and much compensating with everyday activities. After struggling with looking through camera viewfinders. After not being able to get decent sunglasses (the best were Revision Military Sawfly with prescription inserts behind the lenses). My surgeon recommended multi-focals: "why do it when you still need glasses afterwards?" I got them and he was right. After the second eye I drove myself home. And with both eyes I was able to see an hour after the operation. I was very pedantic following the post-op eyedrop regime instructions and kept away from dust and dirt! I now have perfect vision far and near, can do everything that I struggled with, need NO glasses. It was a good decision. The world is much brighter and I wear sunglasses a lot, same Revision Sawfly because they protect my precious eyes! At night looking at the moon there is a slight halo, it was more noticeable when it was just done. Having multi-focal implants means that the brain sorts out the image far or close but there is a slightly 'soft' range approximately 1m to 2m from the eye where sharp focus is maybe 90% of close and far focus, I think that is a small payoff for not wearing any glasses. Last, you see EVERY wrinkle and facial hair on people standing close to you, and my beautiful wife does not appreciate that but then again I don't mention this to people. Hope my experience helps you decide what is right for you.

 

[ranger9]

I was reluctant to have both eyes done at the same time, so had one about 18 months ago and the other last October. A few thoughts:

• The surgery itself is basically a breeze. Tip: Book the earliest appointment you can get on surgery day. Why: You're not allowed to eat or drink before the surgery (rules vary; I was told nothing after midnight) so if you are scheduled for later in the day, you will be miserably hungry and thirsty by "go" time. If you get an early appointment, you won't have as long to be miserable!
  
  
• Choice of your intraocular lens is a big deal and you should make sure the surgeon doesn't just brush it off when you go in for your pre-surgery consultation. The biggest choice is what distance range you want for your correction (this isn't super-exact; they only recognize four categories: close, reading distance, middle distance, and distant.) The surgeon told me that for men, usually they use a distant-vision IOL without even asking the patient, because "most guys want to be able to play golf without wearing glasses." At that point I put up my hand and said whoa: I told the surgeon I had been wearing glasses for distance vision since I was six and don't mind continuing to do so; I'd rather be able to read or use a computer without having to wear glasses. (So he set me up with a "grandma" prescription; he said a lot of older ladies having cataract surgery want to be able to read or do needlework without glasses, so they get a reading-distance IOL.) Incidentally, this is how I lucked into my Canon RF result, although I would not recommend choosing your IOL based solely on what will work best with your favorite camera. Still, it might not hurt to tell the surgeon you're a photographer and want to be able to use a camera comfortably.
  
  
• Another IOL consideration: If you have any significant amount of astigmatism (ask the eye doc, or look for a big number in the "spherocylindric" section of your prescription) you will still need to wear glasses for perfect vision even at the target distance for your IOL. How big a nuisance this is depends on your amount of astigmatism and your tolerance. Personally, I have a fairly large amount of astigmatism, but can still see well enough to read or use a computer (or a Canon P) without needing to wear glasses, but I need them if I want to enjoy stage shows or read the street signs while driving. Suggestion: Give your vision a month or so to settle down after surgery and then get a refraction done to see what you need (and don't be afraid to pester them so they don't just rush through it.)
  
  
• There are IOLs that are advertised as correcting astigmatism, and others that are advertised as covering multiple distance ranges. I immediately ruled those out because besides reading, stage shows, and photography, my favorite thing to do is driving, and I like driving at night. The special IOLs have multiple curvatures that can cause double images and flaring when looking at light sources at night, so no-go for me.
  
  
• The glasses you end up with after surgery play a big role in your overall satisfaction. It took me four months and three tries to get the opticians to fix me up with glasses that were actually right. They'll probably recommend "progressive" lenses (aka no-line bifocals) set up to correct whatever distances your IOL doesn't cover, plus whatever astigmatism correction you need. This is usually a pretty good compromise, but if you've never worn progressives before, be aware that they take getting used to (there's only a small zone appropriate for each viewing distance, so you have to learn to point your nose at what you want to look at and then raise/lower your chin until it's in focus.) They also make it harder to use many kinds of cameras. I got a pair, but what I wear most of the time is single-vision lenses set up for distance vision plus astigmatism correction. My IOL lets me see well enough without glasses to get by at reading and middle distances, while the single-vision glasses let me enjoy a full field of sharp vision while driving or watching a show.

Key points: Don't let anyone rush you into anything, and don't feel embarrassed about insisting that people listen to what you want and do their best to deliver it. You really don't want to need a do-over on your cataract surgery!

 

[halfaninchawater]

Thanks for sharing the experience and the info, especially from a photographic perspective. I'll need cataract surgery soon and this thread has been good reading. You have my appreciation.

 

[Calzone]

I’m 65 and it seems my need for surgery likely will be way off in the future, but “Maggie” my partner at the age of 69 had one eye done and then the another.

In her case she got lenses that corrected a bad astigmatism, but the possibility of needing reading glasses became a reality.

Her eye pressure got high, and an eye drop was prescribed, and a side effect was “dry-mouth” that for her became a serious condition that luckily subsided. It was uncomfortable.

Know that her lenses were mucho expensive because of her severe astigmatism, and there were all these upgrades that were not covered by Medicare and her Advantage Plan that she paid a lot of money for. Her doctor was very good and surgery was booked well into the future.

Anyways the upgraded lenses that insurance would not cover were very-very costly In her case. If I remember correctly $8K.

In my last eye exam the doctor told me that my night vision is likely only 90% -95% of what it use to be, but it could be a decade before it should be addressed. They mentioned that the longer I wait the better and more evolved the surgery will become, so the advice was to hold off as long as possible.

I suspect though that as the technology evolves it could be more costly. In my case my eyes and my prescription are stable, so they expect my required surgery could likely be a decade off into the future.

BTW I’m near sighted and can read and use a computer without glasses.

Cal

 

[maddoc]

Thanks to all for the very useful advice.

I had not thought about changes in the pupil. I read that pupil response to light sometimes returns to normal and sometimes not. The people I've asked locally have not been bothered by this after their cataract surgery.

About changes in the pupil, mine was completely removed from the eye and therefore no more pupil response to light possible. This is irreversible.

I have tried bifocal contact lenses after the surgery (for both eyes) but the eye-sight is quite blurry for distant objects, especially when using soft contact lenses. Hard contact lenses worked slightly better. I need +2.5D correction for hyperopic correction but there are no contact bi- or multifocal contact lenses available (at least in Japan), which can handle the difference +2.5 to 0D.

 

[KoNickon]

About changes in the pupil, mine was completely removed from the eye and therefore no more pupil response to light possible. This is irreversible.

I have tried bifocal contact lenses after the surgery (for both eyes) but the eye-sight is quite blurry for distant objects, especially when using soft contact lenses. Hard contact lenses worked slightly better. I need +2.5D correction for hyperopic correction but there are no contact bi- or multifocal contact lenses available (at least in Japan), which can handle the difference +2.5 to 0D.

Your information about your pupil being completely removed was news to me -- and kind of alarming, since I've never heard of that before. Maybe I just never put 2+2 together, since I did know that folks can be more sensitive to light post-surgery. Is this true for all these procedures?

I am 64, no issues as yet, though I am myopic and have worn glasses since 4th grade (age 8). I have heard of some folks having one eye corrected for distance and the other for close vision -- I guess the brain can sort this out?

This is a very informative thread. Thanks, all.

 

[muser53]

I had mine done 2 years ago for the same reasons the OP noted. As I was pretty nearsighted I decided to try Alocon's Vivity lenses. They are considered an extended range of vision lens. My surgeon thought i would get good intermediate to distance vision.
My goal was to be able to see from my dashboard to infinity. I was ok with the idea of needing reading glasses. The result is that in good light I don't need readers and only rely on them in the evening. My recovery was easy and I've experienced no side effects or new vision issues. I only wish I could have done this sooner. Oh yeah I am an M user and acquiring accurate focus is again really easy.
Do it!

 

[MarkWalberg]

Thanks to all for pointing out things to think about. ranger9 noted some issues about the multifocal length lenses being trouble at night because of reflections. I wouldn't have thought to ask about that. Thanks !

Also, I realize that my astigmatism can be caused either by my lens, in which case the new lens should fix it, or by my cornea, in which case the new lens won't fix it. I'll have to ask the doc if they can tell before the surgery. If I'm still going to need glasses after cataract surgery to correct the astigmatism from my corneas, then I think I'd do best with distance vision lenses and a pair of progressive glasses like I use now. However, your advice about the choice of distance correction gives me something to think about for the next couple months before I do this.

 

[Calzone]

Mark,

“Maggie” my partner had a very bad astigmatism. Her prescription glasses cost about $1K for the lenses.

When she got her cataract surgery performed they performed a combined new lens with a laser correction.

There was a possibility that no reading glasses would be needed and pretty much she would have perfect vision, but it ended up she needs reading glasses. Oh-well…

In our case we got a very highly skilled Doctor/Surgeon that utilized the newest technology. It was costly, and insurance didn’t really cover the upgrades.

The technology available is amazing, and the choices are kinda overwhelming.

Also know that everyone is different…

Maggie’s surgery was all the latest technology, and I’m pretty sure not all are cutting edge and skilled in the newest technology.

In my case I don’t think when I need the procedures performed that mine will be so complicated as Maggie’s.

Cal

 

[JWC1957]

Still doing the eyedrops at this time for my right eye. Left eye is yet to be scheduled. I couldn't believe the difference between the two eyes. I was asked to put together a show for a local museum and declined for financial reasons. Now I'm glad I didn't do it for any reason.

I'm just coming out of long Covid (2 years) and blamed my eyesight on that little bug. Turns out that this was building up before-hand.

Can't wait to get the other eye done. I'm also going to need hip replacement.

 

[maddoc]

Your information about your pupil being completely removed was news to me -- and kind of alarming, since I've never heard of that before. Maybe I just never put 2+2 together, since I did know that folks can be more sensitive to light post-surgery. Is this true for all these procedures?

I am 64, no issues as yet, though I am myopic and have worn glasses since 4th grade (age 8). I have heard of some folks having one eye corrected for distance and the other for close vision -- I guess the brain can sort this out?

This is a very informative thread. Thanks, all.

Me neither but it is what the doc told me. I just googled myself and found case reports of dilate non-reactive pupils after cataract surgery, indicating that pupils remain in the eye. Perhaps the surgery process is different here in Japan. In my case, pupil is dilated and non-reactive. If I shine with a bright light into my right eye there is no pupil reaction, even 2 yrs after the surgery.