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Post-cataract op eyewear

 Poster: A snowHead
Poster: A snowHead
under a new name wrote:
@Tiredoldskibum, yeah, I think tho' only confusing because patients' experiences are so varied.


That's the thing. Difficult to predict the outcome. I'd have the Panoptics if I could be reasonably sure that the nighttime halos etc would be bearable, but some people get that so bad that they have to get them taken out again. Only want to do this once so...


under a new name wrote:
@Tiredoldskibum
edit to add, I'm not sure there's anything that they can put in your eye that will improve poor light skiing!!


Indeed. You have to be realistic. Nothing is going to give you 20 year old eyes again, but you want the best outcome you can get don't you.
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
@Tiredoldskibum, exactly, so in my experience, monofocals and putting up with readers are the ideal. YMMV.
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 Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
Bump. (I've not started bumping into things yet, but might before long).

I've been NHS referred for cataract surgery but it's likely to take a long time so am looking at private treatment and am after some advice.

First, I have double vision, corrected by prisms in my glasses. Absolutely fine, but I'm surprised to have no very clear answer (having googled it) to the question of whether cataracts cause double vision. Very little mention of it. I have binocular double vision (if I cover either eye it disappears). This is the most common form of double vision.

Second, looking at IOLs. I have worn monocular vision contacts in the past (distance vision in dominant right eye, near vision in left eye). I was cack-handed with the contacts and never liked them much, but when I did get them in my vision was fine and I had no difficulties with the focus. I've also worn varifocal specs for years, with no difficulty, so two different IOLs might suit me well. But would be useful to know what people thought.

I would be relaxed about wearing specs afterwards if necessary. If I choose the right shape frames they do help to disguise the bags under my eyes. Shocked

The technology of these things seems to be changing fairly rapidly and I'm surprised at the relative paucity of information on the internet, so real-life experiences of SHs would be helpful.
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@pam w, As I understand it all cataract surgery involves dissolving your own lens and replacing with IOLs. It takes about 10 minutes per eye and is really trouble free. I had mine done last August.

You can get multifocal IOLs but a chum used to sell them and they are either fantastically good or unbelievably awful. With about a 50:50 distribution.

My results were great, eyes basically as good optically as before (when I had contact lens correction for my myopia).

But I do have mild astigmatism which they don't correct for, so I have glasses and a test of contacts hopefully next week. And ultimately laser correction (if it can be done) next year.

My suspicion is that you'll still need the prismatic correction for the double vision.

But given I could not drive (both my eyes came on overnight) I am super happy with my results.
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Quote:

My suspicion is that you'll still need the prismatic correction for the double vision.

yes, that's rather what I thought. All will no doubt be revealed when I talk to an opthalmic guy or gal but I would like to learn as much as possible to know what questions to ask. I don't like the sound of the multifocals, for the reason you set out - hence a different monofocus IOL in both eyes.

And they're cheaper!
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@pam w, I had tried multifocal contacts of several types and didn't like any of them. And the social would only cover the monofocal IOLs.
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Then you can post your own questions or snow reports...
NHS cataract ops don't seem to have a terribly long waiting list due to contracting out to specialists that churn through them.
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After all it is free Go on u know u want to!
I'm very happy with my multi-focal lens replacements. I think some makes of lenses are better than others, so worth some research. I had mine done by the 'Consultant Eye Surgeon & Head of Corneal & Refractive Surgery at Bristol Eye Hospital' at his private practice, so he gets to choose rather than what the bean counters at specsavers choose, and knows his stuff!
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@MorningGory, Specsavers are very nice but not very effective!
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@Dave of the Marmottes, yes, the optician told me the waiting was not too long but my GP surgery thought otherwise when I spoke to them today. I'll try to get on to the hospital booking people tomorrow and get a feel for it before making any rash decisions.
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pam w wrote:
Bump. (I've not started bumping into things yet, but might before long).

I've been NHS referred for cataract surgery but it's likely to take a long time so am looking at private treatment and am after some advice.

First, I have double vision, corrected by prisms in my glasses. Absolutely fine, but I'm surprised to have no very clear answer (having googled it) to the question of whether cataracts cause double vision. Very little mention of it. I have binocular double vision (if I cover either eye it disappears). This is the most common form of double vision.

Second, looking at IOLs. I have worn monocular vision contacts in the past (distance vision in dominant right eye, near vision in left eye). I was cack-handed with the contacts and never liked them much, but when I did get them in my vision was fine and I had no difficulties with the focus. I've also worn varifocal specs for years, with no difficulty, so two different IOLs might suit me well. But would be useful to know what people thought.

I would be relaxed about wearing specs afterwards if necessary. If I choose the right shape frames they do help to disguise the bags under my eyes. Shocked

The technology of these things seems to be changing fairly rapidly and I'm surprised at the relative paucity of information on the internet, so real-life experiences of SHs would be helpful.


Had mine done last year here in CH, dominant eye for distance and the other for near. This solution is known as Monovision. If you found this acceptable with contact lenses then you'll be more than happy with the same solution with IOLs. I've had no issues whatsoever, and frankly it’s the best money I ever spent. Mrs t_m had IOLs from the same clinic a few months later - same experience. Totally happy - there are no downsides (cost excepted).
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And love to help out and answer questions and of course, read each other's snow reports.
@telford_mike, thanks - that's reassuring. I did wear contacts for skiing, and sailing. Generally I found them a faff. But at least it did enable me to be confident that the "monovision" solution works well for me. I think my brain is very tolerant of vision adjustments and less than perfect vision. I never had any problems going to varifocal spectacles, and my rapid changes in vision over the last few years (including rapid improvement) have been less of a problem than they would have been for some people. I am conscious I am not seeing well with my specs - walking up to the shops yesterday I was playing around reading car number plates and I was better without them. And until fairly recently driving short distances in the day without them wasn't a problem. But now the general swimminess and double vision is more of a problem I would definitely not be safe without specs - and that's changed in the last 8 weeks or so.

I really need to see a proper eye person!

One other question. My eyes have changed so quickly it's been expensive in glasses. I know the cataracts are largely responsible for that but changes in the overall shape of the eyes can make a difference too (longer eyeball, different focal length etc). The new IOL will solve any problems caused by cataracts, but other changes can continue?
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pam w wrote:


One other question. My eyes have changed so quickly it's been expensive in glasses. I know the cataracts are largely responsible for that but changes in the overall shape of the eyes can make a difference too (longer eyeball, different focal length etc). The new IOL will solve any problems caused by cataracts, but other changes can continue?


I had the same question for my surgeon before I had the procedure. His answer was that of course your eyes can still change shape a little post-op, but this is less likely once you're rid of your cloudy natural lenses. No guarantees however. Given that millions of people have cataract surgery every year, it seemed a (small) risk worth taking, particularly at my time of life.
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 You know it makes sense.
You know it makes sense.
Just managed to get through to the right number at QA Hospital. The bad news is that the wait is 14 months...... the good news that I've already done a month. Laughing

So - private it is, and I'm so grateful I can afford it!
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 Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
@pam w, My better half had an op 2(?) years ago after wearing contacts/glasses for years. She had one corrected for long vision, the other for short vision. She says it's the best thing she ever did and 2 friends have gone to see the same "proper eye person" since and also had very good results!

https://uk.trustpilot.com/review/customvisionclinic.com
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pam w wrote:
Bump. (I've not started bumping into things yet, but might before long).

I've been NHS referred for cataract surgery but it's likely to take a long time so am looking at private treatment and am after some advice.
.....




Hi Pam, sorry for late reply, not been around.

I've done a lot of research on this and seen three different consultants now. Two out of three advised me to wait as long as possible (the 3rd one couldn't wait to sign me up!) so I have kicked it down the road for now.

Lens choice seems to be the most important thing and the choice is confusing but basically there are three options, monofocal (which means you will need either reading glasses or distance glasses depending on your preference) these seem to offer the best chance of no visual issues and the clearest vision (for whatever distance you choose), multi-focal, which offer vision at all distances but which come with higher risk of halos &/or glare at night which some people cannot deal with and EDOL (extended depth of focus) which give a range of vision (probably need glasses for small print reading) and less chance of glare/halos than multi-focus.

One of the consultants I saw was Prof David Gartry (who is a top man at Moorefields and world renowned), He advised me to wait for a year or two but showed me his preferred lens which is this

https://www.teleon-surgical.com/en/international/products/quantum-iol/lentis-quantum/

He has implanted these lenses for my cousin who is now glasses free, but he did say that not every patient gets as good an outcome.


Another lens which looks promising is this one, which is multi-focal but which, apparently, reduces the risk of visual aberrations associated with MF iols

https://ophthalmologybreakingnews.com/a-novel-approach-to-trifocal-iols-sinusoidal-optic-design


Should add, some of these lenses, particularly the MF ones, carry a risk of reduced contrast (which you really don't want for skiing), so you should do your research and ask the questions before you let someone place them in your eyes.



There's a good forum here which has a lot of info

https://patient.info/forums/discuss/browse/cataract-386


Best of luck
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
Thanks, @Tiredoldskibum.
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 Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
@pam w
First off - it could be worse if you havent started bumping into things (tongue in cheek as the comment may have been)... before I had my (rapid-onset following other problems) cataract ops 2 years back I was struggling to recognise my own children in the park - can get quite awkward!
My cataracts also caused a double vision effect with very small separation, but this is not the same as the binocular double vision you describe (which I also now have thanks to muscle damage on one eye following a complication with one of the retinal surgeries...). I'm not an ophthalmologist but from what you describe I would anticipate no change between pre and post op.
Multi-focal IOLs weren't an option for me (due to the retina problems) so both eyes were done for best long sight, and I use reading glasses. Can be a bit of a faff (particularly on the mountain), but actually most of my essential apps & devices (mapping, navigation etc) I can use adequately without glasses. Have experimented with varifocals but they didn't work for me (due to the elevation problems of one eye). My main goal has been to avoid having to use glass & goggle combos, as I experimented with these in 2021 and it was a right pain...
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@offpisteskiing, I've now had one eye done - on 2 Jan, and all went well. You are quite right about the double vision - I will continue to need specs with prisms to correct that. Both my eyes will be optimum distance vision as my very good optician advised that having monovision would complicate the double vision correction.

I am thrilled that my vision in the "done" eye is markedly brighter than the other one - as everybody says, you don't notice the gradual deterioration but the world looks yellow and dull through my left eye. I keep swapping eyes, to appreciate the difference! Driving at night, the "halos" round bright lights are a lot less in the eye with the new lens, so I am hopeful that with two good eyes, I will be able to continue to drive at night without the fear of mowing down invisible cyclists because of being blinded by on-coming traffic.

And it's being done on the NHS, which is a bonus.
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Anyway, snowHeads is much more fun if you do.
As for eyewear, a cheap pair of reading glasses from the chemist will do for close up, and I have to wait till the surgery on the second eye settles before getting new glasses for driving etc, for the double vision. The optician says I will need stronger prisms, but that'll just have to wait. I really need those just for pottering around, as the "swimmy" double vision is disorientating. I don't mind wearing specs; they help to disguise the bags under my eyes. wink
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Back in 2012 I had a sudden onset of visual fogging, left eye only, which turned out to be a cataract forming on the back of the lens. Cue lens replacement, long sighted focus as the natural lens was long sighted. Right eye completely unaffected, but conveniently, short sighted.

When skiing, cycling, sailing I favour eye protection over prescriptive correction but carry some indestructible readers in case of having to read something, like a chart, a piste map or similar. Driving I mostly wear varifocal specs, unless driving towards sun on horizon then I'll switch to uncorrected sunglasses since without them I'll be struggling to see anything against the glare.

Last year I became aware of slight but increasingly noticeable lack of colour rendition in my left eye, not quite misty but definitely more faded colours as compared with my right eye. This apparently is "normal" multiple years post lens replacement and is caused by an increased opacity of the membrane behind the lens - in my case this was resolved by laser surgery, not the most comfortable of procedures but it was fairly quick (maybe 30 minutes or so) and seems to have restored acceptably normal vision.

Opthalmology consultant reckoned that outdoors in daylight (particularly on snow or on water), really good quality uv protective polarising eyewear is rather more important than sight corrective eyewear - assuming that your vision is good enough for getting about safely.
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@Mick_Br,
Quote:

really good quality uv protective polarising eyewear


Not sure about the polarising bit but defo good UV protection is essential.

I'm currently skiing with astigmatism correcting contacts and I love them. Still need readers though. These are in my Oakleys https://www.amazon.co.uk/OKH-Reusable-Adhesive-Magnifying-Sunglasses/dp/B0BTLVRRX1/ref=sr_1_3?crid=9P3HTX43HFX9&keywords=hydro+reading+lenses&qid=1705219746&sprefix=hydro+reading+lenses%2Caps%2C175&sr=8-3&tag=amz07b-21 stick on lenses ...
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After all it is free Go on u know u want to!
I think the polarising part related to reducing the amount of reflective glare from water and snow so probably more a comfort factor.

The magnifying stick-ons are new to me - how easily and cleanly are they removed, should you wish to? I'm guessing they rely on vacuum rather than glue to remain in place?

The focal length of my previously relatively short sighted right eye (which allowed me to read without specs) with advancing years is becoming longer, to the extent that now if text is at a sufficient distance to be in focus it's too small to read!
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pam w wrote:
@offpisteskiing, I've now had one eye done - on 2 Jan, and all went well. You are quite right about the double vision - I will continue to need specs with prisms to correct that. Both my eyes will be optimum distance vision as my very good optician advised that having monovision would complicate the double vision correction.

I am thrilled that my vision in the "done" eye is markedly brighter than the other one - as everybody says, you don't notice the gradual deterioration but the world looks yellow and dull through my left eye. I keep swapping eyes, to appreciate the difference! Driving at night, the "halos" round bright lights are a lot less in the eye with the new lens, so I am hopeful that with two good eyes, I will be able to continue to drive at night without the fear of mowing down invisible cyclists because of being blinded by on-coming traffic.

And it's being done on the NHS, which is a bonus.



Congratulations. Hope the other eye goes as well. I delayed mine on advice last year but skiing in flat light this year is even worse and I'm starting to get double vision in some situations (driving at night, reading) so I'll be getting them done now.
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@Tiredoldskibum, I am advised that the cataract ops won't help the double vision, because that's caused by a muscle issue. My very good optician told me that, confirmed by the consultant eye man.
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pam w wrote:
@Tiredoldskibum, I am advised that the cataract ops won't help the double vision, because that's caused by a muscle issue. My very good optician told me that, confirmed by the consultant eye man.


Sorry to hear that.

I hope that won't apply in my case as it's only recently started and only seems to happen to illuminated objects, lights and ipad/phone screen mostly, and then, oddly, only for green and blue things. I think that may be due to the growing cataracts starting to scatter the light in particular wavelengths.

But what will be will be Confused
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And love to help out and answer questions and of course, read each other's snow reports.
Yes, that sounds quite different from my double vision, @Tiredoldskibum - if I am looking at the boat moored outside my house, and turn my head just slightly sideways, it has two masts. And a house over the way, with one chimney, has two.

Fingers crossed new lenses will sort out your problem! It's a miraculous procedure.
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