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Post-cataract op eyewear

 Poster: A snowHead
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Anyone out there that has had cataract ops done?

Due to various ongoing retina problems I will shortly be having both eyes done for cataracts, with monofocal lens implants (good for medium & long vision in theory). For those of you who have had cataract ops done, assuming your long and medium sight is ok without correction do you bother with anything for short-range vision while skiing or just stick on a pair of 'reading glasses' as and when needed?

Trying to think ahead as to what will work best... though I may end up with some correction anyway for longer range (its a long and complicated story) so it may be a moot point, but does it work to ski in 'progressive' glasses?
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@offpisteskiing, I opted for long range vision and have variefocal specs for reading and computer. These are quite fancy/expensive and I don't want to lose them, so I just pop a magnifying glass in my pocket for reading piste maps and menus.If the light's good I don't usually even need that.
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@offpisteskiing, I've not had a cataract op, but my Father did many years ago and one interesting thing about it I remember him telling me was the immediate post op effect on colour perception. Cataract tissue tends to have a yellowish tinge which filters out some of the blue and violet colours, but your brain gets used to that and things still look normal. Immediately after the cataract is removed as the retina is now receiving more blue and violet light than previously those colours look particularly vivid, however over time the brain adapts to the new normal. I wonder if anyone else who has had a cataract op noticed the same thing?
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@offpisteskiing, I opted for varifocals to try and regain some accommodation. You'll lose most or all of your ability focus on things (accommodation.)
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It is normal as the haze on the lens you are born with is a murky brown yellow one ,so most are astonished at the colors they see post cataract,as the sight slowly degrades people get used to living with bad vision. The latest generation lenses are really quite remarkable, trifocals and non diffractive extended depth of focus.

Most still go for distance vision correction with readers for near vision as a lot of surgeons harp to the conservative side or patient cost considerations but what cost is your sight, I’d easily pay extra for non spec vision when the options are out there.

The technology to aid the surgeon to implant high tech lenses is out there to improve the outcomes so why not.
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@Alastair Pink, generally two types of cataract, cloudy white and yellowy/brownish AIUI. My yellow one meant that after removal, yes some colours changed. A shirt I thought was burgundy was actually a blue and purple check. In bright sunlight I could also 'see' the veins of the retina as a kind of shadow as the brain had not yet learned to 'filter' them out.
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@offpisteskiing, Haven't had cataracts but I once went skiing without wearing contact lenses, I had hard lenses then that needed building up wearing time gradually. I found that my distance perception was off, I could see moguls well enough but not where my corrected vision would expect them to be.

Think I would want consistent distance perception rather than progressive lenses.
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@rjs, first couple of days skiing in varifocals was interesting... It seemed to affect my balance, the dull weather wasn't helping either.
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@Alastair Pink, That is very common in people after cataract surgery, almost the first thing they notice actually. The cloudy natural lens effectively gives everything a brown/yellow tint but as it is gradual, people don't notice it. Then you instantly return to a normal red/blue/yellow colour balance after surgery which you do notice!

@offpisteskiing, Before the surgery, decide what your visual requirements are and then discuss those with your surgeon. Basically, the options are good unaided near vision, good unaided distance vision (assuming the surgery goes well and depending on the nature and extent of your retina problems), one eye set up more for near and one eye set up more for distance (depending on your tolerance of this and prescription) and multifocal/extended depth of focus intraocular lenses.
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I had cataract ops on both eyes a couple of years ago and they significantly improved my unaided vision. Now I wear varifocals with a transition coating. I use then for skiing without any issues.
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@DrNo,
Quote:

Before the surgery, decide what your visual requirements are and then discuss those with your surgeon. Basically, the options are good unaided near vision, good unaided distance vision (assuming the surgery goes well and depending on the nature and extent of your retina problems), one eye set up more for near and one eye set up more for distance (depending on your tolerance of this and prescription) and multifocal/extended depth of focus intraocular lenses.
I was only offered the first two. Must have had a noddy surgeon. Confused
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@Hurtle, I doubt it! Option 3 doesn’t work for a lot of people so may not have been possible for you and option 4 also isn’t an option for some people, is not available on the NHS (OP is based in France and I’m not sure how things work there) and some surgeons don’t offer those lenses so that’s probably why!
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@DrNo, thanks, that's comforting to know. Does unsuitability for Option 3 have anything to do with astigmatism? I always wanted differently focused contact lenses during my 42 years of wearing them (gas permeable ones) and was always told that I was too astigmatic for them.
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I haven't had cataract surgery but I do ski in full on progressive s. They have three different lenses in them, close, computer distance and long distance. I don't notice any issues. All progressives are a bit weird when you first get them. They take a bit of
brain training
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Hi all,

Thanks for all the replies... The surgeon is aiming for as good as possible unaided mid and long vision (due to the nature of my work areas) - only have the option of fixed focal length as had multiple ops last year for detached/torn retina (and the other eye took up the baton in Jan this year) and in France if there is a history of retina problems they will not use a multi-focal implant. They are trying to correct an astigmatism due to a complication from one of the surgeries with the implant so hopefully that works.

The cataracts are rapid onset (following vitrectomy) so no colour degradation noticeable just increasing blurriness...

Definitely hoping I can avoid having to wear glasses for skiing as I experimented with various solutions this winter before the right eye went pete tong and none of the options worked for my particular case (tried OTG goggles none of which really seemed to fit, and in-goggle inserts which gave a massive double vision effect...!!
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@Hurtle, potentially though astigmatism doesn't necessarily mean that option 3 wouldn't work. Often a trial with different contact lens is needed though so that may have been a factor.
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@offpisteskiing,

Hi, "offpisteskiing". If you still look in here and have had your surgery I'd be interested to know how you got on (a year since the last post)

I have early stage but fast progressing type cataracts and have increasingly struggled with skiing in flat light. First diagnosed a year ago but had already been struggling before that. Missed last season and this year was noticeably worse, to the point where I just didn't want to ski at all on overcast days. So I'm booked in for a consultation next week.
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@Tiredoldskibum, had mine done in February this year. My cataracts were not severe - I had no problem driving, but like you I was beginning to struggle on skis in flat light. I was more interested in correcting my vision and eliminating my need for contact lenses and reading glasses. Happy to report it was all a complete success. Recovery time was quick - was told not to ski for 4 weeks after getting the second eye done.
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@telford_mike,

Cheers. Did it help with the flat light problem much?
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@Tiredoldskibum, yes it did. It’s not like you suddenly have x-ray vision or anything, but everything is much better. Talk to your consultant about what sort of refractive correction you want - I was offered a number of options, some of which can be trialled with contact lenses before you commit to whichever you prefer. You're only going to get this done once, so take your time.
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@offpisteskiing, I had mine done in January this year. My problems deteriorated surprisingly quickly ie the cataracts to the stage where I couldn't drive at night or in tunnels. I also had color deterioration but didnt know that -- but not seeing everything in sepia is absolutely brilliant. I just wish I knew that BEFORE chasing all the colours for the house renovation. Oops.

Like you I couldn't have varifocals so had distance only. My distance vision is now 8/9

For the first 4 weeks I just used cheap and nasty reading glasses for screen work and books etc. Driving was an absolute joy and I can now drive without glasses all the time.

I was then given a full prescription by the ophthalmic surgeon and bought 3 pairs of glasses Varifocal, photochromic anti-glare blah blah. I only use the lightest (titanium) of these for screen work and reading. 1 pair were sun glasses and I use them outside a lot in the sun .

For skiing I skied a few weeks ago with nothing ( same as my driving) and carry a pair of off-the-peg collapsible Foster Grants for menus and maps etc.

Id have them done again in a heartbeat.
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@telford_mike,

Thanks again. Seeing a surgeon next week for exam and advice.


@Agenterre,

Thanks, also
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Gave my mum my yellow lens cat 1 cycling glasses for driving post her cataract replament. Seemed to work ok.
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@Tiredoldskibum, skied/worked 40+ days this winter... My mid & long range vision is 9-ish (with some complicating factors with a membrane & oedema on/behind the right retina) following the cataract ops, so pretty happy with that. I am definitely way more sensitive to bright light now (mainly thanks to the retinal tears/detachments and associated repairs) so spend as much time as possible in goggles where previously I was in sunglasses unless it was really bad... (also helps keep cold air off the eyes which is definitely an irritant now).

Flat light is slightly problematic, but I think more due to the fact that there is a damaged muscle in one eye so it does not 'elevate as much as the other (and produces double vision effects from mid-line up) - I am due to see a specialist to see about some remedial surgery on this, but it was noticeable this winter that flat light days were way more tiring... Not sure any of it relates to the cataract op though.

As for the cataract op bit by mid-April last year I was struggling to recognise my kids at the park if they were more than 2 metres away (which could lead to some 'interesting' scenarios...!! Happy ) and now it is only sub 1m which is problematic - have mostly been using cheap pharmacy reading glasses, have a pair of vari-multi-focals form the optician but have really struggled to adapt to these, partly due to the unequal elevations as above...
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@offpisteskiing, I've had three pairs of prescription varifocals for cycling and skiing.

As you probably know if I'm not skiing, I'm riding and kitesurfing all year, though I did lose a pair kiting which was an expensive stupid mistake, but I can't wear contacts.

One pair of orange low light lenses and for brighter conditions blue reflective lenses, and they work really well, think I've been wearing them for three or four years?

Bolle and Cebe frames, being able to read the phone was important as is bike computer, I can also spot beasties from afar and they're way better than most peoples eyesight who choose to not wear glasses.

I also have a pair of Snow-Vision Goggles with prescription inserts and when it's snowing, (the only time I wear goggles), I have not had any issues. Review here.

If you want I could PM you my optician who did both sets?
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Quote:

I was offered a number of options, some of which can be trialled with contact lenses before you commit to whichever you prefer.

That sounds ideal - it's a big decision to make without certainty. I have used varifocal glasses (good quality ones) and contacts with different prescriptions left/right. Had no problem with vision - though I didn't wear contacts much and was cack-handed with them, once I got them in, I could see fine.

My cataracts are not yet bad enough for NHS treatment. I've had different reports from friends who've had it done but would be ready to shell out for private treatment if I thought I could do away with any eyewear. My eyes are light tolerant, so I don't even need sunnies much of the time. I'm very interested in the reports in this thread, so keep them coming, please!
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@pam w,you should still be protecting your eyes from the UV even if they are tolerant to sunlight.
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I do if it's really bright, as it's more comfortable, but I don't understand why most people, in most parts of the world, for almost the entire human history, have managed without sunglasses. No school kids every wore sunglasses when I was young. Why hasn't evolution equipped people to cope without sunglasses?

In parts of the world with a lot of hot sun, evolution gave rise to black skin. But not in northern Europe. All those blue eyed, blond, Norsemen seemed to cope with sun in their eyes?
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b]@pam w[/b], people did not live so long for a start, and we actually have no real idea of the percentage of people who were blind. They didn't apply sunscreen either, but you would still apply sunscreen now. Visual impairment is a huge health problem in Africa and while much of it is from communicable disease, age-related conditions are increasing and cataracts can be attributed to UK exposure.
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Perhaps I should be more careful, @Hells Bells!
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@pam w, one of the options with lens implants is to have blue light and UV filters. I opted for this and I've not worn sunglasses since, though in fairness it is still winter. I don't need to use any eyewear / contacts at all now, near and distance vision is spot on.
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That sounds good, @telford_mike. Was that done privately?
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@pam w, yes, everything is private here in CH, but our health insurance made a contribution of about a third of the cost.
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For those considering which corrective lens to chose seeing as the thread subject is widening:

I didn't have cataracts but had elective lens replacement surgery October 2020 following advice that my deteriorating relationship with contact lenses would be forced to end within a couple of years following an abscess/infection and increasingly dry eyes as I aged. Pre-op I was -8 in both eyes and an astigmatism in one of them and achieved reading comfort by removing my specs. CL in daily life needed cheap reading glasses to read menus etc and for work I never wore CL. I had to endure 3 ski trips in specs with v expensive over specs goggles (sadly, which I lost...) But skiing in specs for me was every bit as inconvenient and annoying as I expected. However, by this stage a full day in my daily contacts was also uncomfortable and they were a higher priority to remove than taking off my boots at the end of the day!

I had both eyes done the same time as it was lockdown and hospitals were minimising contact and I had tri-focals and laser treatment on the astigmatism. Wow. No correction required at work, reading, driving, watching TV, football etc etc. Absolute game changer in all areas of my life. Due to Covid it was just over a year before I got to test them out on the mountain. Skiing, I am a goggle wearer whatever the weather (habit developed due to dry eyes and CL) and I continue to be as eyes still dry, but my vision on the mountain is just as amazing whatever the light compared to my pre-corrected days. The only area that is not 100% is a bit of glare at night from bright lights but I used to suffer in CL too. Flat light or a change of shadow etc requires lots of quick blinking to adjust but this was the case before as well.

Obviously there was nothing wrong with my cataracts and now never will be, and I had to finance it myself, and the NHS does not (yet) offer trifocals anyway but, to anyone who is able to choose their type of lens my experience is go the very best lens you are able to in the circumstances. Especially, if you have had a life time of vision correction!! Its worth it.
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An inspiring story, @frogslegs!
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pam w wrote:
I do if it's really bright, as it's more comfortable, but I don't understand why most people, in most parts of the world, for almost the entire human history, have managed without sunglasses. No school kids every wore sunglasses when I was young. Why hasn't evolution equipped people to cope without sunglasses?

In parts of the world with a lot of hot sun, evolution gave rise to black skin. But not in northern Europe. All those blue eyed, blond, Norsemen seemed to cope with sun in their eyes?

Before there's cataract surgery, it was accepted that old people lose their eyesight as they age. But as Hells Bells pointed out, people didn't live long enough for it to matter. I think there're good reasons why we're so... "careful" these days.
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It's encouraging that some kinds of lens replacement surgery does away with the need for eyewear - seems a bit pointless spending all that money and still having to swap spectacles around!
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So I had my consultation. Surgeon opines that my cataracts are still early stage and that he is disinclined to recommend surgery at this stage. Reasoning being that my general vision is still very good, that there is always some level of risk with any procedure (including lasting slightly increased chance of detached retina) and that if I wait a few years, depending on how fast they progress, I might benefit from improved technology.

He also suggested that I would easily find another surgeon who would be happy to take my money now but he would not be. A conservative opinion but an honest one, so I will probably wait.


For skiing, next season, I'll try flat light contrast enhancing lenses, any views as to which are best? I had a peep through someone's this year (think they were pink Smith ones) but I didn't notice much difference (didn't ski in them).
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That's interesting, @Tiredoldskibum. I suspect that's exactly what an honest surgeon would tell me, too!
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Well, one of my father’s surgeon gave the same “honest opinion” too. But several years later, after he had his surgery done, he said he wished it was done then, without the wait.

He felt his eyesight was bad enough, those few years of his life were wasted.
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