Cataracts & reading glasses

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fmhealth
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Cataracts & reading glasses

Post by fmhealth » Wed Jun 14, 2017 9:05 pm

My wife (68) has cataracts & needs surgery so she can read w/o glasses. My feeling is that even after this procedure, she very well may still need reading glasses. I'm not asking for a medical opinion, simply any anecdotal insights with family or friends that can help with her decision. Thanks so much for any actionable comments.

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fmhealth

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Re: Cataracts & reading glasses

Post by 123 » Wed Jun 14, 2017 9:11 pm

The eye doctor may advise about a number of options for lens implants, depending on the patients situation. Some replacement lens, in limited cases, may eliminate the need for glasses for some period of time. In the case of one relative he had to decide whether he wanted to still use glasses for reading or for distance. Lens options can be expensive and the full cost of some lens may not be covered by insurance. Some replacements lenses can be like "progressive" eyeglasses, whether they can be used depends on the patients circumstances, including the size and shape of the eyeball.
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RudyS
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Re: Cataracts & reading glasses

Post by RudyS » Wed Jun 14, 2017 9:18 pm

There is a financial aspect to the question. My understanding is that Medicare won't pay for surgery unless there is a real vision problem, including excessive glare driving at night. Just wanting to read without glasses might not do it. In my case, I asked for the doctor to put in a lens that lets me read without glasses, but I do need a moderate distance correction, which is OK since outdoors i want glasses for protection, sun, etc.

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Re: Cataracts & reading glasses

Post by jbranx » Wed Jun 14, 2017 9:29 pm

I paid the extra couple thousand for an upgrade from the standard lens that Medicare pays for. Well worth it in my case. Because of a slight retina issue, was not able to get the very latest lens that would have meant no glasses, but I can see 20/20 and read most print without glasses, though I wear a pair of dollar store glasses--1.25x--to read print this small on the computer. My wife completed surgeries one year past me and has a later generation lens, but she also needs reading glasses. So, best advice is to go to a very well seasoned surgery center and get a good consult on the options and likely outcomes, then decide if any extra expense is worth it. Cataract surgery, like a colonoscopy, is no big deal; it's the preparation--dang drops drops drops you have to dutifully use before and after!

Btw, also highly recommend the extra expense of laser surgery. Not all centers use it, but it adds precision to the process, my doc claimed.

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Jazztonight
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Re: Cataracts & reading glasses

Post by Jazztonight » Thu Jun 15, 2017 7:52 am

While any surgery brings stress and there are always chances for complications, cataract surgery has become so common and routine, and the procedure itself so streamlined and fast, that your wife will most likely not have any serious difficulties. Virtually everyone is happier after cataract surgery.

Assume that your wife will need reading glasses after the surgery, and that that prescription will change over time. You'll have the option of spending a certain amount of money for prescription glasses, or (if it's an option) wing it with over-the-counter magnifiers. You will get post-surgical eyeglass prescriptions; where you have the Rx filled is totally up to you. Generally, unless you have vision care insurance, you'll be paying out-of-pocket.

With time, you'll solve all of the post-cataract related eyeglass problems, and your wife will very likely be very happy to see better than she has in years.

(Disclosure: I'm a retired optometrist; my own wife recently had cataract surgery, both eyes.)
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Re: Cataracts & reading glasses

Post by climber2020 » Thu Jun 15, 2017 8:00 am

Standard cataract surgery generally corrects for distance vision only. Patients still need reading glasses after.

There are lenses called multifocals that correct both distance and near that you can pay extra for (not covered by any insurance). But this implant has optical compromises that degrade clarity and contrast compared to the regular lens. Some people are very happy with it while others hate it. There is nothing in existence that will replicate what a person's vision was like in their 20s.

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Re: Cataracts & reading glasses

Post by jebmke » Thu Jun 15, 2017 8:02 am

I had cataract surgery just over a year ago. It was life-changing. I still use readers for reading and computer use. My surgeon suggested trying inexpensive "drug store" versions before resorting to any kind of prescription. She said that prescription readers are a waste of money for many people. I buy three-packs for $15, keep a spare pare in the car. I have a more expensive ($35) pair of dual-focal (1.5X for computer use, 2X for reading) that I keep in my laptop bag for when I do taxes.
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Re: Cataracts & reading glasses

Post by Sheepdog » Thu Jun 15, 2017 8:12 am

My wife was declared "legally blind" so that she could not drive or read very much. She had two cataract surgeries. She does not have to wear glasses and has not for the last 4 years.

I had cataract surgeries also with special lenses to correct my extreme astigmatism. Wonderful result. I am 20-20, the physician said, but I find that glasses are more comfortable, so I wear them.
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Re: Cataracts & reading glasses

Post by Jazztonight » Thu Jun 15, 2017 12:04 pm

Sheepdog wrote:My wife was declared "legally blind" so that she could not drive or read very much. She had two cataract surgeries. She does not have to wear glasses and has not for the last 4 years.
The term "legally blind" as used here is a bit misleading, with all due respect. Generally it refers to decreased vision that is not correctable. If the decrease in vision is correctable with glasses or contact lenses, then it really does not fall into this category. Vision that can be corrected with cataract surgery? Maybe 50 or 70 years ago, but not now.

People often say that they're "legally blind when I don't have my glasses on." Not so--the vision is correctable. But like I say, if the decrease in vision is correctable with cataract surgery, it's in a different category. Just my opinion.
"What does not destroy me, makes me stronger." Nietzsche

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Sheepdog
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Re: Cataracts & reading glasses

Post by Sheepdog » Thu Jun 15, 2017 12:14 pm

Jazztonight wrote:
Sheepdog wrote:My wife was declared "legally blind" so that she could not drive or read very much. She had two cataract surgeries. She does not have to wear glasses and has not for the last 4 years.
The term "legally blind" as used here is a bit misleading, with all due respect. Generally it refers to decreased vision that is not correctable. If the decrease in vision is correctable with glasses or contact lenses, then it really does not fall into this category. Vision that can be corrected with cataract surgery? Maybe 50 or 70 years ago, but not now.

People often say that they're "legally blind when I don't have my glasses on." Not so--the vision is correctable. But like I say, if the decrease in vision is correctable with cataract surgery, it's in a different category. Just my opinion.

I agree with you, but it was the same at that time in her point of view (and mine probably.), It was her term because she could not go anywhere or do very little without help (for about a year) until treatment followed by surgery. When she came out of the first surgery, it was like a miracle (her words, not mine) Anyway, I can't argue with you. Really, the only point I was trying to make to the OP was that she doesn't require reading glasses.
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Re: Cataracts & reading glasses

Post by IMO » Thu Jun 15, 2017 1:19 pm

fmhealth wrote:My wife (68) has cataracts & needs surgery so she can read w/o glasses. My feeling is that even after this procedure, she very well may still need reading glasses. I'm not asking for a medical opinion, simply any anecdotal insights with family or friends that can help with her decision. Thanks so much for any actionable comments.Be Well,


Understand that there are essentially/practically 3 distances (technically more) that people want clear vision: a) Distance b) Intermediate or typical computer distance, and c) near vision or typically the distance of holding a book. There are multiple ways to try to provide clear vision for those 3 distances, and unfortunately there are no perfect solutions even with the latest technology, as every option has pros/con's and every option is a compromise. Other conditions can complicate the options (for example my elderly mother has some macular degeneration) and this along with someone's visual goals need to be individually considered. So for anecdotal insight on my elderly mother, she has standard distance implants in each eye, but must use very very high powered reading glasses to read in a compromised fashion.

This is an article I found that gives some feedback:
https://www.eyeworld.org/article-the-pr ... ating-iols

There are other options not mentioned which include monovision (one eye for distance / one eye for near). Someone could even opt for variations on that such as 1 eye for intermediate, and 1 eye for near that would allow one to read a book/computer clearly, but need glasses for driving.

These same issues come into play for someone like myself who's lost focusing ability with age. Multifocal contact lenses are theoretically an option, but provide me too much glaring effect with less than adequate near vision. Monovision for me works somewhat, but has some compromises also. Having already dealt with these issues in contacts will make the cataract surgery options/visual issues more understandable when the time comes for cataract surgery.

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Re: Cataracts & reading glasses

Post by earlyout » Thu Jun 15, 2017 1:52 pm

It is perfectly reasonable to expect to read without glasses after cataract surgery. I had my second cataract surgery a month ago and the first surgery 6 months ago. After discussion with my ophthalmologist we decided to use the standard (Medicare pays) lenses optimized for an intermediate distance. Following the surgeries I do not need glasses for reading or computer work or anything else around the house except maybe TV. Actually reading is much more comfortable now without glasses since both eyes are the same and I am no longer reading with just one eye. My near vision (fine detail at a few inches) without glasses is much better now than before with glasses. If I had elected to use replacement lenses designed for reading and neqr vision I would probably be surprised at what I could see. My distance vision is a now little blurry but in a month or so I'll get new progressives which I'll use for golf, driving, movies, TV,etc.

The surgery itself was a lot more pleasant that any trip to a dentist. The surgery itself only takes about 15 minutes. I had asked my doctor about the laser procedure which is often mentioned for cataract surgery and he told me it would just be added expense and had no advantages for me.

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Re: Cataracts & reading glasses

Post by tennisplyr » Thu Jun 15, 2017 6:07 pm

I have cataract surgery scheduled for next month. I'm going with the slightly better lens/laser route as I have a slight astigmatism and retinal issue. I'm hoping for improvement in vision though not sure how much is correctable. Doc says I need the cataract surgery soon. If my distance vision improves I'll be happy. The center I am using is state of the art.
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Re: Cataracts & reading glasses

Post by jebmke » Thu Jun 15, 2017 6:27 pm

tennisplyr wrote:I have cataract surgery scheduled for next month. I'm going with the slightly better lens/laser route as I have a slight astigmatism and retinal issue. I'm hoping for improvement in vision though not sure how much is correctable. Doc says I need the cataract surgery soon. If my distance vision improves I'll be happy. The center I am using is state of the art.

I had severe astigmatism. I had toric lenses and laser surgery. The astigmatism is near zero -- I do not correct for it.
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Re: Cataracts & reading glasses

Post by Doom&Gloom » Thu Jun 15, 2017 6:53 pm

jebmke wrote:
tennisplyr wrote:I have cataract surgery scheduled for next month. I'm going with the slightly better lens/laser route as I have a slight astigmatism and retinal issue. I'm hoping for improvement in vision though not sure how much is correctable. Doc says I need the cataract surgery soon. If my distance vision improves I'll be happy. The center I am using is state of the art.

I had severe astigmatism. I had toric lenses and laser surgery. The astigmatism is near zero -- I do not correct for it.


Same here--but without the laser. My doc said he put the highest-powered toric lenses in my eyes that he had ever installed. I think one was the highest power on the market. He was amazed how successful that turned out. After 55 years of wearing glasses, it is readers only for me now. The $900/eye extra (above Medicaid coverage) for the toric lenses was the best money I ever spent.

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Re: Cataracts & reading glasses

Post by Rich in Michigan » Thu Jun 15, 2017 7:14 pm

Your wife will have to speak with her surgeon to determine her options.

I had my cataracts done last month and the results have been awesome. I previously could see fine close up without correction but needed glasses or contacts for distance. When wearing contacts I wore drugstore reading glasses.

I chose to have distance correction during my surgery and now have 20/20 vision. On fact, my second eye was 20/20 the day after surgery.

I do have to wear reading glasses for computer, etc but am thrilled that I can now see like a hawk...or at least how a hawk would see if he were walking around instead of flying.

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Re: Cataracts & reading glasses

Post by Nowizard » Thu Jun 15, 2017 9:50 pm

Scheduled for the surgery myself. Standard, replacement lens allow focusing on near and far, but not in between. Intra ocular lens allow focusing from multiple distances and will result in not needing glasses in approximately 75% of the cases. Medicare will pay for standard lens only. The IOC lens used by my doc are an additional $1,500 per eye. As one who has worn glasses for a number of years, I feel they are not a problem and have chosen the standard lens. There is no difference between types in terms of durability.

Tim

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auntie
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Re: Cataracts & reading glasses

Post by auntie » Thu Jun 15, 2017 11:17 pm

I had one eye done for distance and one for intermediate. I'm extremely happy with how it turned out. I only need glasses for very small print.
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Re: Cataracts & reading glasses

Post by RudyS » Fri Jun 16, 2017 10:14 am

earlyout wrote:It is perfectly reasonable to expect to read without glasses after cataract surgery. I had my second cataract surgery a month ago and the first surgery 6 months ago. After discussion with my ophthalmologist we decided to use the standard (Medicare pays) lenses optimized for an intermediate distance. Following the surgeries I do not need glasses for reading or computer work or anything else around the house except maybe TV. Actually reading is much more comfortable now without glasses since both eyes are the same and I am no longer reading with just one eye. My near vision (fine detail at a few inches) without glasses is much better now than before with glasses. If I had elected to use replacement lenses designed for reading and neqr vision I would probably be surprised at what I could see. My distance vision is a now little blurry but in a month or so I'll get new progressives which I'll use for golf, driving, movies, TV,etc.

The surgery itself was a lot more pleasant that any trip to a dentist. The surgery itself only takes about 15 minutes. I had asked my doctor about the laser procedure which is often mentioned for cataract surgery and he told me it would just be added expense and had no advantages for me.


Two years post-surgery now. I had the same arrangement, and am very happy with the outcome.

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Re: Cataracts & reading glasses

Post by fmhealth » Fri Jun 16, 2017 5:12 pm

As the OP, I just wanted to circle around & tie up this thread. First of all,thanks so much for all the rapid-fire responses. They were exactly what my DW & I were searching for.

After further due diligence with numerous friends & family my DW has decided to forgo this procedure, at least for the foreseeable (no pun intended) future. It appears that in approx. 25% of the cases folks are still required to wear reading glasses. This is precisely why was considering this surgery in the first place. So it's a no-go.

Thanks again, you folks are the best!!

Be Well,
fmhealth

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Re: Cataracts & reading glasses

Post by jebmke » Fri Jun 16, 2017 5:21 pm

Seems odd that her cataracts only affect reading. I was pretty much unable to drive at night and getting worried even about daytime driving before my opto declared mine "ripe."
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Re: Cataracts & reading glasses

Post by The Wizard » Fri Jun 16, 2017 5:28 pm

auntie wrote:I had one eye done for distance and one for intermediate. I'm extremely happy with how it turned out. I only need glasses for very small print.

I hate to give medical advice here, but I did similar. A near eye and a far eye, with some overlap.
No glasses and read the forum on my 5" smartphone just fine...
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Re: Cataracts & reading glasses

Post by Dottie57 » Fri Jun 16, 2017 7:31 pm

My mom had cataracts. Her vision greatly improved. My advice is to not cheap out on this issue.

I've had a cornea transplant. Vision should be taken seriously.

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Re: Cataracts & reading glasses

Post by tennisplyr » Sat Jun 17, 2017 6:15 am

Dottie57 wrote:My mom had cataracts. Her vision greatly improved. My advice is to not cheap out on this issue.

I've had a cornea transplant. Vision should be taken seriously.


+1
I was told if I waited too long, my cataracts might be difficult to remove and this would not be good.
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Re: Cataracts & reading glasses

Post by CountryBoy » Sat Jun 17, 2017 10:21 am

I had severe astigmatism. I had toric lenses and laser surgery.
That is about 2 mos. ago.

One eye has lens for book reading and the other eye has lens for distance. Remember you may wish to get a pair of magnifying glasses for computer work. I got my pair today and they work fine. $10-20.

Other than that, no need for glasses.

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Re: Cataracts & reading glasses

Post by ImaBeginner » Sat Jun 17, 2017 10:46 pm

The laser makes a crap surgeon a mediocre surgeon, or a mediocre surgeon a good surgeon. A great surgeon is what you want, and wont benefit much from the laser.
Definitely upgrade the lens, people who do that are way happier.

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Re: Cataracts & reading glasses

Post by climber2020 » Sat Jun 17, 2017 11:35 pm

ImaBeginner wrote:The laser makes a crap surgeon a mediocre surgeon, or a mediocre surgeon a good surgeon. A great surgeon is what you want, and wont benefit much from the laser.
Definitely upgrade the lens, people who do that are way happier.


The part about the lens is false. It's an appropriate option for some people. That's about it. I've seen plenty of patients in my office who paid thousands of dollars for multifocal implants (done elsewhere) and they are miserable.

I do implant these myself, but am extremely selective about who I recommend them to and warn everyone about all the various side effects that you don't see with the normal, cheap lens implant.

As far as the laser goes, as of this date there is no good evidence that it leads to better visual outcomes than using a $14 disposable blade. Maybe in the future research will suggest otherwise, but that hasn't been shown yet.

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Re: Cataracts & reading glasses

Post by obgraham » Sat Jun 17, 2017 11:48 pm

As far as the laser goes, as of this date there is no good evidence that it leads to better visual outcomes than using a $14 disposable blade. Maybe in the future research will suggest otherwise, but that hasn't been shown yet.

Glad to hear you say that, Doc. There is an aura surrounding the Laser that somehow everything works out better when done by laser. I can't begin to tell you how many times I, as an obgyn surgeon was asked "are you going to do that with a laser?"
There is no question that laser technology has improved some procedures, but often as not it's a marketing tool that allows the user to send a big bill.
And once you've acquired a laser, it's a lot like that hammer story -- you find nails to hit all over the place!

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Re: Cataracts & reading glasses

Post by JPH » Sun Jun 18, 2017 7:21 am

It's a complicated question, and there are many different options available. You need to discuss this with the surgeon because each case is unique. Be cautious of relying on the experiences of others. Don't be rushed. Also, the end result is not entirely predictable. If acuity is not satisfactory after a healing period you still have additional options.
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Re: Cataracts & reading glasses

Post by ImaBeginner » Sun Jun 18, 2017 11:56 pm

climber2020 wrote:
ImaBeginner wrote:The laser makes a crap surgeon a mediocre surgeon, or a mediocre surgeon a good surgeon. A great surgeon is what you want, and wont benefit much from the laser.
Definitely upgrade the lens, people who do that are way happier.


The part about the lens is false. It's an appropriate option for some people. That's about it. I've seen plenty of patients in my office who paid thousands of dollars for multifocal implants (done elsewhere) and they are miserable.

I do implant these myself, but am extremely selective about who I recommend them to and warn everyone about all the various side effects that you don't see with the normal, cheap lens implant.

As far as the laser goes, as of this date there is no good evidence that it leads to better visual outcomes than using a $14 disposable blade. Maybe in the future research will suggest otherwise, but that hasn't been shown yet.


Apologies, I defer to your expertise. Obviously I am not the one picking the lens. My comment was based on grandparents and some aunts and uncles, but nowhere near the breadth of your experience. That limited pool showed a difference, but is too small an "n"
I do think the laser helps surgeons who are less "polished" to do a better job, but again the really good people have no issues the "old" way, and would definitely be the ones I would send family to. Definitely get a few recommendations from a variety of people regarding the surgeon.

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Re: Cataracts & reading glasses

Post by Shallowpockets » Mon Jun 19, 2017 9:06 am

No reading glasses is a major goal of cataract surgery. For me.
I had left eye done last month and will be having right eye done tomorrow.
I paid extra for a multifocal lens, not covered by medicare. $2400. I am medicare advantage kaiser. Surgery was $50.
With only the left eye done I have not worn glasses since then. I can see with just the one multifocal lens. Can read the fine print on packaging. I expect to be even better after tomorrow right eye done having two eyes good. My binocular vision will be better.
It is amazing that I am able to do this. I figured it would be better, but it is like having new a new eye and soon, both.
I am pretty active, hiking, mtn biking, orienteering where I have to read maps, trail running, etc. My goal was improved vision of course, but no glasses was a primary focus.
I think if you have one far and one near monofocal lens each eye you might also be able to go without glasses. My sister has that and does not wear glasses.
If you have to wear reading glasses with your new lenses, that would be a pain. You still have to carry a pair of glasses. Put them on, take them off, have them near. Better to just wear glasses with progressive lenses that you do not have to constantly take on and off. That is what I had before.

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Re: Cataracts & reading glasses

Post by likegarden » Mon Jun 19, 2017 10:30 am

There were threads like this in our forum. Cataract eye surgery is quite common.
My wife had cataract eye surgery 15 or more years ago on one eye. Everything is fine, she has a mono-focal lens and uses reading glasses. Our eye surgeon had many years experience before that.
Based on my wife's good experience, and a little problem a friend of ours had with multi-focal lenses, I also opted for mono-focal lenses 3 years ago for my cataract surgery on both eyes, at the same surgeon. I can see now very well, have 5 or 6 reading glasses around the house and in my car. I even can read a newspaper without reading glasses by holding the paper at arms length. Only for fine print I need reading glasses, no need to use them for typing on my computer right now. Medicare paid for all, except for my upfront $100 or so fee required by the clinic and my insurance.

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