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Cataract Surgery

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Wobbley
Allen Barnett
lakemurrayman
Mike M.
mspingeld
CharlieJ
SonOfSwede
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Caster3845
REConley
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james r chapman
daveG
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Post by daveG 11/12/2020, 11:13 am

I went to see the eye surgeon yesterday and we had a long discussion about Cataract Surgery and pistol shooting.  The bottom line was insurance (Medicare +) only covers single focus lenses in Cataract Surgery.  After discussion and explanation of how to properly site a pistol, he thought the single focus lens would be worse that what I’m seeing now.  He suggested I talk with other shooters who have had Cataract Surgery to see what worked for them.  Thus this post.
I know some of you have had Cataract Surgery.  What type of lens did you end up with?  I know seeing the sites is only part of the equation (SA + TC = X;  Site Alignment + Trigger Control = X).

How has the surgery affected and/or helped your shooting?
Any comments would be helpful.  Thanks for the input.

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Post by james r chapman 11/12/2020, 11:28 am

I got single (infinity) focus and just wear corrective lenses for close up and iron sights.

Surgery in 2005 so options probably have changed.

No complaints with 20-15 from 20-400!

Suggested reading
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Post by mikemyers 11/12/2020, 11:45 am

Multi-focal IOL's cost more and give you convenience, but do NOT give you the best vision.

Get single-focus IOL's.

Jim is 100% correct - but he didn't list all the reasons why you do NOT want multi-focal lenses.  Multi-focus costs more, and does NOT give you the sharpest possible vision, as they are simultaneously giving you two images at the same time, one for distance and one for close-up.  They also often create halo's, making it harder to drive a car at night.

The only "beneficial" thing the do for you, is allow you to see reasonably sharply at two (or three) different distances.  Convenience.
.....and they make a lot more $$$$ from selling them.

I know this both from doing volunteer work at an eye hospital, and from personal experience.
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Post by REConley 11/12/2020, 11:57 am

https://www.bullseyeforum.net/t15090-eye-surgery

Here is a thread about my surgery and results this past August.


Let me know if you have any further questions.
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Post by Caster3845 11/12/2020, 10:41 pm

I have talked to NO one that has had good results with the multi focus lenses. One person that I know initially got the multi focus and ended up having the surgery again to have the infinity lenses inserted. For myself, I had both eyes done when I was in my forties (I am now 70). My vision is still 20/15 after 30 years. I just use bi-focals so I don't have to keep taking readers on and off for close work. My wife has had both of her eyes done and she also just wears readers for anything close. Both of us wore glasses for most of our lives. Don't make the mistake of the multi focus lenses until they have really gotten all of the bugs worked out
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Post by mikemyers 11/13/2020, 12:26 am

Caster3845 wrote:.........Don't make the mistake of the multi focus lenses until they have really gotten all of the bugs worked out

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5747227/
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Post by joem5636 11/14/2020, 7:48 am

Single focus! The multi-focus is really just a trick based on lighting. Theoretically, in bright light your Iris will contract to reveal only the center lens; in dim light a concentric lens is exposed for your other prescription. It is very inexpensive to buy glasses from, say, goggles4u.Com for specific needs. Many people have reported problems with the 'multifocus' lenses, and there is no cheap fix.

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Post by daveG 11/16/2020, 10:00 am

Thank you all for the information.  It is very helpful.  Obviously single focus is the way to go!

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Post by SonOfSwede 11/16/2020, 10:46 pm

+1 on single focus.

I have been near sighted since I was in grade school, 60 years ago.  I also lost the sight in one eye at about the same time.  For the last couple of years my vision was driving me nuts.  During the day I could not read road signs.  I saw each letter doubled and shifted horizontally.  At night I did not have a problem.  It turned out I had a small cataract in the center of my lens that was striated vertically so it was acting as a grating and producing a double horizontal image when my Iris was small.  At night my Iris was larger so I would get an image around the cataract.

Just before COVID I had a single vision lens put in that also corrected my distance vision to 20/20.  The corrected vision lens is not covered by Medicare so I had to pay about $1,000 for it.  It has been GREAT.  I purchased a pair of bifocal safety glasses from McMaster-Carr that I wear full time.  Since the safety glasses are wrap around I don't see a frame. I am not even aware they are there.  It also means that I have shooting glasses on all the time.  I could not be happier with the result.  

My wife will need cataract surgery in a year or so.  She has been fooling round with single vision and multifocal contacts to see what she would like when she has the surgery.  She came to the same conclusion as others.  The multifocal lenses give reasonable vision at multiple distances.  But, they are never good vision.

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Post by CharlieJ 11/27/2020, 2:20 pm

The doctor asked, do you want to see at a distance or up close, he knew I was a machinist and thought up close would be better but  since I've always been nearsighted and always hated it I chose distance. I've since come to regret that decision because as the good doctor had pointed out I do most of my work up close.  When your asked the same question I'd think long and hard about it if you do close work.
   But the up side is that surgery was the greatest thing that I have ever had done. It's like a gift from God.

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Post by mspingeld 11/27/2020, 4:51 pm

CharlieJ, Interesting point. I don't have cataracts but I do have astigmatism in my shooting eye and I'm nearsighted in both eyes. The dot is not round. I've been considering Lasik. Contacts allow me to see clearly but don't address the astigmatism. Got glasses with the astigmatism correction but the dot is still not perfectly round. If I wear contacts I'm putting the readers on and off all day long. If I don't wear contacts I'm really only putting the glasses on for driving and watching TV. That would indicate that correcting my eyes for close-up would be the better choice but, for some reason, it doesn't feel right. One advantage of correcting for distance is I would be able to see clearly from 4 or 5 feet to infinity but I guess I spend more time reading and looking at my phone so I would constantly need the readers. Thoughts? Anyone?

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Post by Mike M. 12/28/2020, 7:12 pm

Monofocal, definitely.  Spend the extra money, have them take care of any astigamatism  while they are at it.

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Post by james r chapman 12/28/2020, 7:26 pm

CharlieJ wrote:The doctor asked, do you want to see at a distance or up close, he knew I was a machinist and thought up close would be better but  since I've always been nearsighted and always hated it I chose distance. I've since come to regret that decision because as the good doctor had pointed out I do most of my work up close.  When your asked the same question I'd think long and hard about it if you do close work.
   But the up side is that surgery was the greatest thing that I have ever had done. It's like a gift from God.

Either way you’re going to need glasses.
You can get cheap diopter safety readers or expensive distance script glasses.
Your choice
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Post by lakemurrayman 12/28/2020, 11:38 pm

I had my surgery in 2008.I opted to have tri focal lenses.One for reading,one for front sight and one for distance.Corrected vision 20/20.
John

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Post by Allen Barnett 12/29/2020, 5:43 pm

Going to ask a stupid question here.  Do you have to have implants after cateract surgery or can you just continue to wear glasses?  I have worn glasses since I was a kid and they are the first thing I put on in the morning and the last thing I take off at night.  My eye doctor told me on my last visit that I had one starting to develop but it was not bad enough for surgery yet.  I have an exam in mid Jan so I am highly interested in this thread.  My main problem is I also have a history of high interocular pressure (precurser to glacoma) which has been medically controlled for 15 years.

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Post by REConley 12/29/2020, 6:00 pm

Yes you need implants as the lens in each eye is removed. I suspect that glasses could be made to work but it would not make sense to do that as I believe you would be effectively blind without the glasses.
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Post by james r chapman 12/29/2020, 6:02 pm

You must have a lense in place.
Generally insurance won’t cover until it’s a disability

I was 20/400 for 55 years. Don’t miss the glasses
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Post by REConley 12/29/2020, 6:09 pm

I bet walking into eye surgery with 20/400 vision and then getting up from the surgery table with 20/20 distant vision (Even with the eye drops fog) was a bit of a pleasant surprise.
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Post by james r chapman 12/29/2020, 6:40 pm

REConley wrote:I bet walking into eye surgery with 20/400 vision and then getting up from the surgery table with 20/20 distant vision (Even with the eye drops fog) was a bit of a pleasant surprise.

Remember waking up in recovery and being able to read the wall clock!


Better than my first colonoscopy, woke up to seeing wife talking to a priest!!
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Post by Wobbley 12/29/2020, 8:58 pm

james r chapman wrote:
Better than my first colonoscopy, woke up to seeing wife talking to a priest!!
What a Face   After I had a mild coronary, one set of visitors was “the God Squad” types asking me if I saw Jesus while I was unconscious....
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Post by jjbhonn 12/29/2020, 9:47 pm

I was a candidate for lens replacement in both eyes at 72. As I am right eye dominant, I opted to have my right eye done first. Doctor encouraged me to select the multi-focus lens. It cost me an extra $1700 for the lens. Surgery and recovery went well. Afterwards, I could only see slightly better. Not worth the dollars and a complete letdown. When it was time for the left eye, I selected the normal lens. I see at a distance better with my left eye than my right. I drive without glasses as well as watch TV. I do wear glasses for reading. As for shooting, I see better shooting out of my left eye using a red dot. Surgery was worth it; extra dollars for the multi-focus lens was not. Joe

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Post by Dr.Don 12/30/2020, 9:43 am

With regard to Allen Barnet's question, many of us are old enough to remember people who had cataract surgery before there were implantable lenses.  Those folks wore glasses that looked like coke bottle bottoms, but that was their only recourse.  You do not want external lenses; the implants are far superior.  I have glaucoma, and they often do a procedure to relieve pressure at the same time as the glaucoma surgery.
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Post by CharlieJ 12/30/2020, 11:42 am

A couple of more things. First is to find out which line of the eye chart you don't read beyond to qualify for insurance. It took me a couple of visits before I discovered which line that was, then when I got to that line, I simply said that's all i can read. That's when I was referred to a surgeon.
  A point the surgeon made on multi focus lenses was they are not for perfectionists, but said his wife loves hers, but didn't think I would.
 Also, do your research on the surgeon, there are websites that rate doctors and they certainly are not all equal.
  Good luck!

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Post by blindshooter 12/30/2020, 8:44 pm

I elected to get distance corrected along with fixing some astigmatism. Like some others here I was very myopic, like -7.0 corrections. It was hell waiting the 3 weeks to get the other eye fixed!
I'd make the same choice again. Shot some today, I used a clip on +.50 over safety glasses. Perfect front sight with slightly blurred target. I love it.

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Post by Mike M. 12/30/2020, 11:08 pm

I seriously considered getting one eye done for distance, the other for close up.  After a lot of thought (and after finding out that the FAA frowns on it), I went with both eyes for distance.  It was the right choice.

The limitation of a monofocal lens is that you have sharp vision at ONE distance.  Set for infinity, or near infinity, they can bring you to 20/20 or better at all distances beyond about 15 feet.  For reading, you need glasses.  For computer work, you need a different set of glasses.  Distance correction buys you the most utility.

There's a third option, the accomodative IOL.  The one currently on the market...well, the surgeon who did my surgery called it "the gift that keeps on giving", due to some issues getting it stabilized.  There's a second generation of IOLs in the development and approval pipeline that should buy a lot more capability, but we're talking about 2025 or so before they are available.

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