Ctaract surgery - a few years on

Posted by Michael Gilligan on 24/09/2023 18:49:18

The problem with the glasses is quite infuriating : For most of my life I was short-sighted, and needed to take my glasses off to do close work. But since I had the cataract surgery I am a little long-sighted [and fixed-focus], so I need to put glasses on to do anything closer than arm’s length away.

Very, very, pleased with the cataract job, but the performance with glasses and various magnifiers still doesn’t come instinctively.

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Michael posted this in another thread. I didn't want to clutter up that thread so started this.

Two or three years ago there was a thread here - just before I had my cataract surgery - which painted a very rosy picture of the procedure. I still basically agree with that picture but I can stand back now and examine it more critically and wondered how some of the other people feel now.

I agree with Michaels comments above 100%. The worst time is out shopping and trying to read a label on something. I really should start carrying reading glasses with me. (The good thing is the readers are off the shelf including those funny fold-up kind From China on ebay).

Having worn glasses since I was 10 (70 years) it actually drives me nuts not to do so now. The worst time is when I sit back in the recliner to watch TV. Since I regularly used graduated lenses I would switch to a plain distance pair for TV. It's very distracting not to do so now.

Another thing I find is that, if I do say a crossword before the program starts (using reading glasses), it takes a noticeable time (a minute or so) for my eyes to refocus at the TV distance afterwards.

Edited By Peter Greene on 24/09/2023 19:58:29

Useful thanks, I shall try and remember these experiences when the day comes for me...

Neil

Just to elaborate a little, Peter [but first, thank you for your courtesy] … My short-sightedness started at school, and I wore ‘negative’ lenses from about age 13

I’m not sure how valid this is, but it was thought to be caused by classroom behaviour: repeatedly looking from blackboard to book puts a strain on the eye muscles, which is counteracted by the eyes becoming gradually more short-sighted.

Whatever the truth of that, my eyes progressively worsened, to the point where I needed about -3 dioptres

[ plenty of people are considerably worse than that ] … at which point, I could easily see to work on small items, simply by removing my glasses.

As the years passed, of course, my accommodation started to deteriorate and I lost most of that ability.

Fast forward a few years and at age 55, my optician gave me the news that he could see signs of ‘early onset cataract’ … believed to be triggered by the use of inhaled steroids for hay-fever

More recently [a long story but I will skip the detail] I started ‘iris pigment shedding’ and this, in conjunction with the worsening cataracts was causing quadruple vision [double vision in each eye] which is decidedly inconvenient.

The cataract surgery, one way and another, fixed all, of that; and I found myself able to drive without glasses for the first time ever. My eyes are now 40/20 but the numbers on the dashboard instruments are noticeably fuzzy, and looking at anything closer requires an optical aid of some sort.

On balance, it’s all worked-out very well, but I do miss that ability to just take off my glasses for close work.

MichaelG.

The great thing about natural eye lenses is that they can alter their focal length.

The problem is that the cornea might not focus correctly.

Right now in the interval of the Wales/Australia match, I am reminded that by my mid-teens I could not see the ball at the far end of the pitch. You could wear spectacles for cricket (I have seen a young Sir Geoffrey do so) but not rugby and we did not have contact lenses in those days.

Don't forget that one can wear one's short-sighted -ve lenses with +ve reading glasses at the same time.

For some reason, people think that it is a little odd.

Now 3 years in since I had both eyes sorted for cateracts. Then at 3 years my right eye went fuzzy, not nice at all. Fear, so off to the opticiaon and examined and decided it was PCO. ( Posterior capsular opacification} I read up and 20 to 30% of cateract subjects suffer PCO. What is it, during the cateract op. Epithilian cells are released and then float onto the rear of the capsule that they put the replacement lens in. It is caused by the cateract op.!

The treatment is to burn off the rear of the capsule with a laser, painless and takes 5 minutes at the most. No side effects yet.

Now here hangs the nasty bit, The eye test was 27 Jan and they said we will send a letter to your surgery to arrange. Come July and being in the surgery I asked if they had received the letter, No, Luckily I had a copy and handed it over. 4 days later I had an appt. 14 days later I had the procedure. Dont trust anyone who says they will send a letter!

I had both my eyes done about 4 years ago. At the time I used varifocal lenses to correct the state of my vision as it then was. After cataract surgery I had the probably normal lens set up of acceptable vision at medium to long distance and correction needed for close work. It seemed plain to me that the best option for me was a set of varifocal lens glasses with the top of the lens having very little effect and the lower portion having a magnifying effect for the close work. In practice I now only have 1 pair of glasses which I wear all day and as I was already well used to varifocal lenses I had no difficulty. Having just the one pair of glasses I rarely lose them.

Be aware that varifocals can take a bit of getting used to for some people but as I recall when I first started with them it took me only a day or 2 before the action required to see clearly at all distances came naturally.

As an aside I also suffered from PCO in my right eye after about 30 months and although the treatment was as Clive says, a quick laser zap, I waited over a year to get it done. Moral is if you notice a treated eye is getting cloudy again get off to your optician and start the ball rolling to get it lasered as soon as you can.

Jim

Edited By Jim Nic on 24/09/2023 23:56:15

The eye focuses through a combination of the cornea; changing the lens shape, and changing the shape of the eyeball.

These shape changes are accomplished by muscles in and around the eye.

Like any muscle in the body; if we don't regularly use them or exercise them; they will weaken. Wearing glasses mean that the eye muscles don't need to do any work to focus on close (or distant) objects, so all the muscles used for focussing will weaken. Having weakened the muscles, it makes it harder to not wear glasses and you enter a spiral of worsening eyesight.

So, as much as possible, I don't wear glasses - I force my eyes to focus by themselves, and although my sight is starting to go, I am in my 6th decade and only need glasses for very very small print and for very very fine jobs, such as marking out very fine detail.

I have regular tests and don't need glasses to drive or watch TV or to read labels at the supermarket. I only need glasses for really tiny small print, and I usually just go to the window for more light or use my phone to read that.

Unless you need a strong correction, or you are doing critical or dangerous work; I would recommend not using glasses whenever possible and building up the strength of your eye muscles. That is what I do. "Straining" your eyes is the same as feeling a bit stiff or achy after the gym - it confirms that you have been working your muscles which is beneficial, and not harmful.

It might take a couple of weeks until your eye muscles gain strength.

I exercised my spectacles-free eyes on close work (8 inches and less) virtually every day for nearly twenty years. Presbyopia struck nonetheless. To effectively see at all at close distances (anything under three feet) I now need about four pairs of different strength reading glasses (and or Optivisors) depending on the distance I’m working at.

It sounds like your own presbyopia is relatively mild if you can force your eyes to focus on everything but close-up, very tiny print.

I don't think there is much agreement or evidence that, once the rot has set in, exercising your eyes can significantly prevent them from losing their ability to focus on close work.

Having had cataracts in both eyes done, with the usual long distance and glasses for near work, I was shocked, 3 years later, to be told I needed glasses to drive. The optician told me that there was nothing wrong with the lenses they had put in or the operation itself, the problem was that the eyeball had changed shape and altered the focusing of the eye. Makes sense but my euphoria with the success of the operations evaporated a bit.

Martyn

No, that is not correct.

The lens and iris are controlled by smooth muscles, which cannot be exercised like striated muscles.

Presbyopia arises from stiffening of the lens, not weakening of the muscles.

The extra-ocular muscles swivel the eyes.

For a bit of ‘light reading’ … it’s worth finding a copy of Huxley’s book: **LINK**

https://en.wikipedia.org/wiki/The_Art_of_Seeing

Published long before the internet was available … but full of the sort of misinformation that thrives !

MichaelG.

About 30 years ago I noticed a slight deterioration of my eye sight - I realised that I could no longer see fine detail in the leaves on distant trees. I thought, oh well, here we go, time to get some glasses.

So I went to the optometrist who measured everything and said, well if you really want glasses I can prescribe them, but they will be the very smallest correction I can do. I went ahead and bought the (expensive) glasses anyway, and the distant fine detail was restored.

But then I thought about what I was doing, and did some reading into the subject and stopped using the glasses, instead forcing my eye muscles to stay strong and focus. The muscles do change the shape of the eyeball as well as the lens to assist focus, and this is important as our internal lenses become less pliable with age.

One useful exercise is to focus on something very distant, wait until the eye has fully focussed, then change to something very close, wait to refocus, and so on, back and forth, focussing between the two. I do this 10 times for each eye when I remember to, and this helps exercise the muscles.

30 years later, and having kept those glasses in their case, my uncorrected sight is very good indeed for a person of my age, and I don't need glasses, except for extremely small, fine work. When I read a bed-time book in low lighting, the letters are not completely clear, but I can still read them easily and I persevere to keep my eye muscles strong. I have just checked and I can read, unaided, small print that is just 1mm high - albeit, I need to read it near a window. At a recent airline eye test I was complimented on my visual performance for a pilot of my age and do not need glasses to fly.

Interestingly, my dominant eye has gone longer focus, and my non dominant eye has gone shorter focus, which combine to give me a large focal range. The time it takes for me to change focus from very distant to very near or vice versa, is longer than when I was young.

It is possible that after years of relying on glasses to focus, no amount of practice will bring back atrophied eye focus muscles, but for that reason I avoided and avoid glasses wherever possible, keeping my muscles strong.

For similar reasons to the focussing, I never wear sunglasses, unless it is absolutely unbearably bright, preferring to keep my iris muscles active and fit. And a smaller iris gives you a greater depth of field which aids focus range too.

Obviously, if you need glasses to drive or use machinery etc., you MUST use them !!

.

Edited By John Doe 2 on 25/09/2023 10:30:14

I put off glasses as long as I could, but eventually my arm wasn't long enough to hold a book and focus on the words.

JD2 you are just lucky with your genetics and you should consider that not wearing sunglasses (most have UV filters as do ordinary glasses these days) exposes you to macula degeneration due to UV damage.

Had both eyes done last year other than everything being clearer I still need to wear vari focals which I find disappointing When I had the first one done I had a chest infection which migrated into the eye giving me a very bad eye infection, would I recommend having cataracts done yes !

H

Just had a regular eye test, have been wearing bifocals for a number of years and find they are suitable for my sight requirements. The eye test showed that all items checked were ok, no macular degeneration or retinal damage but apparently I now have cataracts to contend with. I regularly go clay pigeon shooting and for the last 12 months I have noticed a slow but steady decline in my scores, I wondered why it was happening but now I have been diagnosed with cataracts in both eyes that may explain my not being able to see the clays clearly at a distance. Reading fine print close up is no problem but I have found that I have been having trouble in focussing on small objects at distance in bright sunlight. My cataracts are nowhere near ready to remove but probably enough to start impacting on my shooting scores, no fun growing old. Dave W

Had both eyes done (separately ) in spring this year. Wonderful improvement, but cannot get quite the ideal lens for the right eye.

Wear varifocals all the time, only really needed for near work.

Strangely, having optimised the viewfinder on the camnera without galsses, the specs slightly distort the image

A small price to pay for such an improvement in vision, particularly when driving at night.

Howard.

Thanks for the link, Michael!

A real eye-opener. Clearly not Huxley’s finest hour.

You’re welcome, Bill

… and as a special treat Archive.org has it for online viewing, or download

**LINK**

https://archive.org/details/in.ernet.dli.2015.11974/page/n13/mode/2up

MichaelG.