Cataract Surgery

[morgandawn]

 I've done some reading online but no one is answering these questions. My mom is gong for cataract surgery on both eyes. Eye 1 will be first and then a month later eye 2 She is nearsighted and needs to wear glasses to walk, eat, drive, watch TV, move about safely

1. During the one month between the 2 operations - how will she see? Her old glasses will not work on Operated Eye. I've read some people had to pop out the one lens of the old glasses so they can see

2. During the weeks after Second Eye surgery she will have even worse vision. Neither eyes will be able to see through her old glasses. They will give her a new prescription BUT.......

The doctor told her they will not give her a new prescription until one month after her second surgery. It will then take another 4-6 weeks for those new glasses to be made. What is she supposed to do for those 2 months? She is a senior at risk for falls and relies on good vision to walk safely

The new lens will most likely be fixed to give her 20/20 long distance vision.  She will have to use reading glasses or bifocals to read. She will also have problems with computer work - most progressives offer too small a 'slice' for middle vision (computer work)

Comments

[goss]

(*waves hi* - here via network)

I've read some people had to pop out the one lens of the old glasses so they can see

*nods* My dad did this when he first had the procedure done on one eye.


What is she supposed to do for those 2 months?

I am surprised that the surgeries for both eyes are scheduled only one month apart.

My two parents (aged 73 and 80) have each had cataract surgery (my mother is actually a retired nurse who specialized in assisting with eye surgeries) and they did both eyes like 6 months apart, so as to prevent having to deal with such a situation.

[morgandawn]

Thank you.

I am leaning towards having my Mom's fixed lens set to "reading" - that way she can use bifocals for driving/watching TV (top) and reading speedometer/using the microwave/looking inside the fridge (bottom).

To read, she's remove her glasses

These same bifocals would also work for her at work/office.

There is pressure to get the fixed lens set to long distance, but then for driving she's had to have odd bifocals - nothing at the top and middle range (speedometer) bottom. Then yet a second pair with middle (top) and reading (bottom).

She will not be driving for much longer. She is 84

She does not do well with progressives.

[catalenamara]

Wow, interesting. Most of the people I know (in their 60s and 70s) had the operations done on Fridays and went back to driving to work the following Mondays. I don't know what their vision acuity was, however.

[adair]

As it happens, just today I saw the surgeon who will do my cataract surgery. I finally gave in to it because I need more and more light for everything, and I am having difficulty witn mid-level vision - reading road names, reading titles on books on shelves about 4 feet away unless they are in big letters and high contrast, needing to lean in to my desk computer and laptop to read many screens. I am 73; friends who have had cataract surgery recently are in their 70s. We are all retired, mostly from state university jobs.

In this area the surgury is done on one eye; wait 2 weeks, then the other eye. Most people had a bit of a struggle but are happy. They mostly had the lens set for distance vision and use glasses for reading. They had to wait for 4 weeks after the last surgery for final glasses; making them took about 2 weeks. Some people bought commercial reading glasses to fill in the wait time; no one drove until at least 2 weeks after the 2nd surgery, and then only in limited amounts.

Things are different for me; I am extremely near-sighted and one eye has evidence of what seems to be called a corneal cone developing. This may never happen, but will need more surgery if it does. I have never driven, and do not want to be able to not need glasses, so the choice for bot lenses will be to favor close vision. I will probably be able to read without glasses, as I do now. I am uncertain what will happen with computer screens. My iPad will be readable without glasses, as it is now, but I need to be able to see the desk computer well to be able to write anything much.

My eye with the corneal issue will get a standard lens set for close reading. My other eye will get something called a Toric lens that will correct a lot of astigmatism; the first eye won't really do well with that because of the cornea issue. When thei first eye is done I will try taking a lens out of one of my back-up pairs. When both are done I am going to try my husband's backup glasses - he is much less nearsighted than I am. The surgeon chose lenses that gave -2.5 vision rather that the -12 and 10.50 that my eyes currently have. There is no way to predict just how the my eyes will resolve with these new lenses, but my distance vision should improve and I will be able to do close work without glasses. When I am ready for new glasses I will talk it over with my opthamologist, especially the computer use. I have never used progressive lenses, but I might try them this time. My surgeries are not yet scheduled; I expect to do them in August and get the new glasses in late October.

A friend has just finished surgery for her eyes; she is also very near-sighted but not as much as I am. She had the Toric lenses for both eyes, both set for close vision.. She is not yeat driving and will not drive until she gets her permanent glasses. She has always been able to read, but at this point is not comfortable at the computer. Her depth perception is sill not very good; she is careful where she puts her feet. She will see the surgeon this week for the final check of the 2nd eye, and will see the opthamologist in 4 weeks to be checked for new glasses. She will get progressive lenses to enable her to use the computer, and will probably try driving again after she adjusts to the new glasses. During this wait time she is using her son's back-up glasses, which seem to work for getting around, although the depth perception is not good.

My friend who was not so near-sighted has distance vision, but wears her glasses most of the time when driving. She has another pair for reading, but can use her distance glasses some of the time. She is fully recovered, is driving, and still working out how to use glasses for reading. She bought a commercial pair for the wait time and found she could still use them for reading.

Another person used her eye insurance to buy an interim pair; they are still not that good, but her eyes are still healing. Insurance is an issue. Both friends have Medicare and Medicare supplement, plus some state employee glasses insurance. I have the state glasses insurence but am not eligible for Medicare and never will be. I have the insturace given to state employees; it is decent, and will cover the surgery but not the special Toric lens. Email me if you have other questions.

[morgandawn]

This is hugely helpful. I am trying to persuade my Mom to use a ride share service to get to and from work. And then to possibly plan a few weeks off from work. And last to be prepared that her computer work may be difficult/impossible.

Right now her vision is 20/50 (just beyond what is legal in CA)

[stranger]

The standard advice seems to be to replace cataracted lenses with long distance lenses, but that's not necessarily best -- it's a dramatic improvement for some users and gets advertised as a benefit, but not everyone needs that most of all. Choosing a close-up (reading, needlework) plane of focus, or a computer-screen-away plane of focus can make sense for various people. I have the latter, and now function well in most indoor environments with no glasses (can see faces, clocks, food-prep ingredients, desk monitor), and plain magnifying readers for close-up, and the new prescription is for long-distance (driving, outdoor walking) glasses. Reading dashboard info turns out to be possible without bifocals, but I'd guess this will vary with dashboard layouts.

What does she do the most, by time? How inconvenient would it be to mislay the new glasses if they are for (a) driving, (b) reading, (c) work computer screen? Non-prescription reading glasses are relatively cheap and she can keep multiple pairs around for use, unlike prescription glasses.

The waiting a month after both eyes are finished for a new prescription was my doctor's insistence as well, since the new vision doesn't stabilize right away. It's inconvenient but unavoidable. If long-distance vision is what she uses to walk safely, and if that's long-term important to her, choosing the long-distance focus would mean she'd have reasonable use of that vision as soon as the 2nd eye heals a bit (2-3 days). Probably should wait longer to drive, however.

The between-surgeries time is awkward, and the one-lens pair of old glasses may be useful, or may just be confusing to the brain. It does give a transition period when she'll be learning to use the new eye for the focus it's good for, after post-surgery blurriness (1-2 full days) wears off. If she's at risk for falls already, this may be dangerous, because the double vision is disorienting. It's very much an investment of difficult time for future better vision.

[morgandawn]

This is very helpful. She refuses to stop driving though and the doctor kept waving his hands and saying 'no problem'

So you opted for a mid-range (computer) fixed lens?

[(Anonymous)]

Yes, the mid-range focal length is working for me, since I spend a lot of time at the computer, or on day-to-day in-house things like cooking. It's also fine for conversation, indoor walking around, etc. I've been wearing distance glasses all my life anyway, so the habit of making sure I'm wearing the glasses when I get in the car is very ingrained, and this seemed least disruptive to overall habits and lifestyle. I did have to get reading glasses, but being able to just *buy* them instead of waiting for a prescription was quite something.

Going by various friends' parents, the problem with senior drivers isn't usually vision as such, but either slow reactions or slowing cognition. If your mother is holding a job, chances are she's at least technically okay to drive, if her eyes are good for it. This varies a lot by individual, of course. Using rideshares or Lyft or something while she's between surgeries sounds like a really good idea, and also taking vacation for the first part of that time.

[amedia]

TODS had early-onset cataracts; he had his done — maybe six or seven years ago, I think. He was about 52. I don’t remember how he managed between surgeries, but I’ll ask!

[amedia]

So I pumped TODS for information this morning. :-)

He was extremely nearsighted before the surgery—although it was expensive (at that time, the laser was considered experimental, so that part wasn’t covered)—we’ve undoubtedly saved a couple thousand dollars on glasses since then. He got the Toric distance lenses, which corrected his nearsightedness and astigmatism. He does not wear glasses to drive. However, he need reading bifocals (different magnification for different components of tasks). We got them cheap from Zenni.

He’s mentioned that he misses being able to take his glasses off to look at things close up. So I asked him this morning if he wishes he’d gotten the close-vision lenses implanted instead, and he said no, because he loves to travel and the distance vision is good for that.

Between surgeries, he said, he simply took his glasses off and ignored the input from the bad eye, which, he said, was much easier than it sounds. He said the surgery was painless and the results were immediate—he could see perfectly out of the operated-on eye right away. Mind you, he was thirty years younger than everyone else in the waiting room. And I realize that info might not be as helpful to your mom for driving, since she’s looking at the closer-distance lens.

He had asked about using his glasses and taking out the lens in front of the operated-on eye, and the doctor said that wouldn’t work, at least not for him, because glasses distort your vision somewhat (nearsighted glasses make things look smaller), so the input from the two eyes wouldn’t match.

[amedia]

More on the reading glasses, including a weird gendered phenomenon. They told him he could use drugstore reading glasses, but those made him feel nauseated. The female optometrist who wrote the Rx for reading bifocals was puzzled by this, but the male optician wasn’t. TODS came into my office to explain. “I’ll show you!” He said. “Type something,”. So I did, and he looked baffled. “You’re not looking at your hands.” “Of course not!” I said. “Girls my age were taught to touch-type.” Hence the gendered reaction from the specialists—the guy realized the keyboard is farther away than the screen, hence, two different levels of magnification. Didn’t occur to the gal, just as it didn’t occur to me;we don’t look at the keyboard.

The locally-purchased reading bifocals were something like $200. From Zenni, $40-50.