Question: I have had Cataract Surgery in both eyes. When I change environments from outside to inside I experience small tremors that occur in both eyes. Instead of lessening over time this has become constant. My vision is very clear but the shaky feeling is more than I can stand as my eyes are fluttering constantly. My Cataract Surgeon says it will get better but it had grown worse. Please advise.
Answer: You do not state how long it has been since you have had Cataract Surgery and Lens Implants. However the flickering or tremors of light that you describe is not an uncommon complaint that patients who are adapting to newly implanted intraocular lenses (IOL) experience. This visual effect is thought to possibly be due to the reflections off the edges of the IOL and in almost all cases of the flickering or tremoring goes away with time. If it is so disturbing and you are dissatisfied with the answer your cataract Surgeon has provided you may wish to get a second opinion from a top Cataract Surgeon in your area. There is never anything wrong with seeking a second opinion to make you feel more comfortable.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on http://www.aboutcataractsurgery.com/ is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of http://www.aboutcataractsurgery.com/ is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Cataracts, Cataract Surgery & Lens Implant (IOL) facts & information on how to find trusted Cataract Surgeons who are the Best Cataract Surgeon- review costs, risks, complications, side effects, cataract surgery recovery.
Monday, April 25, 2011
Friday, April 22, 2011
No Bad Eye Effects with Steroid Inhalers
Long term use of steroid inhalers for asthma does not increase the risk of cataracts or glaucoma according to researchers reporting at the April 2011 Annual Meeting of the American Academy of Allergy, Asthma and Immunology. Using inhaled budesonide daily for chronic asthma for an average of 16 years from childhood into adulthood didn’t cause more cataracts or significantly change intraocular pressure or vision in a prospective, longitudinal, placebo-controlled study. Previous studies of the risk of posterior subcapsular cataracts from oral or inhaled steroids were cross-sectional studies with little or no information on the dose of inhaled corticosteroid used and thus suspected to be unreliable. This study provided greater control and dose specificity and thus provides a very strong finding of safety with long-term inhaled budesonide for asthma.
Cataract Surgery after LASIK Vision Correction
Question: I have been told I need cataract surgery in both eyes, mostly the right eye for now. About 12 years ago I had LASIK surgery and am very concerned about having cataract surgery with an Intraocular Lens Implant (IOL). Can you just have the cataract removed without the IOL?
Answer: Cataract Surgery after LASIK is becoming more and more common the "baby boomer" population that had LASIK 10-15 years ago are now moving into their 50's and 60's. Further Cataract Surgery with Intraocular Lens Implantation (IOL) after LASIK is becoming more and more precise as superior measurement technology and testing procedures have become available.
Here is what you need to know. There are two primary goals of Cataract Surgery. First, your Cataract Surgeon needs to remove the crystalline lens in your eye which has become cloudy and formed a Cataract. As the name implies, the "crystalline lens" is an actual lens with an actual optical power. Thus the second goal of Cataract Surgery is to replace the optical power that was removed by extracting the crystalline lens and the Cataract. This is accomplished by implanting a tiny artificial plastic lens-an intraocular lens implant or "IOL"-at the time the Cataract is removed. The power or prescription of the lens implant needs to be carefully measured for and calculated as part of your preoperative cataract Surgery workup. Having previously had LASIK does add a certain degree of complexity to the measurements for the calculation of the lens implant power to be used. Today, Cataract & Refractive Surgeons can use very sophisticated instrumentation to increase the precision of these measurements in order to hopefully help you be "glasses free" for at distance after your Cataract Surgery as you probably were after your LASIK Surgery. What might be of help to your Cataract Surgeon is to provide them with a set of your preoperative LASIK examination records and measurements including your original refraction or prescription, your keratometric readings ("K's"), your corneal thickness and the status of your tear film.
Equally if not more important is how you go about choosing a Cataract Surgeon. For someone who has had LASIK and now needs Cataract Surgery and Lens Implantation it would make sense to choose not only the best Cataract Surgeon but also to choose someone is a top LASIK Surgeon. It is preferable to choose an eye surgeon who is BOTH a Cataract & Refractive Surgeon and experienced in the subtleties and complexities of both procedures as they relate to each other. Ideally if your original LASIK Surgeon is also an experienced cataract Surgeon and he or she already has access to your original records this would be a good choice. Most Cataract patients today who have previously had LASIK are quite pleased with their results. Choosing the best Cataract & Refractive Surgeon will help you get there.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on http://www.aboutcataractsurgery.com/ is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of http://www.aboutcataractsurgery.com/ is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Answer: Cataract Surgery after LASIK is becoming more and more common the "baby boomer" population that had LASIK 10-15 years ago are now moving into their 50's and 60's. Further Cataract Surgery with Intraocular Lens Implantation (IOL) after LASIK is becoming more and more precise as superior measurement technology and testing procedures have become available.
Here is what you need to know. There are two primary goals of Cataract Surgery. First, your Cataract Surgeon needs to remove the crystalline lens in your eye which has become cloudy and formed a Cataract. As the name implies, the "crystalline lens" is an actual lens with an actual optical power. Thus the second goal of Cataract Surgery is to replace the optical power that was removed by extracting the crystalline lens and the Cataract. This is accomplished by implanting a tiny artificial plastic lens-an intraocular lens implant or "IOL"-at the time the Cataract is removed. The power or prescription of the lens implant needs to be carefully measured for and calculated as part of your preoperative cataract Surgery workup. Having previously had LASIK does add a certain degree of complexity to the measurements for the calculation of the lens implant power to be used. Today, Cataract & Refractive Surgeons can use very sophisticated instrumentation to increase the precision of these measurements in order to hopefully help you be "glasses free" for at distance after your Cataract Surgery as you probably were after your LASIK Surgery. What might be of help to your Cataract Surgeon is to provide them with a set of your preoperative LASIK examination records and measurements including your original refraction or prescription, your keratometric readings ("K's"), your corneal thickness and the status of your tear film.
Equally if not more important is how you go about choosing a Cataract Surgeon. For someone who has had LASIK and now needs Cataract Surgery and Lens Implantation it would make sense to choose not only the best Cataract Surgeon but also to choose someone is a top LASIK Surgeon. It is preferable to choose an eye surgeon who is BOTH a Cataract & Refractive Surgeon and experienced in the subtleties and complexities of both procedures as they relate to each other. Ideally if your original LASIK Surgeon is also an experienced cataract Surgeon and he or she already has access to your original records this would be a good choice. Most Cataract patients today who have previously had LASIK are quite pleased with their results. Choosing the best Cataract & Refractive Surgeon will help you get there.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on http://www.aboutcataractsurgery.com/ is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of http://www.aboutcataractsurgery.com/ is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
First Bifocal Light Adjustable Lens (LAL) Surgery
The Light Adjustable Lens (LAL) is a type of intraocular lens implant (IOL) that is made from a light sensitive polymer. The LAL can be used as part of Cataract Surgery to correct vision. It is unique because it allows the Cataract Surgeon the ability to adjust or “fine tune” the prescription for the patient in order to get the best possible visual results. The London Eye Hospital has now performed the world’s first bifocal Light Adjustable Lens (LAL) eye surgery. By using a digitally computer controlled beam of light delivered through the patient’s pupil, the Cataract Surgeon is able to precisely correct even the finest imperfections in the patient’s prescription. The precision is so great it can even correct the minor imperfections necessary to provide treatment of aberrations and create bifocal correction. Because the fine tuning adjustment is delivered through the pupil it doesn’t carry the surgical risks of a lens implant exchange procedure and it can be adjusted multiple times throughout the patient’s lifespan without additional surgery in order to keep providing the best vision.
Thursday, April 21, 2011
Cataracts, Cataract Surgery & Dry AMD
Question: I have Cataracts in both eyes and Dry Macular Degeneration (AMD) in both eyes. What are the possible complications from Cataract Surgery given my AMD? Are there many surgeries of this type performed? What generally is the success rate? Thanks.
Answer: Both Cataracts and AMD are typically associated with the aging process. Both tend to increase in incidence with increasing age and so it is not unusual to see patients who have both Cataracts and AMD. What is different is the degree and severity of the AMD and the degree of Cataract formation. Dry AMD is a slowly progressive type of Macular Degeneration that typically causes a dimming of vision, fading of colors and often loss of contrast sensitivity-which are the same types of symptoms caused by the development of a Cataract. The combination of the two conditions occurring concurrently can often result in marked reduction in both visual acuity and visual function. Dry AMD accounts for perhaps 85% of the cases of Age Related Macular Degeneration. Some percentage of cases do progress to Wet AMD which has a much more catastrophic effect on vision.
You do not specify the degree of Dry AMD that you have and how extensive it is. You also do not specify how dense your Cataracts are and what your current level of visual acuity is. For some time there was a concern that removing a Cataract would increase the possibility of the development of or progression of AMD. Here is what we know today. Some of the reduction in your vision is no doubt due to the AMD and some is due to the Cataracts. You need to have a thorough examination, preoperative testing and consultation in order to get an approximation of what you might expect after Cataract Surgery. Realistic expectations are the key here and setting those requires careful evaluation of the Cataract as well as careful evaluation of the Macula by a top Cataract Surgeon. While it is often difficult to quantify what the exact results will be, we do know that people who have mild or moderate degrees of AMD along with moderate or even more advanced Cataracts do experience meaningful benefits in terms of lifestyle and functioning. We also know that the most current research indicates that people who have Cataract Surgery are not at any higher risk for the development or progression of AMD. This is especially true in consideration of the more advanced types of UV blocking lens implants (IOL)s that are often suggested by the best Cataract Surgeons. With regard to the Cataract Surgery procedure itself, there is really no difference in the Cataract operation when done for routine patients versus those with Macular Degeneration. Further there is really no difference in the risks, complications of side effects of Cataract Surgery for patients with or without AMD. Your next step is to find the top cataract Surgeons in your area and schedule a consultation. If you wish additional confirmation of the benefit in your particular case you may also ask for a consultation with a Retinal Specialist who specializes in diseases of the Macula as a source of second opinion.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Answer: Both Cataracts and AMD are typically associated with the aging process. Both tend to increase in incidence with increasing age and so it is not unusual to see patients who have both Cataracts and AMD. What is different is the degree and severity of the AMD and the degree of Cataract formation. Dry AMD is a slowly progressive type of Macular Degeneration that typically causes a dimming of vision, fading of colors and often loss of contrast sensitivity-which are the same types of symptoms caused by the development of a Cataract. The combination of the two conditions occurring concurrently can often result in marked reduction in both visual acuity and visual function. Dry AMD accounts for perhaps 85% of the cases of Age Related Macular Degeneration. Some percentage of cases do progress to Wet AMD which has a much more catastrophic effect on vision.
You do not specify the degree of Dry AMD that you have and how extensive it is. You also do not specify how dense your Cataracts are and what your current level of visual acuity is. For some time there was a concern that removing a Cataract would increase the possibility of the development of or progression of AMD. Here is what we know today. Some of the reduction in your vision is no doubt due to the AMD and some is due to the Cataracts. You need to have a thorough examination, preoperative testing and consultation in order to get an approximation of what you might expect after Cataract Surgery. Realistic expectations are the key here and setting those requires careful evaluation of the Cataract as well as careful evaluation of the Macula by a top Cataract Surgeon. While it is often difficult to quantify what the exact results will be, we do know that people who have mild or moderate degrees of AMD along with moderate or even more advanced Cataracts do experience meaningful benefits in terms of lifestyle and functioning. We also know that the most current research indicates that people who have Cataract Surgery are not at any higher risk for the development or progression of AMD. This is especially true in consideration of the more advanced types of UV blocking lens implants (IOL)s that are often suggested by the best Cataract Surgeons. With regard to the Cataract Surgery procedure itself, there is really no difference in the Cataract operation when done for routine patients versus those with Macular Degeneration. Further there is really no difference in the risks, complications of side effects of Cataract Surgery for patients with or without AMD. Your next step is to find the top cataract Surgeons in your area and schedule a consultation. If you wish additional confirmation of the benefit in your particular case you may also ask for a consultation with a Retinal Specialist who specializes in diseases of the Macula as a source of second opinion.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Wednesday, April 20, 2011
Cataract Surgery Visual Field Loss
Question: My 84 year old father had cataract surgery one week ago. He is in excellent health and takes no medication of any kind. He is not overweight and only started to wear reading glasses about 5 years ago. After the surgery, at next day follow up visit they said all was well. He has been back to the doctor 3 times since the surgery and sent him home with a change in antibiotic drops. Now when he covers his eye that had not been treated and uses the eye that was worked on he has a line of vision only of half of the area he is looking at. When the bad eye is covered he has full vision of the room.. When the eye doctor tested his eye they did not seemed concerned and "think" it will clear up. Should I be concerned and seek a second opinion.
Answer: In general visual recovery after Cataract Surgery and Lens Implantation is fairly quick. By one week after surgery in an uncomplicated Cataract operation in an otherwise healthy individual it it is typical to have rather good vision at distance although perhaps not as clear and crisp as when the eye is totally healed. That said, the vision you describe whereby one half of the visual field is missing is not typical or expected and needs to be verified, examined and explained. There are a number of reasons for this to occur-some of which have to do with the Cataract Surgery and others that have nothing to do with the eye surgery or eye health at all. Your next step is to certainly ask for an explanation from your father's Cataract Surgeon that is satisfactory for both you and your father to understand. If you do not get one, then it is totally appropriate to seek a second opinion from the best Cataract Surgeon you can find. This may be worthwhile even if you get a decent answer as seeking a second opinion is often a responsible healthcare choice.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Answer: In general visual recovery after Cataract Surgery and Lens Implantation is fairly quick. By one week after surgery in an uncomplicated Cataract operation in an otherwise healthy individual it it is typical to have rather good vision at distance although perhaps not as clear and crisp as when the eye is totally healed. That said, the vision you describe whereby one half of the visual field is missing is not typical or expected and needs to be verified, examined and explained. There are a number of reasons for this to occur-some of which have to do with the Cataract Surgery and others that have nothing to do with the eye surgery or eye health at all. Your next step is to certainly ask for an explanation from your father's Cataract Surgeon that is satisfactory for both you and your father to understand. If you do not get one, then it is totally appropriate to seek a second opinion from the best Cataract Surgeon you can find. This may be worthwhile even if you get a decent answer as seeking a second opinion is often a responsible healthcare choice.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Toric Lens Implant for Low Astigmatism
Question: I'm in a quandary about having a toric IOL lens verses a monofocal for one eye that has astigmatism of .75. I've seen two top surgeons in my area, one who says even though my dominant eye has .75 astigmatism, he would place a toric in that eye for optimum correction to have the best results. The other says emphatically that he will not put in a toric in that eye, that it isn't needed. The other eye would be a standard monofocal as it reads .50. I want the best vision possible and if a toric would tweak my vision at all I would do it, if the consequences are minimal. What should I do?
Answer: Astigmatism correcting lens implants (IOL) are very useful for providing Cataract patients with excellent vision at distance. Your Cataract Surgery poses an interesting question because of the small amount of astigmatism. There are really a few other factors other than the amount of astigmatism that can impact the decision of the Cataract Surgeon as to whether to use a toric IOL to correct low amounts of astigmatism. It’s not just based on the degree spectacle correction of astigmatism but also depends on the orientation of the astigmatism-whether it is stronger “vertically” than “horizontally” and what impact or degradation that has on your vision. In addition the decision can depend on whether the astigmatism is located in the cornea or the crystalline lens, which is being removed during Cataract Surgery. There has to be a quantitatively rationale relationship between the amount of astigmatism on the cornea and the total amount in your prescription. If all or most of the astigmatism is in your crystalline lens and this lens is being removed during surgery then a toric lens might be the wrong choice. Further, with such low amounts there may very well be some “astigmatic effect” created by the surgical technique itself. That is to say where the corneal incision is placed-what orientation and what length may induce or reduce small amounts of preexisting astigmatism. So it is entirely possible that the two top Cataract Surgeons you have consulted are giving you the best answer “in their hands”. They may very well use slightly different surgical techniques and in the case of Cataract Surgeon #1 he performs “astigmatically neutral” results and would need the toric IOL to provide the correction whereas Cataract Surgeon #2 might perform a procedure that causes a very slight reduction of the astigmatism as an artifact of his technique. If they are top Cataract Surgeons they both track their outcomes on a statistical basis and know very well what effect their surgical technique does or does not have on inducing, reducing or not effecting preoperative astigmatism. Thus, choose the top Cataract Surgeon you are most comfortable with and go with his recommendation.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Answer: Astigmatism correcting lens implants (IOL) are very useful for providing Cataract patients with excellent vision at distance. Your Cataract Surgery poses an interesting question because of the small amount of astigmatism. There are really a few other factors other than the amount of astigmatism that can impact the decision of the Cataract Surgeon as to whether to use a toric IOL to correct low amounts of astigmatism. It’s not just based on the degree spectacle correction of astigmatism but also depends on the orientation of the astigmatism-whether it is stronger “vertically” than “horizontally” and what impact or degradation that has on your vision. In addition the decision can depend on whether the astigmatism is located in the cornea or the crystalline lens, which is being removed during Cataract Surgery. There has to be a quantitatively rationale relationship between the amount of astigmatism on the cornea and the total amount in your prescription. If all or most of the astigmatism is in your crystalline lens and this lens is being removed during surgery then a toric lens might be the wrong choice. Further, with such low amounts there may very well be some “astigmatic effect” created by the surgical technique itself. That is to say where the corneal incision is placed-what orientation and what length may induce or reduce small amounts of preexisting astigmatism. So it is entirely possible that the two top Cataract Surgeons you have consulted are giving you the best answer “in their hands”. They may very well use slightly different surgical techniques and in the case of Cataract Surgeon #1 he performs “astigmatically neutral” results and would need the toric IOL to provide the correction whereas Cataract Surgeon #2 might perform a procedure that causes a very slight reduction of the astigmatism as an artifact of his technique. If they are top Cataract Surgeons they both track their outcomes on a statistical basis and know very well what effect their surgical technique does or does not have on inducing, reducing or not effecting preoperative astigmatism. Thus, choose the top Cataract Surgeon you are most comfortable with and go with his recommendation.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Tuesday, April 19, 2011
Toric or Near Vision IOL-Which One Should I Have?
Question: I am 72 and have cataracts. I was scheduled for cataract surgery this month but changed my mind after a friend said I was making the wrong decision. I have always been nearsighted and have worn glasses since I was 13. I started wearing bifocals at 44. I have always had to wear glasses to drive.
I have double astigmatism and the Ophthalmologist said I would need Toric lenses and then Lasik to be able to see both distance and close. I am really afraid of the Lasik surgery. I told him I would prefer to have implants for CLOSE VISION instead of distance because I work on the computer a lot, read, play cards and sew. My friend said I should have the DISTANCE corrected with the implants and wear glasses for reading. The eye doctor said I could have one eye for reading and then later do the other eye for about 20 feet to see TV without glasses. But I tried contacts years ago for monovision, and it was always blurry.
In your practice with patients who opted to correct their close vision (instead of distance) and wear glasses for driving, would you say are happy with their decision? If I choose the distance correction, would that mean that everything would be blurry within a 20-30 foot range?
Answer: Your question is somewhat unclear which gives concern to whether you have been fully counseled by your Cataract Surgeon regarding the options for lens implants to correct vision after Cataract Surgery or perhaps you didn't understand what was presented to you. Let's see if we can organize the options that might be available to you. First, it is unclear what "double" astigmatism means. If it means that you have a moderate to high amount of astigmatism we understand this.
For people having Cataract Surgery who have preexisting astigmatism-before their Cataract operation-AND WHO WANT TO HAVE CLEAR VISION AT DISTANCE WITHOUT GLASSES-the Cataract Surgeon can implant an astigmatism correcting toric lens. Astigmatism correcting toric lens implants DO NOT CORRECT NEAR VISION-ONLY FAR VISION and thus you would need to wear reading glasses or bifocals to see the computer screen, play cards and sew-with two caveats. As a practical matter, Toric Lens Implants only correct up to approximately 2.5 D of astigmatism and thus if the amount of astigmatism exceeds this amount ("double astigmatism"?) you might indeed need a second astigmatism correcting procedure to see clearly at distance-thus the POSSIBLE need for LASIK.
For people who wear bifocals and are having Cataract Surgery who want to be able to see far, near and arm's length without being totally dependent on eyeglasses after Cataract Surgery, the Cataract Surgeon can implant a presbyopia near vision correcting lens implant-BUT-AT THIS POINT IN TIME IN THE UNITED STATES PRESBYOPIA NEAR VISION CORRECTING LENS IMPLANTS DO NOT CORRECT ASTIGMATISM AND YOU WOULD STILL NEED TO WEAR GLASSES TO SEE CLEARLY-UNLESS the astigmatism was corrected by a second procedure such as LASIK Surgery for Astigmatism.
Now, the notion of using a monovision lens implant correction after cataract Surgery should be removed from consideration as you did not adapt well to monovision contact lens correction.
SO:
1. You can be MOSTLY OR COMPLETELY corrected for distance using an astigmatism correcting toric IOL in which case you will need to wear eyeglasses-readers or bifocals-to see arm's length and near, OR
2. You can MOSTLY OR COMPLETELY corrected for distance AND near using a near vision presbyopia correcting IOL in COMBINATION WITH LASIK. You should not be afraid of LASIK. Worldwide patient satisfaction studies of LASIK demonstrate that patients are as happy if not more happy with LASIK Eye Surgery than they are with Cataract Surgery.
Typically patients who elect to correct their near vision with monofocal or toric lens implants end up not being terribly happy as compared to those who fully correct their distance vision-and have clear vision to within 4-5 feet, and then wear readers or bifocals. One way or the other, due to the complexity of your prescription and desired tasks you will either need to wear eyeglasses some or all of the time OR have LASIK if you wish to be relatively eyeglass "free". For certain, you should have a complete review and discussion of these options with an eye surgeon who is both a top Cataract Surgeon as well as being one of the top LASIK Surgeons in your area.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
I have double astigmatism and the Ophthalmologist said I would need Toric lenses and then Lasik to be able to see both distance and close. I am really afraid of the Lasik surgery. I told him I would prefer to have implants for CLOSE VISION instead of distance because I work on the computer a lot, read, play cards and sew. My friend said I should have the DISTANCE corrected with the implants and wear glasses for reading. The eye doctor said I could have one eye for reading and then later do the other eye for about 20 feet to see TV without glasses. But I tried contacts years ago for monovision, and it was always blurry.
In your practice with patients who opted to correct their close vision (instead of distance) and wear glasses for driving, would you say are happy with their decision? If I choose the distance correction, would that mean that everything would be blurry within a 20-30 foot range?
Answer: Your question is somewhat unclear which gives concern to whether you have been fully counseled by your Cataract Surgeon regarding the options for lens implants to correct vision after Cataract Surgery or perhaps you didn't understand what was presented to you. Let's see if we can organize the options that might be available to you. First, it is unclear what "double" astigmatism means. If it means that you have a moderate to high amount of astigmatism we understand this.
For people having Cataract Surgery who have preexisting astigmatism-before their Cataract operation-AND WHO WANT TO HAVE CLEAR VISION AT DISTANCE WITHOUT GLASSES-the Cataract Surgeon can implant an astigmatism correcting toric lens. Astigmatism correcting toric lens implants DO NOT CORRECT NEAR VISION-ONLY FAR VISION and thus you would need to wear reading glasses or bifocals to see the computer screen, play cards and sew-with two caveats. As a practical matter, Toric Lens Implants only correct up to approximately 2.5 D of astigmatism and thus if the amount of astigmatism exceeds this amount ("double astigmatism"?) you might indeed need a second astigmatism correcting procedure to see clearly at distance-thus the POSSIBLE need for LASIK.
For people who wear bifocals and are having Cataract Surgery who want to be able to see far, near and arm's length without being totally dependent on eyeglasses after Cataract Surgery, the Cataract Surgeon can implant a presbyopia near vision correcting lens implant-BUT-AT THIS POINT IN TIME IN THE UNITED STATES PRESBYOPIA NEAR VISION CORRECTING LENS IMPLANTS DO NOT CORRECT ASTIGMATISM AND YOU WOULD STILL NEED TO WEAR GLASSES TO SEE CLEARLY-UNLESS the astigmatism was corrected by a second procedure such as LASIK Surgery for Astigmatism.
Now, the notion of using a monovision lens implant correction after cataract Surgery should be removed from consideration as you did not adapt well to monovision contact lens correction.
SO:
1. You can be MOSTLY OR COMPLETELY corrected for distance using an astigmatism correcting toric IOL in which case you will need to wear eyeglasses-readers or bifocals-to see arm's length and near, OR
2. You can MOSTLY OR COMPLETELY corrected for distance AND near using a near vision presbyopia correcting IOL in COMBINATION WITH LASIK. You should not be afraid of LASIK. Worldwide patient satisfaction studies of LASIK demonstrate that patients are as happy if not more happy with LASIK Eye Surgery than they are with Cataract Surgery.
Typically patients who elect to correct their near vision with monofocal or toric lens implants end up not being terribly happy as compared to those who fully correct their distance vision-and have clear vision to within 4-5 feet, and then wear readers or bifocals. One way or the other, due to the complexity of your prescription and desired tasks you will either need to wear eyeglasses some or all of the time OR have LASIK if you wish to be relatively eyeglass "free". For certain, you should have a complete review and discussion of these options with an eye surgeon who is both a top Cataract Surgeon as well as being one of the top LASIK Surgeons in your area.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Should I Have a Multifocal Lens in One Eye?
Question: I have not had Cataract Surgery yet but I am planning to have a Cataract operation and lens implant in my left eye. I am trying to decide between a multifocal implant and a monofocal lens for my left eye. The right eye has the starting of a Cataract, but the ophthalmologist does not feel that my right eye is ready for surgery yet. I would also like to know if I will be able to drive at night if I choose the multifocal lens.
Answer: In general Cataract Surgeons try to schedule Cataract Surgery so that both eyes are operated within a month or so of each other if the first eye is uneventful. Obviously if the Cataract in the second eye is so slight so as not to warrant surgery this isn't the case. However, with almost all types of multifocal lenses the full optical correction and performance is not achieved until both eyes are implanted with the multifocal IOL. That is, you may not get the full benefit of the near correction and may need to continue to wear reading glasses until you have the second eye operated and implanted with a multifocal lens. In addition, all types of multifocal lens implants do require some “neuroadaptation” whereby the brain learns how to see with a new type of optical image created by the implant. If you have only one eye implanted with a multifocal for a substantial length of time the optical adaptation may not occur during that time and you could be uncomfortable. This may or may not bother you. Your best bet is to try and get some idea from your Cataract Surgeon regarding how long the time might be between operations. Also, in consultation with your surgeon you should discuss the issue of neuroadaptation as it can be very different depending on which type of multifocal lens he or she plans on implanting. Last, you should express your night driving concern as again depending on the type of multifocal lens used there can considerable differences in night driving with different types of multifocal IOLs.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Answer: In general Cataract Surgeons try to schedule Cataract Surgery so that both eyes are operated within a month or so of each other if the first eye is uneventful. Obviously if the Cataract in the second eye is so slight so as not to warrant surgery this isn't the case. However, with almost all types of multifocal lenses the full optical correction and performance is not achieved until both eyes are implanted with the multifocal IOL. That is, you may not get the full benefit of the near correction and may need to continue to wear reading glasses until you have the second eye operated and implanted with a multifocal lens. In addition, all types of multifocal lens implants do require some “neuroadaptation” whereby the brain learns how to see with a new type of optical image created by the implant. If you have only one eye implanted with a multifocal for a substantial length of time the optical adaptation may not occur during that time and you could be uncomfortable. This may or may not bother you. Your best bet is to try and get some idea from your Cataract Surgeon regarding how long the time might be between operations. Also, in consultation with your surgeon you should discuss the issue of neuroadaptation as it can be very different depending on which type of multifocal lens he or she plans on implanting. Last, you should express your night driving concern as again depending on the type of multifocal lens used there can considerable differences in night driving with different types of multifocal IOLs.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Monday, April 18, 2011
Dry Eye and Eyelid Inflammation after Cataract Surgery
Question: I had cataract surgery in both eyes about 4 months ago with toric lens implants. My right eye now has supervision. The left has been extremely dry with blurry vision and is uncomfortable. The left eye actually feels larger than the right. I am on antibiotics (doxycycline), putting artificial tears in multiple times a day and the the left feels itchy. The doctor says it is a problem with my eyelids (which I never noticed pre-op). Any suggestions?
Answer: Dry eye, mild ocular surface irritation and eyelid inflammation can sometimes occur after uneventful Cataract Surgery-even if they were not present before your eye surgery. Modern Cataract Surgery, particularly with clear corneal incisions, is considered very safe for the cornea. However, several factors known to exacerbate dry eye can be present surrounding Cataract Surgery. These include the temporary disruption of corneal nerves from the tiny corneal incisions and the mild ocular surface toxicity of topical ophthalmic eye drop medications that are used before, during and after the Cataract operation itself. Further, it is entirely possible that you had "subclinical" eyelid inflammation-that was not bad enough to make you symptomatic-that became activated from the inflammatory factors mentioned above.
It is difficult to know whether you primarily have the eyelid problem causing the dry eye problem or the cataract procedure causing the eyelid problem and thus the dry eye problem-or which caused what. It appears as if your Cataract Surgeon is taking a pretty aggressive course of therapy for you. If you are not getting relief from the therapeutic approach being taken it would be worthwhile to first discuss this and ask about alternative therapeutic approaches with your Cataract Surgeon. If he or she is unwilling or unable to get you some relief, it might be worthwhile to seek a consultation with a Corneal Specialist who has a special interest in ocular surface and external disease. Sometimes these specialists will take a different therapeutic approach towards the inflammation, eyelid issues and ocular surface that you might have a better response to.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on http://www.aboutcataractsurgery.com/ is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of http://www.aboutcataractsurgery.com/ is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Answer: Dry eye, mild ocular surface irritation and eyelid inflammation can sometimes occur after uneventful Cataract Surgery-even if they were not present before your eye surgery. Modern Cataract Surgery, particularly with clear corneal incisions, is considered very safe for the cornea. However, several factors known to exacerbate dry eye can be present surrounding Cataract Surgery. These include the temporary disruption of corneal nerves from the tiny corneal incisions and the mild ocular surface toxicity of topical ophthalmic eye drop medications that are used before, during and after the Cataract operation itself. Further, it is entirely possible that you had "subclinical" eyelid inflammation-that was not bad enough to make you symptomatic-that became activated from the inflammatory factors mentioned above.
It is difficult to know whether you primarily have the eyelid problem causing the dry eye problem or the cataract procedure causing the eyelid problem and thus the dry eye problem-or which caused what. It appears as if your Cataract Surgeon is taking a pretty aggressive course of therapy for you. If you are not getting relief from the therapeutic approach being taken it would be worthwhile to first discuss this and ask about alternative therapeutic approaches with your Cataract Surgeon. If he or she is unwilling or unable to get you some relief, it might be worthwhile to seek a consultation with a Corneal Specialist who has a special interest in ocular surface and external disease. Sometimes these specialists will take a different therapeutic approach towards the inflammation, eyelid issues and ocular surface that you might have a better response to.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on http://www.aboutcataractsurgery.com/ is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of http://www.aboutcataractsurgery.com/ is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Sunday, April 17, 2011
Cataract Surgery after LASIK Vision Correction
Question: I have been told I need cataract surgery in both eyes, mostly the right eye for now. About 12 years ago I had LASIK surgery and am very concerned about having cataract surgery with an Intraocular Lens Implant (IOL). Can you just have the cataract removed without the IOL?
Answer: Cataract Surgery after LASIK is becoming more and more common the "baby boomer" population that had LASIK 10-15 years ago are now moving into their 50's and 60's. Further Cataract Surgery with Intraocular Lens Implantation (IOL) after LASIK is becoming more and more precise as superior measurement technology and testing procedures have become available.
Here is what you need to know. There are two primary goals of Cataract Surgery. First, your Cataract Surgeon needs to remove the crystalline lens in your eye which has become cloudy and formed a Cataract. As the name implies, the "crystalline lens" is an actual lens with an actual optical power. Thus the second goal of Cataract Surgery is to replace the optical power that was removed by extracting the crystalline lens and the Cataract. This is accomplished by implanting a tiny artificial plastic lens-an intraocular lens implant or "IOL"-at the time the Cataract is removed. The power or prescription of the lens implant needs to be carefully measured for and calculated as part of your preoperative cataract Surgery workup. Having previously had LASIK does add a certain degree of complexity to the measurements for the calculation of the lens implant power to be used. Today, Cataract & Refractive Surgeons can use very sophisticated instrumentation to increase the precision of these measurements in order to hopefully help you be "glasses free" for at distance after your Cataract Surgery as you probably were after your LASIK Surgery. What might be of help to your Cataract Surgeon is to provide them with a set of your preoperative LASIK examination records and measurements including your original refraction or prescription, your keratometric readings ("K's"), your corneal thickness and the status of your tear film.
Equally if not more important is how you go about choosing a Cataract Surgeon. For someone who has had LASIK and now needs Cataract Surgery and Lens Implantation it would make sense to choose not only the best Cataract Surgeon but also to choose someone is a top LASIK Surgeon. It is preferable to choose an eye surgeon who is BOTH a Cataract & Refractive Surgeon and experienced in the subtleties and complexities of both procedures as they relate to each other. Ideally if your original LASIK Surgeon is also an experienced cataract Surgeon and he or she already has access to your original records this would be a good choice. Most Cataract patients today who have previously had LASIK are quite pleased with their results. Choosing the best Cataract & Refractive Surgeon will help you get there.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Answer: Cataract Surgery after LASIK is becoming more and more common the "baby boomer" population that had LASIK 10-15 years ago are now moving into their 50's and 60's. Further Cataract Surgery with Intraocular Lens Implantation (IOL) after LASIK is becoming more and more precise as superior measurement technology and testing procedures have become available.
Here is what you need to know. There are two primary goals of Cataract Surgery. First, your Cataract Surgeon needs to remove the crystalline lens in your eye which has become cloudy and formed a Cataract. As the name implies, the "crystalline lens" is an actual lens with an actual optical power. Thus the second goal of Cataract Surgery is to replace the optical power that was removed by extracting the crystalline lens and the Cataract. This is accomplished by implanting a tiny artificial plastic lens-an intraocular lens implant or "IOL"-at the time the Cataract is removed. The power or prescription of the lens implant needs to be carefully measured for and calculated as part of your preoperative cataract Surgery workup. Having previously had LASIK does add a certain degree of complexity to the measurements for the calculation of the lens implant power to be used. Today, Cataract & Refractive Surgeons can use very sophisticated instrumentation to increase the precision of these measurements in order to hopefully help you be "glasses free" for at distance after your Cataract Surgery as you probably were after your LASIK Surgery. What might be of help to your Cataract Surgeon is to provide them with a set of your preoperative LASIK examination records and measurements including your original refraction or prescription, your keratometric readings ("K's"), your corneal thickness and the status of your tear film.
Equally if not more important is how you go about choosing a Cataract Surgeon. For someone who has had LASIK and now needs Cataract Surgery and Lens Implantation it would make sense to choose not only the best Cataract Surgeon but also to choose someone is a top LASIK Surgeon. It is preferable to choose an eye surgeon who is BOTH a Cataract & Refractive Surgeon and experienced in the subtleties and complexities of both procedures as they relate to each other. Ideally if your original LASIK Surgeon is also an experienced cataract Surgeon and he or she already has access to your original records this would be a good choice. Most Cataract patients today who have previously had LASIK are quite pleased with their results. Choosing the best Cataract & Refractive Surgeon will help you get there.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Laser Cataract Surgery
Question: Can you advise which cataract surgeons in the Buffalo New York area utilize the FLAC (Femtosecond Laser Assisted Cataract Surgery) method?
Answer: Some things to know. Femtosecond Laser Cataract Surgery does not completely eliminate the risk of Cataract Surgery which is still dependent on being a top Cataract Surgeon with excellent skills, experience and judgment. Laser Cataract Surgery does offer the promise of better precision and reproducibility however Laser Assisted Cataract Surgery is VERY new at this point in time. Currently the Alcon LensSx® femtosecond laser is on the market with FDA 510(k) clearance for performing lens fragmentation, anterior capsulotomy and corneal incision creation. The OptiMedica Catalys Precision Laser System has completed international clinical trials for performing lens fragmentation, anterior capsulotomy, cataract incision and relaxing incisions for astigmatism correction and is expected to obtain FDA clearance this year, however no laser systems for routine patient care are available in the United States. The LensAr System has FDA clearance for anterior capsulotomy and lens fragmentation and is awaiting FDA clearance for the other surgical steps. As of today there are very few systems in use in the United States. Your best bet in finding a top Cataract Surgeon in the Buffalo area using any of these systems of planning to use any of these systems is to contact the manufacturers mentioned above directly as ask where they have either installed or are contracted to install systems in the near future.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on http://www.aboutcataractsurgery.com/ is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of http://www.aboutcataractsurgery.com/ is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Answer: Some things to know. Femtosecond Laser Cataract Surgery does not completely eliminate the risk of Cataract Surgery which is still dependent on being a top Cataract Surgeon with excellent skills, experience and judgment. Laser Cataract Surgery does offer the promise of better precision and reproducibility however Laser Assisted Cataract Surgery is VERY new at this point in time. Currently the Alcon LensSx® femtosecond laser is on the market with FDA 510(k) clearance for performing lens fragmentation, anterior capsulotomy and corneal incision creation. The OptiMedica Catalys Precision Laser System has completed international clinical trials for performing lens fragmentation, anterior capsulotomy, cataract incision and relaxing incisions for astigmatism correction and is expected to obtain FDA clearance this year, however no laser systems for routine patient care are available in the United States. The LensAr System has FDA clearance for anterior capsulotomy and lens fragmentation and is awaiting FDA clearance for the other surgical steps. As of today there are very few systems in use in the United States. Your best bet in finding a top Cataract Surgeon in the Buffalo area using any of these systems of planning to use any of these systems is to contact the manufacturers mentioned above directly as ask where they have either installed or are contracted to install systems in the near future.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on http://www.aboutcataractsurgery.com/ is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of http://www.aboutcataractsurgery.com/ is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Cataract Removal Lens Implants & Flickering
Question: I recently had a cataract removal with a toric lens implant to correct astigmatism. Since my cataract surgery I have a sensation of flickering in certain light, especially florescent lighting. Is this normal and will this go away?
Answer: The sensation of flickering light after Cataract Surgery and Intraocular Lens Implantation (IOL) is one that is reported by patients from time to time. The actual cause is up for debate but some believe that it might be due to reflections from the edge of the lens or perhaps from elsewhere in the lens optics. Over time this type of flickering will slowly diminish and the symptoms seem to fade away. If, however, the flickering begins to appear more like "flashes" of light it would be important to schedule an appointment with your Cataract Surgeon and have it evaluated quickly as this symptom might indicate another type of problem.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on http://www.aboutcataractsurgery.com/ is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of http://www.aboutcataractsurgery.com/ is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Answer: The sensation of flickering light after Cataract Surgery and Intraocular Lens Implantation (IOL) is one that is reported by patients from time to time. The actual cause is up for debate but some believe that it might be due to reflections from the edge of the lens or perhaps from elsewhere in the lens optics. Over time this type of flickering will slowly diminish and the symptoms seem to fade away. If, however, the flickering begins to appear more like "flashes" of light it would be important to schedule an appointment with your Cataract Surgeon and have it evaluated quickly as this symptom might indicate another type of problem.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on http://www.aboutcataractsurgery.com/ is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of http://www.aboutcataractsurgery.com/ is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Double Vision After Cataract Surgery
Question: I have double vision after Cataract Surgery. What causes this? I this normal?
Answer: Double vision after Cataract Surgery is not a normal or expected occurrence unless you actually had it before the Cataract operation and just didn't notice it due to poor vision from the Cataract. Nonetheless, it needs a thorough investigation by your Cataract Surgeon. Double vision in one eye, or monocular diplopia, has an entire range of causes from improper positioning of the Lens Implant used to correct your vision to a problem in the Retina and many other possibilities. Double vision occurring only when both eyes are open, or binocular diplopia, has an entirely different set of causes that could span a number of optical problems but also systemic, medical, vascular or neurological problems-ALL of which need to be investigated. Or, what you are describing as double vision could be something as simple as an uncorrected refractive error like an astigmatism that can cause shadowing that appears as a doubled image in some cases. Your next step is to return to your Cataract Surgeon and carefully explain what you are experiencing and under what conditions and whether it is one or both eyes and how long you have experienced it. This is not a symptom that you should leave unattended.. If you do not wish to return to your Cataract Surgeon, then find a top cataract Surgeon in your area to provide and examination and opinion.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Answer: Double vision after Cataract Surgery is not a normal or expected occurrence unless you actually had it before the Cataract operation and just didn't notice it due to poor vision from the Cataract. Nonetheless, it needs a thorough investigation by your Cataract Surgeon. Double vision in one eye, or monocular diplopia, has an entire range of causes from improper positioning of the Lens Implant used to correct your vision to a problem in the Retina and many other possibilities. Double vision occurring only when both eyes are open, or binocular diplopia, has an entirely different set of causes that could span a number of optical problems but also systemic, medical, vascular or neurological problems-ALL of which need to be investigated. Or, what you are describing as double vision could be something as simple as an uncorrected refractive error like an astigmatism that can cause shadowing that appears as a doubled image in some cases. Your next step is to return to your Cataract Surgeon and carefully explain what you are experiencing and under what conditions and whether it is one or both eyes and how long you have experienced it. This is not a symptom that you should leave unattended.. If you do not wish to return to your Cataract Surgeon, then find a top cataract Surgeon in your area to provide and examination and opinion.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Cataract Surgery Recovery and High Altitude
Question: Is traveling to higher altitudes advisable during Cataract Surgery recovery?
Answer: Cataract Surgery recovery from modern Cataract Surgery including "no needle, no patch, no stitch" surgery procedures is pretty patient friendly. If you are in good health and have had no other eye surgery concurrent with your Cataract operation-such as Retinal Detachment surgery-then assuming that your Cataract Surgeon has no restrictions, traveling to high altitudes should not pose any real problems or risk.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Answer: Cataract Surgery recovery from modern Cataract Surgery including "no needle, no patch, no stitch" surgery procedures is pretty patient friendly. If you are in good health and have had no other eye surgery concurrent with your Cataract operation-such as Retinal Detachment surgery-then assuming that your Cataract Surgeon has no restrictions, traveling to high altitudes should not pose any real problems or risk.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Wednesday, April 13, 2011
Vitamin D and Macular Degeneration
Researchers reporting in the April issue of Archives of Ophthalmology found that women younger than 75 who get sufficient vitamin D in their diets appear to have a reduced risk of Macular Degeneration, a leading cause of blindness. In the study, researchers say women under 75 who got the most vitamin D had a 59% decreased risk of developing Age Related Macular Degeneration (AMD) as compared to women with the lowest vitamin D intake. The research suggests that perhaps by using a common blood test called Serum 25 (OH) D it might be possible to identify those women at greater risk of developing AMD. Age Related Macular Degeneration (AMD) is a leading cause of vision loss and blindness in our aging population and affects some 8.5 million Americans over 40 years old.
Tuesday, April 12, 2011
Black Eye from Cataract Surgery
Question: I had Cataract Surgery on 3/15/11. I still feel some discomfort mainly at night when I am laying down and closing my eyes. It feels abnormal-almost like a quivering feeling below the eye. I had a black eye atter surgery and am still waiting for some of the bruising to go away. I am scheduled for the left eye tomorrow 4/12/11. Is what I am experiencing normal? The cataract Surgeon said to expect a black eye on the right eye.
Answer: Short term complications of Cataract Surgery such as a bruise can sometimes occur within the first 24 hours after surgery. If there was some factor regarding your overall health and medical condition that caused the Cataract Surgeon to use an anesthetic injection either alone or in combination with anesthetic eye drops it is possible to get a bruise or "black eye". The bruising is temporary and while it doesn't happen very often it can sometimes occur. By all means mention to your surgeon the other discomfort you are experiencing so that he or she can examine the eye and the tissue around the eye for anything untoward.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to LASIK. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Answer: Short term complications of Cataract Surgery such as a bruise can sometimes occur within the first 24 hours after surgery. If there was some factor regarding your overall health and medical condition that caused the Cataract Surgeon to use an anesthetic injection either alone or in combination with anesthetic eye drops it is possible to get a bruise or "black eye". The bruising is temporary and while it doesn't happen very often it can sometimes occur. By all means mention to your surgeon the other discomfort you are experiencing so that he or she can examine the eye and the tissue around the eye for anything untoward.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to LASIK. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Cataract Surgery-Does Age Limit Outcomes
Question: My 98 year old mother is reluctant to have Cataract Surgery. Is her age detrimental to a good surgical outcome?
Answer: The simple answer as to whether age alone limits the positive outcomes of Cataract Surgery is no. If your mother is in generally good health the type of modern Cataract Surgery that can be performed is "topical clear cornea no stitch phacoemulsification". This is a complicated way of saying modern Cataract Surgery in basically healthy patients can be performed with eye drops for anesthesia-no needles and can be performed with a very tiny incision that is so small and self sealing so as not to require stitches. So, modern Cataract Surgery is "patient friendly" even for someone 96 years old. However, there are other eye changes that happen as a result of the normal aging process that CAN effect the outcome of Cataract Surgery. In particular, Age Related Macular Degeneration (AMD) can impact the expectations one should have of Cataract Surgery. In addition any other health or eye problems, conditions or diseases including diabetes and glaucoma that your mother has may also impact the Cataract Surgery outcome-regardless of her age. The best step to take is to arrange a consultation with a top Cataract Surgeon in your area for a thorough examination. he or she should take the time necessary to answer any questions and be able to give you a pretty good estimation of what to expect in terms of outcome.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to LASIK. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Answer: The simple answer as to whether age alone limits the positive outcomes of Cataract Surgery is no. If your mother is in generally good health the type of modern Cataract Surgery that can be performed is "topical clear cornea no stitch phacoemulsification". This is a complicated way of saying modern Cataract Surgery in basically healthy patients can be performed with eye drops for anesthesia-no needles and can be performed with a very tiny incision that is so small and self sealing so as not to require stitches. So, modern Cataract Surgery is "patient friendly" even for someone 96 years old. However, there are other eye changes that happen as a result of the normal aging process that CAN effect the outcome of Cataract Surgery. In particular, Age Related Macular Degeneration (AMD) can impact the expectations one should have of Cataract Surgery. In addition any other health or eye problems, conditions or diseases including diabetes and glaucoma that your mother has may also impact the Cataract Surgery outcome-regardless of her age. The best step to take is to arrange a consultation with a top Cataract Surgeon in your area for a thorough examination. he or she should take the time necessary to answer any questions and be able to give you a pretty good estimation of what to expect in terms of outcome.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to LASIK. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Cost of Lens Implants and Cataract Surgery
Question: I need to have a Cataract removed. I have investigated the AcrySof®ReSTOR® IQ lens. I have Secure Horizons Insurance.What is the estimated cost out of pocket above insurance coverage?
Answer: When you state that you have "investigated" the AcrySof®ReSTOR® IQ Lens Implant it is important to be certain that you have first had a consultation with a top Cataract Surgeon who in fact has thoroughly examined you, discussed your lifestyle needs and your vision expectations and requirements of Cataract Surgery and Lens Implantation. Choosing a Lens Implant for vision correction after Cataract Surgery is not like buying a car where you can read about the manufacturers specifications and marketing hyperbole and get "sold' on it. Each type of near vision presbyopia correcting lens implant available today has very different optical characteristics and thus corrects the range of clear vision after Cataract Surgery in a different manner. This leads to different ranges of clear vision as well as producing different optical side effects and limitations for each one. Thus, the "brand" of near vision presbyopia correcting lens implant should be chosen after considerable discussion with your Cataract Surgeon. That said, assuming you have indeed had an examination and consultation and your Cataract Surgeon has selected the AcrySof®ReSTOR® IQ Lens Implant as being the best one to meet your vision and personal lifestyle needs it is the eye surgeon that sets the fees for the incremental fee to be charged for the AcrySof®ReSTOR® IQ Lens Implant, Each Cataract Surgeon determines their own fees and thus they should be able to tell you what they are. Generally, the incremental cost of a near vision presbyopia correcting lens implant ranges from $1,000-$3,000 above what is reimbursed by standard insurance and Medicare. However, THE DEDUCTIBLES, PERCENTAGE COVERAGE AND ANY CO-PAYS ARE UNIQUELY INDIVIDUAL TO YOUR INSURANCE AND YOUR SPECIFIC HEALTH INSURANCE POLICY and thus should be reviewed with you by the Cataract Surgeon's office and your insurance company.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to LASIK. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Answer: When you state that you have "investigated" the AcrySof®ReSTOR® IQ Lens Implant it is important to be certain that you have first had a consultation with a top Cataract Surgeon who in fact has thoroughly examined you, discussed your lifestyle needs and your vision expectations and requirements of Cataract Surgery and Lens Implantation. Choosing a Lens Implant for vision correction after Cataract Surgery is not like buying a car where you can read about the manufacturers specifications and marketing hyperbole and get "sold' on it. Each type of near vision presbyopia correcting lens implant available today has very different optical characteristics and thus corrects the range of clear vision after Cataract Surgery in a different manner. This leads to different ranges of clear vision as well as producing different optical side effects and limitations for each one. Thus, the "brand" of near vision presbyopia correcting lens implant should be chosen after considerable discussion with your Cataract Surgeon. That said, assuming you have indeed had an examination and consultation and your Cataract Surgeon has selected the AcrySof®ReSTOR® IQ Lens Implant as being the best one to meet your vision and personal lifestyle needs it is the eye surgeon that sets the fees for the incremental fee to be charged for the AcrySof®ReSTOR® IQ Lens Implant, Each Cataract Surgeon determines their own fees and thus they should be able to tell you what they are. Generally, the incremental cost of a near vision presbyopia correcting lens implant ranges from $1,000-$3,000 above what is reimbursed by standard insurance and Medicare. However, THE DEDUCTIBLES, PERCENTAGE COVERAGE AND ANY CO-PAYS ARE UNIQUELY INDIVIDUAL TO YOUR INSURANCE AND YOUR SPECIFIC HEALTH INSURANCE POLICY and thus should be reviewed with you by the Cataract Surgeon's office and your insurance company.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to LASIK. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Cataract Surgery, Dry Eye and Vision
Question: I had Cataract Surgery with presbyopia correction surgery 4 weeks ago. My vision is extremely blurry. The eye is extremely dry and the pupil of the eye that had the surgery is larger than the eye that did not. Could the blurriness possibly be from the dry eye and enlarged pupil?
Answer: Dry eye after Cataract Surgery is not an uncommon symptom as it is thought that Cataract Surgery can either cause a temporary dry eye to occur or even exacerbate a mild preexisting dry eye condition. Dry eye can also cause blurred vision that typically gets better and clears upon blinking. You do not say that there is any pattern to the blurriness and you report that the vision is extremely blurry so the dryness might or might not be contributing to this. The fact that your pupil is "enlarged" 4 weeks after Cataract Surgery is not a typical finding and it needs an explanation sooner rather than later especially in light of the poor vision. There may be no relationship between your poor vision and the enlarged pupil or it may be significant and related. Speak to your Cataract Surgeon and ask for a clear explanation. If you are unable to get one that is satisfactory, it is completely appropriate to seek a second opinion from a top Cataract Surgeon in your area regarding the dryness, the poor vision and the enlarged pupil.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to LASIK. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Answer: Dry eye after Cataract Surgery is not an uncommon symptom as it is thought that Cataract Surgery can either cause a temporary dry eye to occur or even exacerbate a mild preexisting dry eye condition. Dry eye can also cause blurred vision that typically gets better and clears upon blinking. You do not say that there is any pattern to the blurriness and you report that the vision is extremely blurry so the dryness might or might not be contributing to this. The fact that your pupil is "enlarged" 4 weeks after Cataract Surgery is not a typical finding and it needs an explanation sooner rather than later especially in light of the poor vision. There may be no relationship between your poor vision and the enlarged pupil or it may be significant and related. Speak to your Cataract Surgeon and ask for a clear explanation. If you are unable to get one that is satisfactory, it is completely appropriate to seek a second opinion from a top Cataract Surgeon in your area regarding the dryness, the poor vision and the enlarged pupil.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to LASIK. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Monovision Cataract Surgery for Near Vision
Question: I have had Cataract Surgery in my right eye for distance and love it. However I am having my left eye implanted with a reading lens or monovision Cataract Surgery. My question is do most people adjust the this type of vision easily. Do you know what percent of people do not like this.
Answer: The technique of monovision for near vision correction has been used for many years for patients wishing to avoid bifocals or reading glasses. Monovision contact lenses and monovision LASIK have proven to be an effective method of near vision correction for patients requiring correction of nearsightedness, farsightedness and astigmatism. The success with monovision in any correction is dependent of the physician taking careful measurements, doing careful calculations and attempting to determine the patient tolerance to "defocus". This can be approximated by doing an in office trial with a spectacle trial frame and lenses or through the use of contact lenses. It is more difficult to approximate and demonstrate when one eye has a Cataract that blurs the vision as it doesn't give a true demonstration. That said, when it can be demonstrated and is well tolerated by patients in the office trial the success rate is in the 80% range (Cataract & Refractive Surgery, Kohnen and Koch: 2008). In an older survey of the published literature without any standardized testing or screening the composite success rate of all publications was 73% (Survey of Ophthalmology, Jan, Aurora, Azar: May 1996).
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to LASIK. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Answer: The technique of monovision for near vision correction has been used for many years for patients wishing to avoid bifocals or reading glasses. Monovision contact lenses and monovision LASIK have proven to be an effective method of near vision correction for patients requiring correction of nearsightedness, farsightedness and astigmatism. The success with monovision in any correction is dependent of the physician taking careful measurements, doing careful calculations and attempting to determine the patient tolerance to "defocus". This can be approximated by doing an in office trial with a spectacle trial frame and lenses or through the use of contact lenses. It is more difficult to approximate and demonstrate when one eye has a Cataract that blurs the vision as it doesn't give a true demonstration. That said, when it can be demonstrated and is well tolerated by patients in the office trial the success rate is in the 80% range (Cataract & Refractive Surgery, Kohnen and Koch: 2008). In an older survey of the published literature without any standardized testing or screening the composite success rate of all publications was 73% (Survey of Ophthalmology, Jan, Aurora, Azar: May 1996).
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to LASIK. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Saturday, April 9, 2011
Cataract Surgery and Bloodshot Eyes
Question: I had cataract surgery (right eye) about 13 months ago. An intraocular lens was inserted. During past year I tend to have minor 'blood shot' eye that usually it disappears in afternoon. What might be causing this?
Answer: A bloodshot eye after Cataract Surgery is not a common occurrence nor is it unheard of. The fact that it is a minor event is good.You do not say whether there is any irritation or discomfort with the "early in the day" bloodshot and this is important. You also do not say whether there is any discharge-either watery or sticky or whether there is any irritation or redness of the margins of your eyelids. There are many possible causes of some transient redness after Cataract Surgery including dry eye, minor eyelid inflammation or infection or chronic blepharitis, improper closure of your eyelids during sleep ad on and on, all of which can be investigated and diagnosed and a treatment plan recommended by your Cataract Surgeon. Your next step is to schedule a visit to your Cataract Surgeon and be sure to tell them all of the details of your complaint as well as making sure that they know all of the medications you are taking including OTC eye drops for the redness.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to LASIK. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Answer: A bloodshot eye after Cataract Surgery is not a common occurrence nor is it unheard of. The fact that it is a minor event is good.You do not say whether there is any irritation or discomfort with the "early in the day" bloodshot and this is important. You also do not say whether there is any discharge-either watery or sticky or whether there is any irritation or redness of the margins of your eyelids. There are many possible causes of some transient redness after Cataract Surgery including dry eye, minor eyelid inflammation or infection or chronic blepharitis, improper closure of your eyelids during sleep ad on and on, all of which can be investigated and diagnosed and a treatment plan recommended by your Cataract Surgeon. Your next step is to schedule a visit to your Cataract Surgeon and be sure to tell them all of the details of your complaint as well as making sure that they know all of the medications you are taking including OTC eye drops for the redness.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to LASIK. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Cataract Surgery Complications
Question: My mom-in-law had cataract sx two days ago. Today on a p/o visit, she was told she has a "major eye bleed". I worked in an Ophthamology Surgicenter for more than 15 years and absolutely do not remember this complication, ever. She's in surgery now to repair the stitch that never closed the incision. We were told she has a 1 in 30 chance of having vision in the eye when it is healed. How common is this complication? Are there any stats that show better odds? Thanks.
Answer: Cataract Surgery complications are generally pretty rare and typically less than 5% in otherwise healthy patients. Certain health conditions such as diabetes, glaucoma and other blood and healing problems can increase the complication rate but are still considered somewhat rare. Bleeding is a very unusual short term complication of Cataract Surgery. Bleeding inside the back of the eye is quite rare. A chorodial hemorrhage can infrequently and unpredictably occur during Cataract Surgery and for no apparent reason. Acute bleeding can occur in the choroid, which is the delicate pattern of blood vessels underlying and nourishing the retina. Although this complication, called "choroidal hemorrhage" is more common among elderly patients, it is truly unpredictable. In some cases of choroidal hemorrhage, the bleeding is localized, and patients do well. In more severe cases of choroidal hemorrhage, visual loss can be substantial.
While bleeding can occur inside the front of the eye where the actually surgery is being performed, this too is rare-especially since the tiny incision is made in the clear portion of the cornea where there are no blood vessels. If bleeding does occur it is usually limited to the surface of the eye where your surgeon can easily cauterize it and stop it immediately.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to LASIK. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Answer: Cataract Surgery complications are generally pretty rare and typically less than 5% in otherwise healthy patients. Certain health conditions such as diabetes, glaucoma and other blood and healing problems can increase the complication rate but are still considered somewhat rare. Bleeding is a very unusual short term complication of Cataract Surgery. Bleeding inside the back of the eye is quite rare. A chorodial hemorrhage can infrequently and unpredictably occur during Cataract Surgery and for no apparent reason. Acute bleeding can occur in the choroid, which is the delicate pattern of blood vessels underlying and nourishing the retina. Although this complication, called "choroidal hemorrhage" is more common among elderly patients, it is truly unpredictable. In some cases of choroidal hemorrhage, the bleeding is localized, and patients do well. In more severe cases of choroidal hemorrhage, visual loss can be substantial.
While bleeding can occur inside the front of the eye where the actually surgery is being performed, this too is rare-especially since the tiny incision is made in the clear portion of the cornea where there are no blood vessels. If bleeding does occur it is usually limited to the surface of the eye where your surgeon can easily cauterize it and stop it immediately.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to LASIK. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Thursday, April 7, 2011
Should a Torn Lens Implant be Removed?
Question:
My wife just had cataract surgery and was informed that the implanted lens has a slight tear. Is it best to have it replaced?
Answer: Whether to remove or explant and replace a torn or damaged lens implant (IOL) is really dependent on many factors. The vast majority of times it is not necessary. A minor tear or damage that does not effect vision, impact the position of the lens implant in the eye or its stability may not need to be removed at all. If the size or the position of the tear impacts vision by either allowing the IOL to not be stable and in the correct position or it is a tear that might cause irritation and inflammation then it might be worthwhile having a "lens exchange". No one, including the best Cataract Surgeons wants to do surgery that is unnecessary or doesn't have a very comfortable risk:benefit ratio. Thus the question of whether an explant and lens exchange is needed is really a decision to be made at the advice and direction of your Cataract Surgeon. If there is any doubt in your mind in his/her recommendation it is always appropriate to seek a second opinion from a top Cataract Surgeon in your area.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to LASIK. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
My wife just had cataract surgery and was informed that the implanted lens has a slight tear. Is it best to have it replaced?
Answer: Whether to remove or explant and replace a torn or damaged lens implant (IOL) is really dependent on many factors. The vast majority of times it is not necessary. A minor tear or damage that does not effect vision, impact the position of the lens implant in the eye or its stability may not need to be removed at all. If the size or the position of the tear impacts vision by either allowing the IOL to not be stable and in the correct position or it is a tear that might cause irritation and inflammation then it might be worthwhile having a "lens exchange". No one, including the best Cataract Surgeons wants to do surgery that is unnecessary or doesn't have a very comfortable risk:benefit ratio. Thus the question of whether an explant and lens exchange is needed is really a decision to be made at the advice and direction of your Cataract Surgeon. If there is any doubt in your mind in his/her recommendation it is always appropriate to seek a second opinion from a top Cataract Surgeon in your area.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to LASIK. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Tuesday, April 5, 2011
Glaucoma Risks in Asians
Researchers from the Kellogg Eye Center of the University of Michigan reported on the incidence of Glaucoma in Asians in a study published in the journal Ophthalmology (March 2011). Racial-ethnicity risk rates help people and doctors plan for eye care and take extra precautions if appropriate. Since Asian Americans are the second fastest growing population in the U.S., a trend likely to continue for years to come, such risk information is very useful and helpful.
Of the various racial groups in the United States it is generally known that African Americans have the highest risk for Glaucoma of about 12% percent. The rate of Narrow Angle Glaucoma (NAG) was higher in Asian Americans than in any other racial group in the study and highest of all among Chinese and Vietnamese Americans. With NAG, the part of the eye that drains excess fluid becomes blocked and pressure builds up in the eye; the patient usually feels severe, rapid-onset pain and needs immediate treatment to prevent vision damage. The risk of Normal Tension Glaucoma (NTG) was three to 10 times higher in Japanese Americans than other Asian ethnicities studied.With NTG, the optic nerve and vision sustain damage even though the pressure within the eye remains within "normal" levels. Among Asian Americans, Open Angle Glaucoma (OAG) rates were highest among Japanese Americans (about 9.5 percent), followed by Indian and Pakistani Americans (about 7.7 percent).
Of the various racial groups in the United States it is generally known that African Americans have the highest risk for Glaucoma of about 12% percent. The rate of Narrow Angle Glaucoma (NAG) was higher in Asian Americans than in any other racial group in the study and highest of all among Chinese and Vietnamese Americans. With NAG, the part of the eye that drains excess fluid becomes blocked and pressure builds up in the eye; the patient usually feels severe, rapid-onset pain and needs immediate treatment to prevent vision damage. The risk of Normal Tension Glaucoma (NTG) was three to 10 times higher in Japanese Americans than other Asian ethnicities studied.With NTG, the optic nerve and vision sustain damage even though the pressure within the eye remains within "normal" levels. Among Asian Americans, Open Angle Glaucoma (OAG) rates were highest among Japanese Americans (about 9.5 percent), followed by Indian and Pakistani Americans (about 7.7 percent).
Cataract Surgery Costs & Alternatives
Question: I have a cataract in my left eye that my doctor says is 'ripe' for surgery. I also have a less severe one in my right eye, but I am also extremely near-sighted so my doctor says I would have to have the right eye done two weeks after the left in order to function. My insurance pays 90% of the cost, plus a $50 co-pay and a $150 deductible; however, I can't get anyone - insurance company, eye doctor or ambulatory surgery facility - to tell me how much this would cost me out-of-pocket. Frankly, I'm strapped for cash and don't want to have the surgery only to find out I've destroyed my credit if I can't pay. Are there any alternatives to surgery? How long can I get away with progressively stronger eyeglasses (I get one pair free yearly from my union)?
Answer: First, your Cataract Surgeon seems to be giving you sound advice regarding the need to have the second cataract operation performed within two weeks or so. The optical imbalance created as a result of your extreme nearsightedness would probably make you very uncomfortable. I understand your frustration regarding trying to approximate exactly how much cataract surgery will cost you for co-pays and deductibles to have both eyes treated. It is indeed difficult to understand this. Regarding alternatives to Cataract Surgery you need to know that the only way to treat a cataract is to have it removed and to have an intraocular lens implant (IOL). Otherwise, changing glasses is a short term solution that while it might appear to alleviate the vision problem slightly and for a short time, it will not minimize the glare, halos and night driving problems you might be experiencing. The decision as to when to have Cataract Surgery is entirely up to the patient, however, strongly consider your safety, your driving and ability to function as you make the decision. Your best option might be to have a frank discussion with your cataract surgeon's office and explain that you will pay but depending on the amount due you may need to take some time to do so. And, have the same discussion with the surgery center.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to LASIK. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Answer: First, your Cataract Surgeon seems to be giving you sound advice regarding the need to have the second cataract operation performed within two weeks or so. The optical imbalance created as a result of your extreme nearsightedness would probably make you very uncomfortable. I understand your frustration regarding trying to approximate exactly how much cataract surgery will cost you for co-pays and deductibles to have both eyes treated. It is indeed difficult to understand this. Regarding alternatives to Cataract Surgery you need to know that the only way to treat a cataract is to have it removed and to have an intraocular lens implant (IOL). Otherwise, changing glasses is a short term solution that while it might appear to alleviate the vision problem slightly and for a short time, it will not minimize the glare, halos and night driving problems you might be experiencing. The decision as to when to have Cataract Surgery is entirely up to the patient, however, strongly consider your safety, your driving and ability to function as you make the decision. Your best option might be to have a frank discussion with your cataract surgeon's office and explain that you will pay but depending on the amount due you may need to take some time to do so. And, have the same discussion with the surgery center.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to LASIK. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.
Monday, April 4, 2011
Diabetic Retinopathy Screening Challenges
The eye health complication of diabetes, diabetic retinopathy represents a major cause of acquired vision loss in the United States today. Even with considerable effort at public awareness through ongoing public health campaigns as well as published medical and eye care guidelines that promote yearly retinal exams for patients with diabetes, we still have an unacceptably high number of patients who are not screened for diabetic retinopathy according to a report in Current Opinion in Ophthalmology (April 1, 2011). The authors recommend the development of novel methods to improve compliance with retinal screening exams among diabetes patients to preserve eye health and vision. The key to maintaining eye health and vision is early detection, diagnosis and treatment of diabetic retinopathy.
Worldwide Glaucoma Survey and Status
According to a recent article in Lancet (March 30, 2011) reporting on population based surveys, most medical practitioners have regular contact with adults who have one of the two forms of glaucoma: open-angle glaucoma or angle-closure glaucoma. The surveys indicate that one in 40 adults older than 40 years has glaucoma with loss of visual function, which equates to 60 million people worldwide being affected and 8·4 million being bilaterally blind. Even in developed countries, half of glaucoma cases are undiagnosed. Glaucoma is mostly asymptomatic until late in the disease when visual problems arise. Vision loss from glaucoma cannot be recovered, and improved screening and detection methods for glaucoma are needed. Glaucoma is commonly treated with daily eye drops, but adherence to treatment is often unsatisfactory suggesting that other treatment options such as glaucoma laser treatment, neuroprotective strategies and even gene therapy might be useful in the future. Preventing eye health damage and vision loss from glaucoma requires early detection, diagnosis and treatment for the long term preservation of vision.
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