Friday, September 30, 2011

Toric Lens Implant Cost

Question: I have a question about the cost of a toric lens implant for astigmatism and cataracts. Why is my surgical facility is charging $395 cost for the toric lens implant and the cataract surgeon is also charging $755.00 for the toric lens too, aside from the surgery fee, facility fee and anesthesia fee? We don't understand why we are charged twice for one lens. Please help. The surgical facility center is claiming that the toric lens cost is $395 and that they don't know why the cataract surgeon is charging me $755.00 more for the same lens too.


Answer: We can only comment on the usual way in which fees for services and lens implants are assessed. In some eye care practices the surgeon collects the entire fee for incremental cost of the toric lens implant along with the fee for the extra diagnostic, evaluation and measurement services necessary to prescribe and calculate the toric lens implant to be used. In some eye care practices the surgical facility collects the fee for the actual toric lens implant cost AND THEN the surgeon collects only the fee for the extra diagnostic, evaluation and measurement services necessary to prescribe and calculate the toric lens implant to be used.

It seems as if your situation is the second one-the facility is directly charging you for the toric lens implant and your Cataract Surgeon is charging you for the ancillary services related to the evaluation, measurement and calculation for the toric lens implant. These ancillary services and diagnostic tests may include a corneal topography measurement to confirm that the astigmatism is on your cornea and not in the cataract which is being removed, it may include an aberromtery measurement, a dry eye evaluation and testing, a second type of biometry to confirm the actual lens power and possibly an ocular coherence tomography (OCT) assessment to confirm the health and stability of your macula. The diagnostic evaluation and measurement for toric lens implants as well as near vision presbyopia correcting implants requires considerably greater precision and consideration and thus additional testing at the discretion of the surgeon. This generates additional fees and costs for toric lens implants above and beyond what the lens implant itself costs and what insurance or Medicare will pay. Our best guess is that you are being charged $755 for some of these services as opposed to the cost of the lens itself-however you should feel free to question your Cataract Surgeon to determine if this is the case.

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.

Thursday, September 29, 2011

Cataract Surgery Candidate with many Medications?

Question: I want to know if I am a candidate for cataract surgery if I take the following medications:
Flomax, Avodart, Advair, Spiriva, Ventolin.

Answer: The list of medications you provided suggests that you have some type of respiratory and/or pulmonary problem such as Chronic Obstructive Pulmonary Disease (COPD) as well as some type of prostate problem perhaps Benign Prostate Hyperplasia (BPH). Each of these medications individually poses a challenge-but not an impossibility-to Cataract Surgery. Together they make having Cataract Surgery more complex but not impossible. The best Cataract Surgeons will most likely be able to modify their procedure preparation, technique and anesthesia to be able to accommodate your various conditions and medications-they do it all the time. Top Cataract Surgeons do however recommend that you do NOT let the Cataract get too mature as this by itself increases the difficulty of the surgery. Thus as soon as your vision is becoming uncomfortable from the Cataract you should consider having an examination and consultation with the best Cataract Surgeon you can find and be sure to fully advise him or her of all of the medications you are taking and the status of your health overall.

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.

Monday, September 26, 2011

Shadows and Arc of Light after Cataract Surgery

Question: I am very disturbed by the shadows and blind spot I see after my recent cataract surgery. I had cataract surgery 2 weeks ago. Since immediately after the surgery, I have been experiencing a shadow or "blind spot" in the lower right side of the eye. I also see semicircular arcs of light and the feeling of seeing through water. My cataract surgeon referred me to his associate for a second opinion and then to a retinal specialist. Everyone agrees that the lens is in proper position and there is no damage to the retina, but I am not getting any better. Can you tell me what might be happening to me? Is is ever possible to use the wrong size lens? Can I be allergic to the drops prescribed? I'm at my wits end. I work in front of a computer all day and I'm really having a difficult time. Thank you


Answer: The fact that your Cataract Surgeon has sent you for a second opinion from another Cataract Surgeon as well as a consultation with a Retinal Specialist is good and reflects a high standard of care. If we can assume that everything regarding the Cataract Surgery, Lens Implant, Retina and Vitreous are in good order, we have to consider that what you are experiencing is a phenomenon called a "negative dysphotopsia". A fair number of patients who have just had Cataract Surgery and a Lens Implants experience a problem that shows up at night when viewing a light. A halo appears around or near the light. For most, this happens when seeing the headlights of oncoming cars while driving or riding in a car. This phenomenon is called dysphotopsia. It is very common and usually of short duration and lasts no more than 1-2 months or less after their surgery. Some patients experience what is termed a "negative dysphotopsia" in which instead of a halo, they experiences a dark region on the temporal edge of their field of vision. This optical phenomenon is usually caused by the way in which light is reflected off the edge of the lens implant due to its shape. This creates a new visual pattern that patients adapt to shortly after their Cataract Surgery. Both the dysphotopsia and the negative dysphotopsia are caused by the presence of the new lens and the pattern of light reflected and refracted through the Lens Implant edge. In almost all cases the brain adapts to the new light pattern after a brief time as noted earlier and patients simply forget that it ever 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 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 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.

Glasses after Cataract Surgery

Question: I have a question about needing glasses after cataract surgery as I had LASIK some time ago. Like many others I have had LASIK Surgery, 13 years ago. I now require cataract surgery and was told that I may need to wear glasses. What percentage of LASIK patients require glasses after surgery? Also just how limited is their vision.

Answer: Having had LASIK does make taking the measurements for and the calculations for Lens Implants a bit more complicated. However, today there is excellent technology and nomograms for both greatly increasing the precision and accuracy of Lens Implants after Cataract Surgery even for patients who have LASIK or other corneal surgery. It would be helpful if you had or could obtain your records or measurements from your LASIK consultation as some of these measurements are useful.

All patients having Cataract Surgery do need to understand that unless they have a multifocal lens implant or accommodating lens implant of some type or they opt for monovision Cataract Surgery they will need to ear reading glasses or bifocals in order to see things at arm’s length or up close-this is the case whether you have had LASIK or not. Now-there may be limitations your Cataract Surgeon has on whether you can have a multifocal lens implant, an accommodating lens implant or monovision Cataract Surgery as many cataract Surgeons will only use an accommodating lens implant or monovision for prior LASIK patients.

This really depends on your situation. Your best next step is to explore all three options with a top Cataract Surgeon who is also a top LASIK Surgeon to be sure you are hearing all the possibilities and have access to the most advanced measurement technology for your Lens Implant selection. Once you have this information you may be pleasantly surprised that you may come very close to remaining free of glasses.

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 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 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.

Astigmatism & Toric Lens Implants

Question: If you have astigmatism do you have to use a toric lens implant in cataract surgery? If so, do insurance companies normally cover the cost of the toric lens? Can a regular lens be used if the patient is still planning on wearing glasses to help with vision and astigmatism?


Answer: Patients who require correction of astigmatism and need Cataract Surgery really have two basic options for seeing clearly after their eye surgery. The first is to have a toric lens implant used as part of the procedure. The second is to have the astigmatism corrected with eyeglasses after the Cataract operation. In either case the necessary correction for astigmatism could be achieved providing the appropriate vision correction. The vast majority of insurance companies do not cover the cost of a toric lens implant for astigmatism, nor do they cover the cost of eyewear and eyeglasses unless the patient has a specific optical coverage plan.

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 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 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.

Crossed Dominance Monovision Cataract Surgery

Question: I had a cataract surgery on my right eye (dominant). Now I see very well up close from that eye but I have difficulties with distance. My doctor suggested to implant a lens in my left eye-I'll have that surgery in two weeks-to see far distances. I have read about monovision and every article says that the far distance lens should be implanted in the dominant eye. What will be consequences of have the far distance lens in the non-dominant eye and the near vision lens on the dominant eye?

Answer: The question you are asking is whether there are any consequences of “crossed dominance” optical correction for monovision. It is not all that uncommon to inadvertently create monovision using the dominant eye for near and the non-dominate eye for distance vision-it does happen. The question is whether a patient can tolerate crossed dominance. With time, yes most patients do tolerate the crossed dominance and get used to it. The best guesstimate is that 80% adapt to crossed dominance-which is the same percent that successfully adapt to monovision optical correction in general. Your best course of action is to follow the advice of your Cataract Surgeon.

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.

Different Lens Implant Colors

Question: I have a question about having two different color lens implants.I had cataract surgery in August 2011. My left eye was done first, with a yellow tinted lens implant. A problem occurred on my right eye two weeks later during cataract surgery and a clear lens implant was put in. There is a difference in color between the two eyes which does little to bother me, but I wonder if this is a common situation.

Answer: While it might seem that a person's eyes are completely symmetrical in shape and anatomy this is not always the case and thus from time to time the two eyes may respond differently to the same surgical procedure. In your case, for whatever reason or reasons your Cataract Surgeon elected to use a different type of Lens Implant in your second eye in order to get you the best possible results. In doing so, that Lens Implant may not have been available with a yellow tint.The color difference is so slight that most Cataract Surgeons wouldn't even bother to mention it to patients as 90% of patients don't even notice the difference. As you report, it does little to bother you so there is really no issue here. While this does happen from time to time it is not overly common-but it does happen.

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 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 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.

Friday, September 23, 2011

Shadows and Lights after Cataract Surgery

Question: I have a question about seeing shadows and flashing lights after my cataract surgery. Six months ago my vision starting being blurry in my left eye. I am 43 years old and have diabetes. I went to see the doctor and after several months of evaluating my eye, they decided I had an oil drop cataract. Ten days ago they did the cataract surgery which was uneventful. The day after the surgery I started noticing a shadow on the outside corner of my eye. I also noticed that when I was in any area with overhead lighting I would have a flashing sensation on the left outside corner of my eye. It is sort of like a ceiling fan rotating with a light source behind it. I had my post-op follow-up three days ago and the doctor says it will go away. Now, I am ten days out of surgery, my eye sight has not improved at all and I have added these two new problems. I called the doctor and he saw me again today, but says I should continue to give it time. I am very frustrated with this answer. The surgery seems to have been totally unsuccessful and now I have these other problems. Do you have any suggestions? Thanks.


Answer: Assuming that the health of your Retina is normal and has not been compromised by the diabetes, what you are describing as shadows and a flashing sensation from overhead lights may very well simply be your visual adaptation to some of the optical effects of having a Lens Implant. There are a number of visual symptoms called "dysphotopsia" that are experienced by some Cataract patients whereby they sense odd light reflections, shadows and in some cases a temporary darkening of their vision as they adapt to the new optical and visual system that results from a Lens Implant after Cataract Surgery. In the vast majority of patients who do experience this-although it can be terribly annoying-it is temporary and passes over some time. That time can be as short as a couple of weeks or for some patients can extend for a few months-but patients do adapt to it. In the very rare instance of patients not adapting to the optical effect, it is sometimes recommended to have a lens implant exchange with a different style and shape of lens implant. Your best course of action is to follow the advice of your Cataract Surgeon.

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 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 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, September 22, 2011

Cataract Surgery with Respiratory Problems

Question: I have a question about having cataract surgery with respiratory and pulmonary problems. My father needs cataract surgery and he is currently on oxygen for COPD and emphysema. His doctor advised him not to do it because of the complication of him laying flat. Is it possible to have cataract surgery with these conditions?


Answer: Most top Cataract Surgeons and top Cataract Surgery facilities are able to accommodate patients with respiratory problems such as those outlined in your question. Generally speaking, by using techniques of advanced "small incision" Cataract removal including phacoemulsification, "eye drop" topical anesthesia and movable operating microscopes most patients can have successful Cataract Surgery without pulmonary complications. That said, the decision to schedule your father for his Cataract operation MUST be made jointly by his Cataract Surgeon and Internist or Pulmonologist in order to be sure all necessary precautions are employed and he has a safe experience.

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 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 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.

Tuesday, September 20, 2011

Cataract Surgery Risks for Monocular Patient

Question: I only have one functioning eye and I need cataract surgery. I have a prosthesis for my right eye as a result of a childhood accident. Obviously I am very concerned about the health of my left eye. What are the risk I face by having cataract surgery on my only eye? As a result of having just one eye, should I look for a cataract surgeon who has specific training to my problem to insure the surgery doesn't incapacitate me?


Answer: The anxiety you feel and express regarding your situation of needing Cataract Surgery and being monocular are very typical for anyone in your situation. Further, the sensitivity to the situation is shared by any top Cataract Surgeon. The good news is that modern Cataract Surgery is extremely reliable and produces excellent results. That said, it is always possible to experience complications and so you do want to do your best to avoid any potential problems. The biggest error monocular patients make is in waiting too long to address the Cataract in the only good eye because mature Cataracts are associated with higher surgical risk. So as soon as the eye has vision not adequate to perform your daily activities to your satisfaction, surgery is indicated. Don't wait. There are actually no special considerations beyond a choosing the best Cataract Surgeon you can find who will conservatively and carefully perform your procedure. While the risks of the procedure itself are the same, the consequences to risks are great. So a skilled Cataract Surgeon with good experience and a good facility are key. It may be necessary to have not only one, but perhaps two or even three consultations in order to find the best Cataract Surgeon who meets your approval.

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 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 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.

Avastin after Cataract Surgery

Question: How effective is the use of Avastin® after an operation for Cataracts with damage already on the Retina and Macula?

Answer: Although you do not state it we assume that you have some stage of Diabetic Retinopathy or Macular Degeneration. The progression of Diabetic Retinopathy and Macular Degeneration are marked by the growth of "new blood vessels" which are very fragile and can break and hemorrhage easily causing additional damage to the Retina and Macula. Thus, your Cataract Surgeon may recommend that either he or she at the time of Cataract Surgery, or your Retinal Specialist after the surgery, place an injection of an anti-vascular endothelial growth factor (Anti-VEGF) agent such as Avastin™ in order to retard the possible growth of new blood vessels in the Retina. This helps to protect against any new blood vessel growth and additional damage.

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 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 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.

Monday, September 19, 2011

Decreasing Vision after Cataract Surgery

Question: I have decreasing vision after my cataract surgery in both eyes in 2010. The lens implant model was ZMB00 in both eyes. They do not work for me and my vision is getting worse and worse. My cataract surgeon wants to replace these with ReSTOR Lens implants. I have been reading about Crystalens, from what I have read Crystalens is what I think I would prefer, or going with the Monofocal Lens implant. I read one report that said if you have already had cataract surgery you were not a candidate for the Crystalens. Is this true and why?

Answer: The first order of business is to determine why your vision is getting worse and worse after your Cataract Surgery. This is probably not due to the type of Lens Implant that you have but is more likely due to perhaps posterior capsular opacification, also called secondary membranes, or possibly a change in the health of your Retina-in particular the Macula-or a number of other possibilities that need to be explored and a proper diagnosis rendered. Whatever the cause, it needs to be dealt with. If the decreasing vision is due to posterior capsular opacification and you require a YAG Laser Capsulotomy it would be important to consider that any type of Lens Implant Exchange-if one were to have one-is much riskier once the "capsule" has been opened with the YAG Laser. You need to fully discuss and understand the reasons for your decrease in vision with your cataract Surgeon BEFORE even thinking about a lens exchange and need to think long and hard about implanting any type of multifocal or accommodating lens implant as these types of lens implants require extreme precision in their positioning and placement in order to work to their fullest potential. This may or may not be possible as a secondary procedure for eyes that had Cataract Surgery in 2010.

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 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 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.

Friday, September 16, 2011

Eye Specialists for Cataracts

Question: I have a question about what type of eye specialist we need. I have a daughter that had cataract surgery and had a lens implant put in about one year ago. I am now seeing a discolored film developing on the eye. My question is what is the best type of eye doctor to help with this? What type of eye doctor specializes in this type of condition?


Answer: Chances are that your daughter's Ophthalmologist or Cataract Surgeon will be able to diagnose the condition you are observing on the outside of the eye. If you would be more comfortable seeking an opinion from someone who is a specialist in external diseases of the eye, most Corneal Specialists also have specialized training in external eye diseases and would be well suited to evaluating the condition. You can check the credentials of many Cataract Surgeons and will find that they also are Corneal Specialists.

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 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 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 Eye Drops

Question: I have a question about cataract surgery eye drops. When my 93 year old dad had cataract surgery a few years ago, he had only one drop he used before surgery and two after. My doctor has prescribed three to start two days before surgery-Nevanac, Vigamox and Durezol. I am very wary of the Durezol after reading the FDA report. Why is my doctor giving me so many drops and why the Durezol.


Answer: Your Cataract Surgeon has prescribed what would be considered a very safe and reliable set of preoperative medications for your Cataract Surgery. The eye drop regimen for Cataract Surgery has become more universal relying on a quinolone antibiotic drop (Vigamox) for prevention of infection-this is most often started days before surgery, an NSAID (Nevanac) to help with the maintenance of pupil dilation for surgery but more importantly prevent the possible condition of Cystoid Macular Edema- this too is often started before surgery, and a steroid that is straightforward in its action against post-op inflammation. Some eye surgeons start this before and some wait until after the surgery to begin the drop. Durezol is the new drop of choice to represent the steroid in the "recipe". It's very effective in quickly restoring the eye to quiet, can be dosed at a lesser frequency-3 times per day as opposed to the tradition of 4 timed per day with other steroids and the number of days that the patient requires drops is far less with Durezol-and it has a synergistic effect enhancing the NSAID effectiveness. So the protocol your doctor has prescribed represents the current standard of care in order to reduce the incidence of prolonged inflammation, infection and possibility of retinal swelling.

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 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 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 for Musicians

Question: I am a professional musician who needs cataract surgery. Currently, I find that the small mid-range area in my progressive lens eyeglasses is not adequate for the mid-range distance that I need (about 3 ft.). Instead, I use glasses with my distance prescription for about the top third, with a mid-range for the bottom 2/3. A Multifocal Intraocular lens was suggested for me. Is this the best option for me?


Answer: As a professional musician your intermediate and near vision requirements are not only demanding in precision but are also demanding in time. In order to make the accurate assessment and recommendation for the type of lens implant-multifocal vs. aspheric with glasses-after cataract surgery, it is going to be necessary for you to provide the Cataract Surgeon with actual carefully measured distances that require your clear vision. Certainly a multifocal lens implant might be a good choice but should your near distance requirements change, lighting and environmental circumstances vary or change, you will be locked in to one restricted range of clarity. This may not be a problem for you but does warrant discussion with your eye surgeon regarding the exact vision requirements you have and in what environments.

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 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 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.

Multifocal Lens Implant Selection

Question: I have a question about selecting a lens implant for cataract surgery. I need to select the lens type prior to October when I will have cataract surgery. If I choose the multifocal lens replacement, will this serve as my eye glass replacement for the remainder of my life? I am 64 and have been badly nearsighted for my entire life. I currently use bifocals and go up and down for far and near - will this be the same for the lens implant?


Answer: Presbyopia correcting multifocal lens implants used for lens replacement after Cataract Surgery can correct distance vision, near vision and arm's length vision-and enhance your range of clear vision without requiring glasses. There are several types of multifocal lens implants and each one has slightly different vision correction characteristics based on their design and optics. It is highly likely that your full distance vision would be corrected and you would no longer be nearsighted, thus eliminating any need for glasses for seeing distance. The intermediate and near vision correction results will depend on the type of implant selected by your Cataract Surgeon. However any multifocal will certainly decrease if not completely eliminate your need for bifocals although you might need some help with reading glasses in some instances or arm's length "intermediate" glasses in some cases depending on the type of multifocal used.

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 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 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.

Monday, September 12, 2011

Floaters after Cataract Surgery

Question: I am suddenly experiencing floaters after cataract surgery. I had bilateral cataract surgery in February. All has gone very well so far but yesterday I woke up with floaters in my right eye only, that look like thousands of grains of black pepper and a few long, thick strings of the same black color. I've had CNS Lupus for 22 years and Type II Diabetes for 3. I'm on numerous medications, but none of them are new within the past month. Should I call my ophthalmologist or just check with her at my next appointment?


Answer: The sudden onset of floaters after Cataract Surgery can range in seriousness from not very serious if caused by a vitreous detachment with no retinal involvement, to somewhat serious if caused by a vitreous detachment with any associated retinal traction, retinal tear or hole-to very serious if there is an actual retinal detachment. You do not state whether you have any diabetic retinopathy and this too could enter the diagnostic picture as well. Not to overreact-but to use due caution-you should call your Cataract Surgeon immediately and be seen ASAP. Please be clear when you call regarding the sudden onset of the symptoms. While this is most likely not a serious set if symptoms it warrants careful and immediate examination and confirmation.

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 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 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.

Friday, September 9, 2011

Light Streaks after Cataract Surgery

Question: I have a question about seeing streaks of light after cataract surgery. I had cataract surgeries performed on July 26 and 30th, 2011. In both instances diagonal streaks of light across light sources such as headlights and street lights appeared in my vision within days of surgery. The streaks disappeared from my right eye within days, but five weeks after the surgery on my left eye the streaks remain. Comment?


Answer: Seeing streaks of light after Cataract Surgery can occur for a number of reasons-most of which are transient and self limiting as you have experienced with the right eye after Cataract Surgery. While there can be optical effects of adapting to the vision with the intraocular lens implants (IOL) and associated "dysphotopsia", it is also possible that the posterior capsule of the crystalline lens, which is left in place to support the IOL, has a microscopic amount of traction on it causing a fine crease in the actual membrane itself. In most instances this will release itself and the crease disappears, eliminating the streak. If there is indeed a microscopic crease in the posterior capsule of the crystalline lens that does not smooth out on its own or even becomes more annoying then top Cataract Surgeons will perform a YAG Laser Capsulotomy whereby they will use the laser to gently create an opening in the capsule. A YAG Capsulotomy is a brief painless treatment performed using numbing eye drop anesthesia that essentially eliminates the problem in a matter of seconds.

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.

Friday, September 2, 2011

Smartphone to Diagnose Cataracts

Using your Smartphone could help you detect early Cataracts according to researchers at Massachusetts Institute of Technology (MIT). The Camera Culture group of the Media Lab at MIT developed a device called Catra which clips on to a Smartphone and then scans the light as it enters and exits the eye which can help to detect the presence of a Cataract. The Catra device can detect Cataracts at a earlier stage than existing tests because it can pick up changes in parts of the crystalline lens that have not yet been clouded. By presenting a series of green dots to the patient on the phone scanning software it allows for the mapping of the lens that tells the size,shape, location and density of the Cataract.

Waiting to Have Cataract Surgery?

Question: Can I wait to have Cataract Surgery? My local eye doctor says that I need a Cataract Surgery but he did not tell me if I can wait. If I wait a year from the date I was diagnosed, is it too long?

Answer: The decision as to when to have a Cataract removed is really a personal decision driven by the discomfort and visual symptoms experienced by the patient-within certain limitations. Cataracts progress at different rates in different people. As the Cataract does progress not only will it decrease vision and often increase glare and light sensitivity, but it can cause the crystalline lens to swell and it may also become somewhat more difficult for your Cataract Surgeon to easily remove. These two considerations sometimes make it necessary to defer the timing of the surgery to the Cataract Surgeon. If the Cataract is not advanced and is not swelling and/or hardening, your Cataract Surgeon may pretty much allow you the choice of delaying the surgery for a year. If on the other hand you are at any risk or if the difficulty of the surgery might increase too much, he or she will recommend not delaying. Keep in mind that the most important thing is that you do not allow your vision to become reduced so as to cause you inconvenience or disruption of your being able to conduct your daily activities safely.

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 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 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.

Thursday, September 1, 2011

Choosing a Lens Implant: Toric vs. Multifocal

Question: I have astigmatism and cataracts and I am having a difficult time deciding between Toric and Multifocal Lens Implants. Price is not the most important consideration rather what will be best in my situation. I enjoy photography and wood carving hobbies. What do you suggest I do to decide on the best outcome?


Answer: Choosing a Lens Implant for vision correction after Cataract Surgery is very much dependent on the daily activities that you require clear vision for AND want to be able to do without being totally dependent on eyeglasses. Assuming that you are in fact a good candidate for both an astigmatism correcting toric lens implant as well as a presbyopia correcting near vision multifocal lens implant, the decision is really based on what you need or want to do each day without eyeglasses. If most of your daily activities use your distance vision-such as photography-then a toric lens would make a fine choice. You would most likely be able to drive, watch television, take photographs and generally be up and about without eyeglasses. If the greatest part of your day is spent performing tasks that are arm's length or closer then a presbyopia near vision multifocal lens might offer you greater freedom from eyeglasses.

Now, depending on the amount and orientation of the astigmatism that you have it is possible in certain cases to have a Multifocal lens implant with Limbal Relaxing Incisions (LRI) or even LASIK to correct the astigmatism. Not to add to the confusion, but there are other potential options such as this for correcting BOTH the presbyopia-near vision-and the astigmatism after Cataract Surgery. Whether or not you are a candidate for these types of options is best decided by scheduling a consultation with a top Refractive and 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 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.

Teary Eye after Cataract Surgery

Question: My mother has a very teary eye after having cataract surgery in July 2011. She has been experiencing a very teary eye and it tears up often and produces sleep. She consulted with her physician and was told that it was due to allergies. Is there some other reason for this complication?


Answer: It would be difficult to give you much information about why the eye is tearing up after Cataract Surgery without having actually examined the eye. There are many reasons that tearing can occur after Cataract Surgery that can include dry eyes, inflammation of the eyelid margins called blepharitis which could have been there before surgery and just got more active after the operation, allergies, blocked tear ducts and a host of others. You do not state whether it is just in the operated eye or both eyes-this matters as well. Your best course of action is to seek a second opinion with another Cataract Surgeon if you are not satisfied with the answers and treatment you have been given thus far by your primary eye surgeon.

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.

Varied Results with Cataract Surgery

Question: I have a question about varied results with cataract surgery between my two eyes. I had cataract surgery on one eye four years ago and the result was fantastic-no glasses needed, everything clear. Now I had cataract surgery on the other eye and the day after surgery it was 20/25, one week later 20/30 and now three weeks later 20/40. Why? Now I am told I will need a contact lens for that eye. What went wrong? What should be done to fix it?

Answer: It is not really possible to determine why your vision after Cataract Surgery in the second eye decreased over the course of a week. You do not say whether the slip in visual acuity is uncorrected or corrected with a lens or not. If the vision is correctable to 20/20 with a spectacle or contact lens it suggests that the power of the lens implant may be off just a bit. While every effort is taken to calculate the exact required power using sophisticated instruments and technology sometimes there can be some variation that results in a slightly less than perfect correction. IF this is the case and your eye is otherwise in good health AND the amount of the correction is significant enough in the opinion of your Cataract Surgeon, he or she can elect to do a lens exchange and replace the lens implants with the adjusted power. There are a lot of IF's here. If your eye has a best correctable visual acuity of 20/40 it suggest an entirely different list of possible causes that have more to do with the way the second eye is healing or other factors associated with inflammation or even the condition of Retina. Your best next step is to schedule a visit to your Cataract Surgeon and ask for a clear explanation of what has happened and what the best course of action is for going forward.

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.