Wandering Eye & Cataract Surgery

Question: I recently had cataract surgery on my right eye and now have 20/30 vision. My left eye is almost totally opaque and wanders off to the left. My surgeon says cataract surgery would certainly result in double vision. Is this 100% likely?

Answer: If the opaque eye has been amblyopic and thus really functioned poorly prior to the lens becoming cloudy, then cataract removal wouldn’t cause diplopia but of course would result in limited vision. But, this would still allow a better view into the eye to monitor its health overall. If it has drifted more recently and the eye had good vision in the past, then there is the opportunity to rehabilitate it with cataract surgery and then perform muscle surgery afterward to correct the diplopia. You need to have a second opinion with a cataract surgeon is willing to offer you this option if t is possible in your 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 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 or 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 Causes Shadow & Drops of Water in Vision

Question: My inquiry is that since I had cataract surgery and a lens implant I have what "appears" to be drops of water, a shadow or something at the corner of my eye that is very frustrating.  Is this a common result of having cataract surgery?  Can anything be done to eliminate this condition? 

Answer: While it is impossible to tell exactly why you are experiencing this shadow or sensation of seeing a drop of water in your vision, it is something that patients report from time to time after cataract surgery and lens implants and is thought to be related to adaptation to the lens implant or “seeing” the edge of the lens implant. In any event it does seem to just fade away over time-which varies from patient to patient.

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 or 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.

Rhode Island Seniors on Medicare Advantage May Lose Access to Quality Eye Care and Surgery

Providence, Rhode Island (11/13/2013) It is estimated that about a 100 Rhode Island physicians have been dropped from UHC's Medicare Advantage plans also sold under AARP Medicare Complete.  Physician groups dropped include Koch Eye Associates, the leader in eye care and eye surgery in RI. Koch Eye Associates currently treats approximately 3,000 or 10% of the UHC’s Medicare Advantage members.  While United Health Care has the contractual right to shrink its network, in a small state such as Rhode Island it really threatens to limit access, quality and efficient care for seniors.

Why would UHC Medicare Advantage drop a group like Koch Eye Associates?

“We were shocked and disappointed to receive such a notice since we are a leader in eye care, have the only ophthalmic ambulatory surgery center in the state, follow best clinical practices and have an Electronic Medical Record (EMR) to ensure the integration of care both within our group and with physicians in the community. As a result of UHC’s terminations, seniors may have to travel to another state to get their care and even be forced to go to a hospital for cataract surgery,” commented Paul Koch, M.D., Medical Director of Koch Eye Associates.

Perhaps UHC made this decision without knowledge of the local market given a comment made by Jack Larson, UHC’s CEO of Community and State. “We are working to collaborate with a more focused network of physicians to help us provide higher quality and more affordable health care coverage to meet the needs of our members, and help them get more from their health plan benefits.”

Perhaps UHC is trying to reduce their membership of seniors since it appears they are not earning the same quality bonuses experienced by other Medical Advantage Carriers. They seem to be shifting blame to the government.  “Washington is squeezing payments to managed care plans like AARP's — collectively known as Medicare Advantage. The idea is to bring these private plans in line with the cost of original, fee-for-service Medicare,” said Larson.
 
Unfortunately UHC’s recent decision may make it necessary for many seniors to pay more out of pocket or switch doctors. “This is especially troubling for seniors who are on fixed incomes and are under treatment for serious eye diseases such as macular degeneration or diabetic eye problems that require continual care. Having any disruption of care at all has serious consequences. We will continue to see our patients with United Medicare Advantage. It is a shame that they won’t be getting the full benefit from their insurance,” further noted Dr. Koch.

What should seniors do?
1. Make sure you are evaluating your options for coverage.
2. Write to your state representatives asking them to advocate for maintaining access to quality providers and continuity of care.
3. Follow your physician’s advice on how to stay healthy and prevent illness since you are going to be faced with less choice and bigger health care bills in the future.

For additional information, contact:
Katie Carlisle, Medical Management Services Group, L.L.C., 733 Turnpike Street, N. Andover, MA 01845, Katie@aboutcataractsurgery.com, 978-470-8217

SOURCE: Medical Management Services Group, L.L.C.

Shimmering after Cataract Surgery

Question: I had left eye cataract surgery 3 weeks ago. If I turn my head slightly to the left or right or look down, my vision is clear, the problem is when I look straight ahead my eye has a flickering or shimmering movement and blurred. Will this clear up on its own-it’s really annoying?

Answer: Shimmering and flickering after cataract surgery and a lens implant is not uncommon. There is some thought that it is the result of the edge and geometric shape of the lens implant and some resultant reflections. In almost all instances people adapt to the sensation and it becomes unnoticeable over time-please be patient. HOWEVER, if it is accompanied by floaters, a “bubble” in your vision, distortion or bending of your vision or the sensation of a curtain or veil before your eyes please contact your cataract surgeon immediately as this suggests the onset of a more serious retina 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 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 or 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.

Cloudy, Double Vision after Cataract Surgery

Question: It has been 7-8 months since my cataract surgery which was great at first. Now it seems like my lens is cloudy and I see double out of my right eye. What should I expect from my surgeon?

Answer: First, you need to schedule an appointment to see your cataract surgeon so that he or she can determine the cause of your change in vision. It is important to have a proper diagnosis made so that the vision change can be addressed. While you relate it to the cataract surgery-which it may be-it is also possible that it is due to other issues that might involve the retina or even the cornea. It is not uncommon for some patents having cataract surgery to experience posterior capsular opacification whereby the lens capsule left in place to support the lens implant becomes cloudy. If this is the problem, it is quickly treated with a YAG Laser Capsulotomy and vision is restored. BUT, you need to find out the reason for the cloudy, double vision. See your cataract surgeon and follow their advice. 

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 or 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.

Toric Implant for Irregular Astigmatism

Question: I have astigmatism which can't be corrected well with glasses or contacts. Thus the vision in my left eye is always blurry and has been for over 30 years.  Can Toric Lens Implants or a type of lens implant be used to correct my astigmatism even though I don't have cataracts?  

Answer: It sounds like you are describing irregular astigmatism-which would not correct well with any type of lens implants. You do not indicate why you have the uncorrectable astigmatism. If it is due to cornea trauma, cornea disease such as keratoconus or marginal degenerations, infection or previous surgery you need to be evaluated by a cornea specialist to have a firm diagnosis. from this it may be possible to recommend treatment options as many new treatments are available to both strengthen the cornea and correct irregular astigmatism.

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 or 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.

LASIK after Cataract Surgery-Should I Have to Pay?

Question: I had cataract surgery for the left eye a month ago with a lens implant. However, my vision is still no better, if not worse than before surgery.  The cataract surgeon said this was due to a technical miscalculation of the lens strength and might necessitate repeating the procedure, or having the LASIKsurgeon do a correction, as I had LASIK surgery 14 years ago. ( There were no problems for the cataract surgery of my right eye from 2 years ago). My question is, should the fees for surgery correction be waived, as I already paid almost $3000 for the new lens implant which didn't achieve the goal? 

Answer: Patients who have previously had any type of corneal surgery-especially LASIK-require meticulous advanced technology imaging and calculations in order to have precise lens implant power calculations. Even in the most perfect measurement situations, there is often induced calculation error as a result of the previous LASIK surgery and corneal curvature and thickness changes that have been made. Thus, just because you had a relatively uneventful first eye cataract surgery and lens implant operation, it is still not unexpected to experience calculation difficulties. In general there are two possible surgical approaches to correct residual refractive errors when the lens implant is not providing the targeted refractive outcome-LASIK or a Lens Implant Exchange. You do not indicate whether you are overcorrected or undercorrected and we do not know whether your cornea has sufficient tissue and ocular surface health to withstand another LASIK procedure-thus you may or may not be able to have LASIK. Depending on whether your cataract surgery was otherwise uneventful, a lens implant exchange might be a better option. This will really depend on the general condition of your eye. In either case, it would be important to have a thorough examination and consultation and then follow the recommendation of your cataract surgeon. You, or your insurance, should expect to pay for either procedure. Surgery-especially in previously operated eyes-does not come with a guarantee.

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 or 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 Lens Implant Exchange

Question: A local cataract surgeon operated on right eye for cataract and inserted a Bausch & Lomb Lens Model PC LI61AO, length 13.00mm. Optic 6.00mm, power +22.50, to allow reading computer screen without glasses, which made my sight worse-not better.  Can is this lens be removed and if so, what kind of lens replacement should be used?

Answer: Depending on how long ago the initial cataract surgery was performed and whether there were any complications, if the position and condition of the tissue around the lens implant is healthy and intact-it might be possible to remove and exchange the lens implant. It is impossible for anyone other than your cataract surgeon-or other taking current measurements- to know what lens implant it should exchanged for as for best results it requires your initial measurements and calculations as well as the exact distance you wish to have clear vision for, calculated in the implant power along with the current refractive status.

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 or 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.

Best Lens Implant for Severe Astigmatism

Question: What is the best replacement lens implant to correct very severe astigmatism?

Answer: The choice of which is the best lens implant to use for correcting severe astigmatism should be left entirely to your cataract surgeon. Depending on the anatomy of your eye, his or her surgical technique, the amount and orientation of the astigmatism and a number of other factors the choice is best made by the person performing the eye surgery. Lens implants are not a consumer purchase like buying tires for your car and require a high degree of professional judgment in their selection.

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 or 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, Jacuzzi Spa & Mud Bath

Question: How long after cataract surgery can one go to a mud bath and mineral spring Jacuzzi spa. I will be traveling to Napa Valley one week after surgery and wonder if I could enjoy this experience.

Answer: It is always best to ask your cataract surgeon as there may or may not be special considerations based on the type of cataract surgery, how the procedure was performed and tolerated-however, conservatively and safely--a 2 week delay after cataract surgery should be sufficient.

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 or 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.

Aspheric Lens Implants with Glaucoma

Question: What is the difference between aspheric lens implants and Alcon lens Implants for cataract surgery. Which is better with glaucoma?

Answer: Aspheric lens implants are manufactured by a number of lens implant companies including Alcon. Each aspheric lens design is slightly different, but each is designed to correct aberrations and provide good distance vision after cataract surgery. The manufacturer selected is a preference of your cataract surgeon depending on their surgical technique and the anatomical features of your eyes. Thus, if you have glaucoma and there are specific characteristics of the inner structures of your eye they might choose one manufacturer over another-it is NOT your choice-ask 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 or 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.

Laser Cataract Surgery with High Eye Pressure

Question: My Mom is 60 and we are researching having a cataract surgery on her left eye. She has IOP of 26 and 28 in her left and right eye. She also has dry eyes. Is traditional cataract surgery better for her or is laser-assisted cataractsurgery better for her? We are looking for minimum complications or side effects, not necessarily best refractive outcome. She would be very happy with a bare minimum of complications.

Answer: The decision to have laser cataract surgery or traditional cataract should really be made with the cataract surgeon performing the procedure. BOTH types of cataract surgery provide excellent outcomes when performed by skilled surgeons. BOTH types of cataract surgery can have complications and side effects. Laser cataract surgery is highly reproducible and precise and gentler on the inner eye tissues. Your understanding of laser cataract surgery is correct-that it can temporarily elevate the intraocular pressure. Now, you do not state whether your mother has a normal optic nerve, normal nerve fiber layer and normal visual fields or whether she is actively being treated for glaucoma. IF upon visual field testing or Optical Coherence Tomography (OCT) there are any irregularities or defects, it is probable that her cataract surgeon will advise against laser cataract surgery. But, this is call made by the surgeon. Your best bet is to find the best cataract surgeon in your area and get their advice based on the specific findings during her cataract evaluation. Also-you mention that you are not seeking the best refractive outcome. You may want to reconsider this, as the goal of cataract surgery isn’t just to remove the cataract but to provide your mother with the best possible visual functioning-which does indeed require a precise refractive correction through proper selection of lens implants.

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 or 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 with Astigmatism & Prism

Question: I will be having cataract surgery on both eyes in the next few months. I have significant myopia and prism - which I understand that the cataract surgery will not correct, so that I will still need corrective lenses after the surgery. I also have significant astigmatism. The cataract surgeon has suggested using toric implant lenses to correct the astigmatism but I am wondering whether basic monofocal implants might be a better choice since I will need to wear glasses after surgery anyway and the glasses can correct both the astigmatism and the prism.

The toric lenses would cost a total of $2400 more than the monofocal lensimplants which I can deal with so I am only concerned with making the best long-term choice. 

Answer: The goal of cataract surgery is to give you the best overall functional vision that you can achieve so that you can participate in whatever activities you wish in the most comfortable and safest manner. With modern cataract surgery and lens implants it is possible to correct your nearsightedness and astigmatism-but not the prism correction, upon removal of the cataract. This would be the best choice to consider-even though you will need eyeglasses for the prism correction as it will provide the greatest degree of clarity. Sure, you could have BOTH the astigmatism and the prism correction in the eyeglasses-but as you will likely find out, it is much more comfortable and convenient to see your best even without the glasses. Generally speaking, the less dependent you can be on eyeglasses, the better and safer the quality of life-have the toric lens implant if that’s what your cataract surgeon suggests.

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 or 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.

Anesthesia Blocks for Cataract Surgery

Question: My mother recently had cataract surgery and is having a difficult time with blood behind the eye.  Her cataract surgeon said he had to use a "block" on her.  What does that mean?  I can't find anything on the internet that talks about a "block' during cataract surgery.

Answer: There are a number of ways in which cataract surgeons can anesthetize the patient and their eyes for cataract surgery. Today, rarely if ever is general anesthesia used as the main types of anesthesia are “topical” or “blocks” when performing routine cataract surgery. Topical anesthesia is typically achieved by instilling several sets of eye drops in the eye and the surface of the eye-and in almost all instances some oral tablets are administered to relax the patient. Blocks can be of several types including a “retrobulbar block” whereby the anesthetic is placed in the space behind they eye with a needle, a “regional block” of the areas around the eye, a “sub-Tenon’s block” or even a combination of anesthesia techniques. All of the approaches to cataract anesthesia provide adequate pain control, and serious problems are rare. As a result, the choice of technique usually comes down to a physician’s preference and comfort level and any concerns or preferences the patient may have.

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 or 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.

Eyelid Problem after Cataract Surgery

Question: My friend recently had cataract surgery and her eyelid closes and thins out, like she can’t keep it opened. Is it normal? Can she have surgery to fix it?

Answer: What you are describing might be due to some residual swelling in the eyelid from the speculum used during the cataract surgery, or it could be a slight ptosis or droopy lid caused by the speculum-difficult to say but worth scheduling a visit to the cataract surgeon who performed the procedure and bringing it to his or her attention to see what the exact cause is and what can be done.

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 or 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.

No Intermediate Vision after Cataract Surgery

Question: I am 47 and had cataract surgery approximately 6 weeks ago.  I have blurred/spotty vision, which I was told is the folding/scarring and can be corrected with laser. The main issue I am having is midrange vision.  I don't feel it is a clear/focused as it should be. For example, if I am cooking or cleaning, I feel like I have to strain to see it well enough. I knew prior I would have to wear "cheaters" for reading/computer, but almost feel as if I need them for simple tasks like cooking.  I was told my eyes are not as flexible now that the lenses have been placed and may need bifocals for close up and midrange vision.  I thought I would not need anything but the cheaters after cataract surgery.  Everything seems just slightly "off" and it is unnerving. How can I be sure I had the right prescription lens placed?  I know once the laser is done I cannot have it changed.  When they did a 2 week out exam, my distant vision was still not 20/20.  I just don't know what to do to correct my vision issues.

Answer: During cataract surgery the cloudy crystalline lens in your eye is removed and replaced with a clear plastic lens implant. There are several types of lens implants that all correct vision somewhat differently-depending on what you choose and what your cataract surgeon recommends. A basic monofocal lens implant ONLY corrects distance vision-NOT intermediate or near vision really at all and requires bifocals, progressives or reading glasses or “cheaters” to see anything in the midrange or up close. Certain aspheric lens implants, although they are actually only monofocal, do afford some slight intermediate or midrange vision-BUT STILL REQUIRE bifocals, progressives or reading glasses or “cheaters” to see anything in the midrange or up close clearly. Multifocal or Accommodating Lens Implants allow patients to see far, near and in between typically without the use or full time dependence on glasses. We do not know which type was discussed with you or what type you have. If you are concerned with the accuracy of the prescription then ask your cataract surgeon for a current refraction and see if a mild pair of eyeglasses might be of help.

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 or 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.

Glare & Halo from Cataracts

Question: I have cataracts in both eyes, and experience night glare and halos which keep me from driving at night. Will it be necessary to have surgery on both eyes before I will see improvement in the glare/halo caused by the cataracts?

Answer: Without knowing the type and position of the cataract in each it is tough to tell specifically in your case which eye or whether both eyes cataracts are contributing to the glare, halo and night driving problems you are experiencing. In general, there is typically some degree of uniformity and we might assume that both eyes are causing your vision problems. In general, we also know that you will experience immediate but NOT complete improvement after the first eye has the cataract removed and a lens implant put in place-and we also know that the best vision results and best functional vision are achieved after BOTH eyes have cataract surgery and lens implants. You may be interested in knowing that researchers reporting in the journal Ophthalmology studied the impact that cataract and cataract surgery have on clinical measurements of vision, reading speed, objective mobility performance and subjective visual functioning. The results showed that patients who had the cataract surgery in both eyes demonstrated better visual performance, better mobility-based task performance and even scored better on the Activities of Daily Vision Scale (ADVS). Thus, even though patients might find a great improvement after having cataract surgery in only one eye, the data indicate that having cataract surgery on both eyes provides the best visual functioning.

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 or 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.

Problem after Cataract Surgery

Question:  I have a problem that has persisted for 14 months after my cataract surgery in that I have a leaking membrane-not sure where to go or what to do.

Answer: Unfortunately, from your description it is not possible to really understand what you mean by a “leaking membrane”. This could mean that there was a complication during cataract surgery and there was a rupture of the vitreous gel or it could mean that there was a subretinal neovascular membrane that formed spontaneously and leaked fluid and/or blood under the macula or any one of a number of other conditions or complications. There is no way to tell what you are referring to. That said, the most prudent course of action is to schedule a consultation fr a second opinion with an eye surgeon who is a retina specialist to determine the exact nature of the problem and what might be possible if there is a need for treatment.

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 or 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.

Aspheric or Monofocal Lens Implants?

Question: I will be going in to have my eye evaluated for cataract surgery. I will have to choose a lens implant. I would like to be fitted with a monofocal lens implant and then use eyeglasses with progressive lenses. Would using aspheric lens implants be more beneficial than regular monofocal lens implants?

Answer: An aspheric lens implant is actually a monofocal lens implant in that it has only one focal length and thus in general only corrects distance vision. A monofocal lens implant is a somewhat old design in that it simply doesn’t give the best vision-especially in terms of dim illumination. Thus, today, if patients have cataract surgery and wish to wear any type of near vision eyeglasses, the best vision is achieved with aspheric lens implants. There are a few instances where the aberrations of your eyes might make an aspheric lens implant and inappropriate choice but this is somewhat unusual and when you have your cataract surgery evaluation your cataract surgeon will certainly evaluate you and recommend the best 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 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 or 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 Not Ripe for Surgery

Question: My 65 year old mother has a cataract on her left eye. According to the eye doctor they won’t remove it because of her extreme dry eye, as well as the cataract isn't ripe enough for surgery. What exactly does that mean, and should we get a second opinion?

Answer: First, the notion that the cataract is not ripe enough to be removed with cataract surgery is just nonsense. If and when the cataract interferes with vision, mobility, safety and general daily living activities-then it is time to ask a cataract surgeon to evaluate her for cataract surgery and lens implants. Being “ripe” is a 20 year old concept and has no relevance if there is glare sensitivity or any vision comprise as noted above. Even with a dry eye, there are many treatments that are appropriate to effect a more stable healthy tear film including artificial tear eye drops, tiny punctal plugs to help retain tears, dietary supplements, prescription eye drops to help you make more tears and even other prescription drops and laser treatments to treat underlying causes of dry eye. Bottom line-get another doctor who is 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 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 or 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.

Dry Eye Symptoms of Pain & Pressure

Question: Does dry eye cause pain and pressure on eye?

Answer: The most common symptoms of dry eyes include dryness, itching, burning, irritation or grittiness, redness, blurry vision that gets clearer as you blink, light sensitivity and contrary to common sense….excessive tearing. In severe dry eye it is possible to experience pain and even a sensation of pressure of fullness on the eyeball itself.

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 or 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.

Discomfort after Cataract Surgery

Question: Why do I have discomfort? My eye feels like it has a torn contact in my eye after having the cataract surgery six weeks ago?

Answer: It is impossible to tell why you have discomfort and a foreign body sensation after cataract surgery without a thorough examination. However, there are some possibilities to consider. First, you do not say whether a suture or stitch was used to seal the incision. While is this is typically removed before 6 weeks after your surgery, there could be a small stand of stitch left in place. It is also that you have some dry eye related symptoms that feel like a foreign body or even other ocular surface or eyelid problems such as follicular conjunctivitis. In any event you need to schedule an appointment with your cataract surgeon and ask them to give you a diagnosis and recommend a treatment as you should not be experiencing this during this phase of the healing process.

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 or 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.

Blurry Blueish Film after Cataract Surgery

Question: I am two weeks + post cataract surgery in my right eye. My vision is blurry and appears to be a blueish film. My doctor says all looks perfect.  Vision tested at 20/60 worse than before the implant.  I am thinking of cancelling my second eye cataract removal which is now 20/40 with no correction. Not sure what to do.

Answer: Your situation requires further investigation and examination to determine the cause of your symptoms. These are not expected or acceptable and should give pause for scheduling the second eye surgery. There is a long list of possibilities but it is impossible to know from an e-mail. But many causes need to be considered including uncorrected refractive error, corneal problems such as dry eye or edema, posterior capsular opacification, macular problems such as cystoid macular edema, early age related macular degeneration (AMD), Epi-retinal membrane formation which is also called macular pucker-and more. 20/60 is too bad of a vision to proceed with the other eye unless there is a good answer as to why it is 20/60. The first step is to get a definitive diagnosis and treatment if necessary. If your current cataract surgeon cannot provide a clear diagnosis, you need to schedule an appointment with another cataract surgeon and get one before proceeding with the second eye cataract surgery.

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 or 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.

Flying after Cataract Surgery

Question: How long after having cataractsurgery do I have to wait to fly?

Answer:  The best answer would be provided by your cataract surgeon. However, assuming that you have relatively routine cataract surgery without complications-most cataract surgeons require their patients to be examined the first day after cataract surgery and again at about 5-8 days after a cataract operation. This is the period of time where rare, but potentially serious, complications would likely be detected, if they were to occur. Beyond this period of time it is more a matter of making sure that you have access to continued follow up care at your cataract surgeon’s direction. If you are contemplating a trip after your cataract surgery you should discuss this with your cataract surgeon and they can give you any additional advice you might need regarding air travel as it would apply to your post operative instructions.

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 or 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.

Droopy Eyelid after Cataract Surgery

Question: Can cataract surgery cause your eyelid to droop?

Answer: In a cataract aged population, eyelid position anomalies are not terribly uncommon-even without surgery. The muscles of the eyelids tend to become lax and tissue of the eyelids does tend to droop. Thus, many patients do not really notice a preexisting drooping of the eyelids before their surgery-especially if they wear eyeglasses which may shield the direct view of the eyelids. Now, during cataract surgery an eyelid speculum is used to help patients remember to keep their eyes open. Sometimes if the patient squeezes firmly or excessively against the speculum, it is possible to have some swelling and additional trauma to the eyelid muscles and tissue-resulting in drooping or Ptosis. The good news is that if it is disturbing or aesthetically displeasing, it is possible for your eye surgeon to perform an eyelid procedure to correct the Ptosis. However, most eye surgeons suggest waiting until both eye have had cataract surgery and there is a reasonable time for all of the tissue to heal and recover completely-perhaps as long as 6 months.

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 or 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.

Color Blindness after Cataract Surgery?

Question: Does cataract surgery make the patient color blind? Also will it affect my ability to obtain a CDL?

Answer: Cataract surgery in no way should make you color blind. If you weren’t color blind before the cataract operation you shouldn’t be color blind afterward. In fact, cataracts cause colors to become faded and many patients report that colors are much more vivid after their surgery. So, unless you have some other eye problem this should not be a problem-nor should cataract surgery hamper your ability to get a CDL.

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 or 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.

Dry Eye after Cataract Surgery

Question: After cataract surgery is it common to develop dry eye? What are the symptoms of dry eye?

Answer: Developing a dry eye after cataract surgery is actually pretty common. Moreover, the incidence of mild to moderate dry eye in a cataract aged population prior to cataract surgery-and exacerbated by cataract surgery makes dry eye a rather common complaint among this group. According to the Prospective Health Assessment of Cataract Patients Ocular Surface (PHACO) Study some 60-75% of a cataract aged population had a meaningful deficiency in their tear film testing. Further, although cataract surgery is quite friendly to the cornea, it does require and incision which has the potential to temporarily interrupt corneal nerves responsible for reflex tearing and tear film integrity as well. 

This along with some of the solutions used during the cataract procedure can indeed result in a dry eye. The symptoms one might experience could include fluctuations of vision, dryness, grittiness, tearing, burning and a general tiredness as well as an overall sandy feeling. The good news is that for the vast majority of patients with dry eye there are potentially helpful treatment options that include specialized artificial tear lubricants and solutions, tiny punctal plugs to help you retain tears and prescription medication that stimulates production of your own tears. In addition there are more technological approaches such as lasers and other methods to treating underlying blepharitis, eyelid gland problems or eyelid inflammation that can contribute to dry eye as well.

 

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 or 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.

Toric Lens Implant for One Eye

Question: I had a cataract removed from my right eye approximately 8 years ago now my left eye needs cataract surgery. My question is my cataract surgeon offered me the toric lens les implant for astigmatism. But I don't have it in the right eye and I have astigmatism in both eyes. I need glasses to see far with my right eye after I had my cataract removed.  So would the toric lens be a benefit or not?

Answer: It is difficult to answer the question as you do not state the amount of astigmatism that you have remaining in the right eye. If you have an amount and orientation of astigmatism in the right eye that is correctable with Limbal Relaxing Incisions (LRI)-a minor procedure-when you have the toric lens implant in the left eye after your cataract surgery it is quite probable that you would not need to wear glasses to see at distance. Under these circumstances have a toric lens implant n the left eye and the astigmatism correction procedure in the right has some real advantages. If however there is no chance of correcting the residual astigmatism in the right eye, the advantages of having a toric lens might be diminished as you would still need to wear glasses even with the toric lens as the right eye would require correction.

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 or 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.

Lens Implant Exchange for Incorrect Strength

Question: I had cataract surgery on June 4, 2013. My cataract surgeon said he had put the wrong strength lens implant in and I would have to have another one put in, the sooner, the better.  How is this surgery in comparison with regular cataract surgery? In other words how difficult is it going to be to get the lens out and another one put in?

 

Answer: A lens exchange is necessary from time to time if, as you have experienced, there is a need to modify the lens implant power to improve the visual result for you. Assuming that there were no other complications, a lens exchange poses some of the same risks as any other cataract surgery in terms of infection and swelling-and some additional risks in terms of requiring careful manipulation and extraction of the intraocular lens to be removed. The biggest additional risk is damaging or tearing the residual crystalline capsule which is left in place to support the les implant. This requires a precise technique and with care, rupture of the capsule is typically but not always avoided. In the event that it does tear there are additional procedures and techniques that are used to make sure the new lens implant placement is proper and that you have a good result. Follow the advice of your cataract surgeon and have this lens exchange done as soon as possible as this does increase in difficulty the longer you delay. 

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 or 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.

Toric Lens Implant Blurry Vision

Question: I had toric lens implants in my left eye 6 weeks ago and my vision in that eye is blurry. My focus comes in clear but doesn't last long. I had toric lens implant in my right eye 4 weeks ago (nearsighted) and it is fine. I can read fine. How long is normal recovery time for my left eye (farsighted)? 

Answer: It is not apparent whether you had monovision lens implants or one eye was nearsighted and one eye farsighted prior to your cataract surgery. In any case, after 4-6 weeks your vision should be stable and one must look for other reasons for the transient blurry vision. You need to return to your cataract surgeon for a careful examination to see if the lens implant power itself is accurate or whether it is rotated or even if there is a dry eye problem impacting the one eye to a greater extent. These should all be observations easily made by 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 or 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.

Progressive Eyeglasses after Cataract Surgery

Question: If I have cataract surgery and put in monofocal lenses for far distance, can I wear progressive lens eyeglasses to get 20/20 vision? Should I expect halos?

Answer: Progressive spectacle lenses after cataract surgery to correct near vision focusing problems-called presbyopia-are a reasonable choice with monofocal lens implants as they will allow correction of any residual refractive error as well. You will be dependent on these glasses for all close vision tasks. Whether you correct to 20/20 really depends on the overall health of your eyes and the results of your cataract surgery. In addition whether you experience haloes depends on your cataract surgery as well including the position of the lens implants and their centration during surgery as well as the monofocal lens edge design as these could all be factors.

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 or 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.

Bubble Feeling after Cataract Surgery

Question: Ten months after cataract surgery, I still have a bubble like feeling from the left top center to the left bottom center of the eye perhaps just under the eyelid itself. Also, I experience a huge starburst while looking at lights at night and a constant cloudiness which diminishes the sharpness and clarity vs. the opposite eye. I have noted all of this to my new eye doctors since the surgery to no avail. I finally had LASIK surgery with no improvement in the puffiness/cloudiness. What could be the problem and what should I do about it?

Answer: Are you certain that the “bubble’ is simply a feeling and not actually in your vision? A bubble in your vision is a problem that needs attention as it could indicate a problem with the retina or vitreous being loose or even detached. More likely is that you are possibly experiencing an optical phenomenon due to the presence of the lens implant edge or its slight decentration or perhaps some retina swelling. While you state that you had LASIK surgery, we question whether you had LASIK or a YAG Laser Capsulotomy to create a clear optical opening in the posterior lens capsule that s was left in place to support the lens implant. This is much more likely and creates some optical problems as well. Your best next step is to ask your cataract surgeon to refer you to a retinal specialist for a second opinion in order to rule out any retina or vitreous related issues that might be contributing to the visual disturbance.

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 or 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.

Cloudy IOL Problem

Question: What complications can arise from procedure that removes "cloudy" condition from an existing intraocular lens?  Can existing "cloudy" IOL be replaced with new IOL?

Answer: When you are describing a cloudy IOL, we are uncertain whether you actually mean the IOL itself has become cloudy-indicating that there was perhaps some inflammation or other complication during the cataract surgery-or if you are referring to the presence of “posterior capsular opacification” in which the lens capsule of the crystalline lens which had the cloudy cataract material was removed. If it is the former there is no telling what the complications might be as this is a much more complex situation to understand without a clinical exam. If you are describing posterior capsular opacification then it is possible that a YAG Laser Capsulotomy will be performed in order to create a small optically clear opening in the cloudy lens capsule. This is needed in some 30% of patients that have had routine cataract surgery and is relatively uneventful. A YAG Laser procedure is performed using simply eye drops for anesthesia and takes only a few minutes in the office. There really is no recovery tie and the restoration of clear vision is usually immediate. If in fact you need to have a coated or clouded IOL actually exchanged for a new one this does require intraocular surgery and thus the complications are the same as any other primary cataract surgery including infection, inflammation, swelling of the delicate internal ocular tissue and even retinal detachment which is very unusual.

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 or 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 Implants for Musicians

Question: I am scheduled to have cataract surgery in a couple of weeks.  I am thinking about multifocal lens replacement with ReSTOR® Multifocal Lens Implants, which is the only multifocal, type my cataract surgeon recommends and will use.  It will cost an additional $2,000 per eye.  My concern is whether the implants will improve my vision enough to be able to focus on reading music from a little more than arms length to twelve inches or so without any distortion.  I wear progressive lenses and I'm having difficulty reading music now.  Progressive lenses don't work because as I move across the page, the focus wavers.  Mono lenses are a problem because I have to read at different distances and I can't maintain my focus.  Are the ReSTOR® Multifocal Lens Implants going to solve my problem reading music?  What have you heard from musicians who have had this surgery?

Answer: If you are seeking clear vision at 12 inches through arm’s length, you are attempting to optimize the clarity for an intermediate range of vision. The ReSTOR® Multifocal Lens Implants might be able to provide you with this, but it may also require some adjustment of your distance vision and absolutely complete correction of any preexisting astigmatism that you have. Might is the  operative word here as the ReSTOR® Multifocal Lens Implant is not typically recognized as having its nest performance in the  intermediate range of vision. You really need to carefully discuss with your cataract surgery including providing him or her with the precise distances that are you seeking clear vision for. Regarding the other issue of distortion, it is not likely to be a problem with this lens.

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 or 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 after RK

Question: In 1994 I had RK (extensive - 16 cuts in right eye). I recently had cataract surgery on right eye but vision correction, even using the ORA System, was not totally successful.  My cataract surgeon is now suggesting "piggyback" IOL to further correct vision.  Should I consider this and what are the possible complications?

Answer: Cataract surgery and lens implants after RK is more complex than routine cataract surgery where there has been no previous corneal surgery. The complexity of the measurements and calculations diminishes the precision of the lens implant calculations and should there be a need for an adjustment and refinement of the final prescription, the previous RK incisions may limit the options. Certainly the use of intraoperative measurements such as ORA can be helpful but still the precision isn’t perfect. Generally there are a few options for achieving the desired refractive outcome including wearing eyeglasses, corneal laser eye surgery such as LASIK or PRK, a lens implant exchange or a piggyback lens implant. Your previous RK may preclude you from LASIK for sure. You do not state whether the residual refractive outcome requires correction for nearsightedness, farsightedness and/or astigmatism. This too will be part of the decision on the likely usefulness of a piggyback lens implant as if there is irregular astigmatism-somewhat common with RK-you may not achieve your desired outcome. It is also not clear from your description why one would choose a piggyback over a lens exchange-either could be appropriate but your description precludes knowing the best choice. So-the best advice and opinion is to follow your cataract surgeon’s suggestion. That said, the complications of piggyback IOLs are similar to primary lens implants with the added risks of a second surgery-as long as the primary was uneventful.

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 or 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 for Bifocal Eyeglasses

Question: I am 58 and wear bifocals. It has been my dream for decades to be free of eyeglasses. This summer I am going to do it. It appears I have a choice of two methods to correct my vision:
Should I get a corneal transplant? Or should I get a multifocal lens implant? What are the risks and benefits to each?

Answer: Being free of eyeglasses is an admirable goal however you need to get more information about you vision correction options. Multifocal Lens Implants could very well correct your near and far vision-however it may depend on your prescription and exactly what your expectations are for seeing up close and intermediate distances. Further, for some reason you have stated that you are considering a corneal transplant for vision correction. Do you have some underlying corneal disease or problem that makes a corneal transplant medically necessary or are you simply confused? Before doing anything you need to go find the best cataract & lens implant surgeon you can and if you have some other corneal problem you probably want that surgeon to also be a corneal specialist. Schedule a consultation and absolutely take the surgeon’s advice on what your options might or might not be.

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 or 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.

Cataracts with Astigmatism

Question: I have cataracts and astigmatism in both eyes. I have heard there is a procedure that can fix both. I am 65 and have health insurance. How much should I expect to pay after insurance pays?  What is the success rate of this procedure?

Answer: If you have cataracts and astigmatism, and are in need of cataract surgery there are actually two ways to correct the astigmatism as part of the cataract surgery procedure. One way is to use an astigmatism correcting toric lens implant and the other is to have Limbal Relaxing Incisions (LRI). Most insurances, as well as Medicare do not pay for astigmatism correction and ask the cataract surgeon to charge for the incremental cost of the toric lens implant or the LRI procedure. In order to get the best results your cataract surgeon will need to take additional measurements that might include a corneal topography measurement, corneal thickness measurement, aberrometry and ocular coherence tomography-most or all of which should be part of the additional fee charged for the astigmatism correction regardless of which method is chosen. 

Which method is better in your particular case can only be determined by the cataract surgeon after your examination and consultation as it may depend on the degree and orientation of the astigmatism correction you require as well as other factors regarding the health and stability of your cornea. Further, it is not possible to tell you what the out of pocket costs might be as they vary by cataract surgeon, geography and procedure as well as by your insurance co-pay ad deductible allowances as well. The best thing to do is schedule an eye exam and consultation with a cataract surgeon and they should be able to advise you of the scope of options and the fees involved.

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 or 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.

Glare after Cataract Surgery

Question:  My mother had cataract surgery about 5 years ago and to this day she has a lot of problems with glare and she can't stand going in the sun or into rooms with too much light. She has gone back to her cataract surgeon numerous times, but he has not been able to help her. I keep mentioning contact lenses to see if that would help.  Do you think that contacts might help her?

Answer: First, it is important that you and your mother understand why your mother has continuing glare 5 years after her cataract surgery. The degree of glare disability you describe is not typical and should be evaluated. If you have been unable to get a satisfactory answer from her previous cataract surgeon then you need to find a top cataract surgeon in your area and schedule an examination for a second opinion. There are many reasons that there might be persistent glare problems after cataract surgery and with a thorough exam it should be possible to determine the cause and find possible solutions.

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 or 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.