Removing Contact Lenses before A-Scan

Question: My father has thick cataracts and he is 87 years old. He presently wears Acuvue® Oasys® contact lenses for 2 weeks straight because he is disabled, then I put new ones in for him. Should he go without wearing his contact lenses for 2 weeks before getting an A-scan? One eye doctor says yes and the other said not necessary. Question 2: Would there be any other reason for using a toric lens implant on a patient that doesn't have astigmatism?

Answer: Generally speaking removing soft contact lenses 2 weeks prior to an A-Scan is usually not necessary. However, because your father wears the  soft contact lenses for a 2 week extended wear period-and if he has some other even mild predisposition to corneal swelling as a result of reduced cell counts on the  innermost layer of his cornea due to age-it is possible that that there is some corneal swelling and possible distortion. This would make it necessary to remove the contact lenses for some period of time prior to measurement and might explain the difference in opinion between eye doctors. You should follow the specific instructions of the cataract surgeon who is taking the measurements, selecting the lens implant and performing the cataract surgery. There would be no reason for using a toric lens implant in a patient who does not have astigmatism, however, again, with 2 week extended wear in a person with even mildly compromised corneal deswelling capability, there is the  possibility that the  cornea has become “warped’ mimicking the  presence of astigmatism. This will typically resolve after the contacts are removed for a period of time.

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 & Clear Vision

Question: I have a cataract that isn’t ripe and wear progressive lenses. About 4-5 months ago I noticed that I have to take my glasses off to see at a distance and I can see clear as a bell. What would be the reason I can see clearly without my glasses?

Answer: What you are describing is often referred to as “second sight’ and accompanies cataract development of certain types in farsighted people. If you have been farsighted and required glasses, as the cataract forms in the “nucleus” of the crystalline lens of the eye, it is often results in a shift toward becoming nearsighted and thus offsets the farsightedness rendering your distance vision clear without correction for some period of time. However, this does indicate that the crystalline lens is changing and indicates the progression of the cataracts. Even though you might be seeing clearly it is likely that colors are becoming faded, you might notice glare and light sensitivity and difficulty in dim or dark illumination which further indicate the progression of cataracts.

Now, the notion that a cataract has to be “ripe” in order to be removed is completely outdated. Today, with modern cataract surgery and lens implants it is possible to remove a cataract and replace it with a permanent clear lens implant as soon as you personally feel like your vision or mobility are compromised. You need to find the best cataract surgeon in your area and schedule a consultation BEFORE your vision is so disturbed as to cause you more serious symptoms.

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.

Monovision Cataract Surgery & Astigmatism

Question: Is monovision cataract surgery for near vision possible if you have astigmatism?

Answer: Monovision cataract surgery to help you with near vision correction after cataract surgery is certainly a possible option for many people. Depending on what your near vision requirements and demands are and what your expectations are it is possible to find monovision cataract surgery using astigmatism correcting toric lens implants a good solution. This does require very careful measurements and calculations as well as meticulous lens implant selection and placement. In addition, if you have no previous experience with monovision contact lenses it would be important to have a trial with them if your vision allows in order to determine your tolerance to defocus which is a predictor of monovision correction success. Your most appropriate next step is to schedule a cataract exam and consultation with the best cataract surgeon you can find in your area-and it may be helpful to find a cataract surgeon who is also a refractive surgeon as they may be a bit more experienced in providing specialized refractive solutions such as monovision. 

Feel free to check out our seewithlasik.com blog and LASIK website too for a great discussion on 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.

Frosty Vision after Cataract Surgery

Question: Upon awakening after my cataract surgery I had frosty vision. It was like looking thru a frosted window. It has slowly become better. Why did I not see the bright vivid colors and the clarity others told me about?

Answer: It is difficult to know exactly why you experienced frosty vision after your cataract surgery but there could be several reasons. The important thing is that it has cleared. One of the more likely causes was that for whatever reason or reasons, you experienced some swelling of your cornea or corneal edema. This can happen from time to time during cataract surgery and if your eyes are otherwise healthy returns to normal in short order.

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 & Astigmatism Correction

Question: My mom is scheduled to cataract surgery in one of her eyes and her cataract surgeon insists on correcting her astigmatism at the same time as cataract removal. Besides extra cost for astigmatism correction I would like to know is this really necessary as she is 76 years old? How safe it is considering her age? Does it make sense to do only cataract removal without correcting astigmatism or we should go for this extra procedure?

Answer: In order to have the best results and vision after cataract surgery, patients who have astigmatism need to have it corrected. It can be corrected in eyeglasses-that you will have to purchase, probably several times over the  year, it can be corrected with a second surgical procedure called Limbal Relaxing Incisions (LRI), or it can be corrected with a toric lens implant. Both the LRI and the toric lens implant provide your mother with less dependence on glasses for seeing clearly at a distance which is a safer and more comfortable correction in terms of mobility. She could however wear glasses if the astigmatism wasn’t too bad and didn’t limit her mobility. I am sure you would NOT want to see your mom take a fall and break a hip due to uncorrected astigmatism blurring her vision. So, yes it needs to be corrected and you should follow the advice of her 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.

Insurance for Toric & Multifocal Lens Implants

Question: Is there ever insurance coverage (even partial) for toric lens implants for astigmatism or multifocal lens implants for cataract surgery?

Answer: Generally there is no insurance coverage for astigmatism correcting toric lens implants or multifocal lens implants. What is possible is if you are still employed you may use your Flex Plan to pay part of the cost. Flex Plans were severely limited and cut back under Obamacare so even these employer based benefits will only cover a portion of the lens implant fee. In very rare instances an employer might offer some stipend toward these implants but it is quite 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.

Cataract Surgery, Astigmatism, Eyeglasses & Flomax

Question: I have astigmatism and take Flomax and need to have cataract surgery on both eyes. I have been wearing progressive lens glasses for 20 years and am very happy using this type of eyewear. Is it possible to have surgery and still use progressive lens eyeglasses after? I take Flomax. How much before the cataract surgery should I stop taking Flomax? Is it better to have the surgery done by the new laser assisted method or the "old" fashion way. Will it be possible to have 20/20 vision after the surgery while using progressive lens eyeglasses?

Answer: It is quite possible to continue wearing progressive addition spectacle lenses to correct your near and intermediate vision as well as your astigmatism should you so desire. It is also possible to have an astigmatism correcting toric lens implant in which case your distance vision could very well be clear enough to not be dependent on eyeglasses for seeing far away at all. This is entirely your choice. If your eyes are otherwise healthy-especially the retina and cornea-it may very well be possible to achieve 20/20 with the progressive lenses after cataract surgery. Now, UNDER NO CIRCUMSTANCES should you discontinue your Flomax until you have discussed this with your cataract surgeon and your urologist. Your cataract surgeon will ABSOLUTELY need to be involved as there are surgical procedure modifications to be employed when someone has taken Flomax prior to cataract surgery. They will advise you of whether and when to alter your medication. Either traditional or laser cataract surgery can produce good results for you in the hands of a skilled 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.

Toric Lens Implant Vision Blur & Sloping

Question:  My wife recently had cataract surgery with a toric lens implant for astigmatism in her right eye. 10 days after her operation the vision is fuzzy-out of focus-and horizontal surfaces seem to slope to the right, and despite several attempts the cataract surgeon was unable to find any external lens or combination that would give any clearer vision. She can see clearly through a pin-hole mask and the macula, retina, and pressure are all good, and the lens seems to be correctly placed. They say come back in 6 weeks - what do you recommend? 

Answer: There are many reasons that your wife may be experiencing blur that clears with a pinhole mask and also several others that might cause a sloping of her vision. Some of these are related to the healing process and should self limit in the next 6 weeks as your cataract surgeon suggests. Others may not clear and could represent complications that require more immediate attention and possibly intervention as they could involve the retina. While you state that the retina is normal, prudence suggests that a retina consultation is to be considered to rule out subtle swelling of the macula, fine epiretinal membrane formation and other subtle changes that might be contributing. A conservative approach would be to have the retina consultation now and then the waiting for six weeks will likely be a less anxious time.

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 Rotation Problem

Question: I have just had cataract surgery and a toric lens implant for astigmatism in my left eye done. My cataract surgeon told me the lens had "rotated" about 10 degrees-how serious is this?  Should I consider correcting this?  How soon?  I am doing my right eye next week. 

Answer: It is possible to have a primary misalignment during the cataract surgery itself or in the unusual case a secondary rotation of the toric lens implant after the surgery. This is extremely rare with the Alcon AcrySof® Toric Lens Implant but is known to occur with other brands. In any event, there is no need to be concerned or to actually do anything to adjust the rotation unless it causes a problem with vision. A small rotation of 10 degrees-unless it is a very significant amount of astigmatism-should not typically cause too much vision disturbance. The best course of action is to follow the recommendation 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 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 & Near Vision

Question: I am having cataract surgery but can’t decide whether to have multifocal lens implants. I do not always need my glasses to read and when I do I wear minimal eye wear for reading.  Should I spend $7000 for multifocal lens implants as they might cause haloes around lights?

Answer: Since you are able to read pretty well with minimal correction, it suggests that you are mildly nearsighted in at least one eye prior to your cataract surgery. If you have cataract surgery and the lens implant prescription is calculated to render your distance vision as close to 20/20 as possible-thus eliminating the  nearsightedness-you will no longer no able to see up close and read without bifocals or reading glasses. Your options are to discuss with your Cataract Surgeon the possibility of creating the same type of refractive errors that you have now so as to remain a bit nearsighted-which may very well require a mild correction for seeing clearly at distance-or to select multifocal lens implants which provide an extended range of clear vision. In some designs and for some patients they do experience glare and haloes although in most instances this goes away.

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.

Vision without Toric Lens Implant for Astigmatism

Question: I need cataract surgery and have significant astigmatism but can’t afford a toric lens implant to correct the astigmatism. How much less "good" vision I will have because of this?

Answer: Depending of the amount and the orientation of the astigmatism you could have somewhat distorted or blurred vision for far and near. If you do not have a toric lens implant it is possible that you could have Limbal Relaxing Incisions (LRI) or else you will likely have to wear glasses to see clearly. When making the decision not to have a toric lens implant to correct your astigmatism make sure that you take into account the recurring cost of buying glasses for the astigmatism correction over the course of multiple years.

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 Glare

Question: I am a 57 yr old woman who had cataract surgery in my left eye on December 5, 2012 and around December 15, 2012, I noticed daytime and nighttime glare in the left eye. What is causing the glare in my left eye? What procedure(s) can be done to correct the glare in the left eye and how soon can it be done?

Answer: There are many reasons that you might be experiencing glare after your cataract surgery and lens implant procedure. It is really not possible to know what is causing the glare without a clinical exam. You do not specify the type of lens implant used to correct your vision which also could contribute to the glare. Some things to consider are residual inflammation, any compromise of the posterior lens capsule which has been left in place to support the lens implant, swelling or irregularity of the cornea and even a remote possibility of mild swelling of the retina. Your best course of action is to return to your Cataract Surgeon and express your concern regarding the glare. After  an examination he or she will be able to tell you whether the  glare you are experiencing is part of the  healing process and thus transient or in fact needs medical, laser or surgical intervention.

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.

Nervous & Anxious about Cataract Surgery

Question: I have been told I will require cataract surgery in the near future for both eyes. My concern is that I am extremely phobic about any near or actual eye contact.  I literally have to take valium before a routine eye exam.  So can this typically be done in hospital with some minor anesthesia? There is no way can I keep eyes open with someone closely approaching or touching my eyes. Please comment and give advice? 

Answer: Modern cataract surgery is typically performed using only eye drops for anesthesia and with some oral medication such as Valium to help patients stay relaxed. However, if you are phobic, anxious or fearful you need to discuss this with your cataract surgeon who very well might suggest any one of a number of other alternatives-as well as possibly even more traditional anesthesia. Keep in mind that the “lighter’ the anesthesia, the quicker and more comfortable the recovery. Also, modern cataract surgery is pretty quick so you won’t experience the fear or phobia for too long-thus it might be possible to use more than eye drops but less than complete sedation.

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.

Eye Watering after Cataract Surgery

Question: My mom had cataract surgery in September 2012 and still has an issue with extreme watering of that eye. The vision is fine and there is no sign of infection. This was not an issue before surgery. Any suggestions? 

Answer: Eye watering after cataract surgery can be due to a range of issues including dry eye, turning in of the eyelid-called entropion, eyelash problems-called trichiasis, a constriction or blockage of a tear duct-and on and on. The best thing to do is schedule an examination and consultation with your cataract surgeon and explain the issue. If you do not get satisfactory answers then seek a consultation with a cataract surgeon who is also a corneal specialist as they will be more inclined to evaluate the eye surface and tear film from a different perspective.

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 & ReSTOR Multifocal Lens Implants

Question: I had LASIK surgery with cataract removal and ReSTOR® Lens Implants in both eyes in past 2 weeks. One eye sees clearly for distance, but still blurry near vision. The second eye done one week ago is still very blurry for near and far, my cataract surgeon says they are not worried, but I am.  I can't see well at all, reading and all activities are an issue. Can someone tell me approximately how long this takes as I was told I would have clear vision at all distances?

Answer: First, it is not likely that you had LASIK surgery. It is more likely that you had laser cataract surgery, cataract removal and lens implants using the ReSTOR® Multifocal Lens Implant. If this is the case, and you and your eyes are otherwise healthy then one would expect that there would be rather good distance vision in each eye within just a few days after the surgery on that eye and that there would be at least decent near vision for reading and close vision tasks within a couple of weeks as you adapt. The multifocal lens implants do require and adaptation period to see comfortably, however one would expect some consistency and improvement in relatively short order. Your cataract surgeon may not be concerned because he or she sees the eyes quieting down and expects a good outcome but perhaps in a slightly or moderately greater length of time. That’s said, if you are not happy with the vision after your cataract surgery and lens implants within a 4-6 week period you deserve to have an explanation and plan to improve it that is reasonable.

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.