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cataract surgery


John Di Leo

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It looks like I am going to have my cataracts removed and replaced with intra-ocular lenses.

When this is done the lens for replacement can correct the patient for distance or for closeup work—there is a multifocal lens, but that is not in the equation—IOW one or the other.

Correct for distance, correct for near, both have pluses and minuses. I am posting here to see what others have done and how it affects taking pictures.

My preference, I think, is to correct for distance and wear reading glasses when necessary. The viewfinders on modern cameras have diopter corrections, so that should preclude needing glasses to shoot through the viewfinder. However, I use Live View more and more for critical sharpness and that would mean using glasses for that.

Thoughts? and TIA

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Getting my second eye done day after tomorrow. First eye was a month ago and I went for clear distance vision supplemented with ordinary reading glasses for close work. The main reason for me was optic free night vision while car driving in traffic. The absence of flare, glare, and light haloes just feels, and probably is, safer.
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I had a kind of 'fresnel' lens put in that allows both close and distant focus (a Restor lens). It took a little adjustment on my part at first, but many years later now, I am not even conscious of the "starry night" sort of effect from some (not all) night lighting. Amazing how the brain,, etc. adapts. Anyway I'm happy. I do find weak 'cheaters' make computer monitor distance easier, but they are not necessary.

 

I'd hate to HAVE to carry around glasses, which is why I went for the Restor lenses

Edited by JDMvW
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I can share my own experience, but I’m not an eye surgeon or physician, so it should be taken as such. The only one who can give you advice is your eye surgeon.

My eye specialist suggested to implant a lens to correct my major myopia, so that I could work at the computer and do generic chores without spectacles. The final adjustment he would make with light eyeglasses for driving, etc.

 

After the first operation I realised there was big difference between the two eyes: the unoperated eyesight was brownish, the operated one was clear. The operation itself lasts about 20 minutes, for me it was quite unpleasant but one gets over it.

 

My myopia is now down to 1.5 diopters, I can photograph with glasses or correct it in the viewfinder and focusing is really smooth and precise.

 

The multi focal lens implant was not considered, probably because of the mentioned correction issues, so I can’t say anything about it.

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I'm a special case because I had a detached retina in one eye; it was corrected anatomically, but I have limited vision in that eye. Having two eyes means you have a spare, and if one doesn't work, then its important to take very good care of the other one.

 

So I opted for distance correction in the interocular implant in my good eye. That means that I don't need glasses for walking around, driving or watching TV, but I do need glasses for reading. The surgeon who did the implant suggested using drugstore or dollarstore readers, but my retina doctor suggested that a better solution would be bifocals with reading correction in the lower portion, and no correction in the upper portion. His rationale was that wearing bifocals all the time would provide physical protection for my good eye - something that is important since I no longer have a spare. He pointed out that one of the things that automobile safety experts don't talk about is that air bags may save drivers and passengers from death or serious injury in the event of crashes, but the deployment of airbags is responsible for thousands of incidents of serious eye injury ..

 

So bifocals work well except for one situation - working at the computer. Bifocals are fine if the text you are reading is held in your hands (like a book or newspaper), but if the text is higher relative to your head, you are forced to tip your head back to engage the bifocals, and this causes neck strain. So I have a set of single-vision readers with fairly large lenses that I use when I'm at the computer. While the issue of whether blue light from computers is actually dangerous is subject to a lot of debate, I think most people agree that too much blue light close to bedtime may interfere with sleep, I opted to get readers that are also 'blue blockers'. They have a faint yellow tint that doesn't interfere with normal reading, but may offer some added value, and they were cheap on Amazon.

 

As to the cataract surgery itself - it was a total non-event. The surgery itself was 10-15 minutes, and I was awake for most of that time. There was a wait of a couple of hours while they were putting in drops to cause the eye to dilate, and of course there are the drops that you have to use afterward. But compared with retina reattachment surgery, cataract surgery is a piece of cake. I was a bit concerned going in because of that spare consideration, but my retina doctor directed me to a new opthamologist who was also the head of the ophthalmology department at a local medical school, and had more experience than the typical cataract surgeon.

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I am so far only near sighted and aging. Whatever you 'll choose will suck. I 'd lean towards a domestically bearable compromise, like focus on text at arm's length, that might be infinity +1.25dpt. My better eye is like that. I think it is most important to be able to get along without further correction.

Live view? Does it still matter at all? Yes, I do own some DSLRs offering it but next wealth they should be history. EVFs offer way higher resolutions than rear screens and I doubt it to be fun to carry +3 reading glasses, to see the screen as good as possible, since they 'll get in the way with everything else. I 'd rather utilize a chimney finder like focusing hood. Saying that as a guy who placed cheap +3 readers (to be worn over Infinity contacts) near every sewing machine, under the dark cloth and at hand for sloppy close up inspection of prints. But they are really meant for reading in bed, resting on your elbows, not a newspaper on the table.

YMMV. I am not overly impressed by the traffic related arguments pro infinity. We 'll need goggles or a visor anyhow, riding at a bit of speed?

Cameras: Shooting with glasses sucked but lots of folks do it quite succesfully. Keep in mind that you might like to know your camera settings too and they are no longer as tactile as they used to be a few generations ago.

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I've worn eyeglasses for nearsightedness for 68 years, so they are a familiar daily attachment. I tried contact lenses, didn't work out. When cataracts, glaucoma, and nerve damage in one eye got soooo bad, I reluctantly opted for surgery a year ago. It was painless, quick, and I'm basically happy with the results. Of the options for lenses, I chose to have the lens give me near vision, as I have done close work for years, enjoy reading, writing and using my computer and smartphone and periodically glance at my watch to see what time it is. I wanted to do those things unimpeded. Since I was used to glasses for driving and distant vision, we found the right distance for focus and went from there. For the first time in years I can read the fine print on labels at the grocery store. Yes, I still needed a light diopter on some of my camera viewfinders, but because things were now much better than before, I'm a happy camper. As I've done for years, I got progressive lenses in my glasses so there is uninterrupted near to distant vision. Although results from the surgery are highly noticeable within a few days, there is a period of several weeks of accommodation as the healing process occurs. The changes are slight, but do need to be monitored. So, go for it and enjoy the results...IMHO for me it was life changing.
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I chose clear distance vision for both eyes for the same reason - night driving without glasses (also much cheaper sunglasses in daytime). I need reading glasses for close work, but the formula is straight-forward, +2 for computer work (1/2 meter) and +3 for reading in bed (1/3rd meter). I sometimes wear half-glasses while driving, to see the road and GPS (or console) clearly.

 

I can now use my Leica and rangefinder, as well as every other camera.

 

I have one acquaintance who chose near in one eye and far in the other. Never sees anything well.

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I am so far only near sighted and aging. Whatever you 'll choose will suck. I 'd lean towards a domestically bearable compromise, like focus on text at arm's length, that might be infinity +1.25dpt. My better eye is like that. I think it is most important to be able to get along without further correction.

Live view? Does it still matter at all? Yes, I do own some DSLRs offering it but next wealth they should be history. EVFs offer way higher resolutions than rear screens and I doubt it to be fun to carry +3 reading glasses, to see the screen as good as possible, since they 'll get in the way with everything else. I 'd rather utilize a chimney finder like focusing hood. Saying that as a guy who placed cheap +3 readers (to be worn over Infinity contacts) near every sewing machine, under the dark cloth and at hand for sloppy close up inspection of prints. But they are really meant for reading in bed, resting on your elbows, not a newspaper on the table.

YMMV. I am not overly impressed by the traffic related arguments pro infinity. We 'll need goggles or a visor anyhow, riding at a bit of speed?

Cameras: Shooting with glasses sucked but lots of folks do it quite succesfully. Keep in mind that you might like to know your camera settings too and they are no longer as tactile as they used to be a few generations ago.

Yes, Live View, I am still using my D810 awaiting the Z8 :).

Are you saying that with correction for distance the VF is easily read without glasses, ie with only the diopter correction on the VF?

That would be good news to me. And distance correction would play well with a full face helmet, Shoei Neotec 2.

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First thanks for the "insight." It sounds like most chose to have correction for distance. That was the info I sought.

Just a POI. I am a (now retired) anesthesiologist and have had exposure to thousands of cataract surgeries during my 50 year career. Yes, the surgery is almost "drive by," and about as stressful as a trip to Walmart—as long as everything is going well. In truth most of the time there are no issues whatsoever. Surgery times vary, depending on the surgeon, but usually from about 12 minutes to maybe 20-25 minutes. Anesthesia is topical, ie "drops." And the patient gets a smidge of sedation usually.

What I have noticed is that patients are really eager to get their second eye done. I think this operation has more satisfied patients than any other I've been party to. They love it. So, I have little concern for the surgery itself. I have both a retinologist and an ophthalmologist because I have dry macular degeneration, worse in my non dominant (left) eye, so how new lenses play with my stable Mac degen is a bit of concern, though both docs say it should be fine.

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Helmets: My first real one was a Shoei. Later I became a fan of BMW and their knockoffs, since Mk. IV didn't fit properly.

I was voicing concerns that you might not see anything besides your slightly diopter corrected VF on your camera, without reading glasses, when you 'll opt for infinity.

Sorry for the late reply. I hope you can enjoy the world's beauty.

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A lot of this IMO depends on what kind of "seeing" you got used to before you got cataracts. For me I had good distance vision in the left eye and was extremely short sighted in the right. So despite being right eye dominant, I grew up a left eyed photographer. The right eye was great for reading and very close work but contributed little or nothing of detail over a metre . I struggled with batting at cricket and long catching because the main eye changed from left to right as the ball approached.

 

I needed a left eye cataract op first. Little debate about what sort of lens to use because that eye had always produced my only good distance vision so we went like for like and my vision was pretty much as it was pre-cataract.. However when the right eye developed a cataract ten years later, there was a different debate and I was concerned ( as was my consultant) that a long vision lens in that eye too would prove difficult because it would be just so different from the way I was used to seeing things. We settle for a short to mid range lens in the right eye . That combination has caused me no issues but my right eye vision is now far more useful . I can still see great close up with the right but instead of being useless , I could now watch tv and interact over medium distances with that eye too. Makes me confident that if ever anything happened to my left eye I could cope. Meanwhile I don't usually wear spectacles apart from tiny stuff extremely close.

 

Main message is don't change too far from the way you saw before. And one more thing. You might see things a little more "blue" than you used to. In general I've had to change nothing about the way I photograph after one or two cataract ops.

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I had one eye done last year. I could barely see out of it and opted for the basic lens replacement that Medicare completely covered. I did the internal injection antibiotic so I didn't have to do the eye drops. Wore the plastic eye protector when I slept that night. Couldn't swim for a week, had a couple of follow up exams to make sure everything was OK and that was it. Was impressed with the ease of the testing, surgery and results. It is supposedly the most common surgery in America. I only need reading glasses if the print is small or the light is dim. My wife buys ten pair at a time at a cost of less than $3 each. To me, my first experience with cataract surgery is a true Cinderella Story.
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Removing cataracts will open up a new world of color. Choose a surgeon who has done a great many operations. As for myself, I was unaware of different replacements for far and near vision. My vision problem is a distorted cornea. Surgery increased distortion. Solution requires that I wear a pair of soft lenses to smooth out cornea, and hard lenses to correct vision. So altogether 4 contact lenses. I have perfect vision for distance as well as reading and other close work. All thanks to modern technology. It should be noted that not all eye surgeons and optometrists are equal.
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Cataracts impart a yellow cast, which suddenly vanishes after surgery. Clothing I had perceived as green now appeared (correctly) blue or dark grey. I'm sure that affected the way I adjusted color in photos. Not so much for prints, though. For printing my goal was to match the screen, and I rarely adjusted the original images. Video is another matter, but again centers on matching between cameras and angles.

 

The painter, Monet, suffered from cataracts, which was manifested in his increasingly blue tones.

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Had mine done about 6 years ago--as a major myope in the -7D range. Doc advised against multifocal. I love it, except for the loss of ability to take off my glasses and get "up and close" with things rivaling 3x magnification. Lose one thing, gain another.

 

The presbyopia tactic we took was to add a +0.50 sphere to both corrective lenses (outstanding for monitor and hand work), and then do the progressive add up to the overall +2D reading half. With the glasses off, it's a charm for distance and general navigation. With them on--near to far is smooth and sharp. Everyone will vary with this--just something you may want to ask about.

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There is a fascinating lecture on YouTube titled "Looking at Ansel Adams: The Photographs and the Man", by Adams' former assistant, Andrea Stillman . She explains that Adams had cataracts in his later years and that she thinks this explains his making of overly dark prints during the last few years of his life, because he could not see blacks that looked sufficiently black to his eyes. Adams never did get cataract surgery. She also states that the same thing happened to Paul Strand, who was making prints that were too dark until after he did get cataract surgery.

 

Edited by Glenn McCreery
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Simple distance correction for both eyes. I wear bifocals, though don't really need to for distance, but they correct for some astigmatism. I use a bit stronger lower section than most, as I do a lot of close-up work. One pair for the computer and one pair for everything else. Color perception is fantastic now! Cameras with diopter correction are no problem, but was never able to use my F3HP SLR again because I couldn't find screw-in lenses for it. Camera viewfinders, AFAIK, are not designed for infinity, but for something like 1 meter, thus the problem if you can't focus sharply there.
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