Sunday, April 21, 2024

Near Vision After Cataract Surgery

Indications For Cataract Surgery

BCH Lecture: Advances in Cataract Treatment

If cataracts are interfering with your ability to see clearly, surgery may be a good option for you.

Cataract surgery removes the lens of your eye, which has become cloudy due to cataracts. The cloudy lens is then replaced by a clear artificial lens, so you can see much more clearly again.

According to the National Eye Institute , most cataracts are a side effect of aging, and they are very common in older people. It is estimated that over 50 percent of all Americans have a cataract or have undergone cataract surgery by the age of 80.

The first step in treating cataracts is to try corrective techniques, such as new eyeglasses, contacts, reading in brighter lighting, wearing anti-glare sunglasses, or using magnifying lenses. If these methods do not provide enough improvement, surgery is your only option for achieving clearer vision.

Cataracts should be surgically removed if:

  • You dont find relief through other corrective measures.
  • Vision loss caused by your cataracts is interfering with your ability to complete everyday activities, such as driving and reading.
  • The cataract is preventing treatment of another vision problem, even if the cataract itself is not interfering with activities of daily life yet.

NEI explains that cataract surgery is one of the most common operations performed in the United States. It is also one of the safest and most effective surgeries performed. Following cataract surgery, approximately 90 percent of people experience improved vision.

Spectacle Free Vision After Cataract Surgery The Pros And Cons

Mr Sameer Trikha MBA FRCOphth

Cataract surgery has evolved tremendously over the past two decades to become the most safe and effective surgical procedure worldwide. Advances in intraocular lens technology have now provided an array of options for patients undergoing this procedure.

There are, however, pros and cons for each option.

Traditionally, cataract surgery involves the replacement of the natural lens of the eye with a clear, monofocal intraocular lens. Usually patients prefer clear distance vision, meaning that they need help with near work using reading glasses. In patients with astigmatism a toric IOL can be offered, which can correct the irregularity. However, this again requires the use of glasses for near work. The benefits of such lenses mean that there is often 100% light transmission and excellent contrast sensitivity . However, glasses are needed for near work nearly all of the time, which of course can be a nuisance.

So what are the options for spectacle free vision post cataract surgery?

In recent years Extended Depth of Focus lenses have also become available, allowing patients to receive excellent distance and intermediate vision, across a better range of distances. In general these lenses have slightly more light transmission compared to Multifocal, but near vision may require additional spectacle use.

I am always happy to discuss lens options following cataract surgery please dont hesitate to contact me at to arrange a consultation.

How Does Monovision Cataract Surgery Compare To Other Refractive Cataract Surgery Options

Over the past 20 years, premium IOL technology has provided more options for glasses-free vision. In addition to monovision IOLs, accommodating IOLs and multifocal IOLs can be chosen to correct presbyopia.

Accommodating IOLs use the movements of the eyes muscles to change focus from distance to near. Some people find that they still need reading glasses for detailed work. Also, accommodative IOLs may become less effective over time.

Multifocal IOLs provide several zones of focus for clear vision at distance and near. However, distance vision is sometimes compromised for clearer near vision. Glare and halos around lights can also be caused by accommodating and multifocal IOLs.

A combination of a premium IOL in one eye and a monofocal IOL in the other eye has been used with some success.

Monovision refractive surgery uses monofocal IOLs, so it costs less than premium IOLs. It is a good option that can provide glasses-free vision for people who can adjust to suppressing the blurry image from one eye.

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Is It Normal To See Black Spots After Cataract Surgery

While it may be somewhat annoying at first, the good news is that there’s most likely no need to worry about this very normal condition. Some of the floaters will go away with time. In some cases, however, floaters following a cataract procedure may represent a sign of a tear in the retina or a hole in the retina.

Unhappy Patients After Cataract Surgery: Reasons For Dissatisfaction And How To Help

Cataract Surgery


Even with a technically perfect outcome after cataract surgery, physicians may find that some patients are unhappy. This dissatisfaction can be due to a number of factors that go beyond visual outcome. Surendra Basti, MD, and Daniel H. Chang, MD, shared what can cause unhappiness and how they discuss it with patients.

Dr. Basti said its not uncommon for patients to be unhappy after what is otherwise a successful cataract surgery. He said that about a quarter of patients who experience this dissatisfaction will not actually spell it out for the surgeon, but if you probe, youll get to why they are unhappy.

In the majority of these cases, Dr. Basti thinks its a lack of proper understanding. A proper conversation with the patient can potentially fix the source of unhappiness, he said. Infrequently, there may be a need for surgery, but it depends on what the primary source of unhappiness is.

The second category of unhappy patients Dr. Basti sees are those with quality of vision issues. This group would include patients experiencing dysphotopsia and those with multifocal lenses who dont quite like the contrast sensitivity. He estimated that around 30% of the unhappy patients he sees after cataract surgery fall into this category.

The third category of patients unhappy after cataract surgery are those with physical discomfort, like dry eye or a stinging sensation from eye drops, Dr. Basti said. This problem can usually be corrected and isnt something that lasts.

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Floaters And Flashes Of Light

Surgery can cause posterior vitreous detachment, where the vitreous separates from the retina. It makes you see moving spider webs and clouds in your vision, along with flashes of light.

Usually, it gets better on its own within a few months. Because the symptoms are similar to retinal detachment, call your doctor right away to get checked out.

How Much Vision Will I Regain After Cataract Surgery

If you have cataracts, you know that living with them can make it harder to accomplish even the simplest of activities. The only way to effectively treat cataracts is by having cataract surgery.

But does cataract surgery mean that you will regain all your vision lost because of cataracts? Keep reading to learn more!

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Better Close And Distance Vision

The new lenses inserted during cataract surgery can correct refractive vision problems such as nearsightedness, farsightedness, and presbyopia.

Nearsightedness is when you have trouble clearly seeing things that are far away. Farsightedness is when you have trouble clearly seeing things that are up close. Presbyopia is a type of farsightedness caused by age-related loss of flexibility in the lens.

If you need eyeglasses for distance-related vision problems, you can expect to see an improvement in your vision after cataract surgery.

Is It Better To Be Nearsighted Or Farsighted After Cataract Surgery

Laser Precision Restores Vision after Cataracts

The new lenses inserted during cataract surgery can correct refractive vision problems such as nearsightedness, farsightedness, and presbyopia. Nearsightedness is when you have trouble clearly seeing things that are far away. Farsightedness is when you have trouble clearly seeing things that are up close.

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How Does Monovision Cataract Surgery Work

In cataract surgery, a cloudy natural lens is replaced with a clear artificial lens called an intraocular lens . A monofocal lens is the most commonly implanted IOL. It provides clear vision at one focus only, usually distance.

After cataract surgery, a person with both monofocal IOLs focused at distance would need glasses to see clearly at near. Some people also still need glasses to see clearly at distance because their refractive error was not corrected by the monofocal IOL.

Monovision cataract surgery is one type of refractive cataract surgery. The goal of most refractive cataract surgery is clear, glasses-free distance vision after surgery. However, it can also be used to achieve clear near vision.

In monovision cataract surgery, one IOL is set for distance, and one is set for near. Your doctor will perform a few tests to determine your dominant eye. The dominant eye is typically chosen for the distance IOL, and the other eye for the near IOL.

After the brain adapts to filtering out the blurry image, this provides clear vision for most activities. Glasses may still be needed for detailed near work or computer work and for night driving.

What Type Of Lenses Can You Get

When Dr. Day performs your cataract surgery, he can insert various types of lenses in your eyes depending on which types of vision problems you may have.

For example, he can insert lenses that improve distance vision or up-close vision or correct for an astigmatism. Or he can use multifocal lenses that are similar to bifocal or progressive lenses that have different focus areas for near, medium, and distant vision.

Before your surgery, Dr. ODay talks with you about the best type of lens to insert into your eye.

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Unexpected Benefits Of Cataract Surgery

Each of your eyes has a lens, which is a clear membrane that allows light into your eye. When you have cataracts, one or both of the lenses in your eyes become cloudy. This cloudiness can interfere with your vision, making it harder for you to watch television, read, drive, and do other activities.

Cataracts are a common aging-related health condition. More than half of all Americans develop cataracts by the age of 80.

Cataract surgery is the only treatment for eliminating cataracts. Its a common procedure thats very effective and safe when performed by an experienced eye surgeon like Dr. David ODay at Charleston Cornea & Refractive Surgery. During cataract surgery, Dr. Day removes the cloudy lens in your eye and replaces it with an artificial lens.

After cataract surgery, you can see more clearly. But cataract surgery delivers some other unexpected benefits, too. Heres a look at what else you can look forward to after having cataract surgery.

Are All Iols Covered By Insurance

Opthalmic Procedures: Cataracts

Monofocal lenses are fully covered. Toric lenses and presbyopia-correcting lens are not covered by insurance. You will pay an additional out-of-pocket expense — around $1000 per eye for toric and between $2000 and $2600 per eye for presbyopia-correcting lenses — if you choose one of these IOLs.

Vision correction achieved with cataract surgery is permanent.

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The Success Of Monovision Depends On The Level Of Targeted Myopia For Near Vision

Graham D. Barrett, MD, FRACO

The ability to accommodate for near and intermediate visual tasks greatly diminishes with age due to the onset of presbyopia. Patients in their fifth decade considering contact lenses, laser refractive surgery, or cataract surgery will require glasses for near and intermediate vision if they achieve emmetropia and excellent distance UCVA in both eyes.

Monovision has been widely practiced, historically with contact lens correction and more recently with LASIK to assist with near UCVA after refractive surgery. However, the largest group of patients who are suitable for monovision are those undergoing cataract surgery.

Although multifocal implants are an alternative to monovision, the patient compromises visual quality and may experience dysphotopsia, such as halos, which some patients find unacceptable. An accommodating IOL would be ideal, but the efficacy and refractive outcomes of today’s models are somewhat unpredictable. Therefore, my personal preference for the past 5 years has been to utilize monovision as an effective solution for patients who desire a greater level of spectacle independence, both for distance and near, following cataract surgery.

Graham D. Barrett, MD, FRACO, is an Associate Professor of Ophthalmology at The Lions Eye Institute, and is Head of the Department of Ophthalmology at Sir Charles Gairdner Hospital, both located in Nedlands, Western Australia. Dr. Barrett may be reached at tel: +61 8 9381 0872 e-mail: .

What To Expect Post Surgery

In general, most people experience significant improvement in their vision following cataract surgery. Certain conditions, such as other eye diseases like glaucoma, that have already caused too much damage can prevent people from experiencing expected outcomes.

No matter what underlying conditions you may have, it is important to be patient with the results after surgery.

Following cataract surgery, you can expect:

  • It to take a few days for your vision to fully improve, as your eyes need to heal and adjust.
  • Colors to appear brighter.
  • Itching and mild discomfort around the eyes for a couple days.
  • Your doctor to recommend wearing an eye patch or protective shield for a couple days while your eyes recover.
  • To take eye drops or medications to prevent infections and reduce inflammation in the eyes.
  • Most discomfort to disappear after a couple days.
  • Complete healing to occur within eight weeks.

Most people make a full and relatively painless recovery from cataract surgery. There are risks associated with the surgery, however, so it is important to contact your doctor right away if you experience any of the following:

  • Extreme inflammation
  • Dislocation of the artificial lens
  • Retinal detachment
  • Pain that doesnt respond to over-the-counter medications
  • Light flashes or spots in front of eyes

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How Soon Will My Vision Improve After Surgery

You may have some blurriness for a few days after cataract removal. But you should notice improved vision within the first several weeks. Nine out of 10 people see better after cataract removal.

You still may need to wear glasses or contacts after cataract surgery. Your prescription may change, so be prepared to buy a new pair of eyeglasses or contacts. If youve had laser vision repair , you may need to repeat it or wear glasses or contacts after cataract removal.

How Long Does Scratchiness Last After Cataract Surgery

BCH Lecture: Latest Advances in Cataract Surgery

Dry eye and itchiness after cataract removal will last for about a month, which is when healing from surgery is usually completed. Keep in mind that patients should notice reduced discomfort, fewer dry eye attacks, and decreased irritation over the course of the first week to two weeks as part of the recovery process.

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My First Thoughts After Surgery

Because of the medication I had been given, I don’t remember being in the recovery area for the obligatory 10 to 15 minutes. But my memory vividly restarts at the point where I was sitting in the chair in the discharge area.

From the discharge area, I could see the holding and recovery areas. Through my right eye, these areas were definitely bright. With my left eye closed, I could see everyone walking around and I easily could recognize them.

Distant images were still blurry. Unfortunately, I decided to look down at my identification wrist band and noticed that the “Charles Slonim” name was crystal clear.

“Oh @$#%& ,” I thought. “Now I’m myopic ! I have the wrong implant power. Someone made a mistake!”

I was agitated. I did not want to be myopic after cataract surgery. I had been emmetropic my entire life. I wondered whether I should say something now, or just wait. I was a doctor myself, after all, and I had to get this straightened out.

Would I need another procedure? I hoped not.

I tried to recall everything I could about clear corneal cataract surgery, the type of procedure I had undergone. I reminded myself that corneal edema or swelling typically induces a myopic shift until it resolves.

I decided I would wait to say anything, although on the way home I continued to fret about the possibility of a less than optimum visual outcome. But on the positive side, and while I was busy second-guessing my surgeon, I did notice the color contrasts in the distance were amazing.

Eye Hygiene After Cataract Surgery

Avoid activities that could increase risk of infection. You will probably find it tempting to touch or rub your eye after cataract surgery. This is an easy way to introduce bacteria, viruses and foreign particles to your eyes. Maintain vigorous hand cleaning with soap and water and resist the urge to touch your eyes. Use a disinfectant wipe to wash down surfaces commonly touched such as door handles, phones and taps.

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What Is The Difference Between Cataract Surgery And Cataract Surgery With Vision Correction

Cataract surgery is the removal of the cloudy lens and implantation of a clear lens, eliminating the haze and decreased vision associated with a cataract.

Cataract surgery with Vision Correction involves a personalized approach and advanced tools to not only remove your cataract, but to reduce dependence on glasses. Most people have certain activities for which they need perfect vision, and they will still use glasses for those activities. Our physicians will use advanced technologies and tools to determine the best surgical treatment based on your lifestyle, activity preferences and desired vision outcome.

You will discuss your needs with your surgeon to determine whether cataract surgery with Vision Correction is appropriate for you.

Activity After Cataract Surgery

Custom Orlando Cataract Surgery

Avoid heaving lifting as it can cause the pressure inside your eyes to increase. This can interfere with healing and cause damage to the eye. Try to avoid strenuous activities over the first seven to ten days. Examples are: heavy gardening, running, hill walking, childcare for young children who require lifting and golf .

Other activities that raise intraocular pressure include bending below your waist to pick up items or reaching up high. We suggest consciously considering the activities you carry out in the house in the week before cataract surgery. Identify the tasks you do daily that cause you to reach high, bend low or generally strain yourself. It is a good idea to eliminate easily avoidable tasks such as finding the remote control, searching for the phone charger, carrying heavy pots.

Locate frequently used items and leave at waist height for your return from hospital, pre-prepare a meal that can easily be heated, leave the kettle with water in and a cup ready with a tea bag. If you have a dog arrange for a friend to do walks.

Your eyes will be sensitive to airborne particles. It is a good idea to vacuum and clean before cataract surgery. This protects your eyes from contaminants such as pet hair, dander, dust, and dirt. It will also help to keep on top of the hoovering after cataract surgery but remember you need to take it easy so best ask your partner, a friend or your children to do it for you.

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