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Question about cataract surgery

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#1 hboswell

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Posted 14 August 2019 - 06:31 PM

It isn't in my immediate future, but probably in the next 6-12 months.  Talked with my eye doctor today, and mentioned observing through the telescope.  He said in that case he might not correct my distance vision to 20/20 so that he could preserve my near vision, so it wouldn't mess with my view through the eyepiece.  For those of you who have had the surgery, did your doctor discuss this with you?  If your distance vision was corrected to 20/20, have you noticed any issues at the eyepiece?

 

Thanks,

Harry



#2 jimr2

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Posted 14 August 2019 - 07:21 PM

Hi Harry,

I had cataract surgery in both eyes last fall, and both were corrected to 20/20 for distance vision, and no, I have no problems seeing objects clearly thru a telescope, binoculars, camera viewfinder, etc. Since I had the type of lenses put in that are for 20/20 distance vision correction, I do have to wear those cheap kind of "reading" glasses you can buy at drug stores, Costco, etc, for reading or any up-close work, like reading computer screens, etc, so I usually do remove those glasses--if I have them on--when looking thru eyepieces of telescopes, camera viewfinders, etc, but since you can change the focus of a telescope by turning the knobs on the focuser, getting a well-focused view is no problem. Ditto for camera viewfinders as you can adjust the little diopter knob on most all DSLRs, etc.

And even if I were to wear my reading glasses at the 'scope, again since you can change the focus of the 'scope, again that would be no problem. If your eye doc has not already discussed it with you however, you should talk to him about the 3 types of corrective lenses available to be used in cataract surgery. like I said, I have the ones that are best for distance vision, but there are others that are optimized for closer up, and yet another type that are supposed to be pretty good for both closer up and distance--think they are called "adaptive" lenses or some such terminology--and while that type may sound the best way to go, my eye doc said that since they are neither optimized for close-up, nor distance vision correction, they are not as good as the types that are optimized for either close-up, or distance vision correction, so again I decided to go with the type that are optimized for distance correction as it sounded like that would work best for me and my life style, etc.

My surgeries went well, but I do have a couple small issues or "artifacts" that resulted from the surgeries. One is that all bright points of light--like stars and bright planets--and street lights, etc--have very small "spikes" of light coming off them. Fortunately however, the spikes of light are oriented somewhat differently around bright lights thru each eye, so that by looking at the lights, stars, etc., with both eyes, they just about cancel each other out, so aren't very noticeable or troublesome. And curiously, when looking at stars, etc., thru a telescope, once I focus on the object using the focuser, the spikes are no longer there! So again, that hasn't been much of a problem for me. The other thing is that I "see" bright flashes of light out of the corners of my eyes when I'm outside in the dark--or in a dark room--when I turn my head or eyes quickly from side to side. Apparently this is a fairly common side-effect of cataract surgery from others that have had the surgery that I've talked to--as are the light spikes. Some have said their light spikes went away in time, but mine are still there! So you can discuss all this with your eye doc before your surgery, but I am sure that he/she will say that there's no way that they can guarantee that none of these side-effects will not happen to you, but for me who was almost totally blind before the surgery, the surgery has been nothing short of miraculous! My last pair of regular glasses (I've been near-sighted most of my life) only lasted 5 mos before everything was a giant fuzzball again, making it dangerous to drive, etc. My eye doc said each new prescription I got for glasses after that would last a shorter and shorter time before I'd have to have them replaced with a new and stronger prescription, so that convinced me to go ahead with the surgery.

Anyhow, talk to your eye doc about all this, and good luck with your cataract surgery when you have it done!

-jim-
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#3 Richard O'Neill

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Posted 14 August 2019 - 07:23 PM

"He said in that case he might not correct my distance vision to 20/20 so that he could preserve my near vision, so it wouldn't mess with my view through the eyepiece."

 

 From that statement it's apparent to me that your doctor may not be aware (or understand) that telescope optics can be refocused to accommodate normal through a degree of myopic vision. Chose whatever seems best for you but I've been down that road and it's a lot better to have 20/20 vision for distant objects than have to rely on glasses to see much beyond your nose or arm's length. Of course you may need glasses for close inspection and reading but that's easily compensated with reading glasses or simply sufficient illumination to restrict your entrance pupil which improves resolution. 

 

PS.

 

 The September 2014 issue of Sky & Telescope contained an excellent article titled, 'Cataract Surgery for Astronomers'.

 

https://www.aarp.org...-cataracts.html

 

https://www.cloudyni...taract-surgery/


Edited by Richard O'Neill, 14 August 2019 - 07:40 PM.


#4 siriusandthepup

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Posted 14 August 2019 - 07:31 PM

It's really about whether you want close vision or distance vision.

 

For me, I wanted distance vision. I can watch TV, drive (day or night). See a full field of stars in the sky actually look like stars.

 

The penalty? My close vision got a little further away. Before surgery, I could see the computer perfect without glasses. Now I need my cheaters (reading glasses). I knew the trade-off when I made my choice.

 

Everything from about 4 feet to the horizon is sharp. I'm happy. I see better now than any time in my life.

 

Think carefully on your priorities.

 

Focusing the telescope doesn't come into play really because that's what the focuser is for. On the other hand, if you want to be approx where the general public is focus-wise, then you must opt for the distance vision option.

 

Good luck, I consider the cataract surgery a net positive. Hope it goes well for you as well.



#5 frankreed45

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Posted 14 August 2019 - 08:25 PM

I cannot remember how long ago I had my cataract surgery. I have 20/20 in the right eye ( which is the eye I use at the eyepiece 99.9% of the time) and 20/25 in the left eye. I have had no problems at the eyepiece. I do use readers for close up . When I was going to have the surgery I was told there is lens which will give you both distance and close up . I said it sounds like a bifocal and was told that's exactly what is - I DESPISED bifocal glasses when I had them and I advised the doctor that I was interested ONLY in distance vision. Like I said - no problems at the eyepiece. 



#6 TOMDEY

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Posted 14 August 2019 - 08:34 PM

It isn't in my immediate future, but probably in the next 6-12 months.  Talked with my eye doctor today, and mentioned observing through the telescope.  He said in that case he might not correct my distance vision to 20/20 so that he could preserve my near vision, so it wouldn't mess with my view through the eyepiece.  For those of you who have had the surgery, did your doctor discuss this with you?  If your distance vision was corrected to 20/20, have you noticed any issues at the eyepiece?

Thanks,

Harry

Hi, Harry! YIKES! No, no, no... your doctor is no doubt a fine eye surgeon... but he completely misunderstands how a telescope works. He must think that a telescope makes distant objects look like they are right there... like pictures in a book, or something. But, properly/nominally used, a visual-use telescope is intended to be afocal. What that means is object at infinity (aka far far away) and image magnified, but still appearing to be far far away. e.g. The moon, at 100x...appearing to be 2,000 miles away, rather than 200,000 miles. Both distances are effectively at infinity, as far as your eyes' foci are concerned.

 

Let me put it this way... You would like to see the stars, naked eye, ideal dark sky, dark-adapted... to look like glorious dot stars... right?! Imagine that, remember that... from childhood?

 

I discussed all that with my surgeon, and insisted on "Astronomical Infinity" for my correction... and he understood, and pretty well nailed it! 20/12.5 each and both eyes, looking at stars, naked eye, dark adapted. "Results may vary."

 

If he were to execute what he described to you... the stars will look like round marshmallows, without glasses!

 

PS: Some surgeons are knowledgeable and embracing the Astronomical Infinity stuff... but many seem to either be unaware, or (even worse) not even understand the concept. I'm not putting them down, just know (from experience designing ophthalmic instruments and photogrammetry workstations for B&L, etc.) that the expert users of instruments, most often are quite weak regarding how those instruments work!    Tom


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#7 Cotts

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Posted 15 August 2019 - 08:59 AM

What Tom said. 

 

 I also got the 'Astronomical Infinity" lens correction.  This is to correct for "Night Myopia" (which term the doctors may actually know....).  In my case, with a very skilled, open-minded surgeon doing my testing (to the extent that he turned off all the room lights and let me dark adapt for 20 minutes before determining my particular degree of night myopia), I got 1.0 diopter "overcorrection".  So I need to wear 1.0 diopter "Cheaters" for daylight distance viewing, driving, watching TV etc...  I've been wearing glasses since childhood so this was a zero-adjustment for me.  For reading, computer use I use 2.0 cheaters and I have a pair of 3.75 cheaters for when I have to do 'thread a needle' up-close work...

 

When I'm dark adapted I do not need those 1.0 glasses.  Perfect, tiny, pinpoint stars!!!  If I put on the 1.0's the stars lose focus noticeably.  The doctor nailed it! 

 

Something else to consider:  if you have significant astigmatism it can also be corrected with 'toric' lenses.  I had 2.25 (L) and 1.25 ® diopters of astigmatism and it was corrected to 0.50 and 0.0 with these nifty lenses.  (My left eye is deformed from birth, something about the shape of my retina, and that's the best he could do....Cost you more $, though, about $1500 per eye extra.....worth every penny in my opinion!

 

Dave   


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#8 bobharmony

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Posted 15 August 2019 - 09:27 AM

I had the right eye done this March and had it set for distance and have been quite happy with that at the scope.  When I get the left eye done, I may opt for a close-up focus there.  For now I use cheaters for computer, reading, and other close-up work.

 

More important to me is that the doctor corrected for my astigmatism.  That has freed me from the need for glasses when looking through the eyepiece, and since I don't use binoculars (I have no capability for binocular vision), I am a happy astro camper.  I did an outreach last Friday with a couple of newbies, and having no need to fiddle with focus when switching who was viewing was a plus.  It also gave me a good idea of how well they were focusing the scope on their own, a skill which they picked up pretty quickly.

 

The process itself was very smooth.  I had some spikes for a while while the lens "settled in", but now they are gone.  I did discuss astroviewing with the doctor and recommend that as a good thing to do.  It turns out he was used to looking at the early morning sky, and I was able to get him his first-ever view of Saturn in the pre-dawn twilight at the time.  I also dragged in some prints of my AP work at his request, and he was able to identify things like M31 and the Orion nebula :)  Biggest pain in the butt for me was the eyedrop regimen that started two days before the surgery, and went for three weeks afterward.

 

Bob



#9 trapdoor2

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Posted 15 August 2019 - 09:49 AM

Had both of mine done last year (before I owned a telescope), corrected to 20/20. No issues with the surgery, etc. No issues with the scope either. The diopter of my reading glasses didn't change either.

 

However, I was concerned with my peripheral vision. I explained to them that I was sensitive to stuff being in my peripheral vision (I have always bought my glasses based on whether I can see the edges or hinges in my peripheral vision...cause I don't like that). Answer: no problem, you will initially see the edges of the implant lenses but that will "go away" after a while.

 

Not. I still see the lens edges. I did eventually get used to it, but sometimes those little gray parenthesis will catch my attention. At night, they can occlude point light sources coming in from the edges of my vision and as my eyes move, I'll get a flicker as the edges pass over the source. Took me a while to figure that out. I've always had excellent night vision, I tend to leave all the lights off in the house after the sun goes down. Very soon after the surgery, I was sitting in the dark in my favorite chair when I saw a blinking light out of the corner of my eye. Turn to look for it...nothing blinking. Turned out to be an LED on a wall-wart...perfectly positioned to be occluded by the lens edge as my eyes moved (I shifted my chair).

 

It really isn't that big of a deal. However, just a month after surgery I did pick up a miserable floater (off center, thankfully), a tiny thread of stuff that floated in and stuck to the lens in my left eye. One end is stuck to the lens and the other waves around as my eye moves. Had my one-year checkup last week and the doc shrugged, "It happens. Nothing I can do about it unless it is so bad that you want another surgery and no guarantee it won't happen again."

 

Meh, I'm just thankful that I'm 20/20. I can buy sunglasses off the rack, cheap readers too.



#10 Migwan

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Posted 15 August 2019 - 10:06 AM

Choosing not to go with 20/20 to preserve close vision also has to do with what level of astigmatism is present.   As they have had a lot of trouble with the more expensive lenses for astigmatism, many doctors don't care to recommend them.   If the OP has astigmatism less than a diopter, then something in the order of 20/25 will allow him passable near and far vision.   I actually asked my doc about this, but would have ended up with 20/30 and 20/35.    Personally, I dislike reading glasses and would have settled on 20/25, if it would have preserved my near vision.

 

I like what Dave did, having done something similar, though perhaps not as effective.  I had him measure my pupils while dilated and described to him the effects of lens edges hitting the exit pupil.     That is, spikes and such.   Surprisingly, he said dilation was 7mm and he managed some large lenses for me.  Those spikes have not been a problem for me up to a 6mm exit pupil, as long as I get my pupil well centered.   So make sure he/she isn't using the smaller lenses I have seen in others peoples eyes in the past.

 

Another thing is to ask if he/she blocks the optic nerve before the surgery.    Blocking the optic nerve has its own risks, separate to the surgery.   It can cause serious problems like a loss of convergence.    I went with a doctor who only blocks the optic nerve where absolutely necessary.   There is much information about this procedure online.

 

Two things I would like to say about cataract surgery.  What a life changer and haven's sake, don't wait. 

 

jd



#11 denny-o

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Posted 15 August 2019 - 10:27 AM

Well, I just went through the cataract check routine and the surgeon declined to do the surgery. He said I correct to 20/20 and 20/25 so it is not indicated. I am wearing a new pair of $500 glasses, over and above the $200 consultation, and I do see better than I was with the previous glasses. But I am still glasses dependent 100% of the time and have to have a couple of back up pair of glasses just in case because I am 20/200 without. (shakes head in disgust)



#12 hboswell

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Posted 15 August 2019 - 10:36 AM

I find it interesting that so many of you use your right eye at the scope - as long as I can remember, I've used my left eye.  Maybe that's because my right eye is so much worse - it peaked at -11 diopters before starting the old-age march back.

 

Harry



#13 Jim4321

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Posted 15 August 2019 - 10:46 AM

I had both eyes done about 12 years ago, before making a serious return to this interest.  I was extremely near-sighted before.  After, I was bothered considerably by glowing rings around bright lights at night, but that pretty much went away in about two years.

 

My biggest gripe is that I wound up a bit too far-sighted.  I need corrective lenses at the computer screen or reading or driving (instrument panel).  This interferes with my use of a hand control or tablet; my arms aren't quite long enough to bring tham to focus. I end up taking my glasses off for the EP, and putting them on for my tablet.  With a granny strap, it's not a bad issue until it gets cold.  Then it becomes a PITA to have to tuck the temple pieces under my cap's ear flaps each time I need to see the tablet.   

 

But at least the stars and room lights aren't yellowish any more, and my prescription hardly varies over time any more.

 

Jim H.



#14 bobharmony

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Posted 15 August 2019 - 10:50 AM

Well, I just went through the cataract check routine and the surgeon declined to do the surgery. He said I correct to 20/20 and 20/25 so it is not indicated. I am wearing a new pair of $500 glasses, over and above the $200 consultation, and I do see better than I was with the previous glasses. But I am still glasses dependent 100% of the time and have to have a couple of back up pair of glasses just in case because I am 20/200 without. (shakes head in disgust)

Not to go off the deep end - you can blame the insurance company for not allowing the surgery.  I have the same with my left eye - it can be fixed with glasses so no surgery until it can't.  Of course I don't wear glasses anymore because my right eye is 20/20, but that isn't important to them.

 

What I wanted to add here is that my astigmatism was corrected by laser surgery, then the lens was replaced... all in about 20 minutes! 

 

Blocking the optic nerve? Hadn't heard that one - I would have missed an impressive light show if they had done that :)

 

Bob



#15 siriusandthepup

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Posted 15 August 2019 - 10:58 AM

 

I also got the 'Astronomical Infinity" lens correction.  This is to correct for "Night Myopia" (which term the doctors may actually know....).  In my case, with a very skilled, open-minded surgeon doing my testing (to the extent that he turned off all the room lights and let me dark adapt for 20 minutes before determining my particular degree of night myopia), I got 1.0 diopter "overcorrection".

I did not go this route, but an alternate. My Doc was also very cool and we discussed Night Myopia. He targeted my daylight vision at 20/20 and he nailed it. Due to the night myopia at night I am about 20/25 - still good enough to drive. Stars look good but not quite perfect.

 

He let me borrow a couple sets of "flippers" to bring home and use at night so that I could zero in on the exact correction. Flippers are lenses on a stalk with various corrections. I think I had both -.50 and -.75 diopter flippers. I gave him his flippers back and told him what I needed to correct my night myopia. He gave me a prescription as I requested for "astronomy night glasses". I now have a set of very mild myopia correction glasses that yield absolute pinpoint stars and I can also use these glasses for night long distance driving just to be a bit more comfortable. Of course I had these glasses made with all the good coatings. :) I don't wear these every night as the stars look OK without them in my driveway. I do take the glasses if I am going to a dark sky site.



#16 GeneT

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Posted 15 August 2019 - 06:29 PM

I find it interesting that so many of you use your right eye at the scope - as long as I can remember, I've used my left eye.  Maybe that's because my right eye is so much worse - it peaked at -11 diopters before starting the old-age march back.

 

Harry

I am also left eyed.



#17 GeneT

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Posted 15 August 2019 - 06:33 PM

I am 76 years old. Every year, my opthamologist tells me that I have some minor cataracts, but not nearly enough for surgery. Last week I had my annual eye exam, and was told the same thing. On a related note, when moving up into the 'older' category, I strongly recommend finding a good opthamologist for your eye care. 


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#18 Chucke

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Posted 16 August 2019 - 06:50 PM

My Ophthalmologist told me my cataracts were not bad enough to need being fixed.  I did it anyway.  Insurance paid for it except for the extra cost of having it done by laser. That part was out of pocket.  The Dr. did a really good job.  It made a hugh difference.  The night sky went from being murky to brilliant. The moon is white now instead of greenish yellow.  I don't think they will tell you need the procedure unless you are nearly blind.



#19 TOMDEY

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Posted 16 August 2019 - 07:35 PM

What Tom said. 

 

 I also got the 'Astronomical Infinity" lens correction.  This is to correct for "Night Myopia" (which term the doctors may actually know....).  In my case, with a very skilled, open-minded surgeon doing my testing (to the extent that he turned off all the room lights and let me dark adapt for 20 minutes before determining my particular degree of night myopia), I got 1.0 diopter "overcorrection".  So I need to wear 1.0 diopter "Cheaters" for daylight distance viewing, driving, watching TV etc...  I've been wearing glasses since childhood so this was a zero-adjustment for me.  For reading, computer use I use 2.0 cheaters and I have a pair of 3.75 cheaters for when I have to do 'thread a needle' up-close work...

 

When I'm dark adapted I do not need those 1.0 glasses.  Perfect, tiny, pinpoint stars!!!  If I put on the 1.0's the stars lose focus noticeably.  The doctor nailed it! 

 

Something else to consider:  if you have significant astigmatism it can also be corrected with 'toric' lenses.  I had 2.25 (L) and 1.25 ® diopters of astigmatism and it was corrected to 0.50 and 0.0 with these nifty lenses.  (My left eye is deformed from birth, something about the shape of my retina, and that's the best he could do....Cost you more $, though, about $1500 per eye extra.....worth every penny in my opinion!

 

Dave   

Hi Dave, Cool! And yes, that's what I opted for. It took a surprising long time for my eyes to entirely stabilize... and, thankfully... they asymptoted to great Astronomical Infinity correction! In my case, the Right eye is perfect, and the left still has a bit of astigmatism left in there. I have glasses that correct that and also provide graded for near stuff as I look down toward the bottoms). That's been quite stable for a few years now. And my left has a gargantuan floater that often migrates right over my pupil. So far, the surgeons refuse to attack it... Geesh!   Tom



#20 hboswell

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Posted 16 August 2019 - 07:42 PM

My Ophthalmologist told me my cataracts were not bad enough to need being fixed.  I did it anyway.  Insurance paid for it except for the extra cost of having it done by laser. That part was out of pocket.  The Dr. did a really good job.  It made a hugh difference.  The night sky went from being murky to brilliant. The moon is white now instead of greenish yellow.  I don't think they will tell you need the procedure unless you are nearly blind.

He's told me I need it, but Whether I have it now or in 6-9 months is my decision, it won't get markedly worse in that time.  And he's recommended Toric lenses to correct my astigmatism, which is fairly significant.

 

Harry




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