I'm new on this site but I have read a lot of posts here for some weeks. I have been searching many questions but I haven't found the answers I need.
First, I start with the problem I have: I have JRA since the age of 11 months and have taken steroids since around the age of 1 year. Due to steroids I always have had some arthritis cataract. Now I'm 30 and the cataract started to puzzle my eyesight a bit. But it wasn't the problem I went to a specialist with last year. My eyes inflamed from a long-time computer usage and my mom frightened. There the doctors said it's cataract which can be operated. Then I wasn't so afraid of it as now. The doctor who examined me said only a few words about the surgery and I was looking for it at home on the Internet. I was searching a lot, for almost everything about this topic, and now, this month I was talking to the doctor who took over the surgery from the other doc. We talked about all the kind of lenses that are available now - anyway, I'm from Europe - and about the severity of the cataract. He said that the cataract isn't so severe but it's in wrong position, in the centre of my eye lens, and offered the monofocal lens because of the low risks. He mentioned Restore multifocals and he had quite a bad opinion about Crystalens because none of his patients were satisfied with this lens. I don't want multifocal lens at all because of the halos, glares and other problems, nor the Crystalens but other accomodative lens could be considered. I read about Synchrony, Tetraflex and other options but I still don't know which is the best and, unfortunately, most of them are under tests. My doctor said the drawback of the Synchrony is that it's from 2 parts and Tetraflex is almost the same as Crystalens - the result cannot be predicted and the accomodation is very low. I understand it and I agree but I don't really want to see only in one distance. The doc said there is a way that the monofocal for distance can be set for intermediate as well. Anyway, he doesn't offer monovision - maybe because of my JRA - it wouldn't be too safe for me if I fell. BTW I can see in all distances, even the small letters, but sometimes distant reading vision isn't perfect. As for my habits: I love reading, doing crossword puzzles, crafting, and all the things that need very good near or close-up vision, furthermore I'm a kind of artist and go to an artists' club every week. Moreover, one of my biggest activities is using the computer. I mostly work on it, so I use it half a day almost every day. And another hobby is watching TV. So I mostly need near and intermediate vision, but distance vision is also a must. I don't really want glasses, especially not for reading and near tasks - I don't want to lose my good sight for near and seeing small things -, I would rather wear glasses for distance if I must. So I'm thinking of monofocal for intermediate with added near vision, but my fear that how I will see at distant. Could someone say how blurred the vision with intermediate will be to distance? And how near can I see with intermediate with some near vision? Or which accomodative lens is worth implanting? Or shall I wait for some time for better lenses?
My vision at distance: 0.8 D and 0.95 D - as I guessed these are around 20/20-20/25 (J1-J2).
The doctor also said some patients get a really good vision at intermediate and near, some can read normal letters as well with monofocal for distance but I don't really trust in this because I have had so many problems with medicines and cures that worked to others.
So could anyone help me in this question? (The surgery would be 14 February if I'm in)
/A doc on this forum said I shouldn't go under surgery, yet, because of my good vision, and the unpredictable healing due to JRA./
Since you have JRA, the inflammation in the eye could be due to uveitis or iridocyclitis. The treatment usually begins with topical steroids (please do not self medicate as this diagnosis cannot be confirmed on net). Oral steroids, immunosuppressants, and non steroidal anti-inflammatory drugs are all added in a step-wise manner to control the inflammation. Surgery is indicated when there is a cataract affecting the vision severely. I would suggest you take a second opinion from another eye specialist. Take care!
The medical advice given should not be considered a substitute for medical care provided by a doctor who can examine you. The advice may not be completely correct for you as the doctor cannot examine you and does not know your complete medical history. Hence this reply to your post should only be considered as a guiding line and you must consult your doctor at the earliest for your medical problem.
Well, the decision for a surgery is best decided on the symptoms/ visual acuity. If the visual acuity is fairly good and there are no issues in day to day life, a surgery may be preferably delayed; while if there are associated symptoms/ complications an early date may be suggested. It would be best to discuss the situation and the suggested management plan in detail with your treating ophthalmologist.
Hope this is helpful.
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