I'm a cop with Astigmatism and Cataracts- What lens should I choose?

Hello, and thank you in advance for help.  I am a 33 year old cop who has never worn glasses and always had excellent vision.

I recently switched to day shift and the blurry vision sent me to the doc, who diagnosed me with cataracts.  I have a tremendous amount of anxiety regarding putting a lens in my eyes, but really have no choice.  

I'm realtively young and have never worn glasses so I'm leaning towards the multifocal or accomodating lenses. I'm a night-owl, so I have concerns about night vision problems.  I love to read and would like to be able to read comfortably. On top of all of that I have concerns about the "hinge" on the crystalens...there's the possibility of my living another 50 or more years-will the hinge hold up with constant use for that long?   I have to make a choice tomorrow...help....  

[Forum-OD-MP]

wow.  i'm sorry.  i'm not a surgeon.  i mean i know about these things, but as for whether the "hinge" will last 50 years, i dont know.  i assume they're fairly durable.

but as young as you are, you're right...you need to consider some type of multifocal.

[K-D]

No one but you, can really decide  on the lens that is right for you.  But please do not make a decision tomorrow.  You have to investigate all the possibilities and not be rushed into this decision.  You will have to live with your choice the rest of your life, unless you want to risk additional surgery to change the lens.
What did your doctor suggest to you, knowing your profession?  What do you know about your doctor?  That is really even more important than the lens, in my opinion.
Would traditional lenses with glasses be alright with you, to avoid the possiblility of circles, and halos at nighttime?
What about monovision?  But would the loss of depth percepton be a problem for you?

I am so sorry that you have this decision to make at such a young age.  Did you get a second opinion?
There are so many things to consider. Please consider all of them before making a rushed decision that you may regret.  The BEST of wishes for you!

[K-D]

Would it be possible for you to wear glasses at this time to correct your blurry vision?  Many people get by for years, with corrective glasses, before cataract surgery.  Then that would also help you to make a decision about your choice of IOLs before your surgery. Maybe glasses will not be a problem for you. And some people with the traditional IOL only need glasses for reading.
And every year IOLs are getting better.  So,the longer you can wait before your surgery, the better, unless, of course, medically contraindicated. Don't rush into this if it is not necessary and you are unsure about which route you want to take.
K-D

[JodieJ]

After reviewing your medical history, examining your eyes and discussing your job duties, lifestyle and vision-related goals, your doctor should be able to make recommendations about what would be best for you.  You could consult more than one doctor for another opinion if your insurance plan allows it.  If not, your best bet would be to follow your doctor's recommendations.  Good luck, and keep us posted.

[K-D]

The thing that concerns me about silverbeard's post is that he is a policeman. He also states that he has astignmatism.  I am very satisfied with my multifocal lens.  However, with I see at night, severe halos and circles around anything that reflects, I cannot imagine driving in the capacity of a policeman.  Then again he may not have the same visual aberrations that I do.  I do not do a lot of night driving so my night aberrations do not matter that much.  However, as a policeman, Silverbeard will have to do a lot of night driving.  And also how would the possible night halos, circles, and glare, affect his ability to see an object, should he need to use a weapon?  To me, his occupation and livelyhood is of more consideration than his age.  Just my opinion as someone that has a multifocal and cannot imagine functioning as a Policeman with my night aberrations. Keep us informed Silverbeard on what you decide to do and the outcome.  The very best of luck to you!!!!!!!!!

[silverbeard]

I have been doing a considerable amount of considering. There is no escaping that night aboritions would be a detriment to my safety and the safety of others because of my profession.  My doc has strongly recommended the crystalens and I am going to go with it.  

I would rather put the whole thing off (indefinitely).  However-as my doc has pointed out, the cataracts are not small.  Also, they are affecting my daily activities to a level that is simply unnacceptable.  

I sincerely appreciate everyones input and I'll let you all know how things go. Thank you.

[K-D]

Silverbeard,

I wish you the very best outcome possible!!!!!!!!  Keep us informed. My thoughts are with you. K-D

[The Queen]

From personal experience I tell you that you will be very happy with the crystalens.  How much astigmatism do you have? - when are you having your surgery?

[The Queen]

From personal experience I tell you that you will be very happy with the crystalens.  How much astigmatism do you have? - when are you having your surgery?

[silverbeard]

Hello Queen.  The operation on my right eye will be next week.  The cloudiness in that eye is progressing rapidly and I will be happy to see clearly. I have no idea how much astigmatism I have.  Having never had complaints regarding my eyes before now, it seems everything I hear is in a foreign language and I am apparently not asking all of the right questions.

[pmhettick]

Silverbeard,  I had Restor lens placed in both eyes 3 weeks ago;  the halos around lights and glare are pretty bad.  Even if it gets better, I don't think you would be comfortable in your profession with all the distortion these lenses cause.  It's hard to understand until it's all over what the outcome will be.  I wish I had read and researched this forum before I had my surgery.  Shouldn't have been in such a hurry!  You'll be required to testify in court some day and an attorney would tear you apart if he knew you saw distorting halos both night and day.

[hud]

I have had bilateral Restors for many months, and the halos are not an issue for me, nor the vast majority of patients. Ask your doctor about the new astigmatic "AcrySof Toric" implant that Alcon has. It is the most reliable way to address cataracts with astigmatism, short of laser surgery.

[pmhettick]

My doctor is Paul Ernest from Jackson Michigan and I read where he had done studies and reported on the toric implant but he didn't even mention its' existance to me.  My astigmatism is very slight or at least was.  -.25 in one and -.75 in the other.  I don't think these lenses are put in unless the astigmatism is 1.25 or greater.   The only thing he said was that I might need some lasik tweaking for astigmatism to sharpen images.  Do you know how long I should wait for the lasik and will it improve close-up vision?  My distance is very good and has never been very bad.  I only needed bifocals for distance after 40.  Does a person's astigmatism change after the restor implants?  This forum is great.  I have learned a great deal and it's always comforting to hear from others all across the country who are experiencing the same things.  I feel much less anxious about the surgeries than I did just a week ago.

[hud]

My goodness, Paul Ernest has done more ReSTOR lenses than anyone in North America. You are in good hands. I know for a fact that he was one of the FDA clinical investigators for ReSTOR, so he has a long track record as well. Your amount of astigmatism usually is not enough to degrade your final vision. If Dr Ernest feels that treating that .75 is worth it, go with his advice. Sometimes .5 residual astigmatism bothers some, but usually not.

[silverbeard]

Well, today was the day for right eye lense replacement.  I was struck as I looked around a parking lot, on the way home, how things had a sharper (blue?) look to them.  I closed the right eye and tried the left and saw a world with a yellowish tint.  Is that the cataract in the left eye???  I am anxious to see the difference in vision between what was my "good eye" once the crystalens eye has healed significantly to accurately judge.

[K-D]

Wow.  Good for you Silverbeard!  Already seeing clearly.  Yes, the yellowish color is from the other cataract.  When I close my eye with the implant, everything is very clear.  When I look through the eye with the cataract, things are yellowish or slight brownish. And I thought I my paint was getting dirty before my cataract surgery. ;-)

[silverbeard]

Hello to all.  I am amazed at the clarity sight that I have.  I am attributing the ghosting/double vision to the fact that it is only day 1, after the surgery.  

I did notice sometihng weird and wondered whether it would disipate.  I noticed that if I look at a small (diode sized) light (specifically, the one off of my electric razor charger) while in the dim light of my room, that there was a band-aide shaped outline of a halo with four dots at the four corners of the circle in my filed of vision.  

Having seen pictures of the crystalens, I'm certain it is the outline of the implant.  My question is, will this disipate or is this a quirk for life??

[K-D]

Sorry, I cannot answer that question. But I do know that you are just recently post- op, and a lot of changes will take place as you heal. Hopefully, this will  disappear. Sure wish this was my only abberation. Sounds like you are doing terrific!  Please keep us updated.

[Rubberduck]

Just found this site.  Hope all goes well with you.  I had one eye done in May (though not with a multifocal IOL-wish I had!)  All my halos and funny lights went away in a week or so.  I, too, was shocked at the difference in color.  Keep us posted on your progress.  I need to have my other eye done at some point in the future and I really want a multifocal lens.

[K-D]

Generally the doctors do not believe that a multifocal works well with a traditional lens.  It is not the same system and confuses the focusing of the eyes.  Do you wear glasses with the eye that had cataract surgery? If so, do you need them for reading only or do you have to wear bifocals.  Did you wear glasses before the cataract surgery?

[Rubberduck]

Yes, I've worn corrective lenses since I was a child and, up until 3 years ago, contacts for more than 30 years.  My cataract development accelerated when I had to do chemo.  I'm very glad to be in remission but my night vision was becoming bad enough that driving to work in Alaska in the winter was getting scary.  My vision is R-.50 w/just a touch of astigmatism and L-.25 w/same astigmatism.  However the operated eye is now +2.25 and the unoperated +1.75.  So I really need bifocals or readers.  I find glasses very uncomfortable and end up taking them off all the time since I see distance fairly well w/out them.  Plus the bifocals aren't good at work on the computer.   I think I've finally talked my doctor into letting me try bifocal contacts.  I know the vision won't be perfect but if I could get near correction to even +1 I would be able to do most things w/out glasses.  If we can't make them work I'll have to go to computer glasses.  I know most doctors don't want to mix single focus and multi focal IOLs but I'm refusing to have the other cataract done until I am very impaired in that eye.  I'm not even 50 yrs old yet and it is literally frightening to have my close vision so bad.  I'm hoping that if the bifocal contact works well enough I may be able to have a a multifocal IOL in the other eye.  Any thoughts?

[K-D]

Gosh rubberduck,  Sure wish I had the answer for you.  But if I were in your position, I would hate wearing glasses too, but it would not be a new adjustment.  It would be an already inconvenience.  And I was told too, that mixing monofocal and multifocal do not work.  And I am guessing it would be hard on the brain to adjust and be more of a problem for you.  And you could be stucked with unbalanced vision as well as night aberrations.  I sure do not want to tell you what to do.  But I would really give it a lot of thought. I heard they have contacts that can be worn over night now.  Would that be an option for you?  Wishing the very best for you!!!

K-D

[K-D]

Another option would be monovision.  You already have the one lens measured for distance.  The other could be set for near.  But you would have to wear contacts first to see if you could adjust to the lack of depth perception.  I could not.  It was visually strange to me.  Just keep investigating all the options and maybe before you need the other eye done, they will have come out with a multifocal that works with a monofocal. Best Wishes.

[gbakes]

Howdy!  I just had 2 MONOFOCAL IOLs implanted recently with the R eye set for distance (20/15) and the L eye pulled in "just a touch" to make things readable.  I can read the computer (doing it now w/o glasses) BUT glasses do make it super sharp.

I decided NOT to go with MONOVISION but rather the setup I currently have.  This allows me to see receipts and phone numbers easily and quickly without glasses (I was also able to read a newspaper on the seat next to me in my car without glasses)

But, for long days working at the computer I am going to get a set of computer glasses that are progressive lenses with the top set for the computer and the bottom set for reading CU.

I hope this might ease you worries about having to go with 2 MONO iols.  I think if your DR does it right you can have partial intermediate and reading distance without glasses.  Again, adding a pair does make things better.

FYI - I'm 38 M and always had perfect vision (until the rapid advancement of my cataracts within the year) and I completely happy with my new eyes.  The thing I love is NO HALOS or glare of any kind.  So clear!  Hope this helps.

[K-D]

Sounds like excellent advice to rubberduck!.  gbakes, I tried to send you an email question, but it wound not through.

[gbakes]

Sorry, K-D.  It's ***@****  I forgot the G.  oops.

[Rubberduck]

Thanks for the feed back.  I'm a notoriously deliberate person.  My husband accuses me of procrastinating but, since I have to live the decisions I make, I'm really thinking very hard and covering all my options.  Especially with something as serious as the very precious gift of sight.  Wearing a contact overnight would not bother me but, according to my dr, my best shot at a functional bifocal contact will have to be a hard lens.  Which I know cannot be slept with.  I like gbakes suggestion and I might see if I could have a try at that with a contact lens to see how it would work before I do anything surgically.  I've tried monovision but the IOL is in the non-dominate eye and after several hours things start to blur.  I still have a fatigue issue which the doctor tells me is a facor in the way my vision fluctuates, ie just like any other muscle, when the eye's tired it doesn't work as well.  I know it doesn't sound like it but I really am very gratefull to have the sight I have.  But since I do have some power over what happens next I want to explore all options.  Thanks again.

[K-D]

The very best of wishing to you rubberduck, no matter what you decide to do.  I know what a difficult decision it is to make.

[silverbeard]

Hello all.  It's been a couple of weeks since my surgery and each day I am amazed at how well I am seeing with the new lense.  I am anxious to have the other done and to get ahold of some reading glasses so that I can get down to some serious reading again.  

One thing that I have noticed is that the outer edge of field of vision (I've always had excellent peripheral vision) quivers a bit, especially when I'm in a bright environment.  It's more an annoyance than anything else.  I'm wondering if the new lense is focusing contantly and if that is causing the quivering effect.   Anyone have any ideas???

[gbakes]

Yeah I've noticed that quiver as well - especially in bright light.  I also had excellent peripheral vision and this has been annoying for me too.  However, it does seem to go away with time.  I had my R eye done 7/31 and L eye on 8/7 and, although I still have times when it's bad, it doesn't bother me as much as it used to.

In my NON-EXPERT opinion, it seems to be the edge of the IOL and I don't think there is much one can do about it.  It was really discouraging at first - but I'll take this over the the alternative (horribly cloudy cataract eyes.)

If anyone has any further knowledge about this I would love to hear your thoughts as well.

[silverbeard]

Saw the doc today.  My new Crystalens is doing well, except for a quiver on the peripheral vision in bright light.  It is time to get the other one done and he is recommending ReZoom to bring my intermediat (computer) back into focus.  I was wondering if anyone had had the same thing done and if they were happy with the outcome.

[silverbeard]

I would be very interested to know which multifocal you had implanted (specifically whether it was ReZoom) since that is what will probably be put in my left eye.  

[K-D]

Silverbeard, I had a Rezoom implanted. Posted  to you also  on another topic.  Best possible outcome for you!!!!!!!

[silverbeard]

hello to those who may be interested in the outcome of my second inmplant...The ReZoom was implanted on 8/24 and is healing nicely.  Again, I am so pleased to be able to see.  

Reading is a problem, and I must admit that I grieve the lose of the excellent vision  that I have had all of my life (but it sure beats the alternative).  

I havent done any night driving as of yet, but I haven't noticed any aberritions walking past lights at night (except for the ones I have with the Crystalens).  I'll give them a little more time to settle, but I'm thinking the combination of the two lenses will turn out to have been the right choice for me.  

I feel blessed to have had the good fortune to have an excellent doctor and surgean.

[K-D]

Fantastic Silverbeard!!!!  So good to hear you are doing so well!!!!!  Great news.

[grannyk59]

I had crystalens implanted in both eyes year ago June & July.  I had to have two zag surgerys and both eyes vaulted (that is when they go to only seeing distance vision)and had to have surgery to put them back in position.  I have great vision, no problem with halos or any of that since eyes have not been dilated after the surgerys.  But & it is a big one.  I have blurry vision in both eyes in the outsides of my line of vision.  They flicker cause I blink my eyes.  It has gotten worse in the past 2 to 3 months.  I go back to dr for scheduled check up and I am ready to have them removed.  I have not worn glasses, (had to have glasses for reading, computer and driving) in over a year.  You are to use your eyes for reading as much as you can to help exercise the muscles that having been working for a long time.  It was only in one eye until they vaulted & after put back, it is now both.  Where it used to be way on the outside of my vision, it is now like I am wearing blinders.  You know like they used to put on plow horses.  I have headaches all the time.  It seems I am the only one that my dr has that has this problem.  My cousin even went to the same dr and had the crytalens in both eyes and no problems at all.  he is thrilled.  Just wanted everyone to know that not always does it settle down.  Or go away.

[T Keseler]

Hi my name is Ted Keseler. A month ago I had a ReStor lense put in my right eye. When looking at a small bright sun spot on a crome bumper of a car I see a silver target made up of multaple circles and they are as bright as the sun spot. Stop lights look like large Targets. I was told that it will get better when I get the other one putin the other eye.Hay folks I didn't just fall of the turnup truck. I hope to get more info before I make any decision. I hope this sight devlops more info.
                                          Thank Youall Ted.