When should I have Cataract surgery?

[BayGrrl]

I was diagnosed with a cataract in my left eye about 5 years ago. I had noticed "something" in my eye ("from the inside out") several years prior to that and had inquired as to whether it was a floater (I had no idea what cataracts were at the time, but had heard of floaters). Anyway ... my HMO said to wait till I'm 50 before having cataract surgery, but they didn't tell me WHY and I guess I was so shocked at the thought of having a cataract in my mid-40s that I didn't think to ask why! I'm a bit concerned because my HMO premium will go up tremendously when I turn 50 and I'm not at all sure that I'll be able to continue my coverage with them.

The other thing I'd like to ask about cataracts is why some doctors (optometrists, I suppose ... the docs I've gone to in order to get a new prescription for glasses) fail to mention the presence of cataracts. The last doc/optometrist I went to didn't mention it, so I asked "How is my cataract doing?" The doc became flustered and said that she doesn't tell patients about that sort of thing because it tends to freak them out. HELLO??? This doesn't sound like a responsible doctor to me!!! Would you have any comments on this? Is it common for optometrists to NOT mention such things???

Thanks for answering my questions!

[janjan99]

Hi Anita - yes I did for the 1st week or so...It got a lot better when I had the prescription changed in my glasses so I could see more clearly. T think it kinda even things out.  I was able to function then, went back to work, drove and everything.  When I had the second eye done, it was another adjustment.  Everything is getting better as time pasts.  Hope yours is just as successful...Good luck  Jan

[muppet]

Hey Jan - one more question for you - did you find that in between having your eyes done, you got headaches ?  I find it very disconcerting and have had a horrible headache today and wonder if this is the cause.  I don't know how you did it for 7 weeks, it has only been one for me and it is driving me crazy !  Anita

[muppet]

Hi Jan, 5 days out and I can now see my computer keyboard and the numbers on the phone - not always first thing in the morning though, but usually by midday-ish.  And then in the late afternoon, it is as if my eye is tired and I lose a bit of the crystal clear distance vision.  I guess my eye is still healing and adjusting.  Until I have my second eye done and things are balanced out, I won't really know my final outcome.  But since this is my dominant eye, I am guessing it will sit around here.  My surgeon did say that it would either stay the same or slightly improve.  So are you enjoying getting your face totally wet in the shower and seeing the clock as soon as you wake in the morning ?  I always promised myself that I would start swimming again once I was contact lens free and now I am going to have to do it !  Anita

[janjan99]

HI - Sorry yes, my eyes looked different...There was a little bruising where the incision was, but they seemed to look brighter and clearer.  I had a little pain, but nothing the tylenol couldn't help.  I hope your surgery is as uneventful as mine have been. Good Luck...jan

[muppet]

Thanks Jan - it is amazing how quick the surgery is and how long the eye can take to heal. Although it was quick and painless, I am still apprehensive about going through it again ! Your story was the closest to mine, with someone being very myopic so it was great to hear from you.  You didn't tell me if your eyes "look" any different?? All I can see it bloodshot whites right now, so I can't tell.  After 22 years of contacts, I don't mind having glasses just for reading.  Will keep you posted.

[janjan99]

Hi - Yes it is strange to be able to see...For me I can pretty much see everything first thing in the morning....By the evening my vision in 2nd operated eye is not as good, but the surgery was on June 5, so I sure it is still healing....I also bought cheapie glasses just to read fine print.  I can see everything else well....I think I could probably drive without my glasses, but things are sharper with them... They are +1.00 and +1.25..
I hope you have continued good fortune, let us know how the 2nd eye goes...Jan

[muppet]

Thanks for the reply Jan.  I do have another question for you - do your eyes look any different ? What I mean by that is, can you tell that there is an artifical lens in there ?  I can't tell right now, because the white part is still pretty bloodshot (and I can't see close up in the mirror !)

I also have some macular damage which left a scar 16 years ago, so I lost some central vision in my other eye, but it is amazing how much I must obviously still use the peripheral vision, because I am noticing such a huge difference.  I can't wait until they are evened out.  It is very strange to wake in the morning and not be able to focus on my keyboard and now at 6pm the keys are clear. Did that happen to you ?  I bought some +2 cheapie glasses yesterday, but they don't seem so perfect by late afternoon/evening.  So I guess my eye is still settling down.  My surgeon did say that my result will either stay the same or improve slightly.

Thanks for answering my questions.  I can't imagine having the surgeries 7 weeks apart - I have a headache today and I am sure it is because my brain isn't working properly !  I do have to say though, that waking up this morning and being able to see my alarm clock immediately was the most bizarre feeling - I am sure it was the same for you.  

Thanks again, Anita (in Australia)

[janjan99]

I so glad all went well..Yes it took about 3 weeks for my eyes to settle down.  It should be much easier for you, with 2 weeks between surgeries.  Mine were more like 7 weeks between surguries.  So I had one great eye and one not so great...But I notices a few days after the second surgery that my eyes were working together....It is very weired, but a blessing all the same... I will continue to pray for you speedy recovery and if you have any more questions, I will be happy to answer....I will be checking here for your progress....I think the people here, are a godsend.  The staff in the drs. office are nice, but t really is nothing like talking with someone who has gone through it.  I remember thinking if I could help anyone here, I would be happy to, that why I continue to read.  

I hope you have a speedy recovery...."Jan"

[muppet]

Hi Jan (I think JanJan means your name is Jan !)
Not sure if you are checking here still but thought I would let you know that I have had one eye done and am happy with the result so far.  I am finding the adjustment weird because I have gone from being extremely near sighted to now having perfect distance vision and needing reading glasses !  All in one eye of course, becuase my second surgery is in two weeks.  But so far I don't need anything for driving etc, but am +2 for reading.  (At least I can get some nice looking glasses now - it's like a new fashion accessory).  Did you find it took long to adjust to needing glasses for reading etc - I can't read my watch !  But am so happy that I will wake up and be able to see, shower and even swim without worrying about losing my contact lenses !  It was great to throw it away today.  I could even reading the logo on the bottom of the eye chart as well as the bottom line!

Anita

[muppet]

PS:  Jan, I was wondering if it took a few weeks for your eyes to settle to the reading script you need now ?  Mine seemed to fluctuate yesterday (24 hours post op) to where it wasn't as bad and then this morning is back to the +2 again.  Just wondering if this happened to you.  I got a monofocal lens.

[janjan99]

Good luck , hope all goes well...Keeps us updated...jan

[muppet]

Thanks - my surgery is tomorrow, so I can't tell you how your posts has eased my fears !  (I also have some retinal problems, but have to get this surgery, so what will be will be).  -9.0 is nothing to be sneezed at, so you will have noticed a huge difference in lifestyle.  Thanks for your response.

[Belledonna]

Ihave read that there is a newer trend of thinking not to let the cataract get "ripe" before removing it.Some doctors are even replacing the lens when there is no cataract with the goal's being to provide the middle aged patient with better acuity--using a lens such as crystal lens which can give the patient, ideally ,the vision of a twenty year old.
I think it is pretty common among doctors to fail to disclose information to their patients.In my opinion, some want to control all the factors and understandably just think along much more sophisticated lines than "we Patients" who have to have to have long medical  words decoded.
   Unfortunately, in my work as a social worker and in my experience as a patient, I have found that many specialists are "on the run"--and they are becoming more and more reluctant to tell us about our conditions because  it takes up too much time answering our questions and they don't want to treat the whole person--just the part of the body which they are specializing in. Many are scheduling so many appointments in one day that it takes 4 months to get an appointment with them. And by that time ,your condition is probably going "to do you in" or at least make you feel as though it has. Doctors know this all this   but the AMA  has sold its soul to insurance companies and to HMOs  and the days of the dedicated doctor are vanishing before out "very eyes"

[janjan99]

Hi- My eyesight was not quite that bad...I was -8.50 in left eye and -9.0 in right...

I just used 2 pair of glasses...I bought a cheater pair for reading small print from walmart....and Had prescription for driving....+1.50 and +1.25 respectively....

Hope this helps.  The people here are really great...I was nervous as could be before the surgery and getting answers from other here...I had monofocal lens implanted, because with the multifocals, there was no guarantee that the night vision had improved, some were worse off....I didn't want to risk it...But also, some have had wonderful results...I think it up to you.

Jan

[janjan99]

Hi - I was told i had cataracts when I was 19 years old....My Dr. told they were not growing, but would probably have to be removed later on.  I just had the surgery done and I am 47 years old....I waited until the cataract interferred with my daily life.  I could not drive at night for the halos, glares and could barely see the street lines at night. Everything was fine during the day.  My surgeon said mine were not that bad, but we went ahead with the surgery.   I had my last eye done 2 weeks ago and for the first time in 30 years I did not have wear glasses or contact upon waking up in the morning and to function.  I can watch tv, work on computer, etc without glasses.  I feel this is a blessing.  I still have to wear glasses to drive and read small print, but for the most activities i can get along fine without the glasses.  Hope this helps.

Jan

[muppet]

Hi - I wanted to ask you what level of myopia you were prior to your surgery ?  Mine is two days away and I am anxious to know what I can expect afterwards. My surgeon has said that I will be similar to your results.  I am currently -14 in my eyes, so very myopic.  I cannot imagine a life without contact lenses !

Do you have bifocal glasses or two pairs ?

[muppet]

Hi - I was told I had a cataract about 4-5 years ago when I was 33.  I developed a smaller one in the other eye several years later.  I am now 38 and in two days am having them removed, two weeks apart.  I was going to just leave them, but over the past 12 months the worse one has started to affect my vision quite alot (with driving, reading etc) and so that is what prompted me.  My surgeon has recommended having both eyes done, as I am extremely short sighted and she said I will find the visual differences between eyes disconcerting.  Plus, I will be contact lens free after 22 years.

I don't think there is any recommended age bracket - it really just depends upon when it starts to affect your quality of life.

[Forum-OD-MP]

no HMO can tell you an "age" that you have to be before you get cataract extraction.  thats ridiculous.  i'd argue with them over that.  a doctor makes that call.  i know PLENTY of people under age 50 whe have desperately needed cataract extraction.  now if your HMO doctor said that in your case you'd probably be 50 before you needed it...thats kind of another story.  but i dont see how the HMO administration can say that.

there is debate over what is considered a cataract and when to mention it to patients. there are no "rules" as to when to mention it.  almost no patient over say 35 years of age has a totally clear crystalline lens.  so does that mean we should be telling every 36+ year old patient they have "cataracts"?  if not, then when does the doctor start mentioning it?  when it interferes with acuity?  many patients with 20/20 acuity have cataracts.  when to mention it to patients is a disputable point.