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Question for Dr. Hagan...shooting IOL
Dr. Hagan;
I've become overwhelmed in my "shooting IOL" research. I'm hoping you can give me some guidance and understanding of what I'm up against, what questions I should ask, and what course you might recommend to a patient.
I shoot informal competition at my local hunting club using pistols, carbines, rifles. Speed and accuracy count. I mostly use iron sights; post or blade front, notch or peep rear.
I'm right eye dominant and shoot right handed. My dominant eye needs IOL. The ophthalmologists I visited recommended a monofocal IOL for distance, target plano to -1.0, to match my good eye. Neither ophthalmologist is a shooter or hunter. I understand I may need readers with this IOL.
Assuming IOL target is achieved, will I be able to see my front sights with this IOL? Will I be able to see the target also (slightly blurry target is normal, I'm 61).
If front sights are too blurry, will a + contact lens bring the sights into focus?
What are the downsides to using a + contact to bring the front sights into focus? I guess I'm asking at what distance will targets start getting blurry, 30 feet (plate shoots), 75 yards, etc?
I think these questions sum up my confusion:
Do I have to choose between an IOL for 'overall satisfaction with most activities', and one for 'shooting only'?
If I choose the former, what can be done with contacts or glasses so I can see the front sight and the target?
Thank you for your time and expertise, Dr. Hagan.
I've become overwhelmed in my "shooting IOL" research. I'm hoping you can give me some guidance and understanding of what I'm up against, what questions I should ask, and what course you might recommend to a patient.
I shoot informal competition at my local hunting club using pistols, carbines, rifles. Speed and accuracy count. I mostly use iron sights; post or blade front, notch or peep rear.
I'm right eye dominant and shoot right handed. My dominant eye needs IOL. The ophthalmologists I visited recommended a monofocal IOL for distance, target plano to -1.0, to match my good eye. Neither ophthalmologist is a shooter or hunter. I understand I may need readers with this IOL.
Assuming IOL target is achieved, will I be able to see my front sights with this IOL? Will I be able to see the target also (slightly blurry target is normal, I'm 61).
If front sights are too blurry, will a + contact lens bring the sights into focus?
What are the downsides to using a + contact to bring the front sights into focus? I guess I'm asking at what distance will targets start getting blurry, 30 feet (plate shoots), 75 yards, etc?
I think these questions sum up my confusion:
Do I have to choose between an IOL for 'overall satisfaction with most activities', and one for 'shooting only'?
If I choose the former, what can be done with contacts or glasses so I can see the front sight and the target?
Thank you for your time and expertise, Dr. Hagan.
Please see the post on your other question line. My ACOG is the original small red cross without any other enhancements.
The answer I was looking for. Thank you:
"If you wore +2.50 lens it would blur your distance vision but make near vision better. I have never heard of anyone doing this for anything other than mono-vision for near reading. "
That describes my uncorrected, pre-cataract vision in dominant eye. My other eye had 20/25, uncorrected. With no contacts or glasses and both eyes open I could see my irons AND a clay bird at 100 yards. I could also read, drive, watch TV without glasses.
My thought is to get the distance IOL that was recommended. That's for daily life. For shooting, I thought a +2.50 contact might replicate my pre-cataract vision, and allow me to shoot both eyes open like I used to.
You previously said setting my bad eye for -2.50 (to replicate my pre-cataract vision) wouldn't give me back my pre-cataract sight picture. Is that mostly because the IOL has a fixed focal length?
Didn't know gel was in use/study. It was a question born from reverse engineering perspective.
What reticle ACOG? I like their 3-30 and 4-32 models with horseshoe reticle. You must get hammered with vision questions by your fellow shooters at the range.
"If you wore +2.50 lens it would blur your distance vision but make near vision better. I have never heard of anyone doing this for anything other than mono-vision for near reading. "
That describes my uncorrected, pre-cataract vision in dominant eye. My other eye had 20/25, uncorrected. With no contacts or glasses and both eyes open I could see my irons AND a clay bird at 100 yards. I could also read, drive, watch TV without glasses.
My thought is to get the distance IOL that was recommended. That's for daily life. For shooting, I thought a +2.50 contact might replicate my pre-cataract vision, and allow me to shoot both eyes open like I used to.
You previously said setting my bad eye for -2.50 (to replicate my pre-cataract vision) wouldn't give me back my pre-cataract sight picture. Is that mostly because the IOL has a fixed focal length?
Didn't know gel was in use/study. It was a question born from reverse engineering perspective.
What reticle ACOG? I like their 3-30 and 4-32 models with horseshoe reticle. You must get hammered with vision questions by your fellow shooters at the range.
Q. If post-cataract I'm at or near 20/20 with 0.00 refraction, and I use a -2.50 (or so) contact, will I have my old sight picture back? What will I see/not see?
You clearly do not understand the optics. If you are 20/20 and 0.00 you do not need contact lens. If you wore -2.50 it would blur both distance and near. If you wore +2.50 lens it would blur your distance vision but make near vision better. I have never heard of anyone doing this for anything other than mono-vision for near reading.
If you want to know how to determine focal length of lens systems here is a reference http://hypertextbook.com/facts/2002/RomaKaur.shtml however this is for the focal length of a optical lens and it does not translate exactly to the human eye after IOL surgery.
Yes cheap sights are like cheap shoes or cheap parachutes not really a bargain. I have both EOTECH and Trajicon ACOG and they work fine.
The gel in the lens is extremely new, experimental, not widely available, expensive and not something I would recommend or want in my eye.
You Tube has all sorts of video's on optical/electronic/holographic/laser sights including like the link I sent you that show your sight picture.
You clearly do not understand the optics. If you are 20/20 and 0.00 you do not need contact lens. If you wore -2.50 it would blur both distance and near. If you wore +2.50 lens it would blur your distance vision but make near vision better. I have never heard of anyone doing this for anything other than mono-vision for near reading.
If you want to know how to determine focal length of lens systems here is a reference http://hypertextbook.com/facts/2002/RomaKaur.shtml however this is for the focal length of a optical lens and it does not translate exactly to the human eye after IOL surgery.
Yes cheap sights are like cheap shoes or cheap parachutes not really a bargain. I have both EOTECH and Trajicon ACOG and they work fine.
The gel in the lens is extremely new, experimental, not widely available, expensive and not something I would recommend or want in my eye.
You Tube has all sorts of video's on optical/electronic/holographic/laser sights including like the link I sent you that show your sight picture.
2 Comments
Spelling - 5 "Trijicon"
Thank you so much for all your answers. Finding a shooting ophthalmologist is a very welcome comfort.
If post-cataract I'm at or near 20/20 with 0.00 refraction, and I use a -2.50 (or so) contact, will I have my old sight picture back? What will I see/not see?
In a bad situation optics can be rendered useless and your iron sights will be all you have. To become as proficient as possible with irons, I never used optics.
I didn't know crosshairs and holographic reticles were projected downrange. Before all my eye troubles I sometimes used a cheap $30 red dot that projected a red light beam onto the viewing screen. Focus of the reticle depended on whether or not I wore my (shooting eye) contact lens.
Are low level, fixed power (1.5x to 4x) reticles also projected downrange? If so, an ACOG may be in my future.
Has there been research on using a substance (fluid or gel) that mimics the human lens, instead of using plastic IOL, for cataract surgery? A suitable lens substitute material would allow the ciliary muscle to focus that material.
You said -1.0 lens has approx 39" focal length. Do you mean a contact lens an IOL lens? Where can I find the focal lengths for other lens powers?
If post-cataract I'm at or near 20/20 with 0.00 refraction, and I use a -2.50 (or so) contact, will I have my old sight picture back? What will I see/not see?
In a bad situation optics can be rendered useless and your iron sights will be all you have. To become as proficient as possible with irons, I never used optics.
I didn't know crosshairs and holographic reticles were projected downrange. Before all my eye troubles I sometimes used a cheap $30 red dot that projected a red light beam onto the viewing screen. Focus of the reticle depended on whether or not I wore my (shooting eye) contact lens.
Are low level, fixed power (1.5x to 4x) reticles also projected downrange? If so, an ACOG may be in my future.
Has there been research on using a substance (fluid or gel) that mimics the human lens, instead of using plastic IOL, for cataract surgery? A suitable lens substitute material would allow the ciliary muscle to focus that material.
You said -1.0 lens has approx 39" focal length. Do you mean a contact lens an IOL lens? Where can I find the focal lengths for other lens powers?
Q: Assuming my surgery achieves (a), can I use a contact lens to get result (c)? What power lens and is it + or -?
A: If you are -1.00 myope you need -1.00 glasses or contacts. If you wear the glasses or contacts you will not have a good sight picture for your rear sights.
Q. Would using a prescription eyeglass over the contact give me greater depth of field? What might that ‘script look like?
A: No it would not if your post surgery RX is 0.00 you don't need glasses or contacts for distance.
A -1.00 lens has a focal length of about 39 inches Your sight picture will not be nearly as good for a handgun as when your glasses RX was -2.50 on the other hand your distance vision will be be better (this is shooting without glasses or contacts)
There are many older shooters with impaired vision that do extremely well with pistols, rifles and shotguns. Much better than many younger people with perfect vision and young eyes who have no shooting skills.
Leaving your eye -2.50 will not be like when you were -2.50 when you were younger, did not have cataracts or other eye problems.
Scope and electronic optics do not work like iron sights. When you use a riflescope the cross hair reticule is just inches from you eye but you do not have to focus on it AND the target 100 yards away. Lens systems are used to project the cross hairs at 'distance" so that they enter your eye parallel like light rays from distance objects. Electronic sights the same way. The red dot or red circle is projected out to distance. These optical systems do have a near points that are the closest they can focus. When I do air rifle shooting at 10 meters (30 ft) I have to use a special spotting scope that can focus that close.
One other option for near shooting is laser sights like Crimson Trace.
A: If you are -1.00 myope you need -1.00 glasses or contacts. If you wear the glasses or contacts you will not have a good sight picture for your rear sights.
Q. Would using a prescription eyeglass over the contact give me greater depth of field? What might that ‘script look like?
A: No it would not if your post surgery RX is 0.00 you don't need glasses or contacts for distance.
A -1.00 lens has a focal length of about 39 inches Your sight picture will not be nearly as good for a handgun as when your glasses RX was -2.50 on the other hand your distance vision will be be better (this is shooting without glasses or contacts)
There are many older shooters with impaired vision that do extremely well with pistols, rifles and shotguns. Much better than many younger people with perfect vision and young eyes who have no shooting skills.
Leaving your eye -2.50 will not be like when you were -2.50 when you were younger, did not have cataracts or other eye problems.
Scope and electronic optics do not work like iron sights. When you use a riflescope the cross hair reticule is just inches from you eye but you do not have to focus on it AND the target 100 yards away. Lens systems are used to project the cross hairs at 'distance" so that they enter your eye parallel like light rays from distance objects. Electronic sights the same way. The red dot or red circle is projected out to distance. These optical systems do have a near points that are the closest they can focus. When I do air rifle shooting at 10 meters (30 ft) I have to use a special spotting scope that can focus that close.
One other option for near shooting is laser sights like Crimson Trace.
1 Comments
This video show how EOTech holographic sight is clear as is distant targets even though sight mounted inches from eyes.
https://www.youtube.com/watch?v=dJ_axWuahuE#t=415.381427
https://www.youtube.com/watch?v=dJ_axWuahuE#t=415.381427
You pretty well answered my basic question when you said:
(a) If your vision post surgery in your dominant eye is 20/20 and you have no refractive error for distance (0.00) then your targets further than 20 feet will be clear but not your sights. (b) If you are -1.00 and 20/20 with glasses and shooting with glasses on it will look about the same. (c) If you shoot without your glasses you will have a better (not perfect) sight picture but your distance vision will be reduced."
Assuming my surgery achieves (a), can I use a contact lens to get result (c)? What power lens and is it + or -?
Would using a prescription eyeglass over the contact give me greater depth of field? What might that ‘script look like?
Before my eye troubles I wore a -2.50 contact in my shooting eye and saw 20/20. However, I would always shoot open sights without the contact. I could see the front and rear sights good enough to ring steel. Targets were blurred, more so farther away. But I could still hit 10" steel offhand at 100 yards with open sights. Don't think I had depth perception trouble. Never noticed any, at least.
What's your take on targeting my shooting eye for -1.50 to -2.0, to mimic my "pre-eye trouble" vision? Probably cause me problems because it's a fixed power and the ciliary won't be able to adjust the IOL?
Would you please explain how/why optics pose no problem? Unless mounted in Col. Jeff Cooper’s “scout” position (forward on the foregrip) optics are closer to your eye than an iron front sight is and it seems that would make the reticle appear blurrier than the front sight. Pardon the pun, but what am I not seeing here?
You confirmed my gut feeling when you said:
"You will be best off making your choice of IOLs based on your life off the range/field....I would not base IOL power to be based on what you think will be best for shooting, you don't earn a living that way."
This whole eye thing has been debilitating to the point of extreme indecision. For many reasons I gave up trying to find answers about shooting and IOL’s. Then, yesterday I googled "shooting IOL” and found your medhelp posts. When I learned you’re a shooter I almost stood up and cheered. Months of unanswered and unasked 'shooting IOL' questions poured off my fingertips onto the keyboard. I felt like Alexander Selkirk rescued after 4 years. Couldn't stop talking.
Thank you for listening and taking time to answer my questions.
(a) If your vision post surgery in your dominant eye is 20/20 and you have no refractive error for distance (0.00) then your targets further than 20 feet will be clear but not your sights. (b) If you are -1.00 and 20/20 with glasses and shooting with glasses on it will look about the same. (c) If you shoot without your glasses you will have a better (not perfect) sight picture but your distance vision will be reduced."
Assuming my surgery achieves (a), can I use a contact lens to get result (c)? What power lens and is it + or -?
Would using a prescription eyeglass over the contact give me greater depth of field? What might that ‘script look like?
Before my eye troubles I wore a -2.50 contact in my shooting eye and saw 20/20. However, I would always shoot open sights without the contact. I could see the front and rear sights good enough to ring steel. Targets were blurred, more so farther away. But I could still hit 10" steel offhand at 100 yards with open sights. Don't think I had depth perception trouble. Never noticed any, at least.
What's your take on targeting my shooting eye for -1.50 to -2.0, to mimic my "pre-eye trouble" vision? Probably cause me problems because it's a fixed power and the ciliary won't be able to adjust the IOL?
Would you please explain how/why optics pose no problem? Unless mounted in Col. Jeff Cooper’s “scout” position (forward on the foregrip) optics are closer to your eye than an iron front sight is and it seems that would make the reticle appear blurrier than the front sight. Pardon the pun, but what am I not seeing here?
You confirmed my gut feeling when you said:
"You will be best off making your choice of IOLs based on your life off the range/field....I would not base IOL power to be based on what you think will be best for shooting, you don't earn a living that way."
This whole eye thing has been debilitating to the point of extreme indecision. For many reasons I gave up trying to find answers about shooting and IOL’s. Then, yesterday I googled "shooting IOL” and found your medhelp posts. When I learned you’re a shooter I almost stood up and cheered. Months of unanswered and unasked 'shooting IOL' questions poured off my fingertips onto the keyboard. I felt like Alexander Selkirk rescued after 4 years. Couldn't stop talking.
Thank you for listening and taking time to answer my questions.
I shoot and take care of a lot of hobby and competitive/combat shooters. Whatever you do you are not going to be happy with your sight picture, especially with iron sights (unless peep/pinhole sights). You will be best off making your choice of IOLs based on your life off the range/field.
The reason for this is rather simple. If the front sight is in focus the rear sight and target are out of focus. If the rear sight is in focus the front and target are out of focue. If the target is in focus (assuming 20 feet away or further) the frong and rear sights are out of focus.
The young eye can get a good sight picture by rapdily focusing rear/front/target. Once presbyopia sets in nothing approximates the youthful sight picture. Progressive bifocals done, premium/multifocal/accommodating IOLs don't.
A reasonable sight picture can be obtained with a mobile pupil that gets small when attempting to see the front/rear sights. However it's not possible to know in advance how mobile the pupil will be and the depth of focus. Moreover sometimes to remove the cataract the pupil has to be stretched and it's not as mobile or as small as prior to the surgery.
If your vision post surgery in your dominant eye is 20/20 and you have no refractive error for distance (0.00) then your targets further than 20 feet will be clear but not your sights. If you are -1.00 and 20/20 with glasses and shooting with glasses on it will look about the same. If you shoot without your glasses you will have a better (not perfect) sight picture but your distance vision will be reduced.
You can start Googling articles from shooting magazines about this problem.
with glasses and optical sights like EOTech or telescopic sights you should do just fine. I saw your other posting which is much too complicated and involved for me to answer. The EOTech red ring is not as hyper clear as the fine lines on a riflescope but they are not 'real blurry" if they were when you looked at it I suspect the problem was your cataract or you had the illumination turned up too high.
You are probably approaching the most number of posts prior to cataract surgery. I would not base IOL power to be based on what you think will be best for shooting, you don't earn a living that way.
Good luck
The reason for this is rather simple. If the front sight is in focus the rear sight and target are out of focus. If the rear sight is in focus the front and target are out of focue. If the target is in focus (assuming 20 feet away or further) the frong and rear sights are out of focus.
The young eye can get a good sight picture by rapdily focusing rear/front/target. Once presbyopia sets in nothing approximates the youthful sight picture. Progressive bifocals done, premium/multifocal/accommodating IOLs don't.
A reasonable sight picture can be obtained with a mobile pupil that gets small when attempting to see the front/rear sights. However it's not possible to know in advance how mobile the pupil will be and the depth of focus. Moreover sometimes to remove the cataract the pupil has to be stretched and it's not as mobile or as small as prior to the surgery.
If your vision post surgery in your dominant eye is 20/20 and you have no refractive error for distance (0.00) then your targets further than 20 feet will be clear but not your sights. If you are -1.00 and 20/20 with glasses and shooting with glasses on it will look about the same. If you shoot without your glasses you will have a better (not perfect) sight picture but your distance vision will be reduced.
You can start Googling articles from shooting magazines about this problem.
with glasses and optical sights like EOTech or telescopic sights you should do just fine. I saw your other posting which is much too complicated and involved for me to answer. The EOTech red ring is not as hyper clear as the fine lines on a riflescope but they are not 'real blurry" if they were when you looked at it I suspect the problem was your cataract or you had the illumination turned up too high.
You are probably approaching the most number of posts prior to cataract surgery. I would not base IOL power to be based on what you think will be best for shooting, you don't earn a living that way.
Good luck
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