Vision problems & Multiforcal lens

Is there a way of quantifying a patient's cataracts? The way you can quantify a fever, for instance. If so, majority of people experience vision problems at what approximate number?

When having cataracts removed, what do you think about having multifocal lens implanted? I don't mind using reading glasses if the success rate isn't very high. Perhaps ReZoom? Any idea on the success rate? Do you know of a good 'implanter' in Buffalo, NY area?

Thanks for any informatiion.

[Sandy Feldman, MD, MS]

Dear Barneybary,

Visual acuity can be measured and there are methods to determine the type and extent of cataract.  If the acuity is diminished and  affects your activities, surgical removal may be indication.  To determine the best lens option for you, you should research the options and speak with your eyeMD.  The eyeMD may give you a survey to fill out which determines what type of vision is most important for you.  You can find an eyeMD by searcing the find a doctor on the AAO.org web site.

Dr. Feldman

Sandy T. Feldman, M.D., M.S.
ClearView Eye and Laser Medical Center
San Diego, California

[londonbridge]

I am not a physician only a patient like yourself who had cataract surgery. Usually when your vision is impairing your everyday activities then people consider having them removed. For me night driving became a problem even though I relatively young, 54. A doctor may have other ways of measuring the severity of cataracts.
With regard to multifocal lenses. Please Please read the many posts on this forum about people who have had problems with multifocal lenses. Two weeks ago I had my Restor lens explanted and replaced with a monofocal Acrysof Toric set for intermediate. My right eye still has a natural lens with only a minor cataract and is nearsighted (-8.0). I wear a contact in that eye for distance. Since my cataract surgery I cannot wear glasses alone because my eyes are too different now. While there are satisfied multifocal users, who are probably not on this forum, the technology is not perfected yet. If you truly don't mind wearing reading glasses you may be better off getting a monofocal lens set for distance or blended vision (distance in your dominant eye/ intermediate in non dominant). I wound up doing this and I am pleased. I can use a computer, see most things at arms length and beyond, drive and only need glasses to read. Much much happier than with all the problems I experienced with Restor lens. Some of the newer accomodating lenses like Crystalens seem to be the next generation of lenses. They move with your eye muscles to focus at different distances. However all multifocal cost up to $2500.00 more per eye and are not covered by insurance. So please do your homework and seek several expert opinions before choosing. Good luck.

[Barneybart]

I wish I had got your input before my wife had multifocal implants. It's been nothing but a daily hassle.

Barney

[londonbridge]

Sorry to hear that. I do know that multifocals take a longer period of adaptation, sometimes up to a year. Some of the typical problems, which vary depending on the type of multifocal, such as ghosting, glare, halos, double vision etc, do tend to diminish with time as the brain neuroadapts. So possibly time will improve things. For me while some of the problems diminished, the prescription put in my eye was so far off that I did not have clear vision at any distance and a contact lens on top of the implant only helped a little. I hope your wife's vision woes improove. Some folks with multifocals have found that they need to have them tweaked, ie. further correct the refraction by having a laser procedure, wearing glasses or contacts or having procedures done to correct astigmatism. It seems that even a small amount of astigmatism can affect the qualtiy of vision with multifocals. There are many posts on this forum, see JodiJ, and the MD's about solutions. I would not hesitate to ask your wife's surgeon about whether she is a candidate for any of the above mentioned procedures. I would seek one or more opinions from qualified doctors experienced with multifocals before proceeding. Keep in mind that if you choose to do a Yag laser to the capsule to clear up any blurriness, it makes an explant much riskier. An explant is a last resort, but can be an option if other options are unlikely to help and/or her vision is trurly intolerable. Good luck. You will resolve this. I know how frustrationg this can be as I and my family have been through this now for over six months.