Toric or not to toric

[777pilot]

I am a professional pilot, age 59, have controlled glaucoma and had a macular hole and successful surgery to repair it six months ago. As expected, this resulted in a cataract and I have surgery for that next month. I have a slight astigmatism (1.0) in that eye and my doctor recommended a toric lens but said I was borderline for needing it. I still have a distortion from the macular hole so all straight lines have a little notch and I need near vision help for reading.
My question is; should I get the toric lens or, because of the distortion and very slight astigmatism, will it make any difference?  I am inclined to go with the simpler option of a fixed distance lens. Not sure how the FAA views the toric lens but I understand they do not like the side effects of multifocal lenses.

[Houman Vosoghi, MD]

Toric does not have the same side effects as the muljtifocal lenses so that should not be a concern.  Multifocals are the ones I would advise against.  Toric should not hurt in any way.  What you need to consider is whether you're okay with the extra cost if it may not lead to any additional benefit compared to monofocal standard lenses.

HV

[777pilot]

Hi Fred, I was also a USAF Herc pilot, WX Recon from 1978-1983. Been at the airlines since 1987. I've read your posts before and found them very helpful. I considered the near vision option but not sure the FAA will approve. My doctor does not do the incision to fix astigmatism but I know a doctor in AZ who does and that is still an option. With the cataract my left eye sees close (it didn't before) and the rt eye sees distant fine and I don't wear glasses and like it. But FAA wants the best distant vision and I have a few more years in me I think. It is frightening to read some of the stuff on this forum. Thanks for the input.

[FredZq]

Hi, just have general comment on your post...I was Hercules pilot for 30 years, developed cataracts few years ago at aged 63-64. Considered the options and settled on Tecnis acrylic aspheric lenses set for near vision. So left eye focuses at 11" and right about 15".  I can see w/o specs  for work on computer, reading, kitchen, shop, etc. Also had some astigmatism (CSAF waiver to go to USAF UPT years ago) and doc did limbal relaxing incision which got rid of most of it. Zero issues with glare, halos, etc. Always wore specs so the wasn't an issue. Heck, I can see better now than I could 20 years ago. Just never occurs to me that I had eye surgeries. Good luck on yours.