protocol

[susannahe]

Is it protocol for a doctor to tell a cataract patient that the iol they will be putting in their eye does not focus at different depths like the natural lens does?

[susannahe]

Thanks for writing. I'm not going to be getting my second eye done at least not for a long time. My vision really wasn't that bad and was wonderful compared to what I have now. So since I know I'm going to be stuck with one iol and one cataract eye I have to figure out what kind of vision would be best in the iol eye. At this point I'm thinking I'd like my close-up vision to work well because the biggest problem I was having with my cataracts was with the close vision so hopefully I can get the doctor to do that for me. I don't know what it is called though or which number it is or anything. It's not that close things were too small it's just that they were cloudy from the cataracts.

[John C Hagan III, MD, FACS, FAAO]

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[JodieJ]

IMO, a good surgeon must communicate information about available options and expected results after surgery.  Since you are under 40, your surgeon should have explained how cataract surgery would effect your focusing ability.  He should also have given you information about such options as multifocal/accommodating lenses and "blended vision" with monofocal lenses.

Given your terrible problems with negative dysphotopsia, your priority right now is to eliminate those symptoms through an IOL exchange.  Your new surgeon will explain what he plans to do in that regard.  After your first eye has healed and you are satisfied with your vision, you can discuss your options for your second eye with your surgeon.  If you chose to leave your second eye slightly nearsighted, you'd have a broader range of focus with both eyes.  You'd probably be able to do most activities (including using the computer, applying makeup) without glasses.  If all went as expected, you'd only need glasses for prolonged reading or seeing small print.  (But that would have happened anyway in a few short years.)  

[John C Hagan III, MD, FACS, FAAO]

Most patients that have cataract surgery are older than 55 and at that age and older the eye doesn't have much focus power left in it (its called presbyopia).

We tell patients about needing glasses after surgery, we tell them about monofocal and multifocal IOLs we also tell them we will try and pick an IOL that will give them the best possible distance or reading or intermediate vision possible without glasses but never guarentee them they won't need glasses.  We do tell them the eye cannot focus after a Monofocal IOL is put in it.

JCH MD