Cataract Surgery Stupid Question

Hundo

Sergeant of the Hide
Jul 12, 2018
114
14
18
#1
Although I am not that old (58) I have developed a mild cataract in the middle of my field of vision in my right (dominant) eye. I was bore siting a scope with my Leupold device when I noticed what appeared to by a smudge right over the reticle. I cleaned the scope lens 3 times before looking through it with my left eye, perfectly clear!!!

As a shooter, our eye sight is our stock in trade. I know I need surgery. Anyone had cataract surgery? There are many techniques and many lenses available. Laser vs scalpel, advanced lenses to correct vision and astigmatism. Some let you see far away without correction, but you need readers up front. Some give you a "halo" glare at night. I would like to hear any experiences and get a shooters recommendation.
 
Mar 31, 2017
9
5
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#2
Although I am not that old (58) I have developed a mild cataract in the middle of my field of vision in my right (dominant) eye. I was bore siting a scope with my Leupold device when I noticed what appeared to by a smudge right over the reticle. I cleaned the scope lens 3 times before looking through it with my left eye, perfectly clear!!!

As a shooter, our eye sight is our stock in trade. I know I need surgery. Anyone had cataract surgery? There are many techniques and many lenses available. Laser vs scalpel, advanced lenses to correct vision and astigmatism. Some let you see far away without correction, but you need readers up front. Some give you a "halo" glare at night. I would like to hear any experiences and get a shooters recommendation.
I was just a couple years younger when I had my surgery; it was life changing! Both of mine went, and had the surgeries a couple of weeks apart.

I have the standard single, fixed focal length, and the are set for perfect distance, but I had to get reading glasses for up close. I quickly learned that progressive reading glasses are a must for general purpose (shopping & such), while just plain single power readers are great for computers, reading- stuff where everything is at about the same distance.

Friend of mine got some fancy, multi-focal implants, and loves them.

I have zero issues (that I notice) with night driving, but maybe I don't notice it as much, because my vision was so bad from the cataracts. I actually had triple vision on my right (dominant) eye, which was a bit trippy when shooting trap!

The surgery itself is a breeze- the only pain was some of the drops they put in beforehand. The day after surgery, they take the shield off, and although your eye looks pretty beat up, what YOU will see will be nothing short of amazing! Drove my wife nutz on the way home (she drove) pointing out signs, and saying 'That sign! I can read it!' (I was like 20/200 beforehand).

It is a relatively simple procedure- they make a small incision, and use an ultrasonic vacuum probe to break up, and suck out, the old lens. The new lens is soft, and rolled up tightly in a small tube. They just position the tube, and push it out- POP, and it's in place.

And, I will admit- the first time I glanced up at the night sky, I cried; I didn't remember seeing all those stars- I KNEW they were there, but thought it was light pollution that had taken them away.....
 
Likes: rhydet

Hundo

Sergeant of the Hide
Jul 12, 2018
114
14
18
#3
I was just a couple years younger when I had my surgery; it was life changing! Both of mine went, and had the surgeries a couple of weeks apart.

I have the standard single, fixed focal length, and the are set for perfect distance, but I had to get reading glasses for up close. I quickly learned that progressive reading glasses are a must for general purpose (shopping & such), while just plain single power readers are great for computers, reading- stuff where everything is at about the same distance.

Friend of mine got some fancy, multi-focal implants, and loves them.

I have zero issues (that I notice) with night driving, but maybe I don't notice it as much, because my vision was so bad from the cataracts. I actually had triple vision on my right (dominant) eye, which was a bit trippy when shooting trap!

The surgery itself is a breeze- the only pain was some of the drops they put in beforehand. The day after surgery, they take the shield off, and although your eye looks pretty beat up, what YOU will see will be nothing short of amazing! Drove my wife nutz on the way home (she drove) pointing out signs, and saying 'That sign! I can read it!' (I was like 20/200 beforehand).

It is a relatively simple procedure- they make a small incision, and use an ultrasonic vacuum probe to break up, and suck out, the old lens. The new lens is soft, and rolled up tightly in a small tube. They just position the tube, and push it out- POP, and it's in place.

And, I will admit- the first time I glanced up at the night sky, I cried; I didn't remember seeing all those stars- I KNEW they were there, but thought it was light pollution that had taken them away.....
Wow...Thank you for that. That was very instructive. I bet your shooting got better too!!! I am scheduling surgery for after the new year...better insurance then. I will have to make it through a hunting season with this crap. I have a hard time seeing hits in paper with a 60x spotting scope.
 
Feb 13, 2017
2,729
2,080
113
Camano Island, Washington
#4
Have had both mine done. Had I known, I wouldn’t have waited so long. The first one, I was conscious the entire time. I’m squeamish, wasn’t comfortable, but I bit the bullet, it was quick and I made it through just fine. If that was the only option, I’d still do it again, in a heartbeat.
The second one, they knocked me out and started working when I began to wake up and by the time I was mostly awake, I looked up, said to them “when are you going to start”? And they said “we’re..........done”. Very cool. I was given the option of nearsighted, half and half, or farsighted. I chose nearsighted, so I have to wear glasses (mild prescription) when I’m driving. Works great for me.

My advice to anyone thinking about it is to just go get it done. It really is life changing. I don’t want to write epistles about my experiences and recommendations here, but if you want to discuss, PM me and I’d be happy to talk with you about it.
 
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Snuby642

Sergeant of the Hide
Feb 11, 2017
494
163
43
#5
I had cataract surgery both eyes 2-1/2 years ago it's great.
If you can afford the enhanced version do that, I didn't and am sorry.

Recently had laser surgery to remove secondary? Growth that occurs.

Both painless pretty much the laser is over in about 60 seconds with just numbing drops.
Gtg emediatly pretty much.
The cataract surgery gtg next day
 
Sep 29, 2017
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12
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#6
+1 for having it done. In 2013 I had both done a month apart. My doc reco'd doing one for near and one for far. Surgeries were a piece of cake. No trouble with using my scopes, just adjust their diopter to my shooting eye. I do, after 4 years wear +2 diopter chearter glasses when I need to look at something real close.

Another reason I reco getting it done, is , in my case between diagnosis and surgery, 6-7 months, my cataracts got noticably worse. So, I think, all cats get worse over time, rather than just remain stagnant. Good luck, lg
 

Bigwheels

Gunny Sergeant
Jun 16, 2007
1,600
69
48
51
Anacortes WA
#7
I had it done in my left eye about 2 1/2 yrs ago. At the time had no job & spent several hours on the phone with Obamacare reps to find someone who would take the insurance. :mad:
By the time I was able to get it done I couldn't see a semi truck in front of me with the eye.
Only discomfort for me was the anesthetic they injected behind my eye. Yes with long curved needle. A few drops beforehand maybe burned a bit that's all.
Was awake the whole time & a few minutes after they began the Dr asked me how I was doing. I told him that I was good. He then told me he had already cut my eye open & the noise I was about to hear was the cataract being sucked out.
Literally a few minutes later I was out with the nurse. No fuss no muss.
I can tell you that it will get worse over time. Mine changed from a little halo around lights at night to being almost blind in about a year & a half.
My vision in that eye is now better than my right eye. I had to wear glasses still anyway so they didn't correct my vision to perfect but it's now much better than the other eye.
Just get it done. Its really no big deal.
 
Likes: LG65CM
Nov 30, 2017
70
35
18
#8
If you read nothing else of this post, read the last 2 paragraphs. It's important.

Interesting that some people were awake for their procedure or had some sort of injections. For me, I was completely "out" via IV-administered anesthesia. No pain at all at any time before or after. The anesthesia, as I understand it, is the same stuff used for colonoscopy - the patient is actually "awake" and able to respond to commands, but has no memory of the procedure at all.

I have 20/20 vision in both eyes post-op. Before, it was 20/200 or worse with major astigmatism. I have the standard lenses with distance focus. Takes some time to get used to needing reading glasses for anything closer than 3-4 feet and, after 2+ years, it's still frustrating sometimes. I have a good set of progressive readers in frames whose temples fold under spring pressure. This allows me to "hook" the readers in my t-shirt collar or shirt pocket and the spring-loaded temple acts as a clip to keep the readers from falling out when I lean over.

I also keep a few pair of cheap readers scattered around. My wife will tell you that the most common post-operative epithet is "Where's my #$%^*!!! glasses!!"

Complications: for me, I had Posterior Vitreous Separation (PVS) in both eyes within a few weeks of the surgeries. The vitreous humor is the "jelly" that fills our eyes. As we age, it commonly pulls away from the retina in back of the eye - hence the name. It doesn't hurt. The only way I knew anything was going on was I noticed orange flashes on the periphery of my vision in the affected eye when I blinked after turning the lights out for bed, and the next day I saw a lot of floaters. That was the left eye. Having been warned to call my surgeon if I notices flashes or floaters, I did so, and they had me in the office within two hours. It was explained to me that this occurrence is very common even without cataract surgery, but the surgery combined with aging and significant nearsightedness makes it more likely. They said the symptoms would subside, and they did.

When it happened in the right eye, I wasn't alarmed - until I noticed a literal cloud of tiny spots surrounding the larger floaters. In I went to ophthalmologist. This time, the separation had caused a small tear in the retina. The zillions of tiny spots were blood cells where the tear had bled into the eye. They repaired the tear with a laser, which took maybe ten minutes. The tear was serious in that, if it tore a lot, it could cause retinal separation, which can cause partial to total blindness. Over time, many of the blood cells "sunk" slowly out of the field of view, as have some of the floaters. Enough floaters remain to be annoying because my vision is otherwise so good, but compared with arthritis and such age-related mess, it's not a big deal.

Hope this information is useful.
 
Likes: ShadowBear
#9
I’m 62. Last fall I began to have difficulty seeing the target at 1K through my scope- couldn’t seem to focus on my steel torso target. Worst mirage ever.

Shortly after, I realized I couldn’t see anything out of my right eye- went to my optometrist and discovered I was down to 20/200 with my right eye.

$2500.00 later, I had laser cataract surgery. 15 minuets tops.

Amazing difference. I’ve worn glasses for everything since I was 33yo but now I can actually get away without wearing them for distance stuff like driving, watching TV and shooting.

No pain and no complications (other being double billed by the OP surgical center).
 
Mar 31, 2017
9
5
3
#10
If you read nothing else of this post, read the last 2 paragraphs. It's important.

Interesting that some people were awake for their procedure or had some sort of injections. For me, I was completely "out" via IV-administered anesthesia. No pain at all at any time before or after. The anesthesia, as I understand it, is the same stuff used for colonoscopy - the patient is actually "awake" and able to respond to commands, but has no memory of the procedure at all.

I have 20/20 vision in both eyes post-op. Before, it was 20/200 or worse with major astigmatism. I have the standard lenses with distance focus. Takes some time to get used to needing reading glasses for anything closer than 3-4 feet and, after 2+ years, it's still frustrating sometimes. I have a good set of progressive readers in frames whose temples fold under spring pressure. This allows me to "hook" the readers in my t-shirt collar or shirt pocket and the spring-loaded temple acts as a clip to keep the readers from falling out when I lean over.

I also keep a few pair of cheap readers scattered around. My wife will tell you that the most common post-operative epithet is "Where's my #$%^*!!! glasses!!"

Complications: for me, I had Posterior Vitreous Separation (PVS) in both eyes within a few weeks of the surgeries. The vitreous humor is the "jelly" that fills our eyes. As we age, it commonly pulls away from the retina in back of the eye - hence the name. It doesn't hurt. The only way I knew anything was going on was I noticed orange flashes on the periphery of my vision in the affected eye when I blinked after turning the lights out for bed, and the next day I saw a lot of floaters. That was the left eye. Having been warned to call my surgeon if I notices flashes or floaters, I did so, and they had me in the office within two hours. It was explained to me that this occurrence is very common even without cataract surgery, but the surgery combined with aging and significant nearsightedness makes it more likely. They said the symptoms would subside, and they did.

When it happened in the right eye, I wasn't alarmed - until I noticed a literal cloud of tiny spots surrounding the larger floaters. In I went to ophthalmologist. This time, the separation had caused a small tear in the retina. The zillions of tiny spots were blood cells where the tear had bled into the eye. They repaired the tear with a laser, which took maybe ten minutes. The tear was serious in that, if it tore a lot, it could cause retinal separation, which can cause partial to total blindness. Over time, many of the blood cells "sunk" slowly out of the field of view, as have some of the floaters. Enough floaters remain to be annoying because my vision is otherwise so good, but compared with arthritis and such age-related mess, it's not a big deal.

Hope this information is useful.
definitely an important tip for anyone having cataract surgery AND having a pre-op extreme nearsightedness- you are at a higher risk for retinal tears, or complete detachment.

When you are VERY nearsighted, your eyeballs are too long; this puts additional stress on the retina as the vitreous (gel) begins to shrink, and wants to pull the retina away from the inside surface of your eye.

I was beyond 20/200, but corrected to 20/20 with the cataract surgery. My surgeon said I had the longest eyeballs he had ever seen....

About 9 months after the surgery, I did notice an increase in floaters, and an occasional 'flash' if I glanced sideways quickly. Of course, I had no idea what was coming.

It started with a simple flap tear, which they fixed in the office. A month or so later, the entire retina in my right eye completely detached. The surgery to fix it wasn't bad, but the recovery sucks- once they have the retina back in place, and 'riveted' down with a laser, they put a bubble in your eye to apply pressure to the retina, and force it against the back of your eye. This requires you spend a few weeks always looking down. You can rent special chairs that are just glorified massage chairs, so you can comfortably sit and read, etc. Sleeping face down was the hardest part.

In my case, I lost the very center of my vision in the right eye, and had to learn to shoot left handed.

Moral of the story is, if you see a lot of floaters, or flashes of light when you look around, call your opthamologist IMMEDIATELY!
 

bobke

Sergeant
Sep 17, 2010
659
39
28
66
Tx Hill Country
#11
Have had astigmatism corrective process with implants done now in both eyes, about a year apart-the delay between surgeries I would not recommend, but had to wait for insurance coverage and enough cataract to warrant them picking up the tab. Easiest surgical procedure I’ve yet experienced. Next day could see almost 20/30 distance, but need glasses for near and a little help with distance. Drive without glasses now.
Shooting pistol in between procedures was such a PITA I quit IDPA for 2 years. Picked it up again, with a continuing issue with an aggressive stance and looking through the distance upper portion of no line bifocals. Simple solution turns out to be single vision .75-1.0 diopter safety glasses-can see sights now, and enough distance to get back in the game.
Hundo-I’m 66, so have faith. I can recommend an excellent ophthalmic surgeon in San Antonio at Nix if you’re looking for one.
 

rhydet

New Hide Member
May 1, 2018
6
0
1
#12
Guys, I have also had surgeries in both eyes. Detached retinas caused by nearsightedness. The Dr. explained that with a near sighted eye the shape is like a football and is constantly pulling on the eye. Like others on here, I didn't recognize the first signs of the issues. If you see flashes of light, see spider webs in your vision or have dark spots in the vision area, get to your Dr.

The left eye has had 3 surgeries. They had to use silicon oil instead of the gas bubble, do to the fact that I was traveling at the time and needed to fly. Try recovering from surgery in a hotel room. 4 months later out came the oil, and a week later the retina detached again and back in to have detached retina surgery again and back in with the oil. The detached retina procedure will cause a cataract, no if and or buts. The cataract part is easy with little down time.

In January of this year I had a detached retina in my right eye, but was able to do the gas bubble. Head down parallel to the ground for a week. It took me until April to fully recover. I just had the cataract surgery on Monday, and can see 20/20 at distance, but need reading glasses for computer and other reading.

It's great to see clearly again and I can echo others on here that I didn't realize how much I was missing until I had the eye fixed.

BTW, I am 52 now. Issues started when I was 49. I guess my warranty was up.
 
Mar 18, 2017
53
12
8
Florence, SC
#13
I had both eyes done one at 42 and one at 46. Between my two surgeries I started shooting pistols and competing in USPSA. My first eye was left non dominant eye and the implant that was used was the one insurance paid for which corrected for distance only. The right eye dominant eye was repaired 4 years later using a lense that focuses near and far (2k extra out of my pocket). The interesting thing now is I need NO correction to shoot pistols. My dominate eye focuses the front sight and my left eye focuses the target. I do use bifocals at work and to read. My work requires intricate seeing if that makes sense. My surgeries we're problem free but I hope this will help with choosing an implant. Good luck.
 
Aug 13, 2018
4
1
3
#14
Although I am not that old (58) I have developed a mild cataract in the middle of my field of vision in my right (dominant) eye. I was bore siting a scope with my Leupold device when I noticed what appeared to by a smudge right over the reticle. I cleaned the scope lens 3 times before looking through it with my left eye, perfectly clear!!!

As a shooter, our eye sight is our stock in trade. I know I need surgery. Anyone had cataract surgery? There are many techniques and many lenses available. Laser vs scalpel, advanced lenses to correct vision and astigmatism. Some let you see far away without correction, but you need readers up front. Some give you a "halo" glare at night. I would like to hear any experiences and get a shooters recommendation.
As a long time hunter and new long range shooter and optometrist, I can say that you are going to get the best optical result with a single focus lens implant (with a couple caveats). Your goals for post operative result should be your main concern. If you are looking to be free from all glasses using a multifocal implant for both near and far vision clarity you may or may not be satisfied depending on your expectations. They do function well but it depends on brain adaptation to "simultaneous vision" optics for both reading and distant vision requirements. Your safest bet is definitely the single vision implant for distance or near vision. Now depending on the actual spectacle Rx required by your eyes you may or may not achieve full correction using only a single focus lens. If you have excessive astigmatism your vision may be more blurred without additional spectacle correction after surgery. This can be corrected a couple ways depending on individual patients eyes: 1. using a special lens implant that corrects the astigmatism as well as your spherical distance /near requirement. 2 Additional surgical incision to change the corneal shape to remove astigmatism from the corneal surface.. Night vision complaints can occur with all proceedures due to reflections off the lens implant or irregularities in the vision correction but I do not typically see this as a complaint. Bottom line is your vision will be improved but you will need glasses to read up close or to see far away at minimum unless you are a candidate for multifocal implants. Multifocal implants are more or less a vision trial that you may or may not like in the end. There is no way to predict how you respond or how much you will be satisfied with your level of vision reading or seeing far away objects. My advice to shooters is to choose the single vision implant (or toric for astigmastism) to obtain the sharpest image possible after surgery. Then you will need the respective spectacles for either distance /near. Talk to your doctor about your specific case and discuss the outcome you would like to obtain or at the very least your surgeon prior to surgery. I have seen patients in my office that liked reading without glasses and after cataract surgery were unhappy they could no longer do so without reading glasses because a distance implant was placed simply due to lack of communication or miscommunication. Finallly, don't be hesitatant to have surgery if your vision is suffering. As long as everything else is normal in your eyes , the final outcome will be noticeably better. Its a quick 10 min surgery and little to no discomfort once the eye is prepped. Its not without risk but if nothing is done your vision will continue to become more blurred with time. I hope this helps and is understandable. Best of luck.
 
Likes: bobke

Hundo

Sergeant of the Hide
Jul 12, 2018
114
14
18
#15
As a long time hunter and new long range shooter and optometrist, I can say that you are going to get the best optical result with a single focus lens implant (with a couple caveats). Your goals for post operative result should be your main concern. If you are looking to be free from all glasses using a multifocal implant for both near and far vision clarity you may or may not be satisfied depending on your expectations. They do function well but it depends on brain adaptation to "simultaneous vision" optics for both reading and distant vision requirements. Your safest bet is definitely the single vision implant for distance or near vision. Now depending on the actual spectacle Rx required by your eyes you may or may not achieve full correction using only a single focus lens. If you have excessive astigmatism your vision may be more blurred without additional spectacle correction after surgery. This can be corrected a couple ways depending on individual patients eyes: 1. using a special lens implant that corrects the astigmatism as well as your spherical distance /near requirement. 2 Additional surgical incision to change the corneal shape to remove astigmatism from the corneal surface.. Night vision complaints can occur with all proceedures due to reflections off the lens implant or irregularities in the vision correction but I do not typically see this as a complaint. Bottom line is your vision will be improved but you will need glasses to read up close or to see far away at minimum unless you are a candidate for multifocal implants. Multifocal implants are more or less a vision trial that you may or may not like in the end. There is no way to predict how you respond or how much you will be satisfied with your level of vision reading or seeing far away objects. My advice to shooters is to choose the single vision implant (or toric for astigmastism) to obtain the sharpest image possible after surgery. Then you will need the respective spectacles for either distance /near. Talk to your doctor about your specific case and discuss the outcome you would like to obtain or at the very least your surgeon prior to surgery. I have seen patients in my office that liked reading without glasses and after cataract surgery were unhappy they could no longer do so without reading glasses because a distance implant was placed simply due to lack of communication or miscommunication. Finallly, don't be hesitatant to have surgery if your vision is suffering. As long as everything else is normal in your eyes , the final outcome will be noticeably better. Its a quick 10 min surgery and little to no discomfort once the eye is prepped. Its not without risk but if nothing is done your vision will continue to become more blurred with time. I hope this helps and is understandable. Best of luck.
Thank you very much Doctor. I do have a fairly significant astigmatism so I am thinking a single focus Toric lense that will give me visual acuity at distance. I don't mind wearing readers. My left eye is still good and I have progressive lenses. Will the progress lense over my left eye. Will that be enough to read or will I need a prescription lense over the right aye as well?
 
Aug 13, 2018
4
1
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#16
Thank you very much Doctor. I do have a fairly significant astigmatism so I am thinking a single focus Toric lense that will give me visual acuity at distance. I don't mind wearing readers. My left eye is still good and I have progressive lenses. Will the progress lense over my left eye. Will that be enough to read or will I need a prescription lense over the right aye as well?
You will need progressive lenses over both eyes after surgery to read comfortably. I have never prescribed only one progressive lens (PAL). I suppose just for shooting use only this could be done but for every day you won't want to have it that way. I t would take some adjustment if you were to attempt only one progresive. Most will simply just adapt to using only the PAL for everything but I have some that prefer distance only for shooting. Some that like to read without glasses keep it that way after surgery and simply used single vision distance glasses and took them off to read close up (this is not the norm though). Just realize you will only have one clear distance, near or far, you choose. Also, there is no guarantee of the outcome will be perfect without additional glasses correction.
 
#17
Being a VA patient, I struggled with the threshold issue: The Attending at my hospital kept telling the Residents, "It isn't bad enough, Check again next year." While I was traveling, I saw a provider at the local VA, who refered me to Veteran's Choice. Three phone calls later, I saw a civilian optometrist, who did the full diabetic exam, and referred me to get the cataracts done. Up to then, I was having to shine high intensity lights onto my desk top, to do any close work at all. My night vision was clouded badly so varminting was out of the question.
Once done, the most significant change for me was the sudden blast of color! i hadn't realized how brown and dim my vision was through these cataracts. I kept comparing one eye to the other, while I was waiting for the second.
I still marvel at the colors.
 
Likes: ShadowBear
Aug 13, 2018
4
1
3
#18
Being a VA patient, I struggled with the threshold issue: The Attending at my hospital kept telling the Residents, "It isn't bad enough, Check again next year." While I was traveling, I saw a provider at the local VA, who refered me to Veteran's Choice. Three phone calls later, I saw a civilian optometrist, who did the full diabetic exam, and referred me to get the cataracts done. Up to then, I was having to shine high intensity lights onto my desk top, to do any close work at all. My night vision was clouded badly so varminting was out of the question.
Once done, the most significant change for me was the sudden blast of color! i hadn't realized how brown and dim my vision was through these cataracts. I kept comparing one eye to the other, while I was waiting for the second.
I still marvel at the colors.
Sadly, I find this to be true all too often. Mostly due to insurance coverage requirements though. I recommend it to any of my patients if vision complaints are there though and glasses are not helping any more. Provided the ocular health is good.
 
Mar 31, 2014
80
11
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Michigan
#19
I had both eyes done, right eye - my shooting eye is set for distance, left eye is set for close reading - it is called mono vision - never wear glasses for reading or for long distance, but if skiing or hunting i occasionally wear a contact in left eye so vision is best at distance. I had my left eye done first and my brain handled the difference in vision between the two foca distancesI hear not everyone can handle the near/ far but I really am happy even after about 7-8 years. Can shoot pistol pretty good right handed but left handed I see the front sight better. Ask your doc about mono vision.
 

Greg Langelius *

Resident Elder Fart
Aug 10, 2001
5,282
581
113
Arizona, good place for me...
#20
I have reached the point where I simply can't ignore the cataracts anymore.

My initial consult/exam for cataract surgery at the VA is next week.

I've heard that sometimes, it doesn't all go quite so swimmingly, but it must be done; I can't read the street names anymore. I can see to shoot well enough with optics, but I also have to be able to drive there.

Greg
 
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#22
One other thought. When the VA refers you via Veteran's Choice, to a private doctor, the doctor "accepts Assignment" That is, he accepts whatever they pay as payment in full. So, when mine was done, I could not opt for the variable focus or other fancy-dancy lens implants, only the cheapeast offered. I am still happy, but for sure, the distance view is not as crisp at it was with the orignal Mark I issue eyeball.... When I was 20.
 
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