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PATIENT PERSPECTIVE

Cataract Surgery - from a High Myope's Point of View

“You’re not going to like this,” said my OD after a scant five seconds of scoping my eyes. “You’re developing some pretty ripe cataracts.”

Yikes! This after many years of “remarkably clear” lenses. But alas, further examination revealed that both eyes were in fact developing cataracts at a rapid rate. However, instead of the usual wailing and gnashing of teeth that most people do when receiving this news; I began thinking, “Oh boy, now I can finally get rid of my thick lenses!”

You see, I’ve been in Optical for over 36 years now, starting as a lab rat, learning Opticianry from people a lot smarter than me and paying attention when wiser heads than me spoke. This process still goes on today. Anyway, now I was finally going to get some action concerning my ever-dimming vision.

My prescription was steadily getting worse over the last two years after being rather stable for the last ten years or so. I still smile when I get some young customer that complains that they’re “nearly blind as a bat” - and they’re only a -.50 sphere. They start to understand a bit more when I tell them that I’m thirty times more nearsighted than they are.

I have seen some pretty good results from cataract surgery, so I was looking for some relief. We had a long-time customer who had always been +11.00 spheres OU so we always had to fit her in small frames. She brought in her new Rx after surgery that was +1.00 spheres OU. So I told her that she just lost 90% of her prescription and did she know what that means? I swept my arm at the frame boards and said, “Any frame you want is now open to you - anything you want, any size, any shape you want - you can now have.” She was just so happy.

Now the roundabout started. I had selected my surgeon because of a personal friendship and my OD had also stated that he did excellent surgery. His incisions were always straight and precise, and he rarely had any problematic results. So I called his office to set up my appointment. Surprise! His office was not listed with our insurance. So they applied to be a vendor, a process that usually takes six months. Five months later, we changed our insurance company and guess what? His office was also not listed with the new company. So again they applied and I waited.

Meanwhile my prescription was worsening by about -1.50 sphere every three months or so. When everything was all ready to go, my Rx had gone from -11.25 -2.25 X 14 OD and -11.25 -2.00 X 165 OS to -15.00 -2.25 X 15 OD and -15.00 -2.00 X 163 OS. I have been an advocate of 1.70 index lenses as a real alternative to the poor optical Abbe values of 1.67 and 1.74 since in my Rx, the Abbe was a very noticeable factor in visual clarity. While the 1.70 index did have better optical clarity and the 1.67 was virtually useless, neither one gave me crisp vision due to the cataracts. How much I was missing I didn’t realize until after my first surgery.

My first surgery was on my left eye. I arrived at the surgical enter with a small amount of anxiety. I had looked at cataract surgery on the online video site, so I knew what to expect and my surgeon had reassured me that it would be quick and fine. So I lay on a gurney and got a regimen of drops and hooked up to an IV and pulse monitor. Another round of drops followed, then an injection and some calming agent, and I was finally whisked to the operating room. All I could see in the OR was a bright watery light from the surgical microscope. After a few minutes of covering my face with a blue cloth, the surgery started. Again, all I could see was a light with a shadow moving around in it. My surgeon had said he spends a little extra time polishing to remove all traces of the lens, and as I saw the shadow move about I asked him if he was polishing, to which he replied that he was. Then everything got much clearer as he positioned the intraocular lens.

Next up was the collagen antibiotic-soaked contact lens, and my eyelids were taped shut and a patch was applied to my eye. I was helped to a sitting position where the surgeon had a Polaroid photo taken of us. After getting home, I took it easy and tried not to move my eye much, as it was pretty itchy. On my visit to the surgeon the next day he removed my patch and examined my eye. Everything turned out well and I was amazed at my new vision, although it was still a bit watery. I could actually watch TV from 5 feet away - without my glasses (one eye only though).

However, there was still a very big problem. My right eye was still -15.00 -2.00 X 165 and my left eye was a -1.50 -1.50 X 165. No brain in the world could make those hugely divergent images converge into one useable image to see with due to the extreme Anisometropia. I could see about 20/70 through my right eye in the reality that I had grown used to, while I could see better with my left eye, but in a totally different reality, due to the image being about 20% larger than what I was used to. So the only thing I could do was patch one eye at a time.

If I was watching TV, I would use my left eye, but it had optic neuritis years ago so there’s a bad spot just left of center in my left eye that made reading on the screen difficult. When I drove, I patched my left eye, as I was used to seeing with my right eye when driving and the sizes made it easier to judge distance, a difficult enough task with one eye. So here I was, switching a vinyl cling patch from eye to eye as the occasion demanded. If I tried to drive using my operated on left eye, while things were much clearer than before, the larger size made it very strange. Imagine riding in a car and looking out ahead of you while wearing 2X binoculars. Not to mention that it was just as difficult to use my non-dominant eye as my dominant eye. Boy, did I ever miss binocular vision.

Finally the day came for the surgery on my right, dominant eye. The same routine, but this time there was a bit of pain the next day. And when they removed my patch, everything had a very orange look to it. My surgeon put a drop of atropine in and an hour later, everything returned to normal.

Did I say normal? In fact, now that I finally had binocular vision again and both eyes were nearly the same power, a whole new vista opened up for me. The brightness and clarity was astounding. My cataracts had become so cloudy that they were preventing a very large amount of light from reaching my retinas, so everything had become very dim and very fuzzy. My visual acuity had been reduced to 20/70 with best glasses. Now everything was so much brighter and the blues stood out so much more. No more looking like everything was seen through a dirty yellowed window. I had prevented myself from doing any driving at night the last few years, now I can plainly tell taillights and streetlights far away, and can even read license plates.

So, I ended up going from -15.00 -2.00 X 165 OD to -.50 -2.00 X 18 OD and -15.00 -2.00 X 163 OS to -1.50 -1.75 X 158 OS. Not a bad change and my vision now is far better unaided than at any time in my life. I can even appreciate the difference between standard-def TV and Hi-Def TV now!

Mark H. Morris
Optician

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