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Cataract surgery and photography

Photonadave
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p.7 #1 · p.7 #1 · Cataract surgery and photography

jowul wrote:
"As far as floaters is concerned my surgeon mentioned that these are at the back of the eye and can’t be removed with a cataract operation. Perhaps there is some other intervention?"

Usually a Vitrectomy is done to remove obstructions caused by massive floaters leftover from a ruptured blood vessel, usually from a torn retina, that leaves you essentially blind in that eye. A Vitrectomy is very invasive procedure so is not done for minor floaters. I've heard of lasers being experimented with however it is considered to not be worth the risk just to fix minor floaters. I've learned to ignore my largish floater in my right eye caused by a childhood injury. That's the eye I had cataract surgery done only a few years ago that upgraded me to 20-20 my sight in that eye. That is better than it ever was even with optical correction that did not quite get me all the way there. I'm not sure if my left eye will ever be done as its doing fine right now. We will see! (pun intended)

Dec 17, 2021 at 01:48 PM

campy
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p.7 #2 · p.7 #2 · Cataract surgery and photography

One day after my second eye surgery everything looks great. I am going to be 71 next month and I think my eyes are probably 20 years younger. Now if I could the old one eye to be 20 years younger that would be great.

Edited on Dec 18, 2021 at 08:14 AM · View previous versions

Dec 17, 2021 at 03:12 PM

15Bit
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p.7 #3 · p.7 #3 · Cataract surgery and photography

Alek Komarnits wrote:
If you were shooting for plano (at distance), then 2-3 meters is only "missing" the refractive target by 1/2-1/3 diopter (minus 1/6 if you want to nitpick since typical eye test is at 20 feet) ... which is pretty decent results. Better to undershoot rather than overshoot.

Yeah, that was my feeling too. As i said, maybe not perfect but still transformative to my life.

Dec 18, 2021 at 06:48 AM

rljones
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p.7 #4 · p.7 #4 · Cataract surgery and photography

Tollefsen wrote:
I’m here in CO and at almost 60 have the beginnings of cataracts! I’m excited to get the surgery when ever I can…. I have floaters so bad that when I do get the surgery they can remove them as well. No more seeing lots of things in the sky or landscape along with what ever I’m trying to take a photo of!

Floaters are not removed at the same time as cataract surgery. In fact, since contrast is improved after cataract surgery, the floaters are usually more obvious (and annoying) after surgery.

Most floaters are due to a posterior vitreous detachment (PVD), not retinal trauma. PVDs naturally come with aging, starting in the 40s and occurring in most all humans by the 80s. But some degree of floaters are normal and can be seen at any age (I remember seeing them when I was ~10 yo). Floaters are most obvious when looking at a brightly lit background, like the sky or a white wall, which causes our pupils to constrict. The combination of bright background and small pupils are required to see them. When our pupils are larger, those same floaters seemingly disappear, but they're still there.

If floaters are suddenly noticed, especially if accompanied by flashes of light, like a lightning bolt, then a visit for an eye exam is a good idea. While new floaters are ~99x out of a 100 due to a PVD, there could be a retinal hole causing them. If there is a hole, the hole could extend into a retinal detachment, which is serious and could result in blindness if not promptly fixed. (The subject of holes, tears and detachments is complicated and well beyond the scope of this thread.)

As for removing the floaters, it can be done via a vitrectomy. While this is invasive, in competent hands, it can be a 20-30 min procedure with excellent outcome when done after cataract surgery (if done before, this procedure will likely create or speed the formation of a cataract.) In all of the ~15,000 cataracts surgeries I've performed, I've only referred perhaps a dozen patients (to a retinal surgeon) who've then chosen to have an elective vitrectomy because the floaters were so bothersome.

However, trying to 'remove' floaters with a laser is not a good idea: it only breaks up large floaters into smaller ones (still visible; nothing is removed from the eye) and the energy distribution can (documented), tear the retina and even 'bruise' the macula, resulting in irreversible blindness.

Dec 19, 2021 at 06:09 AM

Tollefsen
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p.7 #5 · p.7 #5 · Cataract surgery and photography

rljones wrote:
Floaters are not removed at the same time as cataract surgery. In fact, since contrast is improved after cataract surgery, the floaters are usually more obvious (and annoying) after surgery.

Most floaters are due to a posterior vitreous detachment (PVD), not retinal trauma. PVDs naturally come with aging, starting in the 40s and occurring in most all humans by the 80s. But some degree of floaters are normal and can be seen at any age (I remember seeing them when I was ~10 yo). Floaters are most obvious when looking at a brightly lit background, like the sky or a...Show more →
Wow, thanks for all the information! The eye surgeon I spoke with did mention the laser, but said since mine are like shear curtains along with the ones I have name amoebas, It may not work well. She did mention the fluid removal and speeding up cataracts. However she did say she could refer me to someone who would do the fluid and cataract surgery at the same time…. Sounds like that is not normal or not a good idea. And yes both eyes the vitreous sack has broken. I did and still have some lightening, but my optometrist said the retina was fine.

Again, thank you for the detailed information. I think I will live with them for now!
Beth

Dec 19, 2021 at 09:18 AM

kimknapp
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p.7 #6 · p.7 #6 · Cataract surgery and photography

I had and still have the same thing, floaters that are like big blobs. Mine started after a racing accident. Helmet against even a padded roll cage causes a lot of bonging! I had lightning flashes that night and did not know, at that time, how serious they could be - I was lucky they did not progress.
Anyway, after the cataract surgery the floaters just don't seem to be as noticeable most of the time, everything is so sharp and high contrast (although I think I aged 20 years. When I look in the mirror, now, there is an old man in there that I did not see before - sort of like sliding the clarity slider back to center after it had been to the left!).

Dec 19, 2021 at 09:49 AM

chiron
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p.7 #7 · p.7 #7 · Cataract surgery and photography

rljones wrote:
Floaters are not removed at the same time as cataract surgery. In fact, since contrast is improved after cataract surgery, the floaters are usually more obvious (and annoying) after surgery.

Most floaters are due to a posterior vitreous detachment (PVD), not retinal trauma. PVDs naturally come with aging, starting in the 40s and occurring in most all humans by the 80s. But some degree of floaters are normal and can be seen at any age (I remember seeing them when I was ~10 yo). Floaters are most obvious when looking at a brightly lit background, like the sky or a...Show more →

Thank you for the information on floaters. I have had two multifocal IOLs for about 10 years and I have been very happy with them. I think they have been fine for my photography and for other purposes.

But I do find that a largish floater in my left eye is interfering with my vision, including for reading and often enough for photography. The issue seems to be that one of the left floaters is largish and has some opacity and when that floats into view I see a blur. It is almost like something has gotten into my eye and I often automatically rub the eye as though to try to remove it. It is enough to make me stop reading for a while or to interfere with my sharp perception of an image. Otherwise, I rarely notice the floaters. The left floater bothers me enough that I am doing a consult in January--but I hear your cautions about lasering it.

Do floaters change over time, i.e., do existing floaters get reabsorbed and new ones appear?

Dec 19, 2021 at 10:00 AM

rljones
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p.7 #8 · p.7 #8 · Cataract surgery and photography

chiron wrote:
Do floaters change over time, i.e., do existing floaters get reabsorbed and new ones appear?

The vitreous in our eyes becomes less viscous as we age. (Initially it has the consistency of un-cooked egg white.) Due to these changes, our head position and other reasons, the floaters do move about some with the tendency to settle towards the bottom (which changes due to our head position and gravity). I've described them to patients as like a snow globe after shaking. Some floaters do get absorbed, but new ones can form from trauma, bleeding, or from other surgery.

One such surgery is a YAG laser done to remove a posterior capsule opacity (PCO); PCOs form often after cataract surgery. The YAG laser is a one time, one minute, office procedure that immediately clears up the vision, but the resulting debris forms more floaters. (Sigh.)

Dec 19, 2021 at 10:50 AM

chiron
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p.7 #9 · p.7 #9 · Cataract surgery and photography

rljones wrote:
The vitreous in our eyes becomes less viscous as we age. (Initially it has the consistency of un-cooked egg white.) Due to these changes, our head position and other reasons, the floaters do move about some with the tendency to settle towards the bottom (which changes due to our head position and gravity). I've described them to patients as like a snow globe after shaking. Some floaters do get absorbed, but new ones can form from trauma, bleeding, or from other surgery.

One such surgery is a YAG laser done to remove a posterior capsule opacity (PCO); PCOs form often...Show more →

Thanks for the information. I did have a YAG done in the left eye (the one with the opaque floater) shortly after the lens was placed, but it was done about 9 years ago, so seems not likely to be causing the present opaque floater which is about 2 years old.

I can deal with most floaters easily enough. It is this one opaque one that is troubling me.

Dec 19, 2021 at 10:55 AM

gdanmitchell
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p.7 #10 · p.7 #10 · Cataract surgery and photography

Dec 19, 2021 at 03:22 PM

RDKirk
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p.7 #11 · p.7 #11 · Cataract surgery and photography

jrhoffman75 wrote:
My wife had both eye cataract surgery. Medicare/insurance would pay for the "basic" replacement lens. A custom lens to get back to 20/20 and avoid needing glasses was considered a "cosmetic" process and was not covered. We paid $1200 each for custom lenses (I think product was Toric). Worked great; she now has 20/20 vision. She does need reading glasses but nothing for camera or computer.

Did your wife have 20/20 vision before the cataracts? I have severe myopia with presbyopia , currently wearing transition lenses, so I'm concerned about the possible outcomes.

Dec 20, 2021 at 01:01 AM

jrhoffman75
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p.7 #12 · p.7 #12 · Cataract surgery and photography

No. She had bifocals before the operation. She now has bifocals that are clear (no prescription on top) but reader prescription on bottom. She chose that option because she was so used to wearing glasses.

Dec 20, 2021 at 07:39 AM

andyptak
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p.7 #13 · p.7 #13 · Cataract surgery and photography

I just booked my cataract surgeries yesterday. Number one for August and number two for October. I live in Canada so the cost is from zero to $400 for each eye, depending upon the lens. Nothing significant enough to consider as part of my decison. I wear glasses and intend to continue doing so - masks the wrinkles and bags around the eyes of this 74 yr old. All I care about is accuracy of color, contrast etc., for my shooting and Photoshop work. Any knowledgable person have recommendations?

Apr 02, 2022 at 12:43 PM

kimknapp
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p.7 #14 · p.7 #14 · Cataract surgery and photography

andyptak wrote:
Any knowledgeable person have recommendations?

Not sure how knowledgeable I am, but as I stated earlier in this thread, I went with single focus lenses by Alcon, set to focus about 15" out (which is a little farther than my near-sighted natural eyes were) and I am happy. No glasses when reading and no glasses when using computer. The computer monitors are probably a little closer than most people have them, at about 20", and I lean forward when I am really working on photo details, but even when I lean back, I can use a very small font.
Variable lenses for everything else, so I can still see ok up close when out hiking, driving, etc.
Not entirely sure why, but I do have a better DOF.

Remember, this is just what worked for me, it is not a strong recommendatetion.

Apr 02, 2022 at 02:14 PM

rljones
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p.7 #15 · p.7 #15 · Cataract surgery and photography

andyptak wrote:
I just booked my cataract surgeries yesterday. Number one for August and number two for October. I live in Canada so the cost is from zero to $400 for each eye, depending upon the lens. Nothing significant enough to consider as part of my decison. I wear glasses and intend to continue doing so - masks the wrinkles and bags around the eyes of this 74 yr old. All I care about is accuracy of color, contrast etc., for my shooting and Photoshop work. Any knowledgable person have recommendations?

Based on your requirements, I would suggest a simple monofocal style of implant in each eye. The exact model will probably be dictated by the familiarity of the surgeon with their usual and customary implants: most surgeons I've known rarely offer a laundry list of implant choices.

Personally, I prefer the B&L Akreos MICS implant as a monofocal design, and if having surgery on my own eyes would request that model.

As I've alluded in previous posts, the exact point upon which to have the implants focused is probably best chosen by your own history. If near-sighted for most of your life, remain modestly near-sighted (-3 to -1; the post-operative, distance, refractive power). If far-sighted, set for distance (0, known as emmetropia; no one should remain far-sighted). And if emmetropic for most of your life, remain so (this is aside from reading glasses, which an emmetrope will still need).

Apr 15, 2022 at 03:51 PM

andyptak
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p.7 #16 · p.7 #16 · Cataract surgery and photography

Giving this old thread a bump.

My wife is having her cataracts done soon and the surgeon has recommended doing them one day apart. Mine were done one month apart by a different surgeon. I went the cheap public health route here in Canada, while my wife is going to the most expensive and best known surgeon around here.

Anyone have an informed opinion on such timing? Thanks.

Oct 12, 2022 at 09:10 AM

AGeoJO
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p.7 #17 · p.7 #17 · Cataract surgery and photography

I had my cataract surgeries done of both eyes about 3 weeks apart. I am not sure what benefits you get from getting the surgery done only one day apart. There must be a valid reason for that although getting it done longer apart makes more sense to me but what do I know…

Oct 12, 2022 at 09:25 AM

bjhurley
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p.7 #18 · p.7 #18 · Cataract surgery and photography

I could see clearly within a day after the surgery so one day apart doesn't sound unreasonable to me. Mine were done further apart but I had glaucoma surgery at the same time so they were much more major surgeries. I think the advantage of getting them done closer together is that you won't have to deal with a long period where you need glasses for one eye but not the other.

Oct 12, 2022 at 11:13 AM

RickPJ
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p.7 #19 · p.7 #19 · Cataract surgery and photography

I had both done three weeks apart. Could not be happier with the result. I explained to my ophthalmologist that I was a photographer and that my hobby is astronomy. He quickly recommended that I use single focus lenses set to perfect distant vision. He accomplished exactly that. I no longer wear glasses for distance or even for the computer screen I am using now. I only use them for very close work. My night vision has improved considerably.

The surgery is annoying but by the next day I could see quite well.

If it is any comfort to the OP, I now wear dark glasses and a mask to cover the "character" that age gives one's face.

Oct 12, 2022 at 04:33 PM

runamuck
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p.7 #20 · p.7 #20 · Cataract surgery and photography

My left eye clouded suddenly. Scared me to death. I had cataracts but they were minor. They did the surgery and it took about 2 or3 weeks for my eye to focus. When they did my right eye it focused a few days after. Both eyes are set for distance vision and I use glasses for reading. Now the only problem is occasional floaters that are now visible. Being diabetic I get eye exams annually. I hate the diolation because light actually hurts. Now they do eye exams without diilation using an instrument developed by Nikon. AFAIK it is used only in Europe.

https://www.arthurhayes.co.uk/optomap-retinal-imaging

Oct 12, 2022 at 05:44 PM

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