Cataract Surgery Options for Shooters

I'm getting to the point where I'll need cataract surgery in the not too distant future. I'm struggling to figure out if the multi-focus lenses would be best for a shooter, like myself, or if I should go with a medium focus, etc. I realize that insurance probably won't cover some premium lenses like multi-focus, so I'm soliciting opinions on whether any of you that have had multi-focus lenses think it is worth the, out-of-the pocket, extra thousands of dollars per eye.

my suggestion is not the multi focus.
for most things you will need far focus, shotguns, rifles, Dots.
it's much easier to get that pair of 1.00 readers, or a prescription pair for shooting irons or scoring targets.

Just MHO and I've had cataract surgery in 2005.

Mike I have had cataract surgery in both eyes my right eye is for distance vision and my left is for reading.  My insurance would not cover the whole cost multi vision ones  leaving me to pay a lot I didn't have.  This works fine for me as I have to wear glasses to correct astigmatisms.  I have also had cornea transplants in both eyes which the left eye the last one done is going to have to be redone way to much fogging.  The right is crystal clear and was done first about three years ago.  I can shoot iron sights with the right eye the distance eye but reading glasses helps bring the front sight into focus better.  A EyePal for pistol stuck on a pair of flip up shooting glasses makes the sights and target perfect but I find they are a pain to use as they keep bumping into the spotting scope when flipped up.  Don

I just posted on a related topic...

Was just diagnosed with Early Cataracts, & I joke I will hand over my CCard & do what is ABSOLUTELY the BEST option, SPARE NO COST.  But I'm going to.  No Joke. 
These are YOUR EYES. This is it.   
If you trust your Doctor who is doing the Surgery, ask him/her, "If this were your Father or Mother (for that matter), what Surgery & what Lenses would you prescribe to them for Optimum Vision for their life?"


Maturing vision has been very depressing for me. 
Cannot wait for mine to get bad! 

Go with yur gut in the end.  It'll work out great.

Those are my thoughts firebrand. If I can swing the extra costs, I'll go premium! I hope they can zap my floaters at the same time.

Ugh... got those too! YaY  for us! 

Yeah, go ALL THE WAY !

I just got my 2nd eye done on the 20th, man what a difference. My dominant eye was getting quite blurry before surgery, the black was getting fuzzy so I would pull the dot down close and let her go. I havn't been to the range yet just dry fire training in the basement so far.
    I lucked out and have healthy eyes, no astigmatism, so no limitaions on the lens implant. I was stuck with what medicare and suppliment would pay. They cover single vision lenses; near, middle, or distant. When I was getting my first consultation and testing the doctor fully explained that I might need corrective glasses for near and asked if I would like multi vision lenses. I asked how much and he said $2700 per eye, I told him that's expensive. That's when he said I could volunteer for a national study (test), it's like being a Ginnie Pig for experimental products. It's a blind study where nobody knows which lens you get until December. The lenses are the multivision Symphony or Synchrony (I'm not sure on which name it is), it's been out for a few years, and 2 experimental lenses that are the same lense that have extra gradients of nearer vision added in. I've been on medical studys before with my liver years ago so I knew about studys. 
   For me this study was a win-win because the least I would be getting are the basic lenses that have been out already, the best part, the lenses are free. The lense company also pays you $500. I don't need reading glasses and I have 20/20 in both eyes,it's like being a kid again. So ask your eye surgeon if they were asked to offer this study, not all eye surgeons were selected. My doctor is Jason Jones here in Sioux City. 
  I would have payed for them, they are the only eyes you have. Good luck to you.
 Stan

Just had my first eye exam in 8 years.  My cataracts are only 20% of my aging vision deterioration, lucky for me.  I was shooting with my dominant left eye but the target was getting blurry after a few seconds of holding PoA.  I made a patch for my left eye and my right eye was much clearer and I reduced my 50 yd. groups considerably from my Hyskore rest, but my right eye created a vertical double image after a few seconds of holding PoA.  So I will be getting corrective lenses for the problem, restoring my 20/20 and hope to reduce my groups even more.  I'm really surprising myself getting seven of 10 rounds under 1 1/2" on the long line.  Damn those flyers!   Still tinkering but getting better with more confidence.

I also have floaters in both eyes and cataracts do not require surgery yet. I asked the eye surgeon about the floaters and he said they can be removed but there is always a risk for infection. He recommends leaving them alone unless they get totally unbearable. He didn't say if he can do the floaters at the same time as cataract surgery or not.

During my last eye exam, the optometrist said that one's brain will learn to ignore a lot of the floaters. Most of the time they don't bother me, but during shooting they really are noticeable, to the point that I have to put the gun down and start over, sometimes more than once. I'm due for an eye exam and will schedule one soon and we'll see what the doc has to say.

I have floaters also have had them since I was a kid.  Think I got a few more after cataract surgery.  They are hard to count.  They also give you something to do when you are really bored.  Don

It seems there are so few that opt for the multi-family IOLs that getting a response to your question is very difficult. The question deserves an answer from multiple users to bring confidence. Therefore I chose single focus IOLs.

Thing is after 6 years my vision could now benefit from glasses once again. Bummer! So I'm glad I didn't pay the extra. YMMV

The only thing "premium" about the premium IOL's is the cost.  Do a lot of research before you get them.

They are NOT like a progressive lens for eyeglasses.  Half your vision will be focused for "far", and the other half for "reading", and your brain is supposed to sort this out.  I told my doctor I wanted the best clarity, and I have no problems with needing glasses for close-up work.  The sharpest vision comes from a single-focus IOL, and that focus can be at any specific distance you want it.  Most of the time they give you an IOL with a prescription for distance.

If you get a multi-focal IOL, you're "wasting" half of the ability of the eye when you're seeing something.  Half the light coming to your retina will be focused at distance, and half at close-up.  You may or may not get used to that.  If you do a search for "multifocal IOL on Google, you'll also read about halo's, and other things you might not want to deal with.

The only negative thing about a standard single focal length IOL is that you will almost certainly need to wear glasses for close-up work.

There are also IOL's that actually move inside the eye, and are supposed to use the body's ability to focus.  They work for some people - and not for others.  The doctors that I spoke to about this did NOT recommend getting them.


There are IOL's that correct for astigmatism.  If you have that problem, your doctor will advise you.  

I guess I'm mostly saying to ignore all the hype, and the wild claims about fancy IOL's that you can get.  Do a thorough job of researching this before you agree to get one.

------------------------------

From my own experience, once I understood this, I got an IOL for my right eye that makes everything sharp from 2 meters to infinity.  It is slightly stronger than the IOL that was calibrated for infinity.  Then, I got polycarbonate shooting glasses, with a prescription for the distance to my front sight, and I also got a pair of reading glasses for close-up work.  My main glasses are the best brand of progressive lenses, which are good from close-up to infinity (I could shoot with them too, if they had been polycarbonate).  

Floaters - nothing can be done about them.  Going inside your eye to replace the fluid in the eye with clear fluid would accomplish that, but why would anyone take the risk?  Once you've had the long enough, your brain (at least my brain) has learned to mostly ignore them.  Some are small specs, and others look like a piece of cotton.  You don't actually see them - you see their shadow on your retina.  


I could add one more thing to this discussion, but only if people want to read it.  When you go through the testing to determine the proper power IOL for your eye, there are standardized formulas and machines that come up with a suggested power.  Based on my experience as a photographer, I told them why I wanted a lens a little stronger than that.  My doctors in India thought I was nuts.  The fellow who designs the IOL's agreed with me, as did my ophthalmologist friend from the USA.  They grudgingly gave me the IOL power I wanted, and just as I predicted, not only did everything come out perfectly, I had a wider range of sharp vision than had I gotten the calculated lens.  It's a long story.  If you have a good eye doctor, just be sure to tell him what YOU EXPECT from the surgery.  He can then adjust the IOL power so it suits your needs.

I had Crystal lens - Accommodating lens (IOLs) implanted 3 years ago. These lens "flex" inside the eye, imitating the natural lens. I was near sighted, but developing myopia as well. Needed bifocals, but really didn't like them.  I had the left eye done for 20/10 close and 20/30 distance, and the left eye 20/ 25 close, but 20/20 distance, the "accommodate" in between. This is because there was no way to get each eye to see perfectly both close and far. The accommodating lens do most of it, but the doctor said they wouldn't do 100%. Now, using both eyes, I can see close and fa with no correction needed. It's a form of modified monovision.  I no longer use prescription glasses for anything. I can read the small print on the menu in poor light, drive at night, and shoot iron and dot sights. Best $$ I have spent in a while.  I did get some floaters initially, but the doctor "zapped" most of them with a follow up procedure. Not an issue. The doctor I used had done "a lot" of these, and was very helpful in deciding the precise approach to take.  Cost was $12,000 in Southern California, Medicare paid half (i.e. the procedure, but not the lens).  (Oh, I am 69)

12 Grand, wow! And Medicare paid half, wow!

Thanks for all the the good information. I feel like I have some idea now of what I may want. My distant vision is very good now, as I just deal with presbyopia. If I go with the lenses correcting for distant vision, I may end up just like I am now. That wouldn't be terrible. I have four pairs of glasses now. Two pair I use for shooting (one for irons and the other for dots). I have computer glasses and trifocals. Before presbyopia I had 20/15 in both eyes. I do have a slight astigmatism. A shooting buddy said that when he got his cataracts taken care of that the eye doctor used a laser. He also said, that he zapped his floaters. Maybe he was mistaken, but he raves about his vision and he is shooting very well with the "new eyes".

To remove the old lens with cataract, and put a new lens into the eye, the surgeon needs to make openings in the front of the eye.  Doctors can do that manually, or it can be done very precisely with a laser.  Lots more information here:
http://www.allaboutvision.com/conditions/laser-cataract-surgery.htm

mikemyers wrote:To remove the old lens with cataract, and put a new lens into the eye, the surgeon needs to make openings in the front of the eye.  Doctors can do that manually, or it can be done very precisely with a laser.  Lots more information here:
http://www.allaboutvision.com/conditions/laser-cataract-surgery.htm

My understanding as well.  I just tried to find a doctor with the latest equipment and a history of extensive use with it. Most doctors will advise based on whatever equipment and personal experience they possess.  This really became clear when I was diagnosed with prostate cancer 6 years ago.  Lots of changes in the medical fields,  happening at a rapid pace. Often, doctors not familiar with new technology, or perhaps not yet able to afford the equipment, will nay say those procedures.  This can be very difficult to evaluate.

I'd like to offer a more complete explanation on cataract surgery even though it had been mentioned. The lens is located behind the cornea and an incision is made on the cornea so that the surgeon may enter the eye. The cataract is encased within the lens capsule which must remain intact after the cataract is broken up and removed. A circular opening on the anterior capsule is made to allow removal of the cataract and allow access for the intraocular implant to be inserted. Once the cataract is removed, the cataract will never return. A confusion often exist when the patient reports that vision becomes cloudy once again after the surgery. Posterior capsular opacity often develop after surgery which affects vision but this is a simple fix with YAG laser capsulotomy. It is very important that the integrity of the capsule remains intact because it also provides a physical barrier to hold the vitreous. Those with enlarged prostate and are taking Flomax or similar drugs must inform your surgeon because the desired effects on the prostate also have potential detrimental affects on the iris in relationship to the cataract surgery.

MikeMeyer, thank you for your eloquent apologies and let's move on. If you can provide your email, I'd be happy to share some experiences.

This is ghilliemans wife....I'm a surgical tech. for an ophthalmologist. If youre sitting on the fence about the type of lens, there are so many to chose from. Technology has come so far now that even the most basic lens is a great lens. As far as choosing near or distance vision, you can do one eye for near and the other eye for distance. If you can financially do it, the multi focals are the way to go. If you have astigmatism there are a lot of lenses out there that help correct it. Also later if your vision changes a bit, a lot of Dr.s like the ones I work for offer to tweak your vision with lasik later for no extra charge if you choose a multi focal lens. If anyone has had cataract surgery and your vision is foggy or not as clear afterwards, there may just be cloudiness in your capsule that holds the lens implant in place. So dont just assume that's how your vision will be. Go back to your ophthalmologist and be seen for it. This can be fixed in 5 minutes with a YAG laser. Sometimes the cloudiness is so extreme that you may be able to tell an immediate improvement, even with your eye dilated. Heres the website for the surgeons I work for if anyone would like to look around or look at lens options. and I'm also available if anyone has any questions....just let ghillieman know... www.heatoneye.com

Ghillieman wrote:This is ghilliemans wife....I'm a surgical tech. for an ophthalmologist. If youre sitting on the fence about the type of lens, there are so many to chose from. Technology has come so far now that even the most basic lens is a great lens. As far as choosing near or distance vision, you can do one eye for near and the other eye for distance. If you can financially do it, the multi focals are the way to go. If you have astigmatism there are a lot of lenses out there that help correct it. Also later if your vision changes a bit, a lot of Dr.s like the ones I work for offer to tweak your vision with lasik later for no extra charge if you choose a multi focal lens. If anyone has had cataract surgery and your vision is foggy or not as clear afterwards, there may just be cloudiness in your capsule that holds the lens implant in place. So dont just assume that's how your vision will be. Go back to your ophthalmologist and be seen for it. This can be fixed in 5 minutes with a YAG laser. Sometimes the cloudiness is so extreme that you may be able to tell an immediate improvement, even with your eye dilated. Heres the website for the surgeons I work for if anyone would like to look around or look at lens options. and I'm also available if anyone has any questions....just let ghillieman know... www.heatoneye.com

That is an English interpretation of what I did.  Thanks G.

Rather than type in what I've learned at the Eye Hospital, I'll just post a link to one of the websites that covers most of what's good and bad about multi-focal IOL's compared to a standard single-focus IOL.   I see it as a choice between convenience and quality.  For the best vision, single-focus is best, but it means also wearing glasses.  With multi-focal, things at two different distances can appear sharp.  

http://www.changcataract.com/los-altos/cataract-center/frequent-questions-about-multifocal-lens-implants.htm

BE Mike -

I had both eyes done (2 weeks apart) for far vision in 2013. Correcting an astigmatism and my near vision too would have been outside my eye plan and cost me about $11000. 

My far vision went from 20/80 to 20/15 and I have a reading prescription I rarely use. 

I have SSP shooting glasses with a reading prescription set of lenses and a non-prescription set. I use 1X scopes on many of my pistols so shooting precision has become a pleasure again.

Good luck. You won't be disappointed.

mparker wrote:......I have SSP shooting glasses with a reading prescription set of lenses and a non-prescription set. ....

Can you please say more about which SSP glasses you use?  Are they like these:
   https://sspeyewear.com/collections/top-focal-interchangeable-kits

I assume they're available in polycarbonate, and I like the idea that they wrap around your eye.
My cataract surgery is long over, but I'm still trying to figure out which shooting glasses to use.

mikemyers wrote:

mparker wrote:......I have SSP shooting glasses with a reading prescription set of lenses and a non-prescription set. ....

Can you please say more about which SSP glasses you use?  Are they like these:
   https://sspeyewear.com/collections/top-focal-interchangeable-kits

I assume they're available in polycarbonate, and I like the idea that they wrap around your eye.
My cataract surgery is long over, but I'm still trying to figure out which shooting glasses to use.

Yes - the Top Focal. They come with the prescription of your choice and an extra set of uncorrected lenses. I use both and they are quick and easy to change compared to Wiley.