Hello Again, and Cataract Surgery :-(

Hello Folks, Dwight Here,

I used to be fairly regular on the Bullseye mailing list, and as my log in worked on this forum, I am guessing it has morphed into a forum here.  Have not been shooting a lot, but I am on my 34th year teaching school ( switched to science from music about 5 years ago, but still playing violin and viola) 

One reason for not shooting much is a cataract in my right eye.  I can't even use a camera that needs to be focused ( even a Leica rangefinder is tough)  I'm right eye dominant and right handed and the cataract is on the right.  Kind of makes me a bit crazy.  It isn't any betterwith the aperture sights of a rifle or field crossbow.

There used to be a nice fellow on the list who was an eye doctor.  Is he still around?  I think he was ex Navy.

Any advice would be welcome, the whole thing scares the hell out of me.  I have a feeling my idea of what is acceptable eye sight and the insurance company's idea may be quite different.  Like most of you I am kind of at their mercy.  If I have to I will pay for it myself ($$$$$)


Thanks for Your Kindness

I believe that is
xmastershooter, If the cataract affects any of your job responsibilities you should be good to go.

I believe it's Norman Wong, but I'll check for you.

check this URL
https://www.bullseyeforum.net/t5774-any-optomerists-on-board?highlight=norman

That is exactly who it was!  I have been going round and round with this problem for over a year and have given up several times.  I was sent to an eye doctor group that was much more concerned with volume than anything else.  Fifty people in a waiting room and no ability to communicate.  Very frustrating indeed.  Is Norman still around?  we know each other a bit, I sent him some revolver grips some years ago.

Thank You!

There have been several lengthy discussions on cataracts on this forum as well. There’s also a user on this board by the name mikemeyers who seems to be very knowledgeable about cataracts and options. So search for his posts as well.

Hi K38,

ex Navy, yes!   ...nice fellow??? 
Two things are in your favor.  You're asking questions, and there is a high rate of success in cataract surgery today.  No one will go blind from cataracts because medicare will cover the basic costs of surgery.  "Everyone" will develop cataracts, it's just a matter of when.  When the cataract affect your quality of life, then the cataract should come out.  HMO's tend to delay cataract surgery noting that it is not "ripe," one of the dumbest terms I've ever heard.

Some cannot tolerate less than 20/20 vision, even the slightest.  Others can get by with less than 20/40 vision and not realize there is a problem.  Glare can especially be a problem driving at nights.  Some cataracts can cause visual disturbances due to small pupils when very bright.  Regardless, if the vision is not correctable with a new prescription, then it's time to take care of the problem.  Some cataracts change slowly but others may change quickly.  A rule of thumb is not to wait too long to have the surgery because the cataract becomes more difficult to break up and remove.

I am not a surgeon but many patients come to see me to explain what their Ophthalmologists failed to explain to them, so I fully understand your situation.  Read a recent thread on this forum "Some Past Experiences with Cataracts/Surgery.  You'll find input from many who underwent the surgery.  Read everything about cataract surgery so you can talk to the doctor with confidence.

Basically, the single focus intraocular implant (IOL) is covered by insurance.  This works well but it does not allow you to see up close, so one must need a reading prescription afterwards.  A second choice would be the multifocal IOL which allows for distance and near focus.  It may work well for some but not others and some may still need eyeglasses to see better.  There is possible glare and less than 20/20 correctable vision.  The third choice would be the accommodating IOL in which it will change to near focus as you use your own eye muscles to adjust.  There are limitations on how close one can focus so eyeglasses may still be needed.  There will be some out-of-pocket expense with the latter 2 choices of IOL's.

There's no wrong choice but choose with what fits your needs the best.  There were satisfied shooters with each of the 3 choices who responded in the thread   Paying more does not mean you'll be happy with the results.  Take comfort that surgeons generally do an excellent job with cataract surgery.  A big bonus is that if you need eyeglasses to see distance, then this power will be incorporated into the IOL and you may not need a distance prescription any longer.  Feel free to inquire further if needed, either via the forum or privately.

Norman

For pistol shooting weather with a dot or open sights would that be close vision?  What about rifle sights with a peep rear?

DLB

Thanks Norman!  Long time sincewe talked.  Dwight here from the K frame grips a long while back.

Hi Dwight,

Folks, Dwight represents the best of the best of shooters I've come across.  Not long after joining the original Bullseye list in 2004, so many shooters were so supportive in helping me advance, and Dwight's generosity was astounding.  Words cannot describe my appreciation.  Welcome back to Precision Shooting, aka Bullseye Pistol!

For a quick review of red dot scopes, generally the best distance prescription would help keep the dot in focus.  I conducted a survey many years ago and 116 list members responded.  60% replied that the red dot appeared in front of the target.  Some, including myself, see the dot better with a prescription slightly different than the best distance Rx.  The fuzz may not be from astigmatism.

With open sights I don't use a reading card to test the front sight distance to the eye because errors in the patient's responses may occur.  I use actual iron sights to test.  Your reading eyeglass Rx would be generally too strong but an "add" would be needed.

Even with the rear aperture of rifles, shooters don't see the front sight post as well with aging.  Proper testing would be needed to determine the best Rx.  Typically the add would be less than with the pistol.

K38 I have had 5 eye surgery s done over the last two years.  Cataracts in both eyes and cornea transplants in both eyes the left eye cornea kept fogging so they replaced it.  I have a great eye doctor here in NE Florida and all 5 operations were a cake walk.  It is just the darn schedule of eye drops that is a pain to keep up with.  I went with single vision distance in the right eye reading in the left but need glasses for reading and to correct astigmatism.  The astigmatism can be fixed but I am not letting them mess with these new corneas.  Contacts will correct mine a 100% but i gave up on them due to the hassle.  I am retired Navy and Medicare and Tricare for Life has covered everything.  Don

Getting the cataract surgery done is something you should definitely do, but do this with a doctor who is able to talk to you, not an "assembly line" if at all possible.

As I see it, there are two vision choices, "precision" or "convenience".  

• The "monofocal" IOL that is covered by insurance can give you near perfect distance vision, but you will need to wear glasses for closer focus.  
  
  
• The so-called "premium" IOL's are all questionable, and I'd rather than have perfect vision, needing to wear glasses for reading, than so-so vision but not needing to wear glasses as often..  I was advised by several eye doctors to avoid them, and go with a standard monofocal IOL.
  

For shooting, you need safety glasses anyway, so they can be the prescription to your front sight, and made from polycarbonate material for safety.  For red dot sights, you will likely need plain polycarbonate lenses, with no prescription.  Or, people here have mentioned lots of other types of shooting glasses.  (I got three pair, one for distance and red dot sight, one for front sight shooting one handed, and one for front sight shooting two handed.)

If you can't see the rangefinder on your Leica camera, it is definitely time to get the cataract removed.  

My own "unofficial" advice, is that if they calculate the power of the IOL to give you perfect vision at infinity, ask them to select an IOL a little bit stronger.  Calculating the IOL is not an exact science, there is a "+/-" tolerance on the strength of the IOL, and the IOL may not end up in the exact spot in your eye that was expected.  Getting a slightly stronger IOL means that something, somewhere in front of you, will be perfectly sharp.  On the other hand, if the tolerances (lens and you) result in the perfect focus being behind infinity, nothing in front of you will ever be sharp without glasses.

Thanks guys!  I am starting to look for a new Doctor in the San Antonio area .  My insurance has been nutured pretty badly but getting one eye done should be OK.

DLB