The story of my left eye – so far: Part VII
[NOTE: [Part I can be found here.
Part II can be found here.
Part III can be found here.
Part IV can be found here.
Part V can be found here.
Part VI can be found here.]
The good news – really good news – is that my distance vision in my left eye continues to be fabulous. It’s 20/20 or even better, more clear than I ever remember it being, and this is after having endured quite a few years of 20/200 vision in that eye that glasses couldn’t correct except a tiny bit.
The second good news is that I even have fairly good computer-distance vision (mid-distance) in that left eye now. I still use eyeglasses at my computer because it’s a lot better than not using them, but I can actually read the print without them. It’s just not nearly as comfortable or clear as with the eyeglasses. But it’s a ton better than it was before even when I used glasses.
The less-good news, although it may resolve over time: I still have some irritation in that eye, and it’s been two and a half months since the surgery. I think it’s from dry eye – the eye doctor I saw at home said my eye otherwise looked fine – which sometimes occurs or is exacerbated after cataract surgery either for a few months or permanently. I’ve been holding off using drops for it because I tend to be allergic to a lot of things like that, and I’m hoping it might go away anyway by itself over time. But I may start using the drops soon.
Other less-good (but expected) news is that my operated-on eye, my left, has lost its ability to read closeup print without glasses. I was able to do that with the cataract due to a phenomenon called “second sight,” which sometimes happens with cataracts. As the person’s distance vision degenerates, sometimes the near vision gets quite good for a while. I was in that stage, but since I only was allowed to get a monofocal lens replacement, I chose a distance correction and lost the ability to read as well with the left eye. But reading glasses work very well now, which they hadn’t before.
But – more good news – my right eye, the unoperated one, is taking up the slack and I can still read closeup without reading glasses if only briefly, due to “second sight” in my right eye. I have a cataract there, not quite as bad as the one in my left eye was but bad enough. I’m waiting to have that eye operated on, though, because I need a longer break from eye surgery and also because I’m not too keen on losing that ability to read without glasses. It’s very convenient.
I also can’t decide what to choose in terms of lenses with that right eye. I’m not allowed to have a multi-focal lens because the problems in my left eye precluded one, and that sort of difference in the two lenses wouldn’t work well together. I could choose a close-up monofocal lens, and try to have monovision (which I sort of already have had anyway due to the differences in my eyes). Monovision means using one eye for distance and the other for close.
But sometimes I think I should just finally have the two eyes working together, have a monofocal distance lens put into the right one and surrender to the need for reading glasses every time I read anything close up. Another choice I might be allowed is what’s called an extended vision lens in that right eye, which supposedly would give me distance vision nearly as good as in the left, plus better middle-distance vision, but still not closeup vision. But that choice might involve slightly more night halos and glare.
Am I confusing you enough?
Speaking of night halos and glare, I still have them in my left eye. That doesn’t happen to most people who have cataract surgery, at least that’s what I’ve read. Most of them have had problems with night vision – halos, glare, starbursts – before the cataract is removed, but the problems go away afterwards. Patients with multifocal lenses are more apt to have those halo/glare type of problems continue, but I don’t have a multifocal lens; just a monofocal lens. And yet I, along with a certain percentage of monofocal lens recipients, continue to have halos and starbursts around streetlights and headlights at night, although not as bad as before the surgery.
There’s a possibility this condition will improve, but for a lot of people the problem is permanent. I’ve read tons of articles about it, because of course it affects night driving, but no one really knows why it sometimes happens. Some people are so bothered by it that they have the lens taken out and a new one of a different type put in, but there’s no guarantee that would work, and a second surgery has more risks in general. In my case, with the particularly challenging problems that existed in my eye prior to surgery, I think any surgeon would be even more reluctant to do such a replacement. They would just say to live with it, and I think that probably is the best advice.
I wonder sometimes if I’m getting the night vision halo/glare/starburst problems due to the interaction of the new lens with the much-larger-than-normal iridotomy hole I have in that left eye (see this), but no one has been able to tell me whether that’s the case because the size and shape of my iridotomy hole is apparently quite a unique feature. Fortunately I’m able to drive at night, but I just don’t think I’ll be doing lengthy trips at night out in the countryside – something I actually used to do, years ago, when I often visited friends who lived in rural areas.
Because I’m the type of person who seeks to know the why of things, I’m still troubled by the fact that no one knows why I got all that scar tissue in the first place. And why on earth did it suddenly gets so much worse last fall after having seemingly been stable for years? How could I have had uveitis (deep eye inflammation) and not been aware of it? It’s ordinarily quite noticeable and causes significant symptoms, but I didn’t have them. It’s a frightening thought that so much damage could have occurred silently, and it makes me worry whenever my eye feels even a little bit irritated, which sometimes happens (perhaps because of dry eye).
So I’m left with residual puzzlement and fear about how and why it happened. Was the scar tissue from the iridotomy? One doctor said no, another said absolutely, and a third said he didn’t know. And if it was, why didn’t it occur until years later (up to eight or so, by my estimation)? And also, should I have another operation to have the iridotomy sewn shut, and see if that improves things? The LA eye doctor says I could do that because once the natural lens (cataract) is removed and the artificial one put in, the narrow angles that necessitated the iridotomy in the first place open up and are no longer narrow. Therefore the iridotomy hole is no longer needed for drainage. But he also said that the tissue of the iris is fragile – “like wet Kleenex” – and if it’s sewn shut the iris tissue around it might feel the strain. And of course it might not solve the night light problem anyway, although it might. So far no one can say.
So I think I’ll pass on that for now. And I’ll pass on having my right eye done for a while, too.
That’s probably more than you ever wanted to know about my eye. But that’s the story – so far. I remain very grateful that I found a doctor who seemed to be eager to rise to the challenge, and seems to have had the ability to do so.
Keeping you in mind.
This is GREAT news! Keep on healing!
One thing you might want to try when using computer/tablet/phone screens are what I believe are called “blue-blockers”. Strangely they seem to be tinted yellow … at least they seem that way to me.
I find them somewhat helpful in relieving eye strain while staring at screens.
They don’t seem to have any effect when I’m reading dead-tree books etc.
Of course YMMV 🙂
Tuvea:
My computer glasses supposedly have something that blocks blue light.
After using glaucoma drops for many years, I became sensitive to preservatives used in many drops. I`m using less drops due to surgery to relieve the pressures but I too ended up with cornias drying out. Refresh Plus drops completely solve the problem and they have no preservatives. I hope this helps.
So glad to know that you found the right surgeon and that a complicated procedure turned out well for you. Here’s hoping some of the remaining problems clear up for you over the months ahead.
Your perseverence over the years in posting this valuable blog despite severe visual obstacles is highly admirable.
But sometimes I think I should just finally have the two eyes working together, have a monofocal distance lens put into the right one and surrender to the need for reading glasses every time I read anything close up.
I haven’t studied all of those related issues as much as Neo has, but I’d want both eyes working together. I’m a fan of Ben Franklin’s solution, the lined bifocal eyeglasses. A little trick I use is to lower the bifocal inset (Add Power) about 2 or 3mm lower than normal. With this, I get a more expansive field of view for distance viewing, and there is still enough of the inset lens for computer screens and reading material. The blurry line doesn’t interfere with your distance viewing as much either.
A difference is that I’m very near sighted, so if I take my glasses off entirely, I can see close up quite well. With Neo, or later when I get my cataracts removed, the distance viewing is the norm sans eyeglasses. I suppose one could get into the habit of carrying a little pocket magnifying glass.
These essays about your eyes are interesting, and I am happy to hear that your results are generally very good! Not perfect, but good. I think also that people with other vision problems may benefit from reading this.
My husband has monovision contacts, including on one eye which has had cataract surgery. I tried monovision 30+ years ago, when I began needing reading glasses, and couldn’t handle it. So I wear progressive lenses, glasses, and I can see distances or read at any time. My distance vision is improving as I age. If I ever get to the point of not needing distance correction, or if I get cataracts removed, which would have the same result, I think I’d go for granny glasses on a neck chain so I could read when I wanted to. Friends buy cheap reading glasses at drug stores and leave them everywhere.
I’ve had cataract surgery in both eyes, 5 years apart. Mostly good result, except for some perceived light flickering with the 1st – related to the way the lens edge is shaped. Used different brand lens for 2nd and no flickering with that one. And I hardly notice the flickering now that several years have passed. But – I do now have halo/glare/starburst issues with lights at night – things get tricky with oncoming headlights and wet roads. This issue appeared subsequent to vitreous detachment, which occurred in both eyes, about a week apart, around the time of my 2nd cataract surgery. Seems that the detachment caused clouds of tiny debris particles (along with some larger floaters) – so I get the starburst/glare/halo due to the light scattering from these.
Thanks for all the details. Very interesting to people, like me, who have poor eyesight.
Geoffrey Britain:
Thanks.
I think I was slightly in denial about how bad it had gotten, in part because I always assumed that it could be fixed by cataract surgery. It was only this past January, when I went to the doctor at Mass Eye and Ear and he was so pessimistic, that I realized I might be in bigger trouble than I’d thought.
CATHERINE:
That’s interesting.
I had a vitreous detachment around 2016 in my right eye, and I also had one 10 days post-cataract surgery in my left eye. But I had had the same halo and starburst symptoms in my left eye before and after the PVD, so I don’t think that was the cause for me.
I have had a lot of floaters in both eyes since I was in my 30s, though.
Not easy to sort it all out in terms of cause.
I’m with Kate — both eyes optimized for distance vision. I began having trouble with my computer 25 years ago and my brother-in-law gave me his reading glasses as we left on a trip to England. I’ve used “dollar-a-pair” reading glasses ever since, hung around my neck. Started with .5s and am up to 2.5s now….I expect that I won’t run out at the top end before I depart this mortal coil.
Of course, the ophthalmologist says that I’ll need cataract surgery one of these days, so we’ll see how it goes.
I had cataract surgery and a monofocal lens in each eye. Even before the surgery I had already more or less been using one eye for close-up and the other for distance and had gotten very used to it. Your brain adjusts. It doesn’t seem to be that important for the two eyes to work together.
I still have some halo occurrences, though it’s been several years now, but it’s not enough to bother me.
I can both read and drive without glasses–even passed the driver’s vision test last month without glasses–but both are slightly easier with glasses, especially driving. It’s not usually worth it to use glasses for reading.
It’s good to hear how well your complicated surgery went and how improved your vision is.
I’m so happy for you!
Wendy Laubach:
Glad you’re doing well.
I’ve heard that most people adjust well to monovision but that between 10% and 40% never adjust and have a lot of problems with it. I have been okay with the sort-of-monovision that I have now, and yet I sense some strain with that is hard to describe.
I don’t need glasses for driving at the moment in the daytime. I also don’t need them at night but I sometimes “feel” better with them on at night even though they don’t actually seem to make any difference at all to my visual acuity.
Most people bring up a medical condition or malady they’ve recently faced and it is time to excuse yourself gracefully and get far away. Not you, Neo. Your writing is always so natural and smooth, so easy to read, it’s like engaging in a comfortable conversation with someone you know well. On any topic upon which you touch, your writing is always deeply informative; I confess I have read all the recent posts about your eyes and really enjoyed the time spent on them. Of course, it goes without saying I wish you the very best for continued improvement.
Your descriptions of ocular travails and triumphs are very interesting.
Here are my experiences that correspond to those you described. Of course, your experience may vary.
“The less-good news, although it may resolve over time: I still have some irritation in that eye, and it’s been two and a half months since the surgery.”
I used MURO 128 (Sodium Chloride Hypertonicity Ophthalmic Ointment, 5%) for about a year to ease the irritation. Irritation no longer an issue.
“But sometimes I think I should just finally have the two eyes working together, have a monofocal distance lens put into the right one and surrender to the need for reading glasses every time I read anything close up”
That’s what I did. I was concerned that I would be among those that would not adjust well to monovision. For me, reading glasses for anything within 6 feet has been working fine. However, if “magical” new lenses become available, I would strongly consider going through the procedures again.
“And yet I, along with a certain percentage of monofocal lens recipients, continue to have halos and starbursts around streetlights and headlights at night, although not as bad as before the surgery.”
I had that problem for the 1st year, and then it cleared up on its own.
neo:
Great that things are progressing well!
Mind the drops and dry eyes!
Get the dry eyes sorted out.
Your tear film is very, very important to vision.
My situation is almost identical to Wendy Laubach’s, except I have floaters but no haloes.
One near-distance lens and one long-distance lens, driving glasses if I want them, but usually no problems except for hard-to-read street signs.
@ Scott > “Your writing is always so natural and smooth, so easy to read, it’s like engaging in a comfortable conversation with someone you know well. On any topic upon which you touch, your writing is always deeply informative”
So true!
Even posts about Jell-o.
That opinions from professionals vary is scary, seem you have weighed these and so far done what’s best for you in these episodes.
Hope sight can improve with time for you.
My ophthalmologist questioned me on my daily activities and when I told him I spent a not insignificant time in front of a computer and reading, he suggested lenses that would give me 20-40 vision, which would allow me to use the computer without readers. It has worked well. I could drive without glasses, but wear them anyway. My wife came down with Bell’s Palsy about three months ago and though her facial muscles seem to be back to almost normal, the affected eye is still producing blurred vision. The doc says this could take up to a year to resolve, if ever.
I had cataract surgery in both eyes a little more than a year ago. Like you, the cataracts developed gradually over a number of years and I was unaware how much my vision had degraded over that time. I also observed that my close focus had actually improved in the latter years; I had no idea why, but likely due to the “second sight” phenomenon that you cited. Because I wanted to be able to drive without glasses, I chose distance focus for both lenses. I also had astigmatism in both eyes, so my surgeon chose toric lenses that she precisely positioned in both eyes to correct each one. While initially examining my eyes, my surgeon noted a dry eye condition in both, and gave me drops to use for future examinations. She wanted the upcoming measurements to be accurate and unaffected by dryness. It surprised me about the dry eye condition; there had been no indication of its existence. After both eyes have healed from the surgery, I am very pleased that I chose distance focus for both eyes; I very much enjoy looking into the horizon without glasses and everything in focus. I find when driving that even the gages on the dashboard are in focus enough that I do not need glasses for them. And yes, for reading I do need glasses, but inexpensive readers are perfectly functional, and I have become quite comfortable with them. I like having both eyes working together at distance, and corrected for reading. After the surgery for the first eye, I considered splitting the focus far/close between them, but decided I wanted both to work in pair. Having to use a reading lens on one eye and a distance lens on the other did not seem clever. In hindsight, I am quite pleased with the outcome.
After the first surgery I did observe a noticeable lens flare at night (like a starburst, but only two rays 180° apart). After consulting with my surgeon and the lens manufacturer (who wasn’t too helpful), I concluded it was an artifact of the toric lens, which is a common phenomenon in similar anamorphic cinema lenses. It hasn’t been a problem for me in daylight, and much of an issue at night.
So glad for all your good news, Neo. Best always!
I agree with RTsquard. I also had both eyes set to distance vision. One way or another, I was going to have to use glasses for some things, so I opted for being glasses-free for driving and outdoor activities. I just keep inexpensive reading glasses all over the place and have progressive bifocals specifically for computer work. Just remember to put reading glasses everywhere that you might need them, including your emergency kits.
Like the rest of the commenters, I’m very glad that you elected to take charge of your problem and manage it to the best of your ability. I believe that this action actually has beneficial side effects in the healing process, because of your commitment and personal investment in seeking the right doctor and treatment (not financial) as well as the diligence you brought to bear on the healing process. Thanks very much for sharing this journey with us, and long may it continue!
So glad that you’ve had such an improvement in vision, after all of this!
Monovision is certainly an option to consider for your right eye surgery. I had a monovision prescription for contact lenses for years, and that worked well for me. I understand that not everyone adapts well to monovision, though. Maybe you could get glasses made with a monovision prescription to try it out before your second cataract surgery.
As for bifocals, you can have the close-focus area of the lens cut any way you want. I always had the line higher than normal. Sitting at a computer, I wanted the line to be about where the top of the screen would be, so the whole screen was in focus. That worked well for driving, too, because the line was about where the top of the dashboard was. (Side note: librarians and airline pilots often get bifocals with a second close-focus area at the top of the lens, so they don’t have to tilt their heads back to read above them. You really can get the lens cut to suit your needs.)
As Philu noted, allergic reactions to eye drops are often about the preservatives. There are preservative-free drops. Ask your doctor for recommendations.
Interesting Diane,
I don’t like driving with my bifocals probably because I like the close focus area set extra low. For driving I prefer single vision sunglasses. If I get the distance prescription set correctly, I can still read the dashboard instruments.
Diane E Wilson:
Thanks for the suggestions, but eyeglasses with a monovision prescription wouldn’t tell me anything new. I already have form of monovision because my right eye is terrible at distance and good closeup, and my left eye is great at distance and not good closeup. I am functioning okay that way, but it feels a little strange and unbalanced, perhaps because my right eye is my naturally dominant eye and my brain is having to override that for distance. My brain seems to be handling it, but there’s a bit of stress involved that I think I perceive in some very subtle way.
The other reason why I can’t do a trial of monovision eyeglasses is that my right eye is uncorrectable with glasses, both the near and the far vision. Both eyes were like that before the surgery, but now the left eye doesn’t need correction for distance, and for close work it corrects quite well with eyeglasses. If cataracts are bad enough, eyeglasses don’t help.
I’ll send you one of those neck chains that allow you to have reading glasses fully at hand.
neo:
Glad to hear that the results of your surgery continues to be positive. I’ve followed your updates closely as my wife will soon be needing cataract surgery, but only has effective vision in one eye. She contracted histoplasmosis that resulted in scarring of the blood vessels in front of her retina in the other eye, leaving only very narrow peripheral vision. She is very nearsighted (think of coke bottle bottoms for glasses!) with lots of floaters, and we are looking at who would be the best eye surgeon for the procedure, as it’s important that it goes right the first time.
I really appreciate you sharing what you’ve been through, and the info on the doctor that did your surgery. I’ve in turn shared it with her, which is encouraging for her. I plan to contact the doctor that did your procedure, he looks to be topnotch, and worth flying across the country to have it done.
I really enjoy your site and posts, and wish you the best on further recovery.
I long had 20/20 vision (when young, my left eye was 20/15, even better), even well/deep into adulthood. As I hit about 50s, my eyes weakened, and I have been using non-prescription reading glasses. I could probably now use a prescription pair, but max-non-p (+3.25) seems to still be fully acceptable.
I will assert that being farsighted is VASTLY better than being nearsighted, for the simple fact that you have far more control over the conditions in which you need to read “close up” than you do “far away”, e.g., it’s generally at home, when not physically active, and so forth. Wearing glasses when being physically active is a major pain, as they are going to fly off your face, get stepped on, etc. I love not needing to wear glasses when driving, walking, or doing other things.
Meanwhile, my ability to use OTC cheapo reading glasses (usually from “Dollar Tree” stores, so “cheeeeeeeeeeeeep”) means I have about 5-10 different pairs on hand, one sitting at each place where I typically wind up needing glasses (I also have a pair I keep around my neck, but I don’t always wear it around the house, so they save me from having to go hunt up the “go to” pair).
That’s great! That’s great news! 😀