Cataracts

[The Annoyed Man]

So I went to see my optometrist yesterday, since it had been over a year since my last visit, and my vision has been deteriorating. Overall, my eyes are healthy, no macular degeneration or other pathologies, my prescription has changed.....but not by that much. However, I have a first time diagnosis of cataracts in both eyes, slightly worse in the left than the right eyes. Needless to say, I was taken aback.

But in retrospect, it makes sense..... The past two times I've been shooting rifles, I went to Tacpro on August 22, and I went to Parker County Sportsman Club on October 11. At Tacpro, I shot at 500 yards; and at PCSC I shot at 200 yards. At Tacpro, using a 4.5-16x50 Viper PST scope, the target (a 2/3 scale IPSC steel silhouette) was clearly visible, even at 500 yards and despite some mirage effect. (Pictures here: viewtopic.php?f=87&t=74156&p=933696&hil ... ro#p933696" onclick="window.open(this.href);return false;). At PCSC, using the same scope just 2 months later, and at only 200 yards, I had a lot of trouble getting the target evenly into focus....whether I was using the side focus knob or the diopter adjustment on the eyepiece. Even zoomed in all the way, I could get part of the target board into focus, but other parts of the target board seemed blurry. I describe it as "patchy blurriness". At the time, I wrote it off to needing a new prescription. But in retrospect, I think that each patch of blurriness was a recently developed cataract, surrounded by areas of good focus.

My optometrist says that cataract surgery won't be necessary right away. He's been monitoring my eyes for 4 years now, so it's not likely that this is a misdiagnosis. I also know that there are fewer types of lenses that are effective for older people than for younger people.

So I was wondering for those of you who have had cataract surgery, what sort of choices you've made as far as lenses, and how it affected your shooting ability, particularly with a rifle. The biggest bummer for me so far is how it might affect that.

[rotor]

I have good friends who are optometrists(OD) and opthalmologists. I have my eyes examined by my opthalmologists ( MD or DO ) and my glasses made by my optometrists (OD). My cataract surgeries were done by my opthalmologist. I don't fully understand your question though. Your vision after cataract surgery will be improved both in near and far and night and day as well as color perception. Do not hesitate having the surgery if it is recommended. I think optometrists are much more skilled at fitting for specialized glasses and contacts especially for special shooting glasses and probably even for measuring your vision for special type of lens like some pilots need with overhead switches. I know when I go to my opthalmologist his girls measure my vision and they may not be as accurate as the optometrist might be. The surgery will be done by an MD (or DO -not to be confused with an OD) though. My wife exclusively sees an optometrist and has special contacts with near lens in one eye and far lens in the other.

[The Annoyed Man]

I understand the difference between an optometrist and an opthamologist. One has a medical degree with a surgical residency, and an optometrist does not. My question has to do with the options of replacement lenses available For surgical implant, and how did they affect your long range rifle shooting ability.....and how you compensated for it.

The reason I asked was because the most commonly used replacement lens for people above a certain age (which happens to be my age) only focuses at a specific distance. It does not have the ability to focus at all distances, and therefore sharp vision is limited to the focal length of that lens.

He said that lenses do exist which can be focused by the muscles of the eye at multiple distances, but they don't work in the eyes of older people because those muscles have been atrophied by the processes of aging. He said they don't even work that well in all young people. He said that there is another multi focal lens which is like those multi focal contact lenses, which have an outer ring that focuses at a different distance than the inner part, both the close range and longer range images are projected onto the retina, and the brain learns to select the image that it needs. There may be other options, I don't remember.

My question is along the lines of, what options were you offered, if any, and which did you choose and why, and how has that affected your ability to shoot a rifle? Not sure I can make it any clearer than that.

[b322da]

... So I was wondering for those of you who have had cataract surgery, what sort of choices you've made as far as lenses, and how it affected your shooting ability, particularly with a rifle. The biggest bummer for me so far is how it might affect that.

If all goes well, TAM, everything should be OK. The object of the procedure, of course, is to improve your deteriorating vision. You may expect to have to obtain new glasses even if the operations are entirely successful.

For me the good news is that my optometrist after the surgery had a CHL, and he made me glasses with the right lens which focuses on the front sight of my handguns, for use in competitive bullseye competition, which is the only time I wear them. That is, for self-defense, for obvious reasons I have practiced shooting with my regularly-worn glasses, and without any glasses at all. I am adequately proficient in the latter, as, under the circumstances, I am not concerned with the difference between a "10" and an "X." :)

Since my infrequent shooting with rifles is confined to using open sights (milsurp), after cataract surgery on my right eye my regularly-worn glasses are quite adequate to focus on the front sight. I also have no problem with a scoped rifle when occasionally shooting one belonging to my son, who is a hunter. Usually I do this while trying to teach him the importance of trigger control -- which I have found is not appreciated enough by many rifle shooters. He does well with handguns, but he tends too often to jerk the trigger of a rifle.

For me the bad news is that my right eye, my dominant eye, did not need cataract surgery until more than a year after my left eye. I had moved during the interim, and had a different ophthalmologist for the second surgery. The result was that after the surgery I had a vertical displacement between objects viewed with both eyes open, that is, I saw two of the objects, one atop the other, and I needed a new prescription for the right eye lens which includes a prism, thus correcting the vertical displacement. This is troublesome in general, but it does not affect my shooting, as I am only using the right eye to see the front sight anyway, although I do keep both eyes open, both for marksmanship and self-defense shooting.

You should have no problem, TAM, and I suspect that you will be pleased with the result of having the surgery.

Jim

[Abraham]

I may have mentioned this in a prior thread, but I was diagnosed as needing cataract surgery in "a few years" by my optometrist.

I was then examined by a highly respected ophthalmologist . He said not only did I NOT have any sign of cataracts whatsoever, I didn't even need glasses except for reading or using a computer monitor.

As it turned out, I was having migraine headaches due to being mis-prescribed lenses for everyday glasses. Mis-prescribed may not be the right wording, as I plain didn't need glasses at all.

With his recommendation, I left his office without wearing my glasses.

Now, at least a year and a half or so later, I still no longer wear glasses.

I'm sure my experience is the exception, but I would certainly get a second opinion about needing cataract surgery.

[b322da]

...I'm sure my experience is the exception, but I would certainly get a second opinion about needing cataract surgery.

As a piece of trivia, TAM, having said what I did in my earlier post, I am currently engaged, very late in my life, in trying to do without wearing glasses all the time, and I think that I am making some progress.

The human nervous system is amazing, and it can do unbelievable things. As but one example, a few years ago I had a Cochlear implant on the left side due to my hearing becoming almost completely gone, at least partially, I am sure, because of gunfire -- little ones and big ones -- with perhaps only a twist of cotton for ear protection, before the days of efficient ear muffs. An unfortunate, but predictable result, about which the surgeon had warned me, was that the surgery caused me to lose most of my sense of taste. The nerve upon which my sense of taste depends is adjacent to one which must be cut when the implant surgery is done, and the chance that the surgeon, regardless of efforts to avoid it, cuts both nerves, is real.

Three years later and the similar nerve on the right side has largely taken over the burden of both, and my sense of taste is almost as before the surgery.

Similarly, there are many cases of one losing a facility, such as vision, seeing other senses improve, tending to counteract the loss of vision.

I have convinced myself (possibly just rationalization) that without a prism for the right eye I might be able to overcome the vertical object displacement, and I am continuing to work hard at it. The down-side at this point is that should I be pulled over by an LEO while not wearing the glasses noted on my driving license as being required, I could have caused myself yet another problem -- which I do not need. :(

Jim

[jimlongley]

I have had cataracts for some time now, but Medicare and my coverage say I have to have a certain level of loss of vision, so I am still waiting, and lately suffering.

My wife had her lenses replaced therapeutically a few years ago, with the implanted "Crystallens" adjustables and really enjoys them.

We'll see what my options are when the time comes. My next appointment is in January.

[Jim Beaux]

Tam I wear mono-vision contacts - two different power contacts. I dont need glasses unless I remove my contacts.

One eye dominates for near vision and the other for distance vision. Your brain automatically makes the adjustment subconsciously (Unless youre a lib).

Depending on font, I can read print within 7" - 10" inches away and dont seem to have difficulty with distant objects. I do have a few problems with depth perception & my night vision is not as sharp.

When shooting it takes longer to aim. I have to keep both eyes open and shift from left eye for the sights/scope and then the right for the target; as a result Im not as accurate or as fast as I once was.

Based on what little I know I would guess that you will be fitted with lens and glasses for certain situations.

There are options available and you should adjust.

[jminn1]

TAM,
In 2010 I was diagnosed with sudden-onset cataracts after being treated with very strong steroids for a different life-threatening issue. After having bad vision and wearing glasses and/or contacts my entire life, getting artificial lenses and subsequent lasik has been a amazing, life-altering experience. I CAN SEE! I have to wear reading glasses for reading and computer work, but outside I see 20/15. I do have issues with low-light, but that is a common side-effect of artificial lenses. I was nervous as hell going in, but I can assure you that the surgery isn't a big deal, and the post-op is easy and effective, but you MUST follow the instructions to the letter. I have had to retrain myself on pistol to some extent as my hand-brain perception changed with the huge difference in my eyesight. It had little effect on shooting a scope-sighted rifle, but there is a difference on open sights. I can still hit a quarter at distance with the old single-shot .22 and open sights, but it did take some retraining.
PM if you want the type of lenses and the name of the doctor I used here in DFW.

[rotor]

I should have have clarified. I have always been nearsighted and wore glasses for correction for distant vision. As i got older I eventually needed bifocals to read closeup while wearing my glasses and eventually trifocals while wearing my glasses. After my cataract surgery I am still nearsighted, still need glasses for distant vision and still need trifocals to read closeup while wearing glasses but of course I can take them off and see really close up without them. The difference is that I don't have the cataracts. So, I think you will find things a win win situation. With aging eyes though I doubt that you will be able to handle the near-far like you could at say age 20. But then lots of things don't work the same as the did at age 20 do they?

[joe817]

In reading through the thread, I find myself relating very well to some of the posters. I've been VERY nearsighted all my life. Bifocals were the only way to go. 10 years ago, my optometrist told me of the onset of cataracts. To early to do anything about it. Fast forward to last year. I was noticing I was loosing my night vision. And over this past year it got so bad I couldn't drive at night any more. The deciding factor was when I was at a friend's house and he was showing me his guns. He brought out and SKS, and when I pointed it to the ceiling, I could not even see the front sight. It was a low light level room. Went to optometrist to get new glasses, he did some tests & told me I had advanced cataract impairment. He recommended an ophthalmologist. Saw him in early June, 2014. He immediately told me I needed cataract surgery, to which I readily agreed. A week later he did the left eye, then 2 weeks after that the right eye. The surgeries took all of 17 minutes per eye. Totally painless, and for the first time in my life I can see perfectly at distance. I do have to wear reading glasses but a minor trade off. It was a true blessing to be able to see perfectly(at distance). I have no trouble aligning sights with a pistol. About the lenses, all I know is that they are Alcon lenses that he uses in all his patients. I asked him about lenses that would enable me to see up close as well as far away. He told me it would be $3,000 more, and the cost increase would not justify benefits. I'm thankful I've had the surgery. My quality of life as improved significantly.

[The Annoyed Man]

These replies are reassuring. I just didn't have any knowledge other than what the optometrist told me, and I wanted to know what kind of experience others had had with it.

My eyesight started to go downhill in my late thirties. In my twenties, I was 20/15 in the left eye, and 20/17 in the right. I could see like an eagle at distance, and was fine at reading. In my case, the decline was the usual farsightedness that begins around 40 and just gets worse as you age. For the first few years i just needed reading glasses, but was fine for everything else. At some point, I begin to see light "flares" when night driving, caused by other headlights and so on. The optometrist said I had astigmatism, and gave me a prescription for bifocals/progressives for driving at night. Eventually, I had to wear them all the time, and I had to have prescription sunglasses too.

I'm going to wait for a while for the surgery. I bought new glasses yesterday on my optometrist's recommendation. He said I didn't need the surgery right away, but eventually will. I don't want to waste the cost of the glasses, so I'll wait until they just don't help anymore, and then I'll followup with an opthamologist.

[Lisa]

I'm sure my experience is the exception, but I would certainly get a second opinion about needing cataract surgery.

I would get a second opinion about any surgery if there's time, e.g. I'm not being wheeled into the ER post-MVA.

On the other subject, most people I know would stop wearing glasses if they saw better without them. So I think your experience is the exception in that situation.

[The Annoyed Man]

I thought of another question for those who've had the surgery..... did you notice that your night vision improved afterward? It occurred to me tonight on my way home from church — minus my bifocals which are out for new lenses — that one of the things I've struggled with for a while is that I can't see details in the dark anymore. It's kind of like those flatscreen TVs that don't really reproduce shades of black very well, so details get lost. Does that get better afterward?

[joe817]

Yes TAM! It absolutely DOES get better afterward. I was stunned when I started driving again at night because the clarity and detail of distant signs and objects were just as clear and crisp as they are in the daytime. Hard to believe but true. The details that you are loosing in the dark is the result of your lens(the one you were born with) starts getting cloudy, thus decreasing visual acuity. You need brighter light on the object to see it fully. With cataract surgery, the surgeon actually removes the damaged lens you were born with and replaces it with a manufactured one....one that will not deteriorate over time like your natural lens. Like I said before, to be able to see perfectly at night, and eliminating the need to ever wear glasses is a blessing that defies description.