Reading glasses were avoidable if I’d known

You’ve probably heard people say that they don’t need glasses at all after cataract surgery. I looked forward to the surgery for that reason yet didn’t question the ophthalmologist when he said beforehand that I would still need reading glasses.

In the last day I’ve done more research to write this blog post than before the surgery. I’ve learned that I might have asked for a type of intraocular lens — the artificial lens implanted in cataract surgery — that corrects nearsightedness, farsightedness, and astigmatism so that glasses aren’t needed anytime.

Such premium lenses are expensive, which is why many patients opt for the conventional cataract surgery covered by Medicare. Conventional surgery involves the surgeon’s making an incision in the eye, removing the clouded lens, and implanting a monofocal IOL. Because monofocal lenses provide clear vision at a single focal point, usually far away, these patients still need reading glasses after the surgery. Those with an astigmatism still require glasses to correct it.

Medicare doesn’t cover the additional cost of premium IOLs and of laser surgery, considered more precise than a surgeon’s incision. The type of IOL implanted in both my eyes, a toric lens, cost me $2,000 out-of-pocket in doctor and hospital fees. It corrected both my astigmatism and nearsightedness — and left me needing reading glasses.

Now I’ve learned that a multifocal toric lens costing about $1,000 more out-of-pocket per eye would have corrected for all distances and for astigmatism, freeing me from glasses. But the ophthalmologist never mentioned it. Maybe it wasn’t suitable for me, maybe he doesn’t like it, maybe he sensed I’m penny-pinching. Maybe I would have decided it wasn’t worth the extra money.

It’s uncharacteristic of me to tell a doctor, “Okay if you say so.” In retrospect, I think I didn’t investigate because I didn’t believe I would need readers. I wore bifocal or trifocal glasses since my 40s but preferred to read without them. I didn’t realize that correcting for distance would blur my close-up vision.

It’s a done deal now, and I relate this story to advise people told they need cataract surgery that there are many IOL options available at various prices. These include accommodating IOLs, which provide better near vision than a standard monofocal lens, and multifocal IOLs, which correct vision at all distances. Both may eliminate the need for reading glasses.

My need now is to come to terms with the reading glasses. It’s irritating when I can’t find them. It’s awkward when I have to see close up but would like to see far away at the same time. Last week, for instance, I ushered for plays at both Steppenwolf and Goodman. I was assigned to scanning tickets and reading out loud their row and seat numbers. I needed to wear readers to see the numbers but then couldn’t make out faces until people were right in front of me. Readers blur my distance vision.

I can’t really say that I’m disappointed with the results of cataract surgery. Not since high school have I been able to watch television and drive without corrective lenses. But reading glasses are annoying. I’ve been thinking of how to make them less so:

* Wearing a neck chain to hold the readers. That would keep them nearby and not lost. Since I associate such chains with old ladies and I’m not willing to feel like an old lady yet, maybe this one will begin at home.

* In lieu of the first one, having multiple pairs in expected places around the house.

* Keeping a pair of readers in the same easy-to-reach place in my purse.

* Buying half-frame readers to look over for seeing distances. That would be a solution when I usher.

* Wearing frames with clear glass except for a bifocal reading lens. Being excited about not needing glasses for distance, I don’t like this idea at the moment. It is an option if I get tired of taking reading glasses on and off, however.

At least reading glasses are cheap, don’t require a prescription, and are readily available at the drugstore. Rather than recommend a power range, the ophthalmologist advised trying out a few to see what works best.

If wearing reading glasses were as easy as buying them, I’d be all set.

*****

A SAFE AND EFFECTIVE SURGERY

If you haven’t heard your doctor say that you’re developing a cataract or cataracts, the odds are that you eventually will. “It’s inevitable,” my primary care physician joked, somewhat exaggerating. According to the National Eye Institute, about one-quarter of people have cataracts in their 60s and two-thirds by age 80.

Waiting to have surgery won’t harm your eyes. The cataract in my left eye was detected a few years ago, and the one in my right eye last year. The ophthalmologist said last year that the cataracts were large enough to justify surgery but not so large that I couldn’t wait. Since my eyeglass prescription had changed, I figured it would be either new glasses or surgery this year. I decided there was no reason to wait for surgery, since the new lenses are permanent and cannot develop cataracts.

The outpatient surgeries were performed this summer, the left eye three weeks before the right eye. The procedure took only about 20 minutes, and I was under local anesthetic. Each time I went home with a plastic shield taped over the eye. I returned the next day to have the shield removed and to receive instructions for administering three different eye drops over the next month. Both of my eyes healed quickly.

Cataract surgery improves the vision of 95 percent of patients who have it, according to the National Eye Institute. It is one of the safest and most effective surgeries performed, and complications are rare.

*****
ANTI-TRUMP QUOTATIONS: 73RD IN AN ONGOING SERIES

“[W]hile we would not sink to name-calling in the Trumpian manner . . . we would tell the most dishonest man to ever occupy the Oval Office, the mocker of war heroes, the gleeful grabber of women’s private parts, the serial bankrupter of businesses, the useful idiot of Vladimir Putin and the guy who insisted there are ‘good people’ among murderous neo-Nazis that he’s still not fooling most Americans into believing he’s even slightly competent in his current post. Or that he possesses a scintilla of integrity. Better to have some vermin living in your neighborhood than to be one.”
Baltimore Sun editorial after Trump disparaged the city

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    I did not know I could have opted for the lens. Too late now.

  • If you weren't told about options either, maybe there are drawbacks to some of the premium IOLs. I did further reading and found that toric multifocal IOLs might have slightly-less-clear distance vision than monofocal lenses. So, better distance version and lower price = okay choice.

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