How to deal with a loss of accomodation.

June 21, 2006 1:57 PM

Cataract questions. Is there an ophthalmologic surgeon in the house?

Here's the bullet: 33yo male, non-diabetic, suddenly developed a cataract in left eye this year, pretty rapid progression. Lens replacement surgery is the only treatment.

I saw a specialist today, and even though I had to wait seven weeks for this appointment (which was free; behold the pros and cons of Ontario healthcare), he did little more than examine my eyes to confirm my condition, then explain a price list for the different intraocular lenses offered.

While I try to figure out where to get a second opinion, maybe MeFi can help answer some layman questions for me. It's my understanding that the procedure necessarily involves severing the ciliary muscle. The idea of permanently losing accomodation in that eye is kind of freaking me out, so I'm looking for how to deal with that or avoid it altogether.

• Has anyone experienced what it's like? If you get the eye set to "near" focus, do you end up having to adjust the page closer and farther away until you get a lock? If you instead elect to have "far" focus, do you have a threshold beyond which things are fine, or is there a noticable point in the distance where billboards and such come into focus and then blur out again as you approach?
• The most advanced lens presented to me is the ReSTOR lens (aka AcrySof ReSTOR Apodised Diffractive Optic Posterior Intraocular Lens) , which the fluffy info sheet I have only describes as "a bifocal lens .... eliminates the need for bifocals." I don't want to shell out for this and discover I have to tilt my head and look down my nose for near vision, as if I had a bifocal inside my eye. Is that how it works?
• What about non-fixed focal lenses; does anyone know about those? Is an accomodating lens, or a multifocal lens what I really want? See, in general this kind of surgery is targetted at people twice my age, who probably already need reading glasses and bifocals because of their age. Most of my concerns would be brushed off by doctors, saying "well, you can't expect to see as well as you did when you were younger". But I am younger!

Medical technology has really advanced in this area in the last 10 and even 5 years, so I'm also considering just waiting. I'm presently in Canada which has excellent, if not cutting-edge care, but would be willing to get a procedure in the US if I can afford it.

posted by ceribus peribus to health & fitness (2 comments total)

I thought there was still some controversy about the multifocal IOLs. Sometimes you can get good information from the sci.med.vision newsgroup - either posting the question or searching their archives.
posted by EllenC at 3:47 PM on June 21, 2006

Thanks EllenC, I'll check that out. I realize this is a pretty narrow concern, so the pointer is really appreciated.
posted by ceribus peribus at 10:22 PM on June 21, 2006