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Thread: Cataracts.

  1. #1
    Grand Master Andyg's Avatar
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    Cataracts.

    Yesterday I have been diagnosed with Cataracts. The left eye cataracts has been cause by a “pigment change” meaning that it has come on within the last 6 months and is pretty bad. The right eye, is the more normal old man type of cataracts i.e. the lens is going milky. Otherwise both eyes seem very health.

    The optician has referred me to an eye specialist and said because of my age and general fitness I should get priority, but did talk about a number of option. Having them done via the NHS but waiting a bit longer, going private and finally going private and having “ocular implants”, which could mean never having to wear glasses ever again.

    I just wondered if anyone has any previous experience they can share.

    Many thanks.

    Whoever does not know how to hit the nail on the head should be asked not to hit it at all.
    Friedrich Nietzsche


  2. #2
    Master MartynJC (UK)'s Avatar
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    I can only comment that last time I had my eyes tested my ophthalmologist advised that having lens replacements may limit the range of focus. I can only say seek medical advise sooner than later as these things may degrade quickly and consider all options. Sorry to hear your diagnosis. All the very best. Martyn

  3. #3
    Craftsman
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    My father had them done maybe 5-years ago at a local hospital, one appointment per eye. The op did not take long and he loved the results.

    His was through the NHS and it was a good experience for him.


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  4. #4
    Grand Master Andyg's Avatar
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    Thanks chaps.

    Whoever does not know how to hit the nail on the head should be asked not to hit it at all.
    Friedrich Nietzsche


  5. #5
    I had one, and went to Moorfields Hospital and had Professor James Bainbridge complete the procedure. A great outcome. I wish you all the best Andy.

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  6. #6
    Grand Master GraniteQuarry's Avatar
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    Aha this explains a lot - once fixed you’ll see the sun doesn’t shine out Lewis’s arse!

    Getting older sucks, all the best for a quick remedy

  7. #7
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    Quote Originally Posted by Andyg View Post
    The optician has referred me to an eye specialist and said because of my age and general fitness I should get priority, but did talk about a number of option. Having them done via the NHS but waiting a bit longer, going private and finally going private and having “ocular implants”, which could mean never having to wear glasses ever again.
    The treatment for cataracts is to have your natural lens removed & a replacement lens insterted, but I've no idea what "ocular implants" might be. The procedure is often called RLE - Refractive Lens Exchange.

    When your lens is removed & replaced you lose the ability to focus on different points - in effect you end up with fixed focus eyes. However, the power of the lens inserted can be selected to correct any existing deficiency so you could indeed end up with the best vison you have ever had, with some provisos. Lenses come in a couple of types:

    Monofocal lenses: There are the simplest types of lens which are selected for good vision at a particular distance. They generally have good sharpness & clarity but you will probably need some form of glasses, either for distance or for reading.

    You can select which range of correction you want; you can have good distance vision, which will give you fair mid-range vision & require reading glasses. Alternatively you could opt for good near vision which will mean you need glasses for driving for instance. There is a third option which is confusingly called monovison. In this case your dominant eye is set for good distance vision & your other eye is slightly undercorrected so you can read with it. It's not perfect but it's good enough for 95% of the time & means you can read the label on a packet without reaching for reading glasses.

    Multifocal lenses: these have tiny Fresnel rings engraved in them & they give a wider range of correction so that you can see both distance & near. Although they sound ideal there are several compromises; they overall resolution/contrast is lower & there is a substantial chance of seeing "halos" around light sources which can be particularly bad when driving at night. Many people get on fine with them, some don't & for me the risk was too great to take. Pilots are banned from having multifocal lenses due to the risk of visual issues.

    There is a subset of the Multifocal lens type called a Duet lens. This is literally two implanted lenses, one main monovision lens which corrects for distance vision & a smaller multifocal implanted in front of it. The advantage of this arrangement is that if you don't get on with the multifocal lens it's a fairly simple procedure to remove it, which is what I did.

    On the NHS you can only get monovision lenses implanted so if you want multifocals you will need to go private at around £2500-3000 per eye (very roughly).

    The procedure is quite straightforward & there's no pain, but it does feel weird having your eye messed about with. You won't be able to drive for a couple of weeks or so until your vision has settled down.

    No-one can tell you exactly how your vision will turn out after the operation. They may claim most people will be glasses free but everyone's eyes are different & how you react to the lenses is unique to you. The results are usually very good though: I went from -8.5/-8.0 to -1.00/-0.25

  8. #8
    Master
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    Quote Originally Posted by CatalystGuy View Post
    My father had them done maybe 5-years ago at a local hospital, one appointment per eye. The op did not take long and he loved the results.

    His was through the NHS and it was a good experience for him.
    Ditto that. My father's just had one done after a not very long wait on the NHS. Local anaesthetic, in at 8am and out before 11am, he was delighted by the whole process.

  9. #9
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    I had mine done on the NHS 10 years ago after wearing glasses for over 50 years (severe short sight). It was a 1 year wait list for a general anesthetic at London Moorfields Eye hospital, but I had mine done with local, and only had to wait 6 weeks. Had both eyes done about 4 weeks apart. It is wonderful being able to now live without glasses.
    Only (slight) downsides-I struggle telling the difference between certain dark colours - black, dark blue, dark purple. Also you may have glare, and I sometimes wear lightly tinted plain glasses - for example at the local supermarket, the glare reflected off the floor and ultra bright lights. Finally, I also got a small growth over the back of one eye, that is not unusual - into the Royal Free Hampstead and they zapped it with a laser, and no problems since.

  10. #10
    Hi Andy,

    Have a search on here, there have been a couple of threads on this "fairly recently".

    My wife had multifocal inserts done at Benenden in Kent and has been fine with them. If you are a Benenden member its about £3K for the pair and its a superb hospital.

    All the best with whatever you choose.

  11. #11
    Grand Master Andyg's Avatar
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    Quote Originally Posted by Mr Pointy View Post
    The treatment for cataracts is to have your natural lens removed & a replacement lens insterted, but I've no idea what "ocular implants" might be. The procedure is often called RLE - Refractive Lens Exchange.

    When your lens is removed & replaced you lose the ability to focus on different points - in effect you end up with fixed focus eyes. However, the power of the lens inserted can be selected to correct any existing deficiency so you could indeed end up with the best vison you have ever had, with some provisos. Lenses come in a couple of types:

    Monofocal lenses: There are the simplest types of lens which are selected for good vision at a particular distance. They generally have good sharpness & clarity but you will probably need some form of glasses, either for distance or for reading.

    You can select which range of correction you want; you can have good distance vision, which will give you fair mid-range vision & require reading glasses. Alternatively you could opt for good near vision which will mean you need glasses for driving for instance. There is a third option which is confusingly called monovison. In this case your dominant eye is set for good distance vision & your other eye is slightly undercorrected so you can read with it. It's not perfect but it's good enough for 95% of the time & means you can read the label on a packet without reaching for reading glasses.

    Multifocal lenses: these have tiny Fresnel rings engraved in them & they give a wider range of correction so that you can see both distance & near. Although they sound ideal there are several compromises; they overall resolution/contrast is lower & there is a substantial chance of seeing "halos" around light sources which can be particularly bad when driving at night. Many people get on fine with them, some don't & for me the risk was too great to take. Pilots are banned from having multifocal lenses due to the risk of visual issues.

    There is a subset of the Multifocal lens type called a Duet lens. This is literally two implanted lenses, one main monovision lens which corrects for distance vision & a smaller multifocal implanted in front of it. The advantage of this arrangement is that if you don't get on with the multifocal lens it's a fairly simple procedure to remove it, which is what I did.

    On the NHS you can only get monovision lenses implanted so if you want multifocals you will need to go private at around £2500-3000 per eye (very roughly).

    The procedure is quite straightforward & there's no pain, but it does feel weird having your eye messed about with. You won't be able to drive for a couple of weeks or so until your vision has settled down.

    No-one can tell you exactly how your vision will turn out after the operation. They may claim most people will be glasses free but everyone's eyes are different & how you react to the lenses is unique to you. The results are usually very good though: I went from -8.5/-8.0 to -1.00/-0.25

    What a great answer. Many thanks.

    Whoever does not know how to hit the nail on the head should be asked not to hit it at all.
    Friedrich Nietzsche


  12. #12
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    Whereabouts are you based Andy? There's a few different referral pathways, for instance I can refer patients via the standard NHS route, or (still NHS funded) to private clinics which is much quicker (1st appt can come around within weeks instead of months).

  13. #13
    Grand Master Andyg's Avatar
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    Quote Originally Posted by WarrenVrs View Post
    Whereabouts are you based Andy? There's a few different referral pathways, for instance I can refer patients via the standard NHS route, or (still NHS funded) to private clinics which is much quicker (1st appt can come around within weeks instead of months).

    I am based in damp Wiltshire (the nice bit). Closest hospital is Salisbury/New Hall , but not to far from Bath.

    Whoever does not know how to hit the nail on the head should be asked not to hit it at all.
    Friedrich Nietzsche


  14. #14
    Grand Master 100thmonkey's Avatar
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    Quote Originally Posted by Andyg View Post
    Yesterday I have been diagnosed with Cataracts. The left eye cataracts has been cause by a “pigment change” meaning that it has come on within the last 6 months and is pretty bad. The right eye, is the more normal old man type of cataracts i.e. the lens is going milky. Otherwise both eyes seem very health.

    The optician has referred me to an eye specialist and said because of my age and general fitness I should get priority, but did talk about a number of option. Having them done via the NHS but waiting a bit longer, going private and finally going private and having “ocular implants”, which could mean never having to wear glasses ever again.

    I just wondered if anyone has any previous experience they can share.

    Many thanks.
    I had Lens Replacement 2 weeks ago in both eyes, no longer need glasses and have better than 20/20 in both eyes and everything is sharper, brighter and clearer than ever before, plus Ill never have cataracts later in life so bonus.

    Ring me if need be mate Ill talk you through my experience
    "When You Go Home, Tell Them Of Us And Say,
    For Their Tomorrow, We Gave Our Today"

  15. #15
    Quote Originally Posted by 100thmonkey View Post
    I had Lens Replacement 2 weeks ago in both eyes, no longer need glasses and have better than 20/20 in both eyes and everything is sharper, brighter and clearer than ever before, plus Ill never have cataracts later in life so bonus.

    Ring me if need be mate Ill talk you through my experience
    Did you have better than standard lenses? As already said they’re usually optimised for near or far distance.

  16. #16
    Grand Master 100thmonkey's Avatar
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    I had multifocal lens fitted
    "When You Go Home, Tell Them Of Us And Say,
    For Their Tomorrow, We Gave Our Today"

  17. #17
    Quote Originally Posted by 100thmonkey View Post
    I had multifocal lens fitted
    Interesting, thx.

  18. #18
    I think ocular implants is where they pulverise the lens contents, I think with ultrasound, then use a laser to drill a hole in the lens, suck out the contents, roll up the implant, poke it in through the hole, and it expands out to fill the lens with a clear body. the implant is sized to give you excellent distance vision, but you will need reading glasses.

    Someone I know had them done recently, really pleased with the result.

  19. #19
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    Quote Originally Posted by in_denial View Post
    I think ocular implants is where they pulverise the lens contents, I think with ultrasound, then use a laser to drill a hole in the lens, suck out the contents, roll up the implant, poke it in through the hole, and it expands out to fill the lens with a clear body. the implant is sized to give you excellent distance vision, but you will need reading glasses.

    Someone I know had them done recently, really pleased with the result.
    That's basically a stock cataract operation using phaco emulsification. All procedures have an "implant" as an intra ocular lens is implanted, gone are the days when they didn't replace the crystalline lens but I'm old enough to have seen the tail end of those patients.

  20. #20
    Master
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    Quote Originally Posted by Andyg View Post



    I am based in damp Wiltshire (the nice bit). Closest hospital is Salisbury/New Hall , but not to far from Bath.
    Andy, if you're around here I could find out who or where in south wilts is worth going to, should you wish.
    North wilts will use the Ridgeway in Wroughton (private and nhs) or we venture to Newmedica in Gloucester. I have contacts at all if there is anything you need to know. Last private patient I sent in has just had surgery having only been referred about 3 weeks ago. NHS patients are looking at around 14 weeks so its pretty good for a surgical waiting time.
    Personally I'd stick to single vision implants; I have yet to meet a patient who is genuinely, completely happy with a multifocal implant. Unless the driving force is a need to manage without any sort of spectacle correction the you won't be completely happy with the results.

  21. #21
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    Quote Originally Posted by DavidL View Post
    Andy, if you're around here I could find out who or where in south wilts is worth going to, should you wish.
    North wilts will use the Ridgeway in Wroughton (private and nhs) or we venture to Newmedica in Gloucester. I have contacts at all if there is anything you need to know. Last private patient I sent in has just had surgery having only been referred about 3 weeks ago. NHS patients are looking at around 14 weeks so its pretty good for a surgical waiting time.
    Personally I'd stick to single vision implants; I have yet to meet a patient who is genuinely, completely happy with a multifocal implant. Unless the driving force is a need to manage without any sort of spectacle correction the you won't be completely happy with the results.
    Beat me to it

  22. #22
    Master thieuster's Avatar
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    Apart from a the UK locations, my pennies worth:

    I had a surgery on my right eye last February here in the Netherlands in a eye surgery hospital and the effect was (and is!) amazing. I asked questions here on the forum and I adopted the suggestion for a monofocal lens. (Despite the fact that my health insurance covers the cost of a multi-focal lens as as well).

    I hated the 5 minutes with the ultra bright eye focussed on my eye, but even with that knowledge, I would not hesitate to do it all over again! Funniest thing after the operation one eye is the difference in the colours I see now: with the new lens, all is brighter, more blue-is and the 'old eye' things are 'sepia-coloured'.

    One warning: take the message "Call us when you see flashes, spots or similar" very serious. After three trouble free months, I started to see flashes in the dark and I had black spots 'whirling'. Within 24 hrs I was in surgery for an ablatio retinae repair! I'm not a doctor, but it's known that a cataract operation can cause ablatio retinae.

  23. #23
    Grand Master Andyg's Avatar
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    Quote Originally Posted by DavidL View Post
    Andy, if you're around here I could find out who or where in south wilts is worth going to, should you wish.
    North wilts will use the Ridgeway in Wroughton (private and nhs) or we venture to Newmedica in Gloucester. I have contacts at all if there is anything you need to know. Last private patient I sent in has just had surgery having only been referred about 3 weeks ago. NHS patients are looking at around 14 weeks so its pretty good for a surgical waiting time.
    Personally I'd stick to single vision implants; I have yet to meet a patient who is genuinely, completely happy with a multifocal implant. Unless the driving force is a need to manage without any sort of spectacle correction the you won't be completely happy with the results.

    Yes please. I am in Salisbury, but happy to travel as far as Bournemouth, Christchurch, Southampton, etc to get the best result. I think Monofocal might be the way I go, however I am curious about the Duet option, simply because my left eye (the one most impacted by cataract has always been super dominate.

    Whoever does not know how to hit the nail on the head should be asked not to hit it at all.
    Friedrich Nietzsche


  24. #24
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    Quote Originally Posted by Andyg View Post
    Yes please. I am in Salisbury, but happy to travel as far as Bournemouth, Christchurch, Southampton, etc to get the best result. I think Monofocal might be the way I go, however I am curious about the Duet option, simply because my left eye (the one most impacted by cataract has always been super dominate.
    No bother, I'll send a couple of emails.
    Monovision works well for some but not others. Ideally you would try it in contact lenses but with your vision compromised rather that won't really work. Discuss it with the surgeon as depending on your prescription once the worst one is done you may well be in that position anyway until the other is done. It's basic optics and won't even tax a medic!

  25. #25
    Grand Master Andyg's Avatar
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    Quote Originally Posted by DavidL View Post
    No bother, I'll send a couple of emails.
    Monovision works well for some but not others. Ideally you would try it in contact lenses but with your vision compromised rather that won't really work. Discuss it with the surgeon as depending on your prescription once the worst one is done you may well be in that position anyway until the other is done. It's basic optics and won't even tax a medic!

    Once again, many thanks to you and everyone else who responded. It has certainly put my mind at easy, especially as I am a bit of a hospitalphobe.

    Whoever does not know how to hit the nail on the head should be asked not to hit it at all.
    Friedrich Nietzsche


  26. #26
    Grand Master 100thmonkey's Avatar
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    Quote Originally Posted by Andyg View Post
    Once again, many thanks to you and everyone else who responded. It has certainly put my mind at easy, especially as I am a bit of a hospitalphobe.
    You are in and out in an hour or so, not really a hospital more of a clinic
    "When You Go Home, Tell Them Of Us And Say,
    For Their Tomorrow, We Gave Our Today"

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