My experience with cataracts and cataract surgery
March 5, 2019 10:18 AM Subscribe
"Are the eggplants $1.39 or $1.59? Are those zucchini or cucumbers? Is the guy in the background, with the blue helmet, a friend or neighbour? I couldn't say."
"Briefly, the way the operation works is this: Starting three days prior, eye drops (an antibiotic and an anti-inflammatory) are applied four times daily. A hour prior to the surgery, eye drops dilate the iris. With me lying on a stretcher under bright lights and with optical equipment aimed at my eye, the surgery starts with a tiny 2 mm incision made through the side (base) of the cornea, giving access to the lens capsule. An ultrasonic device is inserted into the lens that turns it into mush, and then the lens bits are pulled apart and flushed out. When the lens capsule is empty, a syringe-like tube is used to insert the implant, rolled up, into the lens capsule. When it has been injected and is in the lens capsule, it unrolls, with two 'legs' that hold it in place, centered on the eye. "
"Briefly, the way the operation works is this: Starting three days prior, eye drops (an antibiotic and an anti-inflammatory) are applied four times daily. A hour prior to the surgery, eye drops dilate the iris. With me lying on a stretcher under bright lights and with optical equipment aimed at my eye, the surgery starts with a tiny 2 mm incision made through the side (base) of the cornea, giving access to the lens capsule. An ultrasonic device is inserted into the lens that turns it into mush, and then the lens bits are pulled apart and flushed out. When the lens capsule is empty, a syringe-like tube is used to insert the implant, rolled up, into the lens capsule. When it has been injected and is in the lens capsule, it unrolls, with two 'legs' that hold it in place, centered on the eye. "
Cataract surgery has quite a long history.(pdf)
posted by Floydd at 10:31 AM on March 5, 2019 [2 favorites]
posted by Floydd at 10:31 AM on March 5, 2019 [2 favorites]
Do discuss with your surgeon the lens options. It seems (as a recent observer) that the choice may possibly be nudged either towards reading or distance.
posted by sammyo at 10:42 AM on March 5, 2019 [5 favorites]
posted by sammyo at 10:42 AM on March 5, 2019 [5 favorites]
After my father-in-law had cataract surgery, he was able to stop wearing eyeglasses entirely after a lifetime of wearing them.
posted by briank at 10:51 AM on March 5, 2019 [2 favorites]
posted by briank at 10:51 AM on March 5, 2019 [2 favorites]
The description of the surgery doesn't seem to include the astonishing levels of sedation that would be required to let me allow someone to "incision" "inject" "liquify" and so forth anywhere near my eyes.
posted by seanmpuckett at 10:53 AM on March 5, 2019 [16 favorites]
posted by seanmpuckett at 10:53 AM on March 5, 2019 [16 favorites]
Floydd, the history of the cataract operation made me want to never stop screaming. It is a literal "poke in the eye with a sharp stick," and apparently its use is still causing problems in rural areas where modern eye care is not available. I don't understand how people could hold their eyeballs still long enough to have that work, which may be why it often doesn't.
My parents have both had this surgery, and I am probably going to need it too someday.
posted by Countess Elena at 10:56 AM on March 5, 2019 [3 favorites]
My parents have both had this surgery, and I am probably going to need it too someday.
posted by Countess Elena at 10:56 AM on March 5, 2019 [3 favorites]
After my father-in-law had cataract surgery, he was able to stop wearing eyeglasses entirely after a lifetime of wearing them.
That's how it was for my mom. She was wearing glasses 30 years before I was born and suddenly stopped needing them a few years back. If she lives for another 30 years there's a small chance I'll stop being freaked out when she shows up not wearing her glasses.
posted by Bulgaroktonos at 11:03 AM on March 5, 2019 [6 favorites]
That's how it was for my mom. She was wearing glasses 30 years before I was born and suddenly stopped needing them a few years back. If she lives for another 30 years there's a small chance I'll stop being freaked out when she shows up not wearing her glasses.
posted by Bulgaroktonos at 11:03 AM on March 5, 2019 [6 favorites]
As much trouble as I had just trying a contact -- like literally 90 minutes of trauma to get the damned thing back out again -- I'm absolutely going to have them give me some serious drugs when I need cataract surgery.
posted by Foosnark at 11:07 AM on March 5, 2019 [2 favorites]
posted by Foosnark at 11:07 AM on March 5, 2019 [2 favorites]
Cataract surgery has quite a long history.
Speaking of blind spots, that article makes no mention of Dr. Patricia Bath, who invented the laserphaco probe and became the first female African American doctor to be issued a US patent for a medical device in 1988, which are only a few of the achievements on her CV.
Here's an interview with her: Patricia Bath On Being The First Person To Invent & Demonstrate Laserphaco Cataract Surgery
Dr. Bath Describes Laserphaco Invention at 1987 ASCRS Convention. She walks through the procedure starting at around 1:25 (it's not too gross if eye things squick you out - the video she uses is an extreme closeup of the eye being treated).
posted by mandolin conspiracy at 11:07 AM on March 5, 2019 [21 favorites]
Speaking of blind spots, that article makes no mention of Dr. Patricia Bath, who invented the laserphaco probe and became the first female African American doctor to be issued a US patent for a medical device in 1988, which are only a few of the achievements on her CV.
Here's an interview with her: Patricia Bath On Being The First Person To Invent & Demonstrate Laserphaco Cataract Surgery
Dr. Bath Describes Laserphaco Invention at 1987 ASCRS Convention. She walks through the procedure starting at around 1:25 (it's not too gross if eye things squick you out - the video she uses is an extreme closeup of the eye being treated).
posted by mandolin conspiracy at 11:07 AM on March 5, 2019 [21 favorites]
I have seen hundreds, maybe thousands of eye surgeries, my mother had cataract surgery, and I have had LASIK. I am as much of a coward concerning poking my eye as anyone (I don’t like eye drops and would never even consider contact lenses) but trust me; if you need eye surgery, do it. It really looks worse than it is, like many medical procedures. Having said that, this was an interesting article. But I was disappointed that it doesn’t mention one interesting side effect of some cataract surgery: ultraviolet vision! I may need cataract surgery at some point, and you can be assured that this will be a topic I discuss in depth with my surgeon. As in I want this superpower!
posted by TedW at 11:07 AM on March 5, 2019 [7 favorites]
posted by TedW at 11:07 AM on March 5, 2019 [7 favorites]
I read the FPP mostly with my right eye, as my left eye is blurred with a growing cataract. I'll be going for the surgery soon. I am terrified, no matter how much people tell me about the speed and painlessness. Even my sister in law who is a nurse where they do this surgery. Ick.
posted by Splunge at 11:07 AM on March 5, 2019
posted by Splunge at 11:07 AM on March 5, 2019
seanmpuckett: Here's my summary of how my cataract surgeries went down, in response to an AskMe question. tl;dr: You're anesthesized so thoroughly that your time in the surgical ward is abstracted and feels like it's being told to you rather than experienced.
My vision is much better after surgery but I still have to wear glasses; I've got hyperopia and astigmatism in both eyes, although for the most part not as bad as the severe myopia, astigmatism and strabismus I used to have. Not to mention the multiple vision due to the cataracts.
posted by Subaru drwxrwxrwx at 11:08 AM on March 5, 2019 [3 favorites]
My vision is much better after surgery but I still have to wear glasses; I've got hyperopia and astigmatism in both eyes, although for the most part not as bad as the severe myopia, astigmatism and strabismus I used to have. Not to mention the multiple vision due to the cataracts.
posted by Subaru drwxrwxrwx at 11:08 AM on March 5, 2019 [3 favorites]
I just had one eye done a couple weeks ago and have the other one scheduled for the end of the month. I couldn't be happier with the results so far, and I'm looking forward to completing the other one.
For those like seanmpuckett who are weirded out by the thought of them slicing your eye open and doing stuff in there, I can assure you that the actual experience is not at all traumatic. Your eye is completely numb and in combination with a mild sedative you won't feel a thing and just see some kind of trippy visual effects during the procedure.
It's completely routine nowadays and the recovery is extremely quick and painless.
posted by mmmtofu at 11:11 AM on March 5, 2019 [2 favorites]
For those like seanmpuckett who are weirded out by the thought of them slicing your eye open and doing stuff in there, I can assure you that the actual experience is not at all traumatic. Your eye is completely numb and in combination with a mild sedative you won't feel a thing and just see some kind of trippy visual effects during the procedure.
It's completely routine nowadays and the recovery is extremely quick and painless.
posted by mmmtofu at 11:11 AM on March 5, 2019 [2 favorites]
Also from recent reading it's apparently one of the most common and reliable forms of surgery. Whatever the anesthesia used it seems that it's very effective.
(oh one thing as ether the patient or proscribed driver/caretaker: DO NOT NOT NOT google youtube videos while waiting)
posted by sammyo at 11:13 AM on March 5, 2019
(oh one thing as ether the patient or proscribed driver/caretaker: DO NOT NOT NOT google youtube videos while waiting)
posted by sammyo at 11:13 AM on March 5, 2019
If you can tolerate Un Chien Andalou levels of eye-pokery, this video, linked from the piece in the FPP is quite something, and features a smoooooth jazz soundtrack (CW: If eye things squick you out, this will DEFINITELY do so).
From the doctor performing said surgery, in the Youtube comments:
I spent a long time eating with chop sticks with my left hand to improve my own coordination!
posted by mandolin conspiracy at 11:19 AM on March 5, 2019
From the doctor performing said surgery, in the Youtube comments:
I spent a long time eating with chop sticks with my left hand to improve my own coordination!
posted by mandolin conspiracy at 11:19 AM on March 5, 2019
As long as chopsticks are not featured in the actual surgery.
posted by Splunge at 11:27 AM on March 5, 2019 [3 favorites]
posted by Splunge at 11:27 AM on March 5, 2019 [3 favorites]
The description of the surgery doesn't seem to include the astonishing levels of sedation that would be required to let me allow someone to "incision" "inject" "liquify" and so forth anywhere near my eyes.
If it's any comfort, Claude Monet felt the same way, although the surgical methods of his time were relatively crude:
After Monet became increasingly despondent and less productive, Georges Clemenceau, former French prime minister and physician, urged his friend to consider cataract surgery. Frightened, however, by the fate of his fellow artists Honoré Daumier and Mary Cassatt, whose cataract operations had been unsuccessful, Monet was adamant to avoid surgery at all costs. He argued that:
‘I prefer to make the most of my poor sight, and even give up painting if necessary, but at least be able to see a little of these things that I love.’
In 1922, Monet consulted another ophthalmologist, Charles Coutela, who recorded a visual acuity of PL (light perception only) on the right, and 6/60 on the left. As Monet was still reluctant to undergo surgery, Coutela prescribed mydriatics in the hope of allowing more light to pass through his cataractous lens. Before a week was up, Monet wrote enthusiastically to Coutela:
‘It is all simply marvellous. I have not seen so well for a long time, so much so that I regret not having seen you sooner. The drops have permitted me to paint good things rather than the bad paintings which I had persisted in making when seeing nothing but fog.’
The positive effect of the drops was, not surprisingly, short-lived. Monet finally agreed to surgery to his right eye, which, in a two-stage procedure (partial iris removal followed by lens extraction), was subsequently carried out in early 1923.
[...]
Monet’s postoperative works are devoid of garish colours or coarse application and resemble his paintings from before 1914. The delicate colour schemes emphasising gentle blues and greens are consistent with the earlier pond and garden views. It is therefore unlikely that he had intentionally adopted the broader and more abstract style of his late paintings, reinforcing the argument that Monet’s late works were the result of cataracts and not conscious experimentation with a more expressionistic style. Nonetheless, it is his late works, created under the influence of his cataracts, that link impressionism with modern abstract art.
posted by mandolin conspiracy at 11:28 AM on March 5, 2019 [9 favorites]
If it's any comfort, Claude Monet felt the same way, although the surgical methods of his time were relatively crude:
After Monet became increasingly despondent and less productive, Georges Clemenceau, former French prime minister and physician, urged his friend to consider cataract surgery. Frightened, however, by the fate of his fellow artists Honoré Daumier and Mary Cassatt, whose cataract operations had been unsuccessful, Monet was adamant to avoid surgery at all costs. He argued that:
‘I prefer to make the most of my poor sight, and even give up painting if necessary, but at least be able to see a little of these things that I love.’
In 1922, Monet consulted another ophthalmologist, Charles Coutela, who recorded a visual acuity of PL (light perception only) on the right, and 6/60 on the left. As Monet was still reluctant to undergo surgery, Coutela prescribed mydriatics in the hope of allowing more light to pass through his cataractous lens. Before a week was up, Monet wrote enthusiastically to Coutela:
‘It is all simply marvellous. I have not seen so well for a long time, so much so that I regret not having seen you sooner. The drops have permitted me to paint good things rather than the bad paintings which I had persisted in making when seeing nothing but fog.’
The positive effect of the drops was, not surprisingly, short-lived. Monet finally agreed to surgery to his right eye, which, in a two-stage procedure (partial iris removal followed by lens extraction), was subsequently carried out in early 1923.
[...]
Monet’s postoperative works are devoid of garish colours or coarse application and resemble his paintings from before 1914. The delicate colour schemes emphasising gentle blues and greens are consistent with the earlier pond and garden views. It is therefore unlikely that he had intentionally adopted the broader and more abstract style of his late paintings, reinforcing the argument that Monet’s late works were the result of cataracts and not conscious experimentation with a more expressionistic style. Nonetheless, it is his late works, created under the influence of his cataracts, that link impressionism with modern abstract art.
posted by mandolin conspiracy at 11:28 AM on March 5, 2019 [9 favorites]
The description of the surgery doesn't seem to include the astonishing levels of sedation that would be required to let me allow someone to "incision" "inject" "liquify" and so forth anywhere near my eyes.
I’ve had two (TWO!) corneal transplants in the past five years. One for each eye, due to scarring from a chemical vapor exposure 30 years ago. They first gave me a very brief acting I.V. injection in my arm that knocked me out for only about 5 minutes, during which they then injected a aesthetic in the eyes. So you never have to see the needle.
As for the actual procedure, which follows immediately, you’re so hopped up on propofol or whatever, you really couldn’t care less what’s going on.
I think my greatest moments of agitation were many months later, when the stitches were removed. They don’t knock you out for that — just give you topical lidocaine drops. The doctor learned early on in this process that “darkstar gets an extra drop” in each eye!
Very pleased with the results, though. Blurriness gone and I wear glasses with 20/30 corrected vision, now. A+++ would definitely Un Chien Andalou again!
posted by darkstar at 11:33 AM on March 5, 2019 [5 favorites]
I’ve had two (TWO!) corneal transplants in the past five years. One for each eye, due to scarring from a chemical vapor exposure 30 years ago. They first gave me a very brief acting I.V. injection in my arm that knocked me out for only about 5 minutes, during which they then injected a aesthetic in the eyes. So you never have to see the needle.
As for the actual procedure, which follows immediately, you’re so hopped up on propofol or whatever, you really couldn’t care less what’s going on.
I think my greatest moments of agitation were many months later, when the stitches were removed. They don’t knock you out for that — just give you topical lidocaine drops. The doctor learned early on in this process that “darkstar gets an extra drop” in each eye!
Very pleased with the results, though. Blurriness gone and I wear glasses with 20/30 corrected vision, now. A+++ would definitely Un Chien Andalou again!
posted by darkstar at 11:33 AM on March 5, 2019 [5 favorites]
The old joke in my business (vision science, not clinical vision, but a joke from the clinical world) is "may you grow old enough to have cataracts."
We'll all get them eventually. Depending on environmental exposure, they can be as early as one's 50s or as late as one's 80s or 90s, but they'll come for all of us in the end.
posted by Making You Bored For Science at 11:50 AM on March 5, 2019 [2 favorites]
We'll all get them eventually. Depending on environmental exposure, they can be as early as one's 50s or as late as one's 80s or 90s, but they'll come for all of us in the end.
posted by Making You Bored For Science at 11:50 AM on March 5, 2019 [2 favorites]
After my father-in-law had cataract surgery, he was able to stop wearing eyeglasses entirely after a lifetime of wearing them.
Seventysomething Pa Biscuit had both eyes done over the winter -- both cataracts and Lasik -- and when I was on a video call with him last week (he lives a couple of time zones away) he drew my attention to the fact that he was not wearing his specs. "Don't need 'em any more," he explained. This was a bit of news as he has worn glasses since about 1956 (except for a brief stretch forty-five or so years ago).
posted by ricochet biscuit at 11:53 AM on March 5, 2019 [3 favorites]
Seventysomething Pa Biscuit had both eyes done over the winter -- both cataracts and Lasik -- and when I was on a video call with him last week (he lives a couple of time zones away) he drew my attention to the fact that he was not wearing his specs. "Don't need 'em any more," he explained. This was a bit of news as he has worn glasses since about 1956 (except for a brief stretch forty-five or so years ago).
posted by ricochet biscuit at 11:53 AM on March 5, 2019 [3 favorites]
I just asked someone at work about the no-more-glasses thing, since she's having the surgery in about a month; I'm interested because I've got the very early stages of cataracts and may need the surgery in about a decade. She said that the no-glasses thing is an option, but that it would be an extra $3600 per eye. (Maybe that's LASIK?)
posted by Halloween Jack at 12:09 PM on March 5, 2019
posted by Halloween Jack at 12:09 PM on March 5, 2019
I had cataract surgery twice in my 30s (very early!) and it was all in all an easy surgery. But it's true, after surgery I no longer need glasses or contact lenses at all. Ok, I need reading glasses, because they can fix distance or reading and went with distance, but I get those reading glasses off a rack at the local drug store. It's trippy being able to see in 20/20, something I could never do before.
posted by aclevername at 1:02 PM on March 5, 2019 [1 favorite]
posted by aclevername at 1:02 PM on March 5, 2019 [1 favorite]
yea, my mom has stopped needing glasses since she had that surgery in december. My dad's so impressed by that he's having his eyes assessed for the same surgery tomorrow.
posted by 5_13_23_42_69_666 at 1:13 PM on March 5, 2019 [1 favorite]
posted by 5_13_23_42_69_666 at 1:13 PM on March 5, 2019 [1 favorite]
My company-provided insurance (AKA Mutual of Tierra del Fuego) wouldn't cover the extra expense of variable focus lenses so my left eye has a focal length of about 18 to 20 inches and my right is set on infinity. Myopia and hypermetropia as a bundle. Apparently this kludge drives a number of people crazy but I adapted within a matter of hours. Never worn glasses since. The only downside is people think I'm winking at them...
posted by jim in austin at 1:33 PM on March 5, 2019 [1 favorite]
posted by jim in austin at 1:33 PM on March 5, 2019 [1 favorite]
ms scruss's mum — 80, a visual artist absolutely terrified of losing her sight — got both eyes done in the last year. While she's still wearing glasses, she's loving that the colours and sharpness have come back after decades of fuzziness. She's telling us we should get cataract surgery as soon as we might need it.
posted by scruss at 1:43 PM on March 5, 2019 [1 favorite]
posted by scruss at 1:43 PM on March 5, 2019 [1 favorite]
I have had encircling scleral buckle surgery for a detatched retina in one eye, and laser "spot welding" of retinal tears in the other. I know cataract surgery is in my future. If it can correct so I don't need glasses, that would be okay, but I've been wearing glasses so long, I feel very vulnerable when I don't have something in front of my eyeballs.
posted by coppertop at 1:51 PM on March 5, 2019 [3 favorites]
posted by coppertop at 1:51 PM on March 5, 2019 [3 favorites]
This article is very relevant to my interests, as someone who has had lifelong bad vision and eye problems. My mom has had cataract surgery and it was no problem for her. She was really glad to have it.
I'm nervous for when the time comes, because I'm very much like Rachel Green at the eye doctor. No lie. I've had the same eye doc for over 20 years, thank god, because he's very calm and patient with my phobias.
This past summer I had to confront my eye phobia because the specialists were worried I was developing a retinal problem, so I had to go in once a week and get my eyeball probed with dull metal instruments. They put anaesthetic drops in and it doesn't hurt, exactly, but it does feel kind of horrible and weird. However, it's amazing what one can put up with as an alternative to going blind. I joked that it was like desensitization therapy for my eye phobia, but it probably really was.
Finally I had a laser repair, which was about as fun as it sounds. Unfortunately for that one, the anaesthetic drops didn't reach the whole surface of my eyeball, and the specialist found the spot they didn't reach with his metal instrument while he was prepping me for the surgery (which takes place while you're awake and unsedated). I just about jumped out of the chair. He was very apologetic! The surgery itself went fine and I am now at reduced risk for a tear or detachment than I was before.
So I say all this to reassure people contemplating cataract surgery or another eye procedure: yes it sucks, but even I, with my eye phobia, was able to do it. I'm glad I did, since it means I have a better chance of preserving my vision in that eye.
posted by hurdy gurdy girl at 1:53 PM on March 5, 2019 [2 favorites]
I'm nervous for when the time comes, because I'm very much like Rachel Green at the eye doctor. No lie. I've had the same eye doc for over 20 years, thank god, because he's very calm and patient with my phobias.
This past summer I had to confront my eye phobia because the specialists were worried I was developing a retinal problem, so I had to go in once a week and get my eyeball probed with dull metal instruments. They put anaesthetic drops in and it doesn't hurt, exactly, but it does feel kind of horrible and weird. However, it's amazing what one can put up with as an alternative to going blind. I joked that it was like desensitization therapy for my eye phobia, but it probably really was.
Finally I had a laser repair, which was about as fun as it sounds. Unfortunately for that one, the anaesthetic drops didn't reach the whole surface of my eyeball, and the specialist found the spot they didn't reach with his metal instrument while he was prepping me for the surgery (which takes place while you're awake and unsedated). I just about jumped out of the chair. He was very apologetic! The surgery itself went fine and I am now at reduced risk for a tear or detachment than I was before.
So I say all this to reassure people contemplating cataract surgery or another eye procedure: yes it sucks, but even I, with my eye phobia, was able to do it. I'm glad I did, since it means I have a better chance of preserving my vision in that eye.
posted by hurdy gurdy girl at 1:53 PM on March 5, 2019 [2 favorites]
Great post and comments.
If you develop cataracts, any fear you have over the operation will (hopefully) be replaced by gratitude that a simple, very short, extremely low risk operation can restore your sight. Honestly, it was like a miracle for me.
One additional comment is that you may be told that if you have the operation in one eye because of a cataract, you should have the operation in the other eye even if that eye doesn't have a cataract. That's what happened to me and my response was I want to hold on to my body parts for as long as I can and it worked out fine (the second eye developed a cataract about seven years later and I had the operation then). FWIW I still wear glasses most of the time because of astigmatism and because I can't stand looking for reading glasses.
posted by bluesky43 at 1:58 PM on March 5, 2019 [2 favorites]
If you develop cataracts, any fear you have over the operation will (hopefully) be replaced by gratitude that a simple, very short, extremely low risk operation can restore your sight. Honestly, it was like a miracle for me.
One additional comment is that you may be told that if you have the operation in one eye because of a cataract, you should have the operation in the other eye even if that eye doesn't have a cataract. That's what happened to me and my response was I want to hold on to my body parts for as long as I can and it worked out fine (the second eye developed a cataract about seven years later and I had the operation then). FWIW I still wear glasses most of the time because of astigmatism and because I can't stand looking for reading glasses.
posted by bluesky43 at 1:58 PM on March 5, 2019 [2 favorites]
For what it's worth, my dad compared the time and discomfort to a minor dental appointment. Not the root canal kind, the semi-annual check-up kind.
posted by ricochet biscuit at 2:11 PM on March 5, 2019 [2 favorites]
posted by ricochet biscuit at 2:11 PM on March 5, 2019 [2 favorites]
I had very similar eye surgery some years back and while it was of course stressful beforehand the actual surgery was no big deal at all. They even gave me a dvd of the procedure, which I looked at quickly once and have never felt compelled to watch ever again.
Cateract surgery can be life-changing and isn’t something that needs to be feared.
posted by Dip Flash at 2:44 PM on March 5, 2019 [3 favorites]
Cateract surgery can be life-changing and isn’t something that needs to be feared.
posted by Dip Flash at 2:44 PM on March 5, 2019 [3 favorites]
Lots of things don't need to be feared. And yet here I am, against all odds, fearing them.
posted by Splunge at 2:57 PM on March 5, 2019 [9 favorites]
posted by Splunge at 2:57 PM on March 5, 2019 [9 favorites]
My father had cataract surgery for both eyes a couple years ago. He reported that the procedure wasn't too arduous or scary and, in fact, if I wanted proof, his doctor had provided him with a dvd recording of the procedure!
Friends, I did not join him and my mom to watch that dvd.
posted by darchildre at 3:40 PM on March 5, 2019 [3 favorites]
Friends, I did not join him and my mom to watch that dvd.
posted by darchildre at 3:40 PM on March 5, 2019 [3 favorites]
"This past summer I had to confront my eye phobia because the specialists were worried I was developing a retinal problem, so I had to go in once a week and get my eyeball probed with dull metal instruments. They put anaesthetic drops in and it doesn't hurt, exactly, but it does feel kind of horrible and weird. However, it's amazing what one can put up with as an alternative to going blind. I joked that it was like desensitization therapy for my eye phobia, but it probably really was.
Finally I had a laser repair, which was about as fun as it sounds. Unfortunately for that one, the anaesthetic drops didn't reach the whole surface of my eyeball, and the specialist found the spot they didn't reach with his metal instrument while he was prepping me for the surgery (which takes place while you're awake and unsedated). I just about jumped out of the chair. He was very apologetic! The surgery itself went fine and I am now at reduced risk for a tear or detachment than I was before. "
Me Too! Only the doctor who did my laser surgery didn't tell me he was going to do it. Apparently the equipment they use to examine you to decide whether to do the surgery is the same setup they do the surgery with. The only way I knew he'd seen enough to make a decision was this tremendous pinching sensation at the back of my eye. And I'm thinking "WHAT WAS THAT?!! What just happened!!? Ohmigod was that the LASER? Is he lasering my eye RIGHT NOW? I didn't know I was supposed to hold still! Was I holding still when I felt that?!!!" The pinching sensations just kept coming and I had no idea how long it was going to last and I was afraid to speak for fear of moving at the wrong time and I dunno... blinding myself? Before I left the room he handed me the consent forms to sign and joked about how he could be in a lot of trouble if I didn't sign them. I was in shock so I just did what I was asked and signed - not that I can vouch for what I signed mind you, it wasn't like I could see well enough to read.
Turns out that wasn't his only breach of medical ethics, and his medical license has since been revoked.
posted by Secret Sparrow at 4:14 PM on March 5, 2019 [13 favorites]
Finally I had a laser repair, which was about as fun as it sounds. Unfortunately for that one, the anaesthetic drops didn't reach the whole surface of my eyeball, and the specialist found the spot they didn't reach with his metal instrument while he was prepping me for the surgery (which takes place while you're awake and unsedated). I just about jumped out of the chair. He was very apologetic! The surgery itself went fine and I am now at reduced risk for a tear or detachment than I was before. "
Me Too! Only the doctor who did my laser surgery didn't tell me he was going to do it. Apparently the equipment they use to examine you to decide whether to do the surgery is the same setup they do the surgery with. The only way I knew he'd seen enough to make a decision was this tremendous pinching sensation at the back of my eye. And I'm thinking "WHAT WAS THAT?!! What just happened!!? Ohmigod was that the LASER? Is he lasering my eye RIGHT NOW? I didn't know I was supposed to hold still! Was I holding still when I felt that?!!!" The pinching sensations just kept coming and I had no idea how long it was going to last and I was afraid to speak for fear of moving at the wrong time and I dunno... blinding myself? Before I left the room he handed me the consent forms to sign and joked about how he could be in a lot of trouble if I didn't sign them. I was in shock so I just did what I was asked and signed - not that I can vouch for what I signed mind you, it wasn't like I could see well enough to read.
Turns out that wasn't his only breach of medical ethics, and his medical license has since been revoked.
posted by Secret Sparrow at 4:14 PM on March 5, 2019 [13 favorites]
I had cataract surgery on both eyes while I was in my 50s and also had to have YAG laser capsulectomy later on at least one eye, maybe both. I don't recall to be honest.
The cataract surgery itself was no big deal. Once they gave me the happy juice in my IV, I could care less. I couldn't feel anything except some pressure. I lay there thinking about whether or not I should say something and then it was all over. I couldn't see anything except a bright light. Once I recovered from the surgery, I could see great at distance although I use reading glasses now for everything including eating. I buy 6 pairs for $20 from Amazon and scatter them around the house. When I had the 2nd eye done, they had a new way to handle the antibiotics -- they inject them in the eye while you are having the surgery which means you don't have to do eyedrops afterwards. I opted for that and it was a lot better than doing the eyedrops.
The YAG laser procedure on the other hand really sucked. There was no happy juice -- I was fully conscious and in pain. I kept getting yelled at for moving, so I tensed up hard because I didn't want to ruin my eyes. It didn't last a very long time -- less than 5 minutes per eye for sure. But, during those 5 minutes, I was damn uncomfortable. I'm glad I did it because I value my eyesight, but I sure wish they could do something to make that procedure less painful. The NHS handout says it is not painful. Maybe I just had a bad doc. I didn't scream or anything, but it was something more than "not painful", that's for sure.
If you do have cataracts, I think it is definitely worth it to get them fixed. Just watch out for that capsule thickening complication.
posted by elmay at 4:52 PM on March 5, 2019 [1 favorite]
The cataract surgery itself was no big deal. Once they gave me the happy juice in my IV, I could care less. I couldn't feel anything except some pressure. I lay there thinking about whether or not I should say something and then it was all over. I couldn't see anything except a bright light. Once I recovered from the surgery, I could see great at distance although I use reading glasses now for everything including eating. I buy 6 pairs for $20 from Amazon and scatter them around the house. When I had the 2nd eye done, they had a new way to handle the antibiotics -- they inject them in the eye while you are having the surgery which means you don't have to do eyedrops afterwards. I opted for that and it was a lot better than doing the eyedrops.
The YAG laser procedure on the other hand really sucked. There was no happy juice -- I was fully conscious and in pain. I kept getting yelled at for moving, so I tensed up hard because I didn't want to ruin my eyes. It didn't last a very long time -- less than 5 minutes per eye for sure. But, during those 5 minutes, I was damn uncomfortable. I'm glad I did it because I value my eyesight, but I sure wish they could do something to make that procedure less painful. The NHS handout says it is not painful. Maybe I just had a bad doc. I didn't scream or anything, but it was something more than "not painful", that's for sure.
If you do have cataracts, I think it is definitely worth it to get them fixed. Just watch out for that capsule thickening complication.
posted by elmay at 4:52 PM on March 5, 2019 [1 favorite]
My basic, bottom line, this is the issue, problem is... And I want to make this very damn clear. How do they stop me from accidentally moving my eyeball while they have something very sharp poking into it? How do I avoid blinding myself with a twitch or jump? What do they do?
posted by Splunge at 4:55 PM on March 5, 2019 [1 favorite]
posted by Splunge at 4:55 PM on March 5, 2019 [1 favorite]
coppertop, I suspect you and I have somewhat similar visual situations. I had a cataract removed from my good eye several years ago, and theimplant corrected me to about 20/40, which is amazing for me. The only thing “extra” I had to do was get my retina specialist to sign off before the procedure.
posted by wintermind at 5:51 PM on March 5, 2019 [1 favorite]
posted by wintermind at 5:51 PM on March 5, 2019 [1 favorite]
How do they stop me from accidentally moving my eyeball while they have something very sharp poking into it? How do I avoid blinding myself with a twitch or jump? What do they do?
I am sure there are different approaches depending on the type of surgery, but for mine they used a nerve block (which feels odd when they inject it, not painful but very odd) to shut off any muscle control of my eye, so no twitching/jumping was possible. Then they used some kind of apparatus to hold my eye in place, but I couldn't feel it at all.
There were a few really weird hours afterwards where I could see fine out of my eye, but I couldn't make it look in the right direction. I should have taken a photo, it isn't often that you have one eye pointing down at the floor and the other focusing forward. Just like after going to the dentist the nerve block wore off and everything was normal pretty quickly.
posted by Dip Flash at 5:55 PM on March 5, 2019 [2 favorites]
I am sure there are different approaches depending on the type of surgery, but for mine they used a nerve block (which feels odd when they inject it, not painful but very odd) to shut off any muscle control of my eye, so no twitching/jumping was possible. Then they used some kind of apparatus to hold my eye in place, but I couldn't feel it at all.
There were a few really weird hours afterwards where I could see fine out of my eye, but I couldn't make it look in the right direction. I should have taken a photo, it isn't often that you have one eye pointing down at the floor and the other focusing forward. Just like after going to the dentist the nerve block wore off and everything was normal pretty quickly.
posted by Dip Flash at 5:55 PM on March 5, 2019 [2 favorites]
The article said that they were working on adjustable implants. What's the status of that?
posted by Joe in Australia at 6:28 PM on March 5, 2019
posted by Joe in Australia at 6:28 PM on March 5, 2019
When I spoke to my doc about the adjustable implants, he said the technology wasn't at the point where he would recommend it. FYI adjustable implants work more like your real lenses - the thickness adjusts to change the focal point allowing up close and distance vision. The older implants most people have are static - you have to select either distance or close up distance that is fixed (the lense doesn't adjust) so that you either have to wear distance glasses or reading glasses depending on implant you choose. But the adjustable lenses would be a game changer.
Also, FYI I had the JAG procedure as well for one eye and it was painless. Uncomfortable but there was zero pain.
posted by bluesky43 at 6:51 PM on March 5, 2019 [1 favorite]
Also, FYI I had the JAG procedure as well for one eye and it was painless. Uncomfortable but there was zero pain.
posted by bluesky43 at 6:51 PM on March 5, 2019 [1 favorite]
As someone contemplating refractive surgery this was very useful. Excellent piece.
posted by ...possums at 6:55 PM on March 5, 2019
posted by ...possums at 6:55 PM on March 5, 2019
Just to add to the low risk, but hey, shit can happen. My husband had cataract surgery three years ago. Almost at the end of the procedure, the surgeon dropped a needle/syringe that pierced right through his eye, bursting the lens capsule. He had to have emergency surgery by a more senior doctor two days later, and though his sight returned in pretty OK shape, they were still like, oh well, it's weakened now, you never know. Cue to 5 weeks ago, his retina suddenly detached in multiple places and he had to have emergency surgery that did not go well (lens all over the place, way too much pressure after). He had to have another surgery, then stay at home and keep his head looking down for 90% of the day, and so much pain. It's getting a little better now, but still in a holding pattern with regards to keeping oil in, bands on, pain in reasonable check and all sorts of other things I never knew about until recently. All procedures have potential for human error and I guess he drew the short one. Here's hoping all others on here going for this have better success!
posted by recklessbrother at 8:21 PM on March 5, 2019 [1 favorite]
posted by recklessbrother at 8:21 PM on March 5, 2019 [1 favorite]
Had my surgery 5 years ago and it was not a great success. I ended up with diplopia, in other words, see two of everything. It's a drag, but have gotten used to it, doesn't really interfere with anything. I can drive fine etc. I had to have the surgery, my vision was going fast. I'd probably be legally blind now if I hadn't done it. My surgeon claimed she had done nothing wrong. Another ophthalmologist finally told me just recently that this can happen occasionally and it's just a chance you take.
posted by charlesminus at 9:01 PM on March 5, 2019 [1 favorite]
posted by charlesminus at 9:01 PM on March 5, 2019 [1 favorite]
My dad's another miracle case; needed glasses or contacts since he was five years old until his cataract surgery a couple years back.
I gather it's a super sweet deal for ophthalmologists to become cataract surgery specialists. Most such procedures are uncomplicated and scheduled in advance during business hours, patient compliance with post-care is high and it's almost always reimbursed without question by insurance. And unlike so many medical niches that meet that description, it's not elective or trivial; you're recovering people's vision dozens of times a day. Nice work if you can get it!
Annnnd that's why it's insanely competitive to become an ophthalmologist.
posted by potrzebie at 9:25 PM on March 5, 2019 [2 favorites]
I gather it's a super sweet deal for ophthalmologists to become cataract surgery specialists. Most such procedures are uncomplicated and scheduled in advance during business hours, patient compliance with post-care is high and it's almost always reimbursed without question by insurance. And unlike so many medical niches that meet that description, it's not elective or trivial; you're recovering people's vision dozens of times a day. Nice work if you can get it!
Annnnd that's why it's insanely competitive to become an ophthalmologist.
posted by potrzebie at 9:25 PM on March 5, 2019 [2 favorites]
Ok, mostly worked story here. Apparently, if you have ever taken Tamsulosin it can complicate the surgery. It took about twice the estimated time for my first eye due to this. In the followup appointment the Doc exclaimed "Oh yeah, this was a train wreck!". Not reassuring, but she was happy with the results. In addition, I have a bit of macular degeneration so she cautioned me up front that I would still probably need glasses afterwards, which I do. Getting the other eye done in a couple of weeks, and in general so far, it has been A Good Thing. Just make sure you tell the doc before-hand if you are taking, or have ever taken any enlarged prostate drugs, so they can compensate during surgery.
I do notice the colors are brighter and the whites whiter in the 'new' eye when I do the A-B thing by alternately closing one eye.
posted by DesbaratsDays at 6:29 AM on March 6, 2019 [1 favorite]
I do notice the colors are brighter and the whites whiter in the 'new' eye when I do the A-B thing by alternately closing one eye.
posted by DesbaratsDays at 6:29 AM on March 6, 2019 [1 favorite]
I was the first patient of the day when I had LASIK. They gave me a Valium tablet but not enough time for it to kick in. While the procedure itself was weird and not painful, my heart was hammering so hard I thought I might have a heart attack. My body was stresssed outttttt.
Later, I fell asleep at a diner right after I ordered some post-LASIK pancakes.
posted by 41swans at 11:28 AM on March 6, 2019 [3 favorites]
Later, I fell asleep at a diner right after I ordered some post-LASIK pancakes.
posted by 41swans at 11:28 AM on March 6, 2019 [3 favorites]
And I'm thinking "WHAT WAS THAT?!! What just happened!!?
I had a moment like that for a completely different surgery. My arm was on a board or something. I was going down for major leg surgery after a whole lot of other surgerys. They put a thing in my left hand. And when they started the pump (I guess) it burned like fire in my arm. I screamed OH MY GOD THAT BURNS!
They stopped all that they were doing. Then gave me another shot. And then... who what snore.
posted by Splunge at 2:40 PM on March 6, 2019 [1 favorite]
I had a moment like that for a completely different surgery. My arm was on a board or something. I was going down for major leg surgery after a whole lot of other surgerys. They put a thing in my left hand. And when they started the pump (I guess) it burned like fire in my arm. I screamed OH MY GOD THAT BURNS!
They stopped all that they were doing. Then gave me another shot. And then... who what snore.
posted by Splunge at 2:40 PM on March 6, 2019 [1 favorite]
Oh my god, Secret Sparrow. I just read your comment and that is awful! I'm sorry that crappy eye specialist did that to you!!
posted by hurdy gurdy girl at 10:25 PM on March 9, 2019
posted by hurdy gurdy girl at 10:25 PM on March 9, 2019
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posted by Peach at 10:24 AM on March 5, 2019