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Medical Forum / General / Vision / July 2006

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Frozen focus?

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Dick DeadEye - 03 Jul 2006 14:11 GMT
In the past couple of years presbyopia has become acutely apparent
(I just turned 40, ugh!) and now a backsided cataract (meaning its
on the inside of the lens, instead of the outside), due to previous
uveitis.  Even at the beginning of the year, my vision was still
20/20 correctedl; it has suddenly dropped in the past few months to
20/50, even corrected, but does improve to 20/20-20/25 while looking
through "pinhole glasses", so both of my eyedoctors (including a
retinologist) are confident it is just the cataract.
It doesn't seem to be the stereotypical "haze" type cataract, or even
blurry presbyopia, but rather like you're looking through binoculars
that are focused near the end extreme, where there is "ghosting" (like
looking through a double-paned window) and faces beyond 20-30 feet have
a mushy blur to them and in general has a somewhat watery-eyed
(as if crying) view.

(BTW, the vitreous is detatched in that eye, and other eye I'm blind in
from similar uveitis, 10 years after this eye!)

The thing is, the main problem seems to be that my focus seems to
have "frozen":  If I look at a streetlight in the distance at night,
I see a triangle of 3-4 lights (now seems to be morphing more into
a blurry circle), and if I hold my finger out to arms lentgh and
try to focus on it as I bring it close in, right up to my nose (so
that I'm crosseyed), the focus doesn't budge!!
I've also tried focusing on a poster on the wall, and I've found
that the FARTHEST in focus (in the same way that "bifocals" have
a sharp dropoff point) seems to be about 18" without glasses, 12"
through the bifocal part and 23" through the distance part--i.e.,
about 1.5-2 feet!!
Could the main problem (compounded by the cataract) be that the
focus is "frozen"--extreme presbyopia?
Is there a name for this?
I had a similar question about "dual focus" last year at about this
time:

   http://groups.google.com/group/sci.med.vision/msg/9b9daa68c98e9b62

Needless to say, things have gotten worse.  P=/
doctor_my_eye@msn.com - 03 Jul 2006 14:57 GMT
There is a type of cataract called a "posterior subcapsular" cataract
that behaves the way you are describing.  The normal human lens is
sitting in a little "hammock" (the lens capsule) that is attached to
the cilliary muscles in an area called the zonules.  In a normal "old
age" cataract the lens is greying in the center and around the outside
edge, much like an old onion gets darker in the center and around its
edge.  In that type of cataract the patient goes through presbyopia as
he ages normally.  Things aren't to simple with PSC cataracts.  The PSC
cataract stiffens and greys the entire back surface of the lens, and
this can freeze your ability to accomodate.
> In the past couple of years presbyopia has become acutely apparent
> (I just turned 40, ugh!) and now a backsided cataract (meaning its
[quoted text clipped - 34 lines]
>
> Needless to say, things have gotten worse.  P=/
acemanvx@yahoo.com - 03 Jul 2006 22:01 GMT
> There is a type of cataract called a "posterior subcapsular" cataract
> that behaves the way you are describing.  The normal human lens is
[quoted text clipped - 44 lines]
> >
> > Needless to say, things have gotten worse.  P=/

Makes sense. Your age of 40 and the fact you have cateracts, which is
unfortunate at only 40 means your vision isnt good and you have no
accomodation. Cateract surgury with IOLs can restore your sharp vision
and you can get monovision, bifocal or undercorrection to let you see
better from near.
Neil Brooks - 03 Jul 2006 23:11 GMT
>> There is a type of cataract called a "posterior subcapsular" cataract
>> that behaves the way you are describing.  The normal human lens is
[quoted text clipped - 50 lines]
>and you can get monovision, bifocal or undercorrection to let you see
>better from near.

Ace,

Would YOU do this sort of surgery, or would you recommend an actual
eye doctor?
acemanvx@yahoo.com - 04 Jul 2006 05:00 GMT
> >> There is a type of cataract called a "posterior subcapsular" cataract
> >> that behaves the way you are describing.  The normal human lens is
[quoted text clipped - 55 lines]
> Would YOU do this sort of surgery, or would you recommend an actual
> eye doctor?

It is up to him if he wants to see a doctor/surgeon when/if he desires
cateract surgury. I cant make the decision for him but just letting him
know millions get it and see much better. When I develop cateracts as I
get older, I am getting surgury to get them removed and my myopia
reduced as well.
Neil Brooks - 04 Jul 2006 05:23 GMT
>> >> There is a type of cataract called a "posterior subcapsular" cataract
>> >> that behaves the way you are describing.  The normal human lens is
[quoted text clipped - 61 lines]
>get older, I am getting surgury to get them removed and my myopia
>reduced as well.

No, no, no.

I mean: would you PERFORM the surgery for him, or would you recommend
that it be performed by an actual eye doctor?
acemanvx@yahoo.com - 04 Jul 2006 18:18 GMT
> No, no, no.
>
> I mean: would you PERFORM the surgery for him, or would you recommend
> that it be performed by an actual eye doctor?

I am not a doctor and I dont do any surguries.

As for his frozen focus, progressive glasses will work wonders. Theres
also bifocals and trifocals.
Dick DeadEye - 04 Jul 2006 14:33 GMT
>>There is a type of cataract called a "posterior subcapsular" cataract
>>that behaves the way you are describing.  The normal human lens is
[quoted text clipped - 51 lines]
> and you can get monovision, bifocal or undercorrection to let you see
> better from near.

Given the condition of the eye, otherwise, I dont't know if they'd even
advise any surgery.
Since my focus seems to be frozen, would cataract glasses help (I know
that they're meant for AFTER one's own lens is removed, but if my vision
is locked at a single focus, couldn't the cataract glasses be
taylored--at least in the ballpark of--to whatever my focus is?)?
Helpful person - 05 Jul 2006 01:04 GMT
Bausch and Lomb have successfully replaced the original eye lens with
an artificial one that is attached in such a way that eye accomodation
is still possible.  This may be an acceptable solution for you.

Please visit my web site at www.richardfisher.com
 
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