Hi,
I am 38 yo and had cataract surgery two weeks ago to remove a
posterior subcapsular cataract in my right eye. I've been myopic, in
the -3 or -4 range, most of my life and I've always worn glasses well.
I'm a bit puzzled by my surgeon's new prescription for progressive
glasses for me:
DISTANT:
RIGHT: -.50 +1.00 95
LEFT: -3.00 +.25 155
ADD FOR READING (SPHERICAL):
RIGHT: +2.25
LEFT: +2.25
What I can't figure out is why he added +2.25 for reading on the left
eye. My left eye is fine, not operated on, and I can see well
close-up and distant with it. Shouldn't I just continue to have a
single-vision lens in the left eye, with the progressive only in the
right? Wouldn't adding +2.25 on the left make things very blurry for
reading?
In fact, I don't remember him measuring my reading vision in any way
after surgery, just the usual Snellen test on the wall. Any ideas
where he's getting this +2.25 from, on the left or the right?
I will be seeing him in 2 more weeks for another followup, and I will
certainly ask for more info then. In the meantime, I have the choice
of getting this prescription filled, or not. The surgeon said that
the prescription is only "temporary", because my eye is still healing
and hasn't returned to 20/20 corrected yet. Given the cost of
progressive lenses (I don't have insurance) I'm inclined to wait.
Finally, should I have my vision measured by someone other than the
surgeon? I've read before that surgeons aren't the best eye
professionals to get prescriptions from, that optometrists do the job
better. Any truth to this?
Thanks,
Jim
Repeating Rifle - 20 Mar 2004 00:00 GMT
> Hi,
>
[quoted text clipped - 37 lines]
> Thanks,
> Jim
Please note that I am not a health professional. From the physicist's point
of view, that prescription seems OK. It just means that your left eye just
means that it does not have to work as hard to see close items.
Bill
The Real Bev - 20 Mar 2004 00:01 GMT
> I will be seeing him in 2 more weeks for another followup, and I will
> certainly ask for more info then. In the meantime, I have the choice
> of getting this prescription filled, or not. The surgeon said that
> the prescription is only "temporary", because my eye is still healing
> and hasn't returned to 20/20 corrected yet. Given the cost of
> progressive lenses (I don't have insurance) I'm inclined to wait.
FWIW, when my mom had her cataract surgery maybe 10 years ago,
Lenscrafters offered a special for cataract patients only that gave
remakes whenever the prescription changed for perhaps a year. I think
she got three pair for the price of one, and they may have been
trifocals (not progressives).

Signature
Cheers,
Bev
===========================================================
"You should be glad that bridge fell down -- I was planning
to build thirteen more to the same design."
-- Attributed to I.K. Brunel, addressing the
Directors of the Great Western Railway
Dan Abel - 20 Mar 2004 00:55 GMT
> Hi,
>
[quoted text clipped - 3 lines]
> I'm a bit puzzled by my surgeon's new prescription for progressive
> glasses for me:
I've had cataract surgery in both eyes, so I've been through something similar.
> What I can't figure out is why he added +2.25 for reading on the left
> eye. My left eye is fine, not operated on, and I can see well
> close-up and distant with it. Shouldn't I just continue to have a
> single-vision lens in the left eye, with the progressive only in the
> right? Wouldn't adding +2.25 on the left make things very blurry for
> reading?
The +2.25 will change the size of the image. This could possibly cause
double vision if you had it in one eye and not the other. As RR posted,
you will just need to use less accommodation in the left eye, it won't
make it blurry.
> In fact, I don't remember him measuring my reading vision in any way
> after surgery, just the usual Snellen test on the wall. Any ideas
> where he's getting this +2.25 from, on the left or the right?
The surgery completely eliminated your accommodation in the right eye, so
there was nothing to measure. +2.25 is fairly standard for people with no
accommodation.
If I didn't have insurance, there's no way I'd fill it, given that your
prescription will change over the next few weeks. What I did was take my
glasses into the optical shop and I had them remove the right lens. That
worked well enough (I mostly wore contacts) until my vision stabilized.
Be sure and make sure you don't get double vision when you get new
glasses. Most of the reason I wore contacts was because of double vision
(I was -9 in the left eye).
> Finally, should I have my vision measured by someone other than the
> surgeon? I've read before that surgeons aren't the best eye
> professionals to get prescriptions from, that optometrists do the job
> better. Any truth to this?
If I didn't have insurance, I'd take the surgeon's prescription. Where I
go, they have you see the OD first (at 4 weeks) and then see the surgeon.
Since I have insurance, I waited awhile and then saw the OD of my choice.

Signature
Dan Abel
Sonoma State University
AIS
dabel@sonic.net
Jim Miller - 20 Mar 2004 20:57 GMT
>I've had cataract surgery in both eyes, so I've been through something similar.
Thanks for the help, Dan and everyone.
Jim
Robert Martellaro - 22 Mar 2004 20:27 GMT
>Hi,
>
[quoted text clipped - 11 lines]
>RIGHT: +2.25
>LEFT: +2.25
If the cataracts are not bilateral (in both eyes), I would have kept the Rx
minus in the operated eye. Most older clients will prefer to remain nearsighted
after cat surgery as well. This is a choice that should be made with the
patients approval.
>What I can't figure out is why he added +2.25 for reading on the left
>eye. My left eye is fine, not operated on, and I can see well
[quoted text clipped - 6 lines]
>after surgery, just the usual Snellen test on the wall. Any ideas
>where he's getting this +2.25 from, on the left or the right?
Do not fill this Rx until it is verified by the prescribing doctor. When there
is the need for an add power it is almost always for both eyes, and the same
power in both. Not in this case though, certainly not the same power. There is a
slim chance that this is as intended, much more likely a typo. Nice catch. Most
opticians would not have red flagged this.
>I will be seeing him in 2 more weeks for another followup, and I will
>certainly ask for more info then. In the meantime, I have the choice
>of getting this prescription filled, or not. The surgeon said that
>the prescription is only "temporary", because my eye is still healing
>and hasn't returned to 20/20 corrected yet. Given the cost of
>progressive lenses (I don't have insurance) I'm inclined to wait.
It's possible that there will be some discomfort performing frequent and/or
sustained close tasks with this type of Rx/glasses. If so, a separate pair for
"near only" may be required.
>Finally, should I have my vision measured by someone other than the
>surgeon? I've read before that surgeons aren't the best eye
[quoted text clipped - 3 lines]
>Thanks,
>Jim
Most, if not nearly all MDs have ophthalmic techs perform the refractions. The
challenge here is more with the lens design and the skill level of your
optician. Ask your doctor for a recommendation. An older optician who works
primarily with ophthalmologists is usually your best bet.
Hope this helps
Robert Martellaro
~~~~~~~~~~~~~~~~~~
Optician/Owner
Roberts Optical
robopt@execpc.com
~~~~~~~~~~~~~~~~~~
"Science is a way of trying not to fool yourself."
- Richard Feynman
John Doe - 27 Mar 2004 02:32 GMT
Jim
I have read the posts replying to your situation and think there are quite a
few good points made.
I too was given an RX for glasses but the DR said they are likley to be
short term, so get a "down and dirty" low cost pair of glasses to get
through the healing and adjustment period.
Just wondering what type of lenses you had implanted? Mono or Multifocal.
Your reports on your satisfaction and problems or adjustments would be a
help for others considering the procedure.
I am 42 and had Array IOLs 2-16 and 3-1 this year. Posted lengthy opinion
and thoughts about the process a few days ago.
Thanks for your post and reply
> Hi,
>
[quoted text clipped - 37 lines]
> Thanks,
> Jim