As requested to move this away from the more serious health thread.
An explanation on what's been done to my eyes and how it works:
Rapidly developing cataracts in both eyes have left no choice for me(at present) other than to have both the lenses I was born with removed and replaced with man made lenses. Technology first developed when an English eye surgeon noted that a spitfire pilot with acrylic splinters in his eyes from his canopy could tolerate them without the body reacting to them.
Move on a few decades and the original lenses in my eyes where broken up with me fully conscious but numbed up using a ultrasonic probe under 2mm across. They suck it out and then insert a new rolled up lens through the same hole. Under body temperature it straightens out slowly enough not to cause damage to the eye.
In my case the new lenses are specified to correct the astigmatism I've got(front of of your eye isn't quite as round or is too round). Having carefully mapped my eyeball before they started they line up a couple of horizontal lines on the lenses (now inside your eye) with Inked lines placed on the surface of your eyeball and with images projected through the microscope the surgeon uses. Provided the lens doesn't move too much after surgery the astigmatism is almost wiped out.
Here's where the confusion starts - there are lots of different lenses by different manufacturers and some use the same buzzwords but work in different ways. There are lenses that are multifocal in that they project multipe different images on the back of your eye in different places that your brain can choose from. Think of lots of donut shapes for some lenses. Contrary to what you might think your brain doesn't need an image like a pinhole camera for you to see properly. It's more like a big CCD that can pick just the right pixels to assemble to make a focused picture.
The lenses in my eyes look more like bifocals than the donut rings seen on on some brands but like some of the donut variety claim the name EDOF extended depth of field.
In my case the theory was to set up my left eye with a lens that covers from newspaper/computer screen reading distance into the distance for pretty average vision (nothing bionic you understand) and the right eye just slightly shorter than that to cover finer print but not quite so far into the distance. I asked to be able to get the soldering iron out without glasses if possible. If i need to see mountain goats a couple miles away I'll get some binoculars out. You can swap this around though apparently pilots and golf players are happier with great distance vision and wearing glasses for most reading.
For me this creates a big overlap between the eyes with no compromise for the stuff i do everyday. But your brain can use the input from each eye to adjust the picture from the other. So with both eyes open I now have very good vision from fine print out to the pines on the hilltops in the distance. This method can still leave some patients needing reading glasses for very fine print. The advantage is that by not trying to guarantee I would be free from glasses for reading tiny print they can use lenses that almost eliminate the chances of problems with glare and halos from bright lights during the day or night time driving associated with some brands of multifocals.
Anyway for me it's working very well with eyesight better than I've had since my twenties (I was Fifty in July).
Hers some links:
YouTube
YouTube
An explanation on what's been done to my eyes and how it works:
Rapidly developing cataracts in both eyes have left no choice for me(at present) other than to have both the lenses I was born with removed and replaced with man made lenses. Technology first developed when an English eye surgeon noted that a spitfire pilot with acrylic splinters in his eyes from his canopy could tolerate them without the body reacting to them.
Move on a few decades and the original lenses in my eyes where broken up with me fully conscious but numbed up using a ultrasonic probe under 2mm across. They suck it out and then insert a new rolled up lens through the same hole. Under body temperature it straightens out slowly enough not to cause damage to the eye.
In my case the new lenses are specified to correct the astigmatism I've got(front of of your eye isn't quite as round or is too round). Having carefully mapped my eyeball before they started they line up a couple of horizontal lines on the lenses (now inside your eye) with Inked lines placed on the surface of your eyeball and with images projected through the microscope the surgeon uses. Provided the lens doesn't move too much after surgery the astigmatism is almost wiped out.
Here's where the confusion starts - there are lots of different lenses by different manufacturers and some use the same buzzwords but work in different ways. There are lenses that are multifocal in that they project multipe different images on the back of your eye in different places that your brain can choose from. Think of lots of donut shapes for some lenses. Contrary to what you might think your brain doesn't need an image like a pinhole camera for you to see properly. It's more like a big CCD that can pick just the right pixels to assemble to make a focused picture.
The lenses in my eyes look more like bifocals than the donut rings seen on on some brands but like some of the donut variety claim the name EDOF extended depth of field.
In my case the theory was to set up my left eye with a lens that covers from newspaper/computer screen reading distance into the distance for pretty average vision (nothing bionic you understand) and the right eye just slightly shorter than that to cover finer print but not quite so far into the distance. I asked to be able to get the soldering iron out without glasses if possible. If i need to see mountain goats a couple miles away I'll get some binoculars out. You can swap this around though apparently pilots and golf players are happier with great distance vision and wearing glasses for most reading.
For me this creates a big overlap between the eyes with no compromise for the stuff i do everyday. But your brain can use the input from each eye to adjust the picture from the other. So with both eyes open I now have very good vision from fine print out to the pines on the hilltops in the distance. This method can still leave some patients needing reading glasses for very fine print. The advantage is that by not trying to guarantee I would be free from glasses for reading tiny print they can use lenses that almost eliminate the chances of problems with glare and halos from bright lights during the day or night time driving associated with some brands of multifocals.
Anyway for me it's working very well with eyesight better than I've had since my twenties (I was Fifty in July).
Hers some links:
YouTube
YouTube
Steve, that's a great readable synopsis of cataract surgery.
No confusion here. From the other thread:
True.
But it's not exactly stereo vision either, with one eye not best corrected at distance.
That's why we refer to it as a modified mono. Just semantics. We also do it with contact lenses using multifocals, or one multifocal & one monofocal lens, or one multifocal and one naked eyeball.
Every patient is different and the amount of disparity they need and can tolerate varies with task, biology, and even personality. It can be quite a balancing act.
Your surgeon did an excellent analysis of your corneal astigmatism via corneal topography. We also use that to fit specialty contacts, primarily rigid gas perms, keratoconus lenses, and therapeutic lenses that offer an alternative to refractive surgery.
From what I see, the Lentis Comfort IOL's are aspheric implants designed for stereo distance vision with a 1.50D bifocal segment for intermediate vision. Most of the add powers I normally see are 2.00 and 3.00. Yours are toric as well to correct the corneal astigmatism. The surgeon went beyond that and selected a slightly more positive central vision power in the non-dominant eye, so that combined with the 1.50D segment, you would able to see at soldering distance. That increase is counterproductive for distance vision, and must be carefully balanced for your particular needs.
Besides precise, your surgeon is obviously very careful and intuitive to manage this balancing act with IOL's. It's trying enough to do it with contacts!
And that's all that matters in the end. Most folks don't end up quite that well off, so it's fantastic that it has worked out so well for you.
I'm glad your year is ending on a high note!
No confusion here. From the other thread:
True.
But it's not exactly stereo vision either, with one eye not best corrected at distance.
That's why we refer to it as a modified mono. Just semantics. We also do it with contact lenses using multifocals, or one multifocal & one monofocal lens, or one multifocal and one naked eyeball.
Every patient is different and the amount of disparity they need and can tolerate varies with task, biology, and even personality. It can be quite a balancing act.
Your surgeon did an excellent analysis of your corneal astigmatism via corneal topography. We also use that to fit specialty contacts, primarily rigid gas perms, keratoconus lenses, and therapeutic lenses that offer an alternative to refractive surgery.
From what I see, the Lentis Comfort IOL's are aspheric implants designed for stereo distance vision with a 1.50D bifocal segment for intermediate vision. Most of the add powers I normally see are 2.00 and 3.00. Yours are toric as well to correct the corneal astigmatism. The surgeon went beyond that and selected a slightly more positive central vision power in the non-dominant eye, so that combined with the 1.50D segment, you would able to see at soldering distance. That increase is counterproductive for distance vision, and must be carefully balanced for your particular needs.
Besides precise, your surgeon is obviously very careful and intuitive to manage this balancing act with IOL's. It's trying enough to do it with contacts!
And that's all that matters in the end. Most folks don't end up quite that well off, so it's fantastic that it has worked out so well for you.
I'm glad your year is ending on a high note!
Last edited:
Thank you Steve for this need to know information.
I cleaned up my act 10 years ago. I am now an über-healthy 63 and intending to live to 120 - so much to do, so much to see! My health in every respect has become vital - especially my sight and hearing.
I am so glad you got the very best treatment available.
ToS
I cleaned up my act 10 years ago. I am now an über-healthy 63 and intending to live to 120 - so much to do, so much to see! My health in every respect has become vital - especially my sight and hearing.
I am so glad you got the very best treatment available.
ToS
I will be having a new lens in my left eye next month. The cataract on that lens has gotten pretty bad in the last couple of years. Unfortunately I have another problem with that eye, a large "floater" in the back of the eye. I gather there is some sort of membrane inside the eye which can break down and detach, and there is a big piece of it floating around inside my eye. sometimes it is edge-on and not too obtrusive, but other times it is like a large dark patch in the middle of my vision. I am concerned that the cataract surgery won't help with that, and the result will be a clear lens that I can't always see through.
Response originally to tsmith1315 in other thread
> getting most folks to purchase a task-specific pair of glasses is nearly impossible.
Well, maybe I've been frustrated since my accommodation faded. Part of my back-problem is straining to read a CRT (the first symptom was inability to read a calculator). For a decade I had "work bifocals": bottom around 1.5add to see the screen, top a half-D shy to see across the room and walk around a familiar campus. When I went to the parking lot I went back for the driving glasses. (Not essential, even legally, just more comfortable beyond 20 feet.)
ALSO..... I am comfortable paying $7 for single-vision spectacles.
SPH CYL Axis
0.00 -0.50 80
+0.25 -0.75 95
Frame Price $6.95
Lens 1.50 Standard Single Vision FREE
Standard Shipping ... $4.95
I'd forgot the 3/4d astig in one eye; that's why I prefer prescribed over plain readers for PC, and how I know Zenni read the Rx correctly.
> Steve's "modified monovision"...
I was trying to figure that out. In my exam there was some discussion about putting me as-I-was, or making me "normal". I mulled and opted to be "normal" (good at infinity, readers for reading), K.I.S.S., all my friends do it. Doc was pleased. No discussion of multiple zones in different eyes. (And they already knew my insurance would cover the basics well; and I just-might pay for extras.)
So Steve got four different focal points? His eye/brain learns which eye and angle to use for the distance? Monocular he usually has a pretty sharp image in one eye; the brain discounts the other eye. In stereo he has one sharp and one fuzzy, which may well be ample for all everyday reach out and grab stereolocation.
> ...progressive multifocal lenses...
That stuff blows my little mind. The aberrations would seem to be atrocious, also annoying. That they are widely accepted means math far above the old optics books (or hand computation!). And as you say, cutting those insane curves.
> virtually no one listens to us professionals about this until it's too late.
Yeah, well, ashamed to say, while I have not yet poked an eye out, I used my New Eyes to arc-weld with a faulty helmet. I gave up quick, but not quick enough. Stars and dim lights I see off-axis can not be seen on axis: retina burn. I suspect this will show in my next eye-exam, the doc will be disappointed in me.
______________________
I posted a detailed tale on another forum, which some folks felt was helpful. If that forum is not Public, tell me, I'll copy it here.
> getting most folks to purchase a task-specific pair of glasses is nearly impossible.
Well, maybe I've been frustrated since my accommodation faded. Part of my back-problem is straining to read a CRT (the first symptom was inability to read a calculator). For a decade I had "work bifocals": bottom around 1.5add to see the screen, top a half-D shy to see across the room and walk around a familiar campus. When I went to the parking lot I went back for the driving glasses. (Not essential, even legally, just more comfortable beyond 20 feet.)
ALSO..... I am comfortable paying $7 for single-vision spectacles.
SPH CYL Axis
0.00 -0.50 80
+0.25 -0.75 95
Frame Price $6.95
Lens 1.50 Standard Single Vision FREE
Standard Shipping ... $4.95
I'd forgot the 3/4d astig in one eye; that's why I prefer prescribed over plain readers for PC, and how I know Zenni read the Rx correctly.
> Steve's "modified monovision"...
I was trying to figure that out. In my exam there was some discussion about putting me as-I-was, or making me "normal". I mulled and opted to be "normal" (good at infinity, readers for reading), K.I.S.S., all my friends do it. Doc was pleased. No discussion of multiple zones in different eyes. (And they already knew my insurance would cover the basics well; and I just-might pay for extras.)
So Steve got four different focal points? His eye/brain learns which eye and angle to use for the distance? Monocular he usually has a pretty sharp image in one eye; the brain discounts the other eye. In stereo he has one sharp and one fuzzy, which may well be ample for all everyday reach out and grab stereolocation.
> ...progressive multifocal lenses...
That stuff blows my little mind. The aberrations would seem to be atrocious, also annoying. That they are widely accepted means math far above the old optics books (or hand computation!). And as you say, cutting those insane curves.
> virtually no one listens to us professionals about this until it's too late.
Yeah, well, ashamed to say, while I have not yet poked an eye out, I used my New Eyes to arc-weld with a faulty helmet. I gave up quick, but not quick enough. Stars and dim lights I see off-axis can not be seen on axis: retina burn. I suspect this will show in my next eye-exam, the doc will be disappointed in me.
______________________
I posted a detailed tale on another forum, which some folks felt was helpful. If that forum is not Public, tell me, I'll copy it here.
Last edited:
This is the premise of computer/workstation/work area progressives. They are designed backwards, that is to say they give priority to the near vision area at bottom and work up the progressive channel/computer area as a vertical power digression.
Comparable to cheap kits on ebay. As a licensed professional, if I did in our office some of what they do, I'd be prosecuted by our state board.Pretty much, and that's a great interpretation as to how they work together.
The brain is fabulously adaptive.
Yeah, 25 years ago, I could estimate the needed curves (all 2 of them) pretty doggone close in my head. There were a couple of times when I actually had to do it, either a computer down or the particular lens out of range for our system and didn't bother to use pencil or paper.
Now the multifocal powers are integrated into the distance Rx and the whole thing is cut onto the back surface. The lens area is divided up into thousands of different "points" and Rx can be optimized for angle & distance from the back surface of the lens to the eye, material index, frame fitting parameters, add power, etc for each point with iterative processes to refine the end result. In at least one design, hundreds of thousands of iterative calculations are performed for every Rx submitted.
Aberrations/unwanted astigmatism were atrocious and when I started 25 years ago, 50% adaptation rate was what I saw. With the new products, I think we had 3 non-adapts this year.
We're not going to talk about the welding incident.
So the discussion about what an optician would call monovision is confusing. A monovision lens is one that traditionally would have one point of focus usually set for distance. Combine that with glasses for reading and you get what is considered acceptable eyesight by the National Health Service in UK or NZ and what most health insurance companies will pay out for by default. You can have monovision lenses in each eye with a different prescription for each that's not what i've had done which is more like a bi-focal or varifocal in each eye.
Next step up for a long time has been multifocal lenses which whilst providing people with the ability to see everything without glasses near to far has created problems for some patients that they haven't been able to live with so that they have had them removed before very long and replaced with old school monofocal lenses. The problems have included difficulty driving at night because headlights from oncoming vehicles and even tail lights are defracted and even magnified by the lenses causing bluring and halo effects. I'm told even bright supermarket lights can be a problem during the day to the point were people abandon their shopping.
In 2013 a scientific paper was presented on Lasik eye surgery with the results of staggering the prescription on each eye. The brain can cope with a difference in each eye to present a clear focused image when you have both eyes open. This research was developed for cataract lens replacement. The overlap between the prescriptions gives excellent stereoscopic vision for depth perception etc in that overlap area.
I'm only two weeks out of surgery on one eye and a week on the other. I measured 20/20 the morning after surgery on the second eye (outpatient visit) and this should improve over the course of month or so. I've had some slight flickering lasting just a few seconds at the periphery of my vision in each eye in the days just after surgery but that's now stopped. There was also a feeling of wearing blinkers (like a horse) thats gone now too.
Without the ability to change the shape of a lens in the eye it's up to the brain to do a bit more work on creating a sharp image. At the moment there's a tangible delay in re-focusing on objects at different distances but nothing worse than you'd experience with an older pair of eyes anyway. Pretty sure that will improve too as the brain adapts.
I guess the message from me is that you can have excellent eyesight without "photopic" problems generated by some lenses if you are prepared to take the gamble that you might still need glasses for very fine print or work. The prescription for my lenses reads as follows:
Left eye LS-313 MF 15TO (Ref for the lens type) TO is toric for the astigmatism correction.
+18.5 C+0.75D
Add +1.5D as 90 degrees
Right eye: LS-313 MF 15TO (Ref for the lens type)
+19.5 C+0.75D
Add +1.5D as 90 degrees
http://www.oculentis.com/Downloads/LENTIS-LS-313-MF15-EN.pdf
The surgery itself was painless, if you can put up with the injections at a dentist this is easy stuff. Because I went through the surgery without any sedation I was told by the surgeon I could go home and have a beer afterwards. Surgery is a like looking up through the bottom of a thick glass tumbler at a bright light whilst someone stirs your drink. No worse that that. I found the pulse rate monitor going beep all the time more annoying. About 15 minutes in the theatre itself. But a bit hanging around before waiting for eye drops to start to numb things up.
Loving my new eyes - Steve
Next step up for a long time has been multifocal lenses which whilst providing people with the ability to see everything without glasses near to far has created problems for some patients that they haven't been able to live with so that they have had them removed before very long and replaced with old school monofocal lenses. The problems have included difficulty driving at night because headlights from oncoming vehicles and even tail lights are defracted and even magnified by the lenses causing bluring and halo effects. I'm told even bright supermarket lights can be a problem during the day to the point were people abandon their shopping.
In 2013 a scientific paper was presented on Lasik eye surgery with the results of staggering the prescription on each eye. The brain can cope with a difference in each eye to present a clear focused image when you have both eyes open. This research was developed for cataract lens replacement. The overlap between the prescriptions gives excellent stereoscopic vision for depth perception etc in that overlap area.
I'm only two weeks out of surgery on one eye and a week on the other. I measured 20/20 the morning after surgery on the second eye (outpatient visit) and this should improve over the course of month or so. I've had some slight flickering lasting just a few seconds at the periphery of my vision in each eye in the days just after surgery but that's now stopped. There was also a feeling of wearing blinkers (like a horse) thats gone now too.
Without the ability to change the shape of a lens in the eye it's up to the brain to do a bit more work on creating a sharp image. At the moment there's a tangible delay in re-focusing on objects at different distances but nothing worse than you'd experience with an older pair of eyes anyway. Pretty sure that will improve too as the brain adapts.
I guess the message from me is that you can have excellent eyesight without "photopic" problems generated by some lenses if you are prepared to take the gamble that you might still need glasses for very fine print or work. The prescription for my lenses reads as follows:
Left eye LS-313 MF 15TO (Ref for the lens type) TO is toric for the astigmatism correction.
+18.5 C+0.75D
Add +1.5D as 90 degrees
Right eye: LS-313 MF 15TO (Ref for the lens type)
+19.5 C+0.75D
Add +1.5D as 90 degrees
http://www.oculentis.com/Downloads/LENTIS-LS-313-MF15-EN.pdf
The surgery itself was painless, if you can put up with the injections at a dentist this is easy stuff. Because I went through the surgery without any sedation I was told by the surgeon I could go home and have a beer afterwards. Surgery is a like looking up through the bottom of a thick glass tumbler at a bright light whilst someone stirs your drink. No worse that that. I found the pulse rate monitor going beep all the time more annoying. About 15 minutes in the theatre itself. But a bit hanging around before waiting for eye drops to start to numb things up.
Loving my new eyes - Steve
Gee, what timing. I'm having cataract surgery Thursday.
By accident I found a good book on the subject at the public library. (it was one section before the NEC code book)
Title Cataract surgery : a guide to treatment
Author Garland, Paul E. (Ophthalmologist)
Publisher:Addicus Books, Inc.,
Pub date:[2015]
Pages:120 pages
:ISBN:9781943886043
By accident I found a good book on the subject at the public library. (it was one section before the NEC code book)
Title Cataract surgery : a guide to treatment
Author Garland, Paul E. (Ophthalmologist)
Publisher:Addicus Books, Inc.,
Pub date:[2015]
Pages:120 pages
:ISBN:9781943886043
Not sure your point. What are they doing that you can't?
Cheap eBay electronics, I can't see if the "2N3055" is really a 30V 20W part until it blows-up.
With my very mild correction I can be "brave" about my specs. My eyes won't "blow up" (certainly safer than me and a welder, or that Prednisone). As a lifetime myopic I am fussy about my corrections and alert to mis-grinds and twisted axis. In several dozen pairs of $200 specs I once had cyl 90deg off (the optician agreed and fixed it); in now near a dozen $39 and $7 specs the optics are perfect. One frame (from $39!) is a little mis-welded (nobody really checks). Frames are very basic but seem to work good/better than $200 specs. FWIW, I have a Trial Frame and lens set, I can know what the numbers should look like. (Yes, you can't buy that stuff in the US, and some of the lenses are not of the best.)
That's about like my lover was. Thick lenses, big lenses impossibly heavy, had to keep the specs on the nightstand to find the floor in the morning (kidding). Clouding was bad, but cutting that out allowed a re-set to "normal" fix-focus (like everybody our age). About a diopter left, so she has specs, but can leave them across the room.
Neither of use were offered, at least not strongly, any "bifocal" option. Or maybe we were not open to the idea, having managed myopia all our lives. She has progressives. I have various readers all over the house, four in regular use, spare in the car for shopping. (I found a bifocal zero in the top and +1.5 bottom, I'm trying that for shopping to find the aisle then read labels.)
Had a few eye issues over the last 2 years.
Floaters in both eyes which gives some cloud shapes as well as what looks like bird swarms. Amazingly, they settle and the brain compensates over time where it becomes less obvious so you hardly notice it except for a bit of fogging. Still get the occasional flash when the floater sticks the the retina and tugs loose.
Low level cataracts are present but not bad enough for surgery but maybe having floaters would diminish the outcome from surgery.
Had wet macular degeneration in the right eye but after 6 Lucentis eye injections, has settled back to close to normal. The floater in the right eye happened at the same time as the last injection which is probably coincidental.
Basically my left eye does most of the work but the right eye does make a contribution especially for depth of field.
Floaters in both eyes which gives some cloud shapes as well as what looks like bird swarms. Amazingly, they settle and the brain compensates over time where it becomes less obvious so you hardly notice it except for a bit of fogging. Still get the occasional flash when the floater sticks the the retina and tugs loose.
Low level cataracts are present but not bad enough for surgery but maybe having floaters would diminish the outcome from surgery.
Had wet macular degeneration in the right eye but after 6 Lucentis eye injections, has settled back to close to normal. The floater in the right eye happened at the same time as the last injection which is probably coincidental.
Basically my left eye does most of the work but the right eye does make a contribution especially for depth of field.
I've had floaters all my life, apparently enough to annoy the guy who looks in my eye. As you say, the brain sees around them, mostly. Cataracts are quite different, and fixing the cataracts was entirely wonderful, even though the floaters are same as ever.
I suppose (am sure) you have had the Talk about any sudden increase of floaters needs quick attention. Mine vary with the seasons, or maybe my activity level, but have not really changed over 60 years.
Well a few weeks on i’m Still putting steroidal drops in my eyes four times a day. Almost all the redness has gone but I have to stick with it for a few more weeks until I see the surgeon again. No real problems to report. I’m still getting a slight fluttering at the edge of my peripheral vision on occasion but it only lasts a few seconds. There’s a video on YouTube where the developers of the lenses call this phenomena “Angel Wings” as though you had wings and where flapping them. Soldered up the ACA no bother. I did need to get a magnifying glass out to read the microscopic print on the smaller transistors but they’d be a problem for anyone.
- Status
- This old topic is closed. If you want to reopen this topic, contact a moderator using the "Report Post" button.