Cataracts and Pistol Sights

[montanadave]

I'm having cataract surgery soon and am concerned about how well I'm going to be able to pick up pistol sights following the surgery. Any members have any experience or feedback on the subject?

[John_Wayne777]

Mention it to your eye doctor. Believe it or not a lot of docs have dealt with people who do various sports and have seen the movie before. If he doesn't know much about shooting, you can give a brief explanation of what's important visually in your shooting now and he can give some input on what might change.

IIRC cataract surgery isn't supposed to muck with your eyesight as far as being able to focus or clarity of vision.

[Pappabear]

JW777 is correct. The MD can choose to make you a little more hyperopic or myopic depending on your preference. He probably has a balance determined of both for his patients already. He will consider this based on what your vision was before. However, if you explain your interest in shooting, he can assist. The reality is you probably want to see your sights pretty good and see your target pretty good. Both cant be crystal clear because you new lens can't "accomadate" or focus.

Consider this, he can give you great eyesight to see your "Sights" but then you may not be able to see your target. Explain you want to see both and hold your hands out and show where your front sight will be. I think for tactical shooting thats the best you can hope for. Also, if you shoot with one eye closed, tell him that too.

There are multi-focal lenses and lenses that attempt to "focus" but that involves many trade-offs as well.

[MiggyE]

hey guys! sorry for a late post, but this was the first time i saw this post. my wife's an ophthalmologist, and so i talked to her about this topic a year ago. actually i have pretty good vision, 20/10 in my dominant left eye and 20/15 in my right eye. but then, almost all of us will develop cataract in the later stage of our lives.
there is a intra-operative lens you might want to talk to your ophthalmologist about. its made by Bausch and Lomb, and its called Crystalens. it has struts/hooks that usually implant in the len's capsule. this allows the focusing muscles to move the lens back and forth, give it focusing ability.
another is made by Alcon, named reSTOR. it uses multiple rings that refract and defract light according to your previous grade. no extra implantation necessary.

ok, now the drawback.....tada!!! the price! if a regular IO lens would cost you 100USD, these lenses would go for around 1000USD. this is a guestimate, of course. but i still suggest you talk to your eye doc about these.

[uwe1]

I'm having cataract surgery soon and am concerned about how well I'm going to be able to pick up pistol sights following the surgery. Any members have any experience or feedback on the subject?

You will have improved vision just from having the surgery so that might improve your shooting from the start.

There is a bit of luck involved with correcting the eye with the implanted intraocular lens. Usually, it's possible to get close to 20/20 vision without any additional glasses or contact lens correction, but in my experience, that happens only about 50% of the time when I have seen patients who are post-operative. It's more common for a post-op cataract patient to be 20/25 or 20/30 which by the way the majority of patients are very very happy with. The vision may also change depending on how the eyes heal and age over time. It can also change from complications due to having the surgery.

The two most commonly used multifocal intraocular lenses in the U.S. are: ReStor and ReZoom. There are also a few lesser known/used ones.

Here is a brief pros/cons description of ReStor and ReZoom:

http://74.125.95.132/search?q=cache:...&client=safari

The Crystalens is an accomodating lens.

If you are someone who wants well-defined, clear vision, I would stick with a standard IOL or the Crystalens if you have the extra money. Don't expect miracles out of the Crystalens' ability to focus your eyes at near either, because the results differ between patient to patient (as they say, YMMV). You will probably be able to pick up the front sight well enough with the Crystalens, but don't expect to effectively see something 8 inches from your face. The first Crystalenses had problems with people not getting enough accommodative amplitude out of them (not able to focus as much as they thought they should have), but the company has made improvements to it in the more recent re-design and I believe it should function a bit better than when it was first released.

The cool part of multifocals is that you get a lot of different focal points. That is also the bad part as you have a lot of conflicting images that your brain has to pick from in order for you to see. This means that you do not see CLEARLY. You can see many things well enough, but they're generally not well-defined (YMMV). This is sometimes so much a problem for some patients who receive the Restor or Rezoom that the surgeon has to remove them. Also, reference the above article on ReStor. It has a higher effective Add. That means your near vision is good, but your intermediate vision isn't! Guess what....your front sight is at the intermediate range.

So multifocal IOLs are good for generally quick, workable vision, but not as good for precision work.

If you want your dominant eye to focus at the front sight, you must be okay with it not being focused sharply at distance. Typically if you were to request this sort of adjustment to your dominant eye's vision, we would change your prescription by +1.00 or +0.75 diopters (in a pair of glasses or contact lenses), most of this depends on how close the front sight is from your eyes. By requesting that the surgeon implant an IOL to allow you to see your front sight clearly would then cause you to only have 20/30 or 20/40 vision in that eye, which isn't bad at all, but it isn't perfect either. Your success level and tolerance to this will be determined by (to put it bluntly) how "anal" you are.

Keep in mind, if after the cataract surgery, you are unhappy with your vision and you picked the standard IOLs, you could still go to your optometrist and have them fit you with a pair of contacts or glasses to smooth things out.

About pricing, Medicare or insurances generally pay for the cost of a standard IOL, but you must pay to upgrade to the multifocal IOL or the Crystalens. The additional cost is usually about $1000.

[LarryD]

montanadave,
I had cataract surgery about a year ago and I am very pleased with the results. I wore contacts for several years before the surgery so my Doc implanted lens to correct my vision to 20/20. I wore reading glasses prior to the surgery and I still need to wear them now. My vision is clear (especially night vision) and my color recognition has returned. My Doc offered lens implants that would correct for reading but he said that the lens were new at that time and yet to be proven so I decided against them. MiggyE is right about the cost, they are considerably more expensive but don't let that sway your decision because you will not want to go thru this surgery again. I suggest you discuss your options with your doctor. I'm sure there have been advancements made in the lenses since I had my surgery.

The thought of cataract surgery can be intimidating since they are operating on your eyes. I did a lot of research prior to going under the knife and learned a lot about the surgery. The sucess rate is very high and it is very unusual for any problems due to the surgical procedure. Most of the problems I read about were due to infection afterwords. The healing process may take 2 to 4 weeks per eye and you will not be able to shoot until your doctor gives you the go ahead. So be prepared for that. If you are interested about the procedures, I can discuss further.

As far as shooting goes, the surgery did not help or hurt being able to see the sights. I disussed shooting with my Doc prior to the surgery so there would not be any suprises after my eyes healed. I have not noticed any change when shooting handguns but I think my rifle skills (using irons) have improved a bit. I have not noticed any change when using a red dot (Eo-Tech, Aimpoint, etc.) or magnified scopes. Just being able to see clearly again will help a lot.

[montanadave]

Thanks for the information, guys. One additional wrinkle I failed to include with my OP was the fact I had LASIK surgery about fifteen years ago. Because of this prior optical surgery, during consultations with a couple of ophthalmologic surgeons (who perform both cataract and LASIK surgeries) I was advised to steer clear of the current generation of "multifocal" lenses simply because, in their practices, they had seen less than optimal results with post-LASIK patients, primarily excessive halos, glare, etc.

I'm leaning towards the standard IOL with a little under correction (monovision) in my dominant eye. I'll get some additional feedback form my doc next week prior to the first surgery. And, yeah, I'm a little freaked about the surgery just because I've had poor vision since I was a kid and was extremely pleased with my results after the LASIK and being free of corrective lenses for the first time since I was 7-8 years old. If I end up requiring reading glasses I can live with that, as I'm starting to need them most of the time anyway. But I'd really like to have my distance vision back and I still want to enjoy shooting.

[LarryD]

Don't worry about the surgery too much, it's really not that bad. I wasn't trying to scare you about the procedure. It really improved my vision and I would do it all over again. I just meant for you to choose the lenses that were right for you.

Is your medical insurance going to cover the surgery? My plan paid about 80% of the cost so that helped a lot. I don't recall the total amount that I was charged but it can be 4-5 times as expensive as LASIK. Good advice from MiggyE and uwe1 on the lenses available.

[Pappabear]

Correct, do not do Multi-focals or accomadative lenses if you have done LASIK. He will be challenged enough with your refraction from that. You may want to consider having him doing your non-dominate eye first.

Good luck.

[MiggyE]

Thanks for the information, guys. One additional wrinkle I failed to include with my OP was the fact I had LASIK surgery about fifteen years ago. Because of this prior optical surgery, during consultations with a couple of ophthalmologic surgeons (who perform both cataract and LASIK surgeries) I was advised to steer clear of the current generation of "multifocal" lenses simply because, in their practices, they had seen less than optimal results with post-LASIK patients, primarily excessive halos, glare, etc.

I'm leaning towards the standard IOL with a little under correction (monovision) in my dominant eye. I'll get some additional feedback form my doc next week prior to the first surgery. And, yeah, I'm a little freaked about the surgery just because I've had poor vision since I was a kid and was extremely pleased with my results after the LASIK and being free of corrective lenses for the first time since I was 7-8 years old. If I end up requiring reading glasses I can live with that, as I'm starting to need them most of the time anyway. But I'd really like to have my distance vision back and I still want to enjoy shooting.

OOOPS. yup, that changes the problem a bit. LASIK works by contouring your lens to make your vision, ergo, your lens becomes thinner than usual. it makes it difficult for IOL surgery.

My advice is to talk to your ophthalmologist. get an IOL to give you very good long distance vision, and just stick with a good pair of reading glasses.