Doctor My Eyes (Part I)

By Christopher Lane

Eyesight is a precious gift for anyone, but particularly for a photographer. Photography is a visual art and it’s pretty terrifying to imagine your self plunged into darkness. Never being able to make another image or look at another photograph, your passion taken away. I suppose I could imagine a blind photographer shooting with the aid of a sighted assistant, but to what end? How joyless a pursuit that would be? Never being able to see the fruits of your labor, whether good or bad.

I have had mild vision problems since my early teens and I have worn glasses for most of my adult life.  Recently, however, I noticed that my last pair—only a year old—seemed be out of whack. Even wearing them, I could not get clear vision with my right eye. I concluded that the lens must have been made wrong. I set the glasses aside until my annual eye exam.

 When that day rolled around, a couple of weeks ago, I immediately expressed my concern to the optometrist. He sent the glasses out to be checked while he performed the exam. After going through the usual routine and looking at my eyes while dilated, he concluded that the prescription was correct and that I had cataracts in both eyes, the right one being the worst. 

A cataract is the clouding of the eye's natural lens. This lens, much like a camera lens, lies behind the iris and the pupil and focuses light onto the retina at the back of the eye. Like a camera lens, it also adjusts the eye's focus. Composed of a precise arrangement of water and protein, a normal lens is crystalline and lets light pass through it. As you age, however, the protein tends to clump together which clouds a small area of the lens and left untreated it will keep growing larger, ultimately resulting in blindness. The solution is a surgical procedure where millimeter incisions are made on each side of the cornea and the lens is removed by an ultrasonic probe. The natural lens is then replaced by a tiny, lightweight, plastic lens known as an intraocular lens.

According to the optometrist, cataract surgery is very successful in restoring vision and only takes about eight minutes to perform. It is the most frequent surgery in the United States, with more than three million patients undergoing it each year. Nine out of 10 people regain normal vision between 20/20 and 20/40.  As a bonus, I would not need glasses for distance vision any more.

Now, the mere thought of anyone messing around with my eyes is extremely distasteful. For that reason I have never even considered the Lasik procedure. But this is another matter entirely. Lasik surgery is elective: you can just keep wearing your glasses if you want. Here, I was faced with an unenviable choice. Either submit to the surgery or slowly go blind. Since I love photography—and seeing—I made my decision quickly, but not without a certain sick feeling in the pit of my stomach. I will consult with a cataract surgeon later this month and most likely schedule my right eye first. I’m concerned, but not scared. There are always risks with every surgical procedure, but I think the odds are very much in my favor.

In Part II, later this month, I’ll let you know how it all works out. 

Chris

Christopher Lane writes about photography and digital imaging at Written by the Light.

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Featured Comment by MartSharm: "Christopher, As an optometrist, I deal with referral and management of cataract patients all the time. I consider the onset of cataract to be a normal consequence of aging and nothing unusual. Of course some patients can feel a little apprehensive regarding the surgery, but it really is very quick and painless; patients often wonder what they were worried about when they see me afterwards.

"Something you may wish to discuss with your ophthalmologist: your residual refraction (what your spectacle prescription will be afterwards). You've already hinted at this with your statement that you won't need to use distance spectacles afterwards. Most patients aren't too fussy, but as you're clearly thinking this through, it may be worth deciding what sort of vision you would like to have afterwards (the surgeon can choose what optical power of implanted lens to use; calculations using pre-operative ultrasonic biometry can predict what the final spectacle prescription will be).

"If you're currently hyperopic (far-sighted), you'll be using glasses for both distance and reading, and plano (zero residual prescription) will be a useful result. If you are currently myopic (near-sighted), you will be able to see at near without specs on; if you are corrected to plano you will lose this ability and will need reading glasses. High astigmatism is a bit more hit and miss. Some myopes prefer to be left a moderate amount myopic post-treatment (something like –1.00), so they don't have to reach for their reading specs every time to see up close. That –1.00 should enable you to see what you're doing at arm's length, and will be easy to compensate for in the viewfinder, at the expense of needing specs for detailed distance vision tasks such as driving. Just a little something to think about."

Featured Comment by Bill McFadden: "I have looked at cataracts from both sides now (with apologies to Joni Mitchell) so feel qualified to comment. I practiced Ophthalmology for 35 years and have done some several thousand cataract operations. Eighteen months ago I realized that I had to have the surgery myself, and have since had it done.

"Do not apologize for being scared. I can think of few things more frightening than having my eyes operated on—and I considered it a heavy responsibility when someone entrusted his/her eyes to me. Do not believe anyone who says or implies that there's 'nothing to it.' It is a delicate procedure on an extremely delicate organ and, as any surgery does, carries a risk (small nowadays but a risk nonetheless).

"That said. surgery today is marvelous—very easy from the patient's side, even compared to what it was 15 years ago. Results are wonderful. As 'MartSharm' commented, I chose to remain a bit nearsighted—computers and books and photographs are nice to enjoy without reaching for glasses. Find a good surgeon and go for it.

"Okay, I have also been enjoying photography since even before I began working on eyes. Yes, the commonest type of cataract is a yellow-brown filter and the restoration of color vision is great fun—before I had my second eye done I went to Photoshop and in one picture duplicated the color as seen by an eye with a cataract vs. one with a new lens. What surprised me most was that most all of my prints in the last year before surgery were terribly oversharpened. I had to go back and redo the ones that were worth it!"

Featured Comment by Patrick Snook: "Uncanny coincidence.

"I just got home from the optometrist, and with my eyes still dilated and enjoying the relief offered by the shady interior light, I woke my MacBook and read this TOP post about optometry.

"During my visit, I reported to my optometrist a recent (6-month) mild symptom, a blurriness that sometimes occurs in my right eye only, and then disappears. It was quickly diagnosed. Nothing to worry about, but I received a salutary lesson in the structure and likely degradation of the eye, and a reminder of the extremely high value and use of eyesight.

"The main lesson came after the office visit. Nothing like having eyes stuck at ƒ/1.0, and stepping out on to white concrete in the city in full sun (ƒ/16), having forgotten to bring along the ND filters (a pair of sunglasses). Shutter speed is not adjustable (eyes must remain open), and there is no adjusting the aperture (or toggling the ISO) to compensate. It is an extremely uncomfortable experience, slightly nauseating, disorienting and even physically threatening (not the most comfortable part of Philadelphia in which to find oneself blinking and staggering).

"Well, good luck with the cataract surgery—although it sounds like there's a lot of reason to take courage and have confidence in the outcome, regardless of 'luck.'" 

Featured Comment by R. Edelman: "I, too, am an ophthalmologist. I do a small variety of surgical procedures, but the most common one that I do is cataract surgery. I started my residency in 1979, so I've been doing this for more than 30 years (hard for me to believe). I trained during an exciting time of transition, when some surgeons were using magnification loupes, and more progressive surgeons (such as my chief, Guy H. Chan, M.D.) were using operating microscopes. There were different methods of removing the cataract, from freezing the cataract with an ice probe and pulling it out through a large incision (hopefully in one piece), to small-incision surgery using an ultrasonic-driven probe. Over the years I have seen the procedure go from an inpatient to an outpatient procedure. Thanks to intraocular lens implants, people no longer have to wear thick glasses or contact lenses to see following the surgery. (I suspect that Ansel Adams had cataract surgery without intraocular lens implants as he wore spectacles with significant magnification in the lenses in his later years.)

"One of the heros of cataract surgery was Sir Harold Ridley, the British ophthalmologist who invented the intraocular lens implant. During the Second World War, Dr. Ridley treated RAF aviators who had fragments of the clear plastic from shattered aircraft canopies lodged in their eyes. He observed that the material, Perspex, was well tolerated by the eye. After the war, he began to work on the first generation intraocular lens, which was made from Perspex. Dr. Ridley also did important research into onchocerciasis, known as river blindness.

"Another hero was Dr. Charles Kelman, an American ophthalmologist who developed the phacoemulsifier, the ultrasound-driven probe that allows cataracts to be removed from small incisions. Kelman got his idea to use ultrasound when he was at the dentist, who used an ultrasound device made by Cavitron to clean teeth. Kelman collaborated with Anton Banko, a Slovenian-born engineer who had immigrated to the US and who worked at Cavitron, to develop the first phacoemulsifier. To this day, the procedure is often referred to by the acronym "KPE", which stands for "Kelman Phacoemulsification". Dr. Kelman also developed intraocular lens implants of his own designs.

"Although intraocular lenses were being implanted in relatively small but growing numbers from the 1950s through the 1970s, in 1980, Ralph Nader and Dr. Sydney Wolfe, of the consumer organization Public Citizen, tried to have intraocular lenses effectively banned in the U.S. by having them classified by the Food and Drug Administration as being experimental. They were almost successful. It was only after the actor, Robert Young (aka Dr. Marcus Welby), testified about his own vision (and career) being saved by intraocular lenses that Congress made sure that these lenses would be made available to the public.

"Today, the holy grail of cataract surgery is being able to restore the full range of vision, from distance, to intermediate, to near, without being dependent on glasses or contact lenses. There are many options for intraocular lens implants which you should ask your surgeon about. Research these carefully, as there are potential pitfalls with any of the new lenses.

"Patients today do not need to be burdened by astigmatism, as this can many times be corrected with adjunct incisions in the cornea, or astigmatic-correcting intraocular lenses (called toric lenses). Many of the lenses also correct for spherical aberration, so ask about these as well.

"By the way, although we began measuring the axial length of the eye using ultrasound, the more accurate way, due to its shorter wavelength, is by using laser technology. We reserve the ultrasound these days to measure eyes which have cataracts that are too dense to allow the laser light to penetrate. This is also a good reason not to let the cataract get too advanced before deciding upon surgery.

"Cataract surgery is very gratifying to do, as most of the patients experience improvement and do not experience pain. However, I never trivialize the surgery. (The definition of minor surgery is surgery that is done on someone else.) When things go bad, they can go very bad. It is delicate microsurgery, and although an experienced and skilled surgeon can make the procedure look easy, it isn't as easy as it looks. And some of the patients are having their only good eye operated upon. I have seen videos of cataract surgery done in less than 10 minutes, but I don't consider the surgery to be a horse race. Most of the time the procedure takes 30 minutes, plus or minus 10, and that doesn't include the setup and breakdown time. In most situations, the patient will be in the operating room for up to one hour. In the U.S., the fee which the surgeon receives is not limited to just the surgery itself, but also includes all routine post-operative care for 90 days following the surgery.

"As far as cost, there are places in the world which offer relatively inexpensive cataract surgery. Some of the surgeons in those countries have been very resourceful in their quest to keep costs down. Of course, those countries also have a lower standard of living, and sometimes the ancillary personnel and facilities do not have the qualifications that are required in the U.S. By the way, the actual amount of money (in other words, not adjusted for inflation) that Medicare reimburses the surgeon in 2010 is less than what was paid in the 1980s.

"So, good luck! Keep in mind that the odds are in your favor. If you had those odds in Las Vegas, you would be rich!"

Comments

[Gary O'Callaghan]

Dear Mr. Lane,

I had cataract surgery on both eyes (1 month apart) last summer. I primarily shoot with a Leica. The surgery was quick and effective. I haven't seen so well in years. I must still wear glasses for reading and driving, but can focus my M9 with or without them.

GaryO

[Robert Roaldi]

My mother had both eyes done. Easier than going to the dentist. Just need to be careful for a few days afterward.

[Max]

Well, I was near sighted for very long, then I underwent the surgery and it's magical. You'll be infinitely thankful about living in an age when those things are possible. And your photography will get a huge boost.
Seeing the leafs in the trees, that's a treat.

[Henry Lesesne, Texas]

Dear Christopher,

Having gone through this a few years ago, I tell you fear not !

First, the discomfort is about the same as having a good dental cleaning, or a small filling done.

The good news is that you will again see colors in the vividness of your childhood ! As a photographer, you will experience real joy !

Best Wishes for successful procedures !

God Bless !
Henry L.

[Mike Johnston]

"You'll be infinitely thankful about living in an age when those things are possible."

Max,
Indeed. My grandmother, born 1901, went blind at the end of her life, and my brother, a doctor, said to me once that all her problems with her eyes happened about ten years too soon for the medical technology that could have fixed them. That is, if her progressive problems had been shifted ten years into the future she would have been sighted until the end of her life.

Mike

[Ed Adams]

Chris, I took up photography two and a half years ago as a hobby AFTER having cataract surgery on both eyes. Like many things, anticipation of the experience is far worse than the actual experience. Surgery worked well for me. Best of luck with yours!

[Jay Tunkel]

I had my right eye done last year. One thing you may notice is the amazing color clarity after the cataract is removed. Cataracts tend to be yellow and the new "intra-ocular lens" is clear - a great improvement.

Since my left eye cataract isn't serious enough to be removed at this time I actually see colors differently between the left and right eyes. A minor annoyance but a daily reminder about how good this surgery is.

[Geoff Wittig]

"You'll be infinitely thankful about living in an age when those things are possible."

This is so true.
My grandfather, who was a pediatrician, had cataract surgery back in the dark ages of the 1960s. At that time this meant a major operation on the eye, surgically removing the lens through a large incision around the cornea, being placed at bedrest for days with your head sandbagged to prevent movement...and when everything was healed, you wore an external contact lens to replace your eye's native lens, together with your original eyeglasses. He found the whole thing so harrowing he passed on the option to fix the other eye.

Nowadays it's still a technically very clever procedure, but it's sort of only one or two steps up from a haircut for the patient.

[Bron]

Chris,

Both sympathy and a lot of empathy; I was poked in the eye with a stick as a young man, very painful and debilitating, and ever since I'm phobic about things near my eyes, I cringed at the surgery description, though rationally I know it's a simple procedure.

Good luck!

[Vance]

Christopher,

I will add another positive experience here. I moved to the desert southwest while in my late twenties. As an artist/photographer I disdained wearing sunglasses because they distorted color. My vision gradually clouded and in my forties I had cataract surgery on both eyes. My vision was improved to a point that was better than in my youth. I now wear sunglasses outdoors and only remove them, briefly, to examine true color. Clarity and sharpness is always there.

Vance

[michael]

Christopher,
Best wishes for you and the upcoming surgery. Both my sister and father had successful and uneventful cataract surgery, so I know you'll do fine.

[Alan Klughammer]

A few years ago I did an interview with Ted Grant. He was legally blind until a neurosurgeon restored sight in one eye. With my tongue firmly planted in my cheek, I wonder if I would be a better photographer if I lost sight in one eye...

PS. I am knocking on wood that I have been blessed with very good eyesight.

[Ezequiel M.]

Chris, I was deeply moved reading your post. I have used glasses since I was 10 years old, because of nearsightedness and astigmastim, and that even had some consequences about my planned future as a grownup, since my greatest passion (along with photography) has been aviation, and as a teen, I dreamed to become a naval aviator. I have pursued general aviation instead and been very happy with my decision. But more than once, I have thought what my life will be like, in case I'd lose my eyesight, and had the same terrifying outlook as you: how about flying only as a blind passenger and try to imagine an aerial view? It seems to me as hollow and pointless as having an assistant take pictures at my request, that I could only compose and complete in my mind...Thanks for sharing, and good luck with the surgery. We never can be grateful enough for the gifts received. Sorry for my lengthy comment, and warm regards to you, to Mike and all TOP readers.

[Archer Sully]

A Lebanese-American friend recently had cataract surgery in Beirut, where the total cost, including airfare, was a about 1/3 the cost of having it done in the US. Just sayin'...

[Kevin]

I read somewhere (which makes it true, right?) that the first generation of artificial lenses were, unlike our natural ones, transparent to long UV wavelengths. Apparently our retinas have some sensitivity there. Recipients reportedly had some vision under "black light" where everyone else has darkness.

[Andreas]

Dear Christopher,

a friend of mine is going to get not a Lasik surgery but a similar (allegedly more modern) method, where the cornea is not removed. It is a ultra high frequency laser that gets through the it. He does it just because his aunt pays and it is only for convenience.

That's the other end of the spectrum. Me on the other hand, I fully understand your concerns, having to wear glasses all the time and always thinking about selling the M6 and getting an Ikon instead, in order to see the 35 framelines. I also considered surgery, but the risk - how tiny it may be - is still too high for me.

Reading your story reminds me that I should enjoy the 50mm and my decent eyesight with glasses on!

However, you having no choice, I wish you good luck, and I am confident that everything will be ok - as others already pointed out with examples.

[Bill Langford]

Christopher,
I was also very hesitant before the surgery, and can only add another FEAR NOT. The odd thing for me (besides sudden 20/20) is the distinct "shift" in color balance between the two eyes. My right eye may need cataract surgery in a few years and everything is a slight warmish yellow, especially in the highlights. The other (which had cataract surgery a month ago), everything seems bluish by comparison. For a while I was convinced I could see ultra-violet in specular highlights! Anyone else have this experience?
Bill Langford

[John Roias]

My father in-law had his done and he is 85 years young! Anyway, he said he could see better after his surgery which made us all laugh. He didn't realize his vision was becoming worse, having never worn glasses in his life. He is fine and I am sure you will be too!

JMR

[JackM]

Cataracts were described to me as if one were adding a drop of milk into a glass of water. Drop by drop, your sight gets clouded. I know that it reduces contrast big time.
After surgery your sight will have improved contrast too.

[Bob Dales]

Chris, best wishes for successful surgery. I had both eyes done 3 years ago and have had good results. Still wear glasses due to needing correction for astigmatism but can go without them. The anticipation is the worst part. Cataracts only get worse so one's choice is to do it now or do it later. I'm glad I didn't wait.
bd

[Bahi]

I was excited to read about light-adjustable lenses (here's a BBC article) a few months back. The fitting procedure seems similar to the one used in today's cataract operations— the surgeon replaces your eye's natural lens with an artificial one—but the LAL's material is very flexible and allows fine-tuning after fitment. Because it's new, the operation is still very expensive and perhaps there will be adverse effects that become known some time down the road but I'm hoping that by the time mine need to be done, the LAL will be an option. Somewhat optimistic, all things considered, but stranger things have happened.

[éric]

I am having a cataract operation in less than 3 weeks (needed because of side effects from a retinal re-attachment, but that's another story). I sympathise entirely with your reticence in having this op done! However, everybody I have talked to has had nothing but positive things to say. Fingers crossed.

[Tom Brenholts]

Yeah, I have one in my left eye. I'll be 56 in Sept. the one in the right eye is OK, not near the center of vision, but the one in the left eye makes me feel like I'm split in two, or something. It's hard to drive, especially in low light conditions. I've been putting it off since Christmas (I had to have a different surgery done first).

There are different kinds of lens implants available. I don't know which my insurance will pay for, probably just the cheapest ones. I am thinking it might be worth it to pay for the upgraded materials. I still have a couple years left, I think.

[Christer Almqvist]

I keep my fingers crossed for you, but I guess it is not really needed. You'll be fine.

Christer

[Mike C]

Chris, my dad in his early 80s had surgery for cataracts on both eyes - all went very well and he's very happy :-)

[Stanley-Rhode Island]

Let me put it this way...."been there, done that." The fear is worse than the actual surgery. I have vision from one eye only since birth. I kept putting it off thinking what happens the surgery goes wrong...I would be blind.

I was finally forced to have the one good eye done, or have them take my drivers license away. Other than wearing a eye patch for a few days it was fine.

Once the patch came off and the eye settled down I can see more now than I ever could.

Bottom line. . . . go for it and let us know how it turns out.

[Rick S.]

Chris, After my vision deteriorated to worst than 20/400, I had cataract surgery on both eyes while in my early 40s. The procedure is quick, recovery in minimal time (2-3 days off work), and I now enjoy photography with 20/20 vision. I need glasses for reading, but it's a small price to pay. Best of luck.

[Eduardo Cervantes]

Christopher: I've been told by friends to get my eyes fixed in order not to wear reading glasses. My mother had both eyes operated for cataracts. A breeze! - Me? I'm a pussy. Unless I'm losing sight I won't have any of my eyes operated. My father was 90% blind because of glaucoma. I'm checking my eyes every year now. So far no problems. If I can give you a piece of advice, reinforce your immune system before the intervention.

[Bill Pearce]

Don't worry. I'm told that the surgery is now performed as an alternative to laser surgery. My father had cataract surgery in his one eye at the age of 90, and came out with 20/20 in that eye. It required a few more than 8 minutes, and recovery was several days, as time is required for things to settle down. Still, in older days, it was necessary to wait until cataracts were quite large and opaque, but now, it can be done sooner and more effectively.

Go for it.

Bill Pearce

[Rick Keir]

Did it last year. Far less annoying than getting my teeth cleaned. I was awake the whole time and chatting with my doctor. The improvement in my eyesight was amazing: I've needed glasses for distance since 3rd grade. When I came out of the surgery room I was stunned at how intensely blue-white the world seemed for an hour or so, till my "automatic white balance" stopped compensating for that yellowish cloud that had been obscuring my vision for so long.

[Mike Plews]

My mother had both eyes done some time back and she did just fine.
Hope all this positive stuff is helping your case of the jitters.
Best of luck.

[Jeff]

Both of my parents and my sister had this surgery on both eyes, all successfully. I'm still waiting, and hope that wearing sunglasses every day, even on cloudy days, and even when photographing, will prolong the necessity. But, if needed, I have good reason to be optimistic (or is that optometristic?)

[Leslie Clement]

Best of luck with your surgery, Chris. I know you'll be fine. My mom had successful cataract surgery several years ago.

[Animesh Ray]

Chris,
I don't wish to scare you, because most cataract surgeries are considered routine. My mother got one eye done and it was a breeze and she saw "better than ever" through that eye afterward. My father had both eyes done, and no problem either. The problem is with people who are VERY myopic (power more negative than minus 8); there is considerable risk of retinal detachment. I doubt if you will fall in that category, but if you do then you might like to get a second opinion on when (not whether) to do the surgery. Optimal timing is recommended for some patients with extremely high myopia.

[Fred]

Chris-
I am an old hand at eye surgery- after having corneal grafts and retinal procedures and cataract surgery.
I am also a "nervous nelly"- but it's nothing to worry about. Just be sure to tell your doctor if your taking medication for a enlarged prostate.
If your in the New York metro area I'd be happy to recommend someone
Good luck.

[Jim Allen]

Hi Christopher,
I wish you luck with your cataract surgery, and have a suggestion. Take a look at this web link and see if any of the surgeons in your area use this system. http://www.wavetecvision.com/patients/information-orange-patients

It may enable a more accurate replacement lens selection, hopefully getting you a bit closer to 20/20. The system can measure the power of your eye with and without your natural lens in place, and can help the surgeon select the ideal replacement lens and orient it correctly for the best results. Just FYI.
Good Luck!

[David]

I recently had an IOL put in to fix a sports related cataract on my only good eye. I have always had one good eye and one 'lazy' (squint) eye, which I can't see much out of. So you can imagine my apprehension at having to have an operation to my only good eye. Anyway, it all went well and I have excellent vision out of it. So I wouldn't be concerned. Cataract surgery is quite advanced these days. Good luck with it.

[GH]

While I haven't dealt with cataracts, I did elect for the Lasik procedure, and it's the best decision I've ever made. Lasik also only takes about 10 minutes, and, outside of a claustrophobic feeling when being clamped in, it was easy going. Good luck!

[Ed Hawco]

Best wishes for the surgery!

A side note, on the topic of blind photographers: if you find the concept fascinating, you might enjoy a small Australian movie from 1991 called "Proof," starring Hugo Weaving (who later went on to play Agent Smith in the Matrix movies) and a then-unknown Russel Crowe.

Bascially, it's about a blind guy who takes photographs and then has his trusted companion describe what's in the photographs when he gets the prints from the photofinisher. Complications ensue, etc. etc.

It's a nice meditation on the nature of trust, seeing, etc. I recommend it!

http://www.imdb.com/title/tt0102721/

[Leigh Youdale]

Personal experience. Age 70. Gave up on SLR and TLR because of cataracts in both eyes. Considered giving up flying. Switched to RF. "Don't mess with my eyes" - but - eventually accepted it would have to be faced and had both eyes done a couple of months apart. Not painful, just had to be careful for a week or so and use drops for a month. Selected lenses for long vision and thus accepted the need to wear spectacles for reading, computer work etc. Still flying and now able to use the SLR/TLR but RF still weapon of choice anyway for reasons of bulk and weight.
Result - brilliant! As others have remarked, it's like removing sunglasses and the colour and intensity of the light is a bit of a shock at first. Needed to wear sunglasses more often as eyes more sensitive to the increased light transmission.
Satisfied - hell yes!

[Linh]

Good luck with the surgery! I'm with you on Lasik, scares the hell out of me even though I know a few people who swear by it.

[Roger]

I had Lasik surgery a few years ago and I'm a guy who can't stand to even do eye drops let alone have my eyes blasted with lasers. Even now I sometimes stop to marvel at the clarity of whatever is in front of me; who knew stucco's texture could be way cool!

I opted to have mine done by a "full-cost" opthamologist rather than one of the much less expensive Lasik-only practices. The concept of discount eye surgery was rather unsettling.

[BWJones]

There are also changes to the lens as we age that lead to alterations in the perception of color as the lens yellows. I've pulled more than a few lenses out of eye (for research) and it is fascinating to look at the changes. I'd be very interested in your assessment of contrast and color as it impacts your photography (and printing).

I'd suggest that you do your homework on places and don't cheap out on your eyes. Don't be afraid to ask questions of your surgeon and make sure they have lots of experience doing the surgery. Let me know if there is anything I can do to help out with more information of make a suggestion on a surgeon. My bias would be for someone at the Moran Eye Center, but I can ask around for a reference wherever you might want to have the surgery.

[robert e]

Chris, I can empathize at least with the dismay and frustrations of vision degeneration. I have had sudden vitreous detachment in each eye (at different times), which has obscured or degraded portions of my visual field. Unfortunately, nothing can be done about it. Fortunately for me, neither case involved retinal detachment, a not uncommon result of this type of episode and a far more serious problem.

As other commenters have said, you are fortunate at least in living in a time when there is a routine, safe and proven remedy for your problem. Best of luck with the procedure and with your vision henceforth!

[Brian]

I see an opthamologist on a yearly basis because of optic nerve damage suffered a number of years ago. This year I mentioned an issue with focusing in one eye and the doctor said I had the beginning of a cataract - so slight that if I had not been involved in photography, I probably would not have even noticed the aberation.

I want to thank all the posters, especially your featured commenters, for their information and positive outlook. The word 'cataract' has so many connotations - I feel much better about facing the issue than I did before reading your column. Thanks very much.

[ranjitgrover]

Hello,
now a days there are lenses those focus near and far at the same time! they are something like fresnel lenses. if you put such lenses in the eye you can almost do away with glasses. they afford you decent vision right from reading distance to distant vision. think of them when you go for the surgery. they cost a bit more than the usual fixed diopter lenses. but is useful.
ranjitgrover.
Kochi, India
rkg1944@gmail.com

[Bob Rogers]

I had cataracts in both eyes in my mid-40s. I was extremely nearsighted (about a 12 diopter correction) but since the surgery I'm about 20/40 without glasses and 20/10 with (I generally leave them on, mostly for the reading part of the bifocals).

As others have said, the results are magical.

The procedure is a little scary, reminiscent of an alien abduction scenario, but with enough sedatives you don't really care.

Good luck!

[Steve Smith]

My father, a photographer with sight in only one eye after an accident at the age of 14 detached a retina, had this operation done about 15 years ago.

Before the operation his sight in his 'good' eye was actually terrible. He used a thick contact lens specially made about -2 dioptres more than their stated maximum strength.

After the operation he couldn't believe what an improvement it was. He had clear vision from arm's length to infinity. He spent a month just going out looking at things.

[Roger Bradbury]

I don't know anything about cataracts but I am very short sighted so I wear glasses. A few weeks ago I noticed that a banner 40 feet away and above the band I was watching shifted from sharply focussed to blurred according to what colour spotlight was being shone on it. The banner had a black silhouette on a white background, and when lit red was sharp, when lit green or blue was blurred.

I suppose it was chromatic aberration, made noticeable by the narrow light frequency range of the LEDs used in the spotlights.

I've just been staring out of the window this morning, trying to see if the warm coloured bricks of the house opposite are sharper than the greenery at the same distance. The bricks seem a little sharper.

This may all have something to do with my inability to see clearly at a distance, while being told that my glasses do not need changing. Perhaps the lenses are corrected for red light.

[Bernard Scharp]

I'd like to thank MartSharm for making me realize something. I'm (hopefully) still years away from needing this kind of surgery, but I've been myopic for nearly my whole life. I started out with -3 when it was discovered around age 6, and it has since deteriorated to -9, though it seems to have stabilized there.

Since I've been wearing glasses for most of my life, I hardly notice them anymore, but I do make frequent use of one of the side-effects of my near-sightedness: the fact that my eye is a pretty good macro lens. Without glasses, my area of good focus is from about 1" in front of my eye, to about 4" away. Since the distance from your pupil to the retina is also roughly an inch, that gives gives my naked eye a magnification of about 1:4 at the furthest distance, to life-size at closest distance, which is very useful if (like me) you enjoy tinkering with things.

MartSharm's comment made me realize that a bit more, and should I ever need cataract surgery, I'll definitely take this in consideration.

Thank you.

Bernard

PS: @Christopher Lane: good luck!

[Mani Sitaraman]

It don't know if it reassures you (but its meant to). Cataract surgery has been performed since the 6th century B.C. in India, and since the 1750s in the West.

Modern techniques make it a commonplace and routine minor operation in the year 2010.

[Patrick Snook]

Uncanny coincidence.

I just got home from the optometrist, and with my eyes still dilated and enjoying the relief offered by the shady interior light, I woke my MacBook and read this TOP post about optometry.

During my visit, I reported to my optometrist a recent (6-month) mild symptom, a blurriness that sometimes occurs in my right eye only, and then disappears. It was quickly diagnosed. Nothing to worry about, but I received a salutary lesson in the structure and likely degradation of the eye, and a reminder of the extremely high value and use of eyesight.

The main lesson came after the office visit. Nothing like having eyes stuck at f/1.0, and stepping out on to white concrete in the city in full sun (f/16), having forgotten to bring along the ND filters (a pair of sunglasses). Shutter speed is not adjustable (eyes must remain open), and there is no adjusting the aperture (or toggling the ISO) to compensate. It is an extremely uncomfortable experience, slightly nauseating, disorienting and even physically threatening (not the most comfortable part of Philadelphia in which to find oneself blinking and staggering).

Well, good luck with the cataract surgery--although it sounds like there's a lot of reason to take courage and have confidence in the outcome, regardless of "luck".

[gene lowinger]

I, like many others who've posted, had a cataract problem, compounded with Corneal dystrophy - which precipitated the need for corneal transplants in both eyes as well as lens replacement for cataracts. my eye problems affected my photography substantially. The procedure for the complete surgery was a one day thing, the recovery time took a while. As a result of my new eyes my vision (with corrective contact lenses) is now 20/15, and the only problem I have is that my eyes are supersensitive to light intensity, so I wear sunglasses whenever I go outside, even on very cloudy days. You may find that you need sunglasses also, in which case I would recommend getting the best you can afford. All sunglasses are not equal. They must be UV protected AND polaroid. There's very few commercial manufacturers that make high end polaroid sunglasses - the best, I think, is Maui Jim. They ain't cheap, but these are your eyes and your eyesight we're talking about here.

[Tim Nelson]

I had lens replacement surgery last November, to treat a cataract in my dominant left eye that worsened so quickly over the previous year that I had stopped taking photos altogether. As others have testified above, unless you have other complications, the surgery is now a routine outpatient procedure, with very rapid recovery. My severe nearsightedness was perfectly corrected, so I just use glasses for reading now. The benefit I hadn't anticipated was the improvement in color sensitivity. Cataracts filter the spectrum you see in a gradually increasing way over a period of years, so when I suddenly had full spectrum vision, the colors were overwhelming in a way that is hard to describe. In fact, it was a very emotional experience for me. I was astonished. The lens replacement has totally revitalized my enthusiasm for photography, and I'm happily back to having a camera with me at all times.

[ctein]

Dear folks,

I have been contemplating ELECTIVE eye surgery at some point in the future. There are flexible corneal implants that provide a useful degree of focus accommodation. My presbyopia (which is nearing 100%) drives me completely nuts.

What keeps me from doing it, aside from the cost, is that my housemate's eye doctor, who is properly extremely conservative in such matters, doesn't feel this is quite proven enough to be recommended as an elective procedure rather than a necessary one. But I imagine it's a matter of only a few years...

Even if I could, I don't think I would have surgery that entirely eliminated the need for glasses. I've worn them my entire life, so wearing them doesn't bother me one bit. In fact, I have actually come to depend upon them unconsciously to protect my eyes. Like wearing permanent safety goggles.

For people contemplating corrective eye surgery of any kind, LASIK, whatever, if you're engaged in hobbies or occupations like astronomy, you should talk to people in those user groups about the pros and cons. Corrective procedures can introduce residual distortions and aberrations that are not at all bothersome for ordinary seeing that really mess with looking at astronomical objects.

~ pax \ Ctein
[ Please excuse any word-salad. MacSpeech in training! ]
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[peter]

Successful surgery depends to a great extent on the skill of the guy with the knife. So I'd ask around. I've had it done at a relatively young age and it turned out OK. The result: the modified eye became a sharp prime lens and juggling two sets of glasses quickly became second nature.

[Declan]

Funnily enough last weekend at 35 I was diagnosed with a congenital cataract. It's small and I've had it all my life, apparently. I never noticed it and if the optometrist hadnt spotted it I wouldnt have known it was there. It shouldn't cause a problem but we have to keep an eye on it to make sure it doesn't get worse. Worst case it will turn into a senile cataract when I'm in my 60's.

I should be more worried I guess, but I know it's a genetic gift from my mother, her father and grandfather had them. Her grandfather went blind, her father (my grandfather) had the surgery when I was a kid and it was a complete success so I figure so long as medical science has progressed in the last 20 years (and continues for the next 30) I should be ok and I'm confident you should be too.

[corrective eye surgery]

I absolutely agree that eyesight is a precious gift for anyone thats why I make sure that I had a maintenance check up to my ophthalmologist. So far, I have a perfect vision. :)

jayn

[cataract eye surgery]

Our eyesight has to last a lifetime, so we should take good care of it with eye health supplements and good safety practices. Eye examination is also an important part of health maintenance for everyone.