# Cataract op and Cycling



## BalkanExpress (23 Oct 2021)

I will be having an op on my cataract(s) soon and need to decide on single focus or bifocal lenses.

My number one concern is which is best for cycling 

Any personal experiences gratefully received, as i try and figure out what will be best for me. 

if it helps, I commute, ride at weekends and do the occasional night ride so use at night which is a factor I need to take into account .

Many thanks


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## oldwheels (23 Oct 2021)

I am not an optician but I have had both eyes done. My distance vision was totally transformed but I still needed reading glasses.
I imagine you may find a similar result but it takes a few weeks for the eyes to settle properly so IMO it is too early to make decisions about glasses.
Bifocals for cycling do not sound a good idea to me and should not really be necessary.
When restarting cycling which I did within a couple of weeks a pair of eye protection glasses are a good idea as getting something in an eye does not bear thinking about.


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## KnittyNorah (23 Oct 2021)

I have had extensive visual issues for the past ~ 10 years, including but not limited to, complex cataracts. Several surgeries last year effectively restored my vision and it's better than it's ever been in my life. 

My first question to you is, do you already have prescription lenses; if so what for and what strength? And if you do have prescription glasses, *the best person to discuss it with and take advice from, is your optometrist and the ophthalmic surgeon to whom you are referred. *

Also bear in mind that what you ask for - and what the surgeon aims for - may not be what you end up with, as there is something referred to as 'refractive surprise', which is more common the more complex one's prescription and/or surgery. 

Cataract surgery _normally_ takes around 10 - 20 minutes per eye. It is a VERY STRANGE sensation; not in the _least_ bit painful in fact scarcely even uncomfortable - but very very odd! 

The rest is "tl;dr" unless you are specifically interested in ophthalmic surgery on complex cataract removal with other ocular issues!



Spoiler: More eye details - some might be squeamish!



As already stated, cataract surgery _normally_ takes around 10 - 20 minutes per eye. 
However mine took over an hour for the first eye, and an hour and three quarters for the second. A drill had to be used to drill the cataract out; the first one was drilled out slowly as expected, without problem, but the second one wasn't stony like the first ; instead it was rather rubbery round the edges and although the centre was drillable, strings of the rubber-like stuff started to escape into the vitreous as the stonier bits were drilled out. BTW it is actually an ultrasound drill, developed from dental ones. I can only emphasise, though, that _none_ of it was painful in the slightest. It was all just very, _very _odd! On my first eye - one with a great deal of corneal scarring - the surgeon 'tapped' my eyeball to see if it needed stitches and again, that was a most odd sensation and a most unpleasant one too - but, again, not painful and of such short duration that I actually wondered if I'd imagined it ... I asked, I hadn't imagined it and he apologised. I also told him that I'd found it all very interesting, but mysterious due to not being able to see anything, and that some sort of running commentary - even if just saying what all the machinery noises were - would be great. What happened as a result of _that _is another story, though!

After my first surgery, I had crystal-clear sharp vision in the operated eye (but everything around me tilted at a 45deg angle ... what was _that _about eh!) _as I was waiting for my transport back home ie _within half an hour of leaving the operating theatre, but by the time the driver was helping me into the vehicle, it had started to blur and once I'd arrived home I was effectively blind again. But only for a few hours!
Each eye progressed very similarly, although the second - with the difficulties during surgery - was about three or four days slower to reach each step than was the first. I started to get really useful vision with the first eye within less than 48 hours;
I found the eyedrops routine quite a challenge and for the first week after each surgery it seemed to take up most of my day - but if I forgot or delayed one, by crikey I knew about it! As long as I did the drops as instructed, I had no more than very minor discomfort; the worst thing was 'unsticking' my eye in the morning. Cotton pads soaked in sterile saline took care of that, though.

Prior to surgery, with advice from my optometrist and discussion with my surgeon and the clinic's optometrist, I'd requested to maintain a small degree of myopia - the aim was -2.5 dioptres. or thereabouts - in both eyes, but with no promises as that was a MASSIVE change. 
I had more follow ups than a basic cataract patient would have - 3, 6, 9 and 12 mo - as other things were (still are) going on - and of course there was the issue of the rubbery strings!
Six weeks after my second cataract surgery, I had -2 dioptres in my right eye and -2.5 in my left. Almost exactly what was aimed for! 
However, that was not the end of the matter. There were vision changes detectable by me and easily measurable by the optometrist, up to 6 mo - so further checks made by ophthalmic surgeon - but after that, everything stabilised and I've ended up with -0.5 dioptres Rt and -3.5 Lt on my one year follow-up so, effectively, almost 20/20 vision on my Rt and good reading/close vision on my Lt. It's not something I'd ever have asked for but it works like a charm - and even my astigmatism is reduced to the extent that I only detect it when I'm really tired (apparently not a stated benefit of cataract surgery, but it often happens - that's what my wonderful surgeon, Felipe, said). My optometrist also told me that he sees many people post cataract surgery who have a remarkable reduction in their required astigmatism correction. 

I never thought I'd adapt - I'd even decided before surgery, that if I didn't need specs afterwards, that I'd get some with plain lenses in, to feel 'less naked'. I'd never known life without them - glasses had been part of me for 70 years - but after the first few weeks of sensitivity to light and thus wearing dark glasses constantly - I've never missed them, except that sometimes I move my hand to push them up my nose ... _and they aren't there! _
LOVE IT!


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## mistyoptic (23 Oct 2021)

Are you asking about single vision or bifocal intra-ocular lenses, or about spectacles afterwards? Important distinction. Night-time has been known to be an issue with multi-focal implants due to some diffraction glare.

Basically, as @KnittyNorah says, go with advice of your optometrist. His/her advice may be more relevant to you than the surgeon's opinion if your current refraction is not simple.


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## BalkanExpress (25 Oct 2021)

many thanks for the responses.

Yes, I am in discussion with the specialists, but they are not cyclists and when i ask questions like "with single focus implants will just in front of the front wheel be in focus" they come up with theoretical rather than practical answers, so it is good to get some real world experience.


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## mistyoptic (25 Oct 2021)

The smallest power change in a lens (I.e. 0.25 dioptres) brings focus in from infinity to 4 metres. The size of your pupil will affect your depth of focus too. This means you will see a better range of distances in daylight than at night, in theory.


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## PeteXXX (25 Oct 2021)

I had a left eye cataract sorted in 2016 due to an old injury. I don't think I was given the option of what they spot welded onto the eyeball.
I was off work for just over a month (HGV licence requires two working eyes) until I got new varifocal spectacles.

The surgeon said that cycling and swimming was a no-no for, I think, 5 weeks.
Maybe things have changed in the last 5 years.
For me, it was totally painless, which did surprise me! 

Good luck with the op!


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## KnittyNorah (25 Oct 2021)

PeteXXX said:


> I had a left eye cataract sorted in 2016 due to an old injury. I don't think I was given the option of what they spot welded onto the eyeball.
> I was off work for just over a month (HGV licence requires two working eyes) until I got new varifocal spectacles.
> 
> The surgeon said that cycling and swimming was a no-no for, I think, 5 weeks.
> ...


Last year I was told no hairwashing for 2 weeks post op; IIRC, swimming pools were closed back then.
Mine were very complex cataracts, though. 
I agree, TOTALLY painless. I wish dentistry were as painfree!


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## KnittyNorah (25 Oct 2021)

BalkanExpress said:


> many thanks for the responses.
> 
> Yes, I am in discussion with the specialists, but they are not cyclists and when i ask questions like "with single focus implants will just in front of the front wheel be in focus" they come up with theoretical rather than practical answers, so it is good to get some real world experience.



Do you already wear prescription glasses? If so the optometrist who sorts those out for you will be the best person to advise about any necessary correction post surgery and what type of implanted lenses will be easiest/best to correct for. But guarantees are impossible due to the ever-present possibility of 'refractive surprise'.

My optometrist and my surgeon asked me what activities were important to me, and I described looking closely at a paper map, then lifting my head to see the landscape in front of me, and thus together we came upon the compromise of aiming at giving me slight myopia for close work), easily correctable by simple glasses.

My experience with my severely myopic and highly-astigmatic 'natural' eyes is that now I have implanted unifocal lenses, I have perfectly functional vision for all the activities of normal daily life without any correction whatsoever. I can easily see my bike's front wheel, the holes in the road which I must avoid, the dirty signs which indicate the cycle route and the board at the junction which points the way to the ice-cream cafe. I can also read small print and see what I'm doing on my knitting machines ...

Obviously everyone's experience will be different.


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## mistyoptic (25 Oct 2021)

[QUOTE="KnittyNorah, post: 6570014, member: 114880“
My optometrist and my surgeon asked me what activities were important to me, and I described looking closely at a paper map, then lifting my head to see the landscape in front of me, and thus together we came upon the compromise of aiming at giving me slight myopia for close work), easily correctable by simple glasses.
[/QUOTE]
you were lucky to have a thoughtful surgeon. My experience, as a referring optometrist, was that some surgeons were only interested in “saving you from wearing spectacles ever again” and not what would work for you, such as leaving you deliberately myopic to fit in with your lifestyle. Couldn’t grasp the concept of leaving you needing spectacles because it suited your needs.


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## KnittyNorah (25 Oct 2021)

mistyoptic said:


> you were lucky to have a thoughtful surgeon. My experience, as a referring optometrist, was that some surgeons were only interested in “saving you from wearing spectacles ever again” and not what would work for you, such as leaving you deliberately myopic to fit in with your lifestyle. Couldn’t grasp the concept of leaving you needing spectacles because it suited your needs.



Having been a medical physicist for almost 40 years, I can _totally _believe what you say, having stood up to enough know-it-all, bombastic surgeons in my time - but there was no need for it in this case, my surgeon being a _most lovely _man as well as being at the top of his field.
Before we knew who my surgeon would be, though (I was, by November 2019, being referred to almost any surgeon who was willing to look at me - most weren't - and just happened on a wonderful youngish surgeon who was very straightforward with me and told me she was going to personally phone Mr XXXX to get me an appointment with him, and the CCG WOULD accept it), my great optometrist had primed me with the best questions to ask and the right things to say, so I sounded much more knowledgeable about optics than I really was, having spent all my career in _radiation _physics! Those ploys proved to be entirely unnecessary though, with the kind and considerate Felipe.


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## BalkanExpress (25 Oct 2021)

Currently have a pair of reading and a pair of driving glasses. My only experience with progressive lenses was a pair for reading and computer screen use. I did not get on well with these.

The surgeon is not pushing one type of lens over the other, but has set out the day to day pros and cons of both types. I now need to think about what will suit my needs best, when the needs are, what will work best for my office job and which will be best for my not in the office time,


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## KnittyNorah (26 Oct 2021)

BalkanExpress said:


> Currently have a pair of reading and a pair of driving glasses. My only experience with progressive lenses was a pair for reading and computer screen use. I did not get on well with these.
> 
> The surgeon is not pushing one type of lens over the other, but has set out the day to day pros and cons of both types. I now need to think about what will suit my needs best, when the needs are, what will work best for my office job and which will be best for my not in the office time,



I honestly think the optometrist who prescribed the glasses which you use satisfactorily is the best person to advise you in this instance; they will know about the practicalities of your prescription/s, and be aware of your issues with progressive lenses.


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## KnittyNorah (13 Jan 2022)

@BalkanExpress - have you had your cataract surgery? How did it go?


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## BalkanExpress (14 Jan 2022)

KnittyNorah said:


> @BalkanExpress - have you had your cataract surgery? How did it go?



It has been pushed back. I’ll post once it is done


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## BalkanExpress (7 May 2022)

Quick update: both eyes done. First on 5th April straight forward, an interesting experience but no issues, no real discomfort after. Second, on 25 April, a bit more complicated, ruptures capsule and so more fiddling around than for the first eye. Not a great experience, I will spare you the details but could have been, much, worse.

Most importantly, I can see again! By the time I had the operation vision had been deteriorating, and on sunny days in particular it was largely a hazy blur. Now I am good at a distance, can read at arms length and have temporary reading glasses.

I’m in next week for a tidy up on the left eye. Then three weeks after that there will be a full eye test to see what I ended up with in terms of sight. Will need reading glasses as this was the plan, will have to check on distance and see how that is as they ended up using an off the shelf lens for the left eye rather than the specific one they had intended.

Not been out on the bike yet, not because I cannot see but because of Dr’s recommendations concerning exercise. Will however be back on the e excise bike if I get the okay next week


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## KnittyNorah (7 May 2022)

BalkanExpress said:


> I’m in next week for a tidy up on the left eye. Then three weeks after that there will be a full eye test to see what I ended up with in terms of sight.


I found that my vision was changing - slowly - for a full six months after surgery; everyone is different of course, but what you end up with after a couple of months is not _necessarily_ the 'be all and end all'. 

The worse your vision originally - and the more issues or complications in the surgery itself - the longer the eye takes to 'settle' even after full healing appears complete, and the more likely there is to be some instability in the level of vision, is what my (very experienced) optometrist told me when I last visited. 

This has certainly proven true for me. My left eye (complex cataract but no real issues during surgery) is stable; my right eye (more issues and a problem during surgery) decided to start to become a little unstable a year or so after surgery, and the eyesight in that eye has deteriorated considerably from the 3-month post-surgery tests - although not to the extent that I can't manage perfectly well without glasses most of the time.


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