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Eyes - The Ultimate Optic - Cataract Surgery and Hunting

Discussion in 'Hunting' started by Johnm1, Oct 6, 2019.

  1. Johnm1

    Johnm1 Member

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    I am scheduled for cataract surgery in my left eye, still my dominant eye, next month and I have settled on single focus lenses that correct my distance vision. I will almost certainly need readers for both reading and computer work and I'm ok with that.

    What are your experiences after cataract surgery and what implants did you choose?

    Do you know what the far point distance that your implant is designed to bring into perfect focus? The answer to this question could be as simple as "I used the manufactures standard mono/multi focus implants.


    Mono focus implants generally standardize the far point distance someplace between 20 and 60 feet. The angle of the light beyond the far point distance is generally 'close enough' to provide a 'clear enough' picture for most applications/people. There are premium implants that are designed to focus at infinity.

    I'm specifically hoping to understand how the implant affected your use of iron sights as well as a scope and shotgun use. Is spotting game at great distances (hundres/thousands of yards) easier now then before the surgery?

    Below are some specific details about my condition that are not necessary to answer the above questions but provide some background information.

    - I am extremely left eye dominant. So much so, that even through my glasses don't fully correct the vision in my left eye, it corrects it enough that my left eye remains dominant. Years ago I switched from shooting left handed to right handed/right eyed because my left eye became useless as far as clarity is concerned.

    - My right eye has nearly perfect distance vision but I need correction to read or use the computer.

    - I suffered a TIA or transient stroke 6 years ago that took 40% of the vision in my left eye. Basically the bottom 30% and a crescent along the left side of my left eye. Wide at the bottom tapering to a point at about the 12:00 o'clock position.

    - Even though my right eye distance vision is near perfect using my right eye is very difficult as it fatigues very quickly. It just isn't as 'strong' as my left eye is, even after the TIA and correction. Basically using my right eye is about as useful as my trying to hit a golf ball left handed. it just doesn't work for me.

    - Although the cataract lens will correct the vision I have left in my left eye, it will not restore the vision that is lost.

    - I have the start of a cataract in my right eye that I had not intended to correct, but the final outcome with the eye doctor wrote it up for both eyes (not at the same time). So I do have the option of doing both eyes.
     
  2. entropy

    entropy Member

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    I have not had cataract surgery, but I know a bit about the subject, as I am an optician. (Not an eye doctor)

    I also am left eye doiminant, but am still correctable to 20/20. You obviously have made the switch to shooting off the non-dominant shoulder OK.

    Most pre-cat patients are also presbyopic. I am also.

    I feel for you. That and the left eye leave very little to shoot with.

    You don't expand on why your OS (left) vision isn't correctable to 20/20. It may be that putting the right IOL (InterOcular Lens) in during the surgery will clear that up. An IOL probably won't clear up your right eye, as the TIA affected blood supply, which does not reach the cornea. (the part the IOL replaces) The damage there is in your retina,on the back of the the eyeball.

    Definitely take the time before the surgery and go over the options with the opthalmologist, and explain that you shoot, and what you need for shooting.

    I will give you my personal opinion as a shooter and optician: In the same situation, I would get DVO (distance vision only) IOL's and use reading glasses or computer glasses for those specific uses. I also recommend using single focal-plane sighting devices on your guns. (Scopes, red dots, peepsights) There is a lens made by Zeiss called Continuum that has the intermediate vision (computer) on the top and the near (reading books,etc) on the bottom (sometimes called 'office glasses') they have no far vision like a progressive (no-line bifocal) lens, but the IOL's will improve that.
    Monovision IOL's work just like monovision contacts; one eye's power is set for distance, the other for near vision. The MD should fit you with a 'try' pair of glasses to test whether you will be able to adapt to it before surgery. Some doctors do this for monvision contacts also, but most don't because if you can't adapt, just take em off and we'll try another type. Not so easy with IOL's.
    The down side of monovision IOL's for a shooter is that for iron sights, the focal distance need is the intermediate range, 18 inches to 20 feet, and this really limits vision for other activities. Again, fine for glasses or contacts, just switch them out for another pair, not somuch with IOL's.
    Do your research beforehand so you can ask the MD the right questions in the consult visit. Here's some sites to get you started:

    https://www.aao.org/eye-health/diseases/cataracts-iol-implants

    https://www.webmd.com/eye-health/cataracts/intraocular-lens-implant#1

    https://www.reviewofophthalmology.com/article/new-hightech-iol-options-in-the-pipeline -This one is written for the doctors. Heavy jargon use alert! But it does showcase the IC-8 lens, a possible option for iron sight use.

    https://www.nvisioncenters.com/cataracts/best-lens/ Covers the basic of the different IOL types.

    Knowledge up.

    Be your own advocate.

    Choose wisely.
     
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  3. Johnm1

    Johnm1 Member

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    Entropy and others,

    What follows is directed at Entropy as he has experience in the field. But I'm still interested in anyone's experiences after cataract surgery. You can skip the details that follow and just provide your response.

    Entropy - You asked/stated:

    You don't expand on why your OS (left) vision isn't correctable to 20/20
    . It may be that putting the right IOL (InterOcular Lens) in during the surgery will clear that up. An IOL probably won't clear up your right eye, as the TIA affected blood supply, which does not reach the cornea. (the part the IOL replaces) The damage there is in your retina,on the back of the the eyeball.

    I was told that they couldn't fully correct for the cataract in my left eye completely. As a point of clarification the TIA was in my left eye and the cataract surgery is scheduled for that eye first. I understood that the IOL wouldn't bring back the vision lost to the TIA. The right eye has a slight cataract that was written up for the implant but I have not decided to move forward with that surgery. Distance vision in the right eye is nearly perfect. To drive I have taken to using a patch over my left eye and not using my glasses at all. It turns out the correction in my glasses for my right eye has changed and the current correction degrades the distance vision in my right eye. For hunting I remove my glasses completely when I arrive for the week and within a couple of hours/a day or so my right eye begins to take over as dominant and the overall picture clears up quite a bit. Better than with my glasses. I just cant work without my glasses as most of my work is behind a computer. The prescription would need to be updated but with surgery imminent it didn't make sense to do it now.

    Another of my hobbies is amateur astronomy. I have a thread on an astro related forum and we are discussing where the standard mono focus (distance) IOL is focused at and the concept of astronomical infinity as the focus point. I would expect that an IOL that focused on infinity would be a premium but the people who have them, I only found 2, love what they do for viewing through a telescope and general long distance vision.

    If i stay with my surgeon and the standard mono focal lens for distance they would install Alcon Acrysof IQ. And there is a lot to be said for them. They are the most used and have a great degree of satisfaction from users. But I dont know at what distance they focus at. I assume that the focus distance is somewhere between 20 and 60 feet and objects farther out come into focus 'good enough'. I'm trying to see if I can improve my vision at the eyepiece (telescope and rifle scope) as well general spotting with my eyes and binoculars (or monocular). Almost everything has a trade off and I need to understand what those are. I am resolved to the use of reading glasses even though some people who selected the distance mono focus IOL report they no longer need readers. That is more the exception than the rule. I'd be willing to give up on the chance of no readers if selecting an infinite focus distance IOL would improve my ability to spot game at 1000 yards. But I have heard one story of needing very specialized glasses (read that as expensive) after choosing IOL's that focus infinity.

    It is likely I will settle on the standard distance mono focus IOL as both hunting and astronomy are relatively small impacts if you just consider the amount of time spent. But I want to know before I decide.

    And thanks for your input.
     
  4. hps1

    hps1 Member

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    Excellent advice^^^^^

    I had cataract removed about 6 weeks ago from right (dominant) eye. Had used same ophthalmologist for 35-40 years. Fortunately he is very familiar with my special needs as a shooter, so I left it up to him to choose the lens to fit my situation.

    Gave up iron sights about 25 years ago when the front sight "sprouted" into what looked like a pitchfork. With his help and an optician friend, settled on adding +.25 to +.5 diopter (IIRC) lenses added to rear sight and a front aperture for target work, managing to remain competitive for another 10-12 years w/irons. Have since retired the irons and concentrated on hunting.

    I doubt I'll ever compete again, but, after surgery, my right eye is corrected to 20/20 and I can see the front sight again! At my Dr's. suggestion, I chose the distance focused lens and, since I had worn progressive glasses for years use those instead of readers. Have yet to shoot iron sights since surgery, but have dry fired enough to feel confident that, with a lot of re-training, I could be competitive once more.

    I'm looking forward to getting the left eye surgery as that eye has deteriorated rapidly (or maybe I'm just much more aware of how bad it is since the other eye has been corrected.

    Regards,
    hps
     
  5. cheygriz

    cheygriz Member

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    I had cataract surgery on both eyes several years ago.

    I was/am extremely pleased with the results.

    I'd do it again in a heartbeat.
     
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  6. Johnm1

    Johnm1 Member

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    hps1 and chevgriz,

    Do you know what was implanted? hps1 I realize you left it up to the surgeon but whatever details you can provide is appreciated. Chevgriz - I see you are happy with the outcome but are you pleased specifically with the ability to see minute detail at long distance? How about scope and iron sight use?
     
  7. entropy

    entropy Member

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    As far as human optics are concerned, ocular infinity is from 20 feet on. That's why Snellen charts are set at 20 feet, though usually by using mirrors; most exam lanes aren't 20 feet long.
    The simulation picture for the AcrySof IQ shows it is set for ocular infinity, @20' and beyond. Looks like a good lens, has some nice features.

    They can correct for the cataract, but the TIA caused other damage not related to the cataract that is probably not reversable, and certainly not with an IOL. I'm sorry, I misunderstood, I thought the right eye was affected by the TIA, not the left.
     
    Last edited: Oct 6, 2019
  8. hps1

    hps1 Member

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    Sorry, I don't. They gave me a card that might have the info on it, but can't locate it at the moment. I'd guess the one that focuses between 20 & 60' as that seems to be where things are sharpest. Haven't had a chance to get out in the field to see how sharp objects are at several hundred yards.

    As far as using irons and scopes, as I said have only dry fired w/irons. Did do some load development & zero a rifle on an indoor range (max 25 yds.) w/scope. Other than finding the sweet spot in my progressive lenses was able to focus scope to my vision and shot .30 caliber groups (w/.308). Awkward bench @ indoor range didn't help matters any :(. Finding the sweet spot w/progressives has been an issue long before the surgery, but once you get the rifle set up for you it's not a problem.

    Regards,
    hps
     
  9. Johnm1

    Johnm1 Member

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    Thanks for trying hps,

    Dont worry about digging anything up. Keep in mind I don't know what distance the standard IOL focuses at. Until I find out for sure I'm just guessing 20-60 feet.
     
  10. Johnm1

    Johnm1 Member

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    Entropy

    The Acrysof IQ appears to be pretty much the standard of the industry with a plurality of use with minimal complaints. In one form or another over 90 million have been implanted.

    Are you familiar with the term 'Astronomical Infinity' as it relates to optics?
     
  11. cheygriz

    cheygriz Member

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    Some kind of artificial lens was implanted. I can see detail much better, especially at distance. It was kind of like being inside a room and taking OFF your sunglasses. The whole world is much brighter.

    Not sure it makes all that much difference with scopes, but irons are sure easier to see.
     
  12. MCgunner

    MCgunner Member

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    Cataract surgery was MARVELOUS!!! I'd stopped driving, my eyes were so bad. Doc said mine were the worst he'd seen in quite a while. I just got the fixed lens, still have to wear bifocals, though, as the replacement eye lens doesn't quite focus right. I've been wearing glasses since the age of 3, so it's a natural thing for me.

    I hunt, of course, even shoot a crossbow 'cause my right eye has always been bad, 20/70 last I heard. My left eye has always been good for 20/15 corrected and 20/50 uncorrected, so I can drive without the glasses, but don't. I rely on handguns for self defense and carry every day. I like to be able to see the threat well. :D
     
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  13. hps1

    hps1 Member

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    I don't notice a difference with scope since they can be adjusted to your eye, but your observation of brightening up the world is spot on. Just like flipping a light switch in a dark room. :)

    Regards,
    hps
     
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  14. entropy

    entropy Member

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    No-only the optical industry's definition as it relates to patient refraction. That standard is 20 feet and out.

    As for this-scopes have a fine focus, which is basically a dioptric adjustment on the back of the eyepiece. most turn, and usually have a -4 to +4 dipotric range, easily able to adjust to ones NVO (near vision only, or reader) add power.
     
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  15. der Teufel

    der Teufel Member

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    I had cataract surgery a couple of years ago. I selected multifocal lenses with a monovision setup. That is, one eye for distance, the other focuses at a near-to-intermediate range. The brand (I think) was Crystalens. I'm left eye dominant, so they set my left eye up for distance and my right eye for best focus closer in.

    It works okay. I passed my driver's license eye exam, although it was close. I was reading the part of the chart in which I use only my right eye, and going pretty slowly. I got to the last letter, and said to the examiner "Hmm, this is tough! I think it's a … um, yeah maybe it's a …" and she just said. You're allowed to miss one and you got the rest right so you're good. I still don't know for sure what that last character was. :confused:

    My hunting buddy went with fixed focal lenses (distance) so he has to wear reading glasses. On the other hand, he can spot a sounder of hogs at twilight 3/4 of a mile away. I just say "Let me get my binoculars so I can see what you're looking at." That makes sense to me. He has two eyes gathering information at a distance while I have only one. My right eye, while it's good for reading and computer work, is somewhat blurry at distances.
     
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  16. Johnm1

    Johnm1 Member

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    This has been very helpful and I want to thank each of you who replied. I figured rifle scope use wouldn’t be a problem. I wasn’t sure about daylight abilities. But I’m becoming more comfortable that I’ll be better able to spot game at distance with my eyes alone. The other hobby, astronomy, is a different issue. It is with a dark adapted eye (dilated pupil) and runs the full spectrum from low light/low contrast to low light/high contrast. Any imperfections in these conditions will be magnified. The question of what distance the lens focuses at is most noticeable looking at stars. I am told the with your eyes corrected
    To see True infinity (astronomical infinitely) stars resolve to pinpoint both with unaided eyes as well as through a telescope. This is a fairly limited use for my eyes. It would be very important if I were a professional astronomer looking through a telescope 8 hours a day 5
    Days a week. I’m not sure anyone does that anymore with Astro imaging at its current state. Also I suspect IOL’s that focus to true infinity (parallel wave front) won’t be covered by insurance. And I don’t know the impact of their use on daily tasks.

    Again, thanks to all who have replied. Any other experiences are Appreciated.
     
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  17. .308 Norma

    .308 Norma Member

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    Even though my distance vision is great because that’s what I elected to have fixed when I had cataract surgery 4 or 5 years ago, I still wear bifocals (with absolutely no correction in the upper lenses) while hunting. As a matter of fact, I wear my bifocals day in and day out.
    I wear my bifocals (again – no correction in the upper lenses) while hunting for two reasons: first, their impact resistant lenses provide some eye protection, and second, because my bifocals do have correction in their lower lenses which makes it possible for me to read things - like the instructions on my deer tag.:)
    I haven’t always liked wearing bifocals though. I was first fitted with a pair of them when I was in my mid-40s. At first I only needed them for reading, but a couple of years later I needed them for astigmatism in my distance vision too. Then I had to go to trifocals and progressive lenses
    They were a pain for hunting – I couldn’t see game in the distance without them, and I couldn’t see through my scope with them. I coped by putting a pair of “gators” (or whatever they’re called) on the earpieces. That way I could spot game in the distance while wearing my bifocals, then drop the glasses down on my chest as I brought my rifle up.
    But that’s all over now. After the cataract surgery, I bought a real nice pair of bifocals with impact resistant, plastic lenses and no upper lens correction from Costco. I can spot game in the distance as well as I could when I was in my 20s, see through my rifle scope, and notch my deer tag properly.;)
    The open sights on my handguns are just a little fuzzy – both front and back. But they’re not too bad. I can still shoot respectable groups at 25 yards, and I’m not going to hunt big game with a handgun anyway.
     
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  18. Loyalist Dave

    Loyalist Dave Member

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    My parents have all had cataract surgery, and my wife has as well although her cataracts were from other health issues rather than age.
    All opted for the top-end implant. Distance vision now is very good. Up close they need reading glasses
    My dad was 89 on Monday, and I'm working on setting up a deer hunt for him this season. He can shoot fine, it's getting him out to where the deer will be and getting him and the deer he harvests back, that's the logistical issue.
    He's got his heart set on using his M1 Garand to take this deer. He likely figures it will be his last, so wants to do it a bit in style.

    So the key for them, and for the older guys that I know from black powder shooting/hunting..., for post cataract surgery..., if they don't use optics, then a peep sight seems to be the key. The rear sight being a circle, one can center the front sight post in the center of that circle and align it with the spot on the deer where the bullet needs to go well enough.

    LD
     
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  19. hps1

    hps1 Member

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    Yep, @ 83, guess I qualify as an "older guy" shooting an M1. :) The problem with old eyes was the front post sprouting "limbs" giving the appearance of a pitchfork. I have only dry fired with a post front since cataract surgery, but I can now see the front sight just fine so feel sure I can use irons again. Some of the NM M1's we were issued on the AMU had shimmed rear sight (with smaller hole), which sharpens the front sight given sufficient light. Smaller aperture can be a problem at daylight/dusk hunting, however.

    If your dad's health permits you could extend his hunting years with his Garand as I did with mine prior to cataract surgery: https://www.thehighroad.org/index.php?threads/mission-accomplished-with-the-m1-garand.845936/

    A similar base is now available @ http://www.hopcousa.com/

    Regards,
    hps
     
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  20. Johnm1

    Johnm1 Member

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    On Friday I will have my left eye cataract surgery using a mono focus IOL bringing my distance vision into focus without any provision to optimize my vision for astronomical infinity. Standard focus. I had pretty much come to that conclusion after many helpful posts here and on another forum and considering my special circumstances. Recall a TIA (a mini-stroke sort of) took more than 30% of the vision in my left eye that will never come back. I had asked my surgeon to call me so we could discuss the implications of AF I requested I requested after my surgical coordinator could not answer my questions and told me there was no mechanism to submit a written question. Three days after my request to speak with my surgeon I was told he was on vacation and wouldn't return until the day of my surgery. I requested that any technical person call me to discuss and spoke with a doctor on the phone on Thursday. Unfortunately I was unable to Express my question well enough to the doctor and to this minute believes I was asking if I should use a premium (toric or tri-focal) lens.

    I'm ok with my decision based on my circumstances, the great discussion here, and the research I have done on my own. I would have preferred to have come to this decision based on a conversation with my surgeon/doctor but think the outcome may have been the same.

    Thanks again for all the help.

    Someone on another forum posted "Old cars need more maintenance" Ain't it true.
     
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