Cataracts, Progressive Bi-Focals and Shooting

[longtooth]

Good job Maam.

[frankie_the_yankee]

As a regular IDPA shooter I went the route of a dedicated shooting pair of glasses. I am another shooter with aged eyes and currently wear progressive bifocals. Had alot of trouble with these shooting prone or getting a correct sight picture.
Spoke to my Dr and he didn't object to my bringing my gun to his office. He generated a prescription that had my right lens (dominant) fixed focus at my front sight and my left eye at my distance correction (not much).
When I wear these my sight is in sharp focus and the target is visible.
Brain can do amazing things, especially if you can shoot both eyes open.

Bob

My exact experience.

Now for street carry, dediccated glasses won't work, because the BG won't stand still and wait for you to access them.

I have found that some type of glowing sight, like Trijicons or (even better) Tru-Glo work great with my normal no-line bifocals. The reason is that I can tell that the glowing dots are lined up even though they are not in focus.

This is hard to explain. All I can say is to try it. I think that unless someone had severe astigmatism, the part of the fuzzy, out-of-focus glowing dot that looks the brightest is also the true center of the dot. And it seems that the eye can key in on this very nicely.

Now all that said, the Crystal Lens implants are the way to go these days. They cost a few thou per eye, and most plans do not cover them. I'm saving my pennies.

[Skiprr]

You guys are too old to be shooting and should let me have your firearms for safe keeping.

[longtooth]

Good job sir.
You do all us old guys prowd.

[chewy555]

I just turned 30, man that is hard to say, but I have noticed that my eyes are getting worse every year. I have started shooting with my normal glasses since that is what I will have on if I have to defend myself or family. Thanks for all of the tips for me to use as I know that my eyes are going to get worse.

[jwp]

I'm surprised you didn't get a CrystaLens implant. I thought that was standard procedure now because it gives the patient the ability to focus just like with their original lens before cataracts.

Insurance companies and Medicare will not pay for upgraded lenses, of which CrystaLens is one example. If you want upgraded lenses, they will pay all of the costs that would be covered for a standard cataract surgery and replacement lens, but you will have to pay any additional opthamologist, eye testing, hospital, and lens costs. I just did this about three weeks ago (using the Acrysoft ReZoom lens) and the additional costs (so far) have been about $1500. Note, by the way, that Medicare and insurance companies won't pay cataract-related costs until the eye reaches the point where it can no longer be corrected to 20-20 vision. Often the additional costs associated with upgraded lenses include fixing other problems (e.g., astigmatism) with laser surgery if there is still a problem after the lens replacement. This needs to be discussed thoroughly with the opthamologist.

If you need cataract surgery, and are considering an upgraded lens (which is probably a good idea if you can afford it), I recommend very strongly that you personally research the various types of lenses available. I also very strongly recommend that you talk to several opthamologists - two at a minimum, and three or four would be better. If you can afford the upgraded lenses, you can afford the opthamologists visits. Read and listen very carefully to exactly what is said/written, and be sure you really understand it thoroughly. For example, CrystaLens does not give patients "the ability to focus just like with their original lens before cataracts.", nor do they make any such claim; they are, in fact, extremely careful to avoid such a claim. However, if you don't pay careful attention and understand clearly what they actually do claim, you could easily get that impression.

All of these lenses - CrystaLens, ReZoom, ReStor, others - have widely varying strengths and weaknesses. Their suitability for a particular person depends to a large extent on what other vision problems the person has, and what their vision needs really are. Any one of them may work spectacularly for one person, and very poorly for another. It is not possible to predict exactly how any one of them will work for a given individual. All that an opthamologist can really tell you is whether you appear to be a good candidate for one of them. It is very unlikely that with any of them you will walk out of the hospital (it's a 20-minute out-patient procedure) with 20-20 vision. In general, there is an "adjustment" period during which your vision will improve. In my case, it's been three weeks since the surgery, and my vision has steadily improved over that time, though the rate of improvement has slowed over the last few days. Or seems to have. What's really happening, mostly, is that your brain has to adjust to the images it gets via the new lens, and that usually takes time, especially if you only have one eye done as I did. And in some people it doesn't improve, and in others it improves and then deteriorates, and... etc, etc. They can't predict this. The best they can do is give you the statistics; you have to decide what to do yourself.

I was very tempted by the CrystaLens, partly because the technology seems to be the right way to go. Ultimately, however, I rejected it for a number reasons: (1) One opthamologist told me that studies indicated that its focusing ability deteriorated with time (which is sensible, given the mechanism); (2) The Europeans, who used it for many years, seem to have abandoned it almost entirely (which may be related to item 1) and, frankly, this is an area where they are significantly ahead of the US; (3) While it works extremely well for some people, there seem to be quite a lot of not very happy users, also; (4) I didn't like the opthamologist who specialized in it (one other used it if patients wanted it, but was less than enthusiastic about it).

I finally chose the ReZoom lens, which is a multifocal type. I won't go into the details of that here as the web is full of clear explanations of this and all other things related to lens replacement, whether for cataracts or to fix other problems. Is it fully satisfactory? No, or at least not yet; as I said above, it has improved steadily since surgery, and it can take up to several months before vision becomes completely stable. However, it has given me good enough vision in my left eye that it's better than my uncorrected right eye (in which I normally use a contact lens), and I'm back to shooting pool again after several months of not being able to see well enough to do that (pool is more demanding of good eyesight than most handgun shooting).

In any case, the real message is that if you have incipient cataract problems, start researching possible solutions. The web is full of information. It's really important that you understand your options, and the trade-offs with and between the various lenses. And remember that anything you learn now is likely to be at least partly out of date in less than a year.

[jimlongley]

My wife chose Crystal lens, had both eyes done and is very satisfied with the results, it's been one year and she is still improving incrementally.

I am waiting for my cataracts to develop to the extent that my medical plan will cover it, which they do at the moment. I had RK (radial keratotomy) fourteen years ago and have been pleased with the improvement in my distance vision. I have worn glasses for nearsightedness since I was about 8 years old and needed thick ones to correct to 20/20 until I went under the knife. My major dissatisfaction with the surgery is that it destroyed my near vision, leading to a necessity to wear reading (and shooting) glasses.