November 19, 2006

Cataract Surgery - What to Expect, Details, Costs

I have recently had cataract surgery. I am 52 years old and have lived with growing cataracts for at least eighteen years. Before the surgery I tried to research several types of details on the Internet -- details I was unable to find. I wanted to know simple things like: How many doctor's appointments will be required? What will be the purpose of each appointment? What procedures will be performed at each appointment? How much will everything cost? In this post I will answer those questions and more based on my experiences. I will simply show the charges listed on my insurance forms, rather than the amounts I paid. I'm sure your charges will differ based on your region, your doctor, and your insurance (or lack of insurance). My surgery was in Anderson, South Carolina, USA. I will list all the costs at the end of this long post.

First Appointment - examination
This was an appointment I made with an ophthalmologist recommended by my family doctor. The appointment was for 3:00 o'clock. I was told to come early to fill out forms. I got there at 2:35 and spent ten or fifteen minutes filling out two forms. I was called at 3:20. A technician asked me a lot of questions about my eyes, my health, my medical history, and my family's medical history. She borrowed my glasses and used a machine to identify their prescription. I looked into a machine that created a printout about my eyes. I was taken to another room where I was given vision tests using projected letter charts and various lenses. Drops were put in my eyes to numb them. I was given a glaucoma test in each eye using a machine that touched my eyeballs. Drops were put into my eyes to dilate my pupils. I waited a long time in a waiting area.

I saw the doctor at 5:20. He examined my eyes. He asked me a lot of questions trying to determine the effect my cataracts were having on my lifestyle. (If you've been living with cataracts you need to make a list of ways they impact you. Here are some examples from my list. I had trouble driving at night due to the glare from oncoming headlights. I had trouble negotiating rocks and roots in the trail while hiking. I had to use a small flashlight to read menus in restaurants at night.) The doctor told me about the surgery and its risks. He told me to think about it before deciding. He said that day's examination results could be used if I had surgery within ninety days. The total charge for the appointment was $155.

I called the ophthalmologist's office and said I had decided to have the surgery. We selected a day for the surgery and I was given a pre-surgery appointment during the week preceding the surgery. They also made an appointment for me to have an EKG (electrocardiogram) made at the surgery center on the same day as the pre-surgery appointment.

Second Appointment (part 1) - pre-surgery consultation and measurement
My appointment was for 8:30 AM. I arrived at 8:20 and was called at 8:36. I looked into a machine that used a beam of red light to take internal measurements of my right eye. The beam could not penetrate the cataract in my left eye well enough to take measurements. We went into another room. First the lady showed me a small zippered bag containing two eye patches, glasses for sleeping, a clear plastic eye shield, tape, wraparound sunglasses, a bottle of Acular LS eye drops, a bottle of Pred ForteZymar eye drops, and instructions. She gave me lots of instructions verbally and asked if I had questions. Next she took my blood pressure. Then drops were put into my eyes to numb them. The lady touched my eyeballs with a light device that took measurements. She got the right eye's measurements okay, but repeated the process on the left eye four or five times (and gave me more numbing drops halfway through). She was unable to get precise measurements on my left eye due to the density of the cataract. I signed a form authorizing the surgery, authorizing the presence of a medical representative, authorizing trainee observers, and authorizing the operation be televised to the waiting room.

Then I saw the doctor. He gave me some glare tests for each eye by having me read a chart as he manipulated lights in the room. We discussed what type of new lens I wanted and whether I wanted to be near-sighted or far-sighted. We talked about the surgery and he answered my questions. When I left I was told that the day's charge would be part of the surgery fee. I was also given an appointment to see the doctor at 11:00 AM on the day after the surgery.

Second Appointment (part 2) - EKG
At the surgery center pre-op building I signed a federal privacy form, waited a few minutes, and was taken into an office where a lady keyed my data into her computer. She told me the surgery center's facility fee ($2,700) and how much I would have to pay on the day of the surgery ($275). I signed forms authorizing the surgery and authorizing them to bill my insurance company. Then after waiting awhile I went into another room. I signed two forms -- one authorizing an EKG be made and one authorizing the company to charge my insurance company. I took off my shirts, shoes, and socks. The technician stuck little pieces of conductive tape on my chest, sides, and ankles and then attached wires to each piece of tape. She started the EKG machine which printed a chart. Then I waited awhile and went to another room to talk with the pre-op nurse. She gave me instructions about what to eat, wear, do, not do, etc. I signed a form verifying that she had gone over the instructions with me, and I left.

I filled the Zymar prescription at CVS. It was $66.59. My instructions required me to start using two types of drops in my left eye four times a day on each of the three days before the surgery. I was told to call the surgery center after 10:00 AM on the day before my surgery to get the time I should be there for surgery the next day. For the day of the surgery I was told to eat a light breakfast and not to use the eye drops that day until after the surgery. I was told to wear a short-sleeved button-up or zippered shirt and no undershirt. I was told to bring the kit the doctor's assistant had given to me and to have a ride home. I was instructed not to bring any valuables (except $275), wear any jewelry, or wear a watch.

Third Appointment - cataract surgery
A friend drove me to the surgery center. We arrived at 7:30 AM as instructed. I paid a $275 deposit. My friend was told which monitor in the waiting room would show my operation. I was called at 7:35. I was asked to remove my shoes and place them in a bag which was provided. I was given little socks with rubberized soles to put on over my socks. I was given a flimsy hair bag to put on my head. I laid down on an operating bed and was attended by three nurses. A pulse and oxygen monitor was clipped onto my left index finger. They took my temperature and blood pressure (which was 185/86, much higher than my usual 116/67). Drops were put in my eye. An intravenous needle was put in my right arm and Versed was administered. The needle was painful and felt like it was being pulled sideways. I complained about the pain and the nurse repositioned it so that it no longer hurt. A nurse put a Xanax pill into my mouth. It began dissolving on my tongue and tasted terrible before the nurse gave me water to drink. Xanax reduces anxiety. Several different drops were put into my eye. The only drops the nurse named for me were Lidocaine, a topical anesthetic. One nurse kept asking me questions like when and what had I eaten last, when did I last empty my bladder, was I in any pain, and more. I kept talking to the nurses and asking questions until they gave me another intravenous dose of Versed. Then I was wheeled into the operating room.

It's hard to remember much of the procedure due to the effects of the Versed. I remember being uncomfortable and making them adjust my pillows and arm supports. The operation lasted twenty minutes, from 8:20 to 8:40. I was lying on my back on the operating bed throughout the operation. I know I talked to the doctor and asked questions during the operation, but I don't remember the questions or the answers. The doctor cut a slit in the side of my eyeball and inserted a device that used sound waves to shatter the lens. He used a small vacuum to suck out the lens pieces. He inserted a folded lens, positioned it, and unfolded it into the capsular bag (i.e. the membrane sack that holds the lens). The sound device and the base unit it was plugged into made eerie noises while I was seeing weird images due to the tool in my eyeball. It reminded me of the old TV series "The Outer Limits" and I said so. A few times during the operation the doctor told me to look at a light or look to the right. I only felt pain once, and I mentioned it. Rather than adding more anesthetic the doctor said we were finished. The nurses removed the various things attached to me. I was surprised when they removed heart monitor leads stuck to my chest, which I had not known were attached. I was helped into the waiting room, given a small cup of Coke to drink, and given verbal and written instructions. The doctor came out to see me and asked me if I had any questions. I asked him the make of the lens. He said Alcon and said I'd get a card with the lens information on it. The doctor told me there was an air bubble in my left eye but not to worry about it. He said it would go away on its own. He told me not to shower that day or the next. He said he would see me at his office the next morning at 11:00 AM. The nurse who gave me the drink and instructions gave me a card containing the specifics about my new lens. We left about 9:00, just one and a half hours after we arrived.

I used my three bottles of eye drops, caught up on my email, ate lunch, researched my lens model, and did other non-demanding stuff around the house. About 2:30 PM I became uncontrollably sleepy, as if one of the drugs was wearing off. I taped my plastic eye shield over my left eye, lay down on the bed, and went to sleep. At 4:30 I was awakened by my telephone. I answered thinking it was my friend who said he might call later to check on me. It was my surgeon, not one of his assistants, but the surgeon himself. He just wanted to check on me, make sure I was doing okay, and confirm our appointment for 11:00 the next morning. Wow. I don't think I've ever had a doctor call me at home to check on me.

Fourth Appointment - examination the day after surgery
My appointment was for 11:00, the doctor saw me at 11:08, and I left at 11:15. The doctor examined my eye, had me read eye charts using various lenses, put drops in my eye, and examined my eye again. He said there is some plaque from scarring on the back of the lens bag that he will remove with a laser later if it proves to be a problem. The appointment's charge would be part of the surgery fee.

Fifth Appointment - one week after surgery
I was called back quickly and looked into a machine that made a printout about my eye. The technician repeated the procedure several times before she got a printout she found acceptable. She made me read eye charts inside the machine. Using the machine's corrective lens my left eye's vision was 20/25. She asked me about any problems I've had. I listed the following four. First, I see a black arc extending from top to bottom on the left edge of my field of vision. Second, when there's a light source on my left I see flickering reflections along the left edge of the lens. Third, there's still a slightly fuzzy area in my field of view, as if I still have a cataract. Fourth, I felt shooting pain in my left eye about ten times that day, the first day I felt any pain since the day after the surgery.

The doctor saw me from about 4:10 to 4:23. He put a numbing drop in my eye and used a machine to check the eye's pressure. I discussed the four problems with him. He had never had a patient report seeing the black arc. He advised me to ignore it so that my brain can filter it out. (I have found references on the Internet to the black arc I'm seeing. It's called "negative dysphotopsia".) He said the edge glare should decrease as the lens bag seals and opacifies around the edge of the lens. He said the fuzzy patch is due to scar tissue on the back of my lens bag. He said with my vision correctible to 20/25 we shouldn't do anything about the scar tissue. The day's pain was because I stopped using the Acular LS drops the previous day, and those drops are for pain. He gave me another bottle of Acular LS and told me to use it four times a day until the bottle ran out. I was given another appointment time in about three weeks. At that appointment if all is well, I'll get a new glasses prescription. Today's charge was again part of the overall surgery fee.

Sixth Appointment - one month after surgery
I was called at 2:30 for my 2:00 appointment. A technician had me look into a machine that made a printout about my eye. Another technician applied numbing eye drops and checked the pressure in each eye. She also swapped lenses and had me read eye charts until she determined my glasses prescription. Then the doctor tried to use a Zeiss machine to make a detailed image of my retina. He couldn't do it because my pupil was too small. So he put drops in my left eye to dilate it. Fifteen minutes later a technician took the picture of my retina. The doctor examined the picture on a computer screen and made a printout. He then examined my eye again (since it was dilated). He told me my retina was too thick. He wanted to make sure all inflammation from the surgery was gone before giving me a new glasses prescription, so he prescribed two eye drops: Prednisolone AC and Acular LS. He told me to use one drop from each bottle four times a day for one month, waiting five to ten minutes between each drop. I left at 4:20. The charge for this visit was $100. At CVS the Prednisolone AC cost me $16.59 and the Acular LS cost me $81.59.

Seventh Appointment - two months after surgery
I arrived at 10:25 for a 10:30 appointment. They called me at 11:00. I looked into the machine that made a printout about my left eye. I worked with a technician to determine my glasses prescription, for bifocals. My vision was corrected to 20/25 and I got two letters on the 20/20 line. Then she put numbing drops in my eyes and tested their pressure -- 15 in each eye. Then she put dilation drops in my left eye and I waited for the doctor. The doctor saw me from 11:55 to 12:20. He examined my left eye and then used the Zeiss Optical Coherence Tomography (OCT) machine to analyze my left eye, first with a normal analysis and then with a detailed analysis. He let me look at the images and explained them to me. The medical term for my condition was "sub-clinical cystoid macular edema" which simply means "a swollen retina". The extra month of eye drops worked. The fluid was no longer in my retina. My retina was no longer swollen. The doctor told me to continue the Acular LS eye drops four times a day until the bottle is empty. He told me to continue the Prednisolone eye drops four times a day for two more days and then taper off for three weeks by decreasing the number of drops by one at the start of each week. I got my glasses prescription and left. I did not buy my glasses at the ophthalmologist's office.

I ordered my new glasses from America's Best. The glasses were ready eleven days later. I picked them up, drove home, and discovered I couldn't read my computer screen with the bifocal lenses, even though we had used a tape measure to get the distance right in determining the prescription.

Eighth Appointment (due to incorrect glasses)
They called me at 3:55 for my 3:45 appointment. The doctor checked my new glasses in a machine and said the glasses were correct for my prescription. He then worked with me to determine a new prescription, and we used my tape measure to make the focal distance 27 inches for the bifocal lenses. The new prescription was different from the prescription from 18 days earlier -- for both distance and for the bifocals for each eye. We corrected my vision to 20/30. The doctor tested the pressure in my left eye and then administered dilating drops. When the eye was dilated he examined the eye and took pictures of the retina to make sure the swelling had not returned. It had not. The assistant who wrote the new prescription card for me wrote "remake" on the card. The next day I took the glasses and the new prescription to America's Best. They agreed to replace the lenses at no additional charge.

A week later I picked up the glasses. They're still not right but I'm trying to adapt to them. The sharpest focus through my bifocal lens is 17 inches for my right eye and 22 inches for my left eye. There is no distance that's sharp for both eyes. My computer screen is 27 to 33 inches from my face when I sit comfortably working at the computer. Neither eye focuses properly at that range. My distance vision is okay through the top lenses, but only for a tiny part near the center of each lens. I have to turn my head to directly face whatever I want to focus on. (My previous glasses were standard plastic lenses and I could see clearly by shifting my eyes toward whatever I wanted to see without turning my head. I can't do that with these polycarbonate lenses.) I first noticed the limited focus area driving home from picking up the glasses. I discovered I had to turn my head toward road signs as they passed to read them. If I kept facing straight ahead and simply shifted my eyes to read the signs the signs were out of focus.

The time from my initial ophthalmologist appointment to when I picked up my glasses was 122 days, or four months (July 17, 2006 to November 16, 2006).

Here's a recap of the costs related to my cataract surgery. Each cost is rounded to the nearest dollar. I will update the list if I receive more bills.



$155 Ophthalmologist
$67 Zymar drops
$181 EKG
$300 Outpatient Anesthesia
$200 Outpatient Surgery
$2,500 Outpatient Surgery
$144 Ophthalmologist Radiology
$1,650 Outpatient Surgery (surgeon's fee)
$100 Ophthalmologist
$17 Prednisolone AC drops
$82 Acular LS drops
$177 Glasses
$100 Ophthalmologist
------
$5,673 Total



Other Blog Accounts of Cataract Surgery
Sneakeasy's Joint: Eye Survived Cataract Surgery Fine
Distractions, reflections: 20/20 vision in my left eye
Michael Swanson's Blog: Cataract Surgery
The Dedalus Log: Second Sight

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118 Comments:

Anonymous Kiril, The Mad Macedonian said...

What a great report!

Thank U for including a link to Sneakeasy's Joint, and the report of my own experience. ;-D

November 19, 2006 at 11:48 PM  
Anonymous Anonymous said...

Thank you for your website and your description of your Cataract surgery before, during and after. Although I searched the internet before my 2 surgeries which I had last week and the previous week, I did not come across your account. It would have been very helpful in that one should not expect miracles. After my left eye, I was thrilled with the results, I could see clearly both near and far. I expected the same with the right. But everything was blurry. That has since improved for near vision, but not for distance. From your experience I will put off getting prescription lenses till more time and healing has taken place. Good luck with your vision and its improvement. Zeep

April 3, 2007 at 3:20 PM  
Blogger Jon Maloney said...

Thanks for posting a comment and for your good wishes Zeep. I can't afford to keep getting new glasses until I get a pair that is right for both eyes at both near and far distances. My next doctor visit will be in August, a year after the surgery. Right now my plan is to get separate prescriptions for distance and for the computer, and get plastic lenses rather than polycarbonate.

I hope your right eye continues improving. Good luck!

Jon

April 3, 2007 at 3:42 PM  
Blogger John said...

Your very detailed account of the cataract surgery hits home as I am in the early stages of getting the surgery scheduled. Your report is helping me deal with the fear factors of cataract surgery.
Thanks again!!
--John

September 4, 2007 at 8:07 AM  
Blogger David Ing said...

Thanks for linking to my blog entry on my cataract surgery experience.

One of the major difference between your experience and my experience was that I didn't have nearly the expense that you did. In Ontario (Canada), cataract surgery is covered under the provincial plan, so there wasn't a direct cost to the surgery. I probably paid $30 to $40 for the eyedrops etc. pre-op and post-op.

However, there was a cost to me in terms of time, because the wait times in Ontario were long. I first saw my optometrist about the problem in November, and then it took a long time to get an appointment with an opthamologist. The final resolution was in May.

The wait had an impact on my day job, but fortunately, I've had been employed with a large multinational corporation for 22 years at that point, so I didn't feel guilty about finally needing to use up some portion of sick time. I'm still with the company, but that amount of time would have really impacted my job evaluation ... so I moved to another job in the company where it wasn't such an issue. It turns out to have been the best career move that I've made in some time, so everything has worked out.

Since Toronto is within a 2-hour drive of the American border, it was an interesting choice for me. I could wait -- like every other citizen in the province -- for my turn at "free" surgery, or I could have probably had it resolved in an American hospital for $5000 within a few weeks. Since I'm a strong believer in socialized medicine, I decided to take the former route. In the end, not only was my surgery successful, but my outlook on life as a result of the job change has been been healthier.

September 30, 2007 at 9:40 AM  
Anonymous prescription drug discount card program said...

your description of your Cataract surgery before, during and after was incredible. im really looking into getting it done becase contacts have completely ruined my eyes more than they were before.

Cheers,
Andie

July 28, 2008 at 4:34 PM  
Anonymous Anonymous said...

Thanks so much for taking the time to write about your experiences. I'm scheduled for surgery in 2 days and have been having nightmares about it. Have been putting off researching it cause of the fear, very glad I came across your site. Hope everything has turned out well for you.
Kerri

October 13, 2008 at 4:06 PM  
Blogger Jon Maloney said...

Hi Kerri,

I am doing well and have just recently gotten two pairs of glasses I like -- one for computer work and one for distance. I got plastic single-vision lenses because I was dissatisfied with the polycarbonate-lensed bifocals I had.

I'm glad you found my write-up helpful. I wish you the best of luck with your operation.

Thanks for commenting.

October 13, 2008 at 4:18 PM  
Blogger Land of Wonderful said...

Hi Jon

I just had cataract surgery and had some of the same after-effects you reported. The one that bothers me most is the black arc. Did that go away in your case?

Thanks and best regards.

November 28, 2008 at 12:19 AM  
Blogger Jon Maloney said...

Hi Land of Wonderful,

Yes, I no longer see the black arc. I don't know if whatever was causing the arc disappeared by itself or if my brain simply learned to filter it out. At one point my doctor expressed his theory that the arc I was seeing was the edge of the lens and that I was seeing it because my pupils dilated a lot in darkness. (I noticed the arc the most when walking into the bright bathroom from the dark bedroom.) I don't think that's what caused the arc. I'm just glad I don't notice it anymore.

Thanks for commenting.

November 29, 2008 at 7:51 PM  
Anonymous Anonymous said...

My cataraxct surgery was a nightmare, not a usual occurance with this surgery. My posterior capsule ruptured during the surgery,my natural lens went into the back of my eye( the gloge) a retinal surgeon was called in to remove the lens, but his instrument broke inside my eye and the tip to the instrument had to be removed in New York City by avery highly educated specialist. Now I have retina swelling,and still cannot see well. Four manor eye surgeries since Oct 1st. Glad we do not come equipped with 3 eyes, I could not go thru with this again.

December 28, 2008 at 11:15 AM  
Blogger Jon Maloney said...

That sounds horrible. I guess any operation has the possibility of going badly. I hope the doctors are able to restore your vision for you. Good luck!

December 30, 2008 at 1:55 PM  
Blogger Maggie said...

Dear Jon
I googled for "arc effect after cataract surgery" and got your site. I am very grateful for your description on arc effect, for it is exactly what I experience. I felt completely dismissed by my surgeon when I complained about the effect one month out. He didn't seem to recognize it and then guessed I was talking about a floater. It is now three months out and though it has diminished somewhat, it is still a distraction when I drive, shop or do anything in bright light and when I shift focus alot. I have been debating whether to go back for another appt or wait for the 6-month follow-up. I found an article on the web from 2006 that says a lot more people experience these various effects after surgery than thought... 1 in 3. And for that reason, people should wait as long as possible before surgery. I had heard so many positive reports from people I knew, that I went ahead and got mine. I'm not sorry, but I am bummed about this side effect. I like that your doctor told to try not to focus on it so that the brain will screen it out. Did that work? I know I HAVE been focusing on it because I obsess about how I am going to describe it to my doctor. Your description is so accurate, I now feel I can use that! I will try not to focus on it. But I will wait as long as possible before I have the other eye done!
I am a health writer and I am going to write a piece about this, to inform people that these anomalous effect happen pretty often and cararact surgery carries a bit more risk that doctors normally identify! I am 56 and my optomitrist said I was too young for cataracts and wondered if I was on steroids. But I see you are young too. For me, it runs in the family.

Oh, My optomitrist also said I had that plaque build up along the incision that the surgeon might laser off, but apparently it isn't what is causing the arcing effect, so I might not get that either. Thanks again for the excellent description. I felt like I was on an assembly line during my surgery. But I did not experience any eye pain. And I agree with the Twilight Zone comparison!

Cool that you are into hiking and psychic stuff. I am getting my MA in transpersonal psychology and have had some interesting experiences with "remote viewing"

Maggie Spilner
Easton, PA
www.walkforallseasons.com

January 5, 2009 at 2:30 PM  
Blogger Jon Maloney said...

Hi Maggie,

Thanks for posting your comments. I'm glad you found this blog entry helpful. I no longer see the black arc. I'm not sure if my eye changed to eliminate it or if my brain is simply filtering it out. Perhaps my reasoning while I was seeing it will help you too. Remember The Serenity Prayer about learning to accept those things you cannot change? Well, the black arc falls into that category. You're not going to undo your surgery to try to get rid of it, and your doctor can't fix it, so you need to ignore it. With me it was the worst when I walked into brightness from dimness or darkness, like when I walked into the bathroom at night and turned the light on.

At one point my doctor expressed his theory that since I am fairly young (54 now), my pupils dilate a lot in darkness. He thought I was simply seeing the left edge of the implanted lens. I think he was wrong.

Anyway, both the black arc and the flickering-light effect along the edge of the lens went away by themselves. I know it's hard, but since you would rather not see the black arc, then you need to choose not to see it, rather than trying to see it to write about it or describe it to your doctor. All you want is for it to go away and my bet is that ignoring it is the best way to make that happen.

Good luck!

Jon

January 5, 2009 at 2:55 PM  
Blogger Interocetor said...

Maggie

I think Jon's advice on the notorious "dark arc" has much to commend it. As a fellow sufferer of this side effect of cataract surgery, I want to share what I know of it as well.

The phenomenon is called "negative dysphotopsia" and it is very common. Up to 10% of cataract surgery patients experience it. For most, it goes away after a few days, weeks, or months. But not for everyone.

Some cataract surgeons act incredulous when you report it, but they are being less than honest. There is a large literature on this problem, but there is no consensus on what causes it or what to do about it, if anything.

There may in fact be multiple causes. One school of thought says that the incision and the resulting edema (swelling) cause a ridge on the cornea that you experience as this dark arc in the periphery of your vision. That would help explain why it often goes away - the swelling goes down. I personally don't buy this explanation because the arc I see is a perfect semicircle, not an irregular area I would expect from an incision artifact. But the edema may alter the geometry of the light hitting your cornea enough to cause some kind of interaction with the lens, an interaction that goes away as the swelling recedes.

Another theory is this. These days, intraocular lenses used to replace your natural lens during surgery are smaller than the natural lens. This allows the incision to be smaller and recovery to be faster. However, because the lens is smaller, light entering your iris can reflect off the edge of the lens. Now if the edge is not completely round and has a surface that is at an angle to the rest of the lens (and many IOLs are so designed), light hitting the edge will get reflected off at an angle, instead of moving straight through to the retina. The result is a dark area in the shape of an arc.

Even if the cause is the edge as described, the person can often adjust to the point of not noticing it very much or not noticing it at all. However, I doubt very much that in these cases one really ceases to see it. How can one not see what is there?

It is possible to do an IOL replacement to get rid of the arc. The key is to use an IOL with a round edge and the largest size possible. However, doing that is risky (more so than the original surgery), and there is no guarantee that it will work.

So the best course of action is probably to follow Jon's excellent advice.

I do think that the risk of negative dysphotopsia should be disclosed upfront to the patient. There is no excuse for what many cataract surgeons are doing by keeping their patients "in the dark" about this very annoying problem.

I personally think that there is not more of an uproar over this problem because most cataract patients have very advanced cataracts and the huge improvement in vision makes this side effect seem trivial. However, if you are not at that point (namely, nearly bind) when you have your procedure, negative dysphotopsia is another matter entirely. You wonder if you really should have waited longer. If I had known about this, I certainly would have waited.

Rest assured that this is a common problem, it does not get worse, and in the overwhelming number of cases it does get better with time.

January 6, 2009 at 12:47 AM  
Anonymous Maggie said...

Thanks to both of you for your explanations and advice. As a health writer for 30 years, I do feel that this would make a great article for a national publication. I did a fare amount of research before I had my surgery and I never found anything that talked about these kinds of side effects --which are deemed to be related to "Successful" surgery. (You see what you want to see, and I wanted to have cataract surgery.) In my case, I am not upset that I got the surgery because the eye was Lazy due to astigmatism. I only recently started correcting it fully with glasses because I used to see double with full correction. The cataract, therefore, was far more annoying than the one in my right eye, which, though I can see that my entire field of vision is slighty cloudy, does not really bother me.

I did some further research on alternatives to surgery and came up with eye drops called Can-C which were created by a Russian bio-physicist. Apparently they were being distributed in the US but the FDA hassled the distributors so much they gave it up. The drops are sold by a company called Wise Medicines that is based in London.

The drops contain the anti-oxidant n-acetylcarnosine. (Therefore any health claims made about them are considered labeling and are therefore illegal as this is not an approved drug. They have proven effective for stopping cataract development and in some cases reversing it. So far I have not figured out if there have been clinical trials or simply anecdotal reports on clinical experience. Oddly, the creator insists that you cannot take Lutein or xenozanthin when using these drops because for some reason, they will cancel out its effect. These are nutrients recommended to help prevent eye problems associated with aging. Many multi's now have those ingredients. I'll have to look around for one than doesn't. The suggested trial period is 6 months. If you don't have any improvement by then, or your cataracts are progressing, it's probably not working for you.

I spoke with a woman in London today associated with company. She suggested I use it on the eye with the cataract also, saying it might help with the healing.

Of course, that depends on whether its an issue of inflammation or something mechanical, like a too small lens. They cost about $40 a month per eye. I do plan to give them a try but I won't keep treating the eye that has the artificial lens more than a month.

Jon, I appreciate your perspective on how to deal with the arc effect. It certainly became mine after I finally identified the problem through your blog. I don't need to "watch" it anymore. I know what it is and I know there's nothing else to be done about it-- not even convincing my opthamologist that it's there. It's certainly helpful to know that you no longer see it.

My brother in law was in a car accident many years ago that left him with a black whole in the center of his vision. When I discussed this with my sister recently she reported that Tony's vision had compensated or healed and that he no longer had the problem.

I also feel that the mind is much more powerful than we realize when it comes to self healing and that anything is possible. This seems a minor problem in the scheme of things -- however, I will put off surgery in my right eye as long as possible.

Thanks again for all the comments.

Maggie Spilner

January 12, 2009 at 10:20 PM  
Anonymous Shady Grove Eye Vision Care said...

The condition is very rare and causes a rapid loss of vision if not treated immediately. Glaucoma is common in the general population. There is literature available and community resources such as support groups and the Lighthouse for the Blind.

May 14, 2009 at 6:01 AM  
Blogger Jon Maloney said...

Shady Grove, Your comment is not clear on what condition you're talking about -- the black hole in the vision of the previous commenter's brother, the black arc effect, or cataracts. The previous poster said her brother's vision got better, my black arc went away, and cataracts take a very long time to cause blindness. So for other readers of this blog, it would be great if you would clarify your comment.

May 14, 2009 at 8:24 AM  
Anonymous Linda said...

Thank you so much for the information about the black arc. I am 60 years of age and I have narrow angle glaucoma and had irridotomies done in both eyes some years back. This past year my right eye began bothering me (no pain) and when I went to get it checked there was some vision loss and the pressure in that eye was in the thirties. I went to a sub-glaucoma specialist and he recommended that I have cataract surgery in both eyes within months. He said that as we age the lens grows and causes more pressure for people with narrow angle glaucoma. Since my father is almost blind due to glaucoma, I was open to any suggestions to hopefully slow or stop progression of the disease, even though the drops I started using were lowering the pressure. I had the surgery in my right eye about three weeks ago. Due to astigmatism in that eye, I had a toric lens implanted. My distance vision is blurry, but the surgeon said that the astigmatism was so bad, the lens did not fully corrrect it. That is the only problem so far with that eye. I had the surgery in my left eye yesterday using a standard monovision lens and when I went back this morning for a recheck, I told the dr. about the black arc on the outside edge of my eye. She seemed to think that it would diminish with time. My vision so far in that is excellent except for the arc. It started with flickering or fluttering of black image sensations before the definitive arc. When I look to the right, it appears. It really concerned me and reading your blog was very helpful. Fortunately, my eye pressures are were very good this morning. I am using Alphagan in both eyes and the doctor did not want to change that therapy yet. Linda

June 30, 2009 at 8:01 PM  
Blogger Jon Maloney said...

Hi Linda,

Thanks for your comment.

I'm glad you found what I described about the black arc helpful. I hope your remaining treatments go well. Good luck!

July 1, 2009 at 2:20 PM  
Anonymous Anonymous said...

Well, I have had the "dark arc" for almost a year now. Its technical name is negative dysphotopsia, and its causes are poorly understood. In some folks it does go away, and in others (like me) it does not.

I would advise anyone who has been told that he or she "needs" cataract surgery to get a second opinion. It used to be the case that only when one's vision was very severely compromised was this procedure indicated. Now, however, it is a money machine for clinics and opthalmic surgeons, and they will steer people toward it who have only mild impairment, often not notifying them of the very real risks, such as the dark arc effect.

Be careful when it comes to your eyes. Be very sure -- very sure -- that you do need the surgery before agreeing to it.

July 2, 2009 at 11:31 PM  
Anonymous Anonymous said...

Thank u for your website! My mom was diagnosed with cataracts and we did not know what to expect. With all the details you described it took out some of the worries and unknown. Her doctor was impatient and did not have much time answering our questions. I have one beef about your site. Pls don't use a BLACK background becuz it is hard to read from. ALso, you could increase the font size becuz most of us who are reading are not so young anymore and need bigger characters or maybe it was the black background. Thank again for telling us your experience. Good deeds reaps many rewards!

July 16, 2009 at 8:49 PM  
Blogger Jon Maloney said...

Hi, Anonymous. I'm glad you and your mother found the information I've posted here helpful. As for the site's colors, obviously I chose what I like. I have trouble reading sites with white backgrounds because of the glare and lack of contrast. I find the black background with white text the easiest on my eyes. I'm sorry you have trouble reading it. The font size is not locked on my blog. You can use your browser's features to increase the font size. I may experiment on just this post, because it's about cataracts, to see if it's easy to increase the font size.

Thanks for your comment.

July 19, 2009 at 10:19 PM  
Blogger Jon Maloney said...

I have changed the font size used in this post to "large" based on the post's subject matter and on a request in the comments. Maybe people with cataracts will have an easier time reading it now.

July 19, 2009 at 10:39 PM  
Blogger jeezmom said...

Hi Jon, Thank you for your cataract surgery account. Some of the things that happen during and after surgery come as a complete surprise. I think many doctors don't really know what the complete process is like. The surgeon sees only his part of the procedure and others only their parts of the production. You did such a great job of detailing: did you carry a notepad or did you record all the scenes and acts?If only the doctors were to read your account, I think they'd understand better what the patients go through. I recently had cataract surgery, experienced the black arc, and now see what looks like the entire circle of the lens when I go to darker or lighter room. From how the doctors react, I'd think I was going nuts. Your account is so reassuring. Thanks, Mary

July 31, 2009 at 9:52 PM  
Blogger Jon Maloney said...

Hi, Mary. I'm glad you found my post reassuring. I hope the aberrations with your vision go away with time. I no longer notice the black arc and I only occasionally notice a flickering along the edge of the artificial lens.

No, I didn't carry a notepad, but I usually have index cards in my front shirt pocket and I think I jotted down some of the waiting times at the doctor. After each appointment I updated the details at home on my computer. When I finally thought I had finished the appointments and received all the bills I cleaned up what I had written and put it into a form for posting on my blog.

Thanks for your comments.

Jon

July 31, 2009 at 10:09 PM  
Anonymous Anonymous said...

HI Jon
just stopped in a year later to review your and my and other's comments about cataract surgery and arcing effect.

I have learned to ignore the arc, though it is still there and mostly just annoys me in the super market, with the bright light and all the scanning eye movement, which causes the arc to move back and forth across my field of vision, and hence, become more noticeable.

Interestingly, I chose a new opthamologist, who acknowledged the arcing effect and said that I was likely to get it in my second eye, because I have blue eyes! She said, with utter confidence, that I am seeing the edge of the lens. Makes sense to me. When I lie on my back, with my eyes closed and a bright light in the room, I can see the edge of the lens perfectly.

Now, my right, dominant eye, is getting very cloudy and I am consdiering the second operation. I wish I could say I was consistent with the Can C eyedrops..but I was not. If I had been, I would know by now whether or not they work. Now that my vision has become difficult again, I am using the drops religiously. But the frustration of not seeing well, and all the glare, is making surgery seem more welcome. It's easy to forget the risks when you are frustrated with your current vision. My biggest problem is driving and reading signs. Its so unpredicitable. About 3 weeks after getting a new prescription ($600 varilux lenses) I already can't read road signs again...and glare in many types of situations makes faces hard to see at normal distances. Working on the computer is extremely tiring (I totally like black background on your site.) My doc seems reluctant to see me again so soon, so I have that "I must be nuts" feeling of wanting to resolve my situation and having other people treat me like an hysteric...like I should know better than to think I ought to be able to see 20/20 with my glasses on. It does undermine one's confidence. Oh well. It was good read everything over again and to realize that surgery is a risk but also can give excellent results. All I can do is hope for the best and wait for my surgeon to make up her mind. C'est la vie.

Maggie

October 13, 2009 at 1:36 PM  
Blogger Jon Maloney said...

Hi Maggie,

Thanks for posting follow-up comments after all these months. I think my black arc is still there, but I don't notice it and I choose not to try to notice it. Like you, I have not yet had cataract surgery in my second eye.

To me, the trigger for action is my driver's license. I had surgery in my left eye in 2006 when the cataract got so bad that I would not be able to pass the vision requirements to drive. I never did get a decent eyeglasses prescription from my ophthalmologist, but how many times can you afford to keep getting new prescriptions and new glasses? Finally, I went to an optometrist who had the proper equipment for determining prescriptions at precise distances. He said the glasses I was wearing were off by 1.5 diopters. I wasn't surprised. He gave me a new prescription and I finally got a pair of glasses that corrected my vision in both eyes as well as possible. My right eye's cataract is not as centered as the one was in my left eye, so I can still see well enough to drive. My vision in the eye that was operated on has gotten a little worse, I think due to clouding of the lens sac, which I understand is a common problem following cataract surgery. My ophthalmologist said when it's time to correct that problem he can do the operation quickly in his office. I'll wait until my vision is sufficiently impeded before pursuing that procedure.

The main lessons for the future that I learned, are: get my glasses prescriptions from an optometrist (not from my ophthalmologist), don't get bifocals (I hated them), and don't get polycarbonate lenses. I'm picky about my vision and found the visual abnormalities associated with polycarbonate lenses to be unacceptable. Plastic (CR-39) is thicker and heavier, but I love the clear vision it provides.

Hang in there, Maggie. I wish you the best in your quest for acceptable vision.

Jon

October 13, 2009 at 2:59 PM  
Blogger Interocetor said...

Maggie

I too still have the dark arc after a year. You are definitely seeing the edge of the lens. This happens in some people and not in others, but it is common. Also, despite what you doctor says, it is not a given that it will occur in your other eye. I have never heard about it being linked to eye color (I have brown eyes).

The good news is that over time it will bother you less and less. The thing to do is make sure you have a surgeon who knows about negative dysphotopsia for your second operation, because there are lense choices that make it much less likely.

Good luck.

October 13, 2009 at 3:30 PM  
Blogger Rositta said...

I wished I'd found your blog before my surgery last Monday. I'm now four days post op and still don't see well. What depressed me is that three people I know were able to see perfectly clearly the next day. Unfortunately they don't remember what lens they got but I have the same one as you. Living in Ontario it cost me a total of 80 bucks which included a pair of sunglasses. I know that the doc will blame my problem on retinal surgery I had last year for scarring. Unfortunately I have to get the other eye done too since not doing it will cause blindness...ciao

January 28, 2010 at 4:21 PM  
Blogger Jon Maloney said...

Good luck, Rositta! I hope your vision improves quickly. Thanks for your comments. - Jon

January 28, 2010 at 4:28 PM  
Anonymous Robin said...

Thanks for the post! Another idea for cataracts surgery crossed my mind.. It's quite nice report for your cataract surgery cost!

Thanks again Jon..

March 8, 2010 at 1:44 AM  
Blogger Rositta said...

I'm writing a follow up comment as well. My vision in my right eye according to the eye doc is 20/30. What he doesn't understand is that it's blurry and it changes a few times during the day. I did not go to my scheduled second operation this past Monday. When I last saw him he said the lens might be a little "wrinkled" and he could fix it with laser. Now I want him to fix it first before I do the second eye. Also my eye actually hurts sometimes and it is super irritated as if I had a bad contact lens in there that needed to come out. I have also scored an appointment with another Ophthalmologist for another opinion. I too had no choice about the first eye, my vision was so bad I would not have been able to drive...ciao

March 25, 2010 at 1:51 PM  
Blogger Jon Maloney said...

Hi Rositta, It sounds like getting a second opinion is a good idea. I sure hope they can fix whatever's wrong with your first lens. If I were in your situation I think I'd delay surgery on my second eye too. I still haven't done my second eye. I'm going to hold out as long as I can see well enough to drive. Thanks for commenting. - Jon

March 25, 2010 at 2:10 PM  
Anonymous Bill Brown said...

Wow, what a great blog! I thought I had combed the internet thoroughly before my cataract surgery, but I missed this one.
I am 54 years old and had surgery in my left eye 4 weeks ago. I have seen the surgeon twice since then, and he says everything is normal, but I too get the black arc on the periphery. Also, going from a dark room to a bright room, or when there is a pin-point source of light in a darkened room, I distinctly see a circular image of a lens. Perhaps the most bothersome effect is the rapid flickering of light when I am reading and the light source from a window is off to the left side. It's like a strobe light!
I am also bothered that, on the first 2 days after the surgery, though the discomfort was great, I could see more sharply at a distance with my left eye than ever in my life before. Then, it started to get a bit blurry and now it is only clear for distances inside the house. I don't have a pair of glasses that work, and my surgeon wants me to wait until late May before he prescribes new ones.
Reading your, and others, comments here has helped me to understand the situation, and I hope these problems diminish over time like yours have.

April 25, 2010 at 11:45 AM  
Blogger Jon Maloney said...

Hi Bill,

It has been almost four years since I had my surgery. I no longer see the edge flicker from light sources to the side, nor do I see the black arc. I'm not sure if my brain has learned to filter those effects out or if the physical mechanics of my body sealing the lens edge is the cause.

I hope the visual aberrations decrease over time for you as they did for me. Good luck! Thanks for your comments.

Jon

April 25, 2010 at 12:09 PM  
Blogger chrissie said...

Hi, Jon. What a great blog: thank you. I'm scheduled for surgery on June 2, the left eye. Like everyone else who's posted, I've put it off for several years, but my reluctance is a result of previous lasik surgery for extreme myopia (20/700 & 20/800). While the surgery was a huge success, the fact that the ophthalmologist did not offer any sedation has left me in basket-case condition. (Talk about a fight-or-flight response!) I am going to a different ophthalmologist and have decided on a multi-focal lens. I think, unless i didn't read carefully, this is not the replacement lens you chose. Can you tell me anything about the several brands of multi-focal lenses and what the consensus is--if there is one? This doctor has said his lens of choice is the Crystalens but I recently overheard a conversation where a woman two years ago was given the Crystalens replacement and then in the past month had a more recently developed lens (she couldn't remember its name) inserted in the second eye and much prefers this new lens. Now I'm back in panic mode.

May 23, 2010 at 12:34 PM  
Blogger Jon Maloney said...

Hi Chrissie,

I don't know anything about multi-focal lenses except that when I researched them four years ago I decided I wanted a mono-focal lens. I can't tell you now what I read then to help me come to that decision.

I performed some Internet searches for you though. Here's a page that lists several different brands of multi-focal lenses and how they differ. You might find it helpful:
ReSTOR®, Crystalens™, Tecnis® Multifocal & ReZoom™Lens Replacement Surgery for Cataracts and Vision Correction. You have to scroll down the page to get to the article. You can perform your own Google searches to find reviews and comments about each specific brand. Good luck!

Jon

May 23, 2010 at 1:38 PM  
Blogger Jon Maloney said...

I just scanned the Wikipedia article Intraocular lens. It looks like the article refers to multi-focal intraocular lenses as "Accommodating IOLs". (IOL stands for intraocular lens.) Here's an interesting excerpt:

"The FDA approved Eyeonics Inc.’s accommodating IOL, Crystalens AT-45, in November 2003. Bausch & Lomb acquired Crystalens in 2008 and introduced a newer model called Crystalens HD in 2008. Crystalens is the only FDA-approved accommodating IOL currently on the market[3] and it is approved in the United States and Europe."

The article includes studies and criticisms of accommodating IOLs.

May 23, 2010 at 1:52 PM  
Anonymous Anonymous said...

how is your vission? was it worth it? thank you jon

June 1, 2010 at 9:39 PM  
Blogger chrissie said...

the operation's tomorrow, i made a mistake on the date when i posted. so far today not freaking out though tomorrow a.m. may be a different story. had a long and satisfying conversation with my doc last week that was very calming. all my questions answered completely. he had to remove two patients' restor lenses because they couldn't endure the dark arcs, which he believes were caused by the restor lens. now only uses crystalens. i feel very comfortable with him.

thanks for following up. i'll let you know the results.

chris

June 2, 2010 at 12:46 PM  
Blogger Interocetor said...

The 'dark arcs' are a phenomenon whose technical term is "negative dysphotopsia". They are a common complication of implanting any type of lens, whether a plain vanillar variety or one of the more sophisticated types. In some folks, they never happen; in others, they occur, but go away over time; in still others, they NEVER go away.

Cataract surgeons don't generally warn prospective patients about this potential side effect. And there is no consensus on exactly what causes it, although the most common theory is that you are seeing the edge of the lens (modern IOLs are generally smaller than your natural lens, which makes implantation much easier).

I would advise anyone contemplating cataract surgery to only have it done if your cataracts have reached the point where your vision is seriously compromised. Too much surgery is being done on people with very mild cataracts, which may or may not progress to a serious problem. It is a very profitable procedure, but they are your eyes and you need to be vigilant. Take it from me, constantly seeing dark arcs on either side of your visual field is no fun at all.

June 2, 2010 at 1:43 PM  
Blogger Jon Maloney said...

I've been offline for a week and I'm just catching up on my blog comments.

Anonymous, You asked how my vision is and if the operation was worth it. I waited 36 years after my cataracts were diagnosed before deciding the vision in my left eye was so bad I had to have the operation. My vision is not 20-20 now, but it's much better than it was before the surgery. Yes, it was worth it.

Chris, I'll be thinking about you. I hope your operation goes well tomorrow.

Interocetor: I had the black arc and talked about negative dysphotopsia in my original post. I agree with your advice about waiting until your vision is so bad that you have no choice but to have surgery. I still haven't done my right eye. As long as I can get glasses that make it so I can pass the driving requirements I'll continue to put it off.

Thanks for commenting, everyone.

Jon

June 2, 2010 at 6:11 PM  
Anonymous Anonymous said...

thank you for responding jon.

June 19, 2010 at 6:33 PM  
Anonymous Breast Augmentation Los Angeles said...

Thanks for the information.It is always good to know the treatment process the costs involved and then go for that medical scope.The laser treatment to treat the cataract is so far the best.

November 2, 2010 at 12:18 PM  
Anonymous cataract surgery said...

My cataract removal experience was fantastic. I had no discomfort at any time. My vision improved from 20/90 to almost 20/20 within 48 hours after surgery. I had a mild sedative
only. I remained awake and alert throughout the surgery. It was outpatient surgery. I was released about three hours after arriving at the Cataract Surgery center.

November 30, 2010 at 3:00 AM  
Anonymous Cataract Surgery Singapore said...

Yes cataract surgeries has became much more easy now a day. Within one day you are back at your home. Though u have to maintain a routine for some days but its minimal.

March 3, 2011 at 4:35 AM  
Blogger Kristi said...

Just came across your site as I was researching the "black arc" phenomenon. I am 40 years old and just had cataract surgery on my left eye yesterday. I was diagnosed more than 2 years ago with Posterior Subcapsular Cataracts, very aggressive. I was scheduled for surgery more than a year ago for my right eye, which was my worst, but was so scared, I canceled. I gave homeopathic remedies a try for about 8 months, gave that up b/c I saw no effect, and then realized that my left eye was way worse than my right by that point. I have 4 kids and gave up driving at night over a year ago and was about to give up daytime driving as well. I knew I had no choice but to have the surgery as my life and the life of my family was severely impacted because of my disability. I was so anxious, and at my request and the doctors agreement, I was knocked completely out during the surgery, so I remember nothing but the after part. I woke up with a bad headache, which they relieved with Vicodin, and was sent home. I slept most of the day away, as you can imagine. My appointment this morning, I will never forget. When they pulled that patch away from my eye, I fell into a blubbering mess. I COULD SEE! I was so completely amazed at the remarkable difference in my vision. I could see at the 20/15 line of the chart! My right eye is about 20/200 (With glasses, pre-surgery, I was 20/40). But, after just a few moments with the patch off, I noticed that black arc on the temporal side, although I couldn't really explain it to my dr. I just said it was like I could see the side of my face or something. He immediately mentioned the arc description and said that MOST people see this after surgery and that it will fade as the eye heals. I know I have only begun in the healing process, but I have hope that all will go well and I am looking forward to my right eye being corrected in a few months. Although, when I got home today after the patch had been removed, I can see the benefits of maybe staying as blind as I was--Oh my! My house was not nearly as clean as I thought it was. I can actually see dust and dirt now, and it ain't pretty! Anyways, thank you for your post and for this place where we can share our experiences with this awfully debilitating disability!

March 5, 2011 at 12:29 AM  
Blogger Jon Maloney said...

Hi Kristi. That's a great story with a happy ending. I remember being very impressed by the clarity of colors and the whiteness of whites after my surgery. Until then everything had a yellowish cast due to my cataracts.

It's wonderful that the surgery improved your vision as much as it did. I hope your black arc goes away, as mine finally did. At least I no longer see it. Whether it's still there and my brain filters it out or it's truly gone doesn't really matter to me. I don't see it.

Thanks for sharing your story here.

Jon

March 5, 2011 at 2:45 PM  
OpenID Kristi said...

Thank you!

I've just put my story out there on the internets, if you're at all interested. I truly appreciated yours.
https://sohappytoseeyou.wordpress.com/

Kristi

March 7, 2011 at 3:09 PM  
Anonymous Maryann said...

Thanks all! I am 61, and am 2-days post-surgery. I do see the black arc and have some flickering but I am going to "practice" not sweating the small stuff because I had given up driving at night, or driving when it was too bright, and was feeling pretty old. Even with the annoying side effects, my vision is so much better I have a little spring in my step again at the thought of gaining back some independence. And speaking of seeing things you hadn't seen in awhile ... I wasn't crazy about seeing all those wrinkles on my forehead ...

September 15, 2011 at 10:42 AM  
Blogger Jon Maloney said...

That's great, Maryann. I remember after my surgery I was dismayed by all the dirt I could see in the bathroom and kitchen that I hadn't been able to see through my cataract. I hope your visual aberrations go away. Good luck!

September 18, 2011 at 10:10 PM  
Anonymous Anonymous said...

This was very helpful. Thank you for documenting your entire experience in detail. I went on line to get more info about cataract surgery after I learned that the out-patient facility at St. Jude Medical Plaza in Fullerton, CA charges, get this $7,788. If paying cash there's 20% discount making an individual's cost $6,100. Keep in mind this is only that facilitie's costs. That doesn't include the doctor's cost nor the anisthesilogist's cost. This sounds absolutely out of line to me. What are your thoughts!

October 12, 2011 at 3:05 PM  
Blogger Jon Maloney said...

This comment has been removed by the author.

October 12, 2011 at 3:30 PM  
Blogger Jon Maloney said...

I'm glad you found my account helpful. My knowledge is only based on my experience in 2006, five years ago, and I know medical costs have increased significantly since then. Plus, my surgery was done in South Carolina, where I'm sure prices for everything are less than in California. I went to a private ophthalmologist, which I daresay was cheaper than if I'd gone to the local eye, ear, nose, & throat medical complex, with buildings, doctors, and overhead. You don't say what your estimate of $6,100 includes. My private doctor did use the facilities at the medical center for the operation. Costs I paid related to the medical facility were these (I think): $181 EKG, $300 Outpatient Anesthesia, $200 Outpatient Surgery, $2,500 Outpatient Surgery, $144 Ophthalmologist Radiology, for a total of $3,325.

October 12, 2011 at 3:31 PM  
Anonymous Anonymous said...

I had cataract surgery 7 weeks ago in my right eye. My vision is now improved. However, since the day after surgery, I have been having extremely annoying flickering of light similar to a strobe light when there is a light source mainly to the side of my eye. The doctor said that everything looks good inside the eye and that these symptoms usually go away. I know we are all different, but for those who have experienced these symptoms, I would like to know how long it took to actually subside. I spoke to another eye doctor the other day who claimed she had never heard of this before which I found truly amazing. I feel as though the doctors are downplaying this symptom for some reason.

January 21, 2012 at 11:51 AM  
Blogger Jon Maloney said...

If you'll search this page you'll see where I talked about the flicker in the original post and which comments also mention it. Three years after my surgery I still saw it occasionally. Now it has been almost six years since my surgery and I don't remember the last time I noticed the flicker. I think it bothered me a lot during the first year. The doctor said it would go away with time and he was right, but it did take awhile. - Jon

January 21, 2012 at 1:33 PM  
Anonymous Anonymous said...

Jon:

Thank you so much for your quick response. I read some more comments on this page. It is
comforting to know that this can eventually
go away, even though it is currently driving me nuts. However, it is hard to imagine having this constant flickering/strobe light sensation for years. I am going for one more opinion soon just to confirm that everything is ok. I have a feeling I am just going to be told the same thing again. Thanks again.

January 21, 2012 at 2:13 PM  
Anonymous deloris said...

I had cataract surgery on 12-12-11. I had the Toric lens put because of stimatisam, and from the very first day I have had flickering in my constantly. I have been back to the Doctor twice and they act like everything is fine. The flickering is on the side and in my pupil. This is very annoying and I'm going to go and get a second opinion because its getting on my nerves even though my vision has improved. everytime I go into a store my eye feels as though its going into spasms. I feel like everyone looks at me but I don.t know if they can tell or not. I wish someone would mention if they have as white film that covers the eye. I've had several people tell me that they see this.

January 30, 2012 at 12:15 AM  
Anonymous Anonymous said...

Deloris, I know just how you feel. I went for a second opinion on the flickering/shimmering in my eye, and the new doctor told me that everything looked great inside the eye. He said that sometimes too much light is coming into the pupil and told me to take certain drops to make the pupil size smaller. My original doctor had told me the same thing. He also said that sometimes, this symptom can last a very long time while the brain adapts to this flickering situation.
I also know what you experience when you go into a store with the lights. It is all very annoying and nerve wracking. Good luck to you.

January 30, 2012 at 3:56 PM  
Anonymous Sandy said...

I have to say, after reading all these comments, I'm not sure if I'm more scared or less scared at the idea of having the cataract surgery. I was just told yesterday that the surgery I need is 'Refractive Cataract Surgery'. Is anyone familiar with that? And what was recommended for me, was the 'Monovision' lens, one eye for distance and one for close (similar to the contacts I used to wear) but now I only wear progressive glasses. I have a friend who had this surgery about 5 years ago, and she said it was the best thing she ever did. Her vision was really bad before, and after the surgery, she said it was wonderful how good she could now see - with no glasses. Her words were very encouraging, but after reading all these comments, I am not so sure. Unfortunately, it seems that people with negative experiences post their comments on sites, and people with positive experiences you don't hear from. IS THERE ANYONE OUT THERE WITH POSITIVE EXPERIENCES? Hope to hear from you. THANKS!

February 4, 2012 at 8:12 PM  
Blogger Jon Maloney said...

Hi Sandy,

This is my blog and I can only speak for myself, but the visual annoyances I suffered after my surgery were far outweighed by the improvement in my vision. I think it's fairly safe advice to say you shouldn't have cataract surgery as long as your vision is good enough to let you do everything you want to do. I think you should only consider surgery when your life is negatively impacted by your cataracts. My cataracts made driving difficult, especially at night. It also hurt me in more subtle ways, like making it so I couldn't tell the suits of cards when I played with my family. After my surgery I could see a book's text while reading, more clearly than I had ever seen text in my life. I had no trouble driving or playing cards. Sure, my vision wasn't perfect. I saw a black arc at the edge of my vision and I saw flickering when a light source was to my side, but overall the surgery's results were very positive.

Jon

February 5, 2012 at 11:27 PM  
Blogger Unknown said...

I had a cataract surgery on my right eye oct.26-2011 and the left one jan.11-2012 and haven't been ok since. My view is like looking true binocular and also have the dark arc on both eyes. Is it ever going to go away?

March 21, 2012 at 12:52 PM  
Blogger Jon Maloney said...

It sounds like your results are worse than most of the other folks who have commented here. I can only say that my black arc did go away. I don't know if my brain learned to filter it out so I wasn't aware of it or if it was no longer there for my brain to deal with, but it's gone now. I haven't noticed it for several years. Good luck!

Jon

March 21, 2012 at 2:45 PM  
Blogger lis said...

I am the one who is(the last post) but would like to explain my experience better. My right eye was done Oct.26-2011 and was told that there was a fold in the implant and the surgeon said he would wait to fix it after the left eye was done because same thing could happen to that one to. Well as it turn out the left one with was done Jan.11-2012 and that one as wrinkle into the implant so I am puzzle now my not the specialist who done the surgery but my own eye doc. don't seem to worry about it at all. Just 3 weeks ago I got up and didn't feel right and started to see flash and then a big floater and a lot of tiny one, it happen on a sat. so had to wait to monday to see him
and he say everything look find and sometimes the gel on the back of the eye brakes down and its the reason why I see those floater and it will go away, its now 3weeks and it as not improve at all.
Since my first surgery and the second I see the dark arc and its so big that my vision is like if I was looking with binocular its so annoying. I have mentioned that to him to and he say it will go away but its 5 months now and it as not improve at all.
Is there any hope for me is there anyone out there who as ad the same symptom?
I am starting to really regret that surgery, I couldn't see to well out of the right eye so I though well lets do something about it, but the left one could have wait I am so disappointed and scare that I will never be ok again.

April 6, 2012 at 3:35 PM  
Anonymous john b said...

I have chronic blepharitis due to over secretion of lubricating oils produced by the glands of the eye lids. I control this condition primarily through hygiene ( washing the eye lids with baby shampoo daily). Would this condition prevent a cataract surgery operation?
Also, I have begun to see rainbow halos around oncoming headlights at night. I did not find this condition referred to in any of the blogs. Has anyone else noticed this condition? Is it a symptom of cataract disease?

April 9, 2012 at 12:00 PM  
Blogger Jon Maloney said...

Hi John, I don't know what effect, if any, blepharitis or washing your eyelids might have on the lens inside your eye. You've probably read this, but in case you haven't, here's the Wikipedia article on blepharitis. Seeing halos around lights is one of the symptoms of cataracts listed on the National Eye Institute's symptoms list.

April 9, 2012 at 2:41 PM  
Blogger Jon Maloney said...

Update: In May 2012 I had another operation on the same eye due to cloudiness in the lens capsule. I posted about that operation too: YAG Capsulotomy after Cataract Surgery - Details, Costs.

June 9, 2012 at 3:55 PM  
Blogger Janet said...

I had acrylsoft lens toric implanted in my left eye June 1st, 2012. like Jon I had 20/20 vision the very next day..I notice the same black arc on outside edge...but it is getting better or maybe healing is helping it fade. I had very poor vision from birth.
I am amazed that I can see without any corrective lens for 1st time in my life, thats all the "positive" I need, I am going to have the right eye surgery as soon as they can get me in...I wish American insurance would cover this so more people could benefit...it really is life changing to be able to see like this...Jon your blog is AMAZING!!

July 1, 2012 at 11:28 PM  
Blogger Jon Maloney said...

Hi Janet. It sounds like you had great results, in spite of the black arc. I hope your second surgery goes just as well. Thanks for posting about your experience.

July 2, 2012 at 2:14 PM  
Anonymous MrsCats said...

I had surgery on my left eye about 2 months ago. I had requested to be as "out of it as possible" but woke completely up during the surgery. I was terrified. Then they gave me too much Versed and I was "out of it " for hours afterwards. Anyway, my vision was immediately clearer. About 2 weeks later I woke up to experience a significant floating gel like blur...no black, like a regular flaoter.....this is like someone put a beige amoeba in my eye. The eye doc says he can fix this in the office with a laser. But I no longer trust him and think I have two separate things going on....one, that he didn't "polish" up the eye as well as he should have to begin with, and two a floating piece of vitreous that will NOT be fixed by the laser. I guess I am better off than I was, but I am not thrilled with this big floating thing, and am too afraid to have the other eye done.

July 25, 2012 at 2:03 PM  
Blogger Jon Maloney said...

Hi MrsCats,

It has been my experience that floaters usually get better with time. A few months ago in May, six years after my cataract surgery, I had to have surgery on the same eye again. The problem was that the lens sac grew too thick to let light pass through properly. The situation is fairly common after cataract surgery. The solution was to use a laser to cut away the part of the lens sac that was blocking the light. I posted an article about the experience on this blog in June: YAG Capsulotomy after Cataract Surgery - Details, Costs. The large flaps from the lens sac that were loose in my eyeball after the surgery sound similar to the large floater you described. When they drifted directly into my line of sight my vision was impaired and I had to tilt my head and roll my eye around until the floater drifted to a new position. That problem was frustrating and lasted several weeks. Now I only have occasional, more normal floaters. So there is hope with time, or at least there was for me. Perhaps you will have a similar experience. Good luck!

Jon

July 26, 2012 at 10:17 PM  
Anonymous Anonymous said...

Dear Jon
Are you glad you had the surgery?

August 24, 2012 at 1:15 PM  
Blogger Jon Maloney said...

Yes. I am very glad I had the original cataract surgery and I'm very glad I had the YAG laser surgery on the same eye six years later.

August 24, 2012 at 1:27 PM  
Blogger kristiswa said...

I am sorry to hear about the problems some of you are having and hope that you all will find some improvement soon. Don't give up and get several opinions. New procedures and solutions are always coming out. Also consider going to a teaching hospital, even if you have to travel a bit.

I had a very positive outcome from my cataract surgeries. I am in the Seattle, Washington area (USA) and there are many top-notch ophthalmologists nearby.

I am 61 and have been near-sighted since age 7. I had been wearing bi-focals for about 5 years. For about 5-6 years, my night vision has worsened, especially when it's raining (happens now and again around here!) and oncoming headlights hit me in the eyes and the light would fracture and I would be nearly blinded for a second or two. I get eye check-ups once a year by an ophthalmologist and the cataracts weren't discovered until about 2-3 years ago. I was told that they weren't "that bad" but finally, I asked enough questions and learned that my cataracts were more like a prism than the cloudy type and they were in a position to affect my line of sight. I avoided driving at night until I got fed up with it and decided to have the surgery done. I was also terrified, but performed a kind of self-hypnosis for a few weeks so I could stay (nearly) sane. (I have been through hypnosis training for other issues, so I do know how to do it.)

I had the right eye (toric lens needed to correct astigmatism) done first and the left eye (regular lens) done 2 weeks later. The doc was absolutely blown away at how well I healed and how great my acuity was (better than 20/20) at the one-day post op appoinment, in each eye. He raved and marveled and said he wished all his patints had such a fantastic outcome. You should know that I am a very obedient patient and follow directions to the letter. I made out a detailed calendar to make sure I administered the pre-op and post-op eye drops on schedule. I go above and beyond sometimes. (For example, I wore the "shield" while sleeping for 2 weeks, instead of just one week.) I figure that someone who's gone to 4 years of medical school and another 4 years of eye medicine school probably knows more than I do about eyes!! So I do what I'm told. (Gah! No eye-make-up allowed 2 days pre-op and 7 days post-op! I even followed that order.)

For a few months before the surgery, I happened to be taking hyluronic acid supplements (for joint pain) which I found out AFTER both eye surgeries, is used in a liquid form to keep the eyes moist during surgery! I just found this out and haven't asked the eye doc about it, but I will at my one-month check-up. Of course, I am wondering if taking the HA could have aided the healing process.

I have many, many suggestions about how to prepare for this surgery and recommendations for anyone thinking about it, but don't want to drone on and on if it isn't appropriate. Maybe if Jon M. or anyone else wants to know more, he/she will leave a comment and I will be happy to share.

August 30, 2012 at 3:10 AM  
Blogger Jon Maloney said...

Hi kristiswa,

I appreciate your posting about the great results of your cataracts surgeries. So many people have posted about their problems that it's good to see another positive account. I don't have any questions for you, but if anyone else does I hope they don't hesitate to ask. Maybe you'll have the answers they need. Thanks for posting.

Jon

August 30, 2012 at 9:00 AM  
Blogger kristiswa said...

Thanks, Jon. If anyone wants some practical ideas to make the whole process less nerve-wracking and more comfortable, I'll be happy to relate my saga.

August 30, 2012 at 12:49 PM  
Anonymous Anonymous said...

Thank you, John, for starting this conversation.

In my mid fifties I was diagnosed with cataracts in both eyes. This was a few years back. I was in a state of shock because neither of my parents (in their eighties) had yet needed cataract surgery. I don't smoke or engage in any other risk factors for earlier cataracts, though I am severely myopic. I have since met a few other early cataract "victims" and they too were very myopic. I wonder if that increases risk?

Anyway, because of a number of events, such as my father's year in hospice and then death, I put off doing something about it for several years. I was scared, and worried about doing more harm than good by going through an invasive procedure. My vision started to severely impact my life, however, and my driver's license was coming up for renewal. I knew I would never pass the eye exam.

So after much research, I found an ophthalmologist who uses the new blameless laser technology to perform cataract surgeries. Given that my extreme myopia already puts me at risk for retinal detachment, and cataract surgery only adds to that risk, the fact that the laser uses about half the force to break up the cataract was a major plus in my decision to pay extra for the laser. The doctor also recommended the ReSTOR multifocal implant because I will (hopefully) be living with it a long time.

Here is a synopsis of my experience with laser assisted cataract surgery:

Oct. 2012: initial consultation. I had a thorough eye exam with glaucoma, macula tests, etc. Fortunately, other than the cataracts, no other diseases were evident. It is interesting to note that though I had an early appointment (9:15), the doctor had already seen two patients with cataracts who were younger than I - a 42 year old and a 52 year old.

The doctor discussed my various options. He had a low key approach that was very reassuring. I agreed to the laser procedure and signed some papers, received an instruction folder and a little case with plastic eye patch, sunglasses, etc, plus prescriptions for three kinds of eye drops.

One week later, Oct. 2012: I had an appointment with the practice's retinal specialist to make sure everything was OK - no tears, detachment, etc. He deemed me a good candidate for the cataract surgery.

In November I had a pre-op exam and an EKG. I did this at my regular doctor's office. (to be continued in the next comment...)

December 30, 2012 at 10:58 AM  
Anonymous Anonymous said...

Continued from previous comment: One day before the surgery on my right eye, I had to use various drops 3X a day. I also had to fast from midnight on because the doctor uses twilight sleep. A nurse called the day before to make sure I understood all directions and to address my nerves and concerns. The day of the surgery I had to put in a dilation drop 3X ten minutes apart before I got to the eye surgery center.

Dec. 2012: The first week in Dec. I went for the first surgery. My arrival time was 10:20. In the waiting room I filled out some forms. A technician put some more drops in my eyes and took my temperature. It was 99.4 and everyone expressed concern that I might be sick. I was not, and after some discussion, it was decided that I could go through with it.

I was taken to a first station where a nurse asked me questions like when I had last eaten, did I take any medications, etc. My blood pressure was taken, I was hooked up to a machine, and I had a little device on my finger to track my pulse (which skyrocketed, though my blood pressure did not. Go figure.) The doctor stopped by to ask how I was doing, and I told him I was very nervous. He joked that he wasn't nervous and he was warmed up, so not to worry.

Then I was taken into the room with the laser. Again, multiple drops were put in my eyes. The doctor came in and I had to be very, very still while he used the laser to break up the cataract and do other parts of the procedure. I hadn't realized I wouldn't be sedated for that part, and I was a bit unnerved. The cataract proved to be very hard and it took some doing to break it up.

Next I was taken to a room where an anesthesiologist administered the twilight sleep. For a while I was thinking it wasn't working, and the next thing I knew, I was coming to in a recovery room. My husband was already there, and the doctor told him everything went perfectly. I had a snack, was given directions, and then was escorted to our car.

My eye did water and sting that afternoon, but in the middle of the night I woke up and was surprised that I could see the clock. BTW, the doctor called my home in the afternoon to find out how I was doing. I was asleep at that point and missed the call. I thought that it was a nice touch, though.

Dec. 2012, the day after surgery: I went to my followup appointment and saw the practice's optometrist. She did the glaucoma test again, as well as examined my eyes, and deemed the surgery a success. At that point my vision in the right eye was 20/100. I was given directions for three kinds of drops to put in my eyes during the coming week.

Dec. 2012, one week later: I went for the next followup appointment, and now my vision was 20/50. I had no complications, and everything was pronounced perfect.

To be continued in next comment....

December 30, 2012 at 11:00 AM  
Anonymous Anonymous said...

Continued from previous comment:

Dec. 2012: Two weeks after the first eye, it was time to have the left eye done. I repeated the day-before eye drop protocols and fasted after midnight. The second eye was a breeze. The cataract wasn't hard, and the laser broke it up quickly. When given in the same dose, apparently the twilight sleep doesn't make you forget as much as the first time around. I was more aware of the surgery, but nothing hurt and I was in no pain, mentally or physically.

This time when I went home, there was no watering or stinging. I took it easy and sat in bed watching DVDs on my laptop.

Dec. 2012: The first followup appointment the next day... My vision was already 20/30 in the left eye, and my right eye was now 20/25! I was happy as a clam. I had none of the side effects others have noted such as black arcs or flickers.

Dec. 2012: One week followup for the left eye - I was now 20/20 in both eyes! The inflammation was down and the optometrist said my eyes looked perfect. For the first time in my entire life, I can see perfectly in both close and distant ranges with no glasses.

I have a one month followup at the end of January, and then hope to put this behind me.

When I was first diagnosed with cataracts, I built it up into a terrible monster in my mind. In reality, the procedure was quick, pain free, and not very scary at all. The key is to choose a doctor you have faith in, and if available and you can afford it, choose the laser technology. It cost me a couple of grand more (above the parts of the procedure my insurance covered) to do it that way, but I am very glad I did. My cataracts were very advanced, but the laser handled them very well.

If anyone has any questions about laser assisted cataract surgery, I would be very happy to answer them.

December 30, 2012 at 11:01 AM  
Anonymous Anonymous said...

LOL in my first comment about the laser, I meant to type bladeless laser. The spell checker puts blameless in automatically. Sorry about that.

December 30, 2012 at 11:03 AM  
Blogger Jon Maloney said...

Wow! Your story is the most positive account of cataract surgery I've seen. Your experience with laser surgery, multifocal lenses, and now having 20/20 vision in both eyes is remarkable. That's great. Hopefully your posts will help other visitors who find this site. Thanks for sharing your story. - Jon

December 31, 2012 at 4:26 PM  
Anonymous Anonymous said...

Thanks, Jon. I posted mostly because I don't want other people to experience the fear that I did before my surgery. I had myself sick over this - I lost weight from the anxiety of it all. Now I wonder what that was all about!

I had very dense cataracts by the time they were diagnosed. Why no previous optometrist had told me they were developing is beyond me. But in any case, even with very advanced cataracts, I had an extremely positive outcome. That is what I want people to come away with from my posts. The chances of a good to great outcome are overwhelmingly in your favor.

Just to add a little more about the laser assisted cataract surgery:

The laser and its computer take the eye measurements with an accuracy within a nano fraction of the width of a fine hair. I think that is part of why my multifocal lens was placed so successfully in each eye. I too had read conflicting opinions about the results of multifocal lenses, but with the laser, the placement was absolutely perfect.

At this point, there are under 100 doctors who offer the laser assisted cataract surgery. You'll most often find them in big urban areas near famous teaching hospitals. I am lucky to live near one of those doctors, but I believe that the use of laser assisted cataract surgery is rapidly growing. I have every confidence that in the not too distant future, most doctors will offer it and most health insurance plans will cover it.

My doctor had performed close to 400 laser assisted cataract surgeries by the time he did mine, so I was also lucky to benefit from his vast experience.

Good luck to everyone who is facing the surgery. I am sure that for almost all of you the outcome will be positive.

January 1, 2013 at 10:49 AM  
Anonymous Anonymous said...

Thank goodness I found this site. Your story could be mine! I am 38 yrs. old and had cataract surgery in the right eye in November. The day after I noticed a crescent shaped shadow and flickering light in my temporal vision. It seemed as though I was looking through shimmering water. That was my follow up day, and the Dr. said he had not heard this description before. I went home and returned to the office the next day freaking out because it was getting much worse. I had a thorough exam and was told to follow up in one week. Well, I did and I was also seen by a retina specialist who said I was fine and the surgeon did "an excellent job". Every thing was perfect... Well, it has been two months and I still see this shadow and flickers. The last thing my surgeon said was that he could laser the capsular bag, because the cataract had grown into the bag, or I may have a wrinkle in it. My mom wants me to go see another dr. in Atlanta and I made an appointment. But it's gonna cost me insurance wise. Do you think I should wait a little longer before deciding or go ahead with the laser?

January 25, 2013 at 9:23 PM  
Blogger Jon Maloney said...

Anonymous,

I'm not a doctor and I'm not qualified to give medical advice, so I can't advise you about what to do. However, I can tell you what I would do. In fact, it's what I did. I applied the same reasoning I applied before I had cataract surgery. I asked myself if my poor vision was having enough of a negative impact on my life that it was worth risking surgery to try to correct it. The black arc and flickering I saw at the edge of my field of vision was a distracting nuisance, but my vision was great. My biggest problem was that I expected perfection and was quite irritated by the black arc and flickering side effects. It sounds to me like you want to try surgery again to try to correct a problem that the surgeon doesn't understand. If the surgeon isn't sure what the problem is, do you really want him lasering your eye in hopes that what he does might correct it?

Your problem sounds like the one I experienced and like the same problem several commenters on this blog also reported. I chose to ignore the black arc and flickering, rather than obsessing over them. I had the surgery in 2006 and by 2009 I no longer saw the black arc or the flickering.

I think you should at least read all the comments on this blog article before you make your decision. I think you'll be surprised by how many other people experienced the same thing you're experiencing.

Good luck!

Jon

January 26, 2013 at 3:51 PM  
Blogger Danny Ramrakhiani said...

Wow....what a report and wow for expenses as well. I just had my cataract operation done for fraction of what you spent...just $650 and it includes everything, all the tests and all the fees...this is the total I spent.

Where: its simple - GO TO INDIA

I believe doctors here are more knowledgeable than western countries.

February 2, 2013 at 11:45 AM  
Blogger Jon Maloney said...

That's great, Danny. Medical costs in the US continue to rise. My operation was in 2006. The same operation and related expenses would probably be more expensive today. Starting in 2014 everyone in the US will be required by law to have medical insurance, which I suspect will result in a significant increase in costs. Thanks for posting.

Jon

February 2, 2013 at 1:13 PM  
Anonymous Anonymous said...

Hi it is me, anonymous who posted on January 25th. I went to the other doctor after ten months of misery. I had an IOL exchange of the square edge for another. Guess what? NO black shadows or flashes.Best thing I ever did. Some times you can't just ignore it. People be proactive in your healthcare and don't be afraid to get a second opinion.

October 27, 2013 at 8:10 PM  
Blogger Jon Maloney said...

Wow! That's impressive, Anonymous. I didn't know doctors could remove an IOL after it had been implanted. Not only did they take yours out successfully, but the new lens seems to have no negative side effects. That's great. Thanks for posting. It would be nice if you could share the make and model of your new lens. It might help other readers who have the same problem you had. - Jon

October 27, 2013 at 8:20 PM  
Anonymous Anonymous said...

It is a silicon lens that replaced an acrylic square edge. Yes they can do IOL exchanges, if appropriate. It all depends on the patient. It seems the square edge design caused MY problem. Millions of people get that lens and in most cases it is a great lens with no side effects. In some cases it is the best type of lens. In my case, I could not tolerate it. I had perfect surgery from a wonderful surgeon. The original lens was placed perfectly in the capsular bag. He referred me to another MD after I asked for it and the symptoms did not go away over ten months. I just wanted another opinion before undergoing the laser. That MD recommended IOL exchange. I went for it. Shadows and flashes are gone. I do have a little shimmering in my side vision but I can ignore that and will trade that any day for the black shadow and flashing lights that never went away. IOL exchanges have risks and I am not telling any one to go out and do that. I am sharing my experience so that others can be helped in knowing that other options are out there and this problem is real.

October 29, 2013 at 7:57 PM  
Blogger Jon Maloney said...

Thanks for the follow-up. At least the readers here will know an IOL exchange may be an option for them now if they can't live with the visual aberrations from their first lens. - Jon

October 29, 2013 at 8:34 PM  
Anonymous Lisa researching cataract surgery said...

Thanks for the candid breakdown of what to expect.

December 22, 2013 at 3:43 PM  
Blogger Jon Maloney said...

You're welcome. I wrote this post because before my surgery I was not able to find detailed information. - Jon

December 22, 2013 at 4:16 PM  
Anonymous Eye Health said...

Great post! Been reading a lot about cataract surgery recently. Thanks for the info!

April 3, 2014 at 10:00 AM  
Anonymous santino. D said...

April, 30 2014 at 6:30 am
Thank you that was great report i fun reading the cataract surgery and i was amazed how its takes to complete the procedures. Thank you for your time well spent.

April 30, 2014 at 5:43 AM  
Blogger Jon Maloney said...

Thanks for your comment, santino. D. I'm glad you enjoyed my post. I was also surprised at how long the process took, from the first appointment through the final checkup. - Jon

April 30, 2014 at 9:38 AM  
Anonymous Anonymous said...

I had cataract sugary on 30 June, I was very disappointed with the sugary because my left eye is completely blurred, it look like I am looking through a white cloud that is very thick, basically I can’t see a thing. The next day my eye was examined and I was told not to worry, come back in two week and we will see what happens. Today is day three and all is the same, has anyone had this type of problem and can it be fixed.

July 2, 2014 at 7:12 AM  
Blogger Jon Maloney said...

I have read that blurred vision is sometimes a temporary side effect of cataract surgery. I hope your vision clears up on its own soon. Good luck! - Jon

July 5, 2014 at 6:27 PM  
Blogger Anonymous said...

I had laser assist cataract surgery in right eye 8/5/14. I also see the black arch and flickering on the periphery but vision was perfect but only for a week. I too will need yag laser because of the clouding of the capsule. My question is how soon can I have this procedure done and has anyone else has experienced this too and so quickly

August 23, 2014 at 10:05 AM  
Blogger Jon Maloney said...

I wish I could answer your questions. My understand is that after cataract surgery the rear of the lens capsule slowly thickens until it interferes enough with vision to have the YAG procedure. I don't think that thickening process would happen the same month as your surgery, but I'm just guessing. Something else may be going on that your surgeon migth be able to assess. Good luck!

August 23, 2014 at 2:04 PM  
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Anonymous Pence Shenter said...

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January 19, 2015 at 11:29 PM  
Anonymous Anonymous said...

had retina and macula detach..successful surgery..year out now..Cataracts advanced both eyes..dense..going laser..found a Doctor that has done eleven thousand cataract surgerys...only does Laser now..cost five thousand for laser..its worth if for you eyes..optimistic about results..will keep you guys and gals informed...

February 26, 2015 at 5:35 AM  
Blogger Anonymous said...

I had cataract surgery done I the right eye in 8/2014 and I did the laser at a cost of $1500.00 . It was performed in morristown,nj. I had lasik surgery done 10 years ago which added some difficulties when having cataract surgery, so for accuracy I decided on the laser.
All went well and I have 20/20 vision. I definitely recommend it if you can afford the procedure , it's not painful and went smoothly.

February 26, 2015 at 8:56 AM  
Blogger Jon Maloney said...

Thanks for your comments (to the last two anonymous posters)!

I didn't know (or had forgotten) that lasers could be used in cataract surgery. I had cataract surgery on my left eye in 2006 and will need cataract surgery on my right eye soon. I've waited too long, but whenever I reread the comments on this blog I remember the risks involved and decide to wait a little longer.

February 26, 2015 at 10:56 AM  
Anonymous Anonymous said...

I waited one year after Retina Detachment....20-60 corrected ..glasses not much of a help...Cataract Dense...Dr asked why wait..i said let eye stable first..said risk of second surgery..but was optimistic with Laser..would give it a 'tug' to get out....question for those that had laser..was it uncomfortable position when they were doing the Laser?? ps..note that Lasik Doctors probably never tell patient can be further complication if you get cataracts later...glad this board is here..lets keep in touch..we can learn together from experience...

February 26, 2015 at 12:54 PM  
Anonymous Sam Windhorst said...

Great post! There is some really great advice here. Thank you for sharing!

March 2, 2015 at 4:25 PM  
Blogger carolyn spencer said...

Hi, I have had two cataract surgeries three weeks apart and have black arcs in both my eyes. I am extremely worried and would like to hear from previous posts whether their arcs disappeared or what intervention got rid of them. My lenses are Rayner c flex. Thank you

June 7, 2015 at 11:31 AM  
Blogger Jon Maloney said...

Hi Carolyn. I'm not sure how many posters here are repeat visitors. You may find some follow-ups if you read through all the comments. In my own case I don't know if whatever caused the black arc corrected itself or if my brain started filtering it out, but either way I don't see the arc anymore. I hope yours go away too. Good luck! - Jon

June 7, 2015 at 11:43 AM  
Anonymous Alice said...

Thanks for sharing

April 27, 2016 at 5:29 AM  
Blogger Me said...

I have been pining for an improvement for my cloudy vision but this blog and comments have terrified me and I will not go forward for years. But does waiting until the cataract is very old make the surgery more risky? Can the cataract grow into deeper portions of the eye? A Kaiser doctor in CA told me to wait until I was "disabled" so I thought waiting was harmless. But is waiting actually MORE damaging? I am scared to death of modern medicine and have suffered several medical mistakes in other areas of the body. Is it better to wait or to take a chance? I am writing to you all from the future now: 2016! Thanks for all your personal insights. Best wishes, Me.

June 2, 2016 at 1:21 AM  
Blogger Jon Maloney said...

Hi Me,

I am not a doctor or an expert on cataracts, but I think I can answer one of your questions. You asked, "Can the cataract grow into deeper portions of the eye?" I think the answer to that question is "No". When the lens in an eye becomes less clear with age it is called a "cataract". The cataract is simply the part of the lens that lets less light through. The idea that a cataract could grow beyond the lens makes no sense.

I performed a Google search to see if there are any dangers to waiting a long time before cataract surgery. Here are three of the pages I found:

Houston Surgeon on Waiting Too Long for Cataract Surgery


What are some of the problems with delaying surgery?


Removal of a Mature Cataract

Jon

June 2, 2016 at 10:01 AM  
Blogger carolyn spencer said...

Dear Me, Please have it done asap. It is no big deal. I went completely blind in one eye in a couple of months It was much more difficult to remove and was very large leaving a big gap. Don't be scared it it amazing the day after and recovery is very easy. Only a bit of scratching like you have a bit of sand in your eye. Please have it done don't leave it as long as me. x

June 2, 2016 at 1:46 PM  
Anonymous Anonymous said...

The capsular bag becomes cloudy more quickly for younger patients and also with multifocal lens. It can become cloudy in weeks even and can be corrected in few seconds as early as a month if there is no inflammation in the eye.

June 6, 2017 at 8:24 AM  
Blogger Unknown said...

The black arc is the lens portion that is being healed and it is more prominent the first few weeks. If the patient is younger it will go away more quickly. The reason is that the place where the edge of the lens meets with the natural skin of the eye is not healed at first and once the cells grow on the edges to completely hide the edge, the arc will vanish. This takes time. For people in their 30's, it takes a month. When the location where the lens edge meets the skin is fully covered with cells,the arc will not be seen.

June 6, 2017 at 8:29 AM  
Blogger Jon Maloney said...

Thanks for the information Anonymous and Unknown. They add to the data about capsular-bag cloudiness and the black-arc side effect so many people experience. Thanks for posting. - Jon

June 6, 2017 at 9:41 AM  
Blogger Ruma Aftab said...

You are welcome. This is the same person. Not sure why it posted as unknown and anonymous and not just one.

June 6, 2017 at 2:11 PM  

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