• When you have cataract surgery and they tell you that your distance vision will be good but you will need glasses to read, will you be able to work on a computer without glasses?


    Question:

    When you have cataract surgery and they tell you that your distance vision will be good but you will need glasses to read, will you be able to work on a computer without glasses, put on make-up without your glasses, etc.? I am kind of confused as to what my sight will be like after the surgery.


    Answer:

    The lens of the eye changes shape when you switch what you are looking at—from things that are far away to things that are very close (and at every point in between those two). A cataract is a clouding of the focusing lens. The cataract lens cannot be cleaned. It must be removed.

    In the old days, people had to wear very thick eyeglasses to make up for the lost focusing power of the human focusing lens. Today we replace the human lens with an artificial lens placed inside the eye called an IOL (intraocular lens).

    We have a great variety of IOL options and these choices can be very confusing. The standard IOL that most insurance companies pay for has a single focus that you and your ophthalmologist agree upon. There are three basic zones of vision: far (driving), intermediate (computer) and near (reading).

    A standard IOL gives you one of these three zones and the other two usually require eyeglasses to achieve good vision. Other factors such as pupil size and the amount of light available can impact how well these people see for the other two zones of vision. Targeting that focus is not a perfectly accurate process, but usually the result is very close to your desired single visual goal.

    Most patients request their IOL focus to be for distance and understand they will need glasses for computer and near vision. Some patients ask for near vision and are willing to wear glasses to see far. Some patients choose mini-monovision, such that one eye is focused for far and the other eye is focused for intermediate vision like computer distance. This requires further conversation with your ophthalmologist.

    More recently we have premium/multifocal IOLs that do a good job of approaching normal vision of far, intermediate and near vision, but none of them are perfect. These premium/multifocal IOLs are usually only partially covered by insurance and the patient must pay for the difference in cost between the standard IOL and the premium/multifocal IOL.

    I urge you to remember that no IOL guarantees perfect vision at all vision zones and under all conditions, but they do provide good to excellent visual results for most people.


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