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Cataracts and model railroading Locked

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Posted by Uncle_Bob on Sunday, January 29, 2017 10:05 PM

Go to the eye doctor.  If your GP won't give you a referral, call an ophthalmologist yourself.  You have two eye doctors tell I you to get this checked immediately.  You should listen to them.  It may just be your Rx, as you said, but it could be something major.  Don't be like my mom and screw around for six months while she was in denial about her "chest cold or allergies," only to find out when she finally went to the doctor that she had lung cancer.  You need to take care of yourself.  

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Posted by BigDaddy on Sunday, January 29, 2017 8:26 PM

Metro Red Line
The steroid is the only logical explanation,

NO, that's why ss122 spent 8 years learning his profession.  There are many things that can gradually cut your normal function of any organ down to 30% before you notice, like COPD or chronic renal failure.  A pulmonary embolus or a blocked urinary system can put you in the same place in minutes or a day or two. It's a little late to tell you to stop smoking after 40 years or to take blood pressure medicine for after decades of hypertension, but we can do something about big prostates, kidney stones or pulmonary emboli.

We are talking eyes and it's a different subset of causes but you only get 2 eyes. There are bionic eyes, but my understanding is the vision isn't much to write home about.  Protect what you have, at any cost.  You have 2 doctors worried that your history doesn't sound typical.

 

Henry

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Posted by ss122 on Friday, January 27, 2017 7:21 PM

Hi Metro,

I read in your post, "my current doctor was supposed to give me a referral but at the time it was still pending".

Not to be blunt , but it's your eye, not his. I agree with Big Daddy, if you have had a sudden change in your vision it needs to be checked promptly. If you were to call my office with that story, you'd get an appointment that day, no referral needed.

I urge you to call an ophthalmologist Monday and be seen.

Best of luck.

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Posted by Metro Red Line on Tuesday, January 24, 2017 9:27 PM

BigDaddy

 

 
Metro Red Line
I'm "thirty-fifteen" years old

 

Does that mean you are 45 and had a cataract in your 30's?  That's unusual. 

Have you seen an eye doctor since this recent change happened?  My understanding is steroid cataracts happen over time, not suddenly.

I'm not the eye doctor of the crowd, but I do have an MD behind my name.  A sudden loss of vision might be a retinal detachment or a retinal hemorrhage, both of which could be considered emergencies.  I would call your eye doctor, tonight.

pm sent so you don't miss this message.

 

 

Thanks. Yes , I'm 45 (just in denial, hence the "thirty-fifteen" :)) the cataract started in my 30s. The first time I noticed anything unusual was around 2004 when I noticed one eye (left eye) was slightly clearer than the other. I seemed to attribute the cataract to neglecting to UV-protect my eyes (for the longest time I detested wearing sunglasses, but since the cataract diagnosis, I never leave the house without them) -- although my left eye is cataract-free.

I have a co-worker in his mid/late-20s who also has a cataract in one eye, his is similar in severity. 

The steroid is the only logical explanation, as my eye had not experienced any sort of injury or trauma. The cataract was already somewhat advanced, though I could still read large letters with moderate difficulty. I had taken the steroid in the past but it has been years (over a decade) since I had been prescribed it until I had this current prescription. I already stopped taking it just a few days after New Year's. 

I have not visited an optometrist/opthamologist since 2009 (due to a long period without health insurance) and my current doctor was supposed to give me a referral but at the time (mid-December) it was still pending. 

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Posted by BigDaddy on Tuesday, January 24, 2017 5:20 PM

Metro Red Line
I'm "thirty-fifteen" years old

Does that mean you are 45 and had a cataract in your 30's?  That's unusual. 

Have you seen an eye doctor since this recent change happened?  My understanding is steroid cataracts happen over time, not suddenly.

I'm not the eye doctor of the crowd, but I do have an MD behind my name.  A sudden loss of vision might be a retinal detachment or a retinal hemorrhage, both of which could be considered emergencies.  I would call your eye doctor, tonight.

pm sent so you don't miss this message.

Henry

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Posted by mlehman on Tuesday, January 24, 2017 3:39 PM

Thanks to everyone who contributed to this thread. I don't need it now, but glad to hear I have options if I ever do and that the experience is generally positive.

Mike Lehman

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Posted by Metro Red Line on Tuesday, January 24, 2017 3:29 PM

I'm also concerend about this. I'm "thirty-fifteen" years old :) I have been diagnosed with a cataract in my right eye since 2009 (it was rather mild then). To top it off, I also have glaucoma in my left eye (though it's kept under control with drops). And to top that off, I'm an N scaler.

My eye conditions have not really been a hindrance to my modeling activities. I had been into N scale since 2006, and have been building my layout since then.  But I have trouble reading in dim light and lately while driving at night, I have some trouble reading street signs that aren't illuminated. 

However, my cataract hit a tipping point just a couple days ago. Almost overnight, I seriously lost a lot of my right eye clarity, most likely brought on by a perscription steroid I had been taking a few weeks ago to treat a skin condition. I could no longer see any words or text unless it's etremely large, and I can only really see light, shapes and general colors. It's kind of annoying now and I'm prone to closing my right eye just to make things less annoying. 

My left eye vision is fine, otherwise I wouldn't be able to type this (okay, there's speeh-to-text programs now, but I don't need that at this stage). I know I'll need cataract surgery at some point this year. Hopeflully my health care won't be taken away. 

I took a look at my layout yesterday. I really had to close my right eye to enjoy it, of course that takes away depth perception. I'm also wondering if I need to register for a temporary disabled placard from the DMV. 

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Posted by ss122 on Tuesday, January 10, 2017 7:45 PM

I always ask my nearsighted patients if they would like to see near or far without glasses after surgery. Most say far but many choose exactly what you did, for the reason you did. For you, you made the right choice.

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Posted by 7j43k on Monday, January 9, 2017 7:31 PM

ss122

Well Ed, I have good news and bad.

There is an implant that does focus at near and far. You are right, when we are young a circular muscle inside of our eye can contract and thicken our lens, making the eye focus at near.

 

The Crystalens, made by Bausch and Lomb can be made to move backward inside the eye when this muscle contracts, also providing near vision.

The bad news is that it is not covered by insurance, and a pair of these lenses generally costs between 4 and 5 thousand dollars.

That makes reading glasses and optivisors or choosing near vision for your implants look pretty good.

 

 

Wow.  Already????

The thing is, I'm happy with what I've got now.  Ever since I was 12, I wore glasses for far vision.  With the surgery, I still wear glasses for far vision.  Point is, I've lived most of my life with glasses, and they're part of my life.  I'm USED to them.  So I'm not really experiencing any regrets at not getting these new and improved lenses.

Thanks for letting me know about these.

 

Ed

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Posted by ss122 on Monday, January 9, 2017 6:36 PM

Well Ed, I have good news and bad.

There is an implant that does focus at near and far. You are right, when we are young a circular muscle inside of our eye can contract and thicken our lens, making the eye focus at near.

 

The Crystalens, made by Bausch and Lomb can be made to move backward inside the eye when this muscle contracts, also providing near vision.

The bad news is that it is not covered by insurance, and a pair of these lenses generally costs between 4 and 5 thousand dollars.

That makes reading glasses and optivisors or choosing near vision for your implants look pretty good.

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Posted by 7j43k on Saturday, January 7, 2017 5:18 PM

BigDaddy

 

He did say there is a specific focal length for near vision at about where you normally would hold a book to read.  Remember when we were young you could see from about to inches in front of your eye to infinity.  These don't work that way. 

 

 

I think the difference is that our as-delivered lenses can focus.  Rather than moving the lens in and out as in a camera, the lens shape gets changed.  Sadly, current replacement lenses don't focus.  I asked my doc "when?", and he said "someday".  But not today.  Sniff.

As I mentioned earlier, I chose near-vision lenses.

 

Ed

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Posted by ss122 on Saturday, January 7, 2017 5:03 PM

Astigmatism occurs when either the lens in your eye, and or your cornea,  has a surface that is not equally round it all directions like the side of a basketbal, but has steeper and flatter curvatures like the side of a football. If your cornea is shaped like a football standing on end, you can get glasses or an implant shaped like a football on it's side, and they will cancel each other out, resulting in good vision.

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Posted by BigDaddy on Saturday, January 7, 2017 8:35 AM

One more data point.

I talked to a retired pediatrician who had multifocal implants with cataract surgery.  He said his distance vision was excellent and his near function was very good, but he had some residual astigmatism.  Astimatism... think of it as an eye that is out of round and a little bit oval; and pole through that oval is not necessarily straight up and down.

He did say there is a specific focal length for near vision at about where you normally would hold a book to read.  Remember when we were young you could see from about to inches in front of your eye to infinity.  These don't work that way. 

I am unconvinced, but he was happy with them.   He still wears glasses because his grandchildren say he doesn't look like grandpa without them Big Smile

Henry

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Posted by bing&kathy on Sunday, January 1, 2017 11:18 PM

 Had both eyes done a few years ago.  Week apart, no problems, talked to the surgeon through both pocedures. I went with the "normal" implant and have 20/30 vision and no need for glasses for distance. Surgeon said go to $ tree for readers. I have them all over the place close at hand.

If you are wearing glasses before surgery and don't need them after, I would get a note from the doctor stating you no longer need glasses and what your new vision is now. This should get you by until liscense renewal.

BTW gall bladder surgery has gotten so when you wake up you've only got three bandaids on you and a wheelchair ride to the door. Day surgery!

 

 

 

God's Best & Happy Rails to You!

Bing  (RIPRR The Route of the Buzzards)

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Posted by Pukka on Tuesday, December 27, 2016 10:34 AM

Went to see an optometrist, he told me I have a cataract in my right eye. Had it for 2 years. It will be a while before surgery as the cataract is not that bad. I'm near sighted and can read without classes but have bifocals and computer classes as I need to see the computer screen at work.

Have been near sighted since 2nd grade; don't remember before 2nd grade as I spoke a diff language before then. The teacher knew my language and taught me English. But I don't remember anything before 2nd grade.

Mother had cataracts but never did surgery. She did not believe in surgery and died almost blind a few years later. She could see a little bit. Her hearing was far worse.

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Posted by BigDaddy on Tuesday, December 27, 2016 8:31 AM

ss122 Thanks for confirming that.  I have a question on optivisors but it would be best to start another thread for that.

Uncle Bob  Anyone reading this thread have left the gymnast phase of our lives far behind the caboose and are closer to the broken hip, ankle, wrist phase of life.  We don't want any broken hips in the forum.  They are far more serious than they sound.

Henry

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Posted by Uncle_Bob on Monday, December 26, 2016 9:44 PM

Another thing to consider is that sometimes your brain has trouble if you have two kinds of lenses.  For example, after my first eye was done, I was told that I could drop the left lens out of my glasses and keep missing them for my right eye till they could do the other operation.  That didn't go well because one eye saw objects at a different size than the other, and my brain couldn't compensate for the difference.  I dug up a couple old contacts for my right eye and, with my doctor's approval, used them till they did my second eye;otherwise, I would've been screwed.  Apparently this is a common problem because the implant t focuses things as larger than eyeglasses do. Make sure you discuss this with your surgeon, especially if you're thinking of implanting one near lens and one far lens.

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Posted by ss122 on Monday, December 26, 2016 8:21 PM

I do not implant multifocal lenses, though I know many excellent surgeons who do. Multifocals are composed of alternate rings that focus your eye at distance or near. Some people complain that they see rings around lights after these lenses are inserted. 

When you are looking at a near object , like that Kadee coupler spring you are trying to insert, through a multifocal implant lens, only the near light rays (only 43% of the total) are on focus on your retina. Some feel that this reduces contrast sensitivity.

Not to get too far into the weeds here but I feel that since we deal with lots of small stuff, a monofocal implant lens, with an Optivisor or similar near magnifier is the way to go.

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Posted by BigDaddy on Monday, December 26, 2016 5:36 PM

ss122
As an ophthalmologist and a model railroader I strongly advise you not to get one eye for distance and one for near.

So what's the scoop on the multifocal implantable lenses for a model railroader?  Is it, as I speculated above, a compromise in terms of precicse vision?

 

Henry

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Posted by riogrande5761 on Monday, December 26, 2016 5:14 PM

My dad had caterac's and got his lenses replaced.  Huge difference and tons better.

Rio Grande.  The Action Road  - Focus 1977-1983

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Posted by ss122 on Monday, December 26, 2016 4:00 PM

As an ophthalmologist and a model railroader I strongly advise you not to get one eye for distance and one for near. 

Having one eye see at distance without glasses and the other at near is called mono vision. It is commonly prescribed to contact lens wearers who get to the age when they need reading glasses. Some people love it, some hate it.

lf you hate it with contacts, you just replace the near seeing contact with a distance lens. Not easily done with an implant.

Also, if both eyes have distance IOLs implanted, when you put on your Optivisor, both eyes will be focused on your work, with good depth perception for fine work.

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Posted by ggnlars on Monday, December 26, 2016 3:00 PM

I think they implant a new lense regardless.  In my case, discussing what I do day in and day out, the best solution was one for distance and one closer.  I still wear glasses for the overall process.  Depending on your eye geometry, you may be able to have lense that allows you to ditch the glasses.  

My whole cost was basically a co pay.  Fancier lenses can add $2000 per lense.  I didn't have that choice, so did not question the cost.

So many trains, so little time,

Larry

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Posted by 7j43k on Sunday, December 25, 2016 12:14 AM

BigDaddy
I am lukewarm on the idea.  I had lasik and wanted normal distance vision. Back then I was young and in theory would be able to see near and far after surgery.

They over corrected me, making me farsighted, right worse than left.  I could see better with both eyes compared to either my left or right eye.  Two eyes are better than one!

In addition, binocular vision is important if you are into detailing engines, building structures or need to use binoculars to see the deer come out of the wood in failing light.  So I would never choose one eye near, one eye far. 

They can replace your lens at the time of cataract surgery with one that focuses both near and far.  It is considered elective and not covered by insurance.  I think they run a couple thousand each.  Because of my previous corneal surgery, I was not a candidate for those lenses, so I did not look into it deeply.

I would want to know that vision with those multifocal vision lenses was not making any compromises.  In other words for the convience of not wearing reading glasses, would I be getting just OK near and far vision.  I want the best vision possible, and if I need glasses to achieve that, I am OK with that.

 

 

It's been a couple of years since I had my eyes done.

I am not sorry that I kept each eye "matching".  We humans (and other mammals) have binocular vision for a reason.

Personally, I strongly suggest avoiding "fancy" lenses.  As I said earlier, I can see from 8" to arms length without glasses.  Farther with glasses (same as my whole life since 5th grade) and closer with Optivisor (same as what I'd been doing anyway, lately).

I believe I got the best possible solution for my cataract problems.  I have no regrets.

 

 

Ed

 

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Posted by cowman on Saturday, December 24, 2016 8:18 PM

Though I am not at the point of needing the surgery yet, the doc says the day will come.  Everyone that I have talked to was very happy with the results. 

I was complaining that these damnable blue headlights blind me, even on low beam.  In discussing it with others that have had the surgery it was mentioned that it had helped at least one other that had had the problem with those lights.  Any of you found this to be helpful or not with the blue lights?

Thank you,

Richard

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Posted by CentralGulf on Saturday, December 24, 2016 7:44 PM

Thank you. That's valuable information for those us who will have to make the decision.

CG

 

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Posted by BigDaddy on Saturday, December 24, 2016 7:06 PM

CentralGulf
One person in particular strongly advocates getting a distance lens in one eye and a reading lens in the other. She has no problems with the arrangement. Someone visiting here said she got the same thing and was barely able to stand two weeks after the surgery

I am lukewarm on the idea.  I had lasik and wanted normal distance vision. Back then I was young and in theory would be able to see near and far after surgery.

They over corrected me, making me farsighted, right worse than left.  I could see better with both eyes compared to either my left or right eye.  Two eyes are better than one!

In addition, binocular vision is important if you are into detailing engines, building structures or need to use binoculars to see the deer come out of the wood in failing light.  So I would never choose one eye near, one eye far. 

They can replace your lens at the time of cataract surgery with one that focuses both near and far.  It is considered elective and not covered by insurance.  I think they run a couple thousand each.  Because of my previous corneal surgery, I was not a candidate for those lenses, so I did not look into it deeply.

I would want to know that vision with those multifocal vision lenses was not making any compromises.  In other words for the convience of not wearing reading glasses, would I be getting just OK near and far vision.  I want the best vision possible, and if I need glasses to achieve that, I am OK with that.

Henry

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Posted by ggnlars on Saturday, December 24, 2016 2:52 PM

This surgery is one that is when, not if.  Medicare tends to cover most after 70.  Before that age, the supplemental insurance picks the largest share.  There are a lot of options. So you have to work with your doctor and understand what will be best for you.  

I had it done this last summer.  I see differently, and so much better.  It is a micro surgery and really easy.  Things can happen, so they usually do one at a time. The problem rate is really low, but it is best to be super conservative with your eyes.  

The clearity amazed me.  I saw colors and sights I had not seen in a long time.  Everything I do, including modeling trains is immeasurably more enjoyable.

So many trains, so little time,

Larry

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Posted by CentralGulf on Saturday, December 24, 2016 2:19 PM

mobilman44

Hi!

What a timely topic.  I was advised last week that I'm almost a candidate for the surgery in one eye.  

That's also where I'm at. Since it appears to be inevitable for me, I have been taking note of how others I know do.

One person in particular strongly advocates getting a distance lens in one eye and a reading lens in the other. She has no problems with the arrangement. Someone visiting here said she got the same thing and was barely able to stand two weeks after the surgery. Moving required her to hang on to things in order not to do a face plant. 

Has anyone here had that done, and what are your thoughts?

CG 

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Posted by HO-Velo on Saturday, December 24, 2016 1:07 PM

Being a very recent, yet resistant inductee into the cataract club I have found this thread to be encouraging and soothing, but at the same time another good reason to not "put off modeling until tomorrow what you can model today."

Thanks and regards,  Peter  

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Posted by Uncle_Bob on Saturday, December 24, 2016 7:40 AM

I had mine about a month apart, in Nov and Dec.  The left eye was worse, so it went first.  There were a couple problems with my right eye (the Versed wasn't as potent and the machine that feeds the new lens into the eyeball malfunctioned twice, causing more trauma), but it's coming along.  I go back mid-Jan to see whether I'll need prescription glasses or not because the right eye seems a bit weaker than my left.  I'm glad it was done because I hadn't noticed how much my vision had deteriorated till after the first operation.  Thanks for the encouragement, guys!

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