51 years old, Farsighted, Astigmatism

If you are thinking about having Lasik, IntraLasik, PRK, LASEK, Epi-Lasik, RLE, or P-IOL eye surgery, this is the forum to research your concerns or ask your questions.

Postby capolst » Mon Feb 18, 2008 1:52 pm

Oops. I mean while searching :?
capolst
 
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Postby LindaT » Mon Feb 18, 2008 11:39 pm

There is so much to learn! I don't even understand the numbering or terminology for the prescriptions. +0.5sph - +0.5cyl in each eye, diopters, +175+100x180, +2+050x005, etc, etc, etc. What exactly should I ask my optometrist for when I go in on Thursday? Do I just ask for my prescription? I suppose I might want to know the thickness of my corneas and pupil size? Measurement of my astigmatism? I just don't know what I need to write down so that I can come here with all the pertinent info.

Walt: your advice sounds good to me. I wouldn't mind popping on glasses to drive if I could put makeup on without a magnifying mirror. It's a trade-off to consider. I just don't want to have to wear glasses to see my face in detail in the mirror. It just doesn't work.

Mack: After reading your post, I read up a little on Light Touch CK. It sounds interesting and worth looking into. Although, I wonder why one would want a temporary solution? Even three years? Do you go back for an enhancement when it starts 'wearing off?' I guess I have to check it out. But I thank you for bringing it up. I really want to know all my options.

Carol: How is your sister doing? You said her adjustment has been a struggle. How so? What is her experience? I agree with you about the contacts. No problem once they are in but it is a hassle putting them in and taking them out. I had a terrible habit of falling asleep with them in. Night after night. Got an infection once because of it. If I go the contacts route, I'll need to make a habit of taking them off in the late afternoon or early evening and wear glasses until bedtime. This is all such a drag, isn't it? I'm going to do some research on the CK procedure that Mack told us about. I also want to read up on refractive lens exchange as you mentioned. I'll let you know what I find out. I get so confused when reading about all the different options. The terminology is over my head, so I have to check definitions here and there as I go. So much fun! Where do you live? I'm in Orange County, halfway between Los Angeles and San Diego. You're in northern CA? You don't have to tell me. Just curious.

Thank you Mack and Walt for your input. You have given me lots of food for thought and several things to research. I really do appreciate it.
LindaT
 
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Postby capolst » Tue Feb 19, 2008 4:35 am

Hi Linda, My sister is doing much better. It's been right at 2 months. The one difference between my sister and me is that she never wore glasses except for drug store readers- so her vision was poor most of the time. I have been wearing progressive lens glasses for around 8-10 years & have had a really good match to my prescription. So.. I know what good vision is- she is just happy to be able to see better (not sure I want to do this just to be a little better- I'd like to be happy the majority of time). She thinks I should do it- I just need to be more sure. The monovision contacts are good a lot of the time, but there are some instances they're not as good as my glasses.
The dr. I go to doesn't do the CK procedure anymore due to the lack of long term results. I haven't been to see them since I've been reading about the Refractive lens exchange. This sounds promising to me- even if I have to wait a year or so (to see more data).
I am an hour east of Bakersfield in the mountains- technically we are considered "southern California" also. I would be willing to travel for an eye procedure to be sure Im getting the best. The dr. in Bakersfield is well-liked & very busy. I'm sure he's good.
As for your prescription, just ask your dr. for a card with it. I haven't gotten a card in years- but I also haven't asked for it. I am going to ask when I go for my next appt. in a few weeks. I just know what my contact strengths are- they have said these are identical to my eyeglass presciption.
I think it's great we're both in similar situations & can share our findings with each other.
Carol
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Postby Pappy » Tue Feb 19, 2008 4:51 am

I'm not entirely sure but I think IOLs require a general anasthesia, so it's not exactly similar to lasik / prk in that regard. I don't know any one who's done it but that's what my doc advised me after I asked (that in NY is also not something which can be done in a doctors office due to the anasthesia).
Pappy
 
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Postby capolst » Tue Feb 19, 2008 5:16 am

Pappy, Are you farsighted? Do you need reading glasses? Are you doing the surgery? Also, I have no idea how much this costs- do you have any idea? Thanks, Carol
capolst
 
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Postby Walt » Tue Feb 19, 2008 5:29 am

capolst wrote:Walt, Are you happy with your monovision Lasik where you'd recommend it? What was your prescription before Lasik? Did you have hyperopia w/presbyopia?
I do not have monovision. I have just been parroting what i have read from others. Before anyone tries monovision it is best to try it out with contacts for a couple of weeks to see if you are compatible with that setup.

I had myopia, both eyes were -2.5, after Lasik my eyes were overcorrected into Hyperopia +1 and +1.25. So right now I do have hyperopia w/presbyopia the result is +1.25 readers for computer and TV viewing and +2.0 readers for near vision reading.

I will have a retreatment to shoot for plano and hope that I am pushed slightly into myopia again, -.25 in each eye would be great. I don't want to ask for it though because while aiming for plano before I ended up with +1.25. At my age (49) I think I would be happy with any end result between 0 and -.75

Best of luck in whatever you decide to do.
Walt
 
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Postby Pappy » Tue Feb 19, 2008 5:40 am

capolst wrote:Pappy, Are you farsighted? Do you need reading glasses? Are you doing the surgery? Also, I have no idea how much this costs- do you have any idea? Thanks, Carol


I was near sighted, I had PRK done about 4 weeks ago (registered after figured one more voice for those of us healing can't be a bad thing).

I do not currently need reading glasses (37) but since refractive surgery greatly increases the odds chances are at some point I will.

My understanding of the IOLs (and it's the reason why I decided to have PRK this time is in the US the FDA approved them for high myopes (-10.5 and greater) about 2 years ago. World wide they are used for a variety of things. Originally I had researched Lasik and my corneas are too thin thought the IOLs might be an alternative and after consulting about 3 docs was told it would be an aggresive treatment for my nearsightedness (-5.25) as far as costs I don't know exact numbers but from all I gathered it would be on par with a normal surgery so guess 10k? I'm not sure I didn't get into pricing since no reputable doc would take my money to do it.

You can ferret out lots of information and I'm sure when LasikExpert dude gets back on the boards he probably has tons of answers on it.

Good luck with your research (I know I spent about 6 years researching and doubting to do it and finally found a doc who I felt comfortable enough with and "sold" my self on the risks).
Pappy
 
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Postby Walt » Tue Feb 19, 2008 5:53 am

LindaT wrote:Walt: your advice sounds good to me. I wouldn't mind popping on glasses to drive if I could put makeup on without a magnifying mirror. It's a trade-off to consider. I just don't want to have to wear glasses to see my face in detail in the mirror. It just doesn't work.
Personally I don't think I would want monovision.

Ideally I would want both eyes at -.5 to -.25, both eyes should easily be 20/30 or better in this range. This range would keep all normal activities from shaving to TV viewing without glasses. Glasses for driving may or may not be needed ( my eyes are 20/40 now and I have no problem driving without glasses. I guess at this level glasses might be required to make the most out of going to the theater or concert.

Maybe they will overshoot the mark a little during my retreatment and I will end up in that range.
Walt
 
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Postby capolst » Tue Feb 19, 2008 1:11 pm

Pappy- good luck in your healing. I believe I've read PRK takes awhile to heal. I think I've read PRK is best for nearsightedness. I think I realized I have plenty of time to make a decision & this helped take the pressure off of me. I CAN wear glasses & have good success- I just am hoping I don't have to.
Walt- I have been wearing moovison contacts as a trial & this is part of my hold-up in doing anything permanent- I'm not sure I want to live like this the rest of my life (it's fine w/contacts & I can take them out at night & wear glasses where I can see the same w/both eyes). This is also why I may be interested in IOL. I am interested in learning more about this. If I have to wear glasses for reading after a surgery, I might as well wear glasses all the time- with my distance vision only I can't read anything close-up!
Carol
capolst
 
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Re: 51 years old, Farsighted, Astigmatism

Postby Walt » Wed Feb 20, 2008 8:31 am

LindaT wrote:My biggest problem (or shall I say, pain) is not being able to groom my own face. Make-up, pluck eyebrows, touch-ups throughout the day, etc. I need my glasses on to see , but of course, as you know, you can't put make-up on while wearing glasses.

Linda check out these reading glasses made specifically to put on makeup. They might give you some relief from your "biggest problem"
Walt
 
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CK does not "wear off" in 3 years anymore

Postby Mack » Sat Feb 23, 2008 9:59 pm

>>>>>The dr. I go to doesn't do the CK procedure anymore due to the lack of long term results.

This is typical of docs who tried CK in the beginning of its development and then gave up on it when it didnt appear to be a longterm solution. Light-touch CK in the hands of the right doc has made CK correction much much more durable. The debate of whether it is permanent has invited more misunderstanding since it was developed as "Near Vision CK" to help baby boomers be able to treat the non-dominant eye for monovision reading so they could toss away their readers. But after the first pair of +1.25's and a few years go by, they started needing +1.5, then +1.75, etc. About every 2 or 3 years another 1/4 D has to be added on until about age 65 or 70 when the add slows down and tends to stabilize around +2.5 or +3. That gave light-touch CK the label of "temporary", when in reality the reformed collagen still provides its original correction, but the lens had changed and stronger and stronger reading scripts were required. Understand the reality of the human eye and the mechanisms that cause refractive error. Both the cornea AND the lens combine to produce refraction so that the images hitting the retina are in focus. As the eye ages, so do the refractive properties of both structures. As the Refractec website confirms, both hyperopia and presbyopia are "progressive diseases" and generally get worse as we age. The lens fills with protein, expands and hardens and the cornea thins, tending to make it flatter. The rate of progression vaires with all individuals. It is more the exception than the rule that as we age past 50, our distance vision remains unaltered or perfect 20/20 until we die due to natural biological processes. With that said, even most folks who get lasik and expect it to be "permanent" will likely see their refractive scripts change over time and will face the decision of getting enhancements or going back into glasses or contacts. Contacts for many folks over 50 eventually prove to be problematic as dry eye symptoms increase. Another down-side of aging eyes. I think CK is a very attractive option since it is generally cheaper than any other RS procedure and so much less invasive. It appears its corrective effects will likely outlast the natural biological refractive changes that most of us will face anyway. And, Refractec points out that CK can be easily redone a number of times if necessary without all the many down-side medical risks of redoing lasik, PRK or lens exchanges.

>>>>>I haven't been to see them since I've been reading about the Refractive lens exchange. This sounds promising to me- even if I have to wait a year or so (to see more data).

I have read where RLE that includes refractive correction typically costs about $10k per eye, so its about 4 to 8 times more expensive than lasik or CK. And with RLE, you still need readers if both eyes are treated for distance 20/20. I do not think RLE is generally recommended for monovision, because presbyopia is continuously changing the refractive error for close vision.
Mack
 
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Postby LindaT » Mon Feb 25, 2008 12:21 am

Hey there! I'm back. Are you guys still out there?

I have my prescription now. Carol, earlier you asked what my prescription is, so here it is...

distance:
R/ +325sphere; -125cyl; 002axis
L/ +275sphere; -200cyl; 180axis

reading addition:
R/ +200
L/ +200

Does this make sense? It's all Greek to me.

How are you doing?
LindaT
 
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Postby capolst » Tue Feb 26, 2008 3:36 am

Hi Linda, I was wondering how your appt. went. I think your prescription makes sense to me- it's been a long time since I've asked for a card. I am guessing you are a little more farsighted than me, but our reading prescription is probably close to the same strength.
I go again next week & am going to ask for my prescription & then we can compare. Have you thought any more about Lasik? One day I think no way & then another I think, maybe. It's hard for me to know if some of the problems I am having are what I'd experience w/Lasik or if they are symptoms of dry eyes + contacts. Dry eyes are another complication I've noticed people write about on these boards. I already suffer from dry eyes w/out surgery!
It scares me reading these boards about all the different problems people are having after their surgery! What are your plans right now- are you still just waiting & researching? Keep me posted.
Carol
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Postby LindaT » Tue Feb 26, 2008 7:30 am

Hi Carol,

Well, since I want to use a flexible spending account to pay for it, I am forced to wait until at least July 1, when my account kicks in. Open enrollment for our insurance is in June and the new plans go into effect on July 1. Meanwhile, I'm searching for THE answer. I'm exactly like you in that one day I feel that NO WAY do I want to do it, and then other days I feel that it's the answer to my prayers.

I did walk away from my recent appointment with a good feeling though. I really like my optometrist and her associate is the one who does the surgeries. He consulted with me and gave me renewed hope that monovision could work for me. Previously, one of the LASIK offices I consulted with told me that monovision wouldn't work well for me because the big HEAVY specs they adjusted for my prescription and had me wear while walking around their office made me dizzy and crosseyed. They decided it wouldn't work. The doctor I talked with last week said those glasses are NOT a good test for what will work. I need to test it out with contacts. He said we just need to find a comfortable "number" for my reading eye and that's it. He said the distance prescription is easy. My optometrist had to order a lens in a power she wanted to try for my reading and tomorrow I go in the office to try them out. I'll wear them for a couple days (hopefully they aren't hard contacts) and if I'm happy with the quality of vision (irregardless of comfort) then that's what we're looking for. Anyway, we'll see. Ha! No pun intended! I still may end up not getting monovision. He said if we correct with LASIK for distance in both eyes, my astigmatism would be much improved or gone, and then it would most likely be easier to fit me in a comfortable pair of contacts. I could try out one contact for monvision, or use reading glasses. I guess there are still options to explore. But today, I don't think I want LASIK. It's scary that we could be trading one problem for a bigger one. I think my quality of life is less than it could be because of my vision, but I don't think my quality of life is terrible. OH, I just don't know what to do.

Okay, now for a stupid question: Is my prescription in my last post, +325 really +3.25? And so forth? There is no decimal point on the prescription card.
LindaT
 
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Postby Mack » Tue Feb 26, 2008 7:31 am

If you have dry eye problems now pre-lasik, your post lasik experience is almost guaranteed to be difficult and could easily be a living hell. Without proper and adequate tearing support, your post lasik refraction will not be accurate. The tear film makes up part of the correction. Having to put in drops every hour or even more often is a real pain. Some lasik patients never fully recover their normal tearing function after lasik cuts the corneal nerves that supply the signals for more tears. Just another reason both of you gals should check out light touch CK. Your scripts appear to be within correctable range for CK. No cutting or corneal surface disturbance with CK means no interference with tearing. You just need to find the right doc. But even if you choose lasik, getting a very experienced hyperopic specialist is crucially important. Too many lasik docs who do thousands of routine myopic corrections with perfect results all the time get a rude awakening when doing higher orders of h-lasik with astigmatism. Too many have under-corrected these scripts and do not allow for enough regression. The astig is always a big wild card making it much more difficult to predict the correct amount of ablation and regression.
Mack
 
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