Cataract surgery: Better to have a lens to focus far or near?
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For an upcoming cataract surgery, I have to choose if I want a lens that can focus far or near. For GA pilots, what makes the most sense? The ophthalmologist said he can focus to any distant I want. 

I suppose either way, I'll need glasses to compensate for whatever distance isn't optimal, but is there a preferred distance for pilots? Thank you!  

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1669 Posts

@Michael Bellino
Talk with your eye doc about the monovision option, where one eye is set near and the other distant.  The FAA allows you to fly with that after a 3-6 month adaptation period.  They don't allow that option with contacts as you'll be switching back and forth every time you'll insert/remove the lenses so adaptation doesn't occur, but it is an option with IOL's. Talk to Bruce Chien (www.aeromedicaldoc.com) for more details on the FAA process involved with that option.

That said, after experimenting with multiple options to correct my very poor uncorrected distant vision complicated by the onset of presbyopia, I've settled on distant vision contacts for normal use plus reading glasses for near vision as needed.  I would not want to have to go back to wearing glasses most of the time, especially for outdoor and sporting activities.  When the time comes (as my ophthalmologist says it will) that cataract surgery and IOL's are needed, my plan is to continue the same idea – implantation of distant vision IOL's with supplemental reading glasses as needed.

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@Michael Bellino A lot depends on your current vision.  I have glaucoma in my left eye and drops accelerated the cataracts in that eye.  However, since I had 20/20 vision in that eye (before the cataracts developed) and do not need reading glasses, he gave me a lens that helps me see better at night.

He also said that he have some patients that only need surgery in one eye that will pick a lens that does not compliment the other eye.  When this is done, the other eye will try and compensate which can  make things worst.  Something else to consider unless you are having both done.
 

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There are multifocal lenses on the market. You may wish to ask your ophthalmologist about that option
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@Ronald Levy
I have been flying with monocular vision with a single contact for more than 7 years  (and living with for 15 years) . It is wonderful. Born with amblyopia (lazy eye) so right eye is poor vision. Ophthalmologist years ago said try making the weak right eye the reading eye. So I have a 30 day contact always in the right eye and set to proper distance for computer (which is similar to plane). It is great. I did get a 3rd class medical before Basic Med came out but now basic med.  I see 20/20 left eye at distance and perfect reading with right eye.  I do keep a pair of cheater glasses in the plane just in case I rub the contact out or get something in my eye for backup.  Also have wetting solution as the contact tends to dry out at altitude (also commercial flying). NO GLASSES.  It does take several weeks to get used to it. And even now when I have the contact out for a few days (if my eye is bothering me), it takes 48 hours for brain to re-equilibrate.  Is it good for you? That ophthalmologist has his wife set up the same.

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1669 Posts

@Randy Sheidler
Are you flying with multifocal IOL's?  Literature suggests they may not be the best choice for flying.

See “Are you a good candidate…”

 I tried multifocal contacts and found them inadequate for flying/driving as the distant vision clarity was less than great, especially at night.  In the plane I was having trouble spotting traffic and in the car I couldn't read street signs well enough.  That moved me to go back to single vision distance contacts and accept the penalty of needing reading glasses for near vision.  I suppose multifocal IOL's  might work better than contacts, but I'd like to hear about actual experiences flying with the IOL version.

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@Michael Bellino
Multifocal IOL technology is better than MF contact lenses.  CL's can develop film, and move with the blink, whereas MF's don't.  In addition, the MF technology has improved, the Alcon PanOptyx and Vivity are great lenses, the Restor is an older version that caused excessive glare; in addition, the JnJ Eyhance is not a MF, yet gives slightly increased depth-of-focus over a single vision IOL, as does the new RxSight Light Adjustable IOL.  You need to consult with an eye surgeon who is familar with all the options, not only monovision (which works great and you could do a CL trial to test it, prior to making a surgical decision).  I'm an ophthalmologist.