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Cataract replacement

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Old 9th Oct 2018, 04:52
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Cataract replacement

Has anyone had both cataracts done almost at the same time, or separated by a few weeks
when only one eye was showing slight damage?

The more I read the more benefits there are to getting both done.
Over the last few years, I've noticed that night vision reducing,
the blinding effect of oncoming lights etc.

CASA appear to rule the multi focus lens illegal for pilots.
The result of the tests between the multi and single focus lens appear to be significant.
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Old 9th Oct 2018, 05:11
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when only one eye was showing slight damage?
I'm not an optho but...I wouldn't be doing a good eye! It's low-risk but nevertheless a risk.
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Old 9th Oct 2018, 05:37
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I had both done 4 days apart(to make sure no infection.).Best thing I ever did,after the first one (took 30 mins!) I came out of the hospital and started laughing ,my wife said whats up?Look at the colours !I realized how much my cataracts were affecting my eyesight then.
Of course I am not a pilot but I don't think its a big risk and cataracts will get worse.
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Old 9th Oct 2018, 07:39
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The odds of an infection is .1%, and its generally bacterial, and treatable.
If you follow the directions and have the follow up checks that risk drops again.
The reality is everyone sooner or later gets Cataracts.
I had was subject to a lot of sunlight for a long time, and the eye it started in
is the side that was subject to that sunlight.

It's also a matter of pain. It hurts to have oncoming lights, especially the high beamers.



Originally Posted by Capn Bloggs
I'm not an optho but...I wouldn't be doing a good eye! It's low-risk but nevertheless a risk.
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Old 9th Oct 2018, 07:59
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I'm surprised you want them replaced not removed

hat, coat, door
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Old 9th Oct 2018, 08:02
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If you are aircrew you need to check the requirements of your CAA. In UK you must allow a minimum of six weeks between the two and can only have single focus lenses installed.

I needed both doing, due to advancing years and a previously undiagniosed genetic problem. My ops were done seven weeks apart. I now have the long distance vision better than most teenagers, but still need weak reading glasses.
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Old 9th Oct 2018, 09:32
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Had my left eye done approximately 12 months after the right eye.

Look at the colours !I realized how much my cataracts were affecting my eyesight then.
Oh yes!!!My right eye was the first to be done and I only realised just how bad it was when about a week prior to the Operation I went out to the local Rifle Club for a shoot. I got down onto the 600 yard mound and could not even see the target butts, let alone the target!! Just one whitish opaque blur! Trying to shoot with both eyes open (which I normally did, and continue to do) did not help!

Once the op was done, it took quite some time to get over the vivid colours of....well. everything!

And after the left eye was done, it was even more so. And now I have 'perfect' distance vision and only need glasses for reading.

All CASA wanted was a short report from the Surgeon who performed the operations.
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Old 9th Oct 2018, 13:56
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Probably the most common medical procedure in Australia with very low risk of complications and a terrific eyesight improvement. I had both done (L -1998 R - 2000) with the second cataract barely evident at the time of the first and the ophthalmologist was reluctant to touch it. In hindsight (no pun intended) I'd have had them done together.
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Old 9th Oct 2018, 15:29
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Thanks Ovation,
Its amazing how optometrists do not tell you about cataracts. I had to repeatedly ask questions to find out
that yes, I had early cataract symptoms. To me its a very serious issue. To Optometrists everyone over the hill
has cataracts in some stage but its not "medically necessary" until you can't drive, very different to flying.

It's obvious that they are generally oblivious to the safety issues of how a slow deterioration can affect driving and flying.

Eyesight tests do not test in "low light", they don't
test for vision under glare, they don't for example simulate a darkened cockpit and what brightness level is needed to
see a glass panel, nor do they test your ability to read the fine print on an approach chart at night in reduced lighting.
Its these kind of practical tests that I think every older pilot should try out with a younger pilot to compare vision.
That's what I did and just thought it was solely related to age, not the effects of cataracts.

The referral route is slow. Optometrist told me to get it from a doctor. Doctor asked why the optometrist did not make the referral
to the specialist, then the specialist tells you "you don't need them replaced yet", It's like talking to a brick wall and now have to wait
for ophthalmologist to send off a referral to an eye surgeon who the secretary says will draft and sign it in "the next few days".]

The pilot advice is overwhelmingly to get both done together ASAP.


Originally Posted by Ovation
Probably the most common medical procedure in Australia with very low risk of complications and a terrific eyesight improvement. I had both done (L -1998 R - 2000) with the second cataract barely evident at the time of the first and the ophthalmologist was reluctant to touch it. In hindsight (no pun intended) I'd have had them done together.
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Old 9th Oct 2018, 17:29
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Had my right eye done (IOL inserted) because it needed doing. Not the result I expected I am afraid. My vision was over corrected with the result that my right eye focuses past infinity. As you know there is not a lot further away than infinity!

One reason you you might want to get an IOL in an eye which does not have cataracts is to balance your eyes. It is quite a challenge to have +0.75 in one eye and -3.50 in the other. Contact lenses are fine but using glasses leads to a lot of double vision.

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Old 10th Nov 2019, 07:45
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Having had the lens replacement surgery over a year ago, and being issued with a CASA Class 2 medical with the restriction of Day, VFR only, I was wondering if it would be possible to get these limitations removed and restore my Class 1 medical?

Last check was 6/6.

Does anyone know if the FAA is any more practical?
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Old 10th Nov 2019, 23:20
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My left eye was done at age 27 in 1992 and resulted in 2.5 diopters of astigmatism, which was disappointing, but otherwise good corrected vision. My right eye hasn't been done as I have no cataract in it.
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Old 11th Nov 2019, 00:00
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Had both done....but 6 months between the two. Mind-boggling the difference it made for both night and day.
Very pleased with the result. I chose a 'long range ' lens for flying and driving.
Even for that, small print is only out of focus about 12" or closer.
Best investment I ever made.!
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Old 15th Nov 2019, 05:50
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I had my right eye done and was going great guns until I suffered a detached retina with 4 tears. Another op followed with resulting inflammation. This was not resolved after 5 months so it was decided to do a retinal peel. 4 months later still have returning inflammation. Associated with the inflammation is a distorted retina and constantly changing vision and fluctuating eye pressure.

I had to give away any possibility of getting my medical back.

So beware there can be complications post op if you are as lucky as me. Not common but possible.

FYI the usual cause of a detached retina is eye trauma or after cataract surgery. Retinal peel is removing the scar tissue from repairing a detached retina, but not always. Dr Google has some good info on these subjects.

​​​​

Last edited by olderairhead; 15th Nov 2019 at 06:03.
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Old 18th Nov 2019, 00:38
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Another question about cataracts and medicals. Is it best to get it done before you are at the limit (or past the limit) to hold a class 1 medical? I am thinking in the worse case scenario something goes wrong in the surgery or post op. How would our loss of licence look at the case?
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Old 18th Nov 2019, 05:25
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Bull atta gate. Please explain how yr new fixed lens can focus..past infinity. !
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Old 18th Nov 2019, 12:08
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Originally Posted by aroa
Bull atta gate. Please explain how yr new fixed lens can focus..past infinity. !
Too much - correction, thus requiring a + lens, usually required for reading, just to bring focus back to infinity.
A camera lens typically has a stop to prevent movement of the components to a point where the lens is focused beyond infinity, but there's no reason it cannot happen in an eye.
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Old 19th Nov 2019, 00:19
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Where is "infinity". I suppose we'll find out when we pop our clogs.
For a lens where you can adjust the point of focus...and the f stop / iris, you can vary the 'depth of field'. ie that only which is in focus/ sharp to view within that range of distances
I my case I got 'distance' lens replacement, which has given me a 'depth of field' for a region of sharp focus capability from 12" to as far away as you can see with the human eye from this planet ..eg sharp stars ie at infinity.

A large format aerial camera has a fixed focal length for imaging distant objects..ie the ground 2 miles below...but far enough away to be regarded as 'infinity' from that perspective.
With this camera, for a vertical air to air shot, with a very small iris, one can work out the depth of field...since you cant 'focus'/ change the lens position. The subject aircraft can then only come into the range near the close limit of focus say 200ft , any closer and the image will be unsharp.
Perhaps the 'beyond infinity' result means that lens was wrong for the users needs.
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Old 22nd Nov 2019, 22:31
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I Had retinal detachments about two years apart. The first required emergency surgery the second did not. The surgeon, who did a fantastic job, told me to expect a requirement for cataract replacement surgery approximately two years post detachment surgery. He was spot on and the lens replacements were brilliant. CASA intially required a full eye specialist check and report every year, for Class 1 medical, and then dropped that requirement after three years. My specialist tells me that I enjoy better vision than 97% of the population although I do require reading glasses because I choose lens that give me excellent distance vision. So in closing just get the lens replaced at the earliest opportunity as you wont regret it.
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