Regaining Sight After Cataracts

Explore cataract surgery options, lens types, and what to expect when regaining vision—tailored to individual needs and explained in clear terms.

Plain to See

Reading the fine print, driving at night, or recognizing faces across the room—these tasks become harder as we age. Often, the culprit is a cataract clouding our vision.

Healthy, youthful eyes are amazingly complex focusing organs. With little effort, they focus near and far with little thought. Over the age of 40, a condition known as presbyopia (literally, “aging eye”) creeps in. This is the loss of lens elasticity, making it difficult to focus on close-up objects. When these compound with other eye conditions like astigmatism and cataracts, seeing requires greater effort.

Astigmatism is an irregular curvature of the eye, often experienced as blurred or distorted text. Cataracts sound like a foreign object, but they are the same lenses that worked well in childhood. Now they are yellowing or cloudy, decreasing the amount of light and contrast.

Removing Cataracts

Since cataracts are the lenses we use for focusing, removal requires replacement with something—an artificial lens. Insurance companies often pay for monovision or blended vision. For patients with a dominant eye, two prescriptions are used—one for distance and another for intermediate. Some ophthalmologists will simulate with prescription contact lenses before committing to surgery.

In some people, having eyes that focus on different distances will cause depth perception issues. It may also be necessary to wear reading glasses or hold objects further away for clarity.

Although blended lenses sound complicated, it’s a common procedure, and most patients adapt over time—not noticing the focus difference.

Advanced Lenses

Toric lenses include the advantage of correcting astigmatism for sharper focus. Some insurance will not pay for this upgrade. Trifocals are rings of lenses that aim to provide clarity at three ranges: close-up, intermediate, and distance.

Types of Lens Replacements

Manual Monovision: Surgeon estimates lens strengths for each eye.
Computer-Assisted Monovision: Lens powers are calculated using precision mapping.
Toric Lenses: Correct astigmatism for sharper distance vision.
Trifocal Lens: Provide near, intermediate, and distance clarity—may cause night halos.
Light-Adjustable Lens: Can be fine-tuned post-surgery using UV light.

The trifocal rings can cause halos when viewing headlights at night. They may complicate computer work, depending on your setup. For patients with another common condition called vitreous membrane detachment, trifocals may amplify a kaleidoscope of internal aberrations called floaters.

Which Will You Choose?

For most people, the answer is simple: Whatever the insurance covers. In some cases, both replacement lenses are matched for the vision required most. So they may be optimized for distance, requiring eyeglasses for reading.

Of all the available remedies, none is perfect because a larger, natural, healthy lens has the ability to flex and focus. A realistic expectation is significantly improved vision at the prescribed focal distances.

Other people with multiple eye conditions might consider options like toric lenses with blended vision. The decision can’t be made by others who have gone through the procedure, since everyone’s stage of cataracts and comorbidities differs.

Ask your ophthalmologist about the full range of lens options available—and how they align with your lifestyle and visual goals.

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