astigmatism, diagnosis and treatment, cataracts

[notrub]

On 11/21/2019 at 7:21 PM, Thomas J said:

I have the need for corrective lenses for distance, reading, and I have astigmatism.  When I was younger I had laser surgery to correct the astigmatism and the distance vision.  I can tell you I wish I had never done it.  Yes for a period of time, I did not need glasses to see distance.  However, immediately I needed glasses to read with.  When you are older Presbyopia causes you to lose the focus ability close up and the laser surgery to correct distance then unmasks the Presbyopia if you are near sighted.  You will get the same effect if you wear single vision glasses for distance.  You won't be able to read.  Now my corneas are flat and contact lens do not fit properly.  I can not use the new multifocal contacts.  If you have astigmatism and need correction for both distance and reading you can try the TORIC lenses.  Multi-Focal to correct both distance and close up.  Also, try mono vision.  One contact in dominant eye for distance, one in other eye with prescription for reading. The TORIC lenses correct for astigmatism and should help with the starburst effect at night. 

Regarding cataracts, my closes friend is a Ophthalmologist.  He said that you want to do cataract surgery only when the cataracts are so bad that they are impacting your life.  In the meantime stick with glasses or contacts.  He stated that though cataract surgery is very simple, getting the correct lens replacement is inexact and made more difficult if you have lasik surgery. He said that he would never recommend multi-focal lenses for cataract correction.  He said they are far too difficult to accurately fit.  He said when absolutely necessary do the cataract surgery but go with single vision and then rely on glasses to read.  The likelihood is that you will still need some glasses to make you 20/20, correct for the astigmatism, and have added power for reading. 

 

Exactly what the doctor said.  Thank you.

[atyclb]

On 11/23/2019 at 7:36 PM, notrub said:

I see on their web site that there is a full eye examination special price for 11,000 baht but the fellow at their phone centre in said a simple exam would be around 2 to 3,000 baht.  Any comments?

 

 

the 11000 baht exams include use of rather expensive machines, namely the one that does oct. some of the studies done are the same ones done when evaluating someone for lasik surgery or other refractive procedures and none of the machines are cheap.  oct can detect some diseases very early even before they become symptomatic. 11000 exam could be worth it depending on medical history and age. in the usa an otherwise healthy person without vision symptoms seeing an optho for routine check would not go through so many extensive studies. would be overkill for some and could be justified for others.  an analogy would be a hospital offering a total body mri scan package, sounds nice but in reality the indications to scan everything as part of a routine checkup are simply not present. any/all tests should have a rationale or justification.

 

fairly simple exams can detect a cataract and if surgery is deemed necessary then some of more advance studies are done as the pre-operative workup