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Dr. James
Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2282
Experience:  Eye Physician and Surgeon
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I had a cataract removed from my right eye 8 months ago w/

Resolved Question:

I had a cataract removed from my right eye 8 months ago w/ lens replacement. Every one I know of (including my husband who had the surgery yesterday on one eye and is already seeing good enough to be legally driving w/o glasses) gets much improved vision. I have not, in fact the vision is only slightly better in the right eye than the left, little change in my glasses prescription and I certainly cannot see w/o the glasses. I am not happy with the doctor's response to that. What would you say?
Submitted: 2 years ago.
Category: Eye
Expert:  Dr. James replied 2 years ago.

Dr. James :

Hello.

Dr. James :

What exactly was the doctor's response?

Customer:

my left eye cataract is not ready to be removed and so the right eye vision cannot be corrected very much - it would be uneven.

Dr. James :

What level of vision do you have in your right eye?

Dr. James :

20/20? 20/40?...

Customer:

I dont know but I have my scrip - can I give you numbers from that? FYI - I am switching doctors . I am very happy about my husbands outcome but it made me a little sadder today about my own.

Dr. James :

The script would not help me much.

Dr. James :

When you cover your left eye, describe what you see out of the right eye.

Dr. James :

is everything blurry at all distances?

Customer:

no

Dr. James :

No?

Dr. James :

meaning it is clear out of the right eye?

Customer:

no

Dr. James :

I'm not sure if I am understanding you.

Dr. James :

Were you expecting to see well without glasses?

Customer:

I am near sighted. With my glasses off I can see only about 10 feet which is better than the left eye. Can I say this any better?

Dr. James :

Did your doctor promise you good vision at distance and near?

Customer:

Promise? We were not going for better near vision - better distance. Maybe this was not an appropriate question to ask on this forum.

Customer:

I guess I should say I do not recall him "promising" anything.

Dr. James :

Can you tell me what the numbers on your script is?

Customer:

SPH - right-3.00; left-5.00. Do you want all columns?

Dr. James :

no, that should be fine.

Dr. James :

Did you ask your doctor if he intended to leave your right eye near sighted or if he was targeting good vision at distance?

Customer:

no - I didnt know there was a choice. Do you think I am stuck with this or can I ever have the replacement replaced

Dr. James :

In general, when cataract surgery is done, the target is to have little prescription left over -- meaning distance is good at distance and you would need reading glasses to see up close.

Dr. James :

The difficulty in your situation is that your left eye is very near-sighted.

Dr. James :

So, if the right eye had little prescription, and the left eye was -5.00, then you would not be able to tolerate glasses.

Dr. James :

The option in that situation would be to wear a contact lens in the left eye or proceed with cataract surgery in that left eye earlier than intended.

Dr. James :

It appears that your doctor left the prescription nearsighted in the right eye on purpose, so that the two eyes would be closer together in prescription.

Dr. James :

So you have a couple of option at this time.

Dr. James :

You can consider exchanging the lens implant in the right eye for a different lens. by doing this, however, you may need to have surgery in the left eye as well to balance out your prescription.

Dr. James :

You may consider LASIK in the right eye to achieve the same purpose of reducing the prescription, without the added risk of intraocular surgery.

Dr. James :

third option would be to wear contact lenses in both eyes.

Dr. James :

I have performed many cataract surgeries. I talk to all my patients in detail about target prescription and what implications that may have on the unoperated eye.

Customer:

well - I guess part of my problem is communication because I have not understood it at all. Also, to be honest I did not feel comfortable with this doctor. He did tell me that if I had an extra few thousand I could get LASIK.

Dr. James :

Exchanging the implant is an option, but carries risk of intraocular surgery.

Dr. James :

It is possible that the doctor did not explain in as much detail as he needed to.

Dr. James :

because of your pre-existing near sightedness, there are many options in terms of which way to proceed with the lens implant.

Dr. James :

that why it is important that i include my patients in the decision making process as to what type of lens i implant.

Dr. James :

a second opinion with an in person exam is helpful.

Customer:

ok thanks

Dr. James :

You are welcome.

Please remember to press ACCEPT so I can get credit for assisting you today.

Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2282
Experience: Eye Physician and Surgeon
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