Sorry I am just getting back to the discussion.

Wow, Jim!

Thank you so much for this information.

The Toric lenses sounds wonderful. However, I do not have an astigmatism.

Monofocal may be the best one for me. I would have to decide which distance
best suits me. I plan on working traditionally in my retirement i.e. Canvas
and board w/ traditional paints and sculpting. With the Monofocal lenses
would I need glasses to paint if I had a portrait commission?



On 8/11/16 12:18 AM, "James A. Perkins" <[log in to unmask]> wrote:

> Hi Linny, 
> I've done quite a bit of research on this topic for myself and for others. I
> developed cataracts in both eyes in my late 40s and had both eyes done. My
> brother also had both eyes done in his 40s (bad eyes seem to run in my family
> since both of us also developed retinal detachments in our mid-50s). And I
> spent MANY hours discussing this topic on the phone with our former listserv
> pal, the late Liz Day, before she had both of her eyes done. Liz was
> particularly concerned about the effects of certain lenses on contrast
> sensitivity and color perception.
> You basically have five options for intraocular lens replacement:
> 1. Monofocal. This is the simplest type of lens that focuses at only one
> distance. You can choose to have the lens focus at any focal length you want -
> near vision, distance vision, or even intermediate distance.
> 2. Toric lenses. This is a type of monofocal lens that also corrects for
> astigmatism. If you have an astigmatism, these work really well, but they have
> to be positioned very precisely within the eye. Make sure your surgeon is
> certified to implant these and has lots of experience with them.
> 3. "Monovision". I think this is a poor term because it sounds so much like
> monofocal. This is what others have described where you put a distance lens in
> one eye and a close up lens in the other. As others have said, this can be
> difficult to adjust to and may not result in good vision at ANY distance. I'm
> not sure why some doctors push this option since I've never heard anything
> good about it.
> 4. Multifocal lenses. This sounds like what you were talking about. These
> lenses literally split the light coming into your eye into multiple beams with
> different focal lengths. I'm aware of two such lenses using slightly different
> technology. The AcrySof Restor depends on differing lighting conditions to
> change the focal length. For example, in bright light, the pupil constricts
> and the light is directed through the center of the lens onto the fovea for
> better close-up vision. In low light, the pupil dilates, allowing more light
> to hit the edges of the lens, which focuses it for distance vision (this is
> great for driving at night but what if you happen to be driving in bright
> light?). The other option, the Tecnis Multifocal, uses somewhat different
> technology that supposedly doesn't depend on differences in lighting
> conditions. Multifocal lenses are very popular because they free people from
> having to wear glasses, but I don't think either of these is a good option for
> an artist. Because the beam of light is literally split into different focal
> lengths, less light hits the retina at any given spot. According to the
> research I read, this results in reduced visual acuity and reduced contrast
> sensitivity (i.e, reduced ability to tell the difference between subtle shades
> of gray or colors).
> 5. Accommodative lenses. When we are young, the lens in our eye is small and
> flexible. There are ciliary muscles in the eye that can stretch and relax the
> lens to change the focal length, allowing us to easily change focus from near
> to far. This process is called accommodation. The Crystalens and Trulign Toric
> (both from Bausch & Lomb) flex with changes in the ciliary muscle, similar to
> the eye's natural focusing mechanism (these two lenses are identical, but the
> Trulign Toric also corrects astigmatism). There's just one problem. According
> to my doctor, by the time most people need cataract surgery, they have already
> lost much of the ability to accommodate. This is because the lens continues to
> get thicker (and more stiff) as we age, and eventually the ciliary muscles
> just stop working. This is why so many people develop presbyopia later in life
> and need glasses for both near and far vision. Even in my 40s my doctor didn't
> recommend this option for me. I also read some research that, similar to
> multifocal lenses, accommodative lenses give poorer contrast sensitivity than
> plain old monofocal lenses. Again, not a great thing for an artist.
> After doing lots of research and discussing this at length with two eye
> doctors, I decided to go with monofocal lenses with the same focal length in
> both eyes. I did have an astigmatism in my right eye, so I had a toric lens
> put in that eye. It completely fixed the astigmatism.
> When choosing a monofocal lens, most people choose either distance (for
> driving) or close-up vision (for reading). Since I do all of my artwork on the
> computer, I told my doctor to give me lenses with a focal length of about 30
> inches - the distance from my face to the computer screen. I wanted to be able
> to work all day without glasses, even if it meant wearing glasses for distance
> and reading. As it turns out, this was a pretty good compromise because my
> close-up vision is good enough to read anything except the tiny instructions
> on medicine bottles and my distance vision is good enough to drive without
> glasses.
> Jim
> James A. Perkins, MFA, CMI, FAMI
> Board Certified Medical Illustrator
> Fellow, Association of Medical Illustrators
> Professor and Graduate Director
> Medical Illustration
> Rochester Institute of Technology
> CBET 75-2129
> 153 Lomb Memorial Drive
> Rochester, NY 14623
> [log in to unmask]
> On Aug 10, 2016, at 10:26 PM, Linda Heagy wrote:
>> Re: [SCIART] Discussion: Cataract surgery for artists
>> Hi Linda, 
>> I will have both eyes done, but not at the same time. ... I thought they
>> could put in a lens that had both far away AND up-close vision in each eye?
>> Good point, Linda. I may be confused about the procedure and lenses. I was
>> thinking that there was one lens that had the ability of both focal powers of
>> far away and up close. I was not thinking of having one focal for distance in
>> one eye and one for close-up in the other eye. No, that does not sound like a
>> promising solution to me at all !
>> My last year visit with doctor alluded to coming new advances in lenses and
>> cataract surgery. Just how soon, I do not know and what those advances are.
>> So I was hoping I could hold out till those new advances were available....
>> If they are even beneficial to me.
>> Have you had cataract surgery and were you satisfied with the results?
>> Best,
>> Linny
>> ___________________________
>> Linny Heagy
>> DBA: Linny/Designer, Illustrator
>> Arlington, TX
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