Ask the Expert: If I have cataracts surgery, will I need glasses afterward?

Answers by Mitchell Gossman, MD, an ophthalmologist at Eye Associates of Central Minnesota, located in St. Cloud

Question: If I have cataracts surgery, will I still need glasses afterward?

Answer: Perhaps not, read on...

Cataracts are a cloudy lens on the eye. Surgery removes the lens and replaces it with a clear, artificial lens. Stock photo

First, some background. Cataract surgery involves removing the natural lens of the eye that has become cloudy and replacing it with a clear, artificial lens implant.

These are the most common reasons you might need glasses before surgery:

1. Myopia, also known as near-sightedness, is where you have blurry vision in the distance and need to wear glasses to see far, but you can remove your glasses and having things in focus somewhere up close. This point where vision is clear may be excessively close, such as near the tip of your nose, and may not be useful, but if you are mildly near-sighted you may be able to read comfortably without your glasses.

2. Hyperopia, also known as far-sightedness, results in distance vision being blurry and near vision being even blurrier.

3. Astigmatism is caused by the cornea of your eye not being round, but instead football-shaped, so it doesn’t focus light clearly at any distance, and this may be corrected in glasses or contacts.

4. Presbyopia. This is the condition where you can have relatively good vision in the distance, but you require glasses to read, most commonly after age 45.

When you have cataract surgery, if you require glasses before surgery it is possible to place a lens implant that corrects these conditions to give you better vision without glasses.

If you are far-sighted and this is corrected with cataract surgery, you will see better in the distance, but will still require glasses to read.

If you are near-sighted and this is corrected with cataract surgery so you see better in the distance, that’s terrific, but you will no longer be able to remove your glasses to read up close.

If you have astigmatism, this may be corrected with a special lens implant called a toric lens and will provide clearer vision without glasses than a plain lens implant.

For presbyopia, the challenge is to be able to use lens implants so that you can see both distance and near without glasses. There are two ways to accomplish this: First, you can correct one eye for distance and make the other eye near-sighted so that it can see for reading. This is called monovision, and most patients do well with this, but it does compromise depth perception and is not for everyone. The second way is to use a specialty lens called a multifocal lens implant that provides clear vision at both distance and near in both eyes. These types of lenses are not covered by insurance, however, so there are out-of-pocket costs.

The key questions to ask yourself are:

1. Would I prefer to see clearly in the distance without glasses, and accept wearing reading glasses or bifocals for reading?

2. Would I prefer to see clearly for near activities such as reading without glasses, and accept wearing glasses to see in the distance?

3. Do I “want it all,” clear vision at both distance and near without glasses. And am I willing to pay additional fees for procedures not covered by insurance?

Your ophthalmologist can more easily plan a strategy best for your own needs if you have thought about these options before being seen for evaluation.

Find out more

Mitchell Gossman, MD., and Andrea Joplin, MD., are ophthalmologists at Eye Associates of Central Minnesota in St. Cloud, Minnesota, and see patients from all over Central Minnesota and the St. Cloud area. They accept new patients, and appointments may be made at 320-774-3789.

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