The Costco Effect - Eyeglasses

#15

My opthamologist did the opposite. My distance vision is good now with no glasses (except mild astigmatism that is correct very well with glasses) but I need reading glasses now plus computer glasses that let me focus between ~2-3 feet. Then I needed to learn how to put glasses on and take them off without banging me hearing aids. :roll_eyes:

The hard part was for the first 66 years of my life I was nearsighted, could read fine, needed glasses for all other activities, including driving. Then I had two cataract surgeries a month apart and became farsighted. That month in between was crazy since neither old glasses or new readers could be used with both eyes. I would close one eye or the other depending on what I was looking at.

#16

Also @teejayess. I’m not sure that the IOLs (the plastic lenses inside the eyes), had evolved enough to deal with my astigmatism when I had my first cataract operation some 7 years ago. They alleged, however, to be able to be made multifocal. My astigmatism is mild, but I still notice quite a difference between glasses and no glasses at distance. So, even if I sprang for the multifocal, I’d still have to wear glasses because of the astigmatism.

I didn’t trust the multifocal option because of a horrible experience some dozen years ago trying to wear graded-index lenses. Basically, they don’t work all that well. They may be better, but I couldn’t even read a book without having to move my head back and forth; I couldn’t share music with other people; I couldn’t see road signs unless I twisted my head severely, thereby taking my eyes off the road for too long to be safe, etc. So, finding Zenni was a godsend. I have all these inexpensive sets of glasses located where I’ll need special help, a pair at church for handbells, a pair on the mantle piece if I’m using a lap top, a pair in my gig bag for when I go play with the geezer band, a pair by my computer, etc.

When I had my first cataract done, I walked around with my glasses on, but with one lens missing. This worked pretty well. I learned to read with one eye. I might have looked weird, but I expect most people didn’t notice. People just don’t. I wore hearing aids at handbell rehearsal for some five years before anyone actually noticed I was wearing them. I’ve never understood why people are so shy about wearing HAs. Deafness is much more noticeable than is help for deafness. People are weird.

#17

I wore multifocal contact lenses for years. If the IOL multifocal lens works like contact lenses I would definitely go for that if I have cataracts.

#18

My research to date is pointing me toward an aspheric toric IOL to correct my astigmatism and distance vision. It will mean I will still need correction for reading. But, I will need correction for distance and reading for at least some time for my other eye anyway. If I get a cataract in that one too, which is probable, then I would probably go the same way with it. Possibly then I would only need glasses for reading. The other option would be to go for near reading monovision in one eye, and distance in the other. I have tried that will contacts, and find it tolerable, but not great. And the other issue is that my current good eye is my dominant eye, so is the one which should be corrected for distance. That means I can’t procrastinate. I have to go to monovision or rule it out with my first operation.

I also read that most operations are successful, but in some case the toric lens can rotate over time which means some eyeglass correction may be necessary. Seems like conceding to the need for eyeglasses for life is the practical thing to do.

#19

I just ordered two pair of glasses from Zenni for $21 total. Single vision, no extras. My prescription is only 0.00/-1.25, but I have a restriction on my license so I needed some to throw in the truck for the days I forget to put in my contact and I realize it while I driving down the road. I figure if I like them, I can order another pair with the bells and whistles. If I don’t, I’m out $20 and I still have backup glasses.

#20

If you are talking about progressive lenses, there is quite a difference in the quality levels. While the lenses look like full lenses that you can look through anywhere the part that provides the best correction is hourglass shaped. The top of the hourglass provides the distance vision, and the bottom half the close up for reading. The part in the middle provides the in between progression. In cheap progressives the middle part especially is very narrow. You have to look right through the sweet spot in the middle or the image is fuzzy. If you get the premium progressives then the center part especially is much wider and more tolerant to looking to each side. And overall the part of the lens that provides crisp imaging is much larger.

My brother got Zenni progressives and that was one of the issues he had. The sweet spot was very narrow and limited.

Costco premium lenses are Essilor Accolade Freedom, and have a wide progressive band. It looks like they now have a Kirkland Signature HD lens that may be essentially the same but without the name brand, similar to the KS8 hearing aids. I hadn’t done much research so I went with the Essilor ones this time. I will consider the Kirkland ones for future glasses…

#21

My wife got the toric’s (5 or 6 years ago) and they work great (never moved, they lock in), but were $pendy. Medicare and insurance didn’t cover. When I had cataracts removed, they did the lasic thing instead and fitted my left eye for close and right eye for distance. I spend some 95%, or more, of my time without any glasses. Have readers if I am going to spend a lot of time reading or if the print is really small. Menus, newspapers, magazines and such are fine without them and I don’t bother to carry them. I do have a pair of distance glasses (for the left eye) that I wear only when driving. Just seems like I should play it safe for driving. I don’t need any glasses for the computer. I am pleased with the setup, been about 2.5 years.
It is not for everyone. There was a lady at the clinic who was very unhappy with that setup. YMMV.
The optician at the clinic has nice glasses, single vision, for $49 (designer frames for a $zilliion as well). When I broke one of the ear pieces, they moved the lenses to another frame for $20. The clinic is connected with a university. Great place, drive 50 miles to get there.

#22

I also think with progressives there’s a wide variety of people’s ability to tolerate them. I seem to be tolerate a wide variety of them–from cheap to moderately expensive without noticing any difference. Others never adjust. Some adjust only after working with a skilled optician and multiple tries. If money is an issue, I think trying cheap ones makes sense.

#23

Yes, there are a number of decisions I need to make before this is done. Toric or non toric is one, Asphericity correction or not is another. My thinking is to not spare the expense. Hearing aids are a 4-5 year investment, and then one will probably replace them for one reason or another. Inter ocular lenses however hopefully last a lifetime, so it seems one could justify spending more on them than hearing aids.

The doctor I have been referred to is a professor at our university as well. Hopefully that means he has a university salary to live off and won’t try to gain an early retirement at my expense!

#24

Something to consider is if you’ve worn glasses all of your life, you’ve likely gotten used to them. I found that I relied on mine to prevent from getting poked in the eye when working around on brush and such. I also find that my astigmatism changes slightly over time. I went with plain cataract lense implants and wear progressive glasses just about all of the time, even though I don’t need them for distance vision. I would tend to avoid multifocal implants, both from what I’ve read and what I heard from my opthalmologist.

#25

I have worn glasses since elementary school days. In about 1975 I started wearing soft contact lenses and did so for many years, until my reading vision started to become a problem. When that happened, I started to use reading glasses, but got tired of carrying them around, and went to progressives. I have tried contacts again now and then, and have also tried the monovision thing using contacts. It was OK, but I did not like driving with that arrangement at night. Vision was just not crisp enough to feel safe.

My issue now is that I am going to still need correction for my non cataract eye for I would expect a year or more. I will go through a short period where I have a corrected right eye, but a left eye that needs correction. Have not figured out how I will deal with that, but wearing a contact in one eye, and reading glasses is an option. Getting my glasses changed again is another option.

In any case I think I will go for the best correction I can for distance, and deal with the reading using reading glasses or if I still need some distance correction with progressives. The hope would be that no distance correction is required, once both eyes are done…

I also read that there were issues with the multifocal IOL’s, and plan to avoid them. Consumer Reports does not recommend them, but also admitted it was based on data from 2012, so somewhat dated.

#26

Maybe just a Mercedes. :slightly_smiling_face:
Good luck, either way you go cataract removal is an amazing thing. Things have the right color again.

#27

Yes, I’m under the impression things have gotten better. I was traumatized by my bad experience, which wasn’t helped by the fact that the optician was a smarmy a-hole. I paid what seemed to me at the time to be a premium price, some $600 or so.

The woman who plays handbells next to me appears to do fine with progressives. I assume her’s are better than the pair I’d tried back in the dark ages when I was still employed.

#28

MDB, I’m looking at new progressive glasses. I’ve bought readers from Zennie but worried about progressives. Were the areas of change like distance, mid & reading just standard for you? In other words you didn’t have anything out of the ordinary. TIA

#29

That is the segment height. After my cataract surgery last year I went to Costco for progressives. I got 2 pair of progressives, 1 photochromic and 1 sunglasses since the photochromic do not work with a tinted windshield. Total cost with several discounts that they applied was about $400. I ended up going back and requested that the segment height be lowered 3mm on both pair. When slightly reclined, such as watching TV or driving I felt the transition point was to high.

#30

I suspect he already has one or two of those, or more likely a Tesla these days.

The procedure is an interesting process. This guy (Chris Rudnisky) does not seem to have a private clinic that does the laser stuff like the others. I did an on line search to try and find more about him, and turned up a video on him demonstrating how to do an IOL insertion. He has been awarded for his teaching for several consecutive years. This is not the part that I like to think about much though… :frowning: I guess the upside is that I know that I will not be his first patient!

#31

Yeah, the time between surgeries is a pain. My interval was only a month or so. I think I popped the lense out of my glasses and used them to correct the vision in the eye awaiting surgery. Can’t remember what I did for reading.

#32

I didn’t have anything out of the ordinary. The height wasn’t quite right, but bending the nose pieces out to let them ride lower solved that. There’s definitely some risk in doing progressives mail order, but it’s pretty inexpensive and if they don’t work you can get a credit and use it towards dark glasses, or maybe readers or computer glasses.

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#33

I’m curious what the problems were. Multifocal contacts are the closest thing I’ve seen to magic.

#34

I’m just going by what Consumer Reports said in an article earlier this year. The study that it was based on is dated, so perhaps their advice is dated too. Here is a quote:

" Be wary of premium lenses. In standard cataract surgery, doctors remove the clouded lens and replace it with an artificial monofocal lens, which provides clear images at either near or far vision. There are multifocal lenses that do both, so you don’t also have to wear glasses.

But multifocal lenses cost up to $4,000—and usually aren’t covered by insurance. More worrisome, a 2012 review found that while the lenses provided better near vision, they also produced more complaints of halos and glare. Other research shows that people with multifocal lenses are also more likely to need repeat surgery.

One time you might consider a premium intraocular lens: if you have an astigmatism, or an irregularly shaped cornea.

Special lenses, called toric lenses, can correct that problem, says David Sholiton, M.D., an ophthalmologist at the Cleveland Clinic. And studies reveal that most people who get them are satisfied. But you will probably have to pay $1,000 or more out of your own pocket because insurance rarely covers them."

I suspect this is the review they are talking about. This seems to be the conclusion:

“The multifocal lenses had drawbacks: people with these lenses were more likely to see halos around lights and had reduced contrast sensitivity (the ability to distinguish an object against a background which is similar to the object itself). Multifocal lens implants reduce spectacle dependence after cataract surgery but at the expense of clarity. Ultimately it will be up to the individual to decide which type of lens they would prefer.”