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Lens replacement surgery, to correct far-sightedness, and astigmatism


tombardier

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Hi. 

I have prescription like so:

Left sphere +3, cyl -1.25, axis 55

Right sphere +4.25, cyl -1.25, axis 130

In other terms, I am far-sighted, with an oblique (diagonal) astigmatism.

I've recently undergone a consultation at Optical Express, with a mind to getting my vision corrected, mainly for astronomy. 

Optical Express have recommended that I could have single-vision lens replacement surgery.  They've said it will correct my astigmatism, and far sightedness, but may mean I need to start wearing reading glasses (which I don't mind).  I'm 41, and they've said that in 6-7 years time, I could have a kind of concentric ring varifocal lens instead, but that it could cause halos.  I'm basically against anything that could compromise my astronomical observation, so that just sounds like a non-starter to me!

The thing I really want to correct is the weird spikes and things I see on stars, which is worse at low power/large exit pupils. 

My main question is whether there is anyone here who has undertaken the surgery, and whether they think it was worth it?

One advantage to wearing glasses, I find, is that my eyepieces don't steam up nearly as often, but of course, the choice of eyepiece is more restricted. 

Any advice/experience appreciated!

 

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The thing is, your eyes continue to change as you age. I had surgery years ago and still have to have new spectacles every 3-5 years.

The surgery comes with risks, with side effects like increased risk of vitreous detachment later ( I know as it happened to me)

I certainly wouldn't rely on a high street outlet for advice.

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8 minutes ago, AstroKeith said:

The thing is, your eyes continue to change as you age. I had surgery years ago and still have to have new spectacles every 3-5 years.

The surgery comes with risks, with side effects like increased risk of vitreous detachment later ( I know as it happened to me)

I certainly wouldn't rely on a high street outlet for advice.

Thank you Keith.  Have you found your reading prescription changing over the years since due to an increase in presbyopia, or has your actual astigmatism changed too, and/or your distance prescription?  I don't mind wearing glasses day to day, but I do want the best correction possible for the astigmatism, for my observation.

I don't like the sound of vitreous detachment!

I should just clarify, its Optical Express, the ones best known for laser eye surgery, not Vision Express, the high street optician! :)

 

 

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I would think that if you have your eye lens replaced with one that corrects your current astigmatism and optimised for infinity, there should be no need to wear glasses whilst using an eyepiece, the telescope focuser should take care of any adjustment needed.    🙂

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My GP gave me some advice many years ago, - "If at all possible, keep yourself out of the hands of surgeons!"  I'd suggest that if you can get along with your present condition you should do so as long as you can. My wife has had both lenses replaced and she's been fine, but one eye now needs a second replacement after 8years. My mother was blinded in both eyes by an incompetent eye surgeon.  Things may have improved since then but there's always a real risk. The question is, is it worth the risk?

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I presume you have already tried a Televue Dioptrix Astigmatism corrector ?

Tele Vue Dioptrx Astigmatism Corrector | First Light Optics

PS - I do have mild astigmatism in both eyes and it varies a little from year to year (annual test for glaucoma). I have a dioptrix for the mean value. I find it most useful when the exit pupil is near my maximum, my problem with small exit pupils are floaters. One tip for the Dioptrix is to establish the best angle (can be done with bare eyes) and mark that with some Tipex which shows up well under a red torch. The dioptrix needs to be turned often when using an equtorial mount.

Edited by Stephenstargazer
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I had eye surgery for this and other reasons more than 10years ago.  It was the type where they remove a layer of cornea to make the optical corrections. 10 years on, one remains practically perfect and the other has some astigmatism again. Sadly instead of bilateral full correction they gave me monovision where one eye is made perfect for distance and one for the middle distance.which is not what I wanted. So I find myself wearing screen glasses and some for close up work like with a soldering iron. 

This seems quite different than replacing the lens like you are mentioning. I dont think there is a problem with being a high street place I think the risk is that you get rushed at the last minute and you don't get the level of follow up you need. I have traded astigmatism for a small degree of halo under fairly rare circumstances. I also feel my dusk eyesight is weaker. Im an archer used to shooting all day into dusk and now have difficulty  resolving that target detail under low dusk light. Maybe that's age though. 

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3 hours ago, tombardier said:

Thank you Keith.  Have you found your reading prescription changing over the years since due to an increase in presbyopia, or has your actual astigmatism changed too, and/or your distance prescription?  I don't mind wearing glasses day to day, but I do want the best correction possible for the astigmatism, for my observation.

I don't like the sound of vitreous detachment!

I should just clarify, its Optical Express, the ones best known for laser eye surgery, not Vision Express, the high street optician! :)

 

 

Everything has changed! Astigmatism perhaps most. The vitreous detachment isn't so bad, at least its not retinal detachment- which is. Its quite common - about 70% of us will eventually get it, but the surgery can bring it earlier.

My astigmatism isn't large, but the angle keeps changing. I've learnt to live with it with low powers, but fortunately I prefer to use high powers (seeking out faint galaxies and PN's) and then it isn't an issue.

Best way to fix the astigmatism is to a) use a dioptrix corrector or b) have some observing spectacles made up. I used to have a pair of mono-vision glasses made up with BK4 glass. These were perfect, but now I find I don't need them.

As Mike said above, best avoid surgery if possible. I had to have mine (cataracts) and have learned to live with the side effects and complications. Lasik is reknown for messing up night vision,

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I have been using specs for 60 years and contact lenses for maybe 20 years.
Looking at your prescription, there is nothing exceptional in there.

I'm in the 'no knives please' camp, while I can see. I think the surgery you were offered was more to obtain bonus/incentive payments than driven by customer care, or necessity.
The only way I would consider eye surgery is because a cataract ruins the view, or if lens defects cannot be externally corrected.

A dioptrix is a very good suggestion. Moderate cost and a reversible procedure if you don't get on.

For correcting the astigmatism have you tried contact lenses?.
Since using contact lenses for visual astronomy I regard them as a very important accessory.
A bit of a faff at first. Fighting to get them in, initially frequent visits for check ups, etc.
Now the optician is happy to leave me two years between check ups unless I see (or don't see😁) a reason for an earlier check.

If (when) your eyes change with time, then you get a different prescription for the lenses.

A benefit of contact lenses is that they are reversible. By that I mean that if they don't work for you, you take them out.
OK if you use a lens in that has been in a muddy puddle, or left in tap water and grown mould, expect problems. But used sensibly they are safe.
Removing your natural lens, or scuplting a cornea is something very different.

HTH, David.

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Thank you all.  A lot to go through.  I was sure I'd already responded w/ref to the Dioptrx, but I can't see my reply now!  I do happen to have two 1.0 Dioptrx correctors already, but they haven't worked for me (and they are for sale!).  On the prescription before last, both eyes showed -1.0, and on the next prescription, my left (primary) eye was still at -1.0, but my right (lazy) eye had changed to -1.25.  Now when doing this consultation the other day, I had some eye drops which dilated my pupils massively, and that showed my left eye to also be at -1.25 (he referred to it as a slight "hidden prescription").  So anyway, I'd love to try some 1.25 Dioptrx, but I haven't been able to find any for sale.  I still feel a bit sore after buying the first pair, because I got stung for nearly £60 in import fees a couple of weeks after importing them from Germany!  I have had a wanted advert on astrobuysell and on here for a couple of months now.  It seems like the 1.25 ones are discontinued by Tele Vue!  I'd try the 1.5s, but I don't want to throw even more money down the drain :(

I also tried some contact lenses, ones which could apparently correct to within 5 degrees of the angle of my astigmatism, but didn't find they corrected the problem as well as my glasses.  I'm sure I would have got used to them, but I really did find them quite uncomfortable, and very difficult to remove!  I also found them rotating when I was looking straight up at zenith with binoculars (reclined, using my parallelogram mount).

So anyway, I'm not wholly convinced by the idea of lens replacement surgery, and I feel like the main option at the moment is to stick with glasses!  I think I'll buy some new glasses, because I have varifocals right now with transition/reactive tints, and that's a bit of a PITA when I do solar observation!  Also a bit of a pain with normal observation, as I have to make sure I'm at an angle where I won't be looking through the transition through to the reading part of the lens!

Thanks for all your advice and for sharing your experience!

Edited by tombardier
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1 minute ago, Second Time Around said:

My observing eye prescription has 0.75 dioptres of astigmatism.  However, I'd read that in low light a greater correction is needed.

I therefore did a head to head test with a 0.75 vs a 1.0 Dioptrx. The latter did indeed work out better.

Yes, that's why I'm toying with the idea of trying the 1.5s, but I think the dilated pupils test probably recreates that same situation, where my right eye has gone from -1.0 to -1.25.

Anyway, if you want to buy yourself some more 1.0 Dioptrx, let me know ;)

 

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