Recommendations for cataract surgery lenses for flying

On Wednesday, March 21, 2018 at 12:32:22 AM UTC-7, Peter Whitehead wrote:
The thread was regarding the possibility of using multi-focal INTRA-Ocular lenses at cataract surgery, not contact lenses.
I would suggest looking at the website www.allaboutvision.com and choose 'multifocal IOL's' to learn a bit more.
I am a family doctor, not an ophthalmologist, but as a glider pilot flying in the same sky as you, maybe one day, I might prefer that you opt for single focus lenses for distance vision. My understanding is that the clarity of distance vision is less good with multi-focal IOL's.
Good luck with your choice.

While the thread is about IOLs, my suggestion is to try contacts with the same optics before you have your eyes cut.

Multifocal lenses come in a variety of optical strategies: center distance and peripheral near correction, center near and peripheral distance, several concentric rings, true aspheric, pinhole focus, etc. IOLs come in some variety too though maybe not as much. All of these work by casting two or more complete images on the retina. Your brain must sort through which to look at, and many people's brains do a remarkably good job of it. Some not so good. Among the complaints are blurry vision and bad night vision (halos around light sources). Another is that it isn't as good as a set of proper reading glasses for long term reading or computer work, and IOLs can't be removed and left on the vanity. Having IOLs put in without knowing whether your brain will adapt, or which multifocal strategy you or your brain prefer, is roulette. However you may adapt very well and love it, which is why I suggest trying it with contacts first.

Even with 2 multifocal contact lenses my vision is 20/20. A large number of pilots have worse vision than someone with a multifocal lens - it is an individual thing.

Hi Peter - just responded to Tom above. The lenses I have are EDOF (extended depth of focus) Symfony IOLs. Many lump these into multifocal lenses group. Regardless of EDOF or multifocal the trade off is not clarity for distance (unless the power is off or there is astigmatism present). Trade off is the night vision. I would think pilots who fly at night would not want that compromise and those who fly commercially I have read are not permitted to select anything but a multifocal lens. with the Symfony lenses I have excellent vision during the day but starting at dusk I see concentric circles around certain light sources. At the beginning it was hard to drive at night. I have adapted but still don’t choose to drive long distances in unfamiliar areas at night.

Well, I already have fixed lenses implanted, but I'm very curious about
how the multifocal lenses work.Â* Since they're fixed in your eye, it
seems to me that you don't shift your eyes up or down for distant or
near vision as you did when you were young and had flexible lenses in
your eyes.Â* So how does it work?Â* Do you need to train yourself
(accommodate) to the fact that near objects will focus high on the
retina and distant objects will be nearer to the center or bottom?Â* Is
it simply a matter of getting used to it and the brain does what it does
so well?

On 3/20/2018 7:21 PM, jfitch wrote:
On Tuesday, March 20, 2018 at 2:22:16 PM UTC-7, teck48 wrote:
Thanks for the thoughts. I'm 65 and fairly active. I'm a hobby glider pilot. And small dinghy sailor. I make videos and do a lot of computer and writing work.

I'm extremely near sighted but not astigmatic. I'm a fussy ******* about glasses, but once these replacement lenses are implanted it's a bit late to be fussy....

–Tom
The multifocal contact lenses come with a prescription correction for far field vision, so they correct that at the same time. It should give you an idea of how your new lenses will work.

I wear one multifocal contact lens while flying or anytime I'm out and around. This lets me see the instrument panel, charts, phone, menu or whatever. My distance vision is still better than 20/20 with it in. The contact lens is a bit of a PITA (in, out, and care), so if I had cataracts I would do the multifocal lens replacement, but I'd shop carefully. I've tried about 5 different types of multifocal contacts, and some certainly worked better (for me) than others.

I've found a pair of sunglasses that I like for flying with or without the multifocal lens. The reason I like them over others I've tried is that the bifocal cheater can be ordered larger and higher than most (which covers the instrument panel better without the neck craning) and they are also available in gradient shading, which keeps from shading the instrument panel. They are available with a prescription correction if you need it.

https://flyingeyesoptics.com/product...on-rx-bifocal/

--
Dan, 5J

In multifocals different parts of the lens (e.g., concentric rings) focuses images from different distances onto the same part of the retina. This necessarily means less contrast (focused image superimposed on blurred image).. As I get older I seem to crave more contrast. Maybe that's why, when I tried multifocal contact lenses briefly, I didn't like them, and stuck with monofocal plus reading glasses. I use bifocal glasses over my contacts when flying.

See, e.g., here for more info:
http://www.allaboutvision.com/contacts/bifocals.htm

Hi I have had cataracts surgery 7 months ago and have extended depth of focus lenses called Symfony. They are slightly different than multifocal lenses which gives one 2 focal points. The vision I have is more seamless without a dip in clarity between the 2 focal points of a multifocal lens. There is a trade off of choosing a multifocal or EDOF lens and that is your night vision. I do know for commercial pilots only standard monofocal lenses to replace cataracts is acceptable. The multifocal and EDOF lenses have more glare and nighttime visuals (for example I see concentric circles around certain light sources at night). This may not be a trade off some people want to get rid of glasses.

I had cataract surgery 14 years ago in both eyes. Have mono focus lenses in both eyes. I wear bi-focals with essentially plain glass for far vision. I was myopic and my far vision is now 20/20. Being able to spot other gliders/aircraft quickly is obviously important in soaring. Sharp focus while assessing a field prior to an off-field landing also important to me. So, I'll opt for the acute far vision option and mono focus without the trade-offs. And yes, my sun glasses are bifocal too.

It would be good to hear from pilots with the multi-focus lenses in this forum too.

Chuck Zabinski

Cataract surgery increases the chance of retinal detachment. If the doctor says to wait a few weeks before flying, consider waiting a bit extra.

Raul Boerner

How does the monovision approah https://www.aoa.org/patients-and-pub...ses/monovision

work out for pilots?

1.Does it degrade your scan for traffic on the side with close vision?

2.Does the associated degradation of depth perception affect your landings, or do you adapt after a short 'retraining period'?

On Wednesday, March 21, 2018 at 6:43:39 PM UTC-4, son_of_flubber wrote:
How does the monovision approah https://www.aoa.org/patients-and-pub...ses/monovision

work out for pilots?

1.Does it degrade your scan for traffic on the side with close vision?

2.Does the associated degradation of depth perception affect your landings, or do you adapt after a short 'retraining period'?

My understanding is mono vision contact lenses are not approved for flying by the FAA.

FAA......I have been wearing mono contacts for 45 years. My medical stipulates only that I wear corrective lenses for far and near vision.
Contacts plus bifocals equal corrected vision.
R