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Expertise

In our center, at Seacoast Eye Associates Inc., we have the best ophthalmology physicians and surgeons in the Wakefield, Rhode Island area. We are experts trying to accomplish the clearest vision and we would like to share with you some thorough information about cataract and astigmatism eye disorders.

Options For Cataract Surgery

We hope this short introduction to modern cataract surgery will improve your understanding of how we can help you achieve better vision. Of course in making the decision to have surgery you must consider and weigh the risks versus the benefits. We will be happy to discuss this important issue in as great detail as you wish. Whether you decide to have surgery or not, we look forward to helping you with all your eye care needs and will be happy to answer your questions.

So, You've Been Told...

You have a cataract... what to do now? First, you don't have to do anything at all. If your vision (with or without glasses) is adequate for everything you do in life, like night driving, reading menus in poorly lit restaurants, following the golf ball, reading the game scores on TV, etc. and you're not avoiding activities you enjoy, then you really don't need to do anything about the cataract! However, if you are struggling with your vision, then read on, we've got exciting news for you.

The eye, much like a camera, has a lens. When we're young this lens is flexible and clear. By the time we reach our forties most of us start noticing our ability to focus up close is diminishing and changing focus from near to far and vice-versa becomes more difficult. This is because the lens is starting to become less flexible; usually a pair of reading glasses or bifocals will improve the ability to read. As the years pass, not only does the lens get harder, its clarity suffers, eventually becoming brown and cloudy, a cataract. This process is usually very slow, taking many years, but sometimes it can occur quickly, a matter of months perhaps. Regardless of how long the cataract takes to develop, when it interferes sufficiently with the activities of daily living, the patient is ready for surgery.

In the early days of cataract surgery, the 1950' s through the mid-seventies, you were hospitalized for a week or more, had sand bags straddling your head to limit movement and, when all was said and done ended up with a very strong eyeglass prescription, one which was difficult to get used to and distorted your vision. We are lucky to be alive in this era of modem medicine where cataract surgery is mostly done as an outpatient, you're home the same day, and can resume most activities the following morning. This seemingly miraculous surgery has been made possible, at least in part, by the development of the intraocular lens, the tiny piece of plastic that replaces the human lens that had become the cataract. What's so exciting today is that we can tailor the intraocular lens power to the individual patient, reducing their reliance on glasses after surgery! You may even know someone who has had the surgery and brags about being able to drive without glasses. If you've dreamed of discarding your glasses (at least for distance vision), cataract surgery may actually be an opportunity worth considering rather than dreading.

When we evaluate you for cataract surgery we always consider your visual needs first and foremost. If you don't have astigmatism you have an excellent chance of having good distance vision without glasses after cataract surgery. That means driving without glasses! If you do have astigmatism and we make no allowance for it your odds of having good distance vision without glasses are only about 25%. There are several strategies we can employ at surgery to correct the astigmatism. Which approach is right for you will depend on your particular anatomy and degree of astigmatism. If it's important to you to maximize your chances of discarding your distance glasses, please tell us.

Medicare and most insurance companies pay for "basic " cataract surgery. Unfortunately astigmatism correction is not covered by insurance at this time. We will be happy to discuss our charges for
this extra service. It's surprisingly affordable, especially when you consider what you may save on glasses in the coming years.

If complete spectacle independence, that means no glasses for anything, is your goal, your options are somewhat more limited. There are three relatively new bifocal implants on the market. This technology is currently in its infancy and will improve over the years. Current studies suggest that many (not all) patients are reasonably happy with this new approach, but it's clearly not for everyone. If this does interest you please do ask about it.

About Astigmatism

Astigmatism can be a difficult concept to understand, but in reality is simple. There is no stigma in having this condition! Most of us have it, at least to a minor degree. If the surface of your eye were like that of a perfectly round ball, we would say there is no astigmatism. If however, the surface were more like that of a football, not perfectly round, we would say there is astigmatism. Small degrees of astigmatism don't generally affect vision and don't require optical or surgical correction. Greater degrees of astigmatism definitely do affect vision and need to be addressed if spectacle independence for distance vision is desired. There are two distinct ways to minimize astigmatism at surgery. We can do this with strategically placed corneal incisions, called Limbal Relaxation, or implantation of a special intraocular lens, called a Toric lens. Sometimes we will combine these two approaches to correct a large degree of astigmatism.

What's The Cost?

No insurance plan covers the additional cost of astigmatism correction and the associated testing and planning. We charge (over and above standard cataract surgery) as follows:

● Limbal Relaxation $500.00
● Toric Lens Implant $950.00
● Combination Above $1050.00

These fees include all additional testing necessary to plan your surgery and decide which approach (if any) is appropriate for you. Because we want you to understand exactly what your doctor can and cannot do for you and what you're paying for, your questions are welcome at any time!

No discussion of cataract surgery, alone or combined with astigmatism correction would be complete without a frank discussion of the risks involved . Cataract surgery by itself is very safe and most patients are quite pleased with the results. An extremely small percentage can lose vision from a variety of complications. including, but not limited to, infection, hemorrhage, glaucoma and retinal detachment. This is why we only operate on one eye at a time! Astigmatism correction at the time of cataract surgery does not add significant risk to the procedure, but cannot be guaranteed to completely correct the astigmatism. Sometimes it is necessary to fine-tune the correction post operatively with additional Limbal Relaxation, usually done in the office, at no extra expense. Occasionally laser reshaping of the cornea, at an additional cost, may be required to completely eliminate the astigmatism.

If you have more questions or comments about our services, contact us at (401) 783-7009.