The Costco Effect - Eyeglasses

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.

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.

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!

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.

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.

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

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.

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.

@Sierra said:

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.

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

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.”

I would guess so, but you could probably do pretty well starting a new thread in the Social category. I’m sure plenty of us (including me) have had cataract surgery. If they’re not impacting your vision, there’s no need to rush into it, but if you need surgery, there’s nothing to fear.

I had a look around but didn’t find much. My first consultation appointment is not until February 2020, so I have kind of put off my research somewhat. In Canada there tends to be a long wait for elective surgery. My initial research showed that in Canada there are three basic choices. First is covered by our healthcare and that is a standard lens for correction of distance only. A second choice is a toric lens for correction of distance and astigmatism, at an extra cost. The third choice is correction for distance and near or a multi focus lens, again at an extra cost. There is an older study that Consumer Reports cautions buyers about for the multi focal lenses, that they have mixed results. That said I have a friend who just had both eyes done with the multi focal type and she likes them. She can read most things, but still carries cheaters to see the real fine print on labels. There are some variations to these three procedures that also use laser or surgical correction. I saw no real conclusion that they were better. Here is a link to an article on what is being used, and some opinions on them.

Surgeons Share their Veiws on IOL’s4

Thanks, MDB, Sierra. The doctor thinks I’m still a couple years away from having to deal, but I’m already wondering about possibilities and choices. I had mono-vision contacts for many years and got along fine that way, but the eye doctor told me the last time my prescription was upgraded that I’d reached the outer limit of when that works, and I found I no longer liked driving with that prescription and switched to just distance correction in both eyes and using reading glasses. Right now I have what they call computer glasses that run from reading at bottom to maybe 10’ out at top, and I like them for around the house.

When I’m out and about, having to use reading glasses on top of the distance contacts is IMO a real PITA, and I’d love it if cataract surgery meant a better solution. My one experiment with multi-focus glasses was a bitter failure, though.

You could try multifocal contacts and see if you like them. They are somewhat of a compromise. You can’t see in the distance as well as with glasses, and you can’t see quite as well up close as with readers, but it is pretty amazing to see 99% of everything you need, regardless of location or angle (not like bifocals or progressives).

If I had cataracts I would definitely go for multifocal, but they dont really seem to be catching on well with contacts or cataract surgery lenses.