Brexit, for once some facts.

oyster

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Just as an update.. Had my 2nd cataract op yesterday, exactly 3 weeks after first (minimum delay between ops here).. Gone from Sphere - 4.75 and Cyl - 2 ( moderately bad) to no glasses. (need reading glasses, didn't before) (and on NHS)!!! Really pleased.
And had flu jab last sat.
Sounds excellent.

My mother had both eyes done and the improvment was astonishing. Despite her having macular degeneration. (They originally said they would only do one, but that was so successful they decided to do the second.)
 
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Zlatan

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Sounds excellent.

My mother had both eyes done and the improvment was astonishing. Despite her having macular degeneration. (They originally said they would only do one, but that was so successful they decided to do the second.)
I can't believe change. Went out and looked at car came back in and asked wife why she let me choose such a bright brilliant white. It almost glows in dark. Thought it was cream.
Thought bathroom tiles were same.
Bausch +Lomb eyes... Should be good... Straight from Japan.??? Thought they were German..??
 
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oyster

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I can't believe change. Went out and looked at car came back in and asked wife why she let me choose such a bright brilliant white. It almost glows in dark. Thought it was cream.
Thought bathroom tiles were same.
Bausch +Lomb eyes... Should be good... Straight from Japan.??? Thought they were German..??
I had to look them up the other day - part of Bausch Health who were renamed from Valeant after scandals.

https://www.bauschhealth.com/

Bausch Health Companies Inc. (formerly Valeant Pharmaceuticals) is a multinational specialty pharmaceutical company based in Laval, Quebec, Canada. It develops, manufactures and markets pharmaceutical products and branded generic drugs, primarily for skin diseases, gastrointestinal disorders, eye health and neurology. Bausch Health owns Bausch & Lomb, a supplier of eye health products
https://en.wikipedia.org/wiki/Bausch_Health

And owners of Grossman in Mexico.
 

flecc

Member
Oct 25, 2006
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Just as an update.. Had my 2nd cataract op yesterday, exactly 3 weeks after first (minimum delay between ops here).. Gone from Sphere - 4.75 and Cyl - 2 ( moderately bad) to no glasses. (need reading glasses, didn't before) (and on NHS)!!! Really pleased.
And had flu jab last sat.
We recently discussed NHS versus private for cataract surgery and you couldn't understand why I said private was better. I refrained from answering since my reply could have disrupted confidence in your treatment midstream, but now that's complete I can answer.

I chose private since that offers a two eye treatment system the NHS doesn't for economy reasons. The benefit is that I don't ever need reading glasses and can even read most small print of the "terms and conditions" kind while still having first class long sight.

What the NHS offer is no different from half a century ago. Since cataracts usually develop more in one eye than the other they aim to only do that eye since that suits many for life, keeping costs down. For that one gets a standard compromise lens insert with good distant vision but which needs reading glasses if that eye is to be used for closer sight. The downside of this standard treatment is that if both eyes are to be done in sequence, one gets the same in each, meaning reading glasses.

What I received by going privately was a system called Monovision. That exploits the fact that few persons eyes are exactly equal so having them unequal is something we handle with ease. My better longsight eye, the left one which also happened to have the worst cataract, had the first operation, using a lens that was very much biased to top class long distance vision.

Just over a month later the right eye had its operation, this time using a lens that permitted me to easily read the statutory number plate at 20 metres but not much further. This though allows me to easily read without glasses. So basically I'm using one eye at a time for either very distant or very close work, but both eyes together for the bulk of visual needs which are intermediate distances . The outcome is 6/5 vision (metric), better than 20/20 (imperial).

Of course Monovision needs exceptional care in scanning both eyes by someone with the right skills to get the extreme accuracy necessary for the inserted lens in each to ensure the right balance of outcome. The system leaves little tolerance for error. For me that meant a special day appointment, the scans taking a very long time on two equipments with each double checked and multiple precise measurements recorded for the surgeon. So one can understand the reluctance of a cost concious NHS to adopt this alternative which would mean more expenditure or reliance on the better of the private facilities.

Monovision shouldn't be confused with another cataract treatment available, using flexible lenses that can focus like our normal lenses. Very few surgeons will touch these since they have a record of unreliability.
.
 
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Zlatan

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Nov 26, 2016
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We recently discussed NHS versus private for cataract surgery and you couldn't understand why I said private was better. I refrained from answering since my reply could have disrupted confidence in your treatment midstream, but now that's complete I can answer.

I chose private since that offers a two eye treatment system the NHS doesn't for economy reasons. The benefit is that I don't ever need reading glasses and can even read most small print of the "terms and conditions" kind while still having first class long sight.

What the NHS offer is no different from half a century ago. Since cataracts usually develop more in one eye than the other they aim to only do that eye since that suits many for life, keeping costs down. For that one gets a standard compromise lens insert with good distant vision but which needs reading glasses if that eye is to be used for closer sight. The downside of this standard treatment is that if both eyes are to be done in sequence, one gets the same in each, meaning reading glasses.

What I received by going privately was a system called Monovision. That exploits the fact that few persons eyes are exactly equal so having them unequal is something we handle with ease. My better longsight eye, the left one which also happened to have the worst cataract, had the first operation, using a lens that was very much biased to top class long distance vision.

Just over a month later the right eye had its operation, this time using a lens that permitted me to easily read the statutory number plate at 20 metres but not much further. This though allows me to easily read without glasses. So basically I'm using one eye at a time for either very distant or very close work, but both eyes together for the bulk of visual needs which are intermediate distances . The outcome is 6/5 vision (metric), better than 20/20 (imperial).

Of course Monovision needs exceptional care in scanning both eyes by someone with the right skills to get the extreme accuracy necessary for the inserted lens in each to ensure the right balance of outcome. The system leaves little tolerance for error. For me that meant a special day appointment, the scans taking a very long time on two equipments with each double checked and multiple precise measurements recorded for the surgeon. So one can understand the reluctance of a cost concious NHS to adopt this alternative which would mean more expenditure or reliance on the better of the private facilities.

Monovision shouldn't be confused with another cataract treatment available, using flexible lenses that can focus like our normal lenses. Very few surgeons will touch these since they have a record of unreliability.
.
I had mono vision offered. (by Spire and NHS) I didn't want it. I wanted best distance vision possible. Don't mind reading glasses. My right eye is 6/4. (ie can read at 6 metres what average eye can at 4,it was 100/20.Could read at 20 what average can at 100)
Yesterday my left eye was 100/20. (ie could read at 20 what average can at 100)
Today,not 24 hours after lying under Karl Zeis laser the size of a small house, with no clouding, haloes or soreness it's better than 20/20. (I think it's better than right but assessment in 2 weeks)
Proof of pudding...
And BTW mono vision isn't new. They were doing it 25 years ago with contact lenses. I tried it, didn't like it. That's why I refused it. My NHS consultant actually advised me to have it yesterday. (she showed me lense choice of near or far. I,m right eye dominant so that automatically gets far. Told her far for left too.
I don't think NHS had Karl Zeis laser eye robotic arms 50 years ago or laser topographic scanners.
The two things not offered to me on NHS have been multi focal lenses, which as you s as you say are as yet problematic and Toric lenses. (effectively lenses cut from a cylinder rather than sphere, used to cure astigmatism. I, m borderline in needing them . NHS reduced it by other means. (LK I believe)
So from my point of view the £7500 I, ve saved will be well spent on other stuff.
I am making a donation to NHS eye clinic./day surgery. They were absolutely superb. I couldn't have wished for better results. Really Flecc, can't see how my eyes could be any better. To be honest, way way better than I expected. Just a pain staying out of sea for next 4 weeks.

And by coincidence. Brother in law has just had his Cataracts sorted. He has lost his glasses too. Like me worn them from child hood. I suspect NHS has undergone a policy change in lenses fitted.??
I was told by all private clinics I visited I would not lose glasses for any distance with NHS. A complete lie.
Private are always showing you statistics about the percentage of folk who lose glasses with them and comparing it to NHS. It's wrong. Yesterday at my visit 3 of patients were bordering on blind. One had Cataracts so badly developed they could not be removed at one visit. Those patients will never show up in private.
 
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flecc

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Oct 25, 2006
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I had mono vision offered. (by Spire and NHS) I didn't want it. I wanted best distance vision possible. Don't mind reading glasses. My right eye is 6/4. (ie can read at 6 metres what average eye can at 4,it was 100/20.Could read at 20 what average can at 100)
Yesterday my left eye was 100/20. (ie could read at 20 what average can at 100)
Today,not 24 hours after lying under Karl Zeis laser the size of a small house, with no clouding, haloes or soreness it's better than 20/20. (I think it's better than right but assessment in 2 weeks)
Proof of pudding...
And BTW mono vision isn't new. They were doing it 25 years ago with contact lenses. I tried it, didn't like it. That's why I refused it. My NHS consultant actually advised me to have it yesterday. (she showed me lense choice of near or far. I,m right eye dominant so that automatically gets far. Told her far for left too.
I don't think NHS had Karl Zeis laser eye robotic arms 50 years ago or laser topographic scanners.
The two things not offered to me on NHS have been multi focal lenses, which as you s as you say are as yet problematic and Toric lenses. (effectively lenses cut from a cylinder rather than sphere, used to cure astigmatism. I, m borderline in needing them . NHS reduced it by other means. (LK I believe)
I'd also tried monovision with contact lenses very long ago during my working years, but like you I didn't like it, though with me that was more through the contact lenses than anything else. Too much trouble. Via the cataract surgery my monovision experience is very different and I'm delighted with it.

Importantly for me is not having the hassle of carting reading glasses around with me, especially with my entymological interests in the smallest of creatures.

At no time on the NHS here was I offered anything but the standard NHS treatment I mentioned. I formed the opinion from my own very unsatisfactory experiences back in the 1990s and since that London's NHS is very poor, outside of the odd centres of excellence like Barts, Moorfields and Kings.

London's conditions and huge housing costs leave us permanently short of medics at all levels, so the outcome is inevitable.
.
 
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Zlatan

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I'd also tried monovision with contact lenses very long ago during my working years, but like you I didn't like it, though with me that was more through the contact lenses than anything else. Too much trouble. Via the cataract surgery my monovision experience is very different and I'm delighted with it.

Importantly for me is not having the hassle of carting reading glasses around with me, especially with my entymological interests in the smallest of creatures.

At no time on the NHS here was I offered anything but the standard NHS treatment I mentioned. I formed the opinion from my own very unsatisfactory experiences back in the 1990s and since that London's NHS is very poor, outside of the odd centres of excellence like Barts, Moorfields and Kings.

London's conditions and huge housing costs leave us permanently short of medics at all levels, so the outcome is inevitable.
.
I think it's all a personal decision. What suits you etc.. I had no problems with contact lenses (until the corneal oedema) but didn't like mono vision for driving, especially at night. (guessing low light exaggerates any visual in abilities)
Chap at Spire explained it can affect depth /distance perception. Funnily enough it was the NHS second consultant pushing it more. (my only concern has been my eyes were operated on by different surgeons)
She did say, as I was laid under machine and rather too late to change my mind, it didn't make much difference now as it used to. (as she punched keys into attached keyboard) I was going to say I see why but actually couldn't by then.
 
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Danidl

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This is amusing First the UK standard

Then the EU standard on the same bulb, same maker

Performance to BSL standard for performance
British Standard Lies that is
And both labels were on the same box! :rolleyes:
Surprise surprise ..but it actually makes sense ..to us who have the benefit of 40 + years in electronic engineering. The UK uses a higher voltage , hence more power consumption. LEDs are current operated component..I am referring to the 2.75 versus 3.00 Kwhr rating.
 
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flecc

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Oct 25, 2006
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but didn't like mono vision for driving, especially at night. (guessing low light exaggerates any visual in abilities)
This was already a problem for me in my late seventies since age brings night vision problems, our eyes as they age less able to cope with contrasts from light to dark. Today's high intensity LED street and headlamp lighting makes it even worse. With safety paramount at 85 now I no longer drive after dark since recovery from dazzle is slower than it used to be, stopping me seeing detail in very dark zones immediately after. It wouldn't be such a problem if people in dark clothing kept to the pavements instead of walking in the road as often they do round here. One young woman has already been killed in the estate doing that. At 22, a stupid waste of a life.
.
 

Danidl

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This was already a problem for me in my late seventies since age brings night vision problems, our eyes as they age less able to cope with contrasts from light to dark. Today's high intensity LED street and headlamp lighting makes it even worse. With safety paramount at 85 now I no longer drive after dark since recovery from dazzle is slower than it used to be, stopping me seeing detail in very dark zones immediately after. It wouldn't be such a problem if people in dark clothing kept to the pavements instead of walking in the road as often they do round here. One young woman has already been killed in the estate doing that. At 22, a stupid waste of a life.
.
Years ago as a young driver I was returning on a wet very dark night and travelling at about 50 along what passed as a main road. The only inklings I had of a person walking was that the car lights picked up a film of water glistening on the sole of their shoe!., As they stepped along They were walking away , wrong side of road, black clothing . On such narrow margins!.
 

oyster

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This was already a problem for me in my late seventies since age brings night vision problems, our eyes as they age less able to cope with contrasts from light to dark. Today's high intensity LED street and headlamp lighting makes it even worse. With safety paramount at 85 now I no longer drive after dark since recovery from dazzle is slower than it used to be, stopping me seeing detail in very dark zones immediately after. It wouldn't be such a problem if people in dark clothing kept to the pavements instead of walking in the road as often they do round here. One young woman has already been killed in the estate doing that. At 22, a stupid waste of a life.
.
When partner became hypothyroid, one of the many very unpleasant aspects was impaired vision. Loss of colour perception. Loss of focus ability. And very bad night vision/recovery from dazzle.

She has improved enormously.

When I became hypothyroid some time later, I too had impaired vision. I remember one long drive in the dark when oncoming headlamps were difficult to cope with. (Though I was never anywhere near as bad as she was.) Luckily that was into spring and by the time autumn came I was being treated.

I am convinced there are many thousands out there who are hypothyroid and driving because they are not properly aware. And few doctors have the slightest appreciation of the issues.

Both of us can now watch television (for example) without glasses and see adequately. I can easily meet driving standard without glasses. And my ability to cope with oncoming headlamps is as good as ever it was.

And, round here, the LED streetlamps are extremely low light level. Lovely. Just what I want.
 

jonathan.agnew

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When partner became hypothyroid, one of the many very unpleasant aspects was impaired vision. Loss of colour perception. Loss of focus ability. And very bad night vision/recovery from dazzle.

She has improved enormously.

When I became hypothyroid some time later, I too had impaired vision. I remember one long drive in the dark when oncoming headlamps were difficult to cope with. (Though I was never anywhere near as bad as she was.) Luckily that was into spring and by the time autumn came I was being treated.

I am convinced there are many thousands out there who are hypothyroid and driving because they are not properly aware. And few doctors have the slightest appreciation of the issues.

Both of us can now watch television (for example) without glasses and see adequately. I can easily meet driving standard without glasses. And my ability to cope with oncoming headlamps is as good as ever it was.

And, round here, the LED streetlamps are extremely low light level. Lovely. Just what I want.
From the other end of the spectrum, I had graves disease (hyperthyroidism with proptosis) that went untreated and partially damaged one optical nerve (lost night vision in one of my eyes). Oddly, I recovered the night vision - not sure if the optical nerve recovered or another process involved.
 

flecc

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Oct 25, 2006
49,068
26,788
When partner became hypothyroid, one of the many very unpleasant aspects was impaired vision. Loss of colour perception. Loss of focus ability. And very bad night vision/recovery from dazzle.

She has improved enormously.

When I became hypothyroid some time later, I too had impaired vision. I remember one long drive in the dark when oncoming headlamps were difficult to cope with. (Though I was never anywhere near as bad as she was.) Luckily that was into spring and by the time autumn came I was being treated.

I am convinced there are many thousands out there who are hypothyroid and driving because they are not properly aware. And few doctors have the slightest appreciation of the issues.

Both of us can now watch television (for example) without glasses and see adequately. I can easily meet driving standard without glasses. And my ability to cope with oncoming headlamps is as good as ever it was.

And, round here, the LED streetlamps are extremely low light level. Lovely. Just what I want.
I don't have any other vision problem, it's simply the slightly greater delay in recovery from dazzle than it used to be. That isn't severe and I could still drive at night but I strongly believe safety comes first.

It was the same with my cataracts, my optician insisting the worst eye wasn't bad enough for a cataract operation. But I regularly check my suitability to drive and had found some unreliability in passing the number plate reading test every time consistently. That was enough for me, there's no room for doubt when lives are at risk.
.
 
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oyster

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From the other end of the spectrum, I had graves disease (hyperthyroidism with proptosis) that went untreated and partially damaged one optical nerve (lost night vision in one of my eyes). Oddly, I recovered the night vision - not sure if the optical nerve recovered or another process involved.
Horrible disease. I keep reading of people who went through treatment, RAI or surgery, became hypothyroid and have never received adequate thyroid hormone treatment.

Hypothyroidism can cause permanent optic nerve damage due to compression - which occurs as myxoedemic swelling compresses the nerve and from pituitary hyperplasia compressing the optic chiasm.

I am convinced that hypothyroidism also impacts vision due to impaired processing in the brain.

That is all, of course, assuming the lens and retina work sufficiently in the first place.
 

jonathan.agnew

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Horrible disease. I keep reading of people who went through treatment, RAI or surgery, became hypothyroid and have never received adequate thyroid hormone treatment.

Hypothyroidism can cause permanent optic nerve damage due to compression - which occurs as myxoedemic swelling compresses the nerve and from pituitary hyperplasia compressing the optic chiasm.

I am convinced that hypothyroidism also impacts vision due to impaired processing in the brain.

That is all, of course, assuming the lens and retina work sufficiently in the first place.
Yes, this is subjective, but I highly recommend that one always does ones own due diligence. With graves, for example, rai or surgery not only usually result in hypothyroidism, but also often catastrophic loss of control over proptosis (for which high dose steroids becomes a temporary solution) - whereas carbimazol(neomercazol) reduce thyroid function to normal (after which one can stop using it) without significant long term damage - which then also reduce proptosis to normal longer term.
 

oyster

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Yes, this is subjective, but I highly recommend that one always does ones own due diligence. With graves, for example, rai or surgery not only usually result in hypothyroidism, but also often catastrophic loss of control over proptosis (for which high dose steroids becomes a temporary solution) - whereas carbimazol(neomercazol) reduce thyroid function to normal (after which one can stop using it) without significant long term damage - which then also reduce proptosis to normal longer term.
Absolutely agree. (So long as you can take it OK.)

The stories I read include treating hyper flares of Hashimoto's as if it is Graves, and Graves patients being pushed to RAI almost immediately. And PTU not being offered if there are issues with Carbimazole.

Agreed about due diligence but all too many simply trust their doctors and only start to understand too late.
 
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jonathan.agnew

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Absolutely agree. (So long as you can take it OK.)

The stories I read include treating hyper flares of Hashimoto's as if it is Graves, and Graves patients being pushed to RAI almost immediately. And PTU not being offered if there are issues with Carbimazole.

Agreed about due diligence but all too many simply trust their doctors and only start to understand too late.
There is the possibility of bone marrow suppression (fortunately rare). How did your hypothyroidism begin? In my reality these things are invariably systemic (regardless of medical research - I knew it was the stress of a newly qualified job and 16 espresso and 50 ciggies a day that triggered the graves)
 
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Zlatan

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Flecc
I forgot to mention. Consultant said if I get fed up with wearing reading glasses I can wear a contact lens in none dominant eye to create mono vision.???
 
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