Rutnin Eye hospital visit follow up (cataract op?)

[notrub]

28 11 2019

 

Thank you again for all your comments.  I did go to the Rutnin Hospital as several persons suggested I do.  Very glad that I did and had the standard exam plus an extra add on for glaucoma (2 or 3 k baht).  It all came to 7000 baht including the first month's drops. I don't have astigmatism or macular degeneration, good news but do have cataracts and glaucoma.  The glaucoma is in a fairly early stage and the doctor thinks it can be controlled by eye drops.  Hope so, don't fancy being blind if I can avoid it.  

 

The cataracts can be fixed by the standard replacing the lens operation.  The doctor there said that she likes to do both eyes, one long range and one closeup.  Both fixed focus.  Apparently my vision is already that way and the brain compensates and uses the appropriate eye, so to speak.  She is reassuringly competent looking and sounding and her recommendations are purely medical.  I am confident that she was not 'drumming up business'.

 

They gave me a quote and it comes to 90K baht per eye not including prep, or something.  The local, Buriram, doctor (who is the eye doctor at the main hospital there) gave me a quote of 14K baht per eye.  Gives a  person some reason to pause for thought.  I know the argument can be that I have only 1 pair of eyes and should I risk getting a dodgy op by an incompetent doctor inn a shoddy operating theatre but moving on from there...  What are the options available and how to explore them?

 

 

 

 

Ivor Bigun commented on his experience at the Queen Sirakit hospital, Satahip and others have mentioned this hospital too.  I am going to post a note in the Buriram Expats' forum to see if the local doctor is known etc. and also will contact the Queen Sirakit hospital to ask if they would do the operation and what would it cost.  Living in the north of Buriram Province I am definitely outside their catchment area and don't know how that works in Thailand. 

 

Aside from the giant cost difference, travelling to BKK is difficult and I do not enjoy spending time in big cities like BKK.  If the Queen Sirakit hospital was a viable option going to Pattaya area would be as far but a bit easier on the nerves than BKK.

 

Putting the 200,000 baht cost into perspective, it comes to about 1 1/2 years of my small pension.  I have some savings, enough to cover the 200K+ for the op and travel and what have you but it would be nice to find a safe alternative at a lower cost.

 

Any comments will be gratefully received.  PS, The name of an online glasses supplier that many expats use has been mentioned a few times but cannot find it now.  Could I be reminded of it please?  Thanks.  And thanks again for encouraging me to go to Ritnin hospital.

[Sheryl]

The online glasses is Zenni

 

What the Rutnin doctor is describing is monovision. It helps prevent the need for reading glasses. When I had LASIK I did monovision and it has worked great for me, 20 years later at age 67 I still do nto need reading glasses. IMO it works far better than the more expensive multifocal lens implants.

 

Simply removing a catarct  is fairly straightfoward. Calculating the best lend=s correction -- esecially for something like monovision - takes more expertise and experience and your run of the mill Thai doctor doesn't, frankly, have it. You will get a "one size  fits all" approach and end up needing reading glasses. I would defininitely spend the money to do it at Rutnin if I were you. Incidentally, while more than government hospitals, it is significantly less than places liek Bumrungrad.

 

Did the doctor say she thought your vision was bad enough that the cataracts need to come out now? What you reported before did nto sound like it. The glaucoma can certainly account for at least some of the night glare. If that is your reason for seeking cataract removal I'd suggest you wait first and see how much it improves on glaucoma treatment. And try the yellow night glasses. Especially since cataract surgery might nto help the glare much.

 

If in daytime your vision is foggy and you are unable to see enough for daily activities then that;s another matter and time for the cataracts to come out.

 

[scubascuba3]

Would make me nervous having both eyes done the same time. In the UK i think it's still one at a time

[notrub]

Thank you.  The doctor said one at a time to see how it goes.  Yes Sheryl, there is time to wait and see.  The doc said she did not recommend the variable type lens unless it was a special need situation.  Her option is to put one long and one short focus and I understand what she means.  When they take out the existing lens the cataracts come out with it, is how I understand it to be.  She said the problem will be when they get so advanced they harden, or something, and are difficult to remove.  

 

She want me back for another puff test for glaucoma in one month.  That is to see if it goes from a value of 20 down to 15 and if the drops are effective.  That test seems like it could be done anyplace that has the equipment and competent staff.  I have a month before another trip to BKK to decide.  I have done a lot of driving in my life and 'The thrill is gone' so there is no joy in the commute to BKK.  Don't suggest flying as the 'Thrill' for that 'is even more gone'.  Thanks a lot for your comments.  I am always ready to take advice and it is good to get some for these sorts of things.

[lopburi3]

The puff test is eye pressure and is not 100% reliable - often doctor will want to manually check later which is much more accurate so let them do.  Yes if you can reduce from 20 (not that bad if not have glaucoma already) to 15 range it should prevent getting worse.  They may want to do the CVFT every year or so to confirm.  As said any doctor/tech can do the pressure test.

 

Cataract as said may not need removal now - should be when blocking vision a lot.  If going with the monovision approach expect the measurements need to be precise (there is a special computer to do this  - was done for my distance lens to get size/shape of lens) so probably best to have done at a major facility.  The operation itself is simple and most doctors do it a lot so if just getting distance vision a good hospital should be safe and a government hospital much cheaper. 

 

But for now would advise trying Sheryls advise to use yellow lens and see if that helps and if actual vision is OK for you hold off on the operations.

Edited November 29, 2019 by lopburi3
remove open/free clinic reference - was in reference to operation being done everywhere all the time but not at recommendation..

[notrub]

Thank you.  I am in search mode to see what my options are outside BKK.  Ivorbigun suggested  Queen Sirakit hospital in Satahip and I will look into that one.  The doctor who examined me said no rush for the op and yes, I already have glaucoma and am using eye drops now.  Follow up exam may be more local(?) in 1 month's time.  Thanks again. 

[ivor bigun]

45 minutes ago, notrub said:

Thank you.  I am in search mode to see what my options are outside BKK.  Ivorbigun suggested  Queen Sirakit hospital in Satahip and I will look into that one.  The doctor who examined me said no rush for the op and yes, I already have glaucoma and am using eye drops now.  Follow up exam may be more local(?) in 1 month's time.  Thanks again. 

pm me if you want more information ,i know Rutnin are top rate ,but expensive ,when i first had a problem a local doctor said i needed a cataract operation next week ,that was 4 years ago lol. he did not even say i had eye pressure ,that was only told to me at Queen Sirakit ,,what drops are you using ,anyway pm me if you like .

[Mansell]

I also was told in my Sept visit that I would need new lenses.

I was also told it would be 80,000 baht for both eyes and it would take a few hours and go home. The double lenses were around 120,000, but she then told me that they would cause flaring at night making driving at night a no no....so besides cost the flaring turned me off. I am doing two different eye drops, mainly because in Korat they don’t sell the two combined....yet. I only have glaucoma, which isn’t a problem only for occasional slightly blurred vision. I wasn’t tol there was any rush etc. It would be good obviously if you could find other farang who have had the surgery, that way you would have a reference point. Good luck with it all.

[Mansell]

What was the name of the doctor you saw at Rutnin......maybe the same One as mine. She is only there Friday’s and Sundays.

[Sheryl]

6 hours ago, scubascuba3 said:

Would make me nervous having both eyes done the same time. In the UK i think it's still one at a time

When seeking to achieve monovision it is essential to do the 2 eyes at different times and the second only after vision on the first has stabilized.

[GreasyFingers]

I understand you not wanting to have several visits to Bangkok. I had a cataract operation at a private hospital in Phitsanulok for the same reason. But the doctor managed to stuff up the operation so if you are going local you need to ask the doctor serious questions on their ability. That can be embarrassing but you need to ask the question of how many operations has he done in the last week and month. If he has not done several go elsewhere. My specialist in Australia will do 5 in a session every week or two.

After the local operation I ended up with a detached retina that was fixed at Rutnin. A not 100% successful operation but I can see and that is all that matters. They are expensive because they greatly over service you. I must have at least 10 separate tests but when I asked for the results to take back to Aus. they only gave me two.

My next cataract is being done in Australia next year. Good luck.

[Blue bruce]

Can  you please give me the name of the eye Dr. In Buriram