My cataract adventures update

[notrub]

Recently I was given some very good advice about where to go for an eye examination.  I went to Rutnin Hospital and they diagnosed cataracts and glaucoma.  So far so good.  Cataract op with them is 90k baht per eye plus some other costs.  I live near Buriram so the trip to BKK is an effort not to mention all the other costs on top. 

 

In Buriram there is an eye Doctor named Nithidol who works at the hospital and also has a clinic which he runs in his spare time.  Many farangs have had cataract operations by him and he is very well thought of.  So, for lots of reasons I am going to him for the op.  His price is 20K baht per eye all in.  I will get to sleep in my own bed on the night of the operation.  He has also supplied the glaucoma drops at 600 per tiny bottle.

 

A very good thing that the doc at Rutnin hospital suggested is going for 'mono vision'.  What that is is to place a long distance lens in one eye and a near vision in the other.  I looked it up on You Tube and there is lots of information about this approach.  One drawback can be if one's brain cannot adapt to the long/short viewing.  Apparently mine are already like that so I don't anticipate any problems with that.

 

A pilot posted on You Tube that he had this treatment years ago before there were bifocal options.  He was obliged to keep glasses handy when working (flying) but he stated that he never needed them.

 

'That's all for now folks'.  I'll keep you posted.

 

PS I picked up some of those yellow sunglasses and they work very well even in the daytime making it easier to see.  I found them on Lazada at 2 pair for 110 baht (55 ea), free shipping for over 100 baht spent.

 

Happy and prosperous New Year.  Thanks again to those who took an interest and commented with advice.  

 

 

  

[Jingthing]

Nice story. 

Congratulations. 

Is there any way to tell beforehand whether your brain will have a problem with that adaptation or not? 

[transam]

90,000+bht per eye, wow, near 200,000bht..I had both mine done for a total 38,000bht the pair..????

[tifino]

 

The AllFocus type of IOL doesn't always work as well as supposed... (well, in my case anyway) 

The Dr much later on says the Pre-op eye pressure reading must have some err at the time of measuring - relative to what the prseeure would have normally averaged out to be... 

Anyways, what was supposed to be an AllFocus IOL, ended up being one that about the only thing that was in focus, is the Moon! What I am thinking about is that if you opty for a Short focus one eye, and Long focus the other... have the eyes done one at a time (not same session) 

you can then at least re-appraise your options for the 2nd one...

 

why Glaucoma drops? for Cataract situation?  what's the medication name on label?     Before the Op, I had a pair of near sighted eyes. Afterwards, I found out that you have to be lucky to get a good optometrist, that can deliveer a set of new glasses than can have one lens with a high +ve factor, and the other with a high -ve factor - and you not result in migraines... 

 

A far as having one long and one short focus eye now - yes luckily the brain does quickly adapt. 

I often quip how one shuts off (brain ignores it?) when reading... just like right now in front of the computer.

 - and then when driving, I can do the long distance stuff for the road ahead, and the other eye for the Speedo etc 

Edited January 4, 2020 by tifino

[notrub]

1 hour ago, Jingthing said:

Nice story. 

Congratulations. 

Is there any way to tell beforehand whether your brain will have a problem with that adaptation or not? 

Not sure but I think one option is to try out with contact lenses b4.   

[notrub]

50 minutes ago, tifino said:

 

The AllFocus type of IOL doesn't always work as well as supposed... (well, in my case anyway) 

The Dr much later on says the Pre-op eye pressure reading must have some err at the time of measuring - relative to what the prseeure would have normally averaged out to be... 

Anyways, what was supposed to be an AllFocus IOL, ended up being one that about the only thing that was in focus, is the Moon! What I am thinking about is that if you opty for a Short focus one eye, and Long focus the other... have the eyes done one at a time (not same session) 

you can then at least re-appraise your options for the 2nd one...

 

why Glaucoma drops? for Cataract situation?  what's the medication name on label?     Before the Op, I had a pair of near sighted eyes. Afterwards, I found out that you have to be lucky to get a good optometrist, that can deliveer a set of new glasses than can have one lens with a high +ve factor, and the other with a high -ve factor - and you not result in migraines... 

 

A far as having one long and one short focus eye now - yes luckily the brain does quickly adapt. 

I often quip how one shuts off (brain ignores it?) when reading... just like right now in front of the computer.

 - and then when driving, I can do the long distance stuff for the road ahead, and the other eye for the Speedo etc 

There will be a month between ops on eye 1 and 2.  Long vision 1st on strong eye then will see how it goes.  The glaucoma drops are a standard treatment to stop degeneration of, I think, the optic nerve.

[Sheryl]

1 hour ago, Jingthing said:

Nice story. 

Congratulations. 

Is there any way to tell beforehand whether your brain will have a problem with that adaptation or not? 

Yes. A fairly easy way is to artificially create monovision via contact lens and try it for a few weeks.

 

I went for monovision when I got Lasik surgery and almost 20 years on still don't need reading glasses (knock on wood)

 

My aunt just had cataract surgery this year and opted for monovision. Very happy with it.

 

Not only does it avoid the higher cost of "progressive lens" but it works better for most people. There are some exceptions which is why the contact lens trial may be a good idea if the person does not already have a significant imbalance between the 2 eyes.

 

It is necessary to do the 2 eyes a few months apart to achieve monovision as need to see what the vision is in the first eye after it stabilizes.

[tweedledee2]

1 hour ago, notrub said:

There will be a month between ops on eye 1 and 2.  Long vision 1st on strong eye then will see how it goes.  The glaucoma drops are a standard treatment to stop degeneration of, I think, the optic nerve.

When I had cataract surgery 4 years ago, I was prescribed 2 post-op eye drop meds, an antibiotic and a steroid. 

[lopburi3]

13 hours ago, tweedledee2 said:

When I had cataract surgery 4 years ago, I was prescribed 2 post-op eye drop meds, an antibiotic and a steroid. 

Yes there are short term medications after operation but that has nothing to do with the glaucoma issue.  With open angle glaucoma you need to keep internal eye pressure relatively low to avoid further issues (gradual loss of vision starting with perficial) and have regular eye pressure tests and occasional computer visual field tests (which may not be available everywhere).  This is most likely for lifetime if it works and operation is not required.   

[notrub]

Thank you all very much for interesting and supportive comments.  Happy to learn of your experience Sheryl and gives me even more confidence to go for the monovision option.  I have been surprised that more people are not aware of this solution given the amount of information posted on Facebook.  

 

I ordered glasses from 'Zenni' online using the prescription provided by Rutnin and they arrived without any surprises.  The price for quality coated, armoured lenses and frames was much, much, (much) less than basic glasses from the local chain store outlet.  They work very well and I am surprised how quickly my brain adjusts to seeing with them on (vision gets progressively better after a few moments).  After a day of driving using the glasses my brain takes some time to adjust and see 'normally' without them when I get home.  Funny ai?  My vision is not too bad and it is primarily for problems driving at night that I am having the cataract surgery done.

 

Thanks again.  Look forward to the next exchange of ideas in the future.

[JHolmesJr]

I suppose this mono vision thing (one eye for distance, one for reading) only works optimally when you are going to both eyes in rapid succession.

 

 

[notrub]

12 minutes ago, JHolmesJr said:

I suppose this mono vision thing (one eye for distance, one for reading) only works optimally when you are going to both eyes in rapid succession.

 

 

No, I understand the contrary.  Apparently one must adjust to the new lens before any further corrective surgery is done to the other.  If that is what you mean...

[ThaiBunny]

3 minutes ago, notrub said:

No, I understand the contrary.  Apparently one must adjust to the new lens before any further corrective surgery is done to the other.  If that is what you mean...

The cataract specialist explained to me that if in the very rare case of cataract surgery going astray, you can end up blind if they do both eyes at the same time. Hence they leave a gap between doing each eye to ensure that the first eye has recovered

[transam]

1 minute ago, ThaiBunny said:

The cataract specialist explained to me that if in the very rare case of cataract surgery going astray, you can end up blind if they do both eyes at the same time. Hence they leave a gap between doing each eye to ensure that the first eye has recovered

Retina detachment is a risk factor after cataract surgery. I had both mine done with a months gap between them.

Unfortunately I was unlucky and had a detached retina after the second lens op.... ????.......They did laser, freeze and eye fluid drain (gas filled) to fix it...All OK now, I hope....????

PS. I had a detached retina fixed back in 2001, the other eye..

[NancyL]

When I was sixteen I really wanted contacts so I didn't have to wear the glasses I'd worn since I was a kid -- near-sighted with astigmatism.  Sadly, I found that they irritated my eyes and I always felt like I had something in them, but I was vain and discovered that I could get my with just one contact for the eye that was in the worst shape, visually.  Eventually, I gave up because I was messing with the contact all the time, cleaning it, trying to make it more comfortable.

 

Five or six years later an optician convince me to try soft contact and while they were more comfortable, I still had that feeling of something in my eye and went back to just wearing one, but at least I could tolerate it.

 

So, yes, the brain does adjust nicely to having sight in one eye, or one eye better than the other.

 

After college, I went to work for a chemical company and we weren't allowed to wear contacts to work because of the likelihood of chemical releases at the plant and the danger of having chlorine gas or something else getting under the contacts.  Besides, they supplied prescription safety glasses for free and there were some frame options that didn't look half bad.  I still wish I could get safety glasses frames because they hold up much better than the frames sold in the optical stores or online if you bang into a open kitchen cabinet door, or some similar boo-boo as I'm prone to do since I have zippo depth perception. 

[dddave]

On 1/4/2020 at 4:57 PM, transam said:

90,000+bht per eye, wow, near 200,000bht..I had both mine done for a total 38,000bht the pair..????

Rutnin seems to be following the Bumrungrad model, catering to well heeled Middle-Easterners.

[notrub]

Take a look at Zenni an on line supplier of prescription glasses.  Their selection of frames and lens types is extensive.

 

[notrub]

On 1/4/2020 at 4:42 PM, Jingthing said:

Nice story. 

Congratulations. 

Is there any way to tell beforehand whether your brain will have a problem with that adaptation or not? 

The Dr. at Nithidol said my eyes were already imbalanced in their focal distance.  I have had the operation in Buriram and it all went 100%.  

[TSF]

I had my right eye cataract done in August at St. Mary's Hospital in Korat. Upfront cost was 28,000 Bt, which included a bag of eyedrops. I had to make about 4 or 5 visits back to the hospital for the doc to check and more drops. Each of those visits cost me approx 1,000Bt. So total cost was about 33,000 Bt. Vision in right eye is brilliant. I no longer wear glasses for driving or watching TV & movies. But do still need reading glasses for computer/shopping. 

[notrub]

2 hours ago, TSF said:

I had my right eye cataract done in August at St. Mary's Hospital in Korat. Upfront cost was 28,000 Bt, which included a bag of eyedrops. I had to make about 4 or 5 visits back to the hospital for the doc to check and more drops. Each of those visits cost me approx 1,000Bt. So total cost was about 33,000 Bt. Vision in right eye is brilliant. I no longer wear glasses for driving or watching TV & movies. But do still need reading glasses for computer/shopping. 

I can't really remember mine were perhaps 20,000 each all in.  (I thought less but  probably wrong) .  Dr Nithadon (Nithadol?) charges 500  or so for a checkup and 700 per tiny bottle of glaucoma drops (they are 1000+ elsewhere).  I have read that some doctors fit different focale length contacts to check on whether your brain can adjust.  Or, I have read that people who co for monovision and cannot  adapt have to have the lens replaced in a second operation.  Happy that it is done and dusted.

[transam]

2 minutes ago, notrub said:

I can't really remember mine were perhaps 20,000 each all in.  (I thought less but  probably wrong) .  Dr Nithadon (Nithadol?) charges 500  or so for a checkup and 700 per tiny bottle of glaucoma drops (they are 1000+ elsewhere).  I have read that some doctors fit different focale length contacts to check on whether your brain can adjust.  Or, I have read that people who co for monovision and cannot  adapt have to have the lens replaced in a second operation.  Happy that it is done and dusted.

Mine came to a total of 36,000bht, all in, for the pair......I kept both for distance, I use specs for the PC and reading.

I can see for miles now....????

 

 

[TSF]

My left eye also has a cataract but according to the specialist at St. Mary's it doesn't need removing at this stage. I'm 74 next birthday so hopefully I'll make it through the remainder of my life without surgery. I really hated the op while it was going on. Last year in Australia I had 2 skin cancers cut out from my thigh and upper arm and they were a breeze as I could turn away and detach myself from the procedure. But I couldn't detach myself when the doc was cutting into my eyeball...not pleasant at all. Anyway, as I said vision is now greatly improved.

[Cake Monster]

On 1/4/2020 at 4:29 PM, notrub said:

PS I picked up some of those yellow sunglasses and they work very well even in the daytime making it easier to see.  I found them on Lazada at 2 pair for 110 baht (55 ea), free shipping for over 100 baht spent.

As a Target Shooter ( many years ago ), Yellow coloured Diopter Filters and Fore Sight Elements were my No 1 choice.

The reason is that Yellow will highlight contour differences and contrast the best.

I am not so sure about using the cheap Glasses though. Cateracts can be enhanced when in bright light.

I would try to  find some Glasses that are Yellow and also Polarized.

On 1/4/2020 at 5:53 PM, notrub said:

The glaucoma drops are a standard treatment to stop degeneration of, I think, the optic nerve.

The Glaucoma drops are a standard treatment for the reduction  of pressure in the Eye, which then causes damage to the Optic nerve.

However, you may be wrapped up in a never ending battle to reduce the pressure through the usage of drops in various Cocktails ( there are only 3 drops that could work )

I had this issue, where I was spending Money every Month at a Private Clinic on drops. Eventually something happened with my treatment  where I questioned the competence and ethics of the Doctor.

Just as well I did, as I then went to The Sirikit Hospital in Sattahip, where I was told I would need an Operation on my Eye to reduce the pressure that by then was well over 24 and in Danger territory.

I had the Operation, and have had no further problem with Eye Pressure, but now  have cateracts as a result of all the previous Trauma.

PM me if you need some advice Re Surgery Etc

 

[ivor bigun]

i have a cataract ,,i was told 5 years ago at a private clinic i needed an immediate operation ,went to queen Sirakit govt hospital in satahip ,still dont need the operation ,but they gave me drops for the pressure in my eyes that the private clinic had not noted .

most private hospitals are just money making machines.

[lopburi3]

11 hours ago, ivor bigun said:

i have a cataract ,,i was told 5 years ago at a private clinic i needed an immediate operation ,went to queen Sirakit govt hospital in satahip ,still dont need the operation ,but they gave me drops for the pressure in my eyes that the private clinic had not noted .

most private hospitals are just money making machines.

Actually private hospitals have doctors that treat you - they make the calls and that can be good or less so depending on the doctor.  Both types of facilities have various quality of doctors but both the top private and government facilities will attract some of the best.  But outside of a handful in major population centers private hospitals may not be as attractive to most doctors.