The Quick Fix: Cataracts and the mature photographer

Over the past couple of weeks, I have had an extraordinary once-in-a-lifetime opportunity to learn what it means to suffer from cataracts. From a photographer’s point of view, I feel like I’ve been processed in Lightroom and emerged all the sharper for it. I can’t help thinking I’ve had a couple of two-stop ND filters in front of my eyes for the past few years.

Many readers will already have had their cataracts removed. Others will be thinking of it, while younger readers won’t have given a moment’s attention to the remote possibility. For those of you of a certain age, however, this story will be of interest.

My decision to stagger the operations, with a week between eyes, gave me the unique opportunity to make direct comparisons and to tweak the prescription for the second eye. As a photographer, I can understand the theory but I was fascinated by this possibility of checking a good eye and a bad eye side by side.

Cataracts coming

Three years ago, during a routine eye test, the dreaded word cataract was mentioned. I had thought I was immune and far too young (which, of course, I am not, but vanity played a part). I didn’t dwell much on the tidings, though, especially when I was assured it would be many years before I really needed surgery.

While I knew nothing much of the consequences of cataracts, I had been having some problems focusing on the computer screen for several years. Even five years ago, the screen image hovered somewhere between my corrected short sight and long sight with the result that working on Macfilos became a bit of a strain. I wavered between a fixed monitor and a laptop where I could adjust the screen to the optimum distance.

A pair of computer glasses promised much when I wrote about them on Macfilos. But they weren’t a permanent solution and I have been struggling.

As far as I was aware, these focus problems were simply a matter of ageing and I was constantly trying new prescriptions in an effort to get back to some semblance of normal. Now I realise that no amount of tweaking the prescription would have ensured perfect focus because of those troublesome cataracts.

Vision correction

Then I heard that a fortunate corollary of cataract surgery is the opportunity to correct focus (at extra cost, however). So, even though I didn’t think I really needed surgery, I decided to go ahead after discussion with two independent ophthalmic surgeons. When your eyesight is in question, it pays to get the best advice.

There are many options for correction, including a full-blown varifocal lens that, in theory, entirely removes the need for glasses. Nevertheless, there are also some potential disadvantages if the results are not absolutely spot on, as I was told.

The recommendation from both ophthalmologists was to opt instead for the simpler correction of long sight. I understood I would still need glasses for reading and for computer work. I still didn’t think the cataracts were all that much of a problem; I was really focused on correcting my long sight so I wouldn’t need to wear glasses in general situations. I also hoped, for the first time in many years, to be able to use a camera viewfinder without wearing glasses.

My chosen ophthalmic surgeon, Professor Riaz Asaria, decided to correct the left eye, which had the poorer long-distance vision, in the first surgery. I didn’t know what to expect. After all, this is an operation that most people experience only once in a lifetime. We all know someone who has “had their cataracts done” but most of us have only the haziest notion of what is involved.

The procedure: Most cataract operations are performed under local anaesthetic. I was offered sedation and, wimp that I am, took it. As a result, I cannot tell you anything about the process. I drifted off with cataracts in place and woke with new lenses inserted. All very stress-free and satisfactory. If you are a bit squeamish, sedation might be the best option.

In transition

Two weeks ago, I had the cataract removed from my left eye. Long-distance focus in that eye had been bad for many years, while the long vision in my other eye was pretty spot on (as I thought but it turned out I was wrong in the assumption). Using both eyes together, I had little difficulty in seeing to infinity. However, I definitely needed glasses for close work.

Immediately after the procedure, there was a dramatic change in my left eye. I found none of the transitional cloudiness or lack of focus that I had been warned about. Instead, my vision was absolutely perfect as soon as I opened the eye, as far as I could judge. Whites were brilliant, the contrast was much improved and the focus tack sharp.

From that moment on, I had a ready reference panel, just like in Lightroom, with the corrected eye on the left and the right eye, still clouded and softened by the cataract, on the right.

Stark difference

The differences were astonishing. My previous norm, still visible through the right eye, was definitely inferior. Whites were yellowish, the contrast was poor, blacks were less intense.

I soon realised that I had been seeing white with a sort of dirty, yellowish hue for many years. It’s rather like a white-plastic computer housing that has started to yellow over the years. An interesting aside was that, when I returned home, the walls in my hall were once more brilliant white. Up to that Friday morning, I had been complaining they had turned yellowish and I was planning to have them redecorated. That’s saved a bit of cash for starters.

If I were an iPhone and not a human being, I would just take a couple of screenshots to show what I mean. Instead, I’ve tried to reproduce in these pictures what I think I was seeing at halfway stage last week. The top photograph simulates the corrected vision, through my left eye. The lower picture represents what I have been seeing for the past few years through the cloudy cataract. It’s very much a simulation and flatters the focus in the bottom example, but it gives you some idea of my perception.

Already, my overall vision (using both eyes) was so much better than before. And the astounding aspect is that I hadn’t realised the real impact of even early-stage cataract formation. With the benefit of the now-corrected left eye, I could see that the focus in the right eye was not as good as I thought. There was some fuzziness, apart from the now-clear yellowing and loss of contrast.

I am now wondering to what extent this disorder has been influencing my image processing in the past few years. It’s possible I have been making the wrong calls, perhaps oversharpening to compensate for the cataract-induced softness. I am looking forward to doing some processing over the next few weeks.

Tailoring the second eye

Following the successful treatment of my left eye, I was able to have a discussion with Professor Asaria on my requirements for the right eye. This possibility is another reason (apart from safety) to stagger the two procedures.

I explained that, while I could see perfectly when driving after the first operation, the instruments (in my case the Tesla’s 15in tablet) was slightly out of focus. I had been driving with reading glasses perched on the end of my nose. He offered to fix this, by increasing the depth of field in the second eye, thus ensuring sharp focus at 30 cm instead of 70 cm with the left eye.

It is now a week since I had the second cataract removed. The distance focus is not quite as tack sharp as in the left eye, but the Prof was true to his word in his adjustment of the near focus. As a result, when using both eyes (which is the default position…) I have what I think is perfectly sharp vision from as close as 30 cm to infinity.

I have the same brightness, brilliant whites and high contrast that I saw two weeks ago in the left eye. I also sense that subject separation is more pronounced. Screen icons are now much strongly defined and leap out in a way that didn’t happen before. All-round good news, really.

Cheap reading

What about reading and screen work? I was prepared for some upheaval and the prospect of not being able to read comfortably in the week between the operations. I also anticipated problems working on a computer screen.

None of this came to pass, although of course we are all different and nothing can be read into this. I was lucky.

I soon discovered that I could manage really well with cheap “pharmacy” glasses. I bought three pairs for experimental purposes (1.5, 2.0 and 2.5 diopter), and all serve well for reading. For computer work, though, 1.5 diopter seems to be the best option, giving me the widest depth of field to encompass both reading and viewing the computer screen. The magnification of the 2 and 2.5 diopter lenses is greater but the depth of field is narrower. It’s a bit like comparing the depth of field of a 28 mm lens with a 35 mm a 50 mm at f/5.6.

I can now happily squirrel away reading glasses all over the house, in every jacket pocket and bag. And if I forget them one day, all I need to do is visit the nearest Boots or Walgreens where replacements are always available. In the past, I’ve been dismissive about these off-the-peg optics. Yet they are working perfectly and I have no need to spend more on prescription glasses.

The computer screen, which I can now use without glasses (although the reading glasses are more comfortable) has come into fresh life, with vibrant colours, tack-sharp focus and incredible contrast. At least, that’s what it looks like to me, although no doubt the euphoria will give way to gentle satisfaction over the months.

Look Ma, no glasses!

For the first time in decades, I can now use a camera (rangefinder or EVF) without wearing glasses. To some extent, I could do this before, with diopter adjustment in the case of the EVF, but I couldn’t keep taking off my glasses every time I wanted to take a picture.

The view through the finders on the Q2 and SL2 is now more vivid and lifelike. Part of this is a result of being able to get the eye much closer to the finder, so there is less stray light coming in from the sides. The rangefinder on my M10-D is sharper and easier to focus. I had feared I might require a diopter attachment for the M but I believe this will be unnecessary. The main point, though, is not having the inconvenience of a pair of glasses between the eye and the viewfinder.

In a matter of days, I’ve gone from peering through a soft classic Summar with a yellow filter attached to seeing the world through a bang-to-rights APO-Summicron ASPH.

At the moment I am enjoying walking around without needing glasses and, undoubtedly, I will find photography more convenient. I have just one qualm and that is the new inconvenience of having to fish out a pair of glasses when consulting the smartphone or reading a caption in a museum exhibit.

There is also another worry at the back of my mind, the feeling that my naked eyes are now more vulnerable, perhaps to the occasion low-hanging twig or speck of dust. I also recalled a story that wearers of glasses are more likely to contract Covid. But this is probably yet another old pandemicist’s tale to be ignored.

For general pottering around, for driving and for all non-close reading, I’m now free of glasses for the first time in adulthood and I’m loving it.

Have you had your cataracts removed? What are your conclusions, particularly in relation to the use of cameras, image processing and the way you now see the world? Any tips on the choice between full correction and long-sight improvement only?

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