Health & Wellness

Cataract Surgery - pros and cons of options

  • Last Updated:
  • Jan 17th, 2019 12:43 pm
Sr. Member
Nov 16, 2011
646 posts
395 upvotes
HAMILTON
I had cataract surgery in SW Ontario a few years ago.

To see an ophthalmologist you must be referred by family or other doctor. Saw an ophthalmologist for a few years till my vision was quite clouded and referred to a surgeon.

Only 3 options presented, OHIP standard lens replacement, more accurate laser measurements of eyes and a lens that would be more accurate and final was a lens that would make so would not need lens.

Went middle of road and had 1 eye done and the other bout 2 months later. Have good distance vision but reading extensively and computer work use $ store type glasses.

Things I found was that I ended up unsure as to whether the surgeon did the work or an assistant and the operations were done by 2 different people as can tell after surgery.

Also found that in the 2nd eye, has felt as if a stitch left or tear duct issue since surgery. Has been checked by ophthalmologist and optomitrist both of which say nothing there\wrong but I need to use eye lubricant and for sure I know an tear duct is blocked now in corner of my eye.

Basically, few issues but vision is better and no issues re driving. Part of the problem is that the whole process is a crap shoot. In Ontario, can only see the ophthalmologist with Dr referral so no choices and they are in control. If you fuss too much, you start hearing that your vision is impaired and may affect your driving ability so best shut up and go with the flow.

I can see so I am good...... and much better than having cloudy lens as I had prior to surgery.
Newbie
Oct 4, 2018
25 posts
8 upvotes
luckystrike1 wrote:
Dec 22nd, 2018 10:00 pm
I had cataract surgery in SW Ontario a few years ago.

To see an ophthalmologist you must be referred by family or other doctor. Saw an ophthalmologist for a few years till my vision was quite clouded and referred to a surgeon.

Only 3 options presented, OHIP standard lens replacement, more accurate laser measurements of eyes and a lens that would be more accurate and final was a lens that would make so would not need lens.

Went middle of road and had 1 eye done and the other bout 2 months later. Have good distance vision but reading extensively and computer work use $ store type glasses.

Things I found was that I ended up unsure as to whether the surgeon did the work or an assistant and the operations were done by 2 different people as can tell after surgery.

Also found that in the 2nd eye, has felt as if a stitch left or tear duct issue since surgery. Has been checked by ophthalmologist and optomitrist both of which say nothing there\wrong but I need to use eye lubricant and for sure I know an tear duct is blocked now in corner of my eye.

Basically, few issues but vision is better and no issues re driving. Part of the problem is that the whole process is a crap shoot. In Ontario, can only see the ophthalmologist with Dr referral so no choices and they are in control. If you fuss too much, you start hearing that your vision is impaired and may affect your driving ability so best shut up and go with the flow.

I can see so I am good...... and much better than having cloudy lens as I had prior to surgery.
Yes, a doctor's referral is required to see an ophthalmologist. It is the same everywhere. But one can still make a private appointment to see one and pay out of own pocket, usually $100 for consultation and perhaps more for various tests.
Very sorry to hear that your tear duct is blocked. Perhaps you could get a referral to see another ophthalmologist who specializes in Dry Eye / blocked tear duct.
If your surgery was done at a teaching hospital, you are probably right about the surgeon's assistant. That is why most people advise NOT go to a teaching hospital when it comes to ophthalmology.
In fact, the site gives these good reasons for considering a private cataract surgery:
"Several newer innovations in cataract surgery are not covered by OHIP and are optional choices for all patients in Ontario. These uninsured services are not medically necessary and are designed to reduce dependence on glasses/contact lenses, and/or to potentially enhance the quality of your vision."
Deal Guru
User avatar
Dec 23, 2003
12629 posts
1421 upvotes
Toronto
My Dad got the Cataract surgery at the Kensington Eye Institute several years ago. The doctor we consulted (Head of Sunnybrook) suggested we just use the free lenses by OHIP as the others are not much better but cost much more.

My suggestion is to get assessments from someone who has been doing this for a long time. The younger guys are after money and will suggest you the more expensive items so that they make $$$.
Sr. Member
Nov 16, 2011
646 posts
395 upvotes
HAMILTON
ophthalmologists are one of the highest paid professions in the medical field.

I previously had 1 for a number of years that retired, one other that just seemed to disappear off the planet and the one that did my surgery. No, not a teaching hospital.

I find it challenging to believe that you can find one willing to take without a Dr's referral as they all want to know your full medical history and are quite busy regardless. And would be interested in the cost as an operating room, anethesiologist, etc certainly cost quite a bit of $.. Would seem that you would have to be quite well off.

Am heading back to the person that did my surgery regarding tear duct issue, etc and have been forewarned that failure to show for the appointment will result in a $150 charge.

Such
Newbie
Oct 4, 2018
25 posts
8 upvotes
We only tried it once when Dad lost partial vision suddenly. The family doctor was fully booked and the earliest appointment would be two weeks away. And even with his referral, the earliest appointment with any ophthalmologist would be another month or months away. Fortunately one ophthalmologist agreed to see my Dad the same day and gave him a laser surgery that afternoon that saved his eyesight. Btw he waived the consultation fee. Like you said, they do not need to make that extra hundred bucks.
As the others mentioned, a private cataract surgery is in the ballpark of $2000 to $4000 depending on the lens of your choice. A tooth implant costs much more.
Deal Fanatic
User avatar
Dec 28, 2007
5062 posts
1450 upvotes
Alberta
I had cataract surgery done a couple of years ago. I chose option 3 but it didn't cost me anything. It was covered 100% by Alberta Health Care. For close reading, I just buy the cheap reading glasses from Costco for something like 3/$19.95. I do have 2 pairs of prescription glasses but find that I rarely use them. No issues so far.
[OP]
Deal Addict
User avatar
Mar 28, 2005
4627 posts
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Ontario / Quebec
beamme wrote:
Oct 7th, 2018 3:34 pm
where are you?
priority 4 patient's first eye specialist appointment, waited on average 83 days, should be seen within a target time 182 days.
priority 3 patient's ....81 days ... 90 days
priority 2 patient's ....96 days ... 30 days
hospitals with the most patients - surgical waitlist average 105 days (Brockville) to 261 days (Cornwall)
Gosh, RFD is really sporadic with email notification.
Works most of the time but not all the time like it did with this thread.
I just checked not even realizing it was my original thread.

Anyway - I'm in Cornwall and once I decided to go ahead with the surgery the wait time was relatively short, certainly nothing even remotely close to 261 days.
Would the interval not depend on the availability of your ophthalmologist?
[OP]
Deal Addict
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Mar 28, 2005
4627 posts
575 upvotes
Ontario / Quebec
My experience with the process.

First I did some research as to which ophthalmologist I eventually wanted to see after I moved to a new city.

Then I made an appointment with the optometrist that worked in the same building and had him refer me to that ophthalmologist of my choice.
Took over six months to get my original appointment with the ophthalmologist but after that everything went very smoothly.
In fact, that ophthalmologist was the first doctor of any type in all my years seeing doctors who actually took you at your appointment time - the norm seemed to be to wait anywhere between 45 minutes and 2 hours after the appointment time before the doctor would see one.

The surgery was done two weeks apart by the ophthalmologist; had the option of either the standard OHIP ultrasound measurement or a slightly more expensive but more accurate laser measurement. On the lenses there were four options from covered by OHIP to quite expensive multi-focus lenses.
I figured since this will be a one-time expense and not something where I can easily upgrade, I went for the laser measurement and the slightly more expensive lenses.
The third and fourth very expensive multi-focus lenses were not suitable for me I was told.

End result of all that after more than a year now - everything worked out very well, I see my ophthalmologist on a regular basis since I also have glaucoma and damage to one of the retinas from years ago, but the cataract surgery provided me with much better vision in general.
For reading and computer work, I use 2.00 reading glasses, otherwise vison is either 20/20 or 20/30
Newbie
Oct 4, 2018
25 posts
8 upvotes
Your case was special. Glaucoma can lead to irreversible damage to the optic nerve; cataract does not. Hence your surgery was fast-tracked.
In some provinces, surgeons are legally prohibited from offering faster surgery for a fee, otherwise known as queue jumping. For those who do not want to wait a further ten months or a year for a cataract surgery, going private is an option. Don't forget that they have waited months (in your case 6 months) just to get that first appointment with the ophthalmologist. And then a further two to four years for the cataract to mature to a point of visual impairment not correctable with glasses (20/50 or worse).
[OP]
Deal Addict
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Mar 28, 2005
4627 posts
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Ontario / Quebec
beamme wrote:
Jan 10th, 2019 5:15 pm
Your case was special. Glaucoma can lead to irreversible damage to the optic nerve; cataract does not. Hence your surgery was fast-tracked.
I don't follow your logic.
What does cataract surgery have to do with glaucoma, ie why would having glaucoma make me a candidate for "fast-tracked" cataract surgery?

I have had glaucoma for more than 30 years - it was kept under control using eye drops.
The reason I had to wait for an opthamologist appointment for 6 months was because I moved to a new town and there were only a few in town and I wanted to be seen by a specific one. based on reviews. That was just a continuation of seeing an othamologist at my previous location.

Maybe the cataract surgery was fast tracked, but I didn't get the impression that it was.
I suppose it depends on the city one is in and the current backlog of cataract patients.

Also a note about luckystrike1's comment/problem - feels like there is stitch left or tear duct issue.
My cataract surgery did not involve any stitches and I didn't end up with any tear duct issues either.
As I understood it, the incision that was made was only a couple of miilimeters - I just wore an eye patch while sleeping for about a week, took some special drops during that time to prevent any infection and that was it.
Newbie
Oct 4, 2018
25 posts
8 upvotes
If you go (*read up) the cataract treatment guidelines, other indications for cataract removal include:
"Lens-induced disease: phacomorphic glaucoma, phacolytic glaucoma, and other lens-induced disease may require cataract surgery and the need for extraction may be urgent."
Newbie
Oct 4, 2018
25 posts
8 upvotes
If you *read up* the cataract treatment guidelines, other indications for cataract removal include:
"Lens-induced disease: phacomorphic glaucoma, phacolytic glaucoma, and other lens-induced disease may require cataract surgery and the need for extraction may be urgent."
-----------* correction

I was in a bit of rush when I wrote that 2 days ago.
The guideline for the cataract surgeons was developed by the Guidelines and Protocols Advisory Committee, approved and adopted by the Medical Services Commission.
A family member cannot comprehend the logic wrt "Visual ability in patients legally blind in one eye"; surgery in patients with cataract in one eye who are legally blind in the other eye are the same as for other patients. Long wait list as everyone else.
[OP]
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Mar 28, 2005
4627 posts
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Ontario / Quebec
Ironically....I opened up the local Cornwall paper today and on page A5 there is a big article entitled:
There's cataract surgery capacity at CCH

Turns out the hospital is funded for 1327 surgeries between now and their fiscal year end of 31 March 2019 and is actually looking for cataract patients.
According to the article,one can "self-refer" and call the hospital directly where they have expert nurses and ophthalmologists to perform the surgeries.
Wait time is 4 to 6 weeks.

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