Will I be wearing a patch after
Following is a synopsis of cataract surgery as experienced by a
patient. This is an edited version of a draft penned by Mr. Edward J. Trethaway.
A number of Dr. Shingleton's patients have added comments to make it helpful to
patients preparing for cataract
When the normally clear lens
within the eye becomes cloudy and opaque it is called a cataract. Cataracts vary
from extremely small areas of cloudiness to large opaque areas that cause a
noticeable loss of vision. One method to treat cataracts is surgical removal
with the use of ultrasound and intraocular lens implantation.
preparing to have cataract surgery may be as apprehensive as I was when told
that the procedure would be done under local anesthesia. While I could accept
having a cyst removed from my face or finger under "local," I found it
intimidating to be conscious during eye surgery. Despite being told by my
primary eye care doctor and Dr. Shingleton that the surgery was short, painless
and that I wouldn't see instruments or anything alarming---I was apprehensive. I
wanted reassurance from another patient. The patient reassured me that the
surgery would be as the doctors described. Therefore, to put everyone who is
contemplating this procedure at ease, I have documented my cataract surgery
Pre-operative Visit with Surgeon
At some point,
a person with a cataract is told that cataract removal is required to improve
vision. If the patient agrees, an eye examination is scheduled with a cataract
surgeon, and, in my case, this was Dr. Shingleton. Dr. Shingleton confirmed that
the cataract should be removed and determined the specifications of the
intraocular lens to be implanted. Information about the surgery was provided and
all my questions were answered. Surgery was scheduled by Dr. Shingleton's
surgical coordinator. The date and time were determined by my sense of urgency
and Dr. Shingleton's schedule. Most patients are accommodated within 1-2 months.
The Day of Surgery
Cataract surgery with Dr.
Shingleton at the Boston Eye Surgery & Laser Center or the Cape Cod Eye
Surgery and Laser Center is a 3-step procedure which takes approximately 3
Preparation - More data is gathered, an identification bracelet is attached
and eye drops are administered for various purposes including dilating the pupil
and anesthetizing the eye. Intravenous is started for safety purposes.
Surgery - My surgery suite had a large, cheery pastoral scene covering an
entire wall---hardly a bleak, unfriendly environment!
You are moved to a
surgical chair and reclined to a comfortable position. The skin surrounding the
eye is sterilized with a solution. It is then covered with what appeared to be a
light gray piece of translucent plastic material with a hole around the eye. The
junction of the sterile material with the hole over the eye is adhered to the
face with medical tape. The plastic drape allows light in and is lifted away
from your nose and mouth so that you can breathe easily and don't feel confined.
The rest of the body is covered with a warm blanket.
At this point you
are ready for surgery. Dr. Shingleton greets and reassures you. He explains what
you will experience. The anesthesia has made the area totally numb and the
eyelids are held open with a lid holder. Throughout the 10-minute procedure you
will see a broad bright light which is not uncomfortable (I saw three rather
small blue lights). While conversation is minimal, you can ask questions and the
doctor may ask you to "look up" or "look down" to reposition the eyeball a
little differently. Some anesthesia does not allow mobility of the eye. In
either case, an ultrasound/vacuum instrument removes the cloudy lens and the
artificial intraocular lens is inserted. There is no pain or discomfort during
One of the things that fascinated me was how Dr.
Shingleton inserted the ¼" diameter lens through a 1/8" opening. When my surgery
was complete, Dr. Shingleton showed me the tool he used to insert the
intraocular lens. It folds the lens into a "taco shape" and then the lens
unfolds in the eye. This is often done without any stitches.
Recovery -- This phase lasts 30 to 45 minutes. The heart, lungs and blood
pressure continue to be monitored. You are brought coffee, tea or juice and a
muffin or cookie. If a friend or relative joined you, they can visit you in the
There is one added, interesting feature in the waiting
room. If someone accompanies you to surgery, they can watch your operation on a
TV monitor in a sectioned off portion of the waiting room. There is no blood and
it is not difficult to watch. On the 18" screen you see a 9" diameter eyeball
and the various steps taking place. My wife declined to watch, but I watched
several cases after mine. When I am at the Surgery Center for another medical
checkup next year, I am actually planning to watch a procedure
Post-operative Information and Comments
several cautions to be observed for up to 4 weeks after surgery. Daily drops in
decreasing numbers are used during this period. Precautions are written and
instructions are given to you following your surgery. Here is the program that I
followed, but each person will be given advice from his own doctor. This
information is provided as an example of what to expect.
Three different drops are placed in the eye four to six times a day for the
first week, three to four times a day for the second week, two times a week for
the third week, and once a day for the fourth week. The surgical facility
provided samples and prescriptions for refills.
A) A shield is worn over the operated right eye for the first night while
B) Bending, kneeling and squatting are
C) Lifting of normal weights can be done with full
activity at two weeks following surgery.
D) If there is minor
discomfort in the eye, Tylenol may be taken. I took one tab on the first night
because of a little scratchiness.
E) The doctor said I could drive a
car 24-hours after surgery. This decision obviously depends on the condition of
the fellow eye.
F) Showers can be taken immediately and your hair can
be washed. It is important to cover to keep it dry. No restrictions in terms of
water contact are present after three weeks.
G) Swimming in a pool is
not recommended until two weeks after surgery.
H) Healing is complete
at 4 weeks and all activity can be resumed at this time.
I) You are
expected to stay in the New England area from one week. Travel outside the
continental United States is not allowed for one month after surgery.
I consider the vision in my operative eye NORMAL for all intents and
purposes, however, I do notice some light sensitivity when looking at a
reasonably bright light. This is not a problem when using both eyes. Also, there
is a difference in color appreciation between the two eyes. The operated eye
The need for new glasses depends on how quickly the eye stabilizes after
surgery as measured by refraction. In my case, there was no effective change in
prescription and no glasses were required. It should be noted that if a patient
is over 65 and on Medicare, 80% of the cost of the lenses and new frames are
covered by that insurance. The optician will fill out the necessary
Surgery and anesthesia can affect blood counts for up to one week. I have
adult onset diabetes type II and my sugar count increased for six
I am delighted with the results of the cataract
surgery, as is everyone I have talked with who has had the same operation. No
one needing similar treatment should be apprehensive. I hope this statement
reassures everyone about the procedure and the post-operative care. It is a very
interesting learning experience, one of life's very tolerable adventures. It is
truly a modern medical miracle!
Note from Dr.
I thank Mr. Trethaway and all other patients who
reviewed his text and added their comments. I hope this will make you feel more
comfortable about your cataract surgery experience.A Poem from a
PatientDoctor Bradford ShingletonBy Catherine L.
LewisThe practice of Doctor ShingletonIs in a large office in
BostonHis given first name is BradfordHis is the one on
StanifordHis staff is absolutely greatNaturally, one has to
waitHe's probably best in the stateHis efforts are called first
rateMy left eye had a vision lackBecause of awful cataractsBut
now my good eyesight is backIt is an art to have the knackOf
removing the cloudy lensTakes his time, an hourspent I'm able to see
what'swritten Yes, with even the finest pensMeet the Doctor in his
practiceIn school, learned what the fact isHow to replace the lens in
the eyeHe succeeds and does more than tryHe gave me some brochures
to readAbout how we would proceedExplaining what he'd do indeedHe
put a lens, like a large seedInto my eye and I am happyNow I am able
to map readI enjoyed a muffin and coffeeIt was like a little
partyI even got a real nice plantIt was healthy and I shantLet
it die from lack of waterA big plant, not a starterAlso, he gave me
resumesOf the doctors and their waysInteresting things they
sayExplained what would happen that dayAnd it worked; it was no
problemNever before have I beenMore excited about visionCataracts
are like a prisonThey put an IV in for shotsAt home I would take all
the dropsMy friends asked if I could tellIf I could see clear as a
bellMy test results were really good Iwish that everyone
wouldRealize just how well it goesDoctor Shingleton's on his
toesSo, my message to all who comeIs get all your cataracts
doneIt's like being now in HeavenMake the appointment when you
canEyesight is such a precious senseAnd there's nothing that makes
one tenseThe whole morning went very fastIt's true, the operation
lastsSo, the Doctor and his crewKnew exactly what to
doEverything they said was trueNow the other eye is due