The Cost of Cataract Surgery

Dr. Gary Foster – Fort Collins & Loveland, CO

how much will my cataract surgery cost fort collins

What are the costs of Cataract Surgery?

The cost of cataract surgery is an important topic because cataract surgery is the most commonly performed surgery in the world. A common question is, “Does Medicare cover cataract surgery?” Fortunately, it does.

Many who have medical insurance make the mistake of believing this important procedure is not covered because they know they do not have “vision insurance.”

Most major medical plans do cover cataract surgery costs when the cataract is “medically necessary.”

Vision Insurance vs. Medical Insurance

Vision insurance covers routine eye exams, glasses, and contact lenses.  It does not generally cover medical eye problems.  Regular medical insurance covers your regular medical care, including medical problems with your eyes like the cataract surgery costs.

When is Cataract Surgery Medically Necessary?

Most insurance companies consider your cataract ripe, or medically necessary, if your vision is 20/50 or worse with glasses AND your vision bothers you in real life situations (trouble seeing signs or reading, etc.).  If your visual problems reach this stage, they are considered medically necessary and the cataract surgery costs are covered according to the details of the insurance plan.

Cataract Symptoms (Cataract Glare)

Cataracts cause glare.  Another way your cataract can be considered medically necessary is if you bothered by glare.  Your eye doctor will do a test to measure the effect of glare on your vision.  It is call a “BAT” test where a bright light is shined at your eyes while you try to read the eye chart.  This is intended to duplicate the effect of a headlight shining into your eyes at night.

If your vision is 20/50 or worse during the BAT test AND you also notice glare bothering you in your real life, then most insurance companies will consider your cataracts as medically necessary and cover the costs of cataract surgery.

The amount your insurance company will pay depends on the company.  Medicare, for example, pays 80% of the cost of cataract surgery after you have met your deductible.

If you have a Medicare supplemental plan, then they generally cover the other 20% of any Medicare approved cataract surgery costs after you have met the supplement’s deductible.

the cost of cataract surgery timeline

The Cost of Cataract Surgery: The Total Number of Cataract Surgeries in the U.S.

Medicare Cataract Eye Surgery Costs

The Medicare cataract Eye Surgery costs add up to the single largest line item expenditure for Medicare.  This should not be surprising if you consider that every senior citizen has the procedure twice, once for each eye.  If you add up the cost of cataract surgery for everyone on Medicare, the total expenditure is enormous.  The total cost of these procedures for the nation is estimated to increase dramatically over the next decade as the baby boomer generation enters Medicare and needs cataract surgery.

Cost of Laser Cataract Surgery vs. Basic Cataract Surgery Costs

The basic cataract surgery costs are covered by Medicare. The additional cataract surgery costs of laser cataract surgery are not covered and would be out of pocket expenses for the upgrade to decrease your astigmatism. There are additional benefits to laser cataract surgery of increased precision and decreased swelling. You will need to find out if your surgeon recommends cataract surgery laser for your eyes.

Cost of intraocular lenses

A lens implant (intraocular lens) is provided by Medicare as part of basic eye procedures. If you prefer an advanced technology intraocular lens that provides benefits not covered by Medicare like a toric IOL or a ReSTOR multifocal IOL, then your insurance would generally cover the standard cataract costs and you would pay an additional amount out of pocket to cover the costs of the higher technology lens implant.

Average Cost of Cataract Surgery

The average cost of  Cataract surgery in a Medicare outpatient setting is generally around $2,500.00/eye for the surgeon, the out patient facility, and the anesthesia provider.  Medicare would pay 80% or $2,000.00/eye and you would pay the remaining $500.00 out of pocket.  If you have a supplement and you have already met your deductible for the year, then the supplement would cover the remaining $500.00/eye.  You will need to check with your eye doctor to know the exact amounts in your region.

The procedure costs more at hospitals than at privately owned surgery centers because Medicare allows hospitals to charge more for the same services.

If you select an advanced technology upgrade like laser eye surgery, a toric lens, or a multifocal lens, then there would be additional out of pocket expenses to pay for the upgrades.  The average cost for laser eye surgery with a multifocal lens in the U.S. is $3,500.00.

Example 1  No Upgrade–Average Costs of Cataract Surgery Per Eye:

$2,500 Average Cataract Cost  – $2,000 Medicare Pays = $500 Out of Pocket  – $500 Supplemental Insurance (if you have it) = $0 out of pocket

Example 2  Laser/Multifocal or Accommodating lens Upgrade Costs Per Eye

$2,500 Average Cataract Cost + $3,500 Upgrade Cost – $2,000 Medicare Pays  – $500 Supplemental Insurance (If you have it) = $3,500 Out of Pocket Per Eye

The Cost of Cataract Surgery

Weighting the Cataract Surgery Cost Against the Cost of Not Having Cataract Surgery

Time Off Work

Time off work or away from important activities is part of the cost of cataract surgery.  Fortunately, cataract surgery recovery is usually quick and most can return to work within a day or so of the procedure.  If there is a large difference between your two eyes after the surgery while you are waiting for your second eye to have the procedure, it can create some imbalance.  This could create issues with depth perception.  If you are involved in activities like climbing ladders etc. you might have to take more time off work.  There are actions your eye doctor could take to minimize this if necessary.

Cataract Surgery Cost

The full total cataract surgery cost that you will bear will depend on how much of your surgery is covered by your insurance, the amount of your deductible, the amount you choose to spend to upgrade your cataract surgery experience with options like laser cataract removal and advanced technology intraocular lens implants, and the time you and your loved ones take off of work.  All of these together make up the cataract surgery cost.  

It is also worth considering the potential costs of not having cataract surgery based on the risks and inconveniences of continuing with poorer vision and troubles with night driving.  

If you would like to learn more about the cost of cataract removal or the procedure, please schedule a consult with me or post your questions in the comments section.

Comments

  1. Susan Shepard says:

    I have cataracts on both eyes. I have been told that I can not have implants because in 2001 I had lasik eye surgery on both eyes, Is this true? I don’t want to wear glasses after I have cataract surgery. Is there a different procedure? I am 68 years old.
    Thank you,
    Susan Shepard

    • Susan: You did not mention the specific IOL type you had in mind. I love LASIK and have had it done myself. Previous LASIK does not automatically disqualify a patient for any of the intraocular implants in my opinion.
      The special considerations are the following: 1. Quality of the LASIK ablation, 2. Quality of the tear film, and 3. Odds of hitting the refractive target. Let me explain each of these.

      1. If the LASIK ablation is normal and smooth then it does not disqualify multifocal IOLs (ReSTOR), accommodating IOLs (crystalens), or toric IOLs. If the ablation is irregular, which would be rare with modern LASIK, then the multifocal lenses are probably a poor choice. These lenses tend to give very good reading, but they decrease contrast sensitivity a bit. If the cornea has any irregularity, it would also decrease contrast sensitivity. These could add up in the wrong direction and a patient might not be please with the quality of the vision.

      I don’t view the crystalens or the toric IOL as having specific contrast issues so they could be at least considered even if the LASIK ablation is not perfect, depending on the patients goals and the amount of imperfections present.

      2. Imperfect tear film (dry eyes). Dry eye can decrease the quality and contrast sensitivity of vision. If your eyes are dry, then the multifocal lenses are often not a good choice unless treating the dry eye easily corrects the problem.

      3. Laser eye surgery changes the shape of the cornea. This can fool some of the formulas we use to calculate which intraocular lens to place. A number of new formulas have evolved that have improved our accuracy and some practices have a new machine called the ORA that is improving our accuracy after LASIK even more.

      I have been using the ORA for over a year and have found it very helpful. Even with this best in the world technology, we have a lower chance of putting in an intraocular lens that is right on the money if you have had previous LASIK. If the goal is to get rid of glasses, then we have to hit very close to the target to make patients happy and there is a lower chance of achieving that post-LASIK. This doesn’t mean individuals post-LASIK shouldn’t have the lens, but it is a bit more complicated.

      Mono vision is another option. In this approach, one eye is set for distance and the other for near. This often decreases how much a patient needs to wear glasses after cataract surgery. Not everyone is comfortable with mono vision so it is helpful if they have already tried it with contact lenses to prove they are good mono vision candidates.

      Your eye doctor will take all of these variables into account as he/she recommends the lens that would give you the best chance of reaching your visual goals. Some doctors are more experienced with these lenses and helping LASIK patients have great results. It would be ideal to have a consult with the doctor in your area that has this type of experience so you can feel comfortable that you have carefully explored all your options.
      Gary

  2. maria oconnor says:

    I had surgery for retinal detachement over thirty years ago (Buckle?) I have a cataract in that eye. How does this previous surgery affect the cataract surgery risks.

    • Maria
      The great news is that, generally, the cataract surgery is just like any other cataract removal. However, there are occasions when the previous retinal surgery does affect the cataract surgery.

      The buckle squeezes the eye and makes it longer. This causes myopia and changes the power of the intraocular lens that a surgeon places. As a result, the intraocular lens power will be different in the eye that has the buckle from the eye that doesn’t.

      Most surgeons have stopped putting injections of anesthetic behind the eye for cataract surgery (retro-bulbar injection). If your surgeon still does retro-bulbar injections, there is a very small risk that the needle could hit the buckle and be deflected into the eye.

      If the retinal detachment was repaired with a vitrectomy rather than a buckle alone, there is a small chance that the movement of instruments inside the eye has weakened the posterior capsule that holds the cataract in place. If this has happened, a piece of cataract could fall backward into the jelly of they eye during cataract surgery. This would require a second surgery to have a retinal specialist removed the retained piece of cataract.

      If there has been a vitrectomy, then the structures inside the eye tend to move around more than in a standard case. This can make the surgery more difficult to perform.

      God Bless with your upcomming surgery
      Gary Foster

      • Hi Dr. Foster,
        This post was helpful. On May 4 I will be having cataract surgery in my right eye.
        In Sept. 2014 I had two detachments in this eye. All in all I underwent laser, cryotherapy, vitrectomy, scleral buckle, and gas bubble with face down positioning for 5 weeks. The retina is holding but I have been treated for persistent CME, most recently with an injection of Kenalog. Needless to say, I am a bit apprehensive about more surgery but my vision is quite blurry so I know I need it. My opthomalogist explained the risk you described above but it was good to be able to read about it and process it a little better. Thanks for all the information you have posted here. Jude N.

        • Jude:
          Sorry for your troubles. God Bless with the decision. The worse your cataract becomes over time, the easier the decision gets.

  3. Raul de la Espriella says:

    The whole article is OK but no COST ($$$$$$) appears on it. Take an example and tell me how much would it cost to remove the cataract using the different surgical procedures available.
    Thank you.

    • Raul, I have added some more specific numbers to the post.
      I hope it helps.
      Gary

      • Peter Surprenat says:

        I have Medicare & supplement. I am looking at Cataract laser surgery in Houston with normal lens at an out of pocket costof $2000.
        It would be a private facility.
        Is this cost normal for the Houston area?

        • Peter:
          If you are using the standard lens without any upgrades like astigmatism management/laser cataract surgery or ORA (intraoperative aberrometry), etc. the usually cataract surgery would be about $500 per eye out of pocket after Medicare (if you have already met your Medicare deductible) or $1,000 for both. If you have met your deductible for the supplemental insurance you have, it would generally cover the 1,000. You describe a $2,000 out of pocket which sounds high unless you have chosen some form of an upgrade.
          God Bless,
          Gary Foster

  4. Bob Perry says:

    I’ve had surgery on my right eye, for cataract.
    I need it on my left eye, what is my out of the pocket cost?

  5. Hello Dr. Foster.

    I am a commercial pilot and the FAA requires me to have 20/20 distant vision in each eye separately, corrected or uncorrected, in order to carry paying passengers. My optometrist has advised I have a Cataract in the right eye which is limiting his ability to correct my distant vision in that eye by external means. He says he can obtain no better than 20/30 distant vision.

    He further advised me that Medicare uses the automobile driver’s distant vision standard of 20/40 as the determining factor with respect to authorizing payment for Cataract surgery and will therefore not cover mine until my eyesight degrades to 20/40 or worse.

    He said that since I am paid to fly ( as opposed to flying privately for pleasure which only requires 20/40 distant vision acuity), there may be an exception to the rule but he is personally unaware of one.

    What is your opinion? Is it is possible to have covered surgery and if so, what would I have to do in order to get a favorable ruling from Medicare?

    Thank you very much,

    John

    • John:
      Medicare is divided into regions in the U.S. Each of the Medicare carriers views these requirements a bit differently. I will speak from the perspective of my carrier which require that your vision be 20/50 or worse with some complaint of visual trouble in your daily life or that your glare test vision is 20/50 or worse and you have a complaint of glare affecting your daily living. You stated that you are best corrected at 20/30. If your vision is 20/50 or worse when a bright light is shined in your eyes (the “BAT” glare test) and you notice glare bothering you with night driving, etc. then you would qualify now for Medicare’s help with cataract surgery. If the BAT test has not been done, then checking that would be the next logical step for you.
      What if you are not 20/50 on the BAT test? With non-Medicare insurance, doctors can often write a letter and explain your extenuating circumstances and seek pre-authorization. Medicare does require preauthorization or have a mechanism for preauthorization. They just publish the strict guidelines and then threaten offenders. The doctors do the surgery they feel meets the guidelines, and if later Medicare audits the case and feels it was not medically necessary, they accuse the doctor of fraud and inflict overwhelming fines. This system put the onus for taking a chance to help you on your doctor to take all the risk or on you to pay cash.
      The good news is that if your vision has already dropped to 20/30 then most of the time your glare test will be worse than 20/50.
      All the Best
      Gary Foster

  6. Mary Bortz says:

    Hi Dr. Foster,
    I am in need of Cataract surgery and I can’t even put drops in my eye or get an eyelash out. How comfortable are the patients made during this procedure and how aware will I be of the surgery? I am really worried about getting this procedure done and just can’t put it off any more.
    Thanks, Mary

  7. Melissa Brown says:

    Dear Dr. Foster:

    I need cataract surgery and have been trying to find the approved Medicare fee schedule for costs. Are the example costs you list ($2000 – $2500) the fee rates for Medicare? Do they vary by region or State? I have Medicare and a high deductible Medigap and am trying to determine my share of this procedure.

    Sincerely,

    Melissa Brown

  8. Mathews says:

    When cataract surgery is being done, is the patient awake? Can the eye being worked on “See” ? I might need surgery soon and looking for a good doctor and I am worried and stressed about the natural urge to close the eye and watching a scalpel up close 🙁

    • Mathews:
      I do have a post on anesthesia for cataract surgery. http://www.garyfostermd.com/anesthesia-for-cataract-removal-surgery/ Generally, patients are awake but groggy during cataract surgery. Some want to receive light sedations so they can chat while others prefer to be much less aware. The microscope light is bright which makes it hard for you to see, and I am working too close for you to see any detail. A lid speculum is placed to hold your eye lids in a safe position so you don’t have to worry about blinking. The anti-anxiety medicines given by the anesthetists make the world seem pretty wonderful during cataract surgery for most patients.
      God Bless,
      Gary Foster

  9. Dr. Foster,

    After being diagnosed as needing cataract surgery in both eyes, I was left with the impression that with the standard IOL, going forward I would just need the occasional use of a pair of drug-store readers to be happy. After the surgery on the left eye I quickly knew I had made a terrible mistake. I needed one pair to read, and one pair to work at computer, one to use to see the dials in the car…etc.
    When my doctor inquired about scheduling surgery on the right eye, I said that I would rather have the multifocal. He was quick to say that I cannot have one eye with standard and one eye with multi. This did not make much sense since after the first surgery they had no problem suggesting a multifocal contact lens to use in the right eye in the interim. Anyway, I developed at detached retina in the left eye after the surgery which caused me to hestitate on the second eye. I now feel comfortable enough to proceed but would still prefer to get the multifocal. Is my doctors refusal to correct with a multifocal in the right eye while I have the standard lens in the left legitimate?

    • Gary:
      In the FDA trial for the ReSTOR multifocal, 64% of patients could read without glasses with the implant in one eye while 94% could read with it in both eyes. If you choose to have the ReSTOR in just one eye, it is possible that it would help with some of your near issues (64% chance in the study). We like to implant the multifocals in both eyes to increase the chance that a patient can read without glasses. Having said that, it is common for optometrists to put a standard contact lens in one eye and a multifocal contact lens in the other eye.

      I have a handful of patients with a standard lens in one eye, that have selected a multifocal in their second eye. I do not encourage it to patients for the reasons listed above, but have had good success since the patients that request it are above average motivated for better reading vision. The possibility also exists of removing the first implant and exchanging it with a multifocal implant if necessary. This carries some specific risks, depending on how long ago the surgery was done. Your surgeon could discuss the specifics of those risks based on your specific eye exam.

      As you know, the current U.S. multifocals have two places in focus. You are describing problems with three distances, far, intermediate, and near. You would need to find out which multifocal your surgeon would use to determine which parts of near vision it could address.

      Placing a single vision distance implant in your second eye is the most conservative option, but other options do exist depending on your eye and your individual goals.
      God Bless,
      Gary Foster

  10. Sabrina St Pierre says:

    Hi Mr. Foster,

    I am writing to you about my husband Dennis St Pierre (age 49). He has cataracts in both eyes and is unable to work any more. We do not have the money to get him the surgery that he needs to correct them. I was reading some of your replies and thought I would write to you to see if you know anyone that lives in Florida that could help us with the coast. He has Medicaid right now and the only thing that they pay for is the surgery and not the licenses. With me being the only one working it is not something that we are able to save for. If you have any information for us that would be gratefully appreciated. Hope to hear from you soon.

    P.S.
    I am putting my phone # in case u have any quetions for me.

    Thank You,
    Sabrina St Pierre

    • Sabrina:
      Sometimes the local Lions Club will help in cases of extreme need. Please contact me off line to let me know which part of Florida you live in.
      God Bless,
      Gary Foster

  11. Dr. Foster,
    I am scheduled to have cataract surgery soon on both eyes, two weeks apart. I am very interested in the multifocal lens since it has the best chance of not having to wear glasses for near, intermediate and far distance vision after the surgery. My doctor does not recommend the multifocal lens and will instead insert Crystalens due to my being a Type II diabetic. Is this a general guidance followed by most ophthalmologists even with controlled diabetic patients who have A1C in the normal range (5.5 – 6.0)?
    Thanks for your professional opinion.

    • Sandra: Your doctor is taking a conservative path in avoiding a multifocal. If your diabetes worsened over the years and you developed changes in blood flow to your macula (central retina) or you developed macular edema, it would decrease your contras sensitivity. A multifocal lens also slightly decreases your contrast sensitivity. If you never developed these kinds of problems, then the multifocal would work as well for you as anyone else. Fortunately, you are aggressively controlling your blood sugars to decrease the chances of problems.

      By not having a multifocal lens, you are not taking the risk you are the one that ends up with diabetic eye problems and a multifocal. It is not unreasonable to choose the multifocal, but it would reflect a choice with greater potential risk. As such it would be considered a relative, rather than an absolute, contraindication. I haven’t examined your retina and I don’t know your age, which could both affect my recommendations, but it sounds like you are working with a doctor that makes decisions the right way.
      God Bless,
      Gary Foster

  12. Dr. Foster:

    I had cataract surgery in both eyes with standard IOL’s. using the VICTUS laser prep. After the first surgery, about 6 weeks ago, my vision in the right eye was amazing; I could read and see everything super clear from a few inches to long distance. That has now changed to no longer being able to see up close but from about 24 inches to long distance which is okay with me. I don’t mind readers for close up.

    The left eye, however, has been blurry ever since surgery and the doctors say it “should get better”. I am concerned that it remains blurry over three weeks post surgery and is not nearly as clear as the right eye at all. I obviously no longer have the yellowish vision of the cataract, but the fogginess or being blurry leads me to question whether this could be that “secondary cataract” that affects a lot of patients and I am just not being told, hoping the situation will resolve itself. I presume the costs involved with the original surgery would cover this YAG Laser procedure to fix this if necessary?

    Thanks so much for your opinion.

    Bruce SDchryver, Ph.D.

    • Dr. SDchryver:
      The lack of near performance is anticipated with most “standard” IOL’s.

      The big question is the prescription for your second eye. If the eye corrects to 20/20 with a glasses prescription, then there are no visual quality issues. The prescriptive error could be corrected with glasses, contact lenses, IOL exchanges, LRI, or laser vision correction, depending on the type of prescriptive error. If your vision clears up a lot when you squint, it often means that you have some prescriptive error. If a manifest refraction doesn’t improve your eyesight to 20/20 then it is reasonable for you to ask your eye doctor why. The possibilities include resolving corneal edema, edema in the retina (cystoid macular edema), macular degeneration, dry eye, etc.

      It would be unusual for a secondary membrane to have formed this quickly. The cost of having a YAG laser to clear a secondary membrane are not included in the cataract surgery costs but are generally covered my major medical insurance including Medicare.
      God Bless,
      Gary Foster

  13. Dear Dr, I currently live in Florida, have type 2 diabetes, wear progressive lenses that work pretty well, 61 yrs old and I’ve been diagnosed with cataracts in both eyes. Vision in the left eye is noticeably weaker and I see a halo when I look at a light (headlamps, street lamp). During the daytime my vision is very good and I have no problems with driving. However, night driving is becoming more difficult with the glare of headlamps. Would you please allow me a few questions?
    1. I have an appointment for an eye exam soon. Depending on the results, I’ll opt for laser cataract surgery. What are some critical questions that I should ask my ophthalmologist?
    2. If I do the cataract surgery, what type of lens is best suited for me? I like to drive at night, but I also spend most of my time with computers and reading.
    3. Since one eye at a time is done, would I still be able to use my current pair of progressives?
    4. Assuming that cataract surgery is recommended and is successful for both eyes, would I still be able to use progressives for the near and intermediate vision? I’m seeing a post above that says the guy has to use different glasses for reading and for computers.
    5. How soon after surgery will I be able to undertake strenuous and stressful tasks, such as vigorous exercise and flying in an aircraft (passenger).
    Let me add that if you were close by in Fl I would have certainly liked to have you examine my eyes. If there is any possibility of this, please let me know.
    P.S. I don’t have insurance, but have decided that I’ll source the funds and pay out of pocket.

    Thank you in advance, Doctor.

  14. I cannot believe how awesome I can see the world around me ! The office staff was amazing and were there every step of the way to make me comfortable. I would highly recommend Dr. Foster for this surgery!

  15. SB Fields says:

    Hello, I had cataract surgery on Sept 17th. On the 25th, while glancing at my cell phone, a grey curtain-like shade dropped from the upper level to just below the mid range of my visual field (the operated eye). There was no pain. I thought it would continue all the way down. It stopped mid way and I thought I might be going blind. It lasted 5 or so mins. I was on my way to the eye Dr for a post op visit. Did not know if I could drive. But as I mentioned, it went away and has not returned.
    Have you ever heard of this happening, weather with or without surgery? What is it?

    • SB:
      It is important that you discuss this with your eye doctor and your primary care physician and that they examine you and your eyes carefully with these symptoms in mind. A couple of potential causes include an ophthalmic migraine or a TIA (mini stroke)
      God Bless,
      Gary Foster

  16. Sharon Englehardt says:

    Dr. I have cataracts in both eyes. The left eye is worse. I can still get 20/25 or so in right eye. The cataract in the left eye had rapidly gotten worse in the last six months. In the last two days it has progressed to the point that I cannot see out of it at all. The problem is I do not have the money for the surgery. I am 62 and started my SS early hoping medicare would cover it. I didn’t know you couldn’t get medicare until 65. I signed up for the Obama health care but the way I understand it I have to meet a $6600.00 deductible before anything is covered other than yearly routine screenings and Ck ups. Help, do you know where I can get help? I live close to Evansville, Indiana. Any info would be greatly appreciated! Thank You

    • Sharon: I am sorry that the bewildering world of insurance coverage is working against you. It is likely that the cataract surgery would cost less than your deductible. Many patients choose to have these types of procedures done early in the year so that as they meet their deductible, they can fully use their insurance for the rest of the year for any other lingering heal concerns.
      Your plight is about to become endemic as a huge wave of patients that have selected high deductible insurance plans begin to move through the health care system.
      If you qualify for Medicaid, you would not have the high deductible. Another option is to change to a lower deductible plan as you know that you will be using the insurance for the cataract surgery and then return to a higher deductible the following year in your final wait for Medicare which has low deductibles.
      Another option is to check with the local chapter of the Lions club, though they tend to only get involved in circumstances of significant visual distress and financial need.
      God Bless,
      Gary Foster

  17. Gary Murtaugh says:

    Dr. Foster, I had cataract surgery on my left eye at the age of 50 with excellent results and 20/20 vision. Unforturnately, my right eye never developed one, and I’ve had to wear a contact lens in that eye due to my poor vision. I am now at the age where my eye is dry enough that a lens (daily wear moist) will fall out of my eye in the middle of the day due to excessive dryness from meds and age. Will Medicare pay for an IOL for that eye if it is the only correction I’ll can comfortably tolerate? Also if I have a monovision power IOL, how much correction is needed to accomodate +2.00 (subtracted from my -4.75). Is the correction less because the lens is inside the eye? Thank you. A fellow Gary.

    • Gary:
      You have become contact lens intolerant. If glasses don’t work because your eyes are so different you have a medical condition called anisometropia. This is caused by differences in the image sizes between the two eyes. Cataract surgery can be considered medically necessary for anisometripia if it is impacting your quality of life and ability to function in my opinion. LASIK on your un operated eye is another option to correct the anisometropia that you could consider with your surgeon.

      The formulas to calculate the correct IOL to place in your monovision eye take into account the fact that the IOL is inside your eye. A surgeon sets your desired outcome (-2.00) into the formula and it tells him/her what IOL to implant to have the best likelihood of achieving that goal.
      God Bless,

  18. Regina Shiner says:

    Dr.Foster I was diagnosed with cataracts about a year ago.. my eye Doctor told me that Medicare does not pay for cataract surgery .Well we havent had the money for the surgery I no longer can drive plus I am extremely nearsighted…your saying Medicare does pay eighty percent …and she also said with the surgery I would no longer need glasses for distance
    ..is that true ? Thank you…

    • Regina:
      It may be that last year your cataract was not bad enough to hit the standards where Medicare will pay, but that this year they have worsened enough that they fall within the guidelines. If your vision is 20/50 or worse and your vision bothers your or your vision is 20/50 or worse with the glare test and glare bothers you then you will likely fall within the guidelines where they will pay.

      If you don’t have much astigmatism and your surgeon selects the appropriate intraocular lens for distance then most have reasonable distance vision without glasses.
      God Bless,
      Gary Foster

  19. You mentioned about the cost of having laser cataract surgery with premium lens. What about just the laser surgery without the premium lens? Can I just have the laser surgery without the lens upgrade? I wonder if you could tell me about how much it would be. Thanks.

    • Diana:
      The laser can be used to help cataract surgery without using a premium lens if there is a need for astigmatism correction. I currently charge $1,600 for that option.
      God Bless,
      Gary Foster

  20. Dear Dr. Foster:
    I’m 76, scheduled for monofocal iol (catalyst laser technology) type surgery. Have Aetna-Medicare Ins. My surgeon wants me to pay him $1,500.00 before the surg. Would you know what $1,5?00.00 x-tra is for? The technician who took measurements indicated its for the catalyst machine!?. My ins. co. seyz ask him to send this bill to the ins. co.!? Am I up a creek with this problem?
    Please let me know what your thinking on this matter is.
    Thank you greatly.
    Mary McClung
    [email protected]
    330-753-9409

    • Mary:
      Insurance covers non-laser assisted cataract surgery. If you decide to not have the surgeon use the laser, then the 1,500 would disappear, but so would the laser’s contribution. If you are fine with that, then you would save the 1,500. If you prefer the laser to at least the tune of 1,500 then you would need to make that payment. Your insurance would still be making its normal contribution to the medical part of the surgery, but the laser part of the surgery to decrease astigmatism is elective and non-covered. The extra costs are to defer the cost of the laser, the ongoing royalty payments the surgeon pays each time he/she uses the laser, and the extra testing and surgeon/staff time that go in to laser surgical planning. In the end, you are either up the creek without the laser, or up the creek without the 1,500 🙂
      God Bless,
      Gary Foster

  21. Michael Knor says:

    Dear Dr. Foster

    My wife age 44 has cataracts in both eyes right eye correctable to 20/200 left eye correctable to 20/70 she is going to have the surgery (least expensive) as soon as we can afford it, since I have been researching it and asking everyone I can how there surgery was I have run in to a few people that say be very careful who does the surgery because they have floaters in there eye. Floaters being pieces of the old lens that weren’t removed I’m guessing. Is this a fairly common problem with cataract surgery? Or is it something else they are seeing in there eye? They describe it as like seeing a fly too close to make out what it is, and they move around.

    Thank you for reading and we appreciate your web sight!
    Michael

    • Michael:
      The floaters your friends describe are most likely a posterior vitreous detachment (PVD). These are common an ultimate happen to all blessed with a long life. The chances of having a posterior vitreous detachment are about equal to your age. For example, a 75 year old has about a 75% chance that they have a PVD in a given eye. Cataract surgery can make the vitreous detach a few years earlier than it would have without the surgery. Choosing a good surgeon does matter, but the vitreous issue is a normal life event and usually independent of surgeon skill.

      I have a blog post on the subject that will explain in greater detail. http://www.garyfostermd.com/posterior-vitreous-detachment-pvd-and-posterior-vitreous-separation/
      God Bless,
      Gary Foster

  22. Just a word of encouragement to those fearful of having someone “poking around” in their eye.
    This is likely the simplest medical procedure you’ll ever undergo. 10 minutes and done. Having your teeth cleaned should be so simple and painless.
    The anesthetic takes you away from the world and while you might be conscious of a light shining in your eye, you won’t feel a thing and most likely you won’t remember anything later.
    In what seems like a minute or two you’re awake and heading out the door with your driver.
    I hope this helps those considering this procedure. I’ve just had both eyes done and the improvement in my vision and especially my night vision is simply incredible!

  23. Rhonda Boyd says:

    Hi Doctor Foster,
    I will be coming to see you shortly in Laramie( May). My question is, I am a 57 yr old insulin dependent diabetic that has in the past always had problems with anesthesia in that I have fluid imbalance and feelings of falling etc and have a horrible time with dizziness for months after procedures, I need to have both of my eye cataracts fixed as I have lost significant vision over the last six months. Because of my issues with anesthesia I wanted to know if it was possible to have both eyes taken care of at the same time? Look forward to seeing you soon, I have heard great reviews about you and your clinic.