I have keratoconus. It's where there is one or more thin spots in my cornea making my eye pointy in those spots as the internal pressure of the eye pushes out. When I lived in s.f. my ophthalmologist asked me to go to Berkeley to test the students - only one of dozens diagnosed me correctly over a few years.

I had to wear contact lenses since junior high because my eyes were so warped that glasses couldn't correct my vision. This was fine but when I hit fifty I started wondering what I'm going to do when I'm really old - I couldn't see myself caring for my scleral lenses at 80 or whatever.

My eyes started to develop cataracts at 50. I was lucky and found a great eye surgeon who implanted custom toric lenses. I can now see well enough that I can legally drive a car without lenses. I can read books at night on my phone without lenses. I start my day in the morning on the computer programming without lenses but in the afternoon I usually put on reading glasses and continue...

Anyway, I'm so much better off after my cataract surgery than I was before. However I have relatives that are worse off after. I think part of it is my warped eye - I can focus different distances because of it. But also I had a great ophthalmologist which sounds like the major difference.