Visual Changes AFTER Cataract Surgery
Photo Credit: Bill Lloyd, MD
For a minority of patients cataract surgery makes vision better but also different. Yes, uncomplicated cataract removal and intraocular lens implantation significantly boosts visual acuity, but some folks experience other changes that were never present before surgery. There is enormous variability. Some people describe halos, ghosting, slight overlapping of images (not double vision) and unexpected flashes of light. The medical term for all these changes is dysphotopsia.
As a result of uncomplicated surgery it appears that patients replace one type of visual symptom with an entirely different (and annoying) problem.
In the past eye surgeons often dismissed these symptoms as temporary optical phenomena that could be expected to disappear once healing is complete. New information published in the American Journal of Ophthalmology contradicts those assumptions.
55 healthy patients undergoing routine cataract surgery were enrolled in this volunteer study. All of the surgery was performed with no complications and all experienced satisfactory recovery of good postoperative vision. It is important to note that 18 patients (roughly one-third of the group) observed dysphotopsias after their surgery and these visual distortions persisted one year after surgery. Halos and starbursts were the most frequently reported symptom. Repeat exams revealed no anatomic explanation for the dysphotopsias such as mild corneal edema or clouding of the posterior lens capsule. There was no correlation between dysphotopsia and patient age, final visual acuity, or contrast sensitivity.
So, how does this information apply to the individual patient? The report suggests that far more people endure postoperative vision changes following uncomplicated cataract surgery than originally believed. Equally important, since one-in-three may experience unwanted photopsias after cataract surgery the decision to perform surgery ought to be postponed until visual performance truly interferes with daily activities.
SOURCE: American Journal of Ophthalmology 2007; 143:522-524
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Technorati Tags: cataracts, eye surgery, halos, vision
20 Comments:
Dr. Lloyd:
My Father in law had cataract surgery recently and it left one eye in fine condition and the other eye with a problem of the pupil not being able to close in bright light. It is very difficult or impossible for him to go outside without extremely dark sunglasses and a cap to help block additional light. Even indoor lighting is hard on him.
Is there something that can be done for this problem?
Thank you for your help.
Dr. Lloyd,
I'm 50 and decided to have cataract surgery after being told that I could have good vision without glasses. I've worn glasses most of my life & was not a candidate for lasic surgery because of a thin cornea. I was told that my close up vision wouldn't be clear until my muscles strengthen. I have the crystalens. The doctor did tell me that it may take up to a year. The surgery was done about four weeks ago. Do doctors know what they are talking about, or have I made a mistake? And what should I do now?
Thank you for your advice.
I had cataract surgery in Feb. and March. Since then I have not been able to see well. I was told I had map,dot,fingerprint dystophy. Now I am starting to see double. My new glasses do not help at all. My eyes are very dry not matter what drops I try wether over the counter or prescription.
My wife just had Cataract surgery in the left eye (9/25/07). During the procedure, the lens capsule was torn, allowing vitreous fluid to enter the lens capsule area. The Dr. inserted the new lens, and some "gel". My wife has a lot of floaters, and gets headaches from reading. What are the possible long term results? and should she see a Retina Specialist? Should we wait until after healing to seek help/advice? Thx
To those of you with specific questions for Dr. Lloyd, please post on WebMD's Eye and Vision Disorders board.
I had Cataract Surgery to both eyes in june of 2005 and since then my left eye keeps tearing. Is their any cure besides surgery?
Thank you M.G.
I am 59 and had cataract surgery 1 year ago. I also have an eye condition called Koloboma. I now have the ghosting, starbursts,ect that causes problems in bright sunlight and night vision problems. Can anything further be done?
My husband had cataract surgery 55 days ago. He still can't see. It is all foggy. We have been using 3 different kinds of drops, one every hour, salt water drops 4 times a day and a different drop at night. The dr said his cornea is swollen. Is there anything else that can be done?
Dr. Floyd,
I have had surgery many years ago to remove something called a teredum from one eye. Well it's grown back, and I would like to know what type of new technology is out there to remove this problem from my eye.
To anonymous above:
Please post your question on Dr. Lloyd's Eye Disorders message board.
Thank you!
Six months after Tecnis wavefront technology lens implants and YAG laser removal of posterior capsule clouding, I'm left with overlapping images. This causes fuzziness around the edge of all images. Most things look blurry. I've tried eyeglasses but they don't do anything. Does anybody know of a fix for the blurry vision?
I saw very clearly after the cataract surgery - for several months. Now I see little black dots floating around and my macular degeneration has become visually apparent (star bursts), in the first eye. I am sorry I had the second eye done. I expect to have the same problem in the second eye. I don't recommend anyone have the surgery until their vision is so terrible that they can't stand it. The cloudy vision was better than what I have now.
Dr. Lloyd: My husband, age 58, had cataract surgery in his right eye approximately 10 years ago. Although the operation was a success, he continues to have what he describes as a "floating blob" in his right eye. Last week he had a cataract removed from his left eye. He did have vomiting following surgery and pressure build up in the eye. His vision is no better than it was before. Is this normal?
anonymous,
Please visit Dr. Lloyd's message board to ask questions about your specific situation.
Thank you!
I AM 79 YEARS OLD. I HAD CATARACT SURGERY ON BOTH EYES SEVEN YEARS AGO. I CAN SEE CLEARLY,WITHOUT GLASSES, AND, HAVE HAD NO PAIN.
MY POOR WIFE, ON THE OTHER HAND, HAD SURGERY TEN DAYS AGO, A WEEK AGO, IS IN CONSTANT PAIN, CAN'T SEE CLEARLY, EVEN WITH GLASSES.
WHY???
Anonymous above,
I'm sorry your wife is in such pain. Have you been in touch with her doctor about it? That is definitely where you should start.
Dr. Lloyd answers your questions on his eye disorders board. You're welcome to post about this there.
After cataract surgery the pressure in the eye went up to 42, the doctor thought it may be due to the omnipred drops, so we changed to lotemax drops. My vision has gone from -250 to -150 what does the -250 and -150 represent.
Thanks
Had I known back in Janaruy 2008 what I know now, I would never of consented to having a cataract removed. I am worse off and the surgeon makes me feel like I am the only one on Planet Earth that has had post op problems. He said he has done 2000 surgeries and no one but me had problems. I saw another doctor and he stated I had a large posterior detached vitreous floater stemming from the surgery. My peripheral vision is also affected. The glob has gone from black sparks to lightening ziz zags to now seeing a circular clear lucent type thingie in the eye. I see non of this when my eyes are closed. The right eye needs a cataract removed also but hell would have to freeze over first before I have another eye surgery. My surgeon never mentioned that i am at risk for a retina tear or detachement....new doctor did. I am also severe myopia Patient beware...not all eye doctors are the same...even if they are affliated with a Teaching school. There alsways can be a rotten apple in the pack.
I agree with one of the posters...Unless you are homebound and falling over your feet....do not have cataract surgery. I did my homework and thought I was going to a top notch eye surgeon who is in Who's Who. This doctor has a hard time accepting post op problems and would just as soon shove you under the rug. He said I am expecting too much like being able to drive at night, being able to read the morning paper and being able to thread a needle. YES...this doctor said this. The whole purpose of cataract surgery was to do all of the baove. IT IS not expecting too much. This doctor needs a good spanking and I pray he gets irreversible eye problems too. Then he will know how we feel.
Dr.. Lloyd:
I had cataract surgery a little over one year ago on both eyes & am now experiencing what I call double vision in my left eye, when I'm not looking straight at something & look out of the corner of my eye, I see double. Also, at night when I look at my digital clock & I'm lying down, I see double when I look at the clock. Could you please tell me what's going on with my eye & is there anything I can do to correct the problem? My Eye Dr. is sending me to a Neurologist to see what's going on, but I wonder if that's the right thing to do?
Thank-you!
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