Double vision after cataract surgery

[pws710]

I had my second cataract surgery 6 days ago.  The first surgery went fine.  Immediately after the second surgery, my eye was very crossed.  The surgeon used a "block", which I guess is called a retrobulbar block.  Now my eye is straigtened, but I'm continuing to have double vision -- the eye is not completely back in place.  I'm patching the good eye in order to strengthen the other eye.  The doctor said it was a result of the block.  Has anyone else experienced this and what is the prognosis or treatment.  The doctor says we will give it 8 weeks, then on to a muscle specialist.
Thanks

[Forum-OD-MP]

did the doctor tell you to patch to 'strengthen the other eye'?  thats a little strange IMO for an adult.  it wont hurt you any, and it of course temporarily gets rid of the double vision, but it probably will not make any difference one way or the other as far as any 'strengthening' is concerned.

6 days is not near enough time to be concerned.  you could easily still get much better.

[aimee37]

Yes, he said to patch the "good" eye to try to strengthen the other eye.  But, for driving, I'm patching the affected eye.  Seems I can function without one or the other patched.  Also mentioned was using prism glasses after a few weeks.  It is very frustrating.  

[aimee37]

I had a restor implant on Jan 24th with a block.  No problems with the block that I know of.  I do have double image problems though.  I am scheduled to have the back layer of the old lens to be removed by laser.  Maybe this will remove the haze and double vision.  If I get the other eye done I will request "no block".  This is not always required.  I heard the patient next to me cry out in pain when they gave her the block.  I was asleep with mine.  It must really hurt.  The laser treatment will make removal of the Restor difficult.  I just want the double vision to go away.

[aimee37]

Yes, I would definitely not opt for another block ever.  The second one was much more tramatic and painful.

[aimee37]

I had my right eye done 3 weeks ago and my left eye last week.  I had a block for both eyes.  I had a sedative, then Pentathol, then the block injected while I was under the Pentathol for about 2 minutes.  I can't imagine getting the injection while awake.  My doctor uses the block for patients whose eyes are sensitive to light, so that there is no movement during the surgery.  Both of the times, my eyelid was taped shut after surgery and I was to remove the tape after 3 or 4 hours.  Both times I had double vision for a few hours after tape removal and then I was fine by evening.  Double vision for some time after the block is a lot better than moving your eye during surgery.  They told me that about 30% of patients require a block.

[aimee37]

the "double vision" that CRUISERPRG is experiencing is a totally different type of "double vision" from the original poster.  CRUISERPRG is referring to monocular diplopia from the optics of the multifocal implant or uncorrected astigmatism.  the original poster of the thread has true/traditional diplopia.  those are not really related at all...

[aimee37]

I am scheduled for a YAG laser capsulotomy.  I hope that this removes the haze/blurry/double image.  I originally had a bad cataract.  Has anyone had good results with this treatment?

[aimee37]

Just curious - since you mentioned patching one eye may not strengthen the muscle, what would help?  In your opinion is the double vision caused by a weakened muscle or a paralyzed muscle or something else?

[aimee37]

i dont have any idea what has caused your individual diplopia.  i am just stating that patching in an adult p/o cataract extraction for "strengthening" an eye is a therapy that i am not familiar with.  heck it may work well!  but i dont understand the mechanics of it if it does work...

[aimee37]

Supposedly the crossed eye/double vision was caused by the block affecting the muscle.  Last surgery the block affected my eyelid and it drooped for a few days -- this time the eyelid was fine, but now this. The Dr. says I have good muscle movement, it's just weakened.  So I'm assuming that's the reason for trying to strengthen.  He's been doing this procedure for 30 years and of course I'm only the 3rd case he's seen, that's why I was wondering if anyone else has experienced this.  I'm a 49yr old female.

[aimee37]

I've read that sometimes the needle from the block can inadvertently injure an eye muscle, which can cause double vision.  As your doctor told you, sometimes the injury resolves on its own.  If not, I believe that a minor surgical procedure would correct the double vision problem.

[aimee37]

Thank you for the input -- anything helps.  Today has been 8 days post op and my anxiety level is quite high.  I'm very worried about this.  Every day I am looking for some change, but don't seem to notice any.  I'm praying for it to heal on it's own -- instead of having to go thru another surgery.

[aimee37]

I think you'll have to give it more time.  Even if your double vision doesn't resolve on its own (and it very well may), I think that it could be easily corrected with prisms or a minor (painless) procedure.

I'm really not a big fan of retrobulbar blocks.  I had one during my retinal surgery in January 2006.  It caused a terrible black eye--and I'm still covering some of the staining with makeup.

Best of luck with your recovery.  

[aimee37]

Well, I went to the surgeon this morning and he seems to see some improvement from this past Monday -- so I'm really hoping he's right.   I haven't noticed a difference yet, but at least that was positive news.  I agree with you -- not a fan of the block and hopefully will never have to have one again.

[aimee37]

Update:  Tomorrow will be 3 weeks post surgery.  The double vision began to subside 3 days ago.  It's not totally gone, but I do not have to patch one eye to be able to function.  Surgeon says this should continue to improve.  Such a relief!

[aimee37]

Just received word that my sister has double vision 24 hrs post cataract surgery.  Eager to know about the further recovery of the person who reported some improvement, and others.  Is it the rectus muscle?

[aimee37]

As of today, 3/27/07, the double vision is totally gone as far as I can tell.  I go back to the Dr. in 2 weeks.  The double vision began after my 02/28/07 cataract surgery.  The surgeon used the "block" for the eye and he seems to think this shot and/or the medication affected the muscle.  He initially told me it could take up to 8 weeks to recover -- if not surgery was an option.   I was able to function by wearing a patch.  

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