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Extreme light/glare sensitivity after cataract surgery
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Extreme light/glare sensitivity after cataract surgery

I am 55 yrs. old. I had bilateral cataract surgery in June'05 on the right eye and the left eye Sept.'05. Laser on the left eye Nov.'05. IOL's were Alcon SA60AT. The left eye is extremely light/glare sensitive. Light entering the left temporal area is very uncomfortable..the outer edge of my left eye/orbit is blurry and exposure to light results in a deep ache that radiates to the brow/temple area...this ache/pain can intensify to migraine like symptoms depending on how much and what type of light I've been exposed to, i.e. flourescent lighting, halogen, backlit signs, sun reflecting off white surfaces such as pages of a book, TV, computer screen...any white/gray glowing type light ... cannot drive at night..traffic lights are huge starbursts and distance vision at night seems worse. I wear welder's type eye protection on bright sunny days ... my polarized sunglasses offer 'normal light' but do not help much.I wear sunglasses while everywhere indoor to ensure some level of comfort. I have researched on my own and recently and quite by accident found a condition dysphotopsia that fits my problem to a tee.  Explantation is very risky due to previous laser as the capsule is now compromised.  I would love to hear from anyone  with this problem ...  my lifestyle has changed drastically and would appreciate comments and suggestions on how to work around our very well lit world.
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Avatar_n_tn
not a common problem or diagnosis.  not too many people here will have had similar experiences.  but good luck!
12 Comments
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Avatar_f_tn
I know it is rare. Everyone told me there was nothing to cataract surgery and I would be back to work in no time ... I'm still not back to work and missing it horribly.Although I knew that light causes the problem I felt it was perhaps my sinuses and had x-rays and CT scan ... nothing. I've had an ultrasound on my eye and there is no decentration.I visited Alcon in April in desperation for an answer and they have not responded to my visit to date. When the eye is dealing with light it feels like it contracts in and out..by the end of the day my eye looks fatigued, puffy and red.  The doctor has not been hasty to diagnose dysphotopsia.  I'm wondering if there could be an allergy to the IOL material...I'm truly at a loss and feel that perhaps I should just try patcing it for a week and see if this helps. I often need to cup my hand around the eye for comfort.  I have a letter prepared to send to a specialist in Utah.  Thanks for your help and I'm praying someone out there relates to my problem.
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Avatar_f_tn
In June 2005 I had cataract surgery in both eyes and had AcrySof ReStor lenses implanted. I
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Avatar_n_tn
I had a vitrectomy in my left eye in March, and cataract surgery Oct 10.  I, too, thought the cataract surgery would be a piece of cake -- especially compared to the vitrectomy.  But, the outcome of the vitrectomy was fabulous -- and, since the cataract surgery I have awful shadows, glare, halos, etc., etc.  The doctor says it will go away.  I'm supposed to have cataract surgery on the other eye Dec 12, and I'm thinking of canceling.  I can't imagine having BOTH eyes with this problem.  My doctor used an acylic lens -- not sure which one -- I'm finding out on Monday at my pre-op app't.  I've since found out that silicone lens have much less glare and shadow problems.  I've been in touch with Dr Weinstein's assistant in NM (article was in Review of Opthamology) about dysphotopsia, both positive and negative -- I have both.  They do lens exchanges, and I might pursue that.  My doctor won't exchange -- he already told me that.  I can't imaging paying for a 2nd surgery -- but, it might come to that.  If you want more info about Dr Weinstein, let me know.  Good luck!

Pete
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Avatar_f_tn
Diamond Eyes (terrific nickname) .... I am so delighted to hear from you ... I really didn't expect to hear from anyone considering the first response I received from MedHelp. I do have good luck from time to time and today is one of those times.  Thank you, thank you, thank you for taking the time to write such a detailed account of your surgery outcome.

I too had a brief glimpse of clear distance vision shortly after my laser treatment ... which was awesome. You see, I had to wait a long time for my cataract surgery.  The first optometrist missed my cataracts, twice.  I returned to an excellent optometrist in my old neighbourhood who spotted them right away ... that was Nov. '04; I couldn't get in to see a ophthalmologist until Apr. '05 ... at this point everything in front of me was blurry (legally blind) ... I tried to keep working at my job of 15 yrs. but had to give notice as I couldn't see my clients clearly across my desk and I nearly fell down the stairs a couple of times and I was DRIVING....after 15 yrs. of the same paperwork, environment and route to and from work I guess I was being selfish in hanging on as long as I did ... my family doctor gave me a strong directive to get off the road, at the very least and he was right.  I cried my eyes out the first work day of the following week ... I worked with the public in a sales position and I knew staying at home full time would be a huge challenge as I hadn't developed a social life outside of work ... work was like one big social on the most part ... on the weekends Sunday was family day (3 granchildren) ..Saturday was all the other stuff we do to prepare for the uncoming work week. Then I waited.
I did speak with a woman who experienced severe post cataract surgery glare and dry eyes even a year after her surgery. The liquid tears didn't help her at all. In fact, she said they worsened the glare/light...she couldn't cry if she wanted to her eyes were so dry.  I wanted to keep in touch with her but didn't. She was very depressed and at this point I was struggling with the black cloud of depression myself. It would come and go. Some days can and have been such an effort but I absolutely must get up, make the bed, shower etc. and ensure I go out daily .. a basic regime was important and living in denial was too .. hahahaha ... still visit that place on a regular basis.
For the first six months after my surgery the eye surgeon and my family doctor said they had never heard of my complaint before and, in fact, made me feel rather small ... once I sought a second opinion and started my research they seemed to change toward me for the better, fortunately.
I have never allowed my frustration to boil over with the doctor's...I need them.  However, I am still considering seeking help possibly in another province or the US ... I live in Mississauga, Ontario.
My near and  mid-range vision isn't very good at all ... distance is pretty good though if I could stand looking at it .  Don't you get a little addled by handling and carrying so many glasses? I do.. Some prescription - some not.  Geesh ! Yes, and my eyes do feel starved for light sometimes.  My eldest grandson asked me, "Grandma, when will you stop wearing sunglasses?" I said "Grandson, just accept whatever Grandma has balanced on her nose ... whatever you see is what I need and sometimes you will see nothing at all covering Grandma' loving eyes".
Closing my eyes to rest them helps a lot ... the ache on the outside of my left eye/temple is soothed by squishing a soft pillow over it. Do you get headaches at all if you received too much light? When reading the eye chart I have difficulty seeing the center letters , can't make them out... I've just recently found an article depicting what I see or rather don't see.  The eye surgeon has never told me why I struggle with those letters .. I think it's central flash.I too had twitching in my left eye continually for about three months from spring into summer then gone ... only experience that once in awhile now.
We are not 'making up' our aberrations ... the problem is real and nagging and if I didn't have or create a lot of distractions in my day to day life I don't think I would be coping at all...I am always aware of my light sensitivity..the distractions just help me cope.  Could you explain to me what the reaction is to the surgery .... physiological or psychological?  Have you read comparison studies of acrylic and silicone lenses and design studies. Acrylic are far more prone to glare than silicon. A recent study I read said my particular lens had a good rating for ease of implantation and patient satisfaction, however, it is known that post capsular opafication is common at the haptic(anchor)/lens join and also reports of glare/aberrations as they are acrylic. Also, the curvature of the lens can pose a problem causing light to bounce from the retina, to the lens and back.
    
I do have glare problem in my right eye and likely wouldn't be driving at night if both my eyes were like my right eye.

You know, Diamond Eyes (I love it), researching has taken a long, long time.  Not knowing the language of medicine is challenging.Once I was on to dysphotopsia my hubby jumped right in to help me.  You are fortunate to have a personal friend who is a renowned surgeon.

I will order the Nature's Tear.  Is it www.naturestears.com?
I'll also try Thera Tears and check out the Harley Panoptic sunglasses.

It's been over a year now for me.  Because of you contacting me I tried going without my eye protection for longer periods and while in the stores and in the car tonight with my husband ... I have quite the headache but will do the same tomorrow - perhaps the rest of the week .. I have tried this several times before (because I am a fiesty girl) but wasn't successful.  When the right light hits I automatically squint my eyes shut. I'll leave the patching for another attempt.

I guess you can tell just how thankful I am for you contacting me .... and I know I have missed some details (denialworld) but do hope I hear from you again.  I have received another message from Pete so I will respond to him now before I go to bed.

At this writing I have my sunglasses on and the brightness on the monitor is dimmed and my eyes are so tired and strained.

Thanks again
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Avatar_f_tn
Hello Pete,
Thank you so much for contacting me ... it's been an uplifting day reading yours and Diamond Eyes' emails.
Yes, I would like information on Dr. Weinstein.
My surgeon initially said he won't change my acrylic lens but just recently has brought up the possibility. It's very risky and the thought of a poor outcome or another complication may just tip me over the edge. He feels that perhaps the lens in my left eye is rubbing/irating something.  
What is a virtectomy? I look forward to hearing back from you
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Avatar_f_tn
How rude of me ... best of luck with your surgery...I certainly can understand your concern having both eyes with the glare/shadowing problem. Isn't it frustrating?  What sort of eye protection is necessary for you to wear ... has the surgery changed your lifestyle? Do you get headaches from the dysphotopsia. Although I've read plenty about the condition there are never any symptoms of discomfort/pain mentioned ... all pretty technical stuff. Keep in touch!
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Avatar_n_tn
Light show:

I am not wearing special glasses.  The glare/halos etc. are primarily at night. Some during the day. No headaches, fortunately. I find the worst problem to be the dark shadow at the eye periphery.  That is negative dysphotopsia, which is the problem that most often causes lens exchanges.  See Dr Olson's article link here -- http://www.revophth.com/index.asp?page=1_643.htm.  It is the best article I have found about the problems.  Note Dr Weinstein's sidebar article in Olson's article.  Weinstien's assistant, who I am emailing, is named Anne Dwyer (***@****).  She has been EXTREMELY responsive and helpful.  If you want to contact her I suggest you mention my name, and that you saw Dr Weinstein's article.

I had a vitrectomy to remove the vitreous from my left eye.  I had a PVD (posterior vitreous detachment) about 2 years ago, and had globs of vitreous in my eye so it was very cloudy.  The surgery is called FOV, for "floaters only vitrectomy".  Typically a vitrectomy is done only to reattach detached retinas, but in the last few years they are using it to remove the vitreous, and replace it with a saline soluntion. In essence they put 3 needles in your eye -- one to provide light, one to suck out the vitreous, and one to put in the saline solution.  There is risk, but in the hands of an expert surgeon the risk is minimized.

I hope all this is helpful.

Pete

PS:  See email from Anne below FYI.

Hello Mr. Beinetti,

I received your email regarding Dr.Weinstein
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Avatar_f_tn
Hi Pete
Thank you for the information on Dr. Weinstein;  I'll contact Anne through email. NM is quite a poke from Canada but looking at the light snow flurry activity outside tonight could possibly work in a little R&R..thanks again.  I look forward to hearing re your decision ... hopefully you can come up with the financial end should you decide to go with Dr. Weinstein ... it would be a squeeze for us to.  Take care
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Avatar_n_tn
Hello Light Show,

I was so glad to read your posting and the comments.
I had cataract surgery on both eyes on November 1, and November 20 of 2006.  I had the AcrySof SN60WF IOL implant.  
I was very nearsighted (-8 and -9 diopters).  My doctor corrected me for distance; I have about 20/40 in one eye and 20/25 in the other.  Still have to wear glasses for reading and intermediate vision (as well as for astigmatism).

I also have the flickering and glare problems.  I had never heard of dysphotopsia until I read this post. It is VERY bothersome.  I was off work for a month and have just returned.
I cannot stand to be in a room with flourescent lights and beingb outside in bright sun is also bad.  I have a noticeable temporal flicker of light I see in both eyes when the light source is coming from my side.

Here is an intersting article I found on Dysphotopsia:
(You probably have already seen it):

http://www.revophth.com/index.asp?page=1_643.htm

My next follow up appt. with my doctor is Dec. 11.  Guess I'll be following the same path as you are.  Why don't they warn you about these results?  I can honestly say I would have waited to have the surgery done had I known about this.  I really don't want to go through an exchange either.

Susan in North Carolina
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Avatar_n_tn
Sorry,
I just realized that the article I referenced has already been mentioned in the comments to this post (article by Olson).
Susan
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Avatar_f_tn
Sorry for the delay, light show, (love your nickname too) this is a very busy time of year for us, at work. When I said that I thought that my aberrations were a reaction to the surgery you asked if I thought they were physiological or psychological. I
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Avatar_f_tn
Pete, this is just food for thought. I'm glad I had both eyes done so close together as I can't imagine having waited all this time for one to resolve before starting over with the second eye. Also my doc said he thought the dark shadow was just a bunch of floaters that were stuck together. Apparently he was right because I never saw the shadow when I saw the floaters and vice versa. Both elements are greatly diminished now and I very rarely see the shadow. Best of luck. Keep us posted.
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Avatar_n_tn
A related discussion, Post op cataract complications was started.
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Avatar_n_tn
A related discussion, Glare from Cataract Surgery was started.
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Avatar_m_tn
A related discussion, Pseudophakic Dysphotopsia was started.
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