After Cataract Surgery

[GenealogyPriscilla]

I had cataract surgery on my left eye on June 26, 2007.  My eyelid drooped after surgery and it was covering a little of my pupil, obstructing my vision. It has improved some since then. On August 14, 2007, I had the cataract surgery on my right eye after which my right eyelid also drooped the same way. It has also improved some.
I had the ReSTOR lens implanted in both eyes and my distance vision is now very good. I can now drive without glasses and am grateful for that even though it cost me $4000 out-of-pocket since Medicare considers the ReSTOR lens "cosmetic" but that's another story.
I am using the computer and reading without glasses but must be about 12 inches from the monitor or book and it's very uncomfortable. I'm 72 and in perfect health.
My doctor says not to get glasses because it will take time for my brain to adjust to the ReSTOR lens. As for the droopy eyelids, he said he didn't have a "before" picture to compare with and that it will probably improve by itself in time.
My questions:
Is there anything I can do to restore my eyelids to pre-surgery appearance? Someone said her mother also had droopy eyelids after cataract surgery and her doctor gave her an exercise to lie on her face for several hours a day and it took six months to improve. People keep telling me I don't look like myself and I know I don't.
The halos around lights are huge at night making it difficult to drive,  so I don't drive at night anymore. I knew that was a possible side effect but wonder if there's anything I can do about it. Night vision glasses perhaps?
My vision was always quite different in each of my eyes and very unsettling. Doctors have told me people pay to get that kind of vision but that wasn't helpful to me. My eyes are much closer to being balanced now, though not perfectly balanced, so I may eventually need a prescription for reading/computer glasses. I'm a genealogist and on the computer all day.
Many thanks for this service.

[John C Hagan III, MD, FACS, FAAO]

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[seriousperson]

After my cataract surgery my vision is similar. Post-surgery I have been fitted with 3 pair of glasses, including progressive bifocals and regular bifocals with the line with the lower half being very wide. The top of the line bifocal is for computer distance, and the bottom half is for reading up close. I can use my progressives for reading and computer, but I only do that when I'm at work on the public service desk where I also need to be able to see distance. When I'm at my office desk at work or at my computer desk at home or just reading in bed, I much prefer the line bifocals that allow me to scan across screens and pages from left to right without running into blur. The horizontal blur of the progressives is much worse after cataract surgery than it was before, even though these are the latest version of progressives with the supposedly wider focal range.

[John C Hagan III, MD, FACS, FAAO]

RE: Lids    Droopy eyelid after cataract surgery is not common anymore but does occur. When Eye MDs use to us a superior rectus bridle suture dropy lids (Ptosis) after surgery was quite common. Now few surgeons use bridle sutures.  What your surgeon could be true. Many people with moderate or thick cataracts after surgery notice details like wrinkles on the face and drooping face and lids that they could not see before the surgery.  

Sometimes the eyelids do improve up to 6 months after the procedure. If it hasn't lifted up by then and truly bothers you you can consult a oculoplastic surgeon (an Eye MD with special training in lids, tear duct and orbital surgery) to have it surgically fixed. If it hangs down as much as you say it should be no problem to get insurance coverage for the surgery and document that its not cosmetic.

I don't know what your surgeons reluctance is to prescribe glasses. I would go in and talk about a referral to get your lids elevated and ask for a refraction and prescription for progressive bifocals to be worn "when you need them"  In your case that would be driving and computer. Remember that most patients that are "happy" with their multifocal IOLs still wear glasses up to 20% or more of the time.

JCH III MD