Cataract Surgery - Vision Alignment Problem

I had cataract surgery five days ago in my left eye.  The angles of my vision do not line up anymore.  If I look at a vertical line with the right eye only, it seems straight up and down.  If I close that eye and open the left eye it seems slanted with the top going to the right and the bottom going to the left.  Trying to use the two eyes together is weird and can make me feel nauseous.  If I tilt my head to the right about 45 degrees, close the right eye and look through the left, a vertical line is now on the same straight up and down as when I hold my head straight up looking only through the right eye.  Also, laying on my back, looking at the stars, I now see double.

Can the lens put in during cataract surgery be put in at the wrong orientation causing this alignment problem

[Michael J Kutryb, MD]

It could be a side effect of the anesthetic block (retrobulbar block or peribulbar block) if you had such a block done on the eye.  I typically avoid a block in 99.5% of cases just to avoid problems like this.  Please talk with your surgeon and describe your symptoms and ask if a block was done and if it could have something to do with the problems.  Of course, perhaps the problem was there before surgery and you just couldn;t notice it because the cataract was so terrible. Generally I think you are noticing torsional diplopia which is usually related in some way to a problem with the superior oblique or inferior oblique muscle.  Keep us posted - and I'm very interested to find out what is going on.

MJK MD