Double Vision after cataract surgery

had 1 cataract removed 2 yrs ago with the immediate result double-vision due, I was told, to a problem with the anesthesia and the muscles around the optic nerve. Problem slowly eased for some time then stopped. I can function well with most activities but it plays havoc with tennis (something I engage in very often and take rather seriously). It is somewhat intermittent i that it almost invariably worsens as the day progresses. The degree of double vision is not constant and will change moment to moment in my play and in other activities. As an example, I can look at an object 12 feet away and slowly a second image will begin to move downward and a bit to the right of the l
eft image) until it appears to be a couple of feet below the other. i can quickly dip my head and return to the original position and all will be well for a few seconds... and the sequence is repeated.I have since had the second cataract removed (using different anesthesia method).
An operation has been suggested to me to strengthen (or weaken?) a muscle to correct this.
Does anyone out there have some thoughts or suggestions for me... thanks

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

I have done considerable research on double vision after cataract surgery. References:

81. “Diplopia Cases After Peri-bulbar Anesthesia without Hyaluronidase”, Hagan III JC, Whittaker TJ, Byars SR Journal of Cataract & Refractive Surgery, 25:1560-61, 1999

82. “Diplopia and Ptosis Following Injection of local Anesthesia Without Hyaluronidase”, Jehan FS, Hagan III JC, Whittaker T, Subramanian M. Journal of Cataract & Refractive Surgery, 27:1876-1879, 2001

84. “Use of a Compounding Pharmacy Hyaluronidase for Ophthalmic Injection Anesthesia”, Hagan III JC, Hill WE. Journal of Cataract & Refractive Surgery, 27:1712-1714, 2001


You should see a strabismus surgery specialist and if he/she advises surgery then go ahead and get it done.

JCH III MD