How Do I move on after cataract surgery?

Hello everyone, I am very much regretting getting cataract surgery done and am concerned what my vision will be like for the rest of my life. I am waking up with anxiety attacks in the middle of the night ever since getting this done, and it's ALL I can think about. I know it's early days yet (got this done in April) and know that I would have had to get it done irregardless in a few years (early onset and getting worse) - but still. I'm only 52! Why did no one bother to inform me about the side effects? i.e. dry irritated days, edge glare, trouble focusing my eyes on anything for more than a few seconds, and light sensitivity. It's like wearing a really irritating pair of contact lenses every day, except that you can't take the lenses out to get some relief! Will my eyes ever feel "normal" again? Some help, please, or suggestions about how I can move on....I just don't know what to do and I panic every day I wake up and realize I don't have my own lenses anymore. Thanks.

[Michael J Kutryb, MD]

Where you truly ready for cataract surgery or did you pay cash for clear lens extraction?  What implants did you have?  Your symptoms are very unusual and I have only seen things like this in perhaps one in 400 cases or so.  Something doesn't all add up.  Didn't you have problems after the first eye and tell your doctor?  If so, why was the second eye done?  Where was your surgery done?

MJK MD

[JodieJ]

Why are you assuming that your current vision problems are something that you must live with?  What does your surgeon say about your problems?  If s/he doesn't have answers that satisfy you, then you should consult another experienced, board-certified surgeon.  If you live in the US, you can find one at www.aao.org.  If you post more details about your situation, perhaps Dr. Kutryb can advise you further.  I'm not an eye care professional, but it sounds like some of your discomfort may be due to dry eyes, which can be treated.

[JodieJ]

Lorac0813, I just read a couple of your recent posts.  It seems that your doctor suggested that you have cataract surgery before you really needed it, and now you are very much regretting having had the surgery.  I definitely don't think that the problems you are having now will be long-term.  As Dr. Kutryb suggested, your edge glare will almost certainly resolve on its own, so try not to focus on it.  You mentioned that you don't have a follow up appointment with your doctor until June, but I think that you should call the office on Monday to set up something for this week--the earlier, the better.  You might ask whether it would be all right for you to use OTC dry eye remedies (drops and lubricants, especially the type without preservatives)--they might make you more comfortable.

You must have been myopic before surgery (but probably not a high myope like I was), so it's natural for you to miss the good near vision that you were used to.  But that loss need not be permanent.  You will soon be able to regain it with monovision (after a few days of adjustment) or with multifocal contacts.  Meanwhile, I think that you will be a lot more comfortable if you get some progressive glasses.  Most optical shops will let you remake them at no charge if your script changes slightly during the  first few weeks.    

[lorac0813]

Hi Dr Kutryb, thanks for responding to my question. To answer some of your questions, I live in Canada, so my cataract surgery was covered by health insurance, I didn't pay anything. All I know about my implants is that they are the standard monofocal ones, corrected for distance. I should have been more specific about my eye problems - they are occurring in my left eye ONLY, my right eye is fine (had my right eye done first). My surgeon did tell me I could wait a few years for the surgery but not many, because I have (had) early onset cataracts and they were getting worse - which is why I chose to have this done now. I did call the office and told them my concerns about my left eye but they said everything I mentioned (glare, dry eyes, trouble focusing etc) was normal and I would have to live with it. And I guess my biggest regret is that I didn't think through my decision to be corrected for distance and now am missing my close vision terribly. My husband thinks I'm being a big baby about this but these are the only eyes I have and I think it's natural to be worried about them. If these problems I'm having will truly resolve on their own then I guess I just need to be patient?? Thanks for your thoughts.

[lorac0813]

Hi JodieJ, thank you so much for your helpful comments. It really helps to talk to someone else who has had this done. I do think that I should have waited a few more years to have this done and I should have researched it more carefully. The surgeon I went to is very highly respected and recommended in the city in which I live, and when we talked about it he said that cataract surgery was a "breeze" and I would be back on my feet in a couple of days. That of course has translated into almost a month, and I still don't feel 100%, but I'm back to work irregardless. You say that the problems with my left eye should resolve in a month or so - I do hope you're right! About calling the office, I did call last week and was told my symptoms were normal and should go away, and that I would have to live with them if they didn't. I did ask if I should see him again (my surgeon), and they said no. So.

As far as dry eye is concerned, that has been a problem with both eyes and I have been using Refresh Tears every hour on the hour but it doesn't seem to be helping. I did call the office about that, as well, but they didn't seem concerned and told me to use the natural tears, which of course I was already using. Sigh. Dr. Kutryb suggested punctal plugs, which I will look into, and oral flaxseed oil, which I have just started om his recommendation.

When you talk about monovision, do you mean correcting one eye with a contact lens set for close? I did have a question about that earlier and Dr. Hagan responded to me with the same information you gave me, so thank you so much for that. I'm not sure how I would respond to monovision as my vision was driving me crazy for the 2 weeks between surgeries...but maybe I should give it more time.

JodieJ, do you mind if I ask how old you are, and when you had your cataracts removed, and what your vision is like today, and did you eventually stop worrying about your eyes?? Thanks.

[JodieJ]

From my perspective, dry eyes are a post-surgery problem requiring evaluation and treatment, and you have every right to insist on an appointment with your surgeon within the next few days.  If needed, some treatments such as Restasis and punctal plugs require a doctor's prescription.  Although it's great that free advice is available online, you should not have to rely on this method.  It's outrageous, IMO, that your surgeon's staff is telling you to wait till June when you need treatment now.

Monovision would involve correcting your non-dominant eye for near vision with a contact lens.  It works very well for most people who try it.  Or you could experiment with different power contacts to fine-tune a modified monovision correction.  Another possibility would involve wearing multifocal contacts in both eyes.  An experienced optometrist should be able to suggest something that will work for you.

I'm about a year older than you.  I developed a cataract as a result of having retinal surgery (to remove an epiretinal membrane.)  Because of the exposure to oxygen during the retinal surgery, my cataract developed much more rapidly than normal.  I really hated the blurred yellow vision it caused, plus it made my affected eye increasingly nearsighted.  It seemed like every other week I was at my optometrist's office getting a new (and stronger) contact for that eye.  By the time I finally had the cataract surgery, I couldn't even see the big "E" on the eye chart with my old glasses (which had given me 20/20 vision in my affected eye just a few months before.)  So I was actually looking forward to having cataract surgery, and I was pleased with the results.  (At least the experience of having worsening cataracts will not be in your future!)  

  

[lorac0813]

Hi JodieJ, thanks so much for your emails and for your advice! I hope I'm not writing this email twice, I had replied to you but I wasn't logged in so I don't think it went through.

I called my surgeon's office today and INSISTED on an appointment, and I have one for tomorrow already! So I will let you know how that goes. I will let him know the horrible problems I am having with dry eyes, as well.

Thanks for your advice about monovision. I will try that a little later down the road. I am finding work a bit difficult right now because I need reading glasses all the time, whereas before, now and then I could take a break from the glasses. Mind you I'm just using cheap readers from Wal-Mart so maybe that makes a difference.

I am glad your cataract surgery went so well! My vision problems weren't as severe as yours but mind you I didn't want to wait until they got so bad - that was one of the reasons I had the surgery in the first place. And you're right, at least I won't have to worry about cataracts in the future!

JodieJ, thanks so much for responding to my emails, and for your advice. It's nice to know that someone cares! Although my problems haven't gone away, at least I'm taking some action and who knows, maybe in time they will go away, or maybe they are fixable in some other way. You have given me hope!

[telya]

Ok, I was kind of ok with getting my eyes both done for distance but after hearing Lorac
I am getting a bit worried.  I wanted great distance vision and good night vision and the left eye with a cataract is driving me crazy it is so cloudy.
But now I am thinking should I not have it done at all or have it set for blended vision instead?
I had the right dominant eye done for distance last Wednesday and have my one week check tomorrow.  I don't know what to ask for.
I noticed today that my vision which was pretty good the day after surgery, like 20/25 even with the pupil still somewhat dialated, now is a little bit blurrier but I can see the computer better so it has changed somewhat.  Why would that be since it's supposed to be set for distance?
I'm getting worried.  I had not heard of all these problems and am getting kind of scared.  The world of color is back however and I am grateful for that.
I can see down the road ok but the speed signs take getting a little closer to focus than I think they did yesterday but I noticed I could see pretty well as it was getting darker before I came home.  I am grateful and just praying I make the right choice for the other eye and that I don't have many side effects.  Any thoughts?
Thank you.

[telya]

Oh, one other thing.   I have read that one of the most important drops after surgery is the
Acular.  I have been very good about putting in the drops, all of them but they say they won't give me any more of the Acular after a week's worth and I have read that some take them for at least 2 weeks.  Should I try to get more?
Also, I have heard that the Pred Forte can be slightly dangerous in causing pressure in the eye, etc.  Should I be worried about being on that for 4 weeks?
Thank you again.
ALso, taking Zymar antibiotic drops.

[JodieJ]

It's probably best to follow your doctor's instructions with the Acular and Pred Forte.  I was on farirly high doses of Pred Forte (6+ drops daily) for a number of weeks following retinal surgery due to severe inflammation from misplaced sutures (done by a resident).  My eye pressure stayed low, but it was monitored.  I was told that more than 3 months on Pred Forte may cause cataract development (obviously not a concern for you.)  

[lorac0813]

Hi telya, from my own personal experience, if I had to do it again, I would have gone the monovision route (one eye corrected for distance, one eye corrected for close). I mean, it's wonderful to drive and shop and walk around without glasses, but I need reading glasses for everything else - reading, computer work, even filing my nails! I think the most annoying thing is having to fumble for your readers in order to look at a label on a store shelf. However, that being said, it's a personal preference and I know just by reading the posts on this site that most people getting cataract surgery opt for the distance vision. On a personal note, many of my friends who have undergone PRK or LASIK have been corrected for distance, and they couldn't be happier. Just think really hard about your decision and make sure it's the right one for YOU.

Can't help you where the drops are concerned, I'm in Canada and my drops have different names than yours. Good luck with your second surgery!

[lorac0813]

Hi JodieJ, I just thought that I'd let you know how my appt with the surgeon went yesterday. He checked my eye very thoroughly and said there doesn't appear to be a problem. He did tell me to come back if my problems haven't resolved in a month or so. So I will do that. Unfortunately he couldn't recommend much for the dry eyes other than what I am already doing. Thanks again for all your advice and help, I hope to stay in touch with you via this forum!

[indi1664]

Hi,
     I can understand your panic..i just  had my operation 2 weeks ago...first few days were awful and like yourself ihad huge anxiety...but day by day things have improved ...I was -20 in left eye and am now +.0.25 and 1.5 astimatism...whilst op has gone well being very myopic i had great near vision ...sadly now I havent ...but tht is price you pay for having good distant vision.but this can be corrected with glasses...at moment i am using cheap reading glasses ...but am told once i have correct astigmatism and prescription lenses things will be much better...In your case if the op has gone well ..just give some time to adjust ...i am sure things will work out well.
Good luck

[Texheart]

What you are describing is identicle to what happened to me 3 months ago .  I just posted to one of the doctors for some answers.  No reply yet.  My surgery has been 11 weeks ago and I am no better.  It was simple cataract surgery.  I did not want any fancy lens...Just give me back what God gave me.  I now have large Black Viteous detachmants with lighted Halo's/wavy lines with suspected Retina tear. I was suppose to remain near sighted.  I am now farsighted.  They cannot do surgery on me as I am a heart patient and on Plavix.  The stress has caused severe angina attacks.  I had to find new doctors as the group I was seeing would not acknowledge my discomfort.  New eye doctors did.  I feel your pain.  I feel your frustration.  I feel you sadness.  I feel your anxiety.  My church is praying for me.  I will add your name.  God Love You.

[Texheart]

P.S.  I am severely nearsighted and you are not a big baby.  Tell hubby to call me and I will tell him the same as will my hubby.  And, to think the original surgeon wanted  to do my other eye in 3 weeks!!!!!  I need my detachements fixed first that they could not see or acknowledge.
I could relate to the NBC news last week with Robert Bazell about Lasix surgery and Lasix doctors.

[lorac0813]

Hi indi1664, thank you so much for responding to my email! It helps so much to know that other people have gone through what I am going through. This is a HUGE life-changing experience and I don't know that I will ever be the same again. However, it is slowly getting better....I guess I just need to hang in there. I hope you're right, that once I get prescription glasses things should be better. Hopefully these headaches I've been having every day will go away then. Thank you again!

[lorac0813]

Hi Texheart, thank you so much for your email! It really struck a chord with me when you said "just give me back what God gave me". I've been feeling that way as well. I am so sorry to hear that you have been having such problems, they make my problems seem very insignificant. I hope your new doctors can help you! Thank you and your church for praying for me...I've been praying to God every night since I got this done so I will add you in my prayers as well. Thank you again for your heartfelt email.

[indi1664]

Hi again,
               I just had my normal eye test...and yes i will need glasses...but you will be truly amazed once you have the correct prescription ...I was shocked...clarity and I have gained about 20-25 % in my distace vision ,,that is aamazing and things are clearer ...but before this eyecheck...I have been feeling exactly as you are...so again bit of time and I am Very ceartain you will feel better and you will be amazed.
The reason for your hadaches is probably because you currently have an a minor prescription imbalance with your eyes...anything nearing a diference of +/- 3 diopters between the 2 eyes will give you headaches...but that is NOT A PROBLEM...as this than can be corrected so EASILY with glasses...I know you are gonna be totaally amazed ...once this is sorted out.
have faith in god ...he has taken care of you thus far ..I am sure he wont fail you now.
or in future...Good Luck

[lorac0813]

Hi indi,

I do hope you're right about the right pair of glasses making all the difference! If I can get fitted with a pair that lets me see close AND far, so much the better. I am still worried about night driving, though, haven't done any since my surgeries but when I'm out with my husband at night, (he is driving of course) I find it really distracting because of the glare around the headlights and street lamps. How have you found night driving since your surgery?

[Troy52]

Hi Jodie,

I’m a 56 year old male with newly discovered macular pucker in his right eye, which occurred this March. I have yet to see the retinal specialist here in Montreal, Canada, but two ophthalmologists here have said it is macular pucker. I'm slated to see the retinal specialist here June the 3rd, and given how much in demand these specialists are, I may be faced with making a decision about surgery fairly quickly in order to get into the queue. With my right eye, I can only see the big E at the top of a Snellen eye chart, so, I'm close to being legally blind in the right eye and surgery would be justifiable. I cannot drive or read with this eye. Fortunately, my left eye is unaffected so far, but the risks of bilateral macular pucker are around 30% so I feel I need to restore the right eye as much as possible in the event the left goes. My understanding of the Montreal retinal specialist is that he is highly competent. Both ophthalmologists independently recommended him. However, he may not use the FILMS technique, and I might begin the hunt again for a surgeon who does it. Given that delay may produce poorer macular restoration as the retina remains folded longer, I have been searching in the meantime to find a surgeon in Canada who uses the FILMS, (Fluidic Inner Limiting Membrane Separation) technique, the fluidic lifting of the epiretinal and ILM membrane as performed in Alabama, rather than the mechanical method of peeling off the ILM (Inner Limiting Membrane) with forceps. Despite wide searches, I have been unable to find a surgeon in Canada. The medical associations will not divulge their membership or the techniques each uses, which means calling up each, one at a time, an impossible task, to find the needle in the haystack.

I spoke with a representative at the Retina Specialists of Alabama, LLC
http://www.maculasurgery.com/Facilities.htm
about their procedure for the epiretinal FILMS peel and the price for such surgery is between 40 and 60 thousand dollars U.S., somewhat out of my range. And, I was told, that the FILMS technique is not even done there in the majority of cases, even if you pay for it as a possibility. It may be a procedure suitable for a membrane growing just over the macula, whereas perhaps most membranes are more widespread on the retinal surface and therefore require the manual peel. Despite this, why other surgeons in North America do not use the FILMS technique for its several advantages puzzles me.

One of the possible post-op effects of epiretinal membrane peeling is an increase in cataract formation, the cataract usually occurring within two years. Given your experience with the gradual formation of the yellowing cataract, multiple visits for eye contacts, would it be wiser to accept the inevitable and ask for the cataract surgery at or around the time of the peel?


A rather persuasive and convincing write-up on the Alabama macular pucker surgery follows. Perhaps it is too good to be true.

“The current method employed for removal of both EMP and the macular ILM consists of cutting and then grasping, or directly grasping, the macular EMP/ILM with specially designed micro-forceps, 1 mm in maximum diameter, and slowly pulling it apart from the neural retina. This is done with great care in order to avoid engaging the neurosensory retina.

One problem with the current method of tearing and peeling away the macular ILM is the physical trauma associated with pulling on the ILM until it separates thereby unavoidably stressing the underlying nerve tissue, sometimes causing irreparable nerve damage with worsened vision than may have been present preoperatively. Accordingly, the surgeon may proceed slowly and carefully but if too slowly the retina may be injured from light toxicity coming from the fiberoptic probe inside the eyeball enabling the surgeon's view. If the surgeon grasps too shallow then his movements are ineffectual, adding to the time of surgery and the chance of light toxicity. If the surgeon grasps too deep, permanent nerve damage and hemorrhage results. The difference is usually a matter of microns of forceps movement, causing the surgeon's mindset to be what has justly been described as "nerve-wracking." The mass of the forceps, although ever so small, often obscures the surgeon's view, further adding to the chance of surgical damage to the retina. As a result of the above factors, complete traction release is the exception rather than the rule. Finally, even in the unusual case of complete traction release, the nerve tissue will usually require several months to resume a smooth contour with best vision returning. Thus, for some twenty years, the removal of epimacular proliferation so as to restore central vision in the eyes that are approaching legal blindness has remained a vexing problem for vitreoretinal surgeons worldwide. The potential surgical risks and the uncertain benefits, as well as the high level of skill required to perform such surgery has caused many surgeons to be reluctant to intervene until vision is substantially lost. This has been true, despite the knowledge that persistence of EMP causes permanent destruction of nerve function at the center of vision, such that visual acuity is only partially restorable, and progressively less so, as the EMP is allowed to persist.

. . .

Briefly, the present invention is directed to a method of separating the ILM layer of the retina from the neural layer of the retina in order to remove the macular internal limiting membrane and all EMP on its surface. The method comprises inserting a hollow microcannula, considerably smaller than any such cannula heretofore, which is shaped at its distal end to conform tangentially to the surface of the retina, between the retinal ILM and the neural retina. After the microcannula is inserted, a sterile fluid is injected at a pressure of about 25 mm Hg through the microcannula between the ILM layer of the retina and the neural layer of the retina. The fluid pressure lifts the macular internal limiting membrane layer away from the neural layer of the retina, separating it in the process of lifting away and allowing for its easy forceps removal from the eye without inflicting any physical trauma upon the neural retina. The lifted macular internal limiting membrane is removed by grasping the free-floating macular internal limiting membrane with forceps and extending the macular internal limiting membrane separation as distant from the fovea as desired before tearing circumferentially about the fovea and removing from the eye. The present invention allows for the removal of the macular internal limiting membrane without mechanically peeling or tearing it away from the fovea, so as to minimize foveal traction and the resultant physical trauma to the fovea. Moreover, the present invention simultaneously actively smoothes the underlying distorted and wrinkled neural retina by an intentional build-up of localized pressure within the confines of the developing FILMS cyst of which it is the posterior border. Thus, visual recovery, the ultimate surgical goal, is substantially accelerated as compared to the months needed for passive, spontaneous retinal smoothing after forceps traction removal. The preferred substance for use in practicing the invention and achieving complete removal of the macular internal limiting membrane is sodium hyaluronate (Healon.RTM.), as manufactured by Pharmacia & Upjohn Inc. or chondroitin sodium hyaluronate (Viscoat.RTM.) as manufactured by Alcon, Inc.


. . .more to come. . .

[Troy52]

. . .cont'd. . .

The present invention allows surgeons to operate, for the first time, inside the human retina (intraretinal) rather than above its surface. In so doing, it enables the surgeon to gently, predictably, and rapidly remove the ILM and all EMP adhered to the neural retina. The gentleness of the invented method eliminates risk of mechanical traction from pulling on the nerve fibers. The speed of the method, typically 4 minutes as opposed to 15 minutes, substantially reduces the risk of light toxicity. The predictability of the method allows for a more certain benefit from the surgery. Moreover, the method affords a significant decrease in the surgical skill level needed to treat traction maculopathy and makes visual recovery more rapid, more certain, and more complete. The sum effect is to enable patients suffering visual loss due to traction maculopathy of any type to seek and find earlier and more certain relief from distorted and reduced visual acuity, while the associated neural retinal abnormality is still reversible.”

Some of the advantages seem, less retinal damage, lower light toxicity because of shorter operation time, shorter recovery period, and a better flattening of the folded retina because of a locally produced fluid cyst which applies greater pressure to the retina to flatten it. That’s why I’d like to find it in Canada, if I could, as our medical system might cover it here. But, I cannot yet find anyone up here who does it.

Some other issues in considering macular pucker surgery are:

a)  the type of stain used by the surgeon to highlight the membrane for removal. Tryphan Blue does not cause toxicity to the retina while Indocyanine Green (ICG) does. Some surgeons still use Indocyanine Green.
b) the size of the surgical instruments used. Gauge 23 and 25 sized instruments are smaller than Gauge 20. The smaller the instruments, the lower the trauma to the eye and the shorter the recovery period. More surgeons are moving to the smaller instruments it is said.
c) In the event of a post-operative retinal detachment, some surgeons use gas and others use silicone oil to stabilize the retinal membrane against the eye’s surface. However, the silicone oil can cause damage to the retina and requires a subsequent operation for its removal. The inert gas seems preferable.
d) Some surgeons peel away only the superficial scar tissue, but this scar sits stuck on the ILM (Inner Limiting Membrane). It has been found that a peeling of the ILM with its scar tissue attached above gives better results.
e) It is the vitrectomy which causes potential lens cataracts (an oxygen effect?) and possible retinal tears, post-operatively, yet surgeons routinely do the vitrectomy. I suppose this is because of the possible recurrence of membrane formation if certain vitreous cells (glial cells) are not removed via vitrectomy.


So, there are questions to be asked prior to surgery. The surgery is very delicate and results vary depending on the techniques used.

My best to the group and the difficult situations each is being faced with. You have to be a little pushy and try to get informed in order to find the best care possible. The specialists are very busy, but I believe they will respond if asked pertinent questions and are informed of the difficulties each person is going through.

Nevertheless, even with all the best information you can find, the eye remains a work in progress and a mystery in many ways. The cause of macular pucker is still largely unknown, idiopathic (no known cause).

[JodieJ]

I have very mixed feelings about the FILMS technique, which (as far as I know) is not used outside the Alabama hospital where it was invented.  My surgery was done by a top American retinal specialist, and he did not seem to view FILMS very highly when I asked him about it.  Per a post in the Google group sci.med.vision, neither did the faculty at the prestigious Wills Eye Institute.  However, for whatever reasons, the FILMS website gets a lot of hits from Google and other search engines.

My retinal surgery was done with 20-gauge equipment (my surgeon's choice), and it restored the acuity in my affected eye to 20/20+.  It did not involve ILM peeling, which (per my surgeon) is generally reserved for cases in which a macular hole is present.  I've read that macular pucker surgery is now done in cases where pre-surgery vision is better than 20/30; in the not-so-distant past, only cases where vision was 20/70 or worse were treated.  (Some of the above quoted text about mainstream surgical technique may be dated.)

Despite the excellent acuity in my affected eye, the image size in that eye (central vision) is about 2-10% larger than in the fellow eye.  This condition (retinally-induced aniseikonia)  is probably attributable to residual damage from the pucker, although it could have been caused by the retinal surgery.  My image size difference was not considered noteworthy by my retinal surgeon, although it has caused me to have binocular vision problems/discomfort (mainly excessive tearing).  There is no data on the frequency of post-surgery retinally-induced aniseikonia, although there are many reports of cases in the literature and on online forums.  Through email correspondence, Dr. Steve Charles in Memphis suggested that peeling the ILM might prevent/resolve the aniseikonia (point "d" above).  So perhaps the FILMS technique is really valuable after all, but has been overlooked in mainstream surgical practice.  However, Troy52, I'd be very reluctant to rely on any technique that was not backed by some solid research.

(Lorac0813, I apologize for this intrusion on your thread.  I've been following your posts, and I keep hoping to read about improvements in your symptoms.)    

[lorac0813]

Hi JodieJ, no worries about you and Troy52 intruding on my thread! I did start to read through them but you both got a little too technical for me...I'm always amazed by how much knowledge people on this forum have about the human eye!

I was on vacation last week so my eyes got a well-deserved rest from the computer. The dry eye problem is slowly getting better, I've gone from putting drops in every hour to about 4 times a day - a HUGE improvement for me! I'm also now off all of my prescription drops so maybe that is making a difference as well. First day back at work today and my eyes were fine.

As for my other problems - the edge glare and the reflection/shimmer off of my left lens - unfortunately, those problems have not diminished. I find I still need sunglasses in stores - especially the big box stores like WalMart - and most definitely need them outside and to drive. I've stopped wearing them in the house but only because I got really annoyed being "in the dark" all the time! I find that when I read, I need to make sure there is no light source on my left hand side - that makes it tolerable.

My surgeon did tell me to come back in a month or so if there was no improvement, and I will do so, but I'm just not sure what can be done for me at this point. Your thoughts, JodieJ? I know that you are not an eye "professional" but I do value your input and advice - you seem to be very knowledgeable. THanks....

[indi1664]

Hi ,
        I am very sorry didnt comeback earlier....I still am not driving as I have not got the correction glasses at moment...as i am due for rgt Eye operation quite soon...than i will get Multifocal glasses for reading,computer work and for driving....In terms of glare or any night vision problems ...Thankfully i have no problem...but just need the correction glasses....perhaps when you have your correction glasses ...might be prudent to get photochromic lenses...these will adjust to light conditions....get some info on this from your Opthalmologist...but i am still confident once your eyes settle down ...this as get older can take a touch longer..perhps 6-12 weeks...than you get the correction glasses i think you will be absolotely fine.
I sense you are allredy feeling a bit better and just a touch more time and you are gonna be feeling grrrreeeeeeeaaaaaatttt...
Take care

Indi

[light show]

Your difficulties with your 'new eyes' are the same as mine.  I had bilateral cataract surgery in '05 and was having a horrendous time dealing with various outdoor/indoor lighting and have had daily painful headaches especially in my left eye.
In February of this year I had the left iol implant removed and replaced with a Technis Aspheric lens.  The blur from edge glare is gone, however, I still remain hypersensitive to lighting and see bright rings in my eye at night. I'm waiting for my new glasses and can't wait.
I doubt I will be able to drive at night anymore - sunglasses weren't even helping ... this fact seems to be relatively common in most that have had cataract surgery.
I still get the headaches/migraines.  I had an eye exam by my optometrist just last week and it took 3 days with a migraine and burning eyes before I felt 'normal'.  I never had this problem prior to cataract surgery.
I don't blame anyone for the outcome of my surgery but as Indi says, try to get a doctor to acknowledge your visual discomfort and resulting pain.  Would it be so bad for doctors just to tell us that our problems are sometimes the outcome...albeit rare?
My recent surgeon agreed with me that although my condition is rare ... it is within the normal range.  Does that make any sense to you?
Once I have my new glasses I'm hoping that I will finally have comfort.
I'm not very good with 'tech speak' either....but certainly do enjoy reading postings of those that do.
I am so thankful for this forum and the Medhelp doctors .... and all the people posting...I'm 56 years old and don't know of anyone within my peer group that has even had cataracts....with Medhelp I'm not alone and neither are you.  Hope to hear from you.

[JodieJ]

I'm sorry that your edge glare problems haven't improved.  I did a little more reading, and it seems that such problems do improve over several months in some cases.  In other cases, replacing the "problem" lens with a silicone lens from a different manufacturer does eliminate the problem.  (But per light show's post, this doesn't always work perfectly, either.)  In your place, I'd probably want to explant the lens, especially if the explant surgery could be done by a very experienced surgeon.  Please keep us posted about your progress.  

[lorac0813]

Hi indi, thanks for your post and your encouraging words! I have never heard of photochronic lenses but I am due to see my opthamologist in June and will discuss with him at that time. Will they help with night driving?

I am very glad for you, that you have no glare problems. I would be curious to know how your night driving goes once you get your multifocal glasses. Truth be told, I'm afraid to even try night driving because even just walking outside at night is uncomfortable for me because of the glare from the headlights, street lamps etc.  

I hope you're right, that given time things will get better. I would really just like to feel normal again! Thanks again for your post.

[lorac0813]

Hi light show, thanks for your post. I see that you are having some of the same problems that I am having.....trouble with light sensitivity, glare at night, headaches, etc. Can you describe to me more about the "burning" in your left eye? I have had that sensation as well, not exactly burning, but it's like my eye feels "hot" all the time. Is that the sensation you are getting in yours as well?

Where night driving is concerned - as I said in my recent post to indi - I'm afraid to even try it because of the glare problems. Do you think your new glasses might help with that or have you resigned yourself to simply not driving at night anymore?

I agree with you, I too don't blame anyone for the outcome of my surgery but still - they should at least acknowledge that we are having problems. It's like they want nothing to do with you once the surgery is over. I really wish someone had told me of the possible outcomes and undesirable side effects.

Do you think your lens explantation was worth it? Would you do it again if you knew what you know now? I wonder why it resolved the edge glare but not the light sensitivity?

Like you, I am grateful for the advice and the encouragement that I have received from others on this forum as well as from the doctors. I am just a few years younger than you and also like you, don't know of anyone my age who even HAS cataracts, never mind had them removed!  I try to be positive but there are still many days when I am very depressed. Ever since my surgeries, I have felt much older than I actually am. It's very discouraging.

Thanks for sharing your problems - it helps so much to know that I am not alone.

[lorac0813]

Hi Jodie, thanks so much for your post. It's good to know that my problems may resolve with time, but still, I worry continuously that I may have this for the rest of my life. As I said in my post to light show, it's very discouraging although some days are better than others.

I am considering the lens explantation option, although I am moving to a different (and much smaller) city in a couple of months and so will have to find a new surgeon, which could be very time consuming. Do you know if there is an "optimum" time frame for lens explantation, i.e. is it better to get it done sooner rather than later? Any advice, as always, is appreciated. Thanks!

[JodieJ]

I think your current doctor is waiting to see whether your symptoms will resolve on their own.  But as far as I know, sooner is better than later for a lens exchange.  You could try asking about it on the"expert" forum.

[indi1664]

Hi,
      photochromic lenses are basically like polaroid sunglassses ...they darken depending on the light sensitivity and also will include your corrected prescription....I have not tried them myself as I am not that light sensitive.In reality these actally help more in day time....I am sorry but i dont know what to suggest for night time.
As for your current symptoms ..try and monitor day by day ..and if things are improving ..even marginally than ...you are heading in right direction...I would strongly suggest a good optical eye test with somebody who is patient, caring and thorough... before moving further and i see you are having one in June ...why not now? also Jodie j suggestion of posting on expert forum.
Take care

[light show]

The burning in both eyes feels like I've been out in the sun and wind far too long. They feel inflamed though don't appear that way...sometimes just puffy looking. I often wish I could just pop my eyes out into a bowl of ice water for some relief.  Does this sound soothing to you?  Perhaps an eye dropper with a chilled saline solution would help for a short time.  Closing my eyes to rest them for 20-30 minutes is best.

I'm not at all confident with night driving. I would like to think my new glasses will help me with night driving ... but, to be honest, I'm not very optimistic.  Headlights (especially halogen), street lights, flourescent lighting....any bright or glowing type light affects my vision....'glowing' light seems to pierce it's way even through my sunglasses. I'm trying a dark brown tint on my new sunglasses...the blue/gray isn't working ...the brown seems to tone things down somewhat. Gray skies, snow, reflected light...well, I could just go on and on.  I have resigned myself to not driving at night .... unless I'm a passenger, of course.  I'm loving our longer days right now but pending shorter days and winter can put me into an emotional slump.

When one has had a very independent life, relying on others isn't always easy to accept.

I cannot figure out our doctors/surgeons and their vague responses.  If we know there can be visual differences and handicaps then I can't believe they don't. They can still retain their reputations as successful surgeons.  No one can predict how an individual responds to an artificial implant.

Have you read any publications by Randall J. Olson from the University of Utah?  Apparently he is the guru of dysphotopsia and associated lighting problems in patients.
Try Googling his name.

The iol replacement surgery did correct the 'blur blob' in the left eye...which was causing the high aberrations.  The aberrations were reduced by half according to the corneal topography.  I now have thin glowing rings when night lighting reflects off the new lens.
The surgeon  said he should be able to provide some measure of comfort and that is what I have and I'm happy to be rid of the 'blur blob'.  Would I do it again ... hmmm, hard to answer that question. It's personal choice ultimately ... I tried this option and did receive 'some measure of comfort'. I know I will not risk any further surgeries(unless an emergency) on my eyes.  

I waited a long time to get to a highly specialized surgeon and have tried to remain proactive in my pursuit of answers to what I was suffering for the past two years..  I endeavored to maintain a calm but persistent quest.  After my last check-up with the surgeon, I cried for the first time but not for long.  I was hoping for some relief from this problem.  However, I am very, very, very thankful for vision I have ... it was pretty scary and frustrating losing it to cataracts. And seeing a number of pretty awful circumstances in waiting rooms you just remember to count your blessings.

I have not been able to return to the job I had for the past 15+ years due to the nature of my work.  I'm hoping to find something eventually that will not require much computer work and avoid certain lighting conditions.  As things stand right now, I would not be a very reliable employee....sunglasses, headaches, eye rests...I wouldn't expect an employer hire me on with these conditions...hahaha

Leaving my job due to advanced cataracts was one of the hardest times...still is.  We often don't realize how much our careers mean to us until they are taken away.  I really enjoyed my job (most of the time) .

We are young to have this affliction.  The average age for cataracts is 76 years.  I met a women, a school teacher, 36 years of age that had bilateral cataract surgery....apparently cataract numbers a climbing in the young to mid age groups.

OUr older friends are less likely to complain about lighting issues because they are not living our lives.  I have spoken to some srs. in waiting rooms and hear their stories.

Yes, this life adventure has taken a toll on us.  I've squinted so much I've increased my 'character folds and creases' tenfold.  I just try to keep in mind the old adage ' life is a state of mind'.

Please keep in touch.  Diamond Eyes was the first to contact me in response to my desperate posting....she has been and still is a wonderful source of support.  
JodiJ has been a constant and informative source of support to many, many members.

I'm going to add you as a 'friend' .  Click on people and add yourself if you wish to send messages directly to a particular contact. Sometimes searching through the general forum in daunting.

Hope to hear from you soon.

[EllenLee]

I can certainly relate to LigthSnow also.  Having a doctor acknowledge a problem?

I just learned that I was black balled from ever returning to the group that did left eye cataract surgery, when I tried contacting them again.  No one would listen to my on going complaints. I feel your pain and frustration.  I am seventy and my life has taken quite a jolt. Can you believe I was fired!  I had no intentions of returning to those Lasix doctors but I did have questions that needed and should of been addressed yet they have not replied to me.  

Wishing everyone better seeing days.

[lorac0813]

Hi EllenLee, I am very sorry to hear that you are having such problems! Yes, it is very frustrating but I am SO thankful to have found this forum, it's been very enlightening. Have the doctors on this forum been able to help you? They are a godsend.

Hopefully you can find another surgeon who will be willing to help you. Until then, I guess we just have to live with it...but that being said, we shouldn't HAVE to just "live with it", should we! I will consider some surgical options down the road if my problems persist, but I am going to give it some time first. Better seeing days indeed! Good luck!

[light show]

Hi Ellen
We merely wish an educated answer from the highly skilled medical professionals we rely on for help.  Just some acknowledgement that, yes, outcomes can present visual obstacles.  
I tred very cautiously but persistently to achieve my diagnosis...and it wasn't easy. I didn't want to be 'fired'.  I can't believe you were.  And in NO WAY was I out to find fault with the surgeons skills.  I believe my surgeries went well. I felt that my post surgical care/counsel was poor.  The surgeons job is done ... I realize this.  But the very evident 'push' to get you off their docket and out the door is terrible.  I know our health system is under a tremendous strain....the doctors are in huge demand and stressed and we the patients are taking the hit.  
One simple acknowledgement of our conditions would have us set to adapt to  our new visual lives.  
Stay in touch with the forum and thank you for contacting me/us.

[light show]

How are you doing?  I'm anxious to hear if you have achieved any relief.

Hooray, I now have my new glasses (all 4 pairs) and my vision sharpness hasn't been as good as this since '05.  However, I still am and likely will continue to struggle with lighting conditions and resulting headaches.  At this writing I my left eye is pulsating/contracting even with sunglasses.
I wanted to let you know that I opted for the brown/amber tint in my polarized sunglass lenses.  2 yrs. ago I was encouraged to select the grey/blue tint but now realize in hindsight it was the wrong tint for me.  The brown/amber tint dulls the brightness somewhat especially at night ... doesn't cure the problem but it helps.
I have found that opticians do come forward with information concerning this condition once I explained my needs to them.  Afterall, they are the ones who deal with the 'end product' meaning us.  Turns out the optician I had this time had contact lenses implanted in her eyes.  She cannot deal with night lighting and will not drive.  However, she has been able to cope with the lighting at work but could never work at a computer in a brightly, flourescent environment.  She gets migraines too.
I often wonder if my eyes have been contributing to the cause of my migraine history although barometric pressure is the main cause ... also seems allergies contribute as well.
I look forward to hearing from you lorac0813.

[lorac0813]

Hi light show, it's SO good to hear that your vision sharpness is somewhat improved. I had to laugh when you commented on your new glasses, "all 4 pairs"!! I may end up with the same, who knows! It's kind of ironic, before I had cataract surgery I was sick and tired of dealing with all my different pairs of glasses and now here I am stuck with 3 - 4 pairs of reading glasses in different strengths, all of which I need depending on what I'm doing - as well as sunglasses strewn about everywhere. Life is cruel, isn't it?

Thanks for the tip about the brown/amber tint sunglasses. Right now I'm using the grey/blue tint which seems to work well for me although if it's overcast outside it makes it hard to see things. Unfortunately my light sensitivity and edge glare remains. I was at a wedding on the weekend and the flashing disco lights at the dance afterwards caused a MAJOR migraine headache for me. I see my surgeon this Thursday and am anxious to hear what he has to say in regards to my continuing light sensitivity. Although I am not expecting any miraculous "cure", that's for sure.

The optician you mentioned who had contact lenses implanted in her eyes - can't she get the lenses explanted, much like you had done? I don't know much about that type of procedure. However, speaking about contact lenses, I had a thought on the weekend, maybe it's a crazy one, but I was thinking, if I got a pair of prescription TINTED contact lenses, would that not stop the reflection / shimmers off of my implanted lens, because the contact lens would be covering it??? I'm probably grasping at straws but....?

Another thing - when I was talking to my brother-in-law about the "starburst" effect of lights at night, he said that an optician should be able to fix me up with a pair of special glasses that would enable me to drive at night. I'm kind of doubtful about that after reading the many posts on this forum from people who can no longer drive at night after cataract surgery. I'm pretty sure that must have been an avenue that you explored??

WHY WHY WHY is the lens in my right eye fine, and the lens in my left eye driving me crazy? It makes no sense to me! It's the same lens, the same surgery, so I wonder why the difference? Oh, I would surely like an answer to that question. I would especially like to know why my left eye feels "hot" all the time. It's a horrible, awful sensation and I hate it. Please excuse my whining!! It's just that I had a tough time over the weekend with all the different lighting conditions I had to deal with.

Thank you for your continuing support - means a lot to me to be able to share my experiences with someone who's been through some of the same things that I'm dealing with right now. I know that my family, friends and co-workers are sympathetic but I think they get tired of my complaints, so I just try to NOT talk about it...and save my whining for this forum! Thanks for listening and hope to hear from you soon!

[lizzie570]

My husband had cataract surgery on his right eye, and now he cannot open his right eye until being up and out of bed for almost two hours.  His eye is very light sensitive and the doc told him to get used to it. The doc also was placing drops in his eye the day after surgvery and tyoldmy husband that if he were being water boarded for secrets, he would be an easy mark for telling secrets.  This doctor is the most incompetent and ill mannered doctor.  He had surgery 6/6 and had to see the doc 6/7 and 6/8 again onb 6/11 and 6/12. His eyes ar constantly tearing, burning and scratchy. The doctor told him that there is nothing he can do and does not know what is wrong and has told him there is no further follow up and that he should see a retina specialist.  Nice way to get rid of a patient.  Maybe someone canshedsome light on this issue   MRSS