Aa
Post Cataract Surgery Vertically Stacked Ghost Images?
I am one month, and 6 weeks post op for cataracts on both eyes. (Right eye was done first)
I am a retired airline pilot so have always been very (extremely?) critical and observant regarding my eye sight. My pre-surgery eyes were almost identical, with 20/30 both eyes distant and required +3 diopter reading glasses for perfect near vision (when young I was 20/15 both eyes, but deteriorated with age). Almost non-existent astigmatism. I had outstanding night-vision despite the cataracts and had no halo or flare from bright lights.
Following surgery with single vision replacement lenses intended to allow far-vision, my main observations (other than specifics below) were that I had a color shift in viewed colors as one would have after removing Brown3 sunglasses, and colors shifted to the "cool" from the "warm" hues previously with cataracts, and lights now seem brighter in good light, though my night-vision ability with regard to light sensitivity in very poor light seems about the same. This reduced daylight visual contrast somewhat, so I now wear Brown3 sun glasses outside.
My 1st (right) eye lens replacement went well but I still have some diagonally streaking (mild) with a bright point light source such as an oncoming headlight or halogen/LED ceiling light). It is in the 9-4 "o'clock position and is tolerable. No real complaints.
The 2ns (Left) eye is the problem I am asking about. One month post op I have a diagonal light streak (8-2 o'clock- Minor) and a VERY troubling vertical stacking of ghost images.
If I am looking at a bright horizontal subject (say the roof of a white oncoming car in daylight) he images are comprised of the prominent primary image, then a strong ghost image (maybe 50% as bright as the primary) very slightly above ( the ghost image is barely above the primary image), and 2 minor (more transparent) images immediately below the primary image (these are maybe 15% as bright as the primary image).
I can make these disappear by looking through a horizontal slit (or squinting) so as to block off light entering except through a narrow horizontal opening. Whether this is because I am blocking off-axis light, or simulating a smaller pupil by increasing the f-stop number and increasing my depth of focus I cannot say.
The visual acuity of the Left eye (one with ghosts) is less than that of the right eye independent of the loss of acuity due to ghosting. My right eye is now 20/20 far, and requires +1 diopter lens for reading. The left eye is about 20/60 due partly from the ghost images, and maybe 20/40 if I squint, or otherwise look through a horizontal slit to block the ghost images. The left eye is OK with +1.25 for reading, but does not achieve the sharpness of the right eye even then.
My doctor has said that it can take up to a year for vision to return to normal following this lens replacement, though before surgery no such time-line was mentioned (more like 1 day to a week). The 1st eye settled down beautifully (except for the minor light streaking) after 2 weeks, so my expectations were that the second eye would as well (plus the first eye experienced no such ghost images). But no such luck.
I might add that on my morning-after-surgery follow-up on my second (left) eye, I was in tremendous pain (as soon as the anesthetic completely wore off) and I was told I had a badly scratched cornea (horizontal scratch across in the pupil vision field of view from "unknown cause" though I'd worn an eye shield). I was given a large contact "bandage" to wear for 5 days, during which I didn't notice the vertical stacked ghosts and my vision was 20/100 w/ the contact inserted. When the contact was removed, my vision deteriorated to 20/200 or worse instantly and I believe the vertical ghosts appeared. My left eye is much inferior to the right even after several weeks (plus I also have the ghosts in the left eye).
Any opinions or recommended procedures? I really am disappointed with the second (left) eye being inferior to pre-cataract surgery, especially with the multiple vertical ghosts which inhibit acuity AND night driving.
Thanks!
I am a retired airline pilot so have always been very (extremely?) critical and observant regarding my eye sight. My pre-surgery eyes were almost identical, with 20/30 both eyes distant and required +3 diopter reading glasses for perfect near vision (when young I was 20/15 both eyes, but deteriorated with age). Almost non-existent astigmatism. I had outstanding night-vision despite the cataracts and had no halo or flare from bright lights.
Following surgery with single vision replacement lenses intended to allow far-vision, my main observations (other than specifics below) were that I had a color shift in viewed colors as one would have after removing Brown3 sunglasses, and colors shifted to the "cool" from the "warm" hues previously with cataracts, and lights now seem brighter in good light, though my night-vision ability with regard to light sensitivity in very poor light seems about the same. This reduced daylight visual contrast somewhat, so I now wear Brown3 sun glasses outside.
My 1st (right) eye lens replacement went well but I still have some diagonally streaking (mild) with a bright point light source such as an oncoming headlight or halogen/LED ceiling light). It is in the 9-4 "o'clock position and is tolerable. No real complaints.
The 2ns (Left) eye is the problem I am asking about. One month post op I have a diagonal light streak (8-2 o'clock- Minor) and a VERY troubling vertical stacking of ghost images.
If I am looking at a bright horizontal subject (say the roof of a white oncoming car in daylight) he images are comprised of the prominent primary image, then a strong ghost image (maybe 50% as bright as the primary) very slightly above ( the ghost image is barely above the primary image), and 2 minor (more transparent) images immediately below the primary image (these are maybe 15% as bright as the primary image).
I can make these disappear by looking through a horizontal slit (or squinting) so as to block off light entering except through a narrow horizontal opening. Whether this is because I am blocking off-axis light, or simulating a smaller pupil by increasing the f-stop number and increasing my depth of focus I cannot say.
The visual acuity of the Left eye (one with ghosts) is less than that of the right eye independent of the loss of acuity due to ghosting. My right eye is now 20/20 far, and requires +1 diopter lens for reading. The left eye is about 20/60 due partly from the ghost images, and maybe 20/40 if I squint, or otherwise look through a horizontal slit to block the ghost images. The left eye is OK with +1.25 for reading, but does not achieve the sharpness of the right eye even then.
My doctor has said that it can take up to a year for vision to return to normal following this lens replacement, though before surgery no such time-line was mentioned (more like 1 day to a week). The 1st eye settled down beautifully (except for the minor light streaking) after 2 weeks, so my expectations were that the second eye would as well (plus the first eye experienced no such ghost images). But no such luck.
I might add that on my morning-after-surgery follow-up on my second (left) eye, I was in tremendous pain (as soon as the anesthetic completely wore off) and I was told I had a badly scratched cornea (horizontal scratch across in the pupil vision field of view from "unknown cause" though I'd worn an eye shield). I was given a large contact "bandage" to wear for 5 days, during which I didn't notice the vertical stacked ghosts and my vision was 20/100 w/ the contact inserted. When the contact was removed, my vision deteriorated to 20/200 or worse instantly and I believe the vertical ghosts appeared. My left eye is much inferior to the right even after several weeks (plus I also have the ghosts in the left eye).
Any opinions or recommended procedures? I really am disappointed with the second (left) eye being inferior to pre-cataract surgery, especially with the multiple vertical ghosts which inhibit acuity AND night driving.
Thanks!
Dr Hagan,
Just an update.
I received my bottle of Muro 128 and began using the drops in my LE (problem eye). I got the 2% as you suggested, and I am glad I did as it stings, so I am sure the 5% would BURN.
I wasn't looking for any immediate, or possibly any improvement, at least quickly, so I have just been using the drops and not paying attention to the multiple vertical image problem, which was really only obtrusive in bright sunlight (reflecting off light colored objects like white car roofs, or off things like bumpers, etc,) or at night with point sources of light (like headlights or bare bulbs).
I drove to the airport today in very bright light and my wife asked me if the images were distracting, and I suddenly realized I wasn't noticing the problem, and waited for a white car (the white horizontal roof was the one that made the multiple images the worst), and they were GONE.
I have not yet had the opportunity to look at a point light source, nor have I driven in the dark to see if the headlight effect has abated, but I wanted to pass along that things had improved. The visual acuity of the LE is still inferior to the RE, but it's probably not worse than pre-surgery (whereas my RE is fantastically better).
Hopefully, if the other effects (near horizontal beam of light emanates from point sources both eyes, though at slightly different orientation) abate, I will be a happy camper.
I did a lot of reading about the cornea, diseases of the cornea, and various conditions thereof (I googled "uses for Muro 128" as well as "Corneal Edema"), and it was fascinating reading. I obviously had taken this body part (and the rest of our magnificent machines we call our body) for granted.
Thank-you again for your contributions to my questions, and perhaps the drops accelerated a change in my cornea that resulted in faster elimination of the vertical images!
I think you asked if my surgeon had recommended Muro 128, and if not, a question would be "Why not?" He had not, and I didn't ask him why not on my most recent follow-up (I didn't want to sound like I was interrogating him, possibly alienating him), but I am very happy you mentioned the drops, though I am not sure how long to continue them. The instructions on the box say "Uses: Temporary relief from corneal edema, so I would imagine that means until ceasing their use does not cause the edema or the effects to return?
Gratefully yours,
Bob.
Just an update.
I received my bottle of Muro 128 and began using the drops in my LE (problem eye). I got the 2% as you suggested, and I am glad I did as it stings, so I am sure the 5% would BURN.
I wasn't looking for any immediate, or possibly any improvement, at least quickly, so I have just been using the drops and not paying attention to the multiple vertical image problem, which was really only obtrusive in bright sunlight (reflecting off light colored objects like white car roofs, or off things like bumpers, etc,) or at night with point sources of light (like headlights or bare bulbs).
I drove to the airport today in very bright light and my wife asked me if the images were distracting, and I suddenly realized I wasn't noticing the problem, and waited for a white car (the white horizontal roof was the one that made the multiple images the worst), and they were GONE.
I have not yet had the opportunity to look at a point light source, nor have I driven in the dark to see if the headlight effect has abated, but I wanted to pass along that things had improved. The visual acuity of the LE is still inferior to the RE, but it's probably not worse than pre-surgery (whereas my RE is fantastically better).
Hopefully, if the other effects (near horizontal beam of light emanates from point sources both eyes, though at slightly different orientation) abate, I will be a happy camper.
I did a lot of reading about the cornea, diseases of the cornea, and various conditions thereof (I googled "uses for Muro 128" as well as "Corneal Edema"), and it was fascinating reading. I obviously had taken this body part (and the rest of our magnificent machines we call our body) for granted.
Thank-you again for your contributions to my questions, and perhaps the drops accelerated a change in my cornea that resulted in faster elimination of the vertical images!
I think you asked if my surgeon had recommended Muro 128, and if not, a question would be "Why not?" He had not, and I didn't ask him why not on my most recent follow-up (I didn't want to sound like I was interrogating him, possibly alienating him), but I am very happy you mentioned the drops, though I am not sure how long to continue them. The instructions on the box say "Uses: Temporary relief from corneal edema, so I would imagine that means until ceasing their use does not cause the edema or the effects to return?
Gratefully yours,
Bob.
1 Comments
Muro 128 is essentially saline and okay for long term use. It is often used in cornea edema associated with Fuch's Dystrophy for years and years. I would use it until your vision is back to normal or your next office visit when you can ask your surgeon. The Muro 128 % ointment is also extremely effective but the ointment is messy and the eye sticks shut in the AM and has to be opened with warm water splashed into it. The Muro helps eliminate the cornea edema and the edema is what blurs the vision and causes the ghost images.
I understand.
Just thinking out loud I guess.
As long as waiting does not compromise my odds of achieving the best results, and I can reasonably function as I am, waiting would give my cornea a chance to stabilize and achieve whatever it is capable of doing on its own, I guess.
I certainly would not want to reduce my chances of a 100% "recovery" by waiting, but no one has suggested that "time is of the essence". At least not that I inferred.
So far I have not experienced any improvement on the effect a bright source of light causes in both eyes (when directly looked at), which is a bright "line" of light across my field of vision emanating outward from the light source on both sides (picture observing a lighthouse beacon shining left and right through thin haze, so the light beam is made visible by the medium through which it is passing). Each eye has one, though the LE forms a line 8am-1pm axis, and the RE is 10am-4pm axis, like spokes of light that are the width of the light source in the center, and maybe twice the thickness of the light source at the ends, with the width of the lines filled with prismatic colors, depending whether the source is a halogen bulb, or an LED, or whatever. I had hoped these would disappear, but so far no luck. They are annoying, but not debilitating. Mt Dr thought those were caused by "folds" in the thin material of the "pouch" the lens is in that would hopefully resolve itself with time, but so far, no luck.
Just thinking out loud I guess.
As long as waiting does not compromise my odds of achieving the best results, and I can reasonably function as I am, waiting would give my cornea a chance to stabilize and achieve whatever it is capable of doing on its own, I guess.
I certainly would not want to reduce my chances of a 100% "recovery" by waiting, but no one has suggested that "time is of the essence". At least not that I inferred.
So far I have not experienced any improvement on the effect a bright source of light causes in both eyes (when directly looked at), which is a bright "line" of light across my field of vision emanating outward from the light source on both sides (picture observing a lighthouse beacon shining left and right through thin haze, so the light beam is made visible by the medium through which it is passing). Each eye has one, though the LE forms a line 8am-1pm axis, and the RE is 10am-4pm axis, like spokes of light that are the width of the light source in the center, and maybe twice the thickness of the light source at the ends, with the width of the lines filled with prismatic colors, depending whether the source is a halogen bulb, or an LED, or whatever. I had hoped these would disappear, but so far no luck. They are annoying, but not debilitating. Mt Dr thought those were caused by "folds" in the thin material of the "pouch" the lens is in that would hopefully resolve itself with time, but so far, no luck.
1 Comments
I've taken this as far as I can. It is your decision to wait or seek 2nd opinion now.
As always, thank-you.
As long as I do not compromise my eventual recovery (whether by time alone or by time and Lasik, when/if time alone doesn't do it) by not taking a different approach, I am OK waiting.
My vision through both eyes is quite acceptable despite night driving being unpleasant, so I can wait if a good outcome can be had eventually in any case. I just don't want to do anything to hurt my long term situation.
As long as I do not compromise my eventual recovery (whether by time alone or by time and Lasik, when/if time alone doesn't do it) by not taking a different approach, I am OK waiting.
My vision through both eyes is quite acceptable despite night driving being unpleasant, so I can wait if a good outcome can be had eventually in any case. I just don't want to do anything to hurt my long term situation.
1 Comments
You have to remember the limitations of this forum. I can't make diagnosis or judgments only generalizations of usual causes.
Dr. Hagan,
I just returned from my 1 mo follow-up on my 2nd (LE) eye that had/has stacked vertical ghost images and poor resolution and asked the questions you kindly provided.
Before seeing the Dr I was given a number of tests starting with acuity (20/20 RE, 20/60 LE). and then a device that had a cone I looked into that had concentric green rings and a red laser in the center (sorry, I didn't get the name), and refractometer (phoropter?). The technician said "Hmmm" after producing a corneal image, and I asked her if that was a good or a bad "Hmmm". She was obviously unaware she had uttered a sound, and said "both," but the Dr should be the one to , though she had 20 years experience.
I then met with the Dr who showed me the image (digital image) of my cornea that he said was very abnormal (now, following cataract surgery), but which had been quite normal before surgery
I didn't know previously that astigmatism is a condition of the cornea (I thought it was an abnormal shape of the back of the eye previously) , but he explained that before surgery I had very mild astigmatism (about 1 diopter) that I never noticed, or needed correct for.
Now, the image of my cornea looked like it had a giant blob above the center, and he said that is likely causing the ghost image and the poor sharpness of images compared to pre-surgery (20/30 uncorrected, but corrected to 20/20 with a plain +1 diopter and not correction for astigmatism-before suregery I was correctable for better than 20/20 if I wanted prescription lenses).
Now my astigmatism is asymmetric and as much as 4 diopters in one plane (vertically above the pupil from what I could see on his monitor). He said that it is BETTER than my last visit and "possibly" due to the corneal damage I likely sustained during the procedure (I awoke the morning after surgery in pretty bad pain after the surgical drops wore off, and the Dr put a large contact lens "bandage" on the eye for 4 days or so.) . The vertical ghosts appeared, or were noticed after the contact was removed.
The Dr adjusted HIS phoropter to what the technician's findings provided, and then tweaked it several times (flipping lenses and rotating the axes of the lenses) with me looking through it and was able to get me 20/20 in the very center (didn't look "crisp," but he said it was 20/20), and said he COULD write me a prescription for my LE alone, but he said he has hopes my cornea will eventually return to normal so as to eliminate the aberration.
He reiterated that it could take up to a year to correct itself, and gave me a 3mo appointment for follow-up to monitor. He said he COULD (likely) eventually use Lasik on my LE after my eye stabilized for a year to correct for the weird astigmatism I developed post surgery, and hopefully get rid of the ghost images. They are bad enough that I have to block my eye for night driving for an oncoming car so would like the ghosting gone.
Indoors with normal lighting levels, the ghosting is fairly benign and just reduces my acuity, but outdoors in bright light, or at night with bright point-source lighting, like headlights, it's really annoying. Thankfully, my dominant RE allows plenty good vision for everyday use, except for the bright-light problems I mention.
You asked for my refraction, and he said that since Medicare insurance does not provide for a prescription, it would be $65 additional if I wanted it, but he handed me a "check-out form" for the front desk (which I used my phone to photograph before turning it in) and written on it was:
"Tracey Refraction":
-1.00 + 1.02 20/20,
-1.62 +2.37 X 097 20/30
He said he noted no Macular OCT or any other abnormality, and commented that I have very "young" eyes in perfect condition internally.
I asked about the MURO 128 (2 or 5%) and he said I could certainly try it, as it's available w/o prescription. I would ask you which would be a logical pick on the 2% vs 5% strength, if I could. I notice on Amazon they list both for sale in drops and ointment. Since the Dr recommended artificial tears to moisturize the cornea, I assume the drops would be the way to go?
Thanks again,
Bob
.
I just returned from my 1 mo follow-up on my 2nd (LE) eye that had/has stacked vertical ghost images and poor resolution and asked the questions you kindly provided.
Before seeing the Dr I was given a number of tests starting with acuity (20/20 RE, 20/60 LE). and then a device that had a cone I looked into that had concentric green rings and a red laser in the center (sorry, I didn't get the name), and refractometer (phoropter?). The technician said "Hmmm" after producing a corneal image, and I asked her if that was a good or a bad "Hmmm". She was obviously unaware she had uttered a sound, and said "both," but the Dr should be the one to , though she had 20 years experience.
I then met with the Dr who showed me the image (digital image) of my cornea that he said was very abnormal (now, following cataract surgery), but which had been quite normal before surgery
I didn't know previously that astigmatism is a condition of the cornea (I thought it was an abnormal shape of the back of the eye previously) , but he explained that before surgery I had very mild astigmatism (about 1 diopter) that I never noticed, or needed correct for.
Now, the image of my cornea looked like it had a giant blob above the center, and he said that is likely causing the ghost image and the poor sharpness of images compared to pre-surgery (20/30 uncorrected, but corrected to 20/20 with a plain +1 diopter and not correction for astigmatism-before suregery I was correctable for better than 20/20 if I wanted prescription lenses).
Now my astigmatism is asymmetric and as much as 4 diopters in one plane (vertically above the pupil from what I could see on his monitor). He said that it is BETTER than my last visit and "possibly" due to the corneal damage I likely sustained during the procedure (I awoke the morning after surgery in pretty bad pain after the surgical drops wore off, and the Dr put a large contact lens "bandage" on the eye for 4 days or so.) . The vertical ghosts appeared, or were noticed after the contact was removed.
The Dr adjusted HIS phoropter to what the technician's findings provided, and then tweaked it several times (flipping lenses and rotating the axes of the lenses) with me looking through it and was able to get me 20/20 in the very center (didn't look "crisp," but he said it was 20/20), and said he COULD write me a prescription for my LE alone, but he said he has hopes my cornea will eventually return to normal so as to eliminate the aberration.
He reiterated that it could take up to a year to correct itself, and gave me a 3mo appointment for follow-up to monitor. He said he COULD (likely) eventually use Lasik on my LE after my eye stabilized for a year to correct for the weird astigmatism I developed post surgery, and hopefully get rid of the ghost images. They are bad enough that I have to block my eye for night driving for an oncoming car so would like the ghosting gone.
Indoors with normal lighting levels, the ghosting is fairly benign and just reduces my acuity, but outdoors in bright light, or at night with bright point-source lighting, like headlights, it's really annoying. Thankfully, my dominant RE allows plenty good vision for everyday use, except for the bright-light problems I mention.
You asked for my refraction, and he said that since Medicare insurance does not provide for a prescription, it would be $65 additional if I wanted it, but he handed me a "check-out form" for the front desk (which I used my phone to photograph before turning it in) and written on it was:
"Tracey Refraction":
-1.00 + 1.02 20/20,
-1.62 +2.37 X 097 20/30
He said he noted no Macular OCT or any other abnormality, and commented that I have very "young" eyes in perfect condition internally.
I asked about the MURO 128 (2 or 5%) and he said I could certainly try it, as it's available w/o prescription. I would ask you which would be a logical pick on the 2% vs 5% strength, if I could. I notice on Amazon they list both for sale in drops and ointment. Since the Dr recommended artificial tears to moisturize the cornea, I assume the drops would be the way to go?
Thanks again,
Bob
.
3 Comments
The instrument you describe is likely a cornea topography instrument. And the surgeon is ascribing your reduced vision (20/30 instead of 20/20) to irregular cornea astigmatism. You have a couple of options. You can wait, stick with your surgeon and try hypertonic drops. I generally have patients use 2% muro 128 first as the 5% while stronger often stings. Many people do not like the 5% ointment because it blurs the vision and makes the eye stick shut in AM. the other thing you can do is get a second opinion from a different corneal surgeon. It make take 3-6 months for the cornea to heal and hopefully flatten to less astigmatism.
Thank-you.
Yes, that name makes sense given it seemed to "map" my cornea.
I would love to know WHY my cornea, which was very "normal" prior to surgery and was not irregular, is suddenly so different that the technician was surprised when she compared it to the pre-surgery condition, as did the surgeon. Perhaps the cut/abrasion to the cornea caused it, and maybe the surgeon's explanation that corneas "react" to the insult of surgery, by scrunching up, folding, or otherwise altering their shape or thickness.
I have no idea if I should be suspicious, trusting, or seek another opinion if it may be likely something is wrong that will not correct itself. I am not trying to put you in the position of judging that, either, of course.
I guess I would wonder what a "reasonable" person would do regarding seeking another opinion, or just using the 2% drops (which I will order tonight and start using) and wait the 3 months to see what happens.
I do not know what can be done at THIS point in any case (Is there something that can be done now?) , but do understand that one would have to wait for the cornea to stabilize before reshaping the cornea by Lasik as was mentioned today in the case the cornea did not return to its pre-operative topography.
I like my surgeon personally, but I doubt we will become close personal friends, so obviously my first priority is getting my excellent pre-surgery vision (zero effects from astigmatism, great night vision for driving, and at least 20/30 acuity) back.
The ONLY thing I expected from cataract surgery was preventing degradation as the cataracts got worse with age. The right eye is fine, but obviously I am disappointed greatly with the left eye and hope to at least regain my pre-surgery vision.
I just need the best advice way to get from here to there I guess. I don;t want to particularly hurt my surgeon's feelings (by going elsewhere), but frankly my first priority is my vision.
Thanks again,
Bob
Yes, that name makes sense given it seemed to "map" my cornea.
I would love to know WHY my cornea, which was very "normal" prior to surgery and was not irregular, is suddenly so different that the technician was surprised when she compared it to the pre-surgery condition, as did the surgeon. Perhaps the cut/abrasion to the cornea caused it, and maybe the surgeon's explanation that corneas "react" to the insult of surgery, by scrunching up, folding, or otherwise altering their shape or thickness.
I have no idea if I should be suspicious, trusting, or seek another opinion if it may be likely something is wrong that will not correct itself. I am not trying to put you in the position of judging that, either, of course.
I guess I would wonder what a "reasonable" person would do regarding seeking another opinion, or just using the 2% drops (which I will order tonight and start using) and wait the 3 months to see what happens.
I do not know what can be done at THIS point in any case (Is there something that can be done now?) , but do understand that one would have to wait for the cornea to stabilize before reshaping the cornea by Lasik as was mentioned today in the case the cornea did not return to its pre-operative topography.
I like my surgeon personally, but I doubt we will become close personal friends, so obviously my first priority is getting my excellent pre-surgery vision (zero effects from astigmatism, great night vision for driving, and at least 20/30 acuity) back.
The ONLY thing I expected from cataract surgery was preventing degradation as the cataracts got worse with age. The right eye is fine, but obviously I am disappointed greatly with the left eye and hope to at least regain my pre-surgery vision.
I just need the best advice way to get from here to there I guess. I don;t want to particularly hurt my surgeon's feelings (by going elsewhere), but frankly my first priority is my vision.
Thanks again,
Bob
I think you understand the options and the choices are yours to make. A reasonable option would be to try conservative treatment Muro drops, tears and TIME and see if you have improved next time in. If you improvement you might consider 2nd opinion at that time. Most of these usually end up having a happy result 3-6 months out if its just the cornea.
Thank-you!
I copied and pasted your list and will take it w/ me on my next follow-up on the 7th.
The image I look at during testing is a chart projected on a back wall of the exam room, and I look through the refractor at a mirror that reflects to the projected image. I imagine that the total distance is indeed 6 meters or 20ft.
I copied and pasted your list and will take it w/ me on my next follow-up on the 7th.
The image I look at during testing is a chart projected on a back wall of the exam room, and I look through the refractor at a mirror that reflects to the projected image. I imagine that the total distance is indeed 6 meters or 20ft.
1 Comments
Good luck
You ask " If your LE is 20/60 UNCORRECTED at distance what is 1. the over refraction for that eye? 2. The visual acuity with that lens. "
1) "At what distance is the over refraction for that eye."
I must plead ignorance. I would imagine that "prefect refraction" would mean my LE would focus at infinity with the implanted lens? Over refraction would mean that the prescription implant lens inserted would be focused "beyond infinity?" I have no way of determining that short of asking during my next 'follow-up" in a week?
I CAN say that both eyes were very similar before surgery, and could be brought to ultra sharp focus with an external lens (glasses). Now with new implant lenses, I can read as close as about 2ft, with reading glasses required inside that distance, though the LE image is not sharp.
The difference is that at ALL distances the image from my left eye is just never "sharp," and slightly fuzzy around the edges of any image. This was never true before lens replacement.
2) "The visual acuity with that lens."
Hmmm.
The 20/60 was the best I could read the eye chart w/o squinting, but I suspect that's not what you're asking. I know the multiple images are complicating that.
During the exam, the doctor tried improving my vision by rotating/flipping lenses in the manual refractor (I think that's what the device is called) I looked through, to see if any additional refractive correction would improve my vision, but my vision could not be made sharp with any of the settings.
As an aside, my LE lens implant is a +22.0D and the RE is a +21.0D and otherwise the same.
My doctor tells me both my eyes are outstanding (behind the lenses) and when he does the exams he says everything is "perfect" so expects the problems to resolve themselves. Reading his body English and demeanor I think he is being sincere and not trying to "mislead."
I do not how bad the abrasion on the LE was, but I can tell you it was extremely painful and I have no idea how it occurred during or shortly after surgery. After the doctor removed the contact "bandage" my vision became considerably worse, which he explained saying my cornea had gotten very "wrinkled" while the contact was in place (ruining my vision upon its removal), but it would eventually flatten out and become smooth again. It HAS improved, but it's FAR from 20/20. Having enjoyed good vision my whole life (except for reading glasses with age), it is disturbing to experience this degradation, though thankfully my RE is dominant and kind of makes up for the LE when both are open.
I will ask specific questions on my next follow-up in a week to see if he thinks the corneal abrasion is still causing problems, or if he suspects something else. Each time the staff does several tests (I wish I knew the names) to examine the back of the eye before I am examined by the doctor, and so far each technician and the surgeon have said my eyes internals show no abnormalities and remark that they are "perfect." (I now realize how truly fortunate I have been.) No one has mentioned macular edema at all, BTW.
Thank-you very much for responding to my questions!
1) "At what distance is the over refraction for that eye."
I must plead ignorance. I would imagine that "prefect refraction" would mean my LE would focus at infinity with the implanted lens? Over refraction would mean that the prescription implant lens inserted would be focused "beyond infinity?" I have no way of determining that short of asking during my next 'follow-up" in a week?
I CAN say that both eyes were very similar before surgery, and could be brought to ultra sharp focus with an external lens (glasses). Now with new implant lenses, I can read as close as about 2ft, with reading glasses required inside that distance, though the LE image is not sharp.
The difference is that at ALL distances the image from my left eye is just never "sharp," and slightly fuzzy around the edges of any image. This was never true before lens replacement.
2) "The visual acuity with that lens."
Hmmm.
The 20/60 was the best I could read the eye chart w/o squinting, but I suspect that's not what you're asking. I know the multiple images are complicating that.
During the exam, the doctor tried improving my vision by rotating/flipping lenses in the manual refractor (I think that's what the device is called) I looked through, to see if any additional refractive correction would improve my vision, but my vision could not be made sharp with any of the settings.
As an aside, my LE lens implant is a +22.0D and the RE is a +21.0D and otherwise the same.
My doctor tells me both my eyes are outstanding (behind the lenses) and when he does the exams he says everything is "perfect" so expects the problems to resolve themselves. Reading his body English and demeanor I think he is being sincere and not trying to "mislead."
I do not how bad the abrasion on the LE was, but I can tell you it was extremely painful and I have no idea how it occurred during or shortly after surgery. After the doctor removed the contact "bandage" my vision became considerably worse, which he explained saying my cornea had gotten very "wrinkled" while the contact was in place (ruining my vision upon its removal), but it would eventually flatten out and become smooth again. It HAS improved, but it's FAR from 20/20. Having enjoyed good vision my whole life (except for reading glasses with age), it is disturbing to experience this degradation, though thankfully my RE is dominant and kind of makes up for the LE when both are open.
I will ask specific questions on my next follow-up in a week to see if he thinks the corneal abrasion is still causing problems, or if he suspects something else. Each time the staff does several tests (I wish I knew the names) to examine the back of the eye before I am examined by the doctor, and so far each technician and the surgeon have said my eyes internals show no abnormalities and remark that they are "perfect." (I now realize how truly fortunate I have been.) No one has mentioned macular edema at all, BTW.
Thank-you very much for responding to my questions!
2 Comments
Distance vision testing is 6 meters or 6 feet. The test the doctor or tech does looking through the machine (phopter) is called a refraction. If this is a simple problem your vision should be 20/20 without streaks when you have the test done. If you vision does not come clear (as you say it did not clear) that is a problem and indicates a physical problem with the eye (probably the cornea).
You can do several things. You can see how the next visit goes if it doesn't go well you can get an independent second opinion.
You can print this discussion out and take it to your surgeon for discussion.
You can ask these questions:
1. What is my uncorrected visual acuity (VA) at distance in my left eye LE
2. What is my refraction (glasses test numbers) for the LE
3. What is my vision corrected with the refraction in the LE
4. If it is not 20/20 CORRECTED why is it not 20/20?
5. Is the problem my cornea has not healed? If my cornea is the problem why am I not on a hypertonic saline drop like MURO 128 2 or 5% eye drops?
6. Have you done a macular OCT to be sure I do not have macular edema? If not why not and will you do that now?
7. If your explanations are not satisfactory I want an independent second opinion. I'm not happy with your explanation or my vision.
You deserve some answers.
You can do several things. You can see how the next visit goes if it doesn't go well you can get an independent second opinion.
You can print this discussion out and take it to your surgeon for discussion.
You can ask these questions:
1. What is my uncorrected visual acuity (VA) at distance in my left eye LE
2. What is my refraction (glasses test numbers) for the LE
3. What is my vision corrected with the refraction in the LE
4. If it is not 20/20 CORRECTED why is it not 20/20?
5. Is the problem my cornea has not healed? If my cornea is the problem why am I not on a hypertonic saline drop like MURO 128 2 or 5% eye drops?
6. Have you done a macular OCT to be sure I do not have macular edema? If not why not and will you do that now?
7. If your explanations are not satisfactory I want an independent second opinion. I'm not happy with your explanation or my vision.
You deserve some answers.
ERROR 20 feet or 6 meters
I come from a family of pilots and was in the USAF during Viet Nam so I understand pilots. Critical information is missing. If your LE is 20/60 UNCORRECTED at distance what is 1. the over refraction for that eye? 2. The visual acuity with that lens. It is NOT true that an uncomplicated cataract may take a year for the results to be know. If the eye does not see 20/20 WITH CORRECTION 4-6 weeks out then a reason needs to be determined. NOTE: you had a complicated cataract surgery, the complication was a cornea abrasion and that is the most likely cause of your problem. Please furnish the 2 items I requested. If your LE cannot be refracted to 20/20 you need to determine a cause with the two most likely 1. residual cornea irregular astigmatism from the abrasion or 2 macular edema (determined by an macular OCT). If your surgeon cannot give you an answer you may want to get an independent 2nd opinion from another surgeon.
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