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Reflection in eye of friend who had cataract surgery
A friend recently had cataract surgery. I notice a different reflection in her eye than before. She had boht eyes done weeks apart. Now that the second eye has been done I see this different reflection in the second eye also. What is it? Thanks
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233488 tn?1310696703
Reflections from the intra-ocular lens.

JCH MD
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19834727 tn?1485172538
My vision in the operated eye is great and I am really happy with it. Day six and three people have commented on the evil look as my eye flashes at them. So yes, it does affect ones sense of self. One friend said, Oh my god I can't look at you it's spooky, so I understand why people are upset. I hate to think what I will look like when I have both eyes flashing at people. My eyes have always been my only redeeming feature in a somewhat plain face, and have been used to people complimenting them. Now I guess I'm just plain.  
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177275 tn?1438375244
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Sounds interesting. Rather than red-eye in photos I used to have white-eye (bits missing in the back of my eye). Now I've had one eye done, I get halos in that eye which apparently is reflections off the edge of the new lens. Could you expand on what type of relfection you see? Sounds like a good party trick! (Hey, you have to look on the bright side!).
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My acrylic AcrySof IQs do have a noticeable reflection (youthful glow?) in certain lighting conditions.  If this is something that you want to avoid, I've read that the new acrylic one-piece Tecnis monofocal does not have this type of reflection.  Neither do silicone IOLs.
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233488 tn?1310696703
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I've had the same problem, and I've noticed that almost every doctor says "it's no big deal," "you're being too sensitive," or some other patronizing remark like "now you have a twinkle in your eye." When you look in the mirror and see what appear to be white holes in your eye, you do feel self-conscious, and even worse when people make comments like, "ooh evil eye." I completely understand why Gail says she avoids looking people in the eye. One doctor gave me pilocarpine drops to make my pupil contract. DO NOT TRY THIS! I ended up with a retinal detachment in that eye and more problems! Gail doesn't need counseling. She and I, and others who are disturbed by this kind of surprise after- surgery result, need a practical solution and honest responses from health care providers, not judgmental, self-protecting remarks. Does anyone make a tinted contact lens that cuts this unnatural looking reflection without compromising vision? I've tried various colored contacts and they were no help at all.
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Have you found a solution to the shine, I am truley bothter by having to address it eveyday.
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https://www.dropbox.com/s/nevk2mdkl21e3nz/catarcts.jpg

My right eye (your left) has a synthetic lens due to cataracts surgery; my left does not.  Notice the reflection difference.
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1878304 tn?1320552384
I am intensely upset that my doctor did not reveal that there would be a reflection and offer me an option to get the lenses you mentioned that DO NOT HAVE THAT BIG PROBLEM.  Yes, to me it is a BIG deal and I HATE that about my eyes now and am EXTREMELY self conscious about it!  I think it is unforgivable that I was not alerted to the fact that I would have Dog Eyes that glow in the dark and that people would think I have might shiny glass in my eyes!  I am truly angry about it.
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1878304 tn?1320552384
You said it sister!  SO AM I.  It is a doggone disgrace that the doctor didn't tell us we would have this issue and give us optional lenses (without that reflection problem) from which to choose.  
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1878304 tn?1320552384
Yes I do am VERY VERY MUCH disturbed by this reflection in my eyes (so much so that I would NEVER have had the surgery done with those lenses since there are others that do not have that "twinkle") -- and especially since MY DOCTOR NEVER INFORMED ME that it would happen.  There oughta be a law!  
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1878304 tn?1320552384
What happened to the link?  Mine would not show.  I really want to see it and show to my eye doctors who CLAIM they don't know why it's a big deal to me and they say they never notice it when they are looking at me, almost indicating that it's all in my head.  Hah!  This glare is UGLY and ABNORMAL looking and I believe it was an AWFUL side effect and I am APPALLED I was never informed that they have OPTIONAL lenses I could have gotten that had no glare.  This is BAD.
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I have never heard that certain IOLs would NOT cause a difference in reflection. I think it may be more dependent on the eyes of the person Some people do not notice anything. Some people are very bothered. I you need cataract surgery you have better things to worry about, like not being blind-- than whether or not your eyes will reflect light in a way that may be visible to others. I have dual optic IOL's and actually have multiple reflections of each image visible in my pupils. The people that notice it usually think its cool and I personally kind of like it. I am sorry that the reflections bother you, but on the bright side,  you will no longer have red eyes in photo's...
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The most important concern is vision improvement.  Did your vision improve?  If the answer is yes, be grateful for modern science and a good medical outcome.  Many of us in this community have serious complications and less than ideal outcomes.  A lens reflection is not unusual and not a big deal.  Stop looking in the mirror and obsessing about what you think you look like.  I promise you, most people would not even notice it unless you bring it to their attention. Take a walk and marvel at the gift of sight!  
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Or..just maybe....your eyes ALWAYS showed that reflection and you didn't notice it because of the vision reduction caused by your cataracts.
What nonsense.
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177275 tn?1438375244
Agree.  I have had patients that like the reflection and call it their "twinkle".  Reflections off the cornea occur in everyone that has a normal shaped cornea and tear film.

JCH MD
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Obviously those of you, including doctors,who are dismissing the claims of the reflection in the eyes as"nonsense" do not know what the others are speaking of nor do you live with it.    If it were an abnormality of the elbow or the knee it would be much easier to live with.  The eyes are the window to the soul.   The "glow" as I call it is nothing so benign as you and others have referred to as a "twinkle"  It is very disconcerting and an upsetting to have others remark when you are out in a social setting  "What is wrong with your eye?,  Or 'Your eyes are "glowing"    Some cataract surgery patients, like myself are in their 50's not their late 70's or 80's.    A person's appearance when it is in their eyes with a freakish 'glow' is nothing to dismiss or make light  of.   It affects ones self esteem and ability to look others in the eye.    The manufacturer of the IOLenses  will never need to look at this side affect if it is not taken seriously by the doctors who should be their patients advocate.    Take it from me,  anyone who is considering cataract surgery especially if you are younger,  research on your own as to which intra ocular implants cause an iridescent glow and which ones do not.    I am looking at a second surgery to change out my intra ocular lenses and hope to  travel to another hospital in another state (John Hopkins) to do so.  Insurance will likely not cover it and I will be paying for it out of pocket as long as the doctor says it is at a low risk.      So I ask you Do you really think I would take the time to research this issue, that I would make trips back to my own doctor, that I would go out of state and go through another surgery at my own costs of thousands of dollars for an unwanted "twinkle" in my eye?     This unnatural glow in my eye due to my IOLens implants is present everyday in sunlight and more at night with ambient light setting it off.   Doctors please listen to your patients complaints.      
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177275 tn?1438375244
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177275 tn?1438375244
For anyone considering cataract surgery that reads this discussion thread.  Consider the statistics for automobile accidents for 2014  in the USA: there were 5.5 million accidents, 2,339,000 injuries, 33,000 deaths. Yet does that really deter any of us from getting in our cars and driving to the store or across the country in our automobiles. Of course not because the risk is relatively very very low and falling due to safer automobiles.

Cataract surgery is the most common and  successful surgery done on adults world-wide. The reflections these posters find so troublesome usually do not occur, when they do occur they rarely bother the patient and some actually like the reflections. The complaints posted here are unusual and rare in cataract surgery.  Internet forums are a magnet for unusual problems and unhappy people.

I'm sorry all these posters find it so troublesome. Certainly some of the problems other posters bring to this forum that involve poor vision, blindness put these complaints in perspective.

Best of luck to those of you that are bothered by this symptom.

JCH MD
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I've got the glow you talk about and yes, it's frequently mentioned but I laugh and tell people it's my bionic eyes!  I went from about -13 to superb vision with my lenses and I'm grateful every day.  I also have a large amount of floaters, including misty ones that make me feel as if I'm looking through a greasy contact lens, these are from PVDs.  I can see them all the time but I've trained myself to look on them as positive!  Yes, I've got floaters but I didn't get retinal detachments!

Try to change your thought process, not your lenses.  You'll be much happier for it.
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re: "Do you really think I would take the time to research this issue, that I would make trips back to my own doctor, that I would go out of state and go through another surgery at my own costs of thousands of dollars for an unwanted "twinkle" in my eye?   "

No one can   know  without seeing you how large an issue it is. The mere fact that you wish to spend money to address it doesn't tell us either. Obviously there are some cosmetic issues such as say facial reconstruction after bad burns that almost everyone,  even the least vain in the populace is likely to feel appropriate.

However  individuals vary in their guesses as to  how much what they consider an  imperfection in their appearance is even noticed by others, and their sensitivity as to whether it matters. A tiny imperfection after say a minor accident that didn't heal fully and left a slight imperfection   might be something one person doesn't even notice, while another hides from public view and runs off to the plastic surgeon to deal with it.

Last year over

http://www.washingtontimes.com/news/2015/mar/12/plastic-surgery-43-percent-among-men-report/

$12 billion was spent in the US on cosmetic surgery, with over 10 million procedures. An estimated $59 billion on cosmetics:

http://www.statista.com/statistics/243742/revenue-of-the-cosmetic-industry-in-the-us/

So the mere willingness to spend money on something doesn't give a good indication about the magnitude of the issue as it would be perceived by the typical person.

There are studies into what leads to lens exchanges in order to try to prevent them. Although I'm merely someone who read about issues due to having had cataract surgery and having visual  issues afterwards, I have read many articles on the topic of lens exchanges and post surgery issues. and hadn't run into this issue mentioned  other than on this thread as far as I can recall. There are many articles talking about the reasons for unhappy patients after surgery and how to handle it, even if the unhappiness doesn't extend to the level of getting lens replacement, and I also hadn't seen this issue mentioned that i recall. (though it is possible since it wasn't a concern of mine  that I missed it).

Lens designers aren't going to expend effort trying to fix an issue they don't hear about as being a problem. It seems likely if another lens does turn out to be better in this regard, that it will be so accidentally and that someone should be cautious beforehand to investigate the odds that a lens exchange will truly make any difference. In theory it is possible, I know my optometrist had commented during an exam on how much more reflective my lenses seemed than others (though I've no reason to suspect it is noticeable to people in general as a problem). Lens attributes differ even if designers weren't trying to worry about something like this.  However any sort of lens exchange surgery has risks, so it is always best to be cautious about whether the surgery is warranted and what the odds are it will improve things.

Even if some surgeon can be found to take your money, they aren't the one taking risks with their vision and risking a potential complication causing visual loss in exchange for a potential cosmetic improvement, you are. Each person has to make their own call about risks/benefits and obviously some will find it worth the risk.

It may very well be that there are rare cases where the issue is so abnormal that the average person would consider it a problem (I have dealt with a rare visual glitch with the lenses so I know some uncommon issues aren't talked about much, some surgeons never see a similar case), but without seeing it for themselves people may be skeptical of the magnitude of the issue when it hasn't been viewed as common enough to be talked about in the literature they have read (or for some surgeons to have seen it). Many people won't be   aware of cases where this is something they would agree is a problem, while they are   aware of the variances of human vanity and concern over even appearance issues that aren't considered a concern by others.

If this truly is an issue that many people would consider a problem if they saw it then you might urge whatever surgeon you use to publish about the issue (without identifying you unless you wished of course), especially if you or someone else with this level of concern might be willing to allow photos to be taken if it is something that can be perceived in photos (perhaps with other facial features photoshopped to hide identity).

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ALERT!  In response to "SoftwareDeveloper" and his blase comments reguarding lense reflections and the resulting freakish glowing "devil eyes" after cateract treatment, I reply:  

THIS IS A REAL THING!  

Yes I can see better and yes I am greatful I did not lose my sight as a result of having the cataract procedure.  That being said, it is TRAGIC that this creepy side effect WAS NOT EXPLAINED TO ME BEFORE I CONSENTED TO THE SURGERY.  

I DO CONSTANTLY get comments ALL DAY LONG!  I am literally sick of constantly having to explain "what's wrong with my eyes".  

IT IS A VERY BIG DEAL and I can say without reservation that I would have NEVER agreed to this brand or type of cataract lense implant...period.  

This is SOCIALLY DEBILITATING...it has nothing to do with vanity.  EVERYBODY NOTICES IT!  People are disturbed by my "spooky eyes" and most are very vocal with their remarks and comments.  It certainly DOES need to be recognized , addressed and, most importantly, discussed with EVERY PATIENT considering cataract lense replacement.  

Shame on anyone who minimizes this Especially to DR JOHN HAGEN.  

Dr. Hagen states "internet forums are a magnet for unusual problems and unhappy people".  Give me a break.  I would love Dr. Hagen to spend one day in my shoes dealing with the constant negative comments and shaming that is now a part of my daily life.  

AGAIN, THIS ISSUE NEEDS TO BE ADDRESSED!
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ALERT!  In response to "SoftwareDeveloper" and his blase comments reguarding lense reflections and the resulting freakish glowing "devil eyes" after cateract treatment, I reply:  

THIS IS A REAL THING!  

Yes I can see better and yes I am greatful I did not lose my sight as a result of having the cataract procedure.  That being said, it is TRAGIC that this creepy side effect WAS NOT EXPLAINED TO ME BEFORE I CONSENTED TO THE SURGERY.  

I DO CONSTANTLY get comments ALL DAY LONG!  I am literally sick of constantly having to explain "what's wrong with my eyes".  

IT IS A VERY BIG DEAL and I can say without reservation that I would have NEVER agreed to this brand or type of cataract lense implant...period.  

This is SOCIALLY DEBILITATING...it has nothing to do with vanity.  EVERYBODY NOTICES IT!  People are disturbed by my "spooky eyes" and most are very vocal with their remarks and comments.  It certainly DOES need to be recognized , addressed and, most importantly, discussed with EVERY PATIENT considering cataract lense replacement.  

Shame on anyone who minimizes this Especially to DR JOHN HAGEN.  

Dr. Hagen states "internet forums are a magnet for unusual problems and unhappy people".  Give me a break.  I would love Dr. Hagen to spend one day in my shoes dealing with the constant negative comments and shaming that is now a part of my daily life.  

AGAIN, THIS ISSUE NEEDS TO BE ADDRESSED!
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I have the so-called "creepy eyes" - which are only visible in the just the right light, with just the right reflection - and friends have mentioned it maybe twice.  So insignificant in the greater scheme of things, in which I've been in danger of losing sight in both eyes to varying degrees.  If this small effect is debilitating to you, therapy might help.
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If you are constantly getting comments on your eyes, then your situation is different from what most of us have commented on. Usually no one ever notices that someone had cataract surgery.In 2+ years postop  I've never had anyone comment on anything visually different or odd about my eyes, let alone do so using a comment implying they are disturbed by it. It may be that your case truly is different than most.

Doctors don't talk about all the very rare complications that might arise since they are rare, and to some extent it is academic. If the person won't get them then they don't need to hear about it, if they get the complication then they'll discuss it. The existence of  all the rare complications isn't relevant if it doesn't change whether someone will get cataract surgery. The surgery is needed and  doctors assume that almost everyone   would prefer being able to see and having a cosmetic issue (even a visibly negative one) to being blind and being cosmetically perfect.

Its unfortunate that you are getting such negative comments.  I don't know what exactly is causing such a visibly negative result, since that isn't typical or common. Have you explored options to cover up whatever reflection or visible issue you are having? Although its unfortunate you have an issue, the productive thing to do is to figure out what can be done now rather than worry about the fact you didn't expect this.

I don't know if colored contacts (even ones the same color as your eye) would cover it up, or  even if a regular contact might change the reflections, or if glasses of some type could change the reflections?  Have you talked to the doctor about whether there is anything that can be done to address the issue, if it is so debilitating, such as whether say if a contact or glasses won't change the reflection, if a piggy back lens might?

  
I hadn't re-read my comments, but I think I left open the possibility that in some rare cases perhaps there is something visible to others in a way that is a problem. If so the issue is to get confirmation from others, rather than fearing the worst. Other posters didn't seem to have such confirmation.   It sounds like you may have gotten that confirmation.

  The issue most of us have addressed here is the more common case where people don't have the issue in perspective. There are some people who are anorexic because if they gain a pound they think everybody is thinking "she looks fat" even though they may be thinking "she looks too skinny".  However obviously other people do have weight issues and people are thinking "she should lose weight", the point is to be sure what others think rather than fearing the worst with something that might not be a big deal.


Its natural that if someone notices your eyes are "different" to interpret that comment as being  a critique, a negative comment. Its sometimes useful to step back to be sure we are interpreting people's reactions accurately. Are they truly being negative, are they really "disturbed" by the appearance of your eyes, or is it mostly that they are surprised by it, that they are "different", but merely in a neutral surprising way that they comment on once, and then don't think about again? I can understand it would be frustrating needing to react to such comments all the time, and to fear people are thinking something negative. However   there is a difference between people merely being surprised, and people truly reacting in a negative fashion. It seems likely most reasonable people would at most be surprised at the difference, but then not really care about it. In the big picture, does it matter if the unreasonable people care?

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It is a huge deal. I cannot concentrate on what someone is saying to me when it looks as if there is a hole into their brain. This cataract surgery effect really is creepy. I can't believe people would downplay that.
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177275 tn?1438375244
Not sure what this needs. patients that have IOL "sparkle" its something other people see not the person with the IOL.

What is this? is saying to me when it looks as if there is a hole into their brain.
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Aside from your concerns about lens reflection, could you share your post surgical visual outcome?
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"Or..just maybe....your eyes ALWAYS showed that reflection and you didn't notice it because of the vision reduction caused by your cataracts.
What nonsense."
That jerky comment does not add any value to this conversation. You must have been having a bad day.
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177275 tn?1438375244
KayakerNC is a thoughtful person who has added much to the discussions here and I know was not trying to be "jerky".  Patients often notice much more after their surgery that was already there.  We have been accused of making post cataract patients hair turn gray, causing wrinkles on their face and body, changing the color of their wardrobe and house furniture and putting dust all over their home. These are all things they could not see before that they can now post improved vision.
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Your response comes across as "jerky" as well.

I had a retinal to touch but it does have to have cataract surgery. That night now shows the strange complexion. It's not in my head. So stop trying to tell us all that we are being absurd. If you went through a surgery and something happened to your appearance, something that you were not told what happened, you'd be concetned as well.
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Well, clearly voice to text failed me miserably on my last response. But the point still remains. I had cataract surgery due to a retinal detachment cataract. There is now a reflection in my eye. If you had some sort of surgery that a tered your appearance, you would be concerned as well.  Especially, if like me, your job is to be in front of a camera.
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"If you had some sort of surgery that altered your appearance, you would be concerned as well."  I've had both eyes done now - one as a result of a cataract following a detachment and vitrectomy like you.  So my appearance has been "altered" in the same extremely minor respect.  The whole reflection thing is so far down the list of issues as to be ridiculous, when your choice is (1) have good vision and an occasional minor reflection, or (2) not be able to see and ultimately have a visible cloudy cataract.
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Unfortunately admittedly it is possible that someone whose living depends on being in front of a camera might be negatively impacted, but I'd wonder if those who are using the photos/videos have expressed concern about the reflection or if this is merely fear that they will. Its possible they won't.  If they do have a problem with the reflection, something impacting a career is a different issue than mere subjective concerns about appearance. I'm not sure there is much to be done, but if someone does concretely have a job issue due to it, then I'd suggest confirming that and people might take the issue seriously and think more about even risky/expensive options (e.g. if perhaps a piggyback lens or ICL might alter how light is bouncing so it isn't visible).  I wonder if there is a cheap option, if any sort of colored contact lens might have an impact.

For those who aren't in front of a camera for their job,  obviously everyone has their own standards regarding appearance and what to be concerned about. The question is how much its worth worrying about, if it truly has an impact on how others perceive you.  

Unfortunately it is hard for people to be aware of how we look to others. The odds are no one else looking at someone with an IOL would notice a minor reflection, or if they did that they would consider it a problem worth thinking about. I guess there are some very appearance-conscious people who might react negatively to it, perhaps some of the posters here are unlucky enough to have someone like that in their life causing them to worry about it. Again, I don't know if it would be a real problem for those in front of a camera or not, but I'd suggest checking with those on the other side of the camera first before being concerned.

At the risk of someone labeling this comment "jerky" for suggesting its productive for someone to try to  forget about the impact of an IOL reflection on their appearance (unless they have concrete evidence of a career impact),  I'd suggest it might be productive for  anyone concerned about the IOL reflection for non career reasons to look up "body dysmorphic disorder" and try to consider whether the impact on their appearance is truly worthy of concern or if its being blown out of proportion.
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177275 tn?1438375244
agree
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Body dysmorphic disorder is a real problem.  It's worth googling it to see if you note anything relevant to yourself.
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No. I have a very hard time looking at someone who is talking to me with a hole to their brain.this shiny mirror into their sole. It is very, very disconcerting. I'm shocked at people who don't get it.
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I completely sympathize with the posters who are upset by this phenomenon. I too have extremely reflective lens implants after cataract surgery and this issue was never made known to me before surgery either. And I thought I had researched everything to do with cataract surgery because I was so scared of having an operation on my eyes!  

I am in no way vain, as some seem to suggest is the problem here, and I have always been somewhat shy, so after so many people have commented on the shiny circles in my eyes, it does affect my confidence in public. I do feel like a freak! I notice when there is bright light to my side or front that might cause the reflection to happen and I move away. I can no longer look people straight in the face for long, and I look down if I notice someone staring intently at my eyes, which probably makes me seem shifty.

My regular optician said he has never seen such reflective lenses before, so it is not just me! My mother and brother had cataract surgery and they did not glow in public! I wonder if I should wear sunglasses permanently, but when I have spent thousands of dollars to regain my eyesight, why should I have to? I am so glad that people have posted here about the same issue, because it makes me feel less alone. I don't think people who are concerned by this should be dismissed so easily. I do think doctors should make people aware of the possibility of this happening, since it is not something people would even consider.  

However I have to balance my discomfort with the fact that after years of struggling with my sight I now have 20/20 vision and, due to complications after my surgeries, would never consider switching out the lenses. I'm learning to live with it.
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That is unfortunate to hear and sounds like a concern that doctors should mention prior to surgery but it seems difficult to judge without there being public information on which IOLs are associated with reflections. Which lens did you have implanted? Being a woman myself it brings concerns with my upcoming procedure as well. To say the least I am glad your vision is great and that you didn't have any of the complications that some need to live with.
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177275 tn?1438375244
Before having cataract surgery when giving permission it is noted there is a rare risk of complete blindness. Just like every time we get in a car, on a plane or bike there is a small risk of dying. Yet we take these risks. If you accept the rare but catastrophic risk of loss of the eye you accept the minor risks that come with it like a "twinkle". They can occur with any type of IOL, more common with acrylic.  As I have posted before some people like the "twinkle".  Would you really rather have not had the surgery and had poor vision that gets worse every year?
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anitajay mine were acrylic, with blue light filter, if that helps, and good luck with your surgery!
John Hagan, your insistence on calling it a "twinkle" is belittling, since under certain conditions they glow like cat eyes which is much more disturbing and frankly, I find your dismissive responses in this forum to be a turn off.  I hope you don't treat your patients with such unsympathetic superiority.  
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Is there a brand that does not have that reflection?
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177275 tn?1438375244
Less common with silicon IOLs more common with acrylic IOLs
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