Aa
Sudden change of visual acuity in one eye seems to be solved.
Ok so I think finally I have what seems like a real diagnosis.
Very slight cataract formation in the right eye and irregular astigmatism.
The irregular astigmatism is caused by both cornea and lens. Corneal thickness is normal so keratoconus is ruled out.
Ophthalmologist believes both of these factors contributed to the change in visual accuity over time, but I just suddenly became aware of it.
Visual acuity in the right eye is now 20/25 uncorrected and due to the irregular nature of the astigmastism they unfortunately don't seem to be able to get it to a clear 20/20. =(
Very slight cataract formation in the right eye and irregular astigmatism.
The irregular astigmatism is caused by both cornea and lens. Corneal thickness is normal so keratoconus is ruled out.
Ophthalmologist believes both of these factors contributed to the change in visual accuity over time, but I just suddenly became aware of it.
Visual acuity in the right eye is now 20/25 uncorrected and due to the irregular nature of the astigmastism they unfortunately don't seem to be able to get it to a clear 20/20. =(
It would be interesting to see your corneal topographies if you have them-both the right and left ones. Perhaps you could post them like you did for your drawings of the halos...Please black out your identifying details on the maps if you do so.
It seems like your vision is fairly good, so it isn't clear if you wish to go to much effort to correct the irregular astigmatism. I'm curious though now that you raise the issue.
Hopefully someone with more information posts. In case they don't, I'll at least offer some suggestions for things to check on. I'm not positive, but I seem to recall RGP, rigid gas permeable, contact lenses I think might able to correct some sorts of corneal irregularities because they physically reshape the eye (though I'm unsure someone with fairly good vision would want to go to the trouble to wear those).
I haven't checked into them, but I have seen references to wave form and personalized contact lens, though I didn't need them so I can't recall if they were on the market or being researched. I also don't know if there are soft contacts like that, or merely RGP ones. One issue with making the lens too customized is that the orientation of the lens matters more. Toric contact lenses to correct for even regular astigmatism need to try to prevent lens rotation, but it still rotates a bit, some RGP lenses would rotate less I think (I never used them).
I know there is research regarding personalized laser correction based on scans of someone's eyes, but I haven't had paid attention to details to know if that addresses what you are thinking of.
When the natural lens is replaced during cataract surgery, There is something called the Light Adjustable Lens where the actual exact surface of the lens is adjusted after implantation using ultraviolet light. The initial versions just altered the lens power, but they are also experimenting with multifocal patterns. I have seen mention of doing toric patterns to correct for astigmatism, but I don't know if they are experimenting with personalized patterns for dealing with irregularities, though it seems a possibility, I'd be curious about it.
Hopefully someone with more information posts. In case they don't, I'll at least offer some suggestions for things to check on. I'm not positive, but I seem to recall RGP, rigid gas permeable, contact lenses I think might able to correct some sorts of corneal irregularities because they physically reshape the eye (though I'm unsure someone with fairly good vision would want to go to the trouble to wear those).
I haven't checked into them, but I have seen references to wave form and personalized contact lens, though I didn't need them so I can't recall if they were on the market or being researched. I also don't know if there are soft contacts like that, or merely RGP ones. One issue with making the lens too customized is that the orientation of the lens matters more. Toric contact lenses to correct for even regular astigmatism need to try to prevent lens rotation, but it still rotates a bit, some RGP lenses would rotate less I think (I never used them).
I know there is research regarding personalized laser correction based on scans of someone's eyes, but I haven't had paid attention to details to know if that addresses what you are thinking of.
When the natural lens is replaced during cataract surgery, There is something called the Light Adjustable Lens where the actual exact surface of the lens is adjusted after implantation using ultraviolet light. The initial versions just altered the lens power, but they are also experimenting with multifocal patterns. I have seen mention of doing toric patterns to correct for astigmatism, but I don't know if they are experimenting with personalized patterns for dealing with irregularities, though it seems a possibility, I'd be curious about it.
Hi,
As far as best corrected vision is concerned he didnt say if he thought it was due to cornea or the cataract. He showed me a corneal topography scan which had colors from red to blue, the blue in the middle very much resembling the pattern of the halos I am seeing. And he showed me another scan that had an 'E' in the middle. For the left eye that E was equally blurry on all sides, he said the left lens is 'pristine', but for the right eye that 'E' was distorted, he said that was due to the lens, possibly caused by the cataract. I am 48 so about the same age you were when you were first diagnosed with cataracts.
I am wondering if there are some more advanced lens manufacturers that can correct for higher order abberations like my irregular astigmatism?
As far as best corrected vision is concerned he didnt say if he thought it was due to cornea or the cataract. He showed me a corneal topography scan which had colors from red to blue, the blue in the middle very much resembling the pattern of the halos I am seeing. And he showed me another scan that had an 'E' in the middle. For the left eye that E was equally blurry on all sides, he said the left lens is 'pristine', but for the right eye that 'E' was distorted, he said that was due to the lens, possibly caused by the cataract. I am 48 so about the same age you were when you were first diagnosed with cataracts.
I am wondering if there are some more advanced lens manufacturers that can correct for higher order abberations like my irregular astigmatism?
Did they give any indication how much of the astigmatism is due to the cornea rather than the lens?
i.e. its "best corrected" vision is also 20/25 (which isn't bad). Did the doc say if they thought any of the reduction in best corrected vision was due to the cornea? It seems more likely the reduction is mostly due to the cataract rather than the cornea, so its possible that the eventual cataract surgery may be able to restore you to 20/20 or better. (at one week postop I was at almost 20/15, that may have improved since).
Typically a cataract progresses very slowly and it would be years before you'd need to worry about deciding how bad to let the eye get before surgery. However it seems like some who are younger than the typical person with a problem cataract are more likely than usual to see them develop quickly (though thats anecdotal, I hadn't seen studies on it, but just some surgeon comments in articles and from knowing others with problem cataracts that are younger). So its just something to keep an eye on. Mine was diagnosed at age 49, and best corrected acuity in that eye went from 20/25 to 20/60 within 3.5 months (though there was a trace cataract in the other eye, and 2.5 years later it was 20/20 correctible and the cataract barely visible to an eye surgeon, so that one was more typical).
Even a seemingly "very slight cataract formation" can cause that shift. My optometrist hadn't been able to diagnose that problem cataract originally, even though the eye had gotten to only 20/60 correctible she was seeing only seeing "slight nuclear sclerotic changes" as she put it on the referral to an opthalmologist. She didn't think it was a cataract yet (likely perhaps given my age it was unlikely) and it didn't seem to explain a shift from -0.75D to -4D of astigmatism over 3.5 months. The eye surgeon however easily diagnosed it as a nuclear cataract (seeing it better I guess through his equipment) with no other eye health issues.
i.e. its "best corrected" vision is also 20/25 (which isn't bad). Did the doc say if they thought any of the reduction in best corrected vision was due to the cornea? It seems more likely the reduction is mostly due to the cataract rather than the cornea, so its possible that the eventual cataract surgery may be able to restore you to 20/20 or better. (at one week postop I was at almost 20/15, that may have improved since).
Typically a cataract progresses very slowly and it would be years before you'd need to worry about deciding how bad to let the eye get before surgery. However it seems like some who are younger than the typical person with a problem cataract are more likely than usual to see them develop quickly (though thats anecdotal, I hadn't seen studies on it, but just some surgeon comments in articles and from knowing others with problem cataracts that are younger). So its just something to keep an eye on. Mine was diagnosed at age 49, and best corrected acuity in that eye went from 20/25 to 20/60 within 3.5 months (though there was a trace cataract in the other eye, and 2.5 years later it was 20/20 correctible and the cataract barely visible to an eye surgeon, so that one was more typical).
Even a seemingly "very slight cataract formation" can cause that shift. My optometrist hadn't been able to diagnose that problem cataract originally, even though the eye had gotten to only 20/60 correctible she was seeing only seeing "slight nuclear sclerotic changes" as she put it on the referral to an opthalmologist. She didn't think it was a cataract yet (likely perhaps given my age it was unlikely) and it didn't seem to explain a shift from -0.75D to -4D of astigmatism over 3.5 months. The eye surgeon however easily diagnosed it as a nuclear cataract (seeing it better I guess through his equipment) with no other eye health issues.
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