Veriseyes implant

I had a Veriseye implant in my Right eye approx. 5 weeks ago.  My RX prior to the procedure was -10.5 (right) and -9.0 (left). I was not a candidate for custom lasik - and PRK was a risk too.The procedure was done on  the Right using a lateral muscle block (?).  The vision and pressures in the right eye are stable.
My right pupil is approx 1mm larger than my left  and the inward drift is also consistently approx 1mm.   I was referred to a neurologist and had a MRI of the brain and orbits w/ normal results.
I am a neuro certified ICU nurse -  Eyeballs are just not my strongpoint - I do know that this involves the  3rd cranial nerve.  The neurologist seems to think that the block that was used my have infiltrated the 3rd CN and will just take time to resolve.
In the meantime I am having debilitating headaches.  My right eye is constantly under stress, feels very heavy and my vision is so distorted.  I am wearing my contact lens in my Left eye.
Of all things that have helped the most - I took the right lens out of my OTC reading glasses so that I could see my computer screen and it has given me the most relief.  Now I am walking around with this silly pair of $5.00 reading glasses with 1 lens all of the time and plan to have a pair of glasses made to use in the interim.
My vision in the individual eyes is stable -  It's my combined vision between the two that is the problem along with the added "bells-palsy" type symptoms in the Right eye.
I know that this is a new procedure in the US and it's hard to find anyone that has had this done...
I am just looking for any help that I can get...I'm at a loss.
Thank you

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

Hello kbrach,   This is an area that I have done a great deal of clinical research and at the end I'll give you the references to some of my scientific papers. Double vision following injection anesthesia around the eye is not unusual. Additionally damage may occur to the nerves to the pupil (causing larger or small pupils), the eyelids (causing a droopy eyelid or ptosis). My paticuliar research was on injection anesthesia that did not have a "spreading enzyme" called hyaluronidase in it. I found (as did others) that when hyaluronidase was not used that the incidence of double vision, often permanent, was much higher.

I would say that if you do not see any improvement over 4 to 6 months the condition likely will not resolve. I would suggest you get a consultation from a pediatric-eye muscle (strabismus) specialist. You're not that far out and I have seen these resolve on their own. In any case these are my research papers.

JCH III MD FACS

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

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

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

90. “Permanent Diplopia Following Cataract Surgery”, Journal of Cataract & Refractive Surgery, 27: 341-342, 2001

[JakeMooreMD]

A little more data would help to answer your question.  What is your post-op refraction?    Are you having double vision side by side or different image sizes images between the eyes?  Did you elect for monovision?  The fact that you are taking one lens out of the reading glasses suggests to me the possibility that you have a different refractive error between eyes.  If you have monovision weather intended or not, is an accepted way to treat presbyopia and something you can adapt to and enjoy if you realize what you are dealing with and are motivated to do so.  I typically give my patients a small amount of monovision with my cataract lens implant surgeries.

Jake Moore MD
Harlingen TX