Dear Lackosleep,
You are not alone. My wife had her original cataract surgeries back in March and April this year. After the first she complained of a sever glare issue which removal of the cataracts was supposed to take care of. It was much worse. I won't go into the whole story because it would take too many words but I'll give you an idea. She has been to three of the best ophthamologists in the Nashville area. The original surgeon and his retina specialists just scratched their heads after much testing and examination. The second tried tear duct plugs (temporary thankfully) but had no other suggestions. The last did say that a very small percentage of patients weren't satisfied with their vision after the initial surgery and opted for IOL Exchange. Well, after all testing (all of which had been done 3 or four times each) there was no reason found for her problem. She opted for the exchange which was done one week ago today. It doesn't appear that it will fix her problem. She does need YAG treatment (we knew that before the exchange but was put off due to complications to the surgery with a little hole poked in the capsule wall before surgery). The glare is still there plus she continues to see (in the light and low light) swirls, starbursts, little things that look like amoebaes even with her eyes closed with any light source around, etc.. It makes her miserable and the only time she has relief is when she is in total darkness. The doc said that all the symptoms that she's giving him doesn't make sense with the exception if she were to have MS. An MRI was done of the optic nerves looking for a Chiasmal Lesion (spelling?) which proved to be negative so the exchange was done. No signs of MS were seen either. The bottom line is that she has thrown things at three reputable opth guys and they don't have a clue. I know that's comforting to you. Just as you my wife is very depressed about this whole thing. The thought of losing one's vision is devastating!! I've sat many times and tried to imagine that and just those thoughts are extrememly painful to me!!!! It almost sounds as if light is triggering a chemical reaction in the retina that is firing those illusive images that she "sees" even with her eyes closed. Once she goes into the dark it takes a while for the eyes to calm down and the aberrations (I guess) to go away. She's been to several neurologists also and nothing there either. She's going to another that is a Neuro Opth person so maybe they'll have some ideas.
The glare keeps her from driving and walking unescorted. Night time is better but her vision still isn't good enough to allow her some normalcy.
By the way, Alcon lenses were used originally and one was replaced with a Starr lens. She says the blur (which requires YAG treatment) can wait because the glare and weird aberrations are what is driving her crazy. Info above is about the right eye. Both eyes have the problem with glare.
By the way, the swirls, etc. didn't occur in the left eye until recently. As I said, all tests done including a angiogram showed no problems. She also has had migraine (real ones, not most that are termed that) since our first child was born and she has taken medication for that since they began. She has cervical spinal stenosis which has needed a surgery fix for a year now but it was put on the backburner when the vision issue started. She also takes pain medicine for that. With migraines, the spinal cord being affect by the neck condition, and cataracts (now removed) it's very complicated for her. Could long term use of so many potent medications cause something? I've researched them and found nothing that mentions her symtoms. After all the research I've done I feel like I should be an eye doctor but that's only because I know so much more than I did before the wife's visual problems started.
I wish you the best but it seems that there are still many puzzles that the med people can't solve. Keep on searching which is what I'm doing.
As you said, the IOLs made the glare so intense that it has basically disabled my wife. It seems that the cataracts were actually filtering the light and camoflaging something else. Have you noticed the John A. Moran Eye Center in Utah?
TB
PS. She has 12 different types of sunglasses and none really take care of the glare. She even watches TV with them on most of the time. After a little while the eyes just tell her to quit watching. She has been unable to see imaging on a pc screen now for over a year. If she worked today she would be termed disabled. She's 61 and all the docs have said she is young to be experiencing what's going on. I'm a type II diabetic and have some cataracts but they aren't the kind that affect my vision.
Discuss with your surgeons trying Alphagan-P to keep the pupil smaller in dim light. It often helps a problem like yours.
JCH MD
While I'm awaiting 2nd opinion, my treating surgeon plugged lower tear duct to promote tear welling and upped the prescription in the "starbust eye" from -1.50 to -1.75 to rule out the obvious.
Wetter eye and Rx change had no effect, but I did a little experiment to see if maybe it was related to the size/position of the YAG rupture relative to the large pupil size in low light condition of driving at night.
I noted size of starbursts while driving/parked at night of passing cars and stationary lights. Then turned on the interior car lights and noticed a slight reduction in the length and intensity of the starbursts. Then I shined a flaishlight into my right eye and the starbursts completely disappeared. I repeated this for both moving and stationary objects. Outcome always the same -- flashlight eliminated starbursts while one the eye, and for very short time (1-2 seconds) after turning off. This leads me to believe either the smaller pupil, or the reduced contrast of having abbient "competing" light can solve this starburst problem.
What's your thought as to which of these factors - pupil size or ambient light might be responsible, and would either suggest a certain treatment? ie, drops to constrict pupil opening or contrast sensitivity when night driving (if exists), or resizing/positioning of YAG opening?
Thanks again.
Lackosleep.
Same recommendations.
JCH MD
Hello I am going through the same hell. Both eyes. difficulty focusing, see dark and light blotches. Eyes get very tired and red from working on computer even for a little while and reading and tv also.
I also had YAG treatment. My eyes were both better right after cataract surgery than now. It seems there is glare I have to deal with and also another way to explain is as though there is oil in my eyes.
No, I haven't had starbursts or halos for several months. Even then, they were not interfering with my night activity.
JCH MD has the right advice for you.
I would suggest you get at least two differenc opinions from well thought of cataract/refractive surgeons.
Your problem could be the yag capsulotomy is too small, the IOL could have shifted, you may have other problems.
Its time for a fresh look. Find other opinions at www.aao.org
JCH MD