Yag after cataract surgery

[Normandie]

My question was answered regarding after Yag laser, vision has a vertical ghost image (ghost on bottom of everything I see).  I also mentioned that I have PVS, lasered horseshoe tear, mild epiretinal membrane and a hard drusen on the fovea.  The answer I received said that maybe Yag opening was too small, or that I should have an OCT scan to see if I have macula edema (CME), or an epiretinal membrane, but I had already mentioned the epiretinal membrane prior to this answer, therefore, is there a strong possibility that it is the epiretinal membrane causing the double vision?  I am corrected with glasses, so perhaps it is something else that need to be addressed.  Thank you for you response.

Normandie


This discussion is related to cataract surgery.

[Normandie]

Dr. Hagan, you have helped me to better understand the ghost image I am experiencing with my monofocal lens which had Yag.  Since prescription glasses do seem to somewhat correct this condition, (cannot read too well with these glasses although they are progressive), I assume now that is not the mild epiretinal membrane or the hard drusen on this eye.  Also has lasered horseshoe tear from years ago.  Is there a possibility that a relaxing incision can improve the ghost image, or PRK if my doctor feels this is okay to do, since they now tell me I have mild FCD?

Normandie

[Normandie]

If I am pinholing, I'm not smart enough to figure out why this clears images.  I thought maybe it meant that I was seeing clearly in the upper part of the lens because the lens may have moved.  Is there any tests that will determine if it has flattened the cornea, or away to determine if correcting astigmatism with relaxing incision will help?  I was also told that I have mild FCD,  not so sure PRK is an option.

Your response is appreciated.

Normandie

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

Last comment. could be pin holing, could be flattening cornea and correcting astigmatism

Important thing is that glasses correct.

JCH MD

[Normandie]

Must clarify myself again.  The glasses correct fine, and they are progressive no lines.  The situation I described to get clarity is without the corrected glasses.  Am I pinholing?  Is this why I can get distance clarity when bending my head, or am I just seeing out of the right spot in the monofocal lens when I do this?  Can Yag laser have caused this problem?  This eye has PVS, horseshoe tear, mild epiretinal membrane, and hard drusen on the fovea.  Not a problem-free eye to begin with.

Appreciate your responses.

Normandie

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

If the glasses correct it then it's a refractive condition not the EMR.

Things change.  Things get worse and occasionally better. People need stronger glasses and sometimes weaker glasses, sometimes no glasses.

I cannot tell you why exactly yours changed but its common almost the rule.

Your glasses should be progressive no lines. If adjusted properly when you drive or look out the window at something further than 20 feet away you should not have to raise or lower your head. To see TV with no line bifocals you should have to raise your head somewhat. You can also get the same effect by lowering your head (but that's not the way they were designed).  The glasses have different RX for different distances at different places.

JCH MD

[Normandie]

Thank you, Dr. Hagan, for such a speedy reply, and Happy Thanksgiving also.  I think my statement may have been confusing, the prescription glasses do correct the vision.  I don't know why I lost the 20/20 eyesight I enjoyed for at least 3 mos. this of course, before opacification became too significant to tolerate.   I did the Yag at about 6 mos. after surgery.  I can only see clear through this lens when I bend my chin down to chest and look up, then TV captions, etc. become clear.  Is there other issues that can be causing this, can the lens have shifted?

Thanks for your response.

Normandie

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

Of the conditions you mention the EMR would be the most likely to cause your ghost image provided it does not go away with a properly prescribed glasses lens.

An EMR ghost will generally not go away with glasses

JCH MD