Double vision effect after cataract surgery

[zeliot]

I had cataract surgery on my right eye three weeks ago.  I have posted before about continuing dysphotopsia problems, but I have now noticed a new symptom.

When I look at an Amsler grid with my cataract eye, all of the vertical lines appear doubled.  I also notice that text often appears that way -- most notably with the last letter in a word occuring again -- eg, I see "doctorr" when looking at "doctor".

My surgeon has told me to wait until I got new glasses before doing anything about this, which has been his advice about the negative and positive dysphotopsia problems I am still having.  My iol is a Clariflex, which is a single focus lens.

Anyone know what might be causing the double vision effects?

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

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[Lerbea]

The ghosting I had from cataract surgery IOL's did not go away with the new glasses. But one must try it.

[zeliot]

Many thanks, Dr. Hagan.

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

Yes certainly. K conus comes in mild moderate and severe.  Mild does fine with glasses, moderate usually needs rigid contacts and severe often requires corneal surgery and is often inherited.

I suggest seeing a corneal eye MD for a second opinion and some other options you might have. Find one near you at www.aao.org

JCH MD

[zeliot]

Dr. Hagan

I went to another ophthalmologist for a second opinion on all of my issues -- the positive and negative dysphotopsia and the ghosting following my cataract surgery.

He told me the cataract surgery looked fine and that the lens (a monofocal one) was perfectly centered.  He suggested eyedrops for the glare and told me that the "dark arc" was likely my seeing the edge of the lens.  He also said that I had the beginning of pco in spite of the fact that the surgery was less than a month ago.  He also said that the ghosting would be eliminated when I got new glasses.

But he then said that I had a mild case of keratoconus in both eyes.  He said it was mild because of the two cornea scanning machines he used, he could only pick it up on the more sensitive one.

He was a bit unclear on what if anything should be done about it.  

Here I was hoping for a simple answer to the after-effects of the cataract surgery and I find out that I have yet another eye condition.  It occurs to me that I should refrain from getting a third opinion, lest a third condition be detected!

Is there such a thing as "mild" keratoconus, in your experience?

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

Thanks and good luck

JCH MD

[zeliot]

Thank you, Dr. Hagan.  Well, I hope it is something other than macular disease.  I am having enough trouble dealing with cataracts!  I very much appreciate the information and in general the great help you provide to folks in this forum.

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

You said you had the problem with your cataract I. Since your cataract was removed I assumed you mean the eye that had NOT been operated on.'

If you mean you have the problem in the eye that had the surgery the answer is the same except that the doubling may be due to the IOL rather than the cataract OR as I said needing glasses, corneal astimatism regular or irregular or macular disease such as CMD.

JCH MD

[zeliot]

Thank you, Dr. Hagan.

But I had the cataract removed and the problem is only in that eye.  If I cover the eye that now has the iol, the problem is not there.

Thanks, Jodie.  I think I probably did not need this surgery (at least not until much later).

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

You are not having true double vision or "diplopia". You are having monocular ghosting. The cause is llikely the cataract. Other causes regular and irregular corneal astimatism, needing glasses, macular disease.

JCH MD

[JodieJ]

My best guess is uncorrected astigmatism.  You've certainly had more than your share of problems.