has anyone had their cataract operation and still had starbursting how do you cope with it

[wigfield]

Hi

when i was waiting to see my eye doctor i was chatting to other people who had their cataract done,and all of them had said everything had improved

i just dont see how i can cope with my bad starbursting for the rest of my life im 30

this now means i cant drive at night because of the starbursting,ive seen two doctors both said there is nothing that can be done as my eye is in good condition.

ive seen some pinhole glasses that might help with starbursting

does anyone have any advice for me

[laker234]

I too have starbursts,especially dangerous meeting vehicles at night. Had cateract surgery about 10 months ago.At that time had problem with headlights blinding me,now have starbursts.Don't which is worse. My eye doctor said to try Brimonidine,which is generic for alphagan.That has helped some. Good luck.

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

I'm sorry but I don't know the answer to that question. You'll need to ask the optician.

Hope it helps.

JCH III MD

[wigfield]

Ive got my polarized glasses it doesn't seem to reduce the light scattering,ive not been out at night yet so im not sure if its improved it for driving

My optician is away at the moment,so i cant ask him this:

Can i have anti-reflective coating on my polarized glasses because im seeing reflections

Thanks

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

Wigfield and Kg17   Let us know how they work out. It may be helpful for other readers.

JCH III MD

[wigfield]

I went to see my optician and i do need glasses for distance and of course reading, so im getting bifocals and its going to be polarized the grey ones

[kg17]

I truly empathize with your situation.  I received Visian phakic lens implants about 3 months ago to correct severe myopia (-17 diopters) and have lived with a disabling visual "light show" and photophobia since.  Not only do I experience halos, starbursts, light streaks, horizontal lines, etc. during low lighting conditions, but I have a very hazy, glassy glare that covers my entire visual field during the day.  I've tried it all - tinted glasses, Alphagan-P drops, cosmetic contact lenses, etc.  I've gone to the best opthamologists in my state (including a teaching university).  The typical response is "your brain will adapt."  I have had no one take the time or make the effort to diagnose what is really going on (is it the prophylatic iridotomy, the phakic lenses, or an interaction between the two.  It is incredibly frustrating and disheartening.  My sympathies go out to any others who have to deal with this.    

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

Just for your information the editor of Cataract & Refractive Surgery Today is a member of our ophthalmology group.

JCH III MD

[light show]

Thank you... based on your info I will try the alphagan-p.

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

For your information alphagan-p is much milder than pilocarpine and has helped many patients that I've taken care of with the same problem.

JCH III MD

[wigfield]

Thanks again

im booked to see my local optician,so now i can tell him everything thats been said here,he is a very advanced optician,and he allways takes his time with you

as you said a lens exchange would be more difficult now due to yag treatment

that is also what the doctor said

when i saw a second doctor she said to me she tells her patients not to get their hopes up,as sometimes it doesn't make it better or sometimes it can be worse

my doctor never said this to me,i asked him wiil this operation stop the starbursting in his words oyes most definitely.

when i went to see what was wrong with my eyes i saw a private doctor,but i had the operation done through the NHS,when i had the operation done i went to see that same doctor he said its fine i have to live with it

the second time i saw a NHS doctor  and she said the same thing

this time ill go to a private doctor

[light show]

I have the same problem with starbursting/halos/streaking and a high sensitivity to various lighting conditions.
I understand your frustration.  After two years of not driving at night, wearing 2 pairs of sunglasses at the same time in bright light, limited tolerance to LCD TV and monitors,  sometimes wearing sunglasses indoors,  reading for short periods of time only and many , many hours of  online research including helpful input from doctors and posters at medhelp, I still am dealing with the same uncomfortable, sometimes painful condition(s).
I've always worn anti-reflective glasses and polarized sunglasses, however, since my cataract surgery there is no way I can venture outdoors without my eyes heavily shaded ... and do wear a broad brimmed hat.  I wouldn't even attempt to drive at night with sunglasses on - besides the sunglasses don't seem to block the bright headlights, traffic lights and store signage, etc. - instead it seems there is even more contrast added to your vision field, i.e. more dark and brighter whites - does that sound familiar to you?  
After 2 years I finally have a diagnosis from a high risk surgeon here in Toronto.  He also contributes to the publication 'Cataract & Refractive Surgery Today'.  He has diagnosed me with dysphotopsia in my right eye and high order aberrations in the left eye. I am cautiously contemplating and IOL exchange.  I currently have Alcon SA60AT monofocal lenses.  The doctor would like to exchange with the Technis lenses which has been developed to somewhat combat what we are experiencing with our current lenses.Surgical outcomes such as ours is rare but not uncommon, so I've been told many times.
Through Medhelp I received a message from a woman in the UK that has had a lens exchange.  Hers was done in Boston, I believe.  She is still having problems.  I should attempt to contact her again ... she's in Suffolk in a educational field....it would be interesting to hear how she is making out....is Suffolk near to where you live?
Just don't give up ... there are some wonderful universities in the UK ... find out where the medical teaching hospitals are.  
I have a prescription for Alphagan.  I've tried pilocarpine and felt my condition worsened and it gave me  a worse headache than I already had.  I'm reluctant to try the Alphagan for fear of the same reaction.
Liquid tears, gels and sprays don't really help either.

I was told I was young when I showed up with cataracts ... You are very young!  Ultimately, you will make the right decision for you.  Nothing is without risk.  You can try to accept your condition and work around the ongoing daily challenges or you can try to get it fixed ... there is no guarantee 'the fix' will solve the problem. Until then Keep Your Eyes Shaded .... don't drive at night (believe me I know how upsetting that is to you and also to the woman in the UK who had some night classes to teach).  Keep the faith and keep posting.

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

Well do some research on the type of implant you have in your eyes; get your second opinion (its important that physician know about the type of implant your have; have a meticulous refraction (glasses check) done; you may want to try anti-reflective coating or polarized lens to see if that helps (AR coating is hard to keep clean), outside wear a hat with a bill; if you have "big' pupil ask your physician to try Alphagan-P one drop twice/day (generic name bromonidine). It keeps the pupil from widely dilating in many situations. It's a glaucoma drop and relatively harmless. About 8% of people can't take it because of irritation of the lids and eyes. If that isn't tolerated a very mile pilocarpine drop .5% or 1% might carefully be tried. Do try Alphagan-P first.

A lens exchange would be the last thing to try and would be more difficult and complication prone now that you've had a Yad capsulotomy.

Here is a reference on Alphagan P paste in your browser:
http://www.crstodayeurope.com/Html%20pages/0706/CRSTEuro0706_rs_dick.pdf


JCH III MD

[JodieJ]

I'm not at all knowledgeable about starbursts.  Nor am I familiar with your health care system in the UK (even though I saw "Sicko", which obviously omitted a lot the big picture).  However, I do know from personal experience that doctors differ greatly in their ability to diagnose and treat uncommon conditions.  So I suggest that you seek additional consultations with the best ophthalmologists available who specialize in refractive/cataract surgery.  I'm sure that there are excellent practitioners in the UK.

Polarized glasses and anti-glare coatings are relatively inexpensive.  By all means, try them.

I also have another suggestion for you if you're inclined to do some independent research (or know someone who could help you with this.)  When I developed an uncommon retinal condition that the local doctors couldn't treat, I did some online research to find out who had recently published articles about my problem.  I contacted these doctors via email, and their responses were enormously helpful to me.  You might try entering "starbursts" in a search engine; I'm sure that will generate a lot of hits.

I hope that one of the forum M.D.'s will have some additional suggestions for you.  

[wigfield]

Thanks i shall get a third opinion

I was never given a card that has the manufacturer, type, model and power of my implant. so ill get the info from them

I have monovision if thats the one for distance but not for reading,for reading i have glasses

I have had yag done on both eyes,and ive been told twice that everything is fine with the implant

Is there any kind of glasses that will reduce starbursting?

I know some people have starbursting problems at night due to the pupil being dilated,but with me it also happens during the day with certain light sources

Many Thanks again

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

Hello wigfield.  Normally you're given a card that has the manufacturer, type, model and power of your implant. If you didn't get it ask for that information. then do a internet search on problems with glare and starbursting. First thing to rule out Is it the implant.  Do you have a monovision IOL or a multifocal or accomodating IOL. Your problems are more common with the latter two.

Next thing is to be sure the implant is properly positioned and has not moved such that these problems are coming from the edge of the IOL entering the pupil when its dilated. In that case a trial of mile pilocarpine to keep the pupil small might help. In severe cases the lens may need reposition.

Next be sure the posterior capsule is not cloudy. This is very frequent and much more common in a young person like you. If that is the problem a yag laser capsolutomy will often take care of the problem.

If it's a good implant, properly positioned and the posterior capsule is clear you may need a IOL exchange.

I would get a second opinion in the near future.

Good Luck

JCH III MD Ophthalmologist

[wigfield]

Thanks Jodie

But im from the uk,the first doctor i saw is pretty high up on the cataract surgeon list so im told

it seems all the top cataract surgeons are out of the uk

one of the doctors said i could try

Polarized glasses

Anti Glare glasses

When i did a search for cataract glasses the only thing that i could find was those pinhole glasses,but im not sure they would be safe for driving,they look like it could make things to dark

If i cant find a solution i think im going to have to find another cataract surgeon

[JodieJ]

It's a real bummer to have those kind of problems at age 30.  I don't have a solution, but I'll tell you what I'd do in your situation:  I'd consult the very best cataract surgeon(s) in my area.  Castle-Connolly (www.castleconnolly.com) is a service that surveys other doctors as to whom they'd want to see themselves (or send a family member to) in various areas of specialization.  These doctors are then screened by the Castle-Connolly staff as to their credentials and malpractice history.  The doctors who make it into their listings certainly aren't the only excellent practitioners in their specialty, but (in my opinion, anyway) it's an excellent way to select a doctor if you don't have a good referral source.  The fee to use their website is low.  (The Caste-Connolly books containing their listings are also available for free at many public libraries.)  Just type in the desired location, select "ophthalmologist" and type in the specialty "cataract."  Most of their doctors are located in large metropolitan areas, so you might have to travel a bit.  Best of luck and don't give up hope for finding a solution.