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problems with flickering vision after cataract surgery
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problems with flickering vision after cataract surgery

I am 49 years old and had cataract surgery on my left eye 11 months ago.  The lens used was a Acrysof IQ Intraocular lens.  After the surgery I experienced flickering light resembling strobe lighting in my vision with this eye.  I returned to by surgeon after 3 months and was was told this would subside in 6 to 12 months as my brain adjusts to the new lens.  It has subsided a little but I continue to have problems under florescent lighting. Under florescent lighting condition my vision in this eye  feels like I am looking through a wet eye. Again it is the feeling of mild strobe lighting .  I find I am blinking all the time and find that this eye gets teary under florescent lighting conditions whereas my other eye does not.

What is causing this and given it has almost been a year, will this ever stop.  I feel as if I have traded one eye problem for a new one.  Is this a common complaint after cataract surgery.
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233488_tn?1310696703
Get a second opinion. Find another Eye MD surgeon at www.aao.org  the problem is called dysphotopsia and is very common with certain types of IOLs.  Options might include special glasses, IOL removal/exchange/repositioning.

Use the archives, eye topics and search feature to read the many posts on "flickering" after IOL surgery.

JCH III MD
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Avatar_f_tn
I have this also.  I had heart tests the other day and the techs had to do a lot of them in almost darkness as I could not stand the overhead lights. I was tearing and smarting and vision distorted.  I have a call into another doctor to remove the cataract lens ASAP as I would rather have dim vision than this mess.  I was never told this could happen to me. Shame on me.
I wish you the best.
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233488_tn?1310696703
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Avatar_n_tn
I had cataract surgery done in my left eye last Weds.  On Thrusday night I started experiencing pain in my eye and sensitivity to light.  Any time I get inb the light my eye flickers and it's annoying.  I'm seeing my eye doctor tomorrow.  I'm 62 and have glaucoma.  Granted, my vision is 20/20 with no blurring, but I'm taking pain pills andd wearing sun glasses every day.  this is day 5 and somethng doesn't feel right.
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233488_tn?1310696703
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Avatar_m_tn
I too have this flickering problem and it's been 6 months and the surgeon seems to believe time will take care of the problem.  Is this problem associated with any particular lenses?  My lense was an AMO model ZCB00.
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Avatar_f_tn
Time certainly hasn't helped in my case.  It's been over 2 years for me and it is not one bit better and no one is willing to even acknowledge there is a problem never mind help me, and I am getting seriously depressed.  
I want my life back.
I want to drive again.
I want to be able to grocery shop without my husband tagging along.
I want to be able to select restaurant seating based on the location of the table, not the orientation to the lighting.
I want to be able to use the computer for more than 10 minutes without having to close my eye.
I don't want to miss yet another year of skiing.

Why won't anyone help me?
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233488_tn?1310696703
There are several world famous ophthalmologists that deal with IOL problems from all over the world. At the Cincinnati Eye Institute Robert Osher MD and in Los Angeles  Samuel Masket MD    

JCH MD
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Avatar_f_tn
Thanks for the names, one of them is already on my list.

I'll just have to keep trying until someone is (a) willing or (b) able to figure out what the problem is.



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Avatar_m_tn
Im at 2 years after surgery,I still get flickering very controllable now,you just get use to it,you had imperfections with vision before surgery.i.e blurry vision,reflections in lenses of glasses,watery vision sometimes with contacts...remember these surgeries are man mad ,synthetic  vision,not natural perfect vision as we want,we are one of people who have a defect,you just need to adjust thats all, having it taken out with a new replacement ,may not solve the problem and cause another.i.e blurry vision,eye pressure ..etc if you vision is good keep with it,it will ease,and very adaptable..there are things you can take,alphagam eye drops,parcarpine eye drops, whichwill shrink your pupils enough to stop the flickering,the flickering is the pupil bleeding over the margins of the lens in certain lights..or you can take tramadol,does the same thing,but these are short fixes,body and eyes will get use to it,best bet just get on with your life and forget about it,its there for good ! then it will disappear,by camouflage in the brain
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Rickyboy

I am sorry that I seem to have hijacked your thread.  

From the information I have gathered over the past couple of years, about negative dysphotopsia, for some people it does go away with time.  Positive photopsia tends to go away on it's own more often than negative dysphotopsia.  

Negative dysphotopsia is where you perceive a shadow on the temporal side of your vision.  Positive photopsia is where you get light rays and streaks from light that reflects off the edge of the IOL ("edge glare").
It's not known what causes it but it's been theorized that it happens more often with: acrylic IOL, square edge IOL, high power IOL.   There has also been some evidence that the edge of the capsulorhexis is somehow involved.  Capsularhexis is the round opening that is made in the capsular bag to allow for cataract removal.  The IOL gets inserted and the edges of the opening overlapped onto the IOL.
From what I understand, Dr. Masket has had some success treating this condition by moving the IOL forward and tucking the edges of capsularhexis behind the IOL.
If this is what you have, and time turns out not to be the healer, don't let anyone tell you it's in your head.  It's a real and documented condition and it can be very distressing.

Best wishes to you from a fellow sufferer.
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Avatar_f_tn
Jaysta

Interesting that you had relief with the pupil constricting drops.
I found the opposite, it is much worse when the pupil is small, whether from the drops or bright light.
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Avatar_m_tn
It is possible that your IOL may be slightly decentered.  If this is the case you might want to ask your opthalmologist about argon laser pupilloplasty.  Perhaps you have already investigated this, but if not you can find some information on the technique on the internet.  Essentially the pupil is "shifted" by small laser pulses to the iris, hopefully resulting in better alignment of the IOL with the pupil..  You can also read more about the technique on some of my journal entires on this site -- just click on my profile.  I had this technique performed and it did help my vision some, although in my case the goal was to provide clearer vision rather than an issue with the IOL edge.  

Pupil costricting drops like pilocarpine or aphagan can help, but most practitioners do not recommend taking them for long periods of time.  

Best of luck to you!
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Avatar_f_tn
If getting used to the phenomenon is impossible, you might--seriously--want to consider, at least at times, the eye patch you jokingly mentioned.

A friend underwent successful surgery for a benign brain tumor, which left her with the unfortunate side effect of two functional eyes that no longer saw quite the same image.  The discordance turned out to be uncorrectable, so being a practical, get-on-with-it sort of person, she has resorted to a colorful selection of eye patches coordinated to her wardrobe.  As it happens, she is a beautiful woman, and the patches do make quite a statement, while providing monocular vision that is functional and no longer distressing.
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Avatar_f_tn
Yes, there have been times when I have thought that I would be doing much better if I had lost the vision in that eye altogether.  I think I would have been able to adjust to it by now.
The flickering is such torture.  Imagine being in a room with a strobe light going off for over two years.  
I do often simply put my hand over the eye to get some relief.   I also have distorted vision, uncorrected refractive error and astigmatism, image size difference between the eyes and zero depth perception.

I have other issues in addition to the negative dysphotopsia.  And they are in fact in my eye, not in my head.  I have epiretinal membrane, intermittent CME, large vitreal floaters, wrong power IOL implanted, loose zonules, previous lasik, and the beginnings of Fuch's corneal dystrophy.

I have often wondered if the IOL is decentered, but every doctor who views it says it's in a good position.

On a positive note, I have just obtained an appointment with a very reputable opthalmologist in Toronto, and he has so far

a) taken the time to review my records

and

b) ordered up some tests that so far no one else has seen fit to do, likely because they (incorrectly!) assume that my problem is a psychciatric one, and/or they just don't want to be bothered trying to figure out what's wrong.

To those doctors I say:  if you want to cherry pick for a living, go pick fruit.  Otherwise, listen to the patients that come to you for care, try your best to help, and if you aren't comfortable helping, direct them to someone who can.

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Avatar_f_tn
Wow - thank you Dr. Hagan. It's 14 months since my cataract surgery and I still have flickering/shimmering and others can see it shimmer when the light hits my eye a certain way also. I have been told by a couple ophthalmolgists that my brain will get used to it and adjust. It has not. I am so happy to see you recommend an eye surgeon at CEI. I live in Cincinnati. Thank you so much!!
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Avatar_m_tn
The sad thing is no one is ever told that this strobe light effect is one possible side effect from cataract surgery.  So I don't say shame on you I say shame on the doctors and the manufacturers for not listing this at the top of a possible negative side effect from cataract surgery.  And, if you were like me you already knew people who had had cataract surgery with no complications and it never occurred to me that I would have to live with this for the rest of my life.  I have been 1 year 4 months since my first surgery and it is still a problem.  A specialist told me just ignore it and it will go away - will apparently he has never been subjected to a disco party all the time in his eye.
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Avatar_n_tn
Thanks for your contribution:  I live in Toronto and have an eye problem after corneal transplant, a good opthomologist is my next step. Would you mind giving me the name of the one you went to in T.O. and did he help
Thanks DonnaL Toronto
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Avatar_m_tn
After surgery, my wife complains of the image in her eyes not aligning properly. Also, the image of the post-op eye is tilted, as a painting that has been hung carelessly.  Any ideas or suggestions here?
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