after-images post cataract surgery

[WebDev]

I had cataract surgery on my right eye 5 weeks ago (have not yet had left eye done). Just over one week ago, after a day spent outdoors, I noticed an after-image in the center of my field of vision, a "burned in" spot just like what you might experience when looking at the sun or a bright light for too long. Just like after seeing a bright light, when I close my eyes, a negative image remains, a bright iridescent spot in the center of my vision; and when my eyes are open, the afterimage makes it hard to see, as everything is washed out, and because when I blink my vision is briefly interrupted by the negative afterimage I see with eyes closed. The after image moves with my gaze, so that it's always in the center of my vision.

Last week, I noticed that over the top of this afterimage, there are tiny, fast moving specks that I can best describe as something like TV snow, or maybe a swarm of tiny gnats (I've been asked numerous times whether I see floaters, and while I do have a few floaters, I would not call these floaters: they move much faster and are very small). These specks are not very bothersome compared to the afterimage they appear on top of. I see them whether my eyes are open or closed. I mentioned this to my ophthalmologist and he had me come in right away, concerned that I might have a retinal tear. On examination, he found no retinal detachment or tear, and said that instead I have posterior vitreous detachment (PVD), and he said the symptoms may subside.

I'm taking his word for it, but I keep suspecting I must have something else going on, as my understanding is that PVD symptoms consist primarily of flashes, not a constant afterimage. Searching online, I can't find anything that matches with my experience, so I'm reaching out here.

Has anyone had a similar experience? If so, please share. I'd like to know what's going on and would love for it to stop.

[Moonbeam1000]

I don’t know the answer but I developed the same symptom in my eye about 3 weeks after cataract surgery. My Dr did an Oct and said she sees no problem. She also said maybe it will go away with time. It seems to me no one knows the answer. I find this disturbing.

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

I would not be concerned 3 weeks post surgery if your surgeon is fine and OCT normal. Often these are 'dysphotopsia" or unwanted light images. Two varieties one seeing white/light like patterns usually gone by 3-4 months post surgery called Positive Dysphotopsia the ther seeing black area called Negative Dysphotopsia which takes much longer to go away and can be permanent

[JohnHaganMD]

The spot in the center suggests a macular problem and I suggest you ask the surgeon to do a macular OCT test to be sure you don't have cystoid macular edema or CSR.

[WebDev]

Thank you, Dr. Hagan. I visited my ophthalmologist today and he said that he suspects it's possibly due to the surgery and will go away in time. He said he doesn't suspect CME because, although there is an afterimage, the objects I see behind that image are in focus, that the central spot would likely be out of focus with a CME. I'm due to have some laser correction in about 8 weeks, and we planned to see if the issue remains when I visit in six weeks just prior to the laser surgery.

[JohnHaganMD]

I'm sure you have read about positive and negative dysphotopsia. However it usually is lateral and not in the central vision. Good luck