Aniseikonia after cataract surgery?

[Beastof57]

I am a 54-year old diabetic with diabetic retinopathy. I have been severely nearsighed all my life, and recently presbyopia. I recently had cataracts surgery in both eyes with Toric lenses to correct astigmatism. The vision in each eye is greatly improved, but they do not work well together. I seeem to be experiencing aniseikonia and diplopia.

Is this a result of a dislocated intraocular lens or something else?

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

It's always a mixed blessing when a physician suspects a disease and tests prove him/her correct. No I think your ophthalmologist is the best to advise you.

Remember to take meticulous control of your diabetes. Keep you A1c at 6 or less, keep blood pressure, weight, cholesterol and exercise maximilized.

JCH MD

[Beastof57]

Bullseye, doctor!

As it happens, I saw my retina doctor yesterday. We performed a macular OCT and also fluorescein angiography (and I am one of the unlucky few who get nauseous from the dye). These images confirm the macular edema in my right eye is causing the image differences in vision between my eyes. He is going to re-evaluate me in two months and then consider treatment options. We've done a lot of laser in both eyes already.

Any comments are welcome.

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

Good luck and if you have time post the results of these retina/macula tests.
JCH MD

[Beastof57]

Thank you again!

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

If you are -2.50 in each eye you do not have aneisometrophia (unequal refractive error) or aneisoconia (unequal image size). Nor do your symptoms suggest IOL problems.

This sounds like a macular problem. You are diabetic, you may have diabetic cystoid macular edema or IOL/cataract caused macular edema or both.

My suggestion would be to see a retina specialist have have a macular OCT. Your cataract surgeon will likely be more than happy to refer you.

Take action.

JCH MD

[Beastof57]

A follow-up question...

I had my left eye done October 16 2011 and my right eye done December 6 2011.

What is an appropriate length of time to wait to see if my aniseikonia clears up?

Thanks.

[Beastof57]

My vision was corrected by the Toric lenses for nearsighted vision, I believe to minus 2.5 diopters. My reading vision is 20/20 in each eye, but together, it's rough. Letters seem to disappear in words. Just now, the last letter in the previous sentence looked like "wrds".

Please forgive me if am saying any of this wrong.

[Beastof57]

Thanks!

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

There are many possible causes. Use the search feature and read the posts about aneisometrophia and aneisokonia by JodieJ.

Get a second opinion.

It would be helpful to know your post operative refraction and vision in each eye.  Please post.

JCH MD