Blurring of vision one month after cataract surgery

[Barman92]

Hi,
I wonder if anyone can help me with this.
I had cataract surgery ony my right eye a little over 4 weeks ago.  I asked for an IOL that would give me good distance vision as I already wear reading glasses and enjoy birdwatching etc.
The surgery apparently went fine, but what now happens is that as soon as I get up in the morning, if I close my left eye I can see clearly to the horizon with the right eye, with no detectable blurring.  However by about 1 hour later, and for the rest of the day, the right eye is blurred at distances above about 10 feet.
My surgeon said (shortly after the operation) that as I am young (41) I may have a thick posterior capsule and I am seeing him tomorrow with a view to discussing a laser procedure on that.  What I don't understand though is why the sight deteriorates after I have been up for an hour or so - is it possible that the posterior capsule changes its dimensions with activity/increased blood pressure etc?

Any advice/help gratefully received.

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

Your capsule is no more thick in the morning than it is in the afternoon so its not likely that is the problem.

If your vision is clear with glasses you will likely need to wear glasses more often.

THE IOL power will not change during the day and should not be a cause. I think a second opinion would be helpful
JCHMD

[Barman92]

Many thanks for your prompt reply Dr Hagan.  I don't think my surgeon was suggesting that the capsule is opaque, just rather that it is thick - I had assumed that the thickness could cause some distortion of the image/interference with the focused rays.

I can see that if the cornea swells during sleep then this could mean that early in the day the focus will be different.  Assuming the capsule is not the culprit, do you know what I ought to be discussing with my surgeon/2nd opinion providers as to possible remedies?  I am finding the blurring to be uncomfortable and unsettling, not to say a little depressing.  If the changes are down to corneal swelling (and I appreciate you are not saying they are, just that they may be) does that suggest that we are talknig about small enough changes that my IOC is about right or does it mean that the measurements may have been substantially off?

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

An opaque capsule should not cause chaning visual blur. It is more likely that its due to changes in the cornea due to some slight swelling due to the eyelids being closed in sleep.

JCHMD