Post cataract light flashes

[Granbynw]

At one week post cataract exam I complained about light flashes.  OD double checked for signs of retinal detachment and gave an all clear.  Since exam light flashes have increased.  Does this increase over rule exam?  Worried about the need for retinal detachment because time is of the essence!
Chuck

[Granbynw]

I have glaucoma and the spike was following cataract surgery.  Surgeon told me surgery went well.  I have been seeing an 0.D. Who works in the same office and consults with the surgeons who were very concerned about the 46 reading and made the comment that high of a reading could snuff out your eyesight.  I do not know if I am a steroid responder.

Just very concerned that an already cupped optic nerve is being further damaged by high IOP.

[JohnHaganMD]

Okay this is what I would consider. You have a very very serious problem and a complicated post operative course. that is not the type of thing an Eye MD should farm out to an optometrist. In our office the surgeon would be managing this problem NOT the optometrist. I would insist that the surgeon do all the post operative care and manipulation of the meds until IOP back to a safe level.  

[Granbynw]

First off, thank you for the professional help that you provide.  Had retinal exam in both eyes that looked clean and a diagnosis of IOL reflection in the cataract surgery eye.  I asked doc if these light shimmers would be anew normal for which he replied, "yes".  My post surgery IOP spiked all the way up to 46 and is now down to 26 which is still too high.  While continuing drops to bring this down further, how much damage is happening to an already cupped optic nerve from glaucoma?

One more question:  What are the percentages of IOP increasing after YAG?

[JohnHaganMD]

Are you talking about IOP spiking post cataract surgery? Or Yag capsulotomy? Do you have glaucoma? Was the surgery complicated? Why does your surgeon think you have that high of IOP? Are you a steroid responder?  There is no way to predict how glaucoma will progress in a situation like this.   It is very rare for IOP to increase post Yag since certain meds like iopidine and other medications like Alphagan P or Azopt are used. However given your history you would be at increased risk and the IOP should be checked 1 hour post treatment and 1 day post treatment.

[Granbynw]

My other eye is also experiencing a very few light flashes that I think are a result of YAG that was performed in June.  Have Appointment tomorrow morning with plenty of questions.

Thanks

[JohnHaganMD]

There is no "one week window" for repairing RD.  If the retina is truly detached but the "macula is on" then it is an emergency and the surgery is done ASAP, if the macula is "pullled off" then its not an emergency and it can be scheduled conveniently. Also some people have RDs for year and years and they do not extend or spread to the rest of the eye and macula.

[Granbynw]

Will your retinal tear require surgery?  I have read that there is only a one week window of opportunity to correct retinal detachment, so in lies the worry.
Have an appointment tomorrow morning.

Thanks

[chazas]

I would go in again if it worries you.  My cataract surgery was closely followed by posterior vitreous detachment, which caused a retinal tear, and 6 weeks out from cataract surgery I'm visiting my retinal doc at least weekly for the time being.  I had some minor flashes that I thought were edge reflections from the IOL, but turned out not.  Better safe than sorry.

[JohnHaganMD]

You will need to discuss this with your surgeon. It's possible the flashes may not be from the retina but from the IOL.