I had cataract surgery ,I see the edges of the lens normal?

[srossmill]

I was told that I would see distance well and would need cheaters for close up.  That was ok with me. I've been wearing glasses for over 50 years.  When they did the first one I could see close up. The Dr. told me that it was because my eyes are so small that they have a hard time with the size.  Now I am no Dr. but that sounds like they are making excuses. Now after the second one that is correct and I see distance.  I see double when I hold my head a certain way during driving. Not Good!  Also I am seeing the edges of the lens in both eyes!  Dr. said that is not what I am seeing, well then what is it?  I also see my pulse in my eyes too..   Dr says give it time but I think he got the wrong lens in the one eye and then not the correct size in both because I don't think I should see the edges.

[JohnHaganMD]

Your best bet is likely to get an independent second opinion. How long has it been since your surgery? What is your glasses prescription and what is your vision with them on?

[radar7]

As for seeing the edge of your lens - I had this problem after cataract surgery six years ago and my surgeon too tried to pretend he didn't know what I was talking about.  It is called dysphotopsia a very disappointing result after cataract surgery.  I have just had my second eye done a week ago by a different surgeon and he was able to use a lens that has avoided this problem.  Hope you can find a solution to the problems you are facing.  Seeing the edge of the lens and loss of peripheral vision are the symptoms I still have six years post surgery.  Artificial lighting makes the symptoms worse.

[JohnHaganMD]

More than half patients experience some degree of dysphotopsia during recovery from cataract surgery. I've written and published on this. The type most likely to go away quickly is "positive" dysphotopsia where light colored lines seen usually superior, outer field of vision. My wife had this in both eyes.  It is usually gone in 3-6 weeks.  "Negative" dysphotopsia where dark lines/area seen takes much longer to go away. there is no complete agreement on what causes dypshotopsia, and no IOL that NEVER has it.  Dr. Sam Masket of Los Angeles has written on this a great deal.   Symptoms 6 years later would likely require either IOL exchange, laser treatment to capsule, or amputating the nasal optic.;

[radar7]

Thank you for your reply.  Having had such a good result from the second cataract surgery, done last week, I am even more aware of what an uncomfortable condition negative dysphotopsia is.  Will speak to the surgeon I am presently seeing for my post op consultation if there is anything he could suggest to fix the problem.  Thanks again.

[JohnHaganMD]

Sure, best of luck.

[radar7]

Just to give an update - saw my surgeon yesterday and asked him about fixing the negative dysphotopsia.  He suggested I wait until I get my new reading glasses in a months time to see how I feel about it then.  Seeing Dr.Masket or you is unfortunately not an option for me as I live on the other side of the world from you!!

[JohnHaganMD]

Your post stays you live in Melbourne Australia.  I have made some inquires with my co-worker John Doane MD, one of the foremost eye surgeons in the United States. He says the surgeon to consult in Melbourne Australia is:  Noel Alpins, MD.     You can ask your 'second surgeon' about his/her opinion for getting second opinion on the eye with the negative dysphotopsia. Hope this helps.

[radar7]

Thanks

[JohnHaganMD]

Dr. Doane says if you have any trouble scheduling just you are being referred by him, he knows Dr. Alpins from international meetings.  

[radar7]

Thanks very much to Dr.Doane and you for your help.  Much appreciated.

[JohnHaganMD]

Best of luck. Glad second eye is going well. Merry Christmas and a better New Year.

[radar7]

Thanks  - Merry Christmas and Happy New Year to you too.

[JohnHaganMD]

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[Badonthebones]

I also have this after my cataract surgery.  Both eyes like have a spasm effect when I am in sunlight or florescent light.  It feels like my lenses are moving across my eyes when I look to the side.   My surgeon has brushed it off and the other doctor said I am seeing the edges of the lens and my brain will have to get used to it and it will be better.  Well my brain never got used to the PVD flashes and floaters 5 months ago.  None of the people I know ever had any problem with "seeing the edges of their lens.  I am so happy to be able to see clearly but this is really bothersome and slightly nauseating as my vision keeps shifting all over the place and as a photographer it as really messed me up for outdoor shooting.  Did yours ever get better and how do you get a straight answer from your doctor.

[JohnHaganMD]

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[radar7]

Hi Badonthebones - I never got better and never got a straight answer.  This is why I went to a different surgeon for my second cataract operation and cannot be happier with the result.  My brain certainly has not adjusted to ND and probably never will.  The other eye is perfect - same brain - different surgeon.  He looked into the problem and found me a lens that avoided all of the problems I have in my left eye.  I hope you can find an ophthalmologist who can help you specially as this is affecting your professional life as well.  Best of luck.  

[JohnHaganMD]

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[Badonthebones]

Thanks for getting back to me.   This shimmy is so annoying and being dismissed as it is all in my head ticks me off.   No one else I know has had this happen except you.  I see the other doc in a week and I am going to demand some answers.   I went on a photo shoot the other day and it was a nightmare being out in the bright sunlight without my sunglasses trying to see my camera settings and shimmy all over.  I was sick to my stomach by the end of it.  I  am on medicare with a supplemental so I think they will cover me to see another doctor.

[JohnHaganMD]

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[radar7]

Hi Badonthebones - have you been able to see another doctor and get any help for your problem.  This problem may not be as rear as just you and me and a few others as if that were the case why would doctors like Samuel Masket be doing research to fix it. Just thought I'd ask how you are, in case any solutions have been suggested to you and you might like to share them.  

[JohnHaganMD]

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[JohnHaganMD]

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[Badonthebones]

No, I asked again and they said I just had to give it time for my brain to adjust.  It hasn't.   Being under florescent lights is the worse.   I asked about going to see another Dr at the university but they kind of brushed that off also and just keep telling me it is normal.  Then why am I the only one of the people I know that have this issue.

[JohnHaganMD]

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[radar7]

Thanks for your reply. This is not normal.  I have one eye with an excellent outcome after cataract surgery and the first one has negative dysphotopsia.  The difference is huge.  Brushing patients off, I suspect, is what some doctors do when they don't want to admit to a bad outcome after surgery - specially when there is no tried and tested solution for the problem.  Very disappointing.

[JohnHaganMD]

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[nulife65]

I don't have an answer but I said the same thing to my dr. he told me it was the edges of the lens I see. I have also been thru 4 pairs of glasses and 5 prescriptions already for my new glasses. I can't seem to get a pair that I can actually use properly. I have no clue what is going and they are either just blowing me off and don't care or something. now they are suggesting a nuro optomologist. so I am wondering what they did wrong. I have never heard of this. going on 8 months now and I can't find glasses to work. any ideas. all I know is the headaches suck. Been to 3 eye drs now too. and I got a second opinion on the surgery. I am at my wits end with this.

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

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