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Post cataract surgery double vision or ghosting

I had a Crystalens HD installed in my right eye 8 days ago due to a single eye cataract.  My left eye is fine. From the start I could see horrible glare at night. It looked like gradients of lights.  I realized today that what I was seeing at night was really a stack of ghost images. I see 2 - 3 double images above the orginal, and at least1 below. The 1st double image above is the most clear of all of them, and the next on top of it is a lighter image, etc.. The bottom ghost is very light in contrast and not as easily recognizable. They are all involved with lighted objects against a dark background such as headlight, tailights, street lights, traffic signals etc. At the top and bottom of the stack I see a rainbow like you'd see from a prism.

My doctor looked at the lens today through a slit lamp and says it's perfect with it's placement and free of imperfections. Has anyone heard of any defects with these Crystalens HD's that could be causing this stacking/prism issue? What causes a vertical double imaging problem?  I think it has something to do with the bottom edge of the lens.I did an experiment. When I bring a piece of paper up from the bottom of my eye (holding the paper right in front of my eye) to go under my vision path the ghosting goes away. The ghosting stays when I bring it down from the top.  
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233488 tn?1310693103
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Avatar universal
It appears that the double vision problem was fixed yesterday through laser surgery. Strands of vitreous were holding my iris open at the bottom and causing my pupil to be sort of heart shaped -- at least the bottom of a heart. I'm not sure of the technical name of the condition, but vitreous had leaked from around my eye muscles towards the front of my eye. It did not leak into the lens capsule. Once the strands were cut, they retracted and my pupil became round and the aberrations went away. The results were immediate.  I do have a big floater left over from the surgery that I hope goes away, somehow.

The problems I had were absolutely horrible at night, and all were gone last night. Putting pupil constricting drops were part of the treatment after surgery, so I'm anxious about seeing the results tonight that are not drug enhanced. I had a slight halo around some lights, but I also had an eye full of clear gel yesterday during the surgery that may have had some residual effect. Compared to what I had before, the halo is nothing.

I think the vitreous was also causing eye pain as my eye feels better today. I have very good near and intermediate vision. The distance is still not back to 20/20 yet, but it is getting better as time goes on.  Using both eyes, I have very good near and far vision. My left eye still has 20/15 distance and needs a reader lens. I'm using a 150 reading glasses with the right lens popped out and see great.

The negative dysphotopsia symptoms and flickering seem to have gone away. I'll try to find out the technical names for the conditions and treatments that I had yesterday. The surgery was done with a YAG laser set to low power.

I'm feeling very encouraged about this lens today. My vision is not the same as when I was 18, but it's much improved. It's probably back to when I was in my early forties. I can read all of the small print all over my car's dashboard and steering wheel at night without glasses. On the 22nd, I'll be one month out. If the treated eye (right) gets to 20/20 distance vision in the next month, or so, I'll be thrilled.
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2 Comments
Can you please provide your surgeons contact details. I’m having the exact issue after cataract surgery but don’t know what’s causing it. I will have my 1month check up soon and will inform my surgeon about my symptoms. He doesn’t seem very receptive unfortunately.
That post was from 2009 and the poster has not been on the website since then. I would suggest you start a new post including your problems, I will respond and you are more likely to hear from others with this problem.   JHagan MD
Avatar universal
If you think you might have this lens removed, you shouldn't get a YAG procedure, as that will make the explantation much more difficult. On the other hand, you might be told that a YAG could possibly improve your vision enough to be happy with the lens. So you may face a tough choice. Hopefully not.

Definitely get a second opinion before going with the YAG, and at least a third opinion before explanting.
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233488 tn?1310693103
MEDICAL PROFESSIONAL
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Avatar universal
Hi,

I might have a very slight touch of negative dysphotopsia in dim light.  I notice the dark edge for the first time while in my walk in closet last night. But, I don't see it in day light.

I'm obviously obsessing over the night glare issue and my doctor knows that. My doctor is not too thrilled with my obsessive behavior regarding this lens and surgery. But, I think my doctor helped put me into this mode by flip flopping back and forth between a Crystal lens HD and a Technis Multifocal. Of course, without the night glare I would have never been on this site.

I've convinced myself that I need one of 2 things to happen. The bottom edge of my pupil somehow needs to go up or the lens needs to be repositioned down. If either happens I think, I'll be good.

My doctor did mention that some viterous material was in my lens bag, and it may need to be lasered. So now I'm wondering how that got in there? The more I read, the more I think that there might be a hole in my bag. I know just enough to be dangerous, but if there is a hole in my bag, I'm wondering if that will impact my distance vision?  I think I'm just a few thousands of an inch away from being pretty happy.

But, If the night vision glare problem isn't fixed, it's coming out!
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233488 tn?1310693103
MEDICAL PROFESSIONAL
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Avatar universal
Hi,

I have some light phenomenon too, but more from the edges of the lens (very little glare at night).

My be you have negative dysphotopsia as well. I am trying to find out who else is effected with Christalens HD. They say this should not happen with Christalens.

Take a read at this thread: http://www.medhelp.org/posts/Eye-Care/Negative-Dysphotopsia-with-Crystalens-HD/show/928766
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233488 tn?1310693103
MEDICAL PROFESSIONAL
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Avatar universal
Thanks for the additional info. I'm cautiously optimistic about this HD lens. During day light hours I have a pretty good mono vision thing going. My left eye is  20/15 for distance but takes about a 1.50 reader for close up. My right eye is doing pretty well on reading. I'm 56 years old and hope to last a good while longer.

Without being too redundant .... at night, I might as well be on LSD.  Actually, LSD, Meth, and heroin - combined. It's unbelievable what I see off of every source of light. It blows my mind that I can turn it off and on now at will by blocking a narrow channel of my vision.  I'm grounded at night for safety reasons, but I was out experimenting with my vision while driving around at 2 AM this morning. It's not too bad when I shut off the glare!

I'm curious how much variation in roundness exist in people's pupils. I'm hoping there's not a deformity in the bottom arc of mine.

I'll keep this thread informed as things progress or decline. I'm thrilled to find this source of information. Only wish I would have found it prior to getting the surgery.  
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Avatar universal
As an HD owner, I can say that it took weeks (months) to find out what my final vision is (will be).

Different doctors use different medications. Find out from your doctor whether or not you should start practicing eye exercises yet. In some cases, it could be dangerous, while in other cases it is pointless to try to start early because the eye is still paralyzed.

Good luck, and please report back whether things improve or not.
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233488 tn?1310693103
MEDICAL PROFESSIONAL
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Avatar universal
My eye had very minor astigmatism before surgery that my doctor thought would correct with the cataract removal. My cornea doesn't have any (I think).  Yesterday, they saw a very slight amount of astigmatism. I had 3 stitches removed from my eye yesterday.

I sent my doctor a message regarding the paper/light blocking experiment last night. I haven't heard back from the doctor. Yesterday, my doctor told me to be patient, and let my eye recover for a few more weeks after yesterday's stitches removal.  

Actually, since I can eliminate the distortion by blocking the light reaching the bottom edge of my vision path. I'm hopeful that the problem is very solvable -- somehow.

I've heard there are some eye exercises  that can be done to improve distance vision. I have good near and intermediate vision, but blurry distance. Do you know of any exercises? Perhaps the bottom edge aberration problem may also be affecting my day time distance vision.
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Avatar universal
Did your doctor have any ideas?

Do you have any residual astigmatism? Did you discuss astigmatism before the procedure? Do you have stitches in your eyes?
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