Pulsating/flashing eyeball after cataract surgery

[Charlie427]

10 months ago, I had cataract surgery in my right eye. As soon as they took off the bandage, my eye was "pulsating". It is not my eyelid but seems to be my eyeball going from light to dark in a pulsating sensation, mostly around bright lights. The pulsating cannot be seen by a eye surgeon. I cannot stay in a brightly lit store without sunglasses on. It usually gives me a headache. The cataract surgeon wanted to do the other eye right away but I said not until the pulsating goes away, it never did, but got 75% better over the last 10 months. I had to have the left eye done 10 days ago, and as soon as the doctor took off the bandage, the left eye is doing the same thing, now I have two eyes pulsating! It is driving me crazy, giving me (migraine?) headaches, and am sometimes dizzy from the pulsating. Both doctors never heard of this problem. Can someone please help me? Thank you.  

[Ray T Oyakawa, MD]

I have never hear this complaint.  Get a second opinion.

Dr. O.

[tsolanto]

I have the same thing.  Its been two weeks for my left eye and four for the right.  Bright lights particularly after rewetting drops are put in I get the rapid pulse.  I talked to my eye doc and he has never heard of this.  Don't know what to do but it make me nuts when it pulses.  Oddly it goes away when I wear sun glasses.

[SoftwareDeveloper]

If its due to bright lights then it makes sense it will go away with sunglasses. I am assuming that since you posted on this thread that you mean you are also post cataract surgery,  by 2 weeks in left and 4 in right?

One source of what they call dysphotopsia, an unwanted visual glitch to to an IOL, is reflection off the edge of the IOL which can potentially cause the issue you are mentioning (though its hard to be sure subjective descriptions of symptoms match). This article discusses it:

http://www.reviewofophthalmology.com/content/d/features/i/1320/c/25409/
"Scintillating vision. I believe this is caused by backscatter from the lens combined with microsaccades, which are a normal physiological occurrence. "

.It seems possible that if the reflection isn't very bright that your brain is tuning it out, and only in bright lighting is the reflection enough to be noticeable/bothersome. As that article mentions, over time the eye will heal around the  edge of the lens and cut down on reflections, while the brain also works to learn to tune them out. I would speculate that  if your brain is able to tune it out in less bright light that this is a good sign that once healing cuts down on the reflections further that it will tune them out entirely.

Newer IOLs are sometimes designed to try to minimize the issue (you might post what IOL you have, they usually give a wallet sized card for the implant with the model name. That would be useful also to know if its a multifocal lens perhaps which might be more prone to issues).

Your eye makes little movements constantly and  so the reflection might either move or go away and the brain is subjectively interpreting it as "flashing/pulsating". Is the issue more pronounced if you try to read in bright light, when your eye makes more movements?  

One issue that doesn't usually cause visual artifacts, but apparently can sometimes, is the iris jiggling after cataract surgery, iridodonesis (since the artificial lens can be smaller than the natural lens and the iris looses support).. Apparently some doctors have seen that cause visual  issues, but others haven't  seen that impact vision so they don't think to look for it or consider it. I managed to do a video using my phone of my iris jiggling that surgeons confirmed was out of the ordinary. In my case it appears the lens bag is likely moving as well since I have other issues, and not just in bright light.

[NoNo222]

I just had my second surgery, two weeks after the first. I also have the pulsations. My left eye which was my first, the sensation seems to be lessening.  I hope it goes away with time as it does drive you crazy.  My lens is a Toric single vision lens. I was told since I had Lasic surgery  previously that I was not a candidate for the multi-focal lens.

[JohnHaganMD]

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[jj2023]

I know that your post is from 2010 and that you are probably okay today. I had the same thing after cataract surgery. I visited my retinal surgeon who helped me years prior to my cataract surgery with retinal tears in both eyes. He checked me out and found an epiretinal membrane near my macula. It was very mild and he said that it didn't need treatment because my vision (other than the pulsating) was not affected. The pulsating gradually reduced as time passed. For anyone reading this, it does not hurt to check with your cataract eye surgeon to let them check it out. If the doctors says that it is not a problem, then trust your doctor. Don't research your problems on the internet. Go get a second opinion instead. God bless everyone that comes across this question in the future.

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

Thank you for sharing your experience

[lindabarber]

It's been well over a year since I had the surgery and while my eye does not really pulse. . .  I am seeing the edge of the lens and it 'flashes' is a better word for my problem off and on for long periods of time in certain light situations and drives me sort of nuts. If I put a bright light on the side table, I can sort of 'wash' the disturbance away but it is really irritating and when I went to ask the Dr., he really just acts as if he did nothing wrong (maybe he didn't except no one warned me how long something like this could last). He didn't offer to 'do' anything and I have a temper so I'm 5'10" and he is like 3 feet tall (kidding) so I introduced him to my husband, and the best medical malpractice attorney in East TN! (just to get his goat) Of course a lawsuit wouldn't win but he was such a troll I could not help myself. I'm going to a new Dr. in another town and see what he thinks is happening. I have not had the other eye done but probably 'need' to but I think I would go nuts if I had 2 eyes. Most people can wait longer for cataract surgery and noone told me how bad my close vision would be afterward. I have to wear bifocals to read now! IT''S A MONEY MAKING MACHINE SO THEY DON'T REALLY GO OVER VERY CLOSELY ALL THE THINGS THAT CAN HAPPEN! You do have a right to know all the possible complications and ramifications and whether you could put this off for a while. Sorry to all of you. If I get this fixed with new Dr., I'll report back what he did. Perhaps the lens is just too large and that is why I'm seeing the edge . . . more later.

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

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