Recurring Eye Pain Following Cataract Surgery

[dwf123]

I had cataract surgery on my right eye 2 years ago without any side affects. I had my left eye done in February 2012 and have had nothing but problems. The doctor who did the surgery said the eye was swollen and put me on several rounds of steroid drops.When I stopped using the drops the pain returned. The doctor couldn't explain that and again wrote a prescription for the same drops. I then switched doctors (not a surgeon) and he put me on the strongest steroid eye drops available and the pain would go away but return. He also said the eye was swollen. I did 2 more rounds of the drops and after weening off slowly thought the pain had fixed. However, a week ago it came back and this time with a drooping left eye lid which interfers with my vision from time to time. I can't believe this eye is swollen again and wonder how long I can continue to use the steroid drops. I'm beginning to think the original doctor really messed up and either put in the wrong lens or damaged my eye and just won't admit an error on his part. Anyway, any suggestions you can offer would be greatly appreciated. It's been nearly 6 months of this pain.

[Christopher C Shen, MD]

Without knowing the details of the cataract surgery, it is difficult to pinpoint why your left eye has had a more rocky postoperative course.  Not all cataract surgeries are equal even in the same person as the nature of the cataract can vary from eye to eye or if there are any predisposing conditions present or encountered intraoperatively.  It sounds like the eye has had an intense inflammatory reaction following the surgery and steroids are required to help reduce the swelling and inflammation, but care must be taken to taper the steroids slow enough so as not to have the inflammation recur.  When you say that you switched doctors to a nonsurgeon, not sure if you mean you switched to an optometrist rather than an ophthalmologist, but given the relapsing nature of your postoperative inflammation, I would consider having your surgeon reevaluate your eye or to have a uveitis or retina specialist take a look to see if they can better manage your steroids to help resolve the inflammation.

[dwf123]

This is a follow up to my orignal post of recurring left eye pain following cataract surgery in February of 2012. I had my eye dr appt yesterday and my left eye was still a bit swollen so he prescribed Prednisolone OP 1% 4x a day for 7 days. He looked behind the eye and saw nothing irregular but he couldn't explain why my eyelid is suddenly drooping since I hadn't been on any steroid drops for almost 2 weeks. The left eyelid Ptosis is 3mm and left pupil is larger than the right. He sent me to the emergency room to rule out a mini stroke and the MRI on my head showed no evidence of a stroke but the hospital referred me to a neurologist but my appt isn't for another 4 weeks. Someone in the hospital told me that steroid drops can cause an eyelid to droop and the internet seems to concur. Since having the cataract surgery in February, I've been on at least 4 rounds of steroid drops. The first two rounds of Prednisolone  1% were prescribed by the opthalmologist who did the surgery and did nothing for the pain. I switched to an optometrist who prescribed the strongest steroid eye drops on the market (can't remember name) which I did for another 3-4 weeks weening off slowly. Which brings me to now. I am starting up again with the Prednisolone 1% every 4 hours for 7 days. My concern is that these drops will exacerbate the droopy lid and that long term damage could be done. My question is three-fold: Is it true that steroid drops can cause droopy lids, is it worthwhile for me to see a neurologist since the MRI cleared my head, or should I go to a new Ophthalmologist for an opinion and skip the neurologist?At this point I'm totally confused.