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Rings of light at night after IOL implantation
Two weeks back I have been treated for cataract with IOL implantation (not multifocal) in my right eye. Now my day vision is ok, but the night vision is disturbed with rings of light of different diameter when looking at one or more spot of light (like car lights or just a lamp). Is this related to the type or size of lens used? Is it going to persist?
I would need to have also my left eye be operated, but I am worried that the same problem can arise. What should I do?
I would need to have also my left eye be operated, but I am worried that the same problem can arise. What should I do?
What about those of us who have multifocal implanted lenses? It's been 6 months since my surgery (both eyes) and I am still plagued by the multiple - 4 or more - concentric rings around lights at night (or even during the day if bright enough). Is there a solution to this? Or do I just have to wait it out until my brain finally determines that it doesn't need to see them anymore?
3 Comments
hi
have you solved the problem with the rings?
No posting since 2015 I suppose you could leave a note on their home page
I know it has been a long time since your initial post...
The Concentric Ring Disphotopsia you are speaking of is very rare. The vast majority of Ophthalmologists will never encounter a case in their career. It is real. I have the same concentric rings. They originate from light sources in low lighting, but are not centered on the light source (like a halo would be). You can have them all over your field of vision at night, all snapping to larger and smaller sizes, all sourcing from a light point and all moving with every moving light source. Driving or watching an IMAX Movie is a psychedelic display that is all but overwhelming.
Mine started immediately after a fixed focal IOL was implanted.
There is some research on this, but not much. It is real though. After being a little dismissive, my Ophthalmologist noticed that I have very large pupils, even in daylight. He prescribed Pilocarpine Hydrochloride Opthalmic Solution 1%. It shrinks your pupils temporarily. It works perfectly! The concentric circles disappear completely!. It only lasts a few hours, but helps with night driving. After it wears off, the concentric rings return.
With time they tend to get reduced through neural adaption anyway. They are there without the solution, but not nearly as noticeable after a year.
Boyd
The Concentric Ring Disphotopsia you are speaking of is very rare. The vast majority of Ophthalmologists will never encounter a case in their career. It is real. I have the same concentric rings. They originate from light sources in low lighting, but are not centered on the light source (like a halo would be). You can have them all over your field of vision at night, all snapping to larger and smaller sizes, all sourcing from a light point and all moving with every moving light source. Driving or watching an IMAX Movie is a psychedelic display that is all but overwhelming.
Mine started immediately after a fixed focal IOL was implanted.
There is some research on this, but not much. It is real though. After being a little dismissive, my Ophthalmologist noticed that I have very large pupils, even in daylight. He prescribed Pilocarpine Hydrochloride Opthalmic Solution 1%. It shrinks your pupils temporarily. It works perfectly! The concentric circles disappear completely!. It only lasts a few hours, but helps with night driving. After it wears off, the concentric rings return.
With time they tend to get reduced through neural adaption anyway. They are there without the solution, but not nearly as noticeable after a year.
Boyd
2 Comments
hello, thanks for your suggestions! I have the same problems and asked the doctor for the drops, they are magical, excellent result (no circles for 20/24 hours). My surgeon suggested that I see circles because of my very irregular cornea. I'm not sure it is because of it though ... Do you have a normal cornea?
Dear Pupillo
Can you pls give me an update of your situation? I guess your implant is a monofocal lens, right? How is your vision now? Any glare, halos, light rings...etc
thanks
nichova
Can you pls give me an update of your situation? I guess your implant is a monofocal lens, right? How is your vision now? Any glare, halos, light rings...etc
thanks
nichova
I noticed that early morning after three weeks after surgery on 20/02/2011 the rings had disappeared but I noticed flickering in vision early in the morning two days after the disappearance of the rings . I will keep on monitoring, but I understand this will also pass, from other observers.
Rings of light in the morning after IOL implantation.
I had cataract surgery on 26/12/10 in my left eye with a valve correction for my glaucoma, pressure is around 17mm Hg as compared to 29mm Hg before surgery. A few days later I experienced these rings early in the morning when I looked at either energy saver or incandescent bulb. An hour and half the effect disappears for the whole day till next morning. Three weeks on the effect is same. The lens implant is an aurolab +19, (no technical info on this lens). I am not using my prescription glasses, I can read clearly, the screen, newspapers etc. Drive at night relatively better than before surgery. The three stitches have since been removed. My doctors says the IOL has nothing to do with the lens suspects cornea edema, whatever that means. Please assist.
I had cataract surgery on 26/12/10 in my left eye with a valve correction for my glaucoma, pressure is around 17mm Hg as compared to 29mm Hg before surgery. A few days later I experienced these rings early in the morning when I looked at either energy saver or incandescent bulb. An hour and half the effect disappears for the whole day till next morning. Three weeks on the effect is same. The lens implant is an aurolab +19, (no technical info on this lens). I am not using my prescription glasses, I can read clearly, the screen, newspapers etc. Drive at night relatively better than before surgery. The three stitches have since been removed. My doctors says the IOL has nothing to do with the lens suspects cornea edema, whatever that means. Please assist.
There is a good article on the web called "Demystifying Dysphotopsia".
It sounded to me when i read this article that rings were sometimes caused by spherical abberation.
If there is newer information (the article dates from 2005), a reference to it would be great.
It sounded to me when i read this article that rings were sometimes caused by spherical abberation.
If there is newer information (the article dates from 2005), a reference to it would be great.
Thanks to everybody for your comments.
In the last visit the doctor who operated put some drops in my right eye to dilate the pupil the most and he took a photograph of the eye. The lens margin can easily be seen in the bottom part which probably causes the problem at night, according to the doctor himself. In a way he admitted that the lens may not be perfectly positioned.
Can this be the only problem? In this case a different lens for the left eye is not required, but probably a different surgeon.
In the last visit the doctor who operated put some drops in my right eye to dilate the pupil the most and he took a photograph of the eye. The lens margin can easily be seen in the bottom part which probably causes the problem at night, according to the doctor himself. In a way he admitted that the lens may not be perfectly positioned.
Can this be the only problem? In this case a different lens for the left eye is not required, but probably a different surgeon.
It is my understanding that cataract surgery itself can create an unknown amount of spherical aberration. In this case, the type of pre-surgery measurement described above is total nonsense.
It wouldn't be difficult to design an experiment comparing the aspheric IOLs of different manufacturers. If one of these brands is clearly superior, then why do no such studies exist? (Hint: No manufacturer will fund and carry out a study which is likely to show that the IOLs of their competitors are just as good as their own.)
It wouldn't be difficult to design an experiment comparing the aspheric IOLs of different manufacturers. If one of these brands is clearly superior, then why do no such studies exist? (Hint: No manufacturer will fund and carry out a study which is likely to show that the IOLs of their competitors are just as good as their own.)
Seaching through the reams of pdf's I saved in my harddrive, I found the topography machines. The Carl Zeiss Meditec Humphrey Atlas, the Nidek-OPD scan and the Oculus Pentacam can do the cornea spherical aberration measurements.
“So, you can export your topography file to Dr. Sarver’s program and find out what the patient’s spherical aberration is,” says Dr. Holladay. “If it comes out to be +0.27 µm, then you know the Tecnis IOL with its -0.27 µm will be perfect. If it’s +0.15 µm, then the Alcon lens would be best. And, if it comes out to be zero, as might happen after a hyperopic LASIK, then the Bausch & Lomb lens would be the preferred option.”
This is the biggest issue I had in choosing a negative aberration lens. I had no idea what the positive aberration from my cornea was!
“So, you can export your topography file to Dr. Sarver’s program and find out what the patient’s spherical aberration is,” says Dr. Holladay. “If it comes out to be +0.27 µm, then you know the Tecnis IOL with its -0.27 µm will be perfect. If it’s +0.15 µm, then the Alcon lens would be best. And, if it comes out to be zero, as might happen after a hyperopic LASIK, then the Bausch & Lomb lens would be the preferred option.”
This is the biggest issue I had in choosing a negative aberration lens. I had no idea what the positive aberration from my cornea was!
The Raynor 620H IOL is not an aspheric IOL. I don't think that the arguments in favor of a negative aspheric IOL would apply in pupillo's case. (These arguments were used by Bausch & Lomb in an attempt to show that their IOLs were superior to those of their major competitors: the Tecnis and the AcrySof IQ.)
Pupillo, in your place I would definitely get a second (and perhaps a third) opinion about the bothersome rings of light. I would certainly choose a different IOL for my second eye, and perhaps a different surgeon.
Pupillo, in your place I would definitely get a second (and perhaps a third) opinion about the bothersome rings of light. I would certainly choose a different IOL for my second eye, and perhaps a different surgeon.
>... they are not exactly halos, but sharp, well defined concentric rings.
Please take what I say with a grain of salt because I am not a doctor.
(ie. I can steer you in a particular direction, but you need to do your own research)
From what you described, it looks like you have spherical aberation:
http://en.wikipedia.org/wiki/File:Spherical-aberration-disk.jpg
I forgot the name of the machine, but there is equipment out there that can measure the spherical aberration of your cornea. Since your IOL is spherical, there is an additive effect.
From what I understand, a one-piece lens has a higher incidence of tilting. Too much tilting is not good for negative-aspheric lenses. Excessive tilting produces coma-aberration. I don't think concentric circles comes from tilting, but your doctor knows best. If tilting is the problem then an aberration-neutral lens will allow for tilting without causing aberration. If tilting is not an issue, then go for a negative aspheric lens.
Please take what I say with a grain of salt because I am not a doctor.
(ie. I can steer you in a particular direction, but you need to do your own research)
From what you described, it looks like you have spherical aberation:
http://en.wikipedia.org/wiki/File:Spherical-aberration-disk.jpg
I forgot the name of the machine, but there is equipment out there that can measure the spherical aberration of your cornea. Since your IOL is spherical, there is an additive effect.
From what I understand, a one-piece lens has a higher incidence of tilting. Too much tilting is not good for negative-aspheric lenses. Excessive tilting produces coma-aberration. I don't think concentric circles comes from tilting, but your doctor knows best. If tilting is the problem then an aberration-neutral lens will allow for tilting without causing aberration. If tilting is not an issue, then go for a negative aspheric lens.
It is now 6 months since the operation and the problem of rings of light at night is still there, though less frequent than early days. My doctor's opinion is that it can be related to the position of the IOL lens which may not be 100% correct. He himself warns about the risks of a new operation to reposition it. The lens used is RAYNER Model 620H, power +17.5D, length 12.5 mm.
Now the question is: what to do with the other eye also affected by cataract? Would you use a different lens or would you opt for a different surgeon?
Now the question is: what to do with the other eye also affected by cataract? Would you use a different lens or would you opt for a different surgeon?
You might want to ask your doctor about LRI's to correct your astigmatism. They are an inexpensive, low-tech, surprisingly safe and effective procedure. I had LRI's done at the time my Crystalens HD's were implanted, and am very happy with the results.
I like that the blade stays away from your pupil area (so doesn't cause further glare) and that it is very forgiving, not requiring super-precise cuts. LRI recovery is much faster than PRK, and for me the idea of a Lasik flap is really icky.
Just make sure whoever does the LRI is an expert who has done a lot of them.
I like that the blade stays away from your pupil area (so doesn't cause further glare) and that it is very forgiving, not requiring super-precise cuts. LRI recovery is much faster than PRK, and for me the idea of a Lasik flap is really icky.
Just make sure whoever does the LRI is an expert who has done a lot of them.
Thanks to both of you. You were both right in a way. Yes my right eye is somehow astigmatic. Since the day after the operation until yesterday I have been using temporary glasses without astigmatism correction. Yesterday I was given the prespcription for new glasses with astigmatism correction and it is already better, though not disappeared yet.
No, that effect wasn't reported in the long list of potential problems I was given and asked to undersign before the operation. Even in the simulations seen on this site I couldn't find it, as they are not exactly halos, but sharp, well defined concentric rings.
Thanks again for your comments.
Maurizio
No, that effect wasn't reported in the long list of potential problems I was given and asked to undersign before the operation. Even in the simulations seen on this site I couldn't find it, as they are not exactly halos, but sharp, well defined concentric rings.
Thanks again for your comments.
Maurizio
MEDICAL PROFESSIONAL
It should get better, especially when you get your glasses.
Dr. O.
Dr. O.
Halos or rings around lights at night are not an unusual phenomenon after cataract surgery. It can be surprising if no one warned you in advance, however.
I can not remember a time when I did not see halos. In my case, astigmatism in both eyes appears to be responsible. Recently, I had cataract surgery in the left eye. The surgeon replaced my lens with a toric IOL. This substantially reduced the halos to a very moderate level in the corrected eye.
Sometimes a spherical IOL will produce a halo effect. An aspheric IOL may be a better choice. You can search the list for info about aspheric IOL's.
Ask your opthamologist (or surgeon) what kind of IOL you received. Ask if you have astigmatism. The astigmatism can be corrected with glasses, contact, surgery. If you don't have astigmatism, you may want to request an aspheric IOL for your left eye.
Will this phenomenon persist? I don't know. You are only two weeks post surgery and the eye is still healing. If they do persist, relax, give yourself a chance, you may be able to adapt and ignore the halos.
I can not remember a time when I did not see halos. In my case, astigmatism in both eyes appears to be responsible. Recently, I had cataract surgery in the left eye. The surgeon replaced my lens with a toric IOL. This substantially reduced the halos to a very moderate level in the corrected eye.
Sometimes a spherical IOL will produce a halo effect. An aspheric IOL may be a better choice. You can search the list for info about aspheric IOL's.
Ask your opthamologist (or surgeon) what kind of IOL you received. Ask if you have astigmatism. The astigmatism can be corrected with glasses, contact, surgery. If you don't have astigmatism, you may want to request an aspheric IOL for your left eye.
Will this phenomenon persist? I don't know. You are only two weeks post surgery and the eye is still healing. If they do persist, relax, give yourself a chance, you may be able to adapt and ignore the halos.
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