Problems with eye surgery and doctor's refusal to accept responsibility

[HawaiiPatient]

I had cataract in my left eye that led to surgery on 9/30/20 from an ophthalmologist in my town. The office was friendly and accommodating before surgery and they drove a hard sell on a PanOptix multifocal lens. They assured me that I would no longer need glasses and the only problems I may have are difficulties seeing very close up. I paid them $3200 cash and scheduled the surgery using laser technology. I went in for my surgery, was sedated, and right before my turn the laser machine broke down, the doctor's wife (the optometrist in the facility) came in frazzled and nervously assured me everything was going to be ok. I was sedated so I let them take me in where the doctor performed the surgery by hand. It took around 10-20 minutes. I was wheeled back to the waiting stall where staff hurriedly sat me up and took me to the front desk where I paid a co-pay and then was evaluated by the facility's optometrist. She inspected my eye closely and said “yep, there’s debris” as if she was upset or irritated, and then she said the laser can fix it if it doesn’t go away.

From Day 1 I had increasing blurred vision and could no longer see distance (I could see distance fine before surgery, I only needed reading glasses). I now needed glasses for distance and reading. Everything was double vision and it was like looking through water. I called the doctor with my concerns and was seen by the Optometrist (doctor’s wife). She negated all my concerns and said I need to wait to see if my brain adjusts to it. When asked why I was seeing double, she said I was not and held her fist in front of my face and asked if I was seeing double. When I said everything was blurry, she said I was fine. When asked if the prescription could be off she said the prescription was correct. She gave me an explanation about possibly needing to scrape the lens, but that could lead to rupture and bigger problems. She did nothing to answer my concerns and I left more worried than when I entered.

I called my usual Optometrist for help and she said I needed to see the doctor that performed my surgery. She followed up and called the doctor and left them messages to contact me. They called me the next day, irritated that my other doctor had called them at home, and said I needed to wait. I told them it was getting worse and that I wanted to see the ophthalmologist who performed surgery on my eye. She (doctor's wife and the Optometrist) said they don't operate that way and that she handles all prescriptions and post op. She yelled at me and told me I was insulting her. She said I was a non-adapt and that she "wasn't getting through" to me. I told her that her explanations and refusal to acknowledge my concerns were scaring me. I urged her to let me see the doctor. She refused and said she would set me up with a second opinion from another doctor in town. I went in to the other ophthalmologist for a second opinion and he said he could see nothing wrong with my eye and that the doctor did a good job. He urged me to go back to the original ophthalmologist and that if I wouldn't then he could send me off island to another expert who could correct any problems.

One week later (yesterday) I experienced dizziness and soon had a black speck just left of upper center in my eye that is still there and constant. I also experienced bright quick sudden flashes right before bed in a dark unlighted room. The blurriness is still there but it seems less watery. I read that I could have a retinal tear and to seek immediate help. I immediately called the original ophthalmologist and they had their office call me back later in the day saying I needed to either go see my original optometrist or the other ophthalmologist. They said "It was the patient's choice to establish care with another ophthalmologist so she can see him for her other concerns as well". I have an appointment with the other ophthalmologist tomorrow but he has already been clear that he can't really help me.

I’m at wit’s end and I’m afraid. I’m looking for professional and personal opinion on this situation.

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

Make your own copies of your records.   $30 for 9 pages is outrageous.  As I understand it the 'prospective' ophthalmologist  in  Oahu never examined you just looked at your records.  I will check with some of my colleagues here in the United States mainland and see if there is any ophthalmologist in Hawaii that specializes in post cataract surgery complications. Hope to let you know soon. It would be a lot easier and less expensive than flying to the mainland.

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

This is what my colleague, John Doane, MD an internationally known eye surgeon in our Kansas City practice says he would suggest"  Alan Faulkner, MD.  Probably the busiest eye doc in Hawaii.  Great guy.  Personal friend.  Great person. "   LINK TO HIS PRACTICE:   https://www.alohalaservision.com/eye-doctors/lasik-surgeon-alan-faulkner-md/    

[HawaiiPatient]

Thank you, Dr. Hagan. I appreciate you taking the time to help me find a good reference. I am seeing my new doctor tomorrow so I will ask for a referral to Dr. Faulkner.

I just read my records and they (Hawaii Vision Specialists) made me out to look like a dishonest and mentally unstable problem patient. They have completely discredited my reputation as a patient so every doctor who reviews my records will surely not want to help me.  Patients who are portrayed as problem patients are blackballed, so I'm not sure how to overcome this.

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

That is not how it is in most offices, our office gives special consideration and care to people with complications, discomfort or who are frustrated or displeased with their results.  I have no reluctance saying some doctors are jerks, not compassionate and a lesser number dishonest.

[HawaiiPatient]

My doctor is trying to get me in to see Dr. Faulkner, so hopefully it'll all work out.

He also suggested one of the issues may be the rings in the lens. Could that be what is making me always feel "off"? I also want to mention that I am getting what I call "robot eye" where I can feel a fluttering and then see a weird reflection in the eye (like a cat eye in the light), which obviously the lens. Is there a way to upload a video so I can show you? Is this normal? So far none of my doctors have noticed it.

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

The reflection other people see in your eye and you can see looking in the mirror is common with any IOL, more common with mutifocal IOLs and acrylic IOLs.   It is okay for your doctor to use Dr. John Doane's name as a referring doctor when trying to make the appointment.

[HawaiiPatient]

Thank you

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

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[HawaiiPatient]

Update:
I traveled to Dr. Faulkner’s office on Oahu earlier this month. His office is a complete contrast to the other practice in Hilo. Everyone had aloha and was very supportive. They believed me and didn’t make me feel like a nuisance. They confirmed the prescription lens they gave me was way off and gave me 20/60 vision. They were baffled I was never offered lasik as a remedy. Well, lasik worked! I can now see distance and there are no side affects besides a temporarily sore eye from the procedure. My vision is now nearly perfect except for the vitreous detachment which feels like a disruptive cataract because the “speck” now has a fuzzy veil around it. I am curious if this has anything to do with the first surgery, because it happened shortly afterwards. I understand to remove it is a complicated and intrusive procedure, and it may go away on its own anyway.

Anyway, I stayed for a week and also had cataract surgery along with the same Panoptic IOL (but with corrected vision) in my other eye. From Day 1 I have had no problems whatsoever. No blurriness. No weird vision. No imbalance. Nothing like when I had the first one done at the Hilo practice. It is night and day.

I am so grateful to you, Dr. Hagan, for your support. You were the only doctor who believed me and offered remedy. Thank you also for your recommendation of Dr Faulkner and referral from your colleague Dr Doane. Dr. Faulkner and his team are the real thing. They know what they are doing and they truly value their patients. Not to mention, the cost of the lens was $1000 less, which is crazy.  I am so so happy and relieved!

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

Thank you so much for taking the time to update your situation.   Your treatment from your previous ophthalmologists makes me ashamed that they are even in my profession. I will pass on to Dr. Doane your satisfaction with the referral to Dr. Faulkner's office. The floater is likely not related at all to any of your surgeries.  Floaters are very common at every age, after age 50 more than half have and by age 70 more than 3 out of 4 have. Sometimes after cataract surgery because the person is seeing better they see things like floaters, gray hair and wrinkles that they couldn't see before. Well done!  

[HawaiiPatient]

My new ophthalmologist referred me to a doctor on Oahu. They asked for medical records from the original doctor (Hawaii Vision Specialists in Hilo) so I called them and asked them to fax over my records to the doctor on Oahu. They said they were happy to release me and said I needed to come in to sign a release. I did, and when asked if they will hold on to my records they would not give me a definitive answer so I asked for the records to be released to me because I didn't want to risk them disappearing. They said it will take at least a day to print them all out and charged me $30 (for 9 pages). The entire office treated me with contempt, and they were so nice before surgery. They obviously don't like to deal with problems. Instead it's my problem, and I am completely lost. The prospective ophthalmologist on Oahu called me this morning to tell me they couldn't help me. So now I am stuck. I am near-sighted in my left eye along with an annoying speck and ongoing slight double-vision (that everyone has disregarded thus far) interfering, and the cataract in my right eye has increased in cloudiness, so I am constantly off balance and frustrated. I called Alcon and they said they will change the lens "if that is what my doctor recommends", but now I have no doctor who can do so. I don't know what to do. Should I just have the trifocal IOL removed and replaced with a standard monofocal (IF I can even find a doctor who is willing)? If so, what will my vision be? What about my right eye with the rapidly worsening cataract? Before surgery I was far-sighted and only needed glasses for reading. Now I am near-sighted but still need glasses for most reading AND I need glasses for driving. I just want to see again. I wish the original doctor kept their promise and corrected my vision. Instead I am worse off than I was before surgery.

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

Please consider this an EMERGENCY.  If you were treated as described you have been poorly served by your surgeon and his optometrist wife. I would make arrangements immediately to  travel to an island that has a retina surgeon. Call them by phone,  tell them you had complicated cataract surgery and have had flashes of light in your eye and a permanent peripheral vision defect. Retina surgeons will usually consider this a same day emergency.  I do not know anything about the ophthalmology services in  Hawaii but when I use internet search engine and look for retina surgeons in Honolulu there are quite a few. PLEASE CONSIDER THIS AN EMERGENCY AND EITHER PLACE CALLS AS SOON AS POSSIBLE.  I strongly suspect you have a problem and that you need to get off your island to another larger, better equipped eye clinic.

[HawaiiPatient]

Thank you, Dr. Hagan. The original ophthalmologist changed their minds and I was able to see him this morning. He dilated my eyes and ran tests and concluded it is a posterior vitreous detachment. He said it is normal and to wait it out to see if it goes away on its own. He said it had nothing to do with surgery. He noted I can see better now with my new lens. When asked why I am still seeing a shadowed double he offered no opinion.
I already have an appointment with the 2nd ophthalmologist later today because he will most likely be referring me off island for cataract surgery on my other eye. Because my original doctor has refused to see me until now I do not fully trust his opinion so I will ask this doctor #2 for a second opinion today.

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

I'm glad you do not have a RD but I'm not sure I would trust the opinion of the original ophthalmologist.  He and his wife sound like jerks and that type of behavior reflects poorly on them and saddens me as a physician. Please post what the 2nd ophthalmologist said, hopefully he/she dilated your eye and looked at the retina.  A PVD does not usually cause a persistent dark shadow.   A RD must be ruled out. Another possibility is "temporal darkness" or "negative dysphotopsia" please do search and read about those. There also is 'positive dysphotopsia" which is much more common and much more likely to go away.  I would get off island for further care. In small communities and small islands often the doctors are never critical of one another and a good 2nd opinion is hard to find.

[HawaiiPatient]

Although the doctor himself was pleasant with me this morning, I agree that as a team they are jerks and it is in my best interest to not return to them. I met with the other ophthalmologist this afternoon and he dilated my eye and said he didn't see any problems with my retina. He came to the conclusion that it should go away on its own. I will see him again in a month, but I will call immediately if it gets worse. Hopefully it is positive dysphotopsia and it will go away on its own. He was very supportive this time around, apologized for the other doctors, and encouraged me to be sent to a more qualified doctor on Oahu (I am on the Big Island) for further surgeries. He had called Alcon prior to our appointment and said they are very willing to make things right and give me the right lens if this one doesn't adjust. The other doctor team both said that wasn't an option, that the tests were indisputable, and the only other option was to remove it and put in a monofocal lens. They were wrong, thank goodness.  What a nightmare this has been. Thank you, Dr. Hagan, for your help.

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

Best of luck. Hope everything turns out well for you. If I can be of help, post again. If all turns out well, please consider coming back and sharing your experience on this forum.