double vision after cataract surgery

[aurelea]

I have had both eyes 'done'. After the second one (left) I noticed my vision was 'garbled'. I was told there was NOTHING WRONG WITH MY EYES!. Once again, they showed me the "E" chart and once again I can read it just fine with one eye or the other but not with both. It is causing me to be unbalanced when walking. Now I have to wear glasses with a prism, I think - the reason for having the surgery in the first place was so I did not have to wear them. I am being sent to opthalneurogolistsand have had MRI, Now, the eye drs.have changed their minds and tell me  "Yes" your  eyes are not aligned correctly. (of course, I know that). Right after the surgery I was aware of a 'fluttering' . It seemed, around my right lens. As though it was not glued down correctly. I am ignorant of the technical language. and procedure.But that's how I describe it to myself . I am also very sensitive to light. and my right eyelid droops slightly where it didnt before surgery. .Is there anything to be done to correct this?
Tomorrow I go back to the original operating surgeon .

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

If glasses make your vision perfect then you have no problem except wearing glasses. Most people do have astigmatism, if not in their glasses then on their cornea, but cataract surgery can induce some astigmatism.  It is not likely phototoxicity at all because modern microscope have filters and the procedure generally lasts less than 15-20 minutes. Phototoxicity was more of a problem with old microscopes without filters and procedures that lasted hours.

If glasses don't take care of the problem get a a second opinion consult from another eye surgeon.Find one near you at www.aao.org

JCH MD

[homecrafter]

I have no idea if this would even be a factor, perhaps one of the Drs. here can verify or dismiss...but I have been reading about cataract surgery sometimes causing Phototoxicity of the retina from the light used during surgery.  Do your OCT scans show any photoreceptor cell damage or "interruptions" ?

The surgeons may not even consider this as a possibility because it would be like admitting they did something wrong...just saying.

[bfl7845]

I had surgery to remove cataracts with ocular implants in March.  I have had blurred and double vision since.  In June I had YAG treatment and still have blurring and multiple images.  The blur is from astigmatism (I did not have that before the cataract removal) and I was told that glasses will help that.  My depth perception is also off making very hard to do my job (IV team specialist).The eye surgeon says he is complete with all treatment and refered me to an opthamologist.  Can eye glasses really correct the multiple images?

[dina257]

Thank you so much for your reply, Dr. Hagan.!

1. I will allow some time before getting eyeglasses with the prism or getting a new refraction. Incidentally, during the refraction, I was told by the optometrist who works at my doctor's office that since the images did fused to single with the prism, the double vision is not caused by the Crystalens  but is due to the misalignment (wandering eye). Do you agree with her assessment?  I am 67 years old and have never had double vision in my life and have had no physical evidence of outright strabismus. The dx of wandering eye was picked up during the pre-op exam by the optometrist. I have not had my prescription glasses filled yet and therefore, don't know whether or not they will work to alleviate the double vision.

2. Are you suggesting vision therapy exercise? What are the chances that this will successfully treat my double vision in lieu of the prism? Does that mean that there is little chance for my brain to adjust naturally and take care of the double vision? Is there any downside if I don't do the exercise and just wait?

FYI, except for the development of slight diplopia, I am not totally unhappy with the result.  I had the Crystalens AT implanted (17 diopter on 1st eye and 12.5 diopter on 2nd eye).  I now have good far and intermediate vision on both eyes. I have good night vision (no bad halo or flares). I can read okay with the first eye without glasses, at arms length. I cannot read with the second eye yet (after 3 weeks). I can read comfortably enough (ou) with reading glasses.

.

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

1 Yes waiting is often a good idea because once you start wearing prism glasses your eyes usually get use to them and you can never do without them and without the glasses you see double all the time.

2. Consider asking for a referal to a strabismus-pediatric ophthalmologist for a consult.

3. No the double vision is abnormal and should not be happening.

Strong advice is see a eye muscle specialist.

JCH MD

[dina257]

I had cataract surgeries w/ Crystalens implants on both eyes by a world re-known cataract surgeon. After second implant, I developed slight vertical double vision when using both eyes. I was told that I have a wandering eye  (second eye) and was prescribed eyeglasses with prism (1.5) for both eyes as well as Rx for far vision and for reading. I am about 3 weeks post-op. I feel that my newly operated eye has not settled down and appears to continue improving, in spite of the double vision.
My questions: 1) Is there benefit to wait another month to allow the second eye to accommodate further before wearing eyeglasses prescribed? Isn't this what Crystalens is supposed to do? 2) With time w/out glasses, will my brain adjust naturally and fuse the images and treat the diplopia? Thanks!

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

Double vision after cataract surgery is not rare and i have published several research articles in medical journals about the subject. You had the surgery to see better not to get rid of wearing glasses. If you see well and single with glasses then wear them.

If you see double with prism glasses ask for a referral to a strabismus specialist.

JCH MD