problems with flickering vision after cataract surgery

[whend]

I am 49 years old and had cataract surgery on my left eye 11 months ago.  The lens used was a Acrysof IQ Intraocular lens.  After the surgery I experienced flickering light resembling strobe lighting in my vision with this eye.  I returned to by surgeon after 3 months and was was told this would subside in 6 to 12 months as my brain adjusts to the new lens.  It has subsided a little but I continue to have problems under florescent lighting. Under florescent lighting condition my vision in this eye  feels like I am looking through a wet eye. Again it is the feeling of mild strobe lighting .  I find I am blinking all the time and find that this eye gets teary under florescent lighting conditions whereas my other eye does not.

What is causing this and given it has almost been a year, will this ever stop.  I feel as if I have traded one eye problem for a new one.  Is this a common complaint after cataract surgery.

[Moxie67]

Time certainly hasn't helped in my case.  It's been over 2 years for me and it is not one bit better and no one is willing to even acknowledge there is a problem never mind help me, and I am getting seriously depressed.  
I want my life back.
I want to drive again.
I want to be able to grocery shop without my husband tagging along.
I want to be able to select restaurant seating based on the location of the table, not the orientation to the lighting.
I want to be able to use the computer for more than 10 minutes without having to close my eye.
I don't want to miss yet another year of skiing.

Why won't anyone help me?

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

There are several world famous ophthalmologists that deal with IOL problems from all over the world. At the Cincinnati Eye Institute Robert Osher MD and in Los Angeles  Samuel Masket MD    

JCH MD

[Tania3b]

Hi Dr. Hagan - is there anyone in New York City that you can recommend for the flickering problem.  I am 8 weeks out of cataract surgery and the flickering has been a nightmare.  I am an attorney and my job involves hours and hours of reading.  I need to get back to work.  When I try to read I get flickering, eye swelling and headaches.  Unable to read more than about 30 minutes.  I am getting really worried.  Thanks in advance.

[CBCT]

I had problems with dysphotopsia after cataract surgery.   A year later, I had lens exchange done by Dr. Richard MacKool Sr. Who practices in Astoria, Queens.

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

The dysphotopsia problem is common, usually is temporary and rarely required IOL exchange or surgery.

[Tania3b]

Thanks, Dr. Hagan.  Is there anything that I can do to speed up getting over this issue?  Also, am I doing any harm to my eyes or impeding recovery by pushing to read for extended periods of time?  My work often requires many hours of reading a day and I am trying to get my reading stamina up to a point that I can return to work.  .  Thanks

CBCY - Thanks for the suggestion.  

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

So you are 8 weeks. What type of IOL? This problem more common in 'premium" iols that are multifocal, extended focus, accommodating or toric and less common with monofocal IOLs.  When my wife has cataract surgery on both eyes she noted flickering in both eyes for about 4 weeks after which it rare occurred.   Reading will not cause any problems with IOL

[Tania3b]

I think it is a monofocal IOL.  So, any idea as to what is causing this?  The flickering happens pretty much only when I am reading.  The healing post-cataract surgery has been slow but eye was feeling pretty good last week (week 7) - inflammation was going down and just light sensitivity, flickering, pain at the back of my eye and general eye strain.  All of this only pretty much only during and after I read.  I am trying to build up the ability to read because my job is pouring over legal documents for hours and hours (typically 8-10 hours).  Dr said that I wouldn't be hurting my eye in pushing to read but my eye seems to be feeling worse after my attempts to read for longer periods.  Any thoughts on this would be appreciated.  thanks

[Tania3b]

I think it is a monofocal IOL.  So, any idea as to what is causing this?  The flickering happens pretty much only when I am reading.  The healing post-cataract surgery has been slow but eye was feeling pretty good last week (week 7) - inflammation was going down and just light sensitivity, flickering, pain at the back of my eye and general eye strain.  All of this only pretty much only during and after I read.  I am trying to build up the ability to read because my job is pouring over legal documents for hours and hours (typically 8-10 hours).  Dr said that I wouldn't be hurting my eye in pushing to read but my eye seems to be feeling worse after my attempts to read for longer periods.  Any thoughts on this would be appreciated.  thanks

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

The flickering in immediate post op period is usually due to light being scattered by the incisions in the cornea. Later it can be from reflections from the IOL or the capsule that holds in place or needing glasses over the IOL

[Moxie67]

Thanks for the names, one of them is already on my list.

I'll just have to keep trying until someone is (a) willing or (b) able to figure out what the problem is.

[jaysta36]

Im at 2 years after surgery,I still get flickering very controllable now,you just get use to it,you had imperfections with vision before surgery.i.e blurry vision,reflections in lenses of glasses,watery vision sometimes with contacts...remember these surgeries are man mad ,synthetic  vision,not natural perfect vision as we want,we are one of people who have a defect,you just need to adjust thats all, having it taken out with a new replacement ,may not solve the problem and cause another.i.e blurry vision,eye pressure ..etc if you vision is good keep with it,it will ease,and very adaptable..there are things you can take,alphagam eye drops,parcarpine eye drops, whichwill shrink your pupils enough to stop the flickering,the flickering is the pupil bleeding over the margins of the lens in certain lights..or you can take tramadol,does the same thing,but these are short fixes,body and eyes will get use to it,best bet just get on with your life and forget about it,its there for good ! then it will disappear,by camouflage in the brain

[Moxie67]

Rickyboy

I am sorry that I seem to have hijacked your thread.  

From the information I have gathered over the past couple of years, about negative dysphotopsia, for some people it does go away with time.  Positive photopsia tends to go away on it's own more often than negative dysphotopsia.  

Negative dysphotopsia is where you perceive a shadow on the temporal side of your vision.  Positive photopsia is where you get light rays and streaks from light that reflects off the edge of the IOL ("edge glare").
It's not known what causes it but it's been theorized that it happens more often with: acrylic IOL, square edge IOL, high power IOL.   There has also been some evidence that the edge of the capsulorhexis is somehow involved.  Capsularhexis is the round opening that is made in the capsular bag to allow for cataract removal.  The IOL gets inserted and the edges of the opening overlapped onto the IOL.
From what I understand, Dr. Masket has had some success treating this condition by moving the IOL forward and tucking the edges of capsularhexis behind the IOL.
If this is what you have, and time turns out not to be the healer, don't let anyone tell you it's in your head.  It's a real and documented condition and it can be very distressing.

Best wishes to you from a fellow sufferer.

[Moxie67]

Jaysta

Interesting that you had relief with the pupil constricting drops.
I found the opposite, it is much worse when the pupil is small, whether from the drops or bright light.