Monday, September 26, 2011

Shadows and Arc of Light after Cataract Surgery

Question: I am very disturbed by the shadows and blind spot I see after my recent cataract surgery. I had cataract surgery 2 weeks ago. Since immediately after the surgery, I have been experiencing a shadow or "blind spot" in the lower right side of the eye. I also see semicircular arcs of light and the feeling of seeing through water. My cataract surgeon referred me to his associate for a second opinion and then to a retinal specialist. Everyone agrees that the lens is in proper position and there is no damage to the retina, but I am not getting any better. Can you tell me what might be happening to me? Is is ever possible to use the wrong size lens? Can I be allergic to the drops prescribed? I'm at my wits end. I work in front of a computer all day and I'm really having a difficult time. Thank you

Answer: The fact that your Cataract Surgeon has sent you for a second opinion from another Cataract Surgeon as well as a consultation with a Retinal Specialist is good and reflects a high standard of care. If we can assume that everything regarding the Cataract Surgery, Lens Implant, Retina and Vitreous are in good order, we have to consider that what you are experiencing is a phenomenon called a "negative dysphotopsia". A fair number of patients who have just had Cataract Surgery and a Lens Implants experience a problem that shows up at night when viewing a light. A halo appears around or near the light. For most, this happens when seeing the headlights of oncoming cars while driving or riding in a car. This phenomenon is called dysphotopsia. It is very common and usually of short duration and lasts no more than 1-2 months or less after their surgery. Some patients experience what is termed a "negative dysphotopsia" in which instead of a halo, they experiences a dark region on the temporal edge of their field of vision. This optical phenomenon is usually caused by the way in which light is reflected off the edge of the lens implant due to its shape. This creates a new visual pattern that patients adapt to shortly after their Cataract Surgery. Both the dysphotopsia and the negative dysphotopsia are caused by the presence of the new lens and the pattern of light reflected and refracted through the Lens Implant edge. In almost all cases the brain adapts to the new light pattern after a brief time as noted earlier and patients simply forget that it ever there.

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