Toric Lens Implant Vision Blur & Sloping

Question:  My wife recently had cataract surgery with a toric lens implant for astigmatism in her right eye. 10 days after her operation the vision is fuzzy-out of focus-and horizontal surfaces seem to slope to the right, and despite several attempts the cataract surgeon was unable to find any external lens or combination that would give any clearer vision. She can see clearly through a pin-hole mask and the macula, retina, and pressure are all good, and the lens seems to be correctly placed. They say come back in 6 weeks - what do you recommend? 

Answer: There are many reasons that your wife may be experiencing blur that clears with a pinhole mask and also several others that might cause a sloping of her vision. Some of these are related to the healing process and should self limit in the next 6 weeks as your cataract surgeon suggests. Others may not clear and could represent complications that require more immediate attention and possibly intervention as they could involve the retina. While you state that the retina is normal, prudence suggests that a retina consultation is to be considered to rule out subtle swelling of the macula, fine epiretinal membrane formation and other subtle changes that might be contributing. A conservative approach would be to have the retina consultation now and then the waiting for six weeks will likely be a less anxious time.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Toric Lens Implant Rotation Problem

Question: I have just had cataract surgery and a toric lens implant for astigmatism in my left eye done. My cataract surgeon told me the lens had "rotated" about 10 degrees-how serious is this?  Should I consider correcting this?  How soon?  I am doing my right eye next week. 

Answer: It is possible to have a primary misalignment during the cataract surgery itself or in the unusual case a secondary rotation of the toric lens implant after the surgery. This is extremely rare with the Alcon AcrySof® Toric Lens Implant but is known to occur with other brands. In any event, there is no need to be concerned or to actually do anything to adjust the rotation unless it causes a problem with vision. A small rotation of 10 degrees-unless it is a very significant amount of astigmatism-should not typically cause too much vision disturbance. The best course of action is to follow the recommendation of your Cataract Surgeon.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Multifocal Lens Implants & Near Vision

Question: I am having cataract surgery but can’t decide whether to have multifocal lens implants. I do not always need my glasses to read and when I do I wear minimal eye wear for reading.  Should I spend $7000 for multifocal lens implants as they might cause haloes around lights?

Answer: Since you are able to read pretty well with minimal correction, it suggests that you are mildly nearsighted in at least one eye prior to your cataract surgery. If you have cataract surgery and the lens implant prescription is calculated to render your distance vision as close to 20/20 as possible-thus eliminating the  nearsightedness-you will no longer no able to see up close and read without bifocals or reading glasses. Your options are to discuss with your Cataract Surgeon the possibility of creating the same type of refractive errors that you have now so as to remain a bit nearsighted-which may very well require a mild correction for seeing clearly at distance-or to select multifocal lens implants which provide an extended range of clear vision. In some designs and for some patients they do experience glare and haloes although in most instances this goes away.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Vision without Toric Lens Implant for Astigmatism

Question: I need cataract surgery and have significant astigmatism but can’t afford a toric lens implant to correct the astigmatism. How much less "good" vision I will have because of this?

Answer: Depending of the amount and the orientation of the astigmatism you could have somewhat distorted or blurred vision for far and near. If you do not have a toric lens implant it is possible that you could have Limbal Relaxing Incisions (LRI) or else you will likely have to wear glasses to see clearly. When making the decision not to have a toric lens implant to correct your astigmatism make sure that you take into account the recurring cost of buying glasses for the astigmatism correction over the course of multiple years.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Cataract Surgery Glare

Question: I am a 57 yr old woman who had cataract surgery in my left eye on December 5, 2012 and around December 15, 2012, I noticed daytime and nighttime glare in the left eye. What is causing the glare in my left eye? What procedure(s) can be done to correct the glare in the left eye and how soon can it be done?

Answer: There are many reasons that you might be experiencing glare after your cataract surgery and lens implant procedure. It is really not possible to know what is causing the glare without a clinical exam. You do not specify the type of lens implant used to correct your vision which also could contribute to the glare. Some things to consider are residual inflammation, any compromise of the posterior lens capsule which has been left in place to support the lens implant, swelling or irregularity of the cornea and even a remote possibility of mild swelling of the retina. Your best course of action is to return to your Cataract Surgeon and express your concern regarding the glare. After  an examination he or she will be able to tell you whether the  glare you are experiencing is part of the  healing process and thus transient or in fact needs medical, laser or surgical intervention.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Nervous & Anxious about Cataract Surgery

Question: I have been told I will require cataract surgery in the near future for both eyes. My concern is that I am extremely phobic about any near or actual eye contact.  I literally have to take valium before a routine eye exam.  So can this typically be done in hospital with some minor anesthesia? There is no way can I keep eyes open with someone closely approaching or touching my eyes. Please comment and give advice? 

Answer: Modern cataract surgery is typically performed using only eye drops for anesthesia and with some oral medication such as Valium to help patients stay relaxed. However, if you are phobic, anxious or fearful you need to discuss this with your cataract surgeon who very well might suggest any one of a number of other alternatives-as well as possibly even more traditional anesthesia. Keep in mind that the “lighter’ the anesthesia, the quicker and more comfortable the recovery. Also, modern cataract surgery is pretty quick so you won’t experience the fear or phobia for too long-thus it might be possible to use more than eye drops but less than complete sedation.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Eye Watering after Cataract Surgery

Question: My mom had cataract surgery in September 2012 and still has an issue with extreme watering of that eye. The vision is fine and there is no sign of infection. This was not an issue before surgery. Any suggestions? 

Answer: Eye watering after cataract surgery can be due to a range of issues including dry eye, turning in of the eyelid-called entropion, eyelash problems-called trichiasis, a constriction or blockage of a tear duct-and on and on. The best thing to do is schedule an examination and consultation with your cataract surgeon and explain the issue. If you do not get satisfactory answers then seek a consultation with a cataract surgeon who is also a corneal specialist as they will be more inclined to evaluate the eye surface and tear film from a different perspective.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Laser Cataract Surgery & ReSTOR Multifocal Lens Implants

Question: I had LASIK surgery with cataract removal and ReSTOR® Lens Implants in both eyes in past 2 weeks. One eye sees clearly for distance, but still blurry near vision. The second eye done one week ago is still very blurry for near and far, my cataract surgeon says they are not worried, but I am.  I can't see well at all, reading and all activities are an issue. Can someone tell me approximately how long this takes as I was told I would have clear vision at all distances?

Answer: First, it is not likely that you had LASIK surgery. It is more likely that you had laser cataract surgery, cataract removal and lens implants using the ReSTOR® Multifocal Lens Implant. If this is the case, and you and your eyes are otherwise healthy then one would expect that there would be rather good distance vision in each eye within just a few days after the surgery on that eye and that there would be at least decent near vision for reading and close vision tasks within a couple of weeks as you adapt. The multifocal lens implants do require and adaptation period to see comfortably, however one would expect some consistency and improvement in relatively short order. Your cataract surgeon may not be concerned because he or she sees the eyes quieting down and expects a good outcome but perhaps in a slightly or moderately greater length of time. That’s said, if you are not happy with the vision after your cataract surgery and lens implants within a 4-6 week period you deserve to have an explanation and plan to improve it that is reasonable.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.