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.

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