Eyelid Problem after Cataract Surgery

Question: My friend recently had cataract surgery and her eyelid closes and thins out, like she can’t keep it opened. Is it normal? Can she have surgery to fix it?

Answer: What you are describing might be due to some residual swelling in the eyelid from the speculum used during the cataract surgery, or it could be a slight ptosis or droopy lid caused by the speculum-difficult to say but worth scheduling a visit to the cataract surgeon who performed the procedure and bringing it to his or her attention to see what the exact cause is and what can be done.

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.

No Intermediate Vision after Cataract Surgery

Question: I am 47 and had cataract surgery approximately 6 weeks ago.  I have blurred/spotty vision, which I was told is the folding/scarring and can be corrected with laser. The main issue I am having is midrange vision.  I don't feel it is a clear/focused as it should be. For example, if I am cooking or cleaning, I feel like I have to strain to see it well enough. I knew prior I would have to wear "cheaters" for reading/computer, but almost feel as if I need them for simple tasks like cooking.  I was told my eyes are not as flexible now that the lenses have been placed and may need bifocals for close up and midrange vision.  I thought I would not need anything but the cheaters after cataract surgery.  Everything seems just slightly "off" and it is unnerving. How can I be sure I had the right prescription lens placed?  I know once the laser is done I cannot have it changed.  When they did a 2 week out exam, my distant vision was still not 20/20.  I just don't know what to do to correct my vision issues.

Answer: During cataract surgery the cloudy crystalline lens in your eye is removed and replaced with a clear plastic lens implant. There are several types of lens implants that all correct vision somewhat differently-depending on what you choose and what your cataract surgeon recommends. A basic monofocal lens implant ONLY corrects distance vision-NOT intermediate or near vision really at all and requires bifocals, progressives or reading glasses or “cheaters” to see anything in the midrange or up close. Certain aspheric lens implants, although they are actually only monofocal, do afford some slight intermediate or midrange vision-BUT STILL REQUIRE bifocals, progressives or reading glasses or “cheaters” to see anything in the midrange or up close clearly. Multifocal or Accommodating Lens Implants allow patients to see far, near and in between typically without the use or full time dependence on glasses. We do not know which type was discussed with you or what type you have. If you are concerned with the accuracy of the prescription then ask your cataract surgeon for a current refraction and see if a mild pair of eyeglasses might be of help.

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.

Glare & Halo from Cataracts

Question: I have cataracts in both eyes, and experience night glare and halos which keep me from driving at night. Will it be necessary to have surgery on both eyes before I will see improvement in the glare/halo caused by the cataracts?

Answer: Without knowing the type and position of the cataract in each it is tough to tell specifically in your case which eye or whether both eyes cataracts are contributing to the glare, halo and night driving problems you are experiencing. In general, there is typically some degree of uniformity and we might assume that both eyes are causing your vision problems. In general, we also know that you will experience immediate but NOT complete improvement after the first eye has the cataract removed and a lens implant put in place-and we also know that the best vision results and best functional vision are achieved after BOTH eyes have cataract surgery and lens implants. You may be interested in knowing that researchers reporting in the journal Ophthalmology studied the impact that cataract and cataract surgery have on clinical measurements of vision, reading speed, objective mobility performance and subjective visual functioning. The results showed that patients who had the cataract surgery in both eyes demonstrated better visual performance, better mobility-based task performance and even scored better on the Activities of Daily Vision Scale (ADVS). Thus, even though patients might find a great improvement after having cataract surgery in only one eye, the data indicate that having cataract surgery on both eyes provides the best visual functioning.

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.

Problem after Cataract Surgery

Question:  I have a problem that has persisted for 14 months after my cataract surgery in that I have a leaking membrane-not sure where to go or what to do.

Answer: Unfortunately, from your description it is not possible to really understand what you mean by a “leaking membrane”. This could mean that there was a complication during cataract surgery and there was a rupture of the vitreous gel or it could mean that there was a subretinal neovascular membrane that formed spontaneously and leaked fluid and/or blood under the macula or any one of a number of other conditions or complications. There is no way to tell what you are referring to. That said, the most prudent course of action is to schedule a consultation fr a second opinion with an eye surgeon who is a retina specialist to determine the exact nature of the problem and what might be possible if there is a need for treatment.

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.

Aspheric or Monofocal Lens Implants?

Question: I will be going in to have my eye evaluated for cataract surgery. I will have to choose a lens implant. I would like to be fitted with a monofocal lens implant and then use eyeglasses with progressive lenses. Would using aspheric lens implants be more beneficial than regular monofocal lens implants?

Answer: An aspheric lens implant is actually a monofocal lens implant in that it has only one focal length and thus in general only corrects distance vision. A monofocal lens implant is a somewhat old design in that it simply doesn’t give the best vision-especially in terms of dim illumination. Thus, today, if patients have cataract surgery and wish to wear any type of near vision eyeglasses, the best vision is achieved with aspheric lens implants. There are a few instances where the aberrations of your eyes might make an aspheric lens implant and inappropriate choice but this is somewhat unusual and when you have your cataract surgery evaluation your cataract surgeon will certainly evaluate you and recommend the best choice.

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 Not Ripe for Surgery

Question: My 65 year old mother has a cataract on her left eye. According to the eye doctor they won’t remove it because of her extreme dry eye, as well as the cataract isn't ripe enough for surgery. What exactly does that mean, and should we get a second opinion?

Answer: First, the notion that the cataract is not ripe enough to be removed with cataract surgery is just nonsense. If and when the cataract interferes with vision, mobility, safety and general daily living activities-then it is time to ask a cataract surgeon to evaluate her for cataract surgery and lens implants. Being “ripe” is a 20 year old concept and has no relevance if there is glare sensitivity or any vision comprise as noted above. Even with a dry eye, there are many treatments that are appropriate to effect a more stable healthy tear film including artificial tear eye drops, tiny punctal plugs to help retain tears, dietary supplements, prescription eye drops to help you make more tears and even other prescription drops and laser treatments to treat underlying causes of dry eye. Bottom line-get another doctor who is a top cataract surgeon in your area.

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.

Dry Eye Symptoms of Pain & Pressure

Question: Does dry eye cause pain and pressure on eye?

Answer: The most common symptoms of dry eyes include dryness, itching, burning, irritation or grittiness, redness, blurry vision that gets clearer as you blink, light sensitivity and contrary to common sense….excessive tearing. In severe dry eye it is possible to experience pain and even a sensation of pressure of fullness on the eyeball itself.

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.

Discomfort after Cataract Surgery

Question: Why do I have discomfort? My eye feels like it has a torn contact in my eye after having the cataract surgery six weeks ago?

Answer: It is impossible to tell why you have discomfort and a foreign body sensation after cataract surgery without a thorough examination. However, there are some possibilities to consider. First, you do not say whether a suture or stitch was used to seal the incision. While is this is typically removed before 6 weeks after your surgery, there could be a small stand of stitch left in place. It is also that you have some dry eye related symptoms that feel like a foreign body or even other ocular surface or eyelid problems such as follicular conjunctivitis. In any event you need to schedule an appointment with your cataract surgeon and ask them to give you a diagnosis and recommend a treatment as you should not be experiencing this during this phase of the healing process.

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.

Blurry Blueish Film after Cataract Surgery

Question: I am two weeks + post cataract surgery in my right eye. My vision is blurry and appears to be a blueish film. My doctor says all looks perfect.  Vision tested at 20/60 worse than before the implant.  I am thinking of cancelling my second eye cataract removal which is now 20/40 with no correction. Not sure what to do.

Answer: Your situation requires further investigation and examination to determine the cause of your symptoms. These are not expected or acceptable and should give pause for scheduling the second eye surgery. There is a long list of possibilities but it is impossible to know from an e-mail. But many causes need to be considered including uncorrected refractive error, corneal problems such as dry eye or edema, posterior capsular opacification, macular problems such as cystoid macular edema, early age related macular degeneration (AMD), Epi-retinal membrane formation which is also called macular pucker-and more. 20/60 is too bad of a vision to proceed with the other eye unless there is a good answer as to why it is 20/60. The first step is to get a definitive diagnosis and treatment if necessary. If your current cataract surgeon cannot provide a clear diagnosis, you need to schedule an appointment with another cataract surgeon and get one before proceeding with the second eye cataract surgery.

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.

Flying after Cataract Surgery

Question: How long after having cataractsurgery do I have to wait to fly?

Answer:  The best answer would be provided by your cataract surgeon. However, assuming that you have relatively routine cataract surgery without complications-most cataract surgeons require their patients to be examined the first day after cataract surgery and again at about 5-8 days after a cataract operation. This is the period of time where rare, but potentially serious, complications would likely be detected, if they were to occur. Beyond this period of time it is more a matter of making sure that you have access to continued follow up care at your cataract surgeon’s direction. If you are contemplating a trip after your cataract surgery you should discuss this with your cataract surgeon and they can give you any additional advice you might need regarding air travel as it would apply to your post operative instructions.

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.

Droopy Eyelid after Cataract Surgery

Question: Can cataract surgery cause your eyelid to droop?

Answer: In a cataract aged population, eyelid position anomalies are not terribly uncommon-even without surgery. The muscles of the eyelids tend to become lax and tissue of the eyelids does tend to droop. Thus, many patients do not really notice a preexisting drooping of the eyelids before their surgery-especially if they wear eyeglasses which may shield the direct view of the eyelids. Now, during cataract surgery an eyelid speculum is used to help patients remember to keep their eyes open. Sometimes if the patient squeezes firmly or excessively against the speculum, it is possible to have some swelling and additional trauma to the eyelid muscles and tissue-resulting in drooping or Ptosis. The good news is that if it is disturbing or aesthetically displeasing, it is possible for your eye surgeon to perform an eyelid procedure to correct the Ptosis. However, most eye surgeons suggest waiting until both eye have had cataract surgery and there is a reasonable time for all of the tissue to heal and recover completely-perhaps as long as 6 months.

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.

Color Blindness after Cataract Surgery?

Question: Does cataract surgery make the patient color blind? Also will it affect my ability to obtain a CDL?

Answer: Cataract surgery in no way should make you color blind. If you weren’t color blind before the cataract operation you shouldn’t be color blind afterward. In fact, cataracts cause colors to become faded and many patients report that colors are much more vivid after their surgery. So, unless you have some other eye problem this should not be a problem-nor should cataract surgery hamper your ability to get a CDL.

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.

Dry Eye after Cataract Surgery

Question: After cataract surgery is it common to develop dry eye? What are the symptoms of dry eye?

Answer: Developing a dry eye after cataract surgery is actually pretty common. Moreover, the incidence of mild to moderate dry eye in a cataract aged population prior to cataract surgery-and exacerbated by cataract surgery makes dry eye a rather common complaint among this group. According to the Prospective Health Assessment of Cataract Patients Ocular Surface (PHACO) Study some 60-75% of a cataract aged population had a meaningful deficiency in their tear film testing. Further, although cataract surgery is quite friendly to the cornea, it does require and incision which has the potential to temporarily interrupt corneal nerves responsible for reflex tearing and tear film integrity as well. 

This along with some of the solutions used during the cataract procedure can indeed result in a dry eye. The symptoms one might experience could include fluctuations of vision, dryness, grittiness, tearing, burning and a general tiredness as well as an overall sandy feeling. The good news is that for the vast majority of patients with dry eye there are potentially helpful treatment options that include specialized artificial tear lubricants and solutions, tiny punctal plugs to help you retain tears and prescription medication that stimulates production of your own tears. In addition there are more technological approaches such as lasers and other methods to treating underlying blepharitis, eyelid gland problems or eyelid inflammation that can contribute to dry eye as well.

 

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 for One Eye

Question: I had a cataract removed from my right eye approximately 8 years ago now my left eye needs cataract surgery. My question is my cataract surgeon offered me the toric lens les implant for astigmatism. But I don't have it in the right eye and I have astigmatism in both eyes. I need glasses to see far with my right eye after I had my cataract removed.  So would the toric lens be a benefit or not?

Answer: It is difficult to answer the question as you do not state the amount of astigmatism that you have remaining in the right eye. If you have an amount and orientation of astigmatism in the right eye that is correctable with Limbal Relaxing Incisions (LRI)-a minor procedure-when you have the toric lens implant in the left eye after your cataract surgery it is quite probable that you would not need to wear glasses to see at distance. Under these circumstances have a toric lens implant n the left eye and the astigmatism correction procedure in the right has some real advantages. If however there is no chance of correcting the residual astigmatism in the right eye, the advantages of having a toric lens might be diminished as you would still need to wear glasses even with the toric lens as the right eye would require correction.

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.

Lens Implant Exchange for Incorrect Strength

Question: I had cataract surgery on June 4, 2013. My cataract surgeon said he had put the wrong strength lens implant in and I would have to have another one put in, the sooner, the better.  How is this surgery in comparison with regular cataract surgery? In other words how difficult is it going to be to get the lens out and another one put in?

 

Answer: A lens exchange is necessary from time to time if, as you have experienced, there is a need to modify the lens implant power to improve the visual result for you. Assuming that there were no other complications, a lens exchange poses some of the same risks as any other cataract surgery in terms of infection and swelling-and some additional risks in terms of requiring careful manipulation and extraction of the intraocular lens to be removed. The biggest additional risk is damaging or tearing the residual crystalline capsule which is left in place to support the les implant. This requires a precise technique and with care, rupture of the capsule is typically but not always avoided. In the event that it does tear there are additional procedures and techniques that are used to make sure the new lens implant placement is proper and that you have a good result. Follow the advice of your cataract surgeon and have this lens exchange done as soon as possible as this does increase in difficulty the longer you delay. 

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.