cataract surgery
Latest edition of A Patient Guide to Cataract Surgery
Return of Blurry Vision After Cataract Surgery
I had both my Cataract Surgeries in October last year, a short five months ago. My vision was so amazing after surgery I felt like I was on cloud nine!
Cataract Surgery, A Patient’s Journal
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But over the last 4-6 weeks, I started noticing I was needing my drugstore readers more and more often because I couldn’t focus on the smaller print again, or the light was too dim. Now I have the Symfony lenses, so super fine print and low light required the readers on occasion, but this was beginning to be an increasing necessity. I was scheduled for a dilated followup, so I waited until that visit to discuss with my surgeon.
I work here at The Harman Eye Clinic, so I knew what was happening… I had Posterior Capsular Opacity (PCO) and was going to need a YAG Laser* treatment. I’ve been here long enough to know that 20-30% of cataract patients develop significant PCO and require this treatment to clear up their vision. I also know it can be anywhere from 2 weeks to 20+ years before it’s needed! Some people refer to it as an “after cataract” because it’s something that develops after cataract surgery. It’s also referred to as a “secondary cataract” which also means after cataract. It isn’t the cataract coming back. It’s not something that went wrong with your surgery. It’s just that some people can develop a thickening of the back (posterior) of the lens capsule which holds the artificial lens in place. This thickening of the capsule causes your vision to become cloudy (opaque).
Sure enough, my exam showed that glare was back and my vision was decreased. Time to schedule the YAG appointments.
While the procedure name sounds pretty unusual, the procedure itself is fairly simple. There weren’t any restrictions… in fact it’s a lot like going for an eye exam! Vitals, drops to dilate the eye that was going to be treated, sit down in front of the laser with your chin in a chin rest, focus on a little green light for a few minutes and you’re done. The surgeon uses the laser to create a small opening in the capsule to allow what you see to get to your retina without having to pass through that opaque tissue. My surgeon explained that I might notice some floaters afterwards (which I didn’t) and to call if I had problems.
I used some artificial tears after I got home because my eye felt dry, and I was dilated for a couple of hours. I drove myself, went shopping on my way home and resumed normal activities… except I couldn’t read through that blurry eye!
Patient Journals as she goes through cataract surgery.
Post Questions on Facebook for LIVE Fridays
We are authentic people who have had the experience of refractive surgery. We have embraced the culture at The Harman Eye Clinic since our first day of employment. We love to share our knowledge and heart with our patients.
Pam loves to talk about life! She loves to hike, get out in a canoe, run and so much more. But she also loves to talk about refractive surgery. That is why her position here as head Refractive Consultant, is an awesome fit. About a year ago, Pam created a LIVE show to help patients navigate through iLASIK and Cataract surgery concerns.
Now it is possible to post your questions on Facebook or on our blog. These questions will help others who may hesitate writing on the internet. If you are so inclined, post your questions and tune-in to The Harman Eye Clinic Facebook LIVE program on Friday and one o’clock.
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Fridays at 1:00 p.m.
Ask you questions now or during the LIVE program.
Look forward to hearing from you!
5 steps to help sort out your lens implant options with Cataract Surgery
Which lens implant will match your lifestyle?
First Step. Take a cataract assessment, (see below) You may be experiencing the effects of cataracts; everything may appear fuzzier, dimmer and driving at night may be an unwelcome challenge. Do you think you may have cataracts? Learn how they affect your life by taking the Cataract Surgery Self-Evalutation.
Second Step: Are you aware that when you opt for the traditional, standard lens implant, you will probably need glasses afterwards to accomplish all ranges of vision. In other words, even though your lens will brighten and clear up your vision, you will need glasses to see various focal lengths with best vision; i.e., up close, intermediate and in the distance. If you like wearing glasses, this may be the lens implant for you.
Third Step: Consider this, if you opt for the advanced technology, like the Tecnis Symfony, lens implant, you can reduce your dependence on glasses for distance, near and most places in between. You may find there are times that you wish to wear glasses to refine your vision, and this is still considered by you and your surgeon as a successful outcome.
Fourth Step: Review your overall health. It plays an important part in reducing your dependence on wearing glasses. Allergies, medicines, even over-the-counter medicines, health problems, all can affect your dependence on glasses. Your eye doctor will be able to address these concerns; it is important that you take note of your doctor’s recommendations.
Fifth Step, and this is most important: Your surgeon can provide a lens designed for an extended range of vision. Expect to keep an active relationship with your doctor by following your surgeon’s recommendations after surgery, maintaining your health to the best of your ability, and working with your doctor in order to sustain continued happy vision.
Whether you choose a standard lens or a premium, advanced technology lens implant, most patients report a brighter, more colorful world after surgery. Your next task is to continue to educate yourself by downloading a complimentary eBook, visiting our website, http://www.20Better.com, or calling upon one of our Refractive Counselors at 360-474-2561. An informed patient is a happy patient!
Barbara Aliaga, a member of The Harman Eye Clinic since 1989, chose an advanced technology lens implant with cataract surgery in 2014. She writes for The Harman Eye Clinic blog and website since their inception and is currently doing so without wearing glasses!
THEC New Year’s Letter
A Happy Patient Is An Informed Patient
You might ask, “What are possible temporary side effects after cataract surgery?” To answer this question and to help you prepare when you talk with your surgeon, here are frequent questions and concerns patients ask about after surgery.
BLURRED VISION: what are common causes of blurred vision after cataract surgery?
- Dropless cataract surgery is routinely performed at The Harman Eye Clinic, and causes black dots in the vision for at least day or two after surgery. Patients are instructed to sit upright for at least a few hours when the get home to help the medicine settle to the bottom of the eye, like a snow globe.
- Dilation lasts for at least a day or two after cataract surgery and commonly causes blurred vision.
- PCO or posterior capsular opacification occurs 10-20% after routine cataract surgery. It causes glare at night, but is curable by a simple YAG laser procedure that takes 2 minutes to perform, but an hour and a half for the paperwork!
- CME or cystoid macular edema occurs about 1% of the time after routine cataract surgery. It causes difficulty reading and even distance vision. Risk factors include diabetes, ERM (epiretinal membrane), prior retinal surgery and possibly cigarette smoking. It often can be cured with topical steroid and anti-inflammatory eye drops.
- Residual refractive error may cause blur until new spectacles are prescribed. If a monofocal lens is chosen for best distance vision, then near vision will be blurred (so called presbyopia) until readers are used.
- Dry Eye syndrome is a life long condition, that may cause fluctuating vision, and may be worse at least temporarily after cataract surgery. It is often exacerbated by prescription eye drops (especially generic drops such as ketorolac), but we are seeing much less dry eye problems since switching to dropless surgery.
- ARMD (age related macular degeneration) or ERM may also limit vision due to aging changes in the retina.
DYSPHOTOPSIAS are unwanted visual phenomena occurring after routine cataract surgery.
- Negative dysphotopsia are likened to “horse blinders” with a shadow or dark crescent on the side and usually subside within days or weeks. They are thought to be more common in square edged lens implants, but have been reported in all types of lens implants, however they are not dangerous.
- Positive dysphotopsia are less common, and are often described as an arc of light under certain lighting conditions.
REBOUND IRITIS IS INFLAMMATION that occurs usually 2 to 3 weeks after cataract surgery.
- It is thought to be a result of the dropless medicine wearing off, especially found in darkly pigmented patients. It happens in less than 10% of patients who have dropless surgery and is treated with topical steroids. This is the best reason for patients to keep their 3-week postoperative appointment after surgery.
For more information. download a free copy of our Cataract Surgery Patient Workbook, here.
Or take time to read, A Patient’s Journal – Cataract Surgery
Second Surgery, Day One – A Journal VI
I had my one day post op after my second surgery. My vision was pretty blurry due to a bit of swelling on the cornea, so I’ve waited to share.
Now when you decide on having a “lifestyle lens,” you really have to think about how you spend your time and what your particular vision needs are. Myself, I work on a computer and interact with patients. Ok, that’s 40 hours of my week. Typically, I’m awake about 122 hours in a week, so that accounts for 1/3 of my time. Driving: an hour a day. Family time includes reading, watching television, board games. Weekends are your typical housekeeping chores. Hobbies? Making quilts! Accurately measuring, cutting, sewing and pressing. Hand sewing the bindings on finished quilts. For me, being able to thread a needle and follow a line of stitching was vital.
These Symfony lenses have the ability to let you see for reading, computer and driving. But super fine like I wanted required either cheaters (non-prescription magnifying glasses you find in a drug store) or, choosing a power for the implant that would provide that. Choosing that option may require glasses for driving. That is the choice I made.
Right now, I’m threading needles and hand sewing along that line of stitching!
My advice to those of you considering a Lifestyle lens? Evaluate your life! What are your visual needs? Communicate this to your surgeon. You may be an avid outdoor enthusiast, golfer, pilot or ham operator! Reading may be your passion. There’s as many lifestyles as there are people, each one unique and important.
I still have a couple weeks for my vision to stabilize, but right now I have what I can only describe as “normal” vision. I’m seeing what I want to see. How awesome is that?!?
One Week & 2nd Eye Surgery – A Journal V
One week later. Scheduled for a one week post op and second surgery. Depending on how your eye heals, your personal preference and the difference between your eyes, surgeries can be scheduled 1-3 weeks or further apart. I was fortunate to be 1 week.
I have noticed a lot of struggle between my new eye and the other one this past week. It felt like the new eye was doing about 90% of the work and the old one was trying to keep up. Those floaters from the medication last week? They were gone 3 days after surgery. What was really cool was turning on my side to read in bed without my glasses getting in the way!
The halos are much smaller around lights, more something I observe but not causing any difficulty, All in all, it’s been a great week between surgeries!
My one week check up was great. Healing well, seeing 20/20 without correction. My biggest hobby is sewing quilt tops, so I’ve asked my surgeon to set my lens power for reading or “near” vision to help me with my hand sewing.
My surgical experience was every bit as good as the first time. I even slept a bit before and during! I still don’t remember a great deal of what went on in the OR… and I can say that because I know what happens since I work there! The medication in my eye this time is more like a cloud over the outside half of my vision. I had a foreign body sensation which I knew was the incision from surgery, and artificial tears took care of that.
I’ll check in again tomorrow and let you know how I am with the dilation gone. I’m still ecstatic with my surgery. I’m very proud to be a part of the Team at The Harman Eye Clinic. It’s a blessing to help others with improving their vision, and I’m one of many staff members who have experienced the benefit of various procedures we can do. iLASIK, Refractive Lens Exchange, Cataract surgery with an assortment of lens options. It’s all good!
