Blurred vision after cataracts surgery

Hi Ricardo, i just discovered this site. I had my surgery about 3 months ago. My doctor assured that I'd be happy I'd done it. Well, my vision is worse! I only wore my glasses for reading (though my doctor kept prescribing trifocals). when he announced that my cataract was 'ready' for surgery, I was elated. I hadnt met anyone who was not pleased with the results (including my 91 year old uncle who found he didn't even need his glasses to read...which he'd been using for many years). Now, once an avid reader (and retired English teacher), I can't read a page without my eyes 'stinging'...I'm very depressed...and looking for ways to correct this disaster....without much luck so far. "I (too) think my doctor botched my cataract surgery and can not prove it."

 

If your eyes are "stinging" that raises the question of whether you have dry eye problems. That  is a reasonably common side effect of cataract surgery (likely they think due to the incisions severing nerves that tell the brain the eye is dry and needs to be lubricated, which need to heall) Although its usually temporary and mild, in some cases it can be more problematic and require treatment beyond merely using rewetting drops. Dry eye can impact visual acuity, and sometimes people don't realize their eyes are as dry as they are due to the issue of nerves having been cut so they don't know to put in lubricating/wetting drops.

It isn't clear without more details what other issues may be at play, if you have residual refractive error that should be corrected via glasses/contacts/laser that is making vision more difficult.  Even those who didn't have refractive error before surgery can wind up with some afterwards, since the formula used to determine the lens power they insert isn't exact, its based on statistics of past patients and their eye measurements and results. Its usually fairly accurate, especially for those with good vision before surgery, but it can sometimes be off.  Sometimes people have astigmatism in one direction on their cornea, which is balanced by astigmatism in the opposite direction on their natural lens, and when the lens is removed they wind up with astigmatism if the surgeon didn't plan to treat it. Or the incisions used for surgery can cause astigmatism, though usually with modern surgical techniques that isn't too much of an issue. 

I can relate, but I know I had options when I had mine done, but it would have been costly. I was given choice of near or far sighted lenses and to what degree, of course the price went up. I chose the basic. My choice. But no one prepared me for seeing out of two different vision fields! One eye was now bright and clear but my old eye dull and different vision, it was scary, like seeing double, couldnt focus, was suicidal. Everyone said it was going to be fantastic IT WASNT. I was miserable. I had to wait ten months to get second eye done and then only with a proper prescription six weeks later did things finally balance out! I still have problems with store lights and fumbling around in dark light. But at least I can drive if i am careful but have to avoid moving my head too fast or focusing on close things then trying to adjust to distance objects!

How is your vision now? Hopefully it is improved. My cataract surgery was only 4 weeks ago. I had the same story as yours. I was told I would be glad that I had it done. My vision was very good except for reading and slight problem with night driving glare from the lights. The surgery was supposed to correct these problems. I was totally blind in that eye immediately after the surgery. He said it should clear up and then left on vacation. I saw another Dr. in the office the next day that said I could "probably get a cornea transplant" to correct it and he put a needle in my eye several times to remove fluid!!! This was so painful the nurse had to hold my head!!! After constant visits over the past month and 24/7 drops I can see a little bit out of that eye. I'm sure my surgery was botched, but I guess there is nothing to be done about it. I still have pain which was initially blamed on blisters from the swelling and pressure. I feel like this is the worst decision I have ever made. There is NO WAY I will even consider having the other eye done now. Did you hear back from ricardo10128?

Had right done in Boston, couldn't be happier, 20/20 uncorrected loke looking at everything in hi def. 

That Dr recommended Dr Pineda, Boston Eye & Ear, performed a procedure that improved my eyesight in left eye that was blurry and it improved considerably.  

Anthony, I am considering going to a different opthalmologist, too, as I am convinced that the wrong lenses were put in my eyes. After 2 months, and about a thousand dollars worth of drops, my vision is still terrible!  I get "rechecked" every 2 weeks, and just more drops.   Frustrating.  Do physicians ever admit an error occurred? 

The Dr that did my right eye said he has done lens implant that patients were not happy with but replacement was done within weeks of original implant. I am of opinion that most Dr are not equipped to do a lens replacement. The longer you wait the more dangerous it gets. Even though it's been ten months I have appointment in two weeks for another opinion. We'll see

If the issue is residual refractive error, often that can be corrected via laser or a 2nd piggy back lens rather than a lens exchange. It depends on the details which approach is best and what the risks are.

re: "longer you wait, the more dangerous it gets"

During the first 2 months is when most of the healing that locks the lens in place in the capsular bag occurs, so replacements are easier during that period. There is some continued healing after that, but I'm not sure that it makes that much difference in terms of risk after that period, though it may vary a bit with the person.  In a followup exam at 2 months postop with a prominent surgeon I was told that if needed I could have a lens exchange  at any point in the future, even years later.

In terms of risk, the major issue is the state of the capsular bag (where most lenses are placed) after the initial cataract surgery and whether it would survive having the IOL extracted or if the process would be likely to tear the bag and require the replacement IOL to be placed at least partially outside the bag, and perhaps sutured to another part of the eye to stabilize it. The results are usually still very good, although there is increased risk, the risks are still low.  

If the capsular bag is in good shape, the exchange is mostly like the initial cataract surgery. The added risks are that a natural lens was easier to break up and vaccum up to be removed from the eye, whereas an IOL wasn't intended to be broken up, and it might require larger incisions to remove it potentially or the capsular bag might tear in the process, leading the replacement lens to need to be replaced partly or totally outside the bag.  

A YAG procedure, to treat PCO, complicates a later lens exchange since it usually leaves the capsular bag in a state that it'll likely tear during a lens exchange and require the replacement lens be put outside the bag. Usually they need to use a different model lens for placement outside the bag,a 3 piece lens rather than a 1 piece lens. 

WOW, thanks for that very informative narration, softwaredev, as it sounds like you have sufficient familiarity with the eye and the procedure being undertaken.   All I know is that with my history of corrective eye surgeries, first RK in 1985 and then Lasik in 2001, there is as much insult to corneas and underlying structures already done to any eye that can be done.   I was told that my surgery was one of his most difficult and that recovery will be slow and unpredictable.  THAT is why pure nutrition has become my best friend.  Food and supplements are "medicine" to the structures that are trying to heal.

 

I wondered same thing, why was not the same lenses put in each eye, the strengths are different and when I close one eye I can see the screen clearly but I do it with the other eye, it is blurry! doesnt make sense. If I look across the street I have to strain to get focus but at least its a bit better with vision. I still squint and my partner wonders why! hmm - I am lucky I can still drive but shifting from close to far is challenging especially if I am reading something then look up fast!

I am having same problem . .had both eyes done left 5 weeks ago..right 3 weeks

Ago. .my left first 8 days was diing great 9th day felt like something was in it and vidion

Started going blurry.,few days later right eye dine..

Dr test eyes..right eye is 20-20 distance..but i still see blurry with it at different feet..like example

2 feet clear 3 feet blurry 5 feet clear 6 feet blurry . .only example

To make point..but the eye feels ok..night driving..lights are wild looking

LEFT EYE FEELS LIKE I HAVE CONTACT LENSE IN IT AND ITS BOTHER ING

ME..I FEEL BLIND . .VERY VERY BLURRY VISION BUT AT NIGHT . .OMGOMGOMG

THE LIGHTS ARE LIKE BEAMS THOUSANDS OF LINES COMING OUT

OF EACH LIGHT . .AND IN MY PERIPHERAL VISION..BOTH EYES..I SEE CIRCLES AROUND EACH LIGHT

PLUS ALL LIGHTS ARE LIKE A SPARKLER IN STOP MODE..LINES COMING OUT..AND NIGHT TIME

I CAN BARELY DRIVE AS ITS TOO BLURRY

I HAD LENSES PUT IN..THSTS WHAT MY INS PAID FOR AND I CANT

AFFORD ANYTHING . MY VISION BEFORE WAS VERY GOOD..NEVER

BLURRY..ONE EYE 20.40..LEFT EYE WAS 20..80 DISTANCE..BUT STILL

I COULD SEE JUST FINE..NOW IM BLIND . .I DONT KNOW WHAT TO DO

DR SAYS HE DOESNT KNOW WHATS WRONG

I JUST WANT THESE LENSES OUT..CAN THEY VOME OUT W NO TROUBLES

FOR MY EYES?

I'm going back to the original surgeon today.  I thought my eye was beginning to stabilize but in the last week it has gotten worse.  They say my vision is better, but cannot explain the blurry part,  Even if I were to get lasix the blurry may not go away and the cost for one eye is 2500.  Doctor should pay. I'm going to research doctors and hopefully find one that will know what the problem is.  My guy said he never heard of this - really???

I don't know your location but Dr Pineda at Boston Eye and Ear

I'm in Florida.  Bascom Hospital is supposed to be #1 in the country.

But now to find the right doctor

re: "Even if I were to get lasix the blurry may not go away and the cost for one eye is 2500.  "

It isn't clear why they are recommending Lasik, but  that implies they at least have some theory of what the issue is. That suggests the blur is either from residual refractive error or from corneal irregularity. If its residual refractive error, then glasses or contacts should provide better vision. If its the sort of corneal irrelegularity they think the laser might be able to smooth then there is some chance its the sort of thing they sometimes use RGP or other hard contacts to try to address, which might be something to try first (though they likley can't correct all of what a laser could correct). Its important to understand why they think laser might help, even if they are saying it isn't guaranteed to fix it.

If vision was better beforehand then it seems likely its some some sort of refractive error that can be fixed, rather than corneal irregularity (unless the attempt to correct astigmatism via laser induced it). 

In terms of: "Sorry I had surgery." people need to realize that cataract is the leading cause of blindness in the world. The cataracts would have gotten worse until you were blind, so the only question was merely when you were going to have surgery, rather than whether you'd have it (unless of course you died before that happened). Usually the younger people are the better they can heal from surgery so depending on the cause its also possible there might have been even more problems if you waited. 

 

If your vision is 20-20 at distance then glasses should be able to correct it for other distances, e.g. progressive glasses would point that 20-20 vision at different distances.

You don't state what sort of IOLs you got, or what your remaining refractive error is (the prescription for glasses/contacts they would give you), but I'm assuming monofocal IOLs. If they were both set for distance (as is the default), then I've seen some doctors describe a typical result as being that everything from 6 feet in wards will begin to get blurry (though results vary, with some unfortunate few I've seen posts suggesting things at even 10-12 feet get blurry, with a tiny group of lucky people having better results and even being able to do some reading).

Were you atypically young for cataracts, i.e.  younger than mid-forties and hadn't experienced presbyopia (age related loss of near? People who are old enough to have presbyopia are used to the idea of losing near vision, and needing to wear readers or bifocals or  progressive glasses (varifocals they are called elsewhere). Monofocal IOLs set for distance leads to the sort of loss of near vision of someone elderly. 

The claim of having clear vision at 2 feet seems rather atypical. That suggests there is some possibility that you were given monovision, that one eye was targeted to see nearer in. However that doesn't mesh with the claim that there is also a clear point at 5 feet as well as at distance. If you had multifocal IOLs you would have had to pay extra for them out of pocket and so I'm suspect you would have mentioned it.

So the description of  blur going in and out at different distances sounds odd, I'd suggest being sure you are describing it accurately. It may be that there is some healing going on still, especially with the claim of feeling like you have a contact lens in it. There are no nerves inside the eye, there is no way to actually feel the lens, you aren't feeling the lens. That  suggests perhaps the surface of the eye is dry or inflamed.

Dry eye is a side effect of surgery at times, often only temporary, since it cuts the nerves that tell the eye that it is dry so it will rewet it as well as it should. Dry eye can also cause fluctuations of vision when you blink, so it may be that your vision isn't fluctuating based on distance (like from 2 to 3 feet) but based on time, as your eye is more or less dry. Lubricating eye drops may help if that is the case.

If you have good 20/20 vision at distance, then that isn't like being blind in any way. 

Many people have night vision artifacts and other issues during the first few months after surgery, especially during the initial first couple of months while the lens is healing into place. Dry eye can exacerbate or cause night vision issues. Residual refractive error, a need for glasses/contacts can also make night vision issues worse. 

The description of not being able to drive since its too burry doesn't mesh with the 20/20 vision at distance. 

The description of vision before being very good, never blurry doesn't mesh with your best eye having been  at 20/40 which most would consider blurry, and obviously more blurry than 20/20. 

If the lenses were taken out, you would need very high powered thick "cataract glasses" (or contacts) and would likely feel far more blind than you do now, and its unclear that would help with the night vision issues depending on what is causing them. 

I fonzi..I tried to reply to you but then it was missing I'm like a little computer stupid...

I too am in Florida so please keep me informed with whats going on with you..perhaps i need to go where you are going..my eye bothers me big time today..like a contact lense is in there but very irratated..im 57 and was told i had just the very begining of cateracts..up close i needed readers 150 about but distance i always had great vision..first 20/10..then 20/15..finally 20..20 and it took about 10 years from 47 to 57 to get 20.40 one eye and 20.60 the other but still..i didnt have blurry..not distant or watching tv...now..everything is blurry and getting worse by the day and im so scared as i have medicare and not the money for lazik..

I will pray for you..im going to call my dr tomorrow...this is really getting me so upset.

I also had trouble logging on for a few days.  I have made an appointment at the Bascom Palmer Eye Institute in Miami.  It may be a long drive but they are #1 in the country.  Hopefully this will be the solution. Can't get an appointment until July but I feel it is well worth the wait. 

Hi AJ.  I’m just reading your post from 11 months ago. I’m now having same issue as you.  I had multifocal lens put in my eyes alittle over 3 months ago. The light shows , bad, blurry night driving is insane. At first close up vision was great both eyes.  Now it’s blurry. Distance vision has been blurry since day one after surgery on both eyes. My Dr keeps saying it will get better.   It’s not.   How are you now? Did you do anything to correct? Second opinion? Thx.  Deb