Blurry vision in morning 1 week after surgery
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It's been a week since my first surgery, and the past few mornings I've been waking up with blurry vision. It generally has cleared up around lunchtime. I see the optometrist for my 1-week followup tomorrow so I'll ask him about it, but wondering if this is pretty typical. It doesn't seem to be related to the room getting brighter--I have an inside room with no windows and I'm seeing the same issue there. I'm using my drops religiously, and using artificial tears a few times a day. There's still a little swelling in the eyelid, and probably still significant swelling in the eye, so it's probably just a matter of being patient, but it would sure be nice to hear this is normal!
0 likes, 10 replies
jettesun lucy24197
Posted
I just had my one-week post-op appointment this afternoon. I've also been waking up with blurry eyes these last few days, and I can't see as well out of operated eye as I could just after surgery. Like you, it clears up a bit later in the day, but still not as clear as just after surgery. I think its the eye drops, especially the steroid drop. My 2nd eye was supposed to be done on Sept 17th, 10 days from now, but Dr said better to postpone and let this eye fully recover. He said my cornea was very dry today, and I should be using artificial tears (which I was hoping they'd have some samples of but they didn't, so I have to order). I've not been able to do my usual lid scrub and heat packs while this eye is healing, and that's traditionally been what's helped me the most with dry eye difficulties.
But my eye doesn't look swollen any more, and it must have looked good other than the dry cornea, because he said I could go ahead and discontinue the antibiotic drops (the Ofloxacin), but must keep up with the steroid one (Prednisolone), dang! I was surprised that they dilated that eye again today, but at least I know he had a good look around in there and all looked well.
I hope you find out at your appointment tomorrow that there's an equally benign reason for the blurriness, and that it gets better soon. I just can't wait to be done with the eye drops, they're such a pain! The steroid one tastes awful going down my throat, and also makes me a tad nauseous.
lucy24197 jettesun
Posted
I hope it's something simple like dry eyes. I'm a little paranoid with my retinopathy since cataract surgery can cause it to flare up. I called the surgeon's office this morning since their paperwork says to call with any vision changes, and they just said to see my optometrist today and they'd make a note on the chart. I'm trying this morning to use the artificial tears more frequently. I know it's been really dry here with a little smoke from wildfires, so that could be aggravating things too. I know it's got my sinuses in an uproar, and that has often affected my vision.
Sorry your vision isn't as good as right after surgery. Neither is mine. It sounds like we're having very similar results, so maybe it's just typical and will clear up for both of us soon. Thanks for replying, and good luck!
lucy24197 jettesun
Posted
I saw the doc today, and everything is looking good. No dilation during the exam. He said there's still some inflammation and my cornea is dry. He gave me some sample lubricant drops that felt wonderful when I put them in and my vision started to improve quickly--then the headache hit about 15 minutes later. I think it was a reaction to something in the drops. I don't usually get headaches, and this was a doozy. I've ordered a different brand/formulation of lubricant drops, but it's such a relief to have my vision come back.It's better tonight than it's been for a couple days. Still on the drops from the surgeon. They're combined so I only do one drop at a time, but it means taking all 3 (steroid, antibiotic, NSAID) for 6 weeks. Only have 3 drops/day starting this week, though, then it's down to twice a day for the final 4 weeks.
jettesun lucy24197
Posted
Our experiences are similar, fluctuating vision post-surgery primarily due to dry eye issues. I live in the pacific northwest US, and wildfire smoke was definitely a problem here the last two days as well. Woke up to ash all over my car yesterday, and had had my windows open with fan running all night. I notice that when my eyeballs are wet, like after just putting in any of the eye drops I'm using, my vision is greatly improved.
But woke up at 4AM with nausea and stomach cramps, which has been getting worse by the day. I am suspecting the steroid drops which are both dripping down the back of my throat, and I'm sure being systemically absorbed as well. Because there is no other thing different than usual (like with my diet) going on right now that could be causing it. I wonder if anybody else has had this reaction to the prednisolone drops?
Were you able to isolate the ingredient in the artificial tears that gave you the headache?
My schedule for the drops is different than yours. First off, I cannot do the NSAID one, the Ketolorac I was given, because those kinds of drugs build up in my system and I start having breathing issues at about the 3rd dose. So that one was off the table from the beginning. I was on the antibiotic Ofloxacin 2 times daily for 2 weeks, but surgeon said (after dilating my eyes and checking) that I could go ahead and discontinue that one. So I took it for only 9 days total. The prednisolone (steroid) was originally prescribed for 4 weeks, twice daily. But at the one week post op appt, surgeon said 10 more days minimum, then I can stop that one as well. So that would be a couple days shy of 3 weeks, twice a day, for the steroid.
lucy24197 jettesun
Posted
Sorry your meds might be making you ill. Hope it's something that clears up soon. I haven't noticed any stomach issues with the drops. I'm not sure what gave me the headache. Based on the timing I suspect the drops. It was bad enough that I don't want to use them again just in case, so not sure what was in them if they are the cause. They were Systane Hydration drops (and felt wonderful in my eyes.) I've always had good luck with Refresh drops and they have a different active ingredient than the Systane drops, so I have some Refresh Optive Advanced coming tomorrow. We'll see how it goes. In the meantime, I'm using plain old Refresh Classic artificial tears. They're ok; the Systane drops felt much better and seemed to have more of a positive affect on my vision. My vision is not quite as good today, but it's better than it was a couple days ago so things are moving in the right direction. The problem with blurriness seems to have been related to dryness.. I think the eye is also feeling a little better from drops going from 4X/day to 3X/day. Getting the combination drops may not have been the best idea since I'll be on all 3 drugs for 6 weeks, but it sure is convenient.
jettesun lucy24197
Posted
I've now started using the Refresh Relieva PF (preservative free) artificial tears. Ordered them on Amazon because couldn't find this particular version in local stores, then promptly found them in Safeway grocery store (typical, lol).
I'm hoping its just the dryness that is causing my difficulty seeing out of operated eye. It is even worse this morning, but had gotten a bit better yesterday afternoon. The fluctuations pretty much prove its not the IOL itself. Eye also a bit more bloodshot looking today. Reading up on the prednisolone, I'm thinking it IS the cause of the nausea, and I need to get better about not letting it drip down the back of my throat. But its supposed to be Helping the inflammation and irritation, so eye should theoretically be doing better with it onboard, not worse. The only thing I can think of is that it is somehow causing the cornea to dry out more, in the process of preventing inflammation.
lucy24197
Posted
Now two weeks out and still blurry. It's changed--I've got a small clear window in the middle of my vision and it's blurry all around it. It was really bad this weekend (when the dr's office was closed)--I only had about a one inch clear spot at 10 feet away. The clear area is expanding and shrinking. It was much better yesterday, worse today, and seems some better this evening. It's very frustrating because the vision in the small "window" seems to be very good, but outside that window it's a mess. Tomorrow I step down from drops 3x/day to twice a day--hoping that will help. If not I might be calling the doctor. They originally wanted to schedule the second eye today --that would have been insane given the way things are going. I'm really ready for this to clear up and settle down. It's quite an emotional roller coaster.
jettesun lucy24197
Posted
Amazing how similar our experiences are. I'm having similar difficulties. I too was supposed to be getting my second eye done today, but cancelled. Already at my one week check up, I was thinking that my non-operated eye was now doing most of the work while the other one healed, and I just felt I should wait. At that appt, surgeon said everything looked good, even though my vision was slightly blurrier than it had been for the first few days (attributed to dry cornea). Every day for the rest of the week, my vision got a little blurrier each day. At some point, I noticed a pattern that it was worse in the mornings, and cleared a little bit in the afternoons. By last Friday, I was concerned enough to call the dr.'s office. They had me come in that morning, and another Dr (not my surgeon) had a look. She said my cornea looked ok, which was a big surprise as I thought it was just dry eyes. She said my BP was high (they took it and it Was high), but unfortunately the rest of the visit was focused on that and nothing more was said about the blurriness in operated eye. However, they did make an appt for Monday with my surgeon.
By next morning (Saturday) when I awoke, there seemed to be a grayish blueish patch in center of my vision, that had a sort of shimmery strobe light effect to it when I caught sight of a light, didn't even have to look directly at it, just have it in my field of vision. And it took a long time to fade off. I called the on-call Dr for the weekend, and she just said to increase the steroid drops. At that time, the blurriness was still getting somewhat better by the afternoons, though did not go away completely. At Monday's appt with surgeon, my BP was high again, and he suggested I get an immediate appt with PCP, in fact, he called and made the appt himself. I went next day, they did a neurological exam and bloodwork, found nothing unusual. Even my BP was down to highish normal by then (140/80).
Went back to eye dr on Wednesday for a field of vision test. By then, my vision has become very patchy in that eye, so that I'm not able to read. I subjectively felt like I did pretty badly on the test of my operated eye vs the non-operated one. I did tell the technician that my vision was declining by the day, that now the blurriness doesn't even get better in the afternoon. And it's now more than just blurry, there are patches where I see nothing, like blank spots mixed in with spots that I can see something. She just said that surgeon wants to see me back in 2 weeks (Sept 28), and I can explain to him then what's going on.
I'm feeling like I need a second opinion. Something's not right. Doctors office wants to blame my difficulties on high BP and anxiety. I feel strongly that something else is going on. I don't know of any other eye Drs to go to that are close enough for me to drive to. I decided to stop the steroid eye drops in case it's a reaction to that. I do have good reason to think that's a possibility. I have told them I have many adverse reactions to medications, as does my sister, and we think it's genetic. But they just aren't listening to anything I say now.
At first, everything was so bright and clear in my operated eye. Now it's darkish, and very patchy-looking. I sure do hope stopping the steroid drops gives my eye a chance to recover, and I regain the wonderful vision I had just after surgery. I didn't take any since yesterday morning. Waiting to see if it helps.
Please let us know what's going on with your situation. Thanks.
lucy24197 jettesun
Posted
I'm so sorry you're having such a terrible ordeal with your vision. That must be so frightening--no wonder your blood pressure is up! My vision has been up and down. It was doing somewhat better for a couple days, then it was a worse, but not quite as bad as it was at its very worst. Tonight it's being somewhat better again after being off all day, although not as good as right after the surgery. I just looked at writing on a piece of paper lying on the floor--earlier today it was very blurry, now it's clear. There are so many variables that I haven't been able to find an exact cause and effect. My eyedrops are on a schedule and they went down from 3x/day to 2x/day several days ago, so that might have helped. I also found some information on using the drops that made me wonder if improper application was having a negative effect--I'd received NO instructions (and no paperwork or info on the bottle) other than how many drops and how many times a day to put them in, so I'd just get the drop in, blink a couple times and go. There are pretty good instructions if you search "How to Put in Eye Drops American Academy of Ophthalmology"--basically pull out your lower lid, put in the drop, close your eye for a minute or 2 while you gently press on your tear ducts to keep the drops from draining out of your eye. Please be careful just stopping your drops--I think prednisone is one of those meds that you don't want to just go cold turkey with. I hope you can find a doctor to help you--maybe if you have a regular optometrist they could assist?
jettesun lucy24197
Posted
Thanks for the info on putting in the eye drops correctly. I wasn't doing it right at first. Was putting in way too much of the steroid, and it was dripping down the back of my throat and making me nauseous. When I started pinching the corner by my nose, that helped a lot. Plus got my daughter to watch and tell me when I was holding bottle in correct spot for a direct hit. Like you, I received no instruction up front on instilling the drops. Didn't even know you're supposed to shake them thoroughly, because (at least the prednisolone ones) are a suspension, and the drug part settles out of the mixture and you only get the carrier part if don't shake good enough. First couple days, I wasn't doing that.
I did stop the pred drops, and have not started them back. My eye looks ok, no outward signs of inflammation, and actually Feels better. No longer feels like something is in there all the time. It Feels more healed, though that could be strictly from the passage of time (3 weeks now). Eye seems to have stabilized, in that it's now not getting worse each day. Symptoms are extreme blurriness when waking in the morning, so much so that it feels much more comfortable to walk around with that eye closed and just let the other one do all the work. I've been gauging it on the refresh relieva PF artificial tears box that the bottle came in. The word "refresh" is written in a lightish green color with white writing on the side of the box. My unoperated eye can see it just fine, but in the mornings, my new eye cannot see it at all, No contrast sensitivity, none, zilch. I can just barely make out that there is small black print else where on the box, but cannot come anywhere close to actually being able to read it. Two and three days after surgery, I could read very small print perfectly with new eye, it was crystal clear. So disappointed that I didn't keep that clear vision.
As the day goes by, vision in operated eye very slowly improves, so that by early afternoon, I can just begin to see a little bit more. There is a definite pattern to it: there are patchy "light" places where I cannot see anything, just blank spots, mixed in with places i can see clearly. Also, everything in that eye looks much Smaller than when viewed with other unoperated eye. By night time, I can somewhat read small print, by holding a steady gaze on one letter or word and moving my head around so I'm looking out of different places of my eye. The patchiness/light spots are still very much there, but maybe more light is coming in? Because when I close the non-operated eye, and look out of only the operated eye, it is dark. Especially in the mornings. Like a blue or grey veil is covering my field of vision. But this is a solid effect, not patchy. The darkness is equal all over my field of vision. Just after surgery, it was delightful how bright everything suddenly was in that eye. Now things look dark with that eye, even at the end of the day, though not quite as badly as in the mornings.
I went online and accessed my patient chart and did some clicking around, finding some links I hadn't noticed before. What is written in doctor's notes there includes some things they never mentioned to me, like some notations about my macula (poor FLR), and cornea (SPK). One of the doctors there had specifically said my cornea looked good, and another one (the weekend on-call dr) had mentioned that the macula measurements they took before surgery, compared to the test done on Sept 10th, showed it was "thicker" in her words, which to me would indicate swelling. Also notations about my "confrontational field of vision" being abnormal. No results listed in my chart from the official field of vision testing they had me come in and do 2 days later, they just noted it as "patient education", not a test. But it was a test, where you hold the clicker while looking into the screen, and click every time you see the dot. I wish they would just explain to me in plain English what they think is going on, so I'm not having to try to figure this all out myself. In the chart notes, the dr that did the surgery seems to be attributing all my difficulties on hypertension and anxiety, and chart notes saying "subjective visual disturbances" makes it seem like its all in my head. Which it Definitely is Not! I think they're just trying to cover their butts, tbh.
Another thing I read in the notes is that my post-surgery refraction is actually -2.75D. That's very disappointing, especially since he (my surgeon) gave me an eyeglasses prescription for -2.50 in that eye, one week after surgery. I wasn't happy with that then, as I had told them going into surgery that I wanted it less myopic than -2.50, I wanted to go for -2.00 in that eye (after reading advice from people here on this forum), to give me more "walking around the room" vision, so won't have to wear glasses indoors. I don't think he changed what lens he put in. This may account for things looking so much smaller when viewing with that eye, as other eye is naturally -2.00D myopic. It IS harder walking around the room now, especially since I have a right-sided acoustic neuroma growing from IAC into my cochlea, so already have major balance issues that my AN doctor was hoping the cataract surgery and vision improvement would help. Wearing glasses makes it harder to walk around because I naturally look down all the time to maintain balance, and looking through the bottom of my glasses throws me off. My routine, which I Did mention to surgeon beforehand (but now I'm seeing how they don't listen to what I'm saying, so he probably didn't hear) has been that I ONLY wear glasses to drive, and very much desired to keep it that way.
I've now officially lost faith in my eye doctor and the eye specialists clinic I go to. Feels like I'm getting the run-around, being blown off.
Since they don't want to see me back in there until September 28th, I feel like I'm on my own recovering from this. I would get a second opinion, but I did some calling around last Friday, and couldn't find an eye clinic with actual MDs taking new patients or making new appointments because there is a major shortage of healthcare workers across the board. Many people are quitting their jobs rather than take the now-mandatory covid vaccine (I'm in state of Oregon). I know 2 nurses personally who recently quit their jobs because of vaccine mandates, and they both know scores of other nurses and healthcare personnel in same boat. Regardless of what one might see on the news, we are actually in a healthcare crisis here, not due to covid pe se, but due to our governor and other administrative officials. They don't seem to care that the whole healthcare system is falling apart. The hospitals are actually Not full, but they Are over-capacity, with floors and wings shut down due to no workers to care for additional patients. The parking lots are nearly empty. What a mess! I now wish I'd delayed cataract surgery until this covid thing had worked itself out.