CME after Cataract Surgery

Thank you Lunabug. You called it before the Dr did, that it was macular edema.

He said at last appt, after doing the OCT scan that the optometrist requested, that if it wasn't better in a month, he would refer me to a Retinal Specialist. I am so not wanting to get a needle in my eye! I made it through the cataract surgery with no sedation, just the numbing drops, but I get the serious heebie-jeebies when thinking about a needle coming at my eyeball! I just want to be done with this whole thing. Patience is not my forte'. Was hoping someone would come on here and say, "oh yeah, I had that... it went away in a couple weeks". But sounds like it might take months 😦

It kinda does help me to ease up a bit on myself for not doing the NSAID drops from the beginning, knowing that it didn't make a difference in your case. I've been kicking myself for not at least trying them. That original one was generic Ketolorac, but I never took it. The Prolensa (NSAID) I'm using now is one drop a day. It's not making a problem, and I've been wishing I would have been prescribed this one from the start.

"It's so infuriating to have repeatedly told the doctors that there was a problem, and consistently have them ignore it." Oh boy, can I identify with this! I even saw in my chart that they wrote "subjective visual disturbance" for one of the times I went in in a panic because my vision had deteriorated so much. It took going for a second opinion from an doctor not affiliated with their practice to get a proper diagnosis so I could begin treatment.

I had just run out of the combined drops from the surgeon for the first eye, so the retina doc prescribed Ketolorac and Prednisone Acetate. A different NSAID than the combo drops and no antibiotic. Both eyes have CME, so I'll be using the combo drops in the 2nd eye at the 4x/day rate.

Glad to hear you're seeing some improvement already. For me, it's been slow going, but trend is in the right direction, as far as what I think is coming from the swelling. If I had to guess, I'd say maybe close to half the way back, compared to those first few days when I could see so sharp and clear out of operated eye.

I agree about having the OCT scans done, because the sooner it is treated, the better. I'm wondering if maybe it looks bad for their practice to have a lot of cases of CME, so they lean towards not acknowledging it and hoping it will resolve on its own.

As I get further out from the surgery date, and especially now that the retinal swelling is going down, I'm noticing that my right (unoperated) eye is not working well with the IOL eye. I can tell that my brain is trying different strategies in it's attempts to blend the 2 now-very-different eyes, but coming up short. I'm now thinking that at least some of the blurriness is coming from a bit of double vision. I've had a headache for several days, and my eyes feel like they are "pulling" weird, hard to describe. I only ever used glasses to drive before, I could always see well enough without glasses to walk around the house, and through the grocery store. Now I can't see good enough without my old-old glasses to get around, and my balance is bad all the time, with or without them.

Before surgery, my surgeon said "oh no, there won't be a wall of blur!" when i asked him how far out I'd be able to see if corrected for near vision. But there IS a wall of blur!! I'm focusing about 12" out, and at about 20" out, things are unrecogizable. (Not just guessing about this, I have a measuring tape I'm using to gauge it). I have to have my face right in the computer screen to read what I'm typing. And things are Really Small in operated eye, even with the font zoomed in as much as it will go. At my last appt, the one where I was officially diagnosed with CME, I asked about that, how small everything looks in that eye. He said that would go away as the macular edema resolves, and I breathed a big sigh of relief, thinking it was just that. But it is Not going away as the swelling is going down. It's actually getting worse as that eye heals, and it's starting to dawn on me that that is probably from how myopic I now am. I think he's got me Way more myopic than I needed to be! So much for trusting the surgeon to know what he's doing.

I auto-refracted at -2.25D in the now-operated left eye, at my pre-surgery measurement appointment in June (-2.00D in right eye on that date). I didn't see that at the time, hadn't figured out yet how to access that report in my on-line patient chart. He said back then that I was -2.75 and he would bring it up to -2.50. I legitimately didn't know what my eyeglasses prescription was at that time, because I hadn't been able to get a workable refraction for several years, mostly because of worsening cataracts. He must have been looking at an old prescription instead of the new test results from pre-surgery measurement appointment. I just hadn't been wearing glasses anymore, because I could see better to drive with just my drugstore sunglasses to help with the glare. So I now know that he wasn't even looking at the correct information when he spoke to me about it. I did contact his office the week before the surgery to say I wanted to be closer to -2.00D in that eye, and did not want to risk being more myopic than I already was, for multiple reasons. I don't think he got that message. Based on how well I can see out of that eye through a pair of old glasses that are -3.00D, I'm thinking I'm at least that, if not more myopic, and that the myopia is increasing as the eye heals.

To be honest, I'm getting quite depressed about this, cause... what can I do? Nothing really. Swelling's going down, but vision's getting worse. No way am I having the other eye operated on after the nightmare this one has been.I'm thinking my eyes are at least a diopter apart now, if not more. I already have a brain tumor and struggle with balance, not to mention deaf in one ear. I feel angry about it. He (surgeon) passes me off so nonchalantly, when this is severely impacting my life and ability to function independently. ok, rant over. did feel good to get this out tho.

Before surgery, my surgeon said "oh no, there won't be a wall of blur!" when i asked him how far out I'd be able to see if corrected for near vision. But there IS a wall of blur!! I'm focusing about 12" out, and at about 20" out, things are unrecogizable.

Yeah, that doesn't sound right. My eyes, with monofocal IOLS both set for -2, wound up at -2 and -2.5. I don't have a wall of blur at all. Things farther than about 24" are somewhat blurry, but I can see well enough quite far away, although of course not in crisp detail.

I hope that, even though it seems to be going the other way, when everything is truly healed, your vision will have greatly improved.

Thank You Bookwoman.

Do things look really small when you look at them out of your -2.50 eye only? Like need a magnifying glass to see it, small?

No. They look normal-sized, and the same size as my -2 eye.

Thank you for this information. I'm baffled as to why I'm experiencing this. Things even look real tiny now when looking through my glasses. Up until just this last couple days, when looking through Both my eyes together, things looked normal sized. The same as they've always looked before, and the way they still look if I close IOL eye. It was only when looking out of IOL eye by itself, to gauge how much I could see out of that eye, that things looked so small. But now, as macular edema is in the process of clearing up, my unoperated eye (which is my dominant eye, btw) is at times letting the smallness take over. So that when I look through both eyes together, everything is so so small. It feels like my brain is trying out different things, different ways of blending the view. I wish I knew how to train my brain to see only the regular size. Otherwise, I'm gonna have to carry around a magnifying glass in my pocket. Seems so unfair as I sacrificed the possibility for plano vision to not lose my near vision. I can see up close just fine from my -2.00 eye, there is just a bit of ghosting when looking at print because of cataract still there. Cataract is not as bad in that eye as the one was in now operated eye.

If it were me, I'd get a second opinion. Are you located anywhere near a major eye hospital?

If "swelling's going down, but vision's getting worse" and "he (surgeon) passes me off so nonchalantly", I suggest you get a second opinion.

This is exactly the sort of health situation where a reassessment is recommended.

Yes, fortunately, I do live near Casey Eye Institute. Have to go into downtown Portland, OR though, they don't have any satellite clinics in my area. I avoid going anywhere near there in recent times. Also, have to wait months to get in, they have long wait list. It's probably the best place to go though, for a third opinion. I already got a 2nd opinion, at a different clinic that is closer to me, is how I finally got diagnosed with CME. That doctor doesn't take my insurance though, and I would have to pay out of pocket to go back there. Might be worth it, even if I had to take out a bank loan to get treated there. At least I was listened to, and taken seriously.

On the up side... I can tell the macular edema is slowly going away. I can see almost all of the amsler grid lines, though they are still very wavery and distorted. Previously, there was a large washed out donut shape taking up half of it, where the little squares were totally occluded. It seems even better this morning than yesterday morning, though a little worse than when I went to bed last night. From the getgo, it has been getting worse during sleep, and is at it's best later in the afternoon and dinner time.

But the "ceiling fan in the middle of my vision" effect is back, even worse than right after surgery. Shimmering, vibrating, flashing... when I look at lights. Especially when first turning them on in the morning. And when looking at computer screen, like now (I have a MacBook with a retina display). If I leave a brightly lit room and go into a darkened room, there is just a patch there, in center of vision, which slowly fades away over several minutes. This may be entirely normal with an IOL, how would I know? Should be getting these answers from the surgeon that operated on my eye. However, I greatly appreciate people's comments on this forum, as it somewhat relieves my anxiety to know others have experienced these things and not gone blind 😃

If I leave a brightly lit room and go into a darkened room, there is just a patch there, in center of vision, which slowly fades away over several minutes. This may be entirely normal with an IOL, how would I know?>

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I would say that is not normal with an IOL. I don't see anything like that.

Thank you for letting me know that. I did choose a monofocal IOL (tecnis DCB00), and wasn't expecting artifacts.