Flickering light in eye after Cataract surgery

It is not normal to have a black halo around your vision. Unless you have some condition that causes this? I know many people with unplanted lenses myself included and we do not have this symptom.

Perhaps a second opinion ion might help.

Hope all goes well

The flickering issue sounds like it is fairly rare so some surgeons may never have encountered it. I would try to see if you can get your surgeon to reproduce lighting so that you see the flicker to see if that will help with diagnosis.  If you read this before going to your appointment, if you hadn't read through all the posts above, I'd suggest having him check for what seems to be my issue, the iris jiggling, iridodonesis, which varies the stray light coming in through the iris. (more likely if you were highly myopic before surgery and have light colored eyes). In my case I caught that on video.

The fact that it seems to be tied to stray light coming in from the side is one thing that suggests to me it might be the iris in your case (it sounds like there are likely multiple vague symtoms which can be described as "flickering" so I suspect that not everyone posting here has the same problem).

However I'd also  suggest making sure the doc takes at least one look at your eye before dilating drops, or that they use a non-cycloplegic dilating drop, to see if the issue might be your capsular bag jiggling due to loose zonules,  pseudophakodonesis, which is another possibility.  

Hi Linda,

I am a cynic when doctors tell you that "you are the first one" or that "I have never seen that before". I had a dark shadow on the left of my left eye and was told that it would go. I then learnt that this does go for many people but sometimes it takes a long time. 10 months later I am still waiting and hoping that the shadow will disappear! 

Many doctors and consultants have not yet faced the reality of people being able to check things out by sharing experiences as on this site.

Good luck with your "jittering" and be persistant!

Thanks for the info.... after this complication I have done a lot of research on my own.  I saw my surgeon earlier this week and we both concluded  that what I am experiencing is positive dsyphotopsia.  This is caused by the IOL that was placed and there's no easy answer as to why.  After I told him I had been doing some extensive research on my own, he opened up and discussed some of the issues on a more indepth level.

As expected, my eyes have healed without any complications.  I had the right eye done 3 weeks after the left eye with no complications whatsoever.  Our hope is that the condition will resolve on its own, as often times it does.  The next step is to perform Lasik on the Cornea to correct my distance vision in my left eye as the IOL did not give the results that we expected.   

In my research I discovered that the acrylic lense (which was what my surgeon chose) has a higher incident for the dsyphotopsia problems.  Silcon lense with a rounded edge and lower refractive index seems to have fewer incidents of this problem.  

This shimmering or pulsating light (jittering as I call it) is called scintillations and it's caused by back scatter from the IOL combined with short eye movement.  It's seen more often in high refractive index IOL's.  Interestingly, the size of the IOL is not the problem.

For now I am trying to keep a good attitude and deal with the annoyance of the this "jittering" that I experience daily.  I will continue with my own reseach and discuss all my new finding with my surgeon.  I would encourage others who are experiencing these same symptoms to use the internet, research and educate yourself and present your finding to your surgeon.  He/She will take notice, because at this point you've proven you are not crazy and the symptoms are real.

 

From my research, the shadow you are describing may be what is called negative dysphotopsia.  Have you read up on this?  Theres lots of information on the internet.  

Thanks Linda, I think you are right and I have read a lot about it. Of course my consultant never used the word! Next time I see him I will be more assertive and let him know that I understand the problem, and just need a solution. He is hoping it will just go. So am I!

 

The phrase "positive dysphotopsia" is broad generic description of a class of unwanted problems, not a specific explanation for what it is in a particular case. The suggestion it is due to back scattter is a specific explanation, a hypothesis, which may be the  potential explanation for some (to avoid sending the post to moderator by including a URL, if you search for "Demystifying Dysphotopsia" the first hit will be an article explaining it from the Jan 2005 Review of opthalmology. That is an old article however and lens designs  and materials have improved).

In my case the iris issue seem more likely, the phrase "flickering" is vague and broad enough to encompass symptoms with different causes.  Actually newer acryllic lenses tend to have newer edge designs intended to cut down on things like dysphotopsias, I don't don't know what model lens you went with.

The index of refraction varies depending on lens model and might be a factor, the Tecnis silicone lenses are 1.46 which isn't much different than their acrylic lenses at 1.47, though the STAAR silicone is lower at 1.41, especially compared Alcon acrylic at 1.55. (the data came from an article titled  "defining excellence in iol optics" which is the first google hit, in the Dec 2014 supplement to Eyeworld).

Although piggyback lenses seem to be promoted more for negative dysphotopsias, I have seen references to them as being effective in some cases of positive dysphotopsias, as might a lens exchange if you are sure enough of the cause that you think a lens with a different material might make a difference. 

The shadow at the edge of vision is a far more common issue than flickering it seems. Common negative  dysphotopsias like the shadow usually go  away in the first few months. However they  may not go away by themselves, and if they do then  how long it takes them to go away varies greatly depending on the person. Unfortuntely no one can give you a concrete answer on if/when it'll go away. There are various approaches to treatment for it that are considered after the first 3-6 months (though some wait a full year), from lens exchange to a piggyback IOL.  Any decent surgeon should be aware of negative dysphotopsia issues since they are reasonably common, but many haven't encountered the flickering issue.

One potential cause of the flickering issue is the lens being loose in the bag initially, which will usually go away in the first few weeks as the lens heals into place. If its still around after 2 months then the cause is likely harder to pin down.

In my case my flickering issue is improving at a glacially slow rate still at 10 months postop, but I still notice improvement so I'm hoping adaptation will solve the issue. I havent' heard of anything that can be done if it is the iridodonesis (iris jiggling) that is the issue, and there are added risks (and question of how much help it'd be) suturing it it is loose zonules, and if its either of those lens exchange is likely not going to help.