Flickering side-light after cataract surgery. Causes?

Posted , 8 users are following.

Hello everyone,

I wrote before on this portal and have seen other people complaining about this symptom, side-light flickering, so am going to write again.

Symptoms

It's always a side flickering, never frontal, and usually at a specific angle. It's caused by strong or relatively strong light coming from the periphery into the eye, usually from the outer side (like a window during a sunny day) or the upper side (ceiling reflectors). Stronger is the light from the side, stronger the strobe-effect inside the eye. If the light is softer, it's perceived like a little flickering of the light source. It doesn't depend on the pupil aperture: it appears with strong light and relatively small pupil too (a sunny day, in the shops). Many times it's enough to wear sunglasses to let less light inside the eye and stop the debilitating phenomena, so the light must be still relatively enough strong to cause this flickering.

The cause

People say it's the lens' squared, truncated (not rounded) edges that reflect the light inside the eye like a reflector. The flickering is strictly correlated to the tiny movements of the eye (called saccades). During the night, especially in younger patients, if the pupil is wide open and some light comes from the periphery, one can notice a flickering half circle (usually called edge-glare). In fact, dilating eye with drops (before an eye exam), it makes the flickering very strong. I can perceive the entire lens reflecting: an entire circle (lens' edges); I can even see the light beam coming from the ceiling reflector right inside my eye.

So, making the pupil very small could stop this flickering, since the light does not hit the edge? Oddly enough, pupil constriction drops (alphagan) helps for night light phenomena but it doesn't help much for the flickering. A doctor told me that it's not necessary for the light to hit the edge but it's enough to hit the lens producing edge reflections. So why the light must comes only from the side?

Wearing contact lenses, even gas permeable (harder) does not help either, so I don't think it's related to the corneal issues, like astigmatism, corneal transplant, diseases or scars.

I have two more options (I don't believe they are the main cause, but worth being mentioned):

  1. IRIDODONESIS (jiggling of the iris after the cataract surgery; check video on youtube)

    Since the flickering is always related to eye movements, maybe it could be the wobbling of the iris causing this problem? (it could stop after dilating the pupils but, as I said, it makes the flickering even stronger).

  2. NEGATIVE DYSPHOTOPSIA

    I don't perceive any darkness in my periphery but what if this flickering could be a very small negative dypsotopsia? A disco strobe effect is actually a light-dark-light-dark phenomenon.

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  • Posted

    Flickering is the only thing I mentioned on my one day post-op. I don't notice it as much since then. The optometrist then said it is due to the Symfony lens characteristics. What lens do you have? The lens haptics are set in the sides to help prevent negative dysphotopsia.

    I assume you have tried alphagan. Did you get any side effects from it?

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    • Posted

      I have silicone in one eye and the Tecnis ZCB00 in the other, both squared edges, the Tecnis even has frosted edges but it does not help at all for the edge glare. Aphagan helps only at night, no glare, no halos, no starburst, but no help for the side flickering.

      I have no visible negative dysphotopsia.

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    • Posted

      does the flickering feel like heart beat?

      does the flickering happen if there is just one light source in the room?

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  • Posted

    i had a little bit of what you describe after 2nd surgery. I would notice slight shimmer when a light source was perpendicular to that side of my head. Gradually went away and now I don't notice it anymore. Likely it was edge glare but not 100% sure.

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    • Posted

      within 6 months it went away. my surgeries were summer 2017. so not sure if it was edge glare or not. happened only if a light source was to the side (left eye) i recall turning my head slowly to try and pinpoint at what angle my head had to be to the light.

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  • Posted

    Wanted to give you a little insight on my experience. I had catarac surgery in both eyes along with yag lasers. I HAVE A SYMPHONY lens in right eye and a tecnis multifocal 3.25 in my left. Shortly after I had yag procedures I noticed i was having shimmering if light in each eye. IT Happened all the time but never head on it was always when i moved my eyes. It was completely maddening to me. Everytime i moved my eyes it would be like a shimmering affect. Went to retina DR. and i had a vitrectomy on each eye. PROBLEM solved. He was amazed that I had what looked exactly like Christmas tensil in my eyes. SO bizzare i know butb problem fixed. Hope this helps.

    Best

    GEORGE

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    • Posted

      Same thing happened to me. I believe it is from the YAG surgery, the pieces of the capsule that are in your eye now had light reflecting off of them.

      Do you have any side effects from the vitrectomy?

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    • Posted

      kevin, yea it was the stuff the yag busted up was stuck in my eyes. It didnt settle as the doctor said it would. The vitrectomy was so easy. SO glad i did it.

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    • Posted

      thanks so much for the reply. getting the YAG was one of the worst decisions I ever made. i have to wear sunglasses all the time to reduce the effects of the floaters.

      I have thought about getting a vitrectomy but never booked an appointment. I am going to do that this week.

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    • Posted

      Well my PCO wasn't that bad. I actually complained about my vision getting worse in lower lighting. He suggested that I get a YAG because I had some PCO but also because it would allow some more light in. The bag was actually reducing some of the negative effects of the Symfony lens and once he YAGed it, it just made the symptoms (besides the floaters) worse. I would have waited for a YAG until it was 100% necessary if I knew this is how it would turn out.

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    • Posted

      thanks for sharing and sorry you have to go through this. vitrectomy will solve this for you and probably also reduce retina detachment risks.

      i have been reading on this and they say the doctors cannot predict if YaG will clear vision or not. the pco caused by capsular folds and residual cells should usually be left untreated until it increases.

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