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Flickering side-light after cataract surgery. Causes?

Posted , 12 users are following.

adlibi
adlibi

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.

1 like, 28 replies

28 Replies

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  • seeherenow49806
    seeherenow49806 adlibi

    Posted

    HI all:)

    I've gotten 2 related answers to this question from 1 optometrist and two retinal specialists. My surgeon was familiar with the edge glare issue, but the other doctors had more detailed info.

    1)The common experience of the flickering right after surgery -

    Because the IOL is so much thinner than our natural lens, there is a displacement of volume in relation to the liquid vitreous gel, (which is about 98% water and 2% collagen). In other words, it's like there's suddenly a hollow space in the eye where the small balloon-like natural lens was. It's only been partially filled by the ~ flat IOL.

    So the vitreous gel suddenly has room to move and does so whenever we move our eyes. This can"pull on" the retinal wall. That pulling causes electrical impulses to occur, which we experience as light flashes.

    1. If you only experience the sudden flashing of light much later, as I did 6 weeks after Right Eye surgery, it is of greater concern. It can be a sign of retinal detachment. In my case, the cutting-edge retinal specialist said there was some detachment at the back of the retina, but no serious detachment from the side walls, (which I guess is the more problematic scenario?)

      I will see him again in 1 month. If no more signs of peripheral detachment, then I go back in 2 months, then 3 months, etc. In my case, the high myopia pre-cataract is the high risk factor. Meantime, that flickering greatly subsided after a few days. But I still notice it, especially when moving my head/eyes while moving from a light space to a dark space. It doesn't especially bother me, but I pay just enough attention to it to monitor any change in frequency. So far it's decreasing - good news!:)

    Most importantly, he said, DON"T WAIT to see a retinal specialist if you have this experience suddenly, weeks after the cataract surgery. Current research shows that serious retinal detachment damage can be prevented (or mitigated) if detected EARLY and treated (via laser, I think?) If you have any doubts, go to a retinal specialist. It would be covered by just about all insurance policies.:)

    • seeherenow49806
      seeherenow49806

      Posted

      Actually, I think he also said DON"T WAIT if the flickering is persistently very rapid for more than a week or two after surgery. 😃

    • adlibi
      adlibi seeherenow49806

      Posted

      You are talking about flickering caused by retina traction that occurs even in the total darkness, we are talking here about flickering caused by the intraocular lens shining inside the eye with side lightning. There are two totally different things.

    • seeherenow49806
      seeherenow49806 adlibi

      Posted

      No, didn't occur in total darkness at all for me. Experiencing edge glare mostly at transition from dusk to dark outside. Greatly subsided now.

    • adlibi
      adlibi seeherenow49806

      Posted

      Ok but this discussion has nothing to do with retinal detachment, it's about iol dysphotopsia.

  • dunya
    dunya adlibi

    Posted

    Hi adlibi,

    It has been a while since you wrote this post.

    I dam wondering if you found the cause and the solution to your problem?

    I have the same effect 3 weeks after surgery.

    Thank you!

  • twinkle65715
    twinkle65715 adlibi

    Posted

    hey has this resolved for anyone?

    i see the flickering in the day tine its so annoying. anytime the light intensity changes. i must add i see a faint cresent too

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