Had cataract surgery in one eye (age 46). Other eye uses contact (-5.25) - having issues

yes, health care will cover the second surgery.

the contact works well for distance. i am still struggling to find the right prescription for reading and computer work. depsite having good distance vision, still getting dizzy spells. it is not repeatable. hiking can make me dizzy, apparently packing to go camping makes me dizzy, looking sideways while walking.

and i typically did not wear the contact from when i first wake up until right before i go to bed. maybe i need a different style. but until dizziness and headaches go away (now 4 wks after operation), i am not convinced a contact alone will help.

optometrist is of the strong opinion second eye should have surgery. but no one answers clearly if the headaches and dizziness are caused by the difference in where eyes focus or if my brain will get used to this.

yes, i have a monofocal iol. it sees better than 20/20 and csn see absolutely clearly with the correct power of reading glasses. this eye had a detached retina, which caused the cataract. i am delighted eith the vision in this eye post surgery.

my healthy eye has nothing wrong and sees 20/20 with a strong contact lens. it can see up close without reading glasses, but borderline starting to need them.

in the last 9 months before surgery, the vision through the cataract went horrible - halos, distorted objects around light and blurry all the time. no headaches, dizziness, or nausea.

it confounds me that both eyes can see clearly. but when the work together and at random times, I get headaches and dizzy, etc. when this did not happen when the cataract eye was blurry for months. in 4 wks post surgery, Iwould have hoped this would go away....if it is going to.

since the day after surgery, my iol has my eye seeing 20/20. before this I wore contacts and glasses. this eye required a -4.5 contact.

so now 4 weeks post surgery, i place a contact in my good eye (-5.5) as soon as i wake up and have to leave it in until i am going to bed as I cannot wear glasses that correct my distance vision in one eye and no lens in the IOL eye without going cross eyed.

even with a contact lens in one eye and the IOL in the other, I still get dizzy spells if turning my head, looking up and down too much, etc.

i did get a prescription for bifocals for reading glasses (even though it is soon after surgery) as I need to be able to work.

so distance wise, eith a contact in, both eyes see 20/20. up close, with reading glasses, both eyes see clearly.

yet there are headaches, dizziness, occassionally nausea, etc. this did not happen before. just wondering if this is normal.

or issues caused by correcting one eye at the lens level and the other at the contact lens level. i have some concern over getting an IOL in my second eye as it is healthy and there are risks asociated with surgery. but if it could fix the dizziness, headaches, and nausea, could be worth it. nevermind that I cannot wear glasses....ever. and while I always wore contacts, it was not 18 hrs a day like it is now.

ty for response.i will discuss this with my optometrist.

interesting. is your eye with the iol completely blind up close? because everything i try to read is a blur.

the dizzy sensation does not leave. it pops up in unpredictable times. on one hike, but not the other, sometimes when reading, but not other times. when i turn my head while walking. it is bizarre.

I can read a computer screen with my IOL eye down to about 18" or so. I can read text fairly close as well as long as it is in really bright light, like sunlight. In normal lighting the ability to read smaller text drops off quite a bit.

I did not have any of this after my vitrectomy. that surgery is bad enough with the head positioning requirements witnout that!

my eye has been checked about 4 times post surgery for a detached retina, and it is attached with no signs of detachment (thank goodness). but yes - when turning head to the side and when looking up and down a lot, the dizziness comes.

I do notice that my pupils dilate to different sizes with the IOL lens being larger.

I will try patching each eye.

optometrist feels this is classic (cannot remember word for different eye strength), although contacts are supposed to correct it.

dizziness was really bad s few weeks ago when I ended eye drops. Optometrist put me on steroids and it helped, but did not go away. I am now down to one drop a day and supposed to stop in a few days. And dizziness has been increasing since I went down to one drop.

i see the opthalmologist in 2 weeks. Will see what he says.

hi Denise,

I didnt have to do the head positioning since the vitrectomy was for floaters only. You mentioned your pupils dilate to different sizes; is the pupil with the IOL larger or smaller than your other eye? Are the drops they are giving you keeping your eye pupil dilated, constricted or neither? Are they steroids drops only? It is interesting that steroids helped a bit. I wonder if the randomness of your dizziness is connected to pupil size, or distance you are trying to focus at a given time. Do you have any eye pain in or around the eye area?

Anisometropia is the term for an imbalance in the prescription vision of the eyes. Before what happened to me I wouldnt think a -1D difference would cause you so much dizziness, but I am near debilitated and i see 20/20 corrected out of each eye. I do have strange linear distortions though and the vision just seems off in the eye.

When you go to the opthamologist, ask him to check you for strabismus (easy exam to do) and ask if a OCT is possible to make sure the retina has not wrinkled since the vitrectomy. It's good that it is reattached but sometimes changes can occur post surgery, and you want to make sure nothing is there before doing the other eye. if they already did the OCT scan then disregard. Are you in the UK? Is it difficult to get a sooner appointment with your opthamalogist?

Another option to try for your IOL eye is a multifocal contact lens. It can give you back the near vision and might help to balance things out.

Do you have any light sensitivity in the IOL eye? Can you describe the dizziness? For example, my symptoms don't feel like classic vertigo; the world doesnt spin around me. Its more like my head is dizzy and swimming and i feel disoriented. I also get nausea, but it feels like a migraine type nausea, not like something i ate nausea. And the symptoms only come from the operated eye. Does yours feel similar?

Like others here have said, until they can provide a definitive explanation for what is wrong, hold off on the other surgery. I realize that is hard, dizziness is scary and it makes us feel helpless. At least me anyway. Please keep me posted.

one other thing i wanted to ask - did you get the covid vaccine shortly before or after your surgery? I got my second dose one week after the vitrectomy. Figured i would ask incase its another common denominator.

has first dose about 5 wks before surgery and 2nd dose almost two weeks after, so I dont think it is related.

my pupil with the IOL is larger in light.

The drops shouldnot be affecting dilation - I believe just a steroid.

I think dizziness is related to movement. for instance, today in a store, walking down aisles, looking up and down, was very challenging. but while both eyes see 20/20 for distance, the IOL eye is not crystal clear because I am too close. but other eye is. so when i look far away, both eyes are clear. Up closer, only one eye is clear....and I think this is what starts to cause me issues. Or that is my explanation.

It is hard to describe my dizziness or nausea as I have never suffered from either before (except when I had low blood pressure). i do not feel I am at risk of passing out dizzy. But my head swims, start getting headache and tension and I then get grumpy, because I am often trying to work...or just live life and I cannot. I cannot tell if this stems from the operated eye or other.

I cannot see opthalmologist sooner. Mostly because he is a retinal specialist, so he is not near the location I live. And likely because I could not get in even if I wanted. Pretty sure I will be getting a thorough exam in two weeks as it is the 6 wk follow up from my surgery. and retinal detachment has been a big concern due to my history. As per usual, I will go in with a list of questions.

Were you dizzy before you got the second vaccine dose? I didn't become dizzy until I started wearing my contacts again - about three weeks after the surgery, and two weeks after the second vaccine dose. I realize it's a strange question but i am looking for any possible patterns. I am not sure why I was okay in my glasses but not contacts.

Do you know if your larger pupil is a temporary side effect from the surgery or is this possibly permanent? One thing I have discovered (having been dizzy for five months now, you learn things) is my dizziness is dependent on the lighting and my pupil size. You could start making note of the lighting when you feel most dizzy and see if there are patterns. Dizziness with movement is a symptom of a bigger problem - is it the eye muscles causing misalignment and the dizziness, or is it the eye trying to focus when you move it from a distant focal point to near? (I'm asking out loud here as a thought process.) Did the retinal surgeon do the cataract surgery? If not, are you in communication with that doctor? In the US, optometrists are not surgeons and retinal surgeons typically do not perform cataract surgery.

My dizziness sounds similar to yours, except mine is constant. Is yours becoming constant? Does it get really bad when you go from like looking down at your phone to out in the distance? Mine gets terrible when i am at the computer and having to look up and down to write notes. If i tilt my head back to look up at a shelf the dizziness is horrible. Sometimes the floor feels like it is coming up towards me and i step sort of funny, almost flat footed. The Pilocarpine has toned it down to a degree where I can get out of bed but I am not really able to live life the way I want to, as you described. It is very disabling.

Please let me know what happens when you try patching each eye. If the dizziness stops when you patch the IOL eye then its likely just coming from that eye. It's too bad they didn't leave you with a little bit if myopia to offset the lack of near vision. But it might be something a multifocal lens can help with.

i was having symptoms before my second covid dose.

i find my dizziness is not repeatable. and things that leave me dizzy one day do not the second. It is not becoming constant. It comes and goes. but on days when it comes, it comes once, then it comes frequently.

i wore a patch on my iol eye last night while I wore glasses on my normal eye. very weird. had trouble seeing out of one eye alone. not sure why.

then when I removed patch and glasses to go to bed, i noticed that my IOL eye saw lights fromhouse across the road coming through blinds, my good eye basically saw it almost pitch black. I put my glasses on the normal eye, and it still didnt see light.yet IOL was still seeing bright light. was alarming as seemed likr my good eye was going blind. but I pulled out phone and it could see and read that.

slept a bit, got up, and then my normal eye could see the light. optometrist will get a call Monday. no idea why it couldn't see light. this is new.

I do not know if my pupils will permanently dilate differently.

my retinal surgeon did do cataract surgery. not his normal surgeries, but based on my history, I went back to him.

It is so weird to struggle so much. People have cataract surgery all the time. yes I am young for it, but this is ridiculous.

When you patch an eye you are devoiding it of any light, therefore the pupil will enlarge, bigger than your unpatched eye. This means when you unpatch it the eye will be super dilated and get blasted with light. That is probably why it seemed like you couldnt see out of the other eye. Also alot of people get visual snow when they patch the eye and it can sometimes make the other eye feel like its going black also. was the room dark when you did the experiment? Did you feel any dizziness while the eye was patched or when you took the patch off?

You mention the dizziness is not repeatable but it seems like you can trigger it, right? Like does it always happen when you look up and down or sideways?

Mine is constant but only improved with the eye drop. So it seems like we may share some components but others are different. I also have light sensitivity but it sounds like you do not? It is interesting we both became dizzy after surgery with a retinal surgeon.

Hey there,

Was just wondering how you are doing, if your symptoms have improved at all, or if any new symptoms have occurred? I do hope you are feeling better.