How do you tell the difference between PCO and toric lens tilt or shift? T/u...
Posted , 5 users are following.
Also, is a toric lens shift, tilt hard to diagnose? Thanks.
0 likes, 21 replies
Posted , 5 users are following.
Also, is a toric lens shift, tilt hard to diagnose? Thanks.
0 likes, 21 replies
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RonAKA hilary13182
Edited
I would think the cataract surgeon should have no trouble doing it. There are marks on the lens that can be used to determine if the angular position is correct or needs to be adjusted.
hilary13182 RonAKA
Posted
What would happen if the bio-metric measurements were off? How could an ophthalmologist tell then? t/u
RonAKA hilary13182
Edited
If you mean the measurements of the cornea to determine the power of lens you need, then I think the best way would be to do a re-measurement of the topography. Perhaps best to get a second surgeon to do the measurements to effectively get a second opinion.
Night-Hawk hilary13182
Edited
PCO should cause cloudy vision at all distances and not correctable with glasses.
Toric lens rotation would increase astigmatism and could correct with glasses.
hilary13182 Night-Hawk
Posted
Hi. How would a tilt represent itself? What do people do if they have a shift? Get a lens exchange? t/u.
RonAKA hilary13182
Edited
Has your optometrist given you an eyeglass prescription? That would give you some idea what the problem might be. For example if the angle is off to correct the astigmatism, then the eyeglass correction for astigmatism should be significant.
hilary13182 RonAKA
Posted
Do you know if astigmatism or tilt could manifest itself by bowed lines, as in looking at a telephone pole that is curved to one side, in the middle? Or eyesight in one eye (w/toric lens) that feels 'drunk'? T/u
RonAKA hilary13182
Edited
I don't believe uncorrected astigmatism would do it. Not sure about tilt.
Sue.An2 hilary13182
Edited
I am no specialist but i see curved lines through my left eye (started a year after cataract surgery). My optometrist has referred me to s retina specialist (still waiting to see one). I was diagnosed with epiretinal membrane.
RonAKA hilary13182
Edited
You should ask your surgeon to check to see if you have Cystoid Macular Edema (CME). It can occur as the result of cataract surgery in a small % of people. It sounds like it becomes an issue about 2 months after surgery if it occurs. And, it is important to deal with it quickly, if you actually have it. Treated early it can be reversed, but if left too long the effects can become permanent.
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Google this for an article on it:
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"Cystoid Macular Edema | retina-vitreous surgeons of CNY"
hilary13182 RonAKA
Posted
Hi. What are the symptoms of CME vs PCO? I have no specific central vision blurriness- it is all over, but I do see slightly curved lines, curiously in the direction of my nose, in each eye. Thanks.
Sue.An2 hilary13182
Edited
Everyone on thus site is a patient (no specialists as far as I know). If you have persisting symptoms I strongly suggest you make an appointment with your surgeon. If you have and feel you are getting the run around you can get a 2nd opinion elsewhere. Many conditions can exhibit similar symptoms. I thought I had pco and once I saw my optometrist learned I gave EM (epiretinal membrane).
I hope you are able to get a proper diagnosis as it is obviously distressing.
RonAKA hilary13182
Edited
I have no experience with CME or PCO. I would think one difference would be the time after the surgery. CME would appear sooner and PCO later. From one source:
"Symptoms of Cystoid Macular Edema"
While this condition does not usually cause pain for most patients, it can cause some of the following:
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Increasingly blurry vision, especially when reading
Decreased central vision
Vision that is wavy
Decreased perception of colors
Retinal swelling or inflammation
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For patients who have had cataract surgery, cystoid macular edema usually occurs about two to eight weeks after surgery. Vision may also be distorted, with straight lines appearing wavy, and may be tinted pink as well. Peripheral vision is usually not affected by this condition."
soks Sue.An2
Edited
what are you talking about? i am a specialist .. a google specialist. 😃)
hilary13182 Sue.An2
Edited
Hi. What are the symptoms of epiretinal membrane vs PCO? Thanks.
hilary13182 RonAKA
Posted
OK, I will make an appointment to see my ophthalmologist at the end of the month- she has post-op optometrists that I have to work around. There has always been problems with my left eye, from day 1, 6 1/2 months ago. Extreme pain, high IOP, etc...Those have calmed down, somewhat, but I still have the dull ache where the incision was. Now I wonder if there is a tilt, because the floor seems to raise-up on one side. I also have a sm transparent floater that always stays in my central vision- it looks like an ice cream cone/tadpole/megaphone- lol. I wonder if the posterior part of the bag was breached.
RonAKA hilary13182
Edited
CME is just a guess on my part based on your described symptoms. The actual cause could be a number of things and I agree with SuAn that seeing the surgeon is the best thing you can do. It seems there are a few ways of diagnosing CME. The first one should be possible by an optometrist, but it may not be the best way.
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"Cystoid macular edema is usually diagnosed in one of three ways: dilated retinal exam, fluorescein angiography, or optical coherence tomography (OCT).
Dilated retinal exam: Your doctor may be able to diagnose the cystoid macular edema using a special lens to see the macula and identify the cysts.
Fluorescein angiography: Alternatively, diagnostic testing may be used to diagnose cystoid macular edema. Fluorescein angiography uses a special camera system to see leakage that results from blood vessels and the associated cystoid macular edema.
Optical coherence tomography (OCT): OCT has become one of the best ways to diagnose and identify cystoid macular edema. OCT is a non-invasive test that uses a special light to create a high-resolution cross-sectional image of the tissues of interest, including the retina."
I think the good news if it was CME is that treatment is a lot less invasive than a lens explant.
Sue.An2 soks
Posted
many of us have earned our doctorate in Google - ha ha.
Sue.An2 hilary13182
Edited
I thought I had PCO as my vision was blurry. However when I had my annual check up just over a year ago my optometrist diagnosed Epiretinal membrane. I cannot see clearly out of my left eye. With both eyes open I see fine as my right eye takes over. But if I close my RE everything is blurry and straight lines appear curvy.
hilary13182 Sue.An2
Posted
Hi SueAn2,
I want to exchange my left eye IOL, but my doc is hesitant. She thinks I'll just get used to the 1 diopter difference. I made a HUGE mistake asking for 'near' vision. She said the curves I was seeing were due to my eye muscles working towards my nose- hmmm, also I've developed major PCO and PVD in that eye. I need a name of an experienced lens exchange doc in Seattle, Wa or north. I'm up in Bellingham.