Is inconsistent vision post cataract surgey normal?
Posted , 8 users are following.
I'm three months post cataract surgery and things are pretty good. I'm a bit myopic, but that I can deal with. My bigger issue is that my vision is not consistent and sometimes during the day it's a lot worse than other times. This mostly impacts my distance vision, but on rare occasions it also impacts my near vision. Drops don't help things at all. The one constant is if I am watching TV and dose off for a little bit, after I wake up my vision is always at it's best. So my layman diagnosis is that my eyes are just getting tired, which wouldn't surprise me since I stare at screens most of the day. However, I'm wondering if this is normal or if there could be something else going on here. If it is normal, would it likely improve?
0 likes, 16 replies
RonAKA Rsko
Posted
It sounds a lot like dry eye disease (DED). There are tests the optometrist can do to diagnose DED. I have to admit I used to be skeptical of DED diagnosis and that they were just an opening to sell very expensive eye drops. When I was using contacts over my contact lens experience to test drive mini-monovison, I broke down and tried the drops. They did seem to help with the late day sticky feeling you can get with contacts. Now, I have had my surgery and no longer use contacts, I have continued to use the drops. I think some of the issues I was blaming the contacts for, could have been DED. In any case I use the drops twice a day now, once in the morning, and once just before bed.
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My research has convinced me that sodium hyaluronate is the most effective ingredient. In Canada this is very easy to find, and I used HydraSense Advanced which I buy at Costco for $24 per three 10 ml dispensers. On sale they are about $19. They contain 0.15% sodium hyaluronate. My wife has much more expensive tastes and uses the HyLo brand which is about $37 per 10 ml, also at Costco. This said, if you are in the US, then for some reason eye drops containing sodium hyaluronate are had to find. If they are interest you may want to try ordering from Canada.
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Hope that helps some,
Rsko RonAKA
Posted
Thanks. My doctor prescribed Cyclosporine .05 drops and I used them twice a day but they didn't help at all. I'll try the 0.15% sodium hyaluronate and see if it helps.
maura04015 RonAKA
Posted
"My research has convinced me that sodium hyaluronate is the most effective ingredient. In Canada this is very easy to find, and I used HydraSense Advanced which I buy at Costco for $24 per three 10 ml dispensers."
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After seeing you mention HydraSense a while back, I decided to try it since I wasn't too impressed with either of the two brands I'd tried to that time. The bottle it comes in is dreadful, but I do like the drops and find them more helpful. They aren't available at any local store, and I have to order them from Amazon. I've been getting the pack of two, one night and one day for $28.46. The nightime drops are a bit thicker than the daytime, but unlike the Optive gel drops don't make my vision too blurry to do anything for half an hour after using (I often read in bed for a while). Looking now I see the 3-pack of Advanced for $28.89. I'm sure it wasn't there last time I ordered, but I'll have to try it.
Rsko maura04015
Posted
I wasn't able to easily get HydraSense in the US and so I just ordered Refresh Celluvisc Lubricant Eye Gel Drops, Single-Use Containers. They have good ratings so I'll see whether it helps.
RonAKA Rsko
Edited
Those drops unfortunately do not contain HA. Also, single use dispensers tend to be very expensive. I see HydraSense Advanced in the 3 pack advertised on the US version of Amazon for $28.89. Even at that price is is way cheaper than the HyLo (0.1%) that my wife uses. A three pack lasts me for over a year. If you google the article listed below you can get a good review by a Canadian optometrist that has reviewed what is available here. You may get some other ideas there. I believe he talks about the Carboxymethylcellulose Sodium that the Refresh Celluvisc drops have. A quote:
"In vitro studies showed that HA preformed slightly better than carboxymethylcellulose (CMC) and hydroxypropyl methylcellulose (HPMC) at water retention and protection of corneal epithelial cells. HA can not only retain water but also slowly release it over time."
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Mike NG Comparing Preservative-Free Eye Drop Products in Canada & Looking Beyond March 4, 2020.
phil09 maura04015
Posted
"The bottle it comes in is dreadful..."
Yes it is! Why on earth would they design it like that?
I got the Advanced three-pack and have been using for a few days after seeing the discussion above. I don't yet have an opinion, and I'm not sure I had any dryness in the first place, but I figure the drops can't hurt.
RonAKA phil09
Posted
I find I have to rinse the nozzle under the hot water tap once a week or so. Otherwise the drops get harder and harder to squeeze out.
phil09 RonAKA
Posted
It was very hard to squeeze out even the first drop from a new bottle. The dropper/cap is unusually short and fat for eyedrops, which has me bumping the cap into my eyeball and wasting many drops on my cheek or eyelid. I'll probably get better with practice, but the design seems very user-hostile.
Thanks for the tip on rinsing with hot water.
RonAKA phil09
Posted
My experience with them is that for the first 1/4 to 1/3 of the contents it is quite easy to get a drop. But then it starts to get progressively harder. My suspicion is that the nozzle gums up and that is how I came up with the idea of running the nozzle part under the hot water tap.
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Yes, it is hard to hit the eye, but I keep the nozzle a fair distance away from my eye. I worry about damaging my eye or contaminating the drops.
pershoot Rsko
Edited
I experience similar; upon waking from sleep / nap it may be clear'ish slightly after but then after an hour or so it reverts back to a haze and not as clear (as best as can be with this particular eye I'm working with). I do have good hours and bad hours, so to speak, at times. I do have a touch of dry eye (mostly visual manifestation) and have opacification forming. I mentioned it to my docs on a follow-up. They suggested to try using Refresh Plus lubricant (drops) and / or Genteal ointment lubricant (night). I have not tried them, as of yet, as I do not want to become chained to them.
Rsko
Posted
My doctor inserted "plugs" into both eyes and that seems to help a lot with the dry eyes. It was simple and took about a minute. They last 6 months and so if these do help a lot, the downside is I will need this done every six months.
Lynda111 Rsko
Posted
I like and use Systane Hydration PF (preservative free) in the multi dose bottle. Made by Alcon. You can buy it off the counter at Walmart and most drug stores
rmsko Rsko
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When I'm watching TV and looking at subtitles, they go from being clear to moderately blurry and then back to clear and moderately blurry and so on. This happens without me putting in drops or doing anything else. I'm using TV as an example, but the same thing happens throughout the day in other contexts. Does anyone have any thoughts on this?
phil09 rmsko
Posted
Did you get cataract surgery? How recently?
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I have the same thing, but I notice it only when I am reading the small lines on the eye chart. Which makes it tough when the eye doctor asks me "Which is better, one or two?" I don't notice the fluctuation when reading TV subtitles or doing any other regular activity. I don't have changes related to time of day or before/after sleep like the OP (rmsko and rsko - any relation?).
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My optometrist said it might be caused by the prednisolone eye drops I took for a few weeks after cataract surgery, but the fluctuation has persisted for a few days now after I stopped taking those drops. I don't notice any dryness in my eyes, but I started lubricant eye drops a week or two ago and that has not helped either. My overactive imagination says the new plastic lens is still wobbling inside my eyeball, but I have not yet found any solid information about such fluctuating focus.
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Since it does not noticeably affect my vision and the optometrist expressed no concern, I'm not worrying about it. But I would be interested to know what causes this.
rmsko phil09
Posted
I had cataract surgery about three months ago and have the Symfony Optiblue lens in each eye. I too am wondering whether the lens is floating around. Some of mine may relate to dryness but the drops really don't help too much. I'm seeing my eye doctor on Monday - I'm scheduled to have YAG but I'm relatively certain that that won't help what I'm experiencing. I too want to find out the reason, especially before I do the YAG because if it has something to do with the lens, I need to know that before the YAG in case a lens exchange is recommended. That said, I doubt it's the lens because it's the same in each eye.