Light streaks at 45 degrees months after cataract Right(OD) 0.25 -0.75 145 +2.5 Lesurgery

The cataracts themselves weren't that bad, I just wanted to get rid of the farsightedness and astigmatism -- which glasses never completely corrected.  The result isn't perfect, but I'm really happy anyway.  This is a minor annoyance;  I'm surprised that my ophtho doesn't know what it is, but the rest of my body is weird too -- so why should my eyes be any different? 

Did you spring for the toric lenses?  Well worth the $1K each, I think.  A friend is contemplating Sympfony multifocals (or whatever exotic descriptor they're using) at $3K each, so I shouldn't complain.  I've been told by different docs that multifocal IOLs wouldn't work for me as well as single-vision lenses, so I bowed to their judgment.  Monovision contacts work pretty well...

Flashes when you squint hard?  Apparently those can be normal too.  I read elsewhere that IOLs can be removed (the additional ones certainly can, so why not the replacements?) so perhaps you'll get lucky.  Floaters are annoying -- trying to figure out the eye-gymnastics required to move them to a less-annoying place isn't easy. They eventually get reabsorbed, though.

"I read elsewhere that IOLs can be removed (the additional ones certainly can, so why not the replacements?)"  I think by "additional ones" you mean phakic lenses (lenses that are used in people that still have their natural lens), such as the Staar Visian ICL.  Those can be removed fairly easily, it's pretty much the same procedure as implanting them.  They go in the posterior chamber (between the iris and the natural lens).  Cataract surgery removes the natural lens and replaces it with an IOL.  That IOL can be removed, but it's not as easy as removing a phakic lens such as the ICL.  The replacement IOL is usually inside the capsular bag (that used to hold the natural lens) and the capsular bag is usually folded around the replacement IOL, so removing it carries extra risks of tearing or damaging the capsular bag, which can mean that you can't have standard IOLs (such as the symfony) any more but need special ones that don't go inside the capsular bag.

Thanks.  I thought the phakic lens went in front of the natural lens and was clearly wrong.  I'm kind of glad I chose single-vision toric lenses (ophtho thought I would have better vision with them than with any sort of multi-focals two years ago)  and don't have to make any more decisions.

Phakic lenses do go in front of the natural lens.  The clear outer surface of the eye is the cornea.  Between the cornea and the iris (the beautifully pigmented muscle that expands or contracts the pupil) is the anterior chamber.  Between the iris and the natural lens is the posterior chamber.  So, the anterior chamber is ante to the iris, and the posterior chamber is post the iris.  But this is all in front of the natural lens.

There are some phakic lenses that go in the anterior chamber, but those had problems and were visible in the eye (since they were in front of the iris).  The more common ones, such as the Visian ICL, go in the posterior chamber.  It's a relatively minor procedure to implant or extract such a lens.  However, they can increase the risk of early cataracts, especially if there isn't enough space between the ICL and the natural lens.

Ouch.  I didn't know there was an anterior chamber in front of the iris and thought that the posterior chamber was behind everything.  Sometimes it's GOOD to look at a diagram, isn't it? :-(

Any ideas about what might be causing my light streaks/beams?

How long ago was your surgery?

April 2015.  I just noticed this a couple of months ago, but it might have been there all along and I just didn't notice it.

A year and a half out, we can't say you're still healing from the surgery .  Did you have any prior surgery on that eye, perhaps a peripheral iridotomy?  Are there any other issues with that eye?  Do the streaks persist if you keep looking at the light source?  Are there any issues when you are in a dark room (e.g., looking at a clock radio in a dark bedroom)?

No other surgery.  No issues.  High pressure, but not yet glaucoma, and I'm using drops twice a day.  Slight dry MD, but no changes in that since I first noticed it maybe 5 years ago.  The light has to be a certain brightness, and the streak persists as long as I'm looking at it.  No light/dark problems.  I've got a retinologist that I'm going to see in 3 months or so -- he's taken a lot of pictures over the ~5 years that the MD has existed -- and he hasn't seen anything interesting in all that time. 

Is there any difference in the streak phenomenon if you are in a dark room versus a bright room (that is, does your pupil size make any difference)?

No, just that the contrast between the streak and the dark background makes it easier to see the streak.  I just looked very closely at one of the curly light bulbs which has a sort of darker band in the middle.  The streak duplicated the bulb lightness and darkness exactly.  AND it's always at the same 45-degree angle.

I wonder if it might be some sort of reflection off the lens?  You might consult a different ophthalmologist since your surgeon doesn't know.  If you do, please post back and let us know what he or she says.

The Costco optometrist who fitted me for contacts thought it might be some sort of reflection from the lens edge, in which case there's nothing that can be done anyway.  I'm going to the retinologist in a few months and will post again then. 

I'm really tired of being WEIRD!

A different refractive surgeon might have a better idea of what it is.

Hey, we're all weird, just in different ways.

I have a similar issue.  Did this ever get resolved for you?

Visited the cornea/lens specialist who thinks it's a crease in the rear of the capsule.  If I ever need to have any other capsule defects YAG-zapped he'll fix it then, but (and I concur wholeheartedly with this opinion) it's not worth the admittedly small risk of retinal detachment to do it just for that. 

Glad he has an answer for you!

My surgeon suggested that I had a wrinkle in the posterior capsule that was interfering with my near vision.

ok thanks for the update.  A wrinkle eh! do you but that? I suppose it makes sense.  Did he say what caused the wrinkle.  Was it damaged during the procedure do you think or was it there anyway before they removed your lense?

During cataract surgery, a hole is made in the capsular bag that surrounds the natural lens.  The natural lens is broken up and extracted through the hole.  The replacement lens is inserted through the same hole, and then the bag is folded around the replaement lens.  Sometimes this folding can result in a wrinkle forming.