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Monocular Ghosting post cataract surgery

Posted , 12 users are following.

luigi42683
luigi42683

Hi everyone!

I had cataract surgery on 10/24/22. i got the vivity implant. im experiencing ghosting. worse at near vision. pre surgery my near vision was 20/70, post surgery im 20/200. far vision is 20/20 lost surgery so thats great. the monocular double vision or ghosting is so bad up close that everything is very blurry and nauseating to look at from 0-10'. had me retina looked at, eye remeasured, refractory retested everything looks text book good. No remaining inflammation, and iol is hooked perfect.

i still have to get my other eye done but am waiting to correct the current issue with the implant.

im 39, was born with cataracts and also have had a lazy eye muscle when I was young. Any input would be appreciated.

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  • greg59
    greg59 luigi42683

    Edited

    I agree with Ron about waiting till you are off the steroid/anti-inflammatory drops to see if the ghosting disappears.

    If the ghosting stays around, two of the possible problems include astigmatism and something akin to a cataract on your capsular bag (PCO) where the IOL was implanted. If astigmatism is the problem, I would have thought it would have been found in a refraction at your 1/2 week post-op appointment. But I would also think if there was any problem with your capsular bag, they would have found it as well.

    I had lots of ghosting when looking through my now-replaced posterior subcapsular cataract lens. I could see 20/30 through pinholes and multiple ghost images in an optometrist's office but was maybe 20/200 outside.

    Since you were born with a cataract your eye/brain may have adapted to pinhole vision available through the cataract and may take longer to adapt to the new cataract-free IOL that your brain is completely unfamiliar with. You might look into vision therapy to see if there might be ways to speed up this adaptation.

    • RonAKA
      RonAKA greg59

      Edited

      I suspect it is possible to distinguish between "ghosting" caused by astigmatism from that caused by the EDOF lens effects. I certainly have ghosting from astigmatism in an eye that has a monofocal lens. I call it a drop shadow as it is located to the bottom right of the main sharp image. I don't have any halo effect, but I suspect if the ghosting is uniformly around the whole sharp image than that is most likely to be due to the EDOF design of the lens.

    • luigi42683
      luigi42683 RonAKA

      Posted

      ghosting is around the entire image. i can also see the edge of the implant in the right side of my eye

    • RonAKA
      RonAKA luigi42683

      Edited

      One of the likely issues to cause this is your age. Younger people, yes 39 is much younger than most of us with cataracts, will have larger pupil diameters. In some cases the pupils can open up large enough that you can see the edge of the IOL. Looking through a pin hole sharpens the image and counters the large pupil issue.

    • luigi42683
      luigi42683 RonAKA

      Posted

      could my lens be corrected somehow for this? should my doctor have ordered a lens to accommodate this?

      i will redo my surgery with a new lens if I have to. whatever it takes. the ghosting is making it hard ti do most of the tasks i need to do.

    • RonAKA
      RonAKA luigi42683

      Posted

      Unfortunately virtually all lenses are 6 mm in effective diameter. As for the ghosting I think I would wait for 6 weeks post surgery before making any decision. One option may be to get a straight monofocal like the Clareon in your second eye. It should give you a sharper distance image, and may allow you to ignore the halo effect on the other eye.

    • luigi42683
      luigi42683 RonAKA

      Posted

      thank for the info. im going to wait until after Christmas. i might have this lens removed and go with clareon in both eyes.

      do you think i would have a better result with panoptix over vivity as far as ghosting goes? would live to get my range of vision back if possible.

    • RonAKA
      RonAKA luigi42683

      Posted

      I think PanOptix would be worse than Vivity for ghosting. Google this and have a look at the halo simulation image down near the bottom of the page. The Clareon should be the same as the AcrySof IQ lens. It is just a newer material with basically the same monofocal design.

      .

      MiVision Shaping the Wave: The Evolution of Extended Depth of Focus Intraocular Lenses

  • greg59
    greg59 luigi42683

    Edited

    With my small amount of astigmatism, I've noticed that if I cover the other eye with an envelope and look at a ghosted object (lighted letters on far-away buildings at night) then move the envelope very slowly towards the other eye, the ghost of the image will go away just before I cover both eyes. At that point, the image is sharp. Evidently, the envelope is cutting off the light that ends up creating the ghosted image.

    You might play with covering your eye slowly from all directions to see if you can get rid of the ghosted image. Might help diagnose the problem.

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