Need advice. Blurry vision since cataract surgery 5 months ago.
Posted , 11 users are following.
I really hope someone can help me because I don't know what to do any more. I am exhausted, frustrated and not getting any cooperation/answers from my doctor/surgeon. I've had blurry vision in my left eye (OS) for five months since my surgery --- it is worse than before the surgery.
My doctor's office never gave me a follow up appointment other than the morning after my surgery. While I was communicating my vision concerns to them via their Health Portal (because nobody answers the phone) that something was wrong and I needed an appointment, the nurse said Dr. So and So said to just keep using the artificial tears. I said I've been doing that 4X/a day and it's not helping. I also have eye pain and burning. I finally got an appointment with the doctor after 5 weeks post op. He looked at my eye and said I needed YAG laser procedure. He didn't dilate my eyes. Just looked at them through his machines. I said will that help my vision? He said yes.
I had the YAG 9-weeks post cataract surgery. It did nothing for my blurry vision in fact made it worse because of the inflammation it caused. The only thing I noticed is that a film was lifted from my eye.
So after that I was in excruciating pain and contacted the office via the portal from you know where. They said to come back in a week. The doctor looked at my eyes (no dilation) and said I had inflammation. Gave me steroid drops. I took those for a month and scheduled an appointment with another doctor at the same clinic because I was not getting anywhere with this guy. My eye was burning, in pain and photophobia, etc. on top of the fact that I couldn't see because of the now even worse blurry vision. This doctor diagnosed me with Iritis. More steroid drops and some dilation drops for burning/pain. I asked him why my vision was still blurry and he said he had no idea since he didn't do my surgery. Then he dismissed me at my last appointment at my one month follow up and said there's nothing more he could do and was referring me to a neuro-opthalmologist.
I didn't really think I'd get an objective opinion from another doctor at the same clinic but I was extremely worried about my eye. After I was dismissed from the last doctor, I thought I could get an objective second opinion yesterday at a totally different clinic/doctor. But no. He said he couldn't do anything because he didn't do my surgery. But he could do laser surgery on my eye if I wanted it. He was totally rude and dismissive.
My suspicion from day one is that my surgeon gave me the wrong prescription for my lens. But I have no idea how to find out. I asked him point blank if that was possible and he said absolutely not. In the meantime, I was never told or given literature on what type of standard monofocal lens he was going to use. He also will not release the reasoning behind why I was approved for cataract surgery. I asked and they (the nurse) emailed me -- it was a combination of your vision/glare testing and one other test I forget the name. My vision in that eye was 20/20. But I had really bad glare/halos when driving during the day and night which made my overall vision numbers worse. I wasn't complaining about having surgery. I just wanted to understand the facts or what did they submit to insurance?
They also won't tell me what formula the doctor used to arrive at my prescription for my IOL. I am convinced that the prescription is wrong because nothing else is wrong with that eye based on all of the tests. So far I have gone to 3 ophthalmologists (including the surgeon) for eye exams. Nothing wrong except inflammation and of course my vision is now approximately 20/80. What is the big secret about determining cataract approval? And why would he not give me information on what formula/method he used to arrive at the lens prescription?
Does anybody know if it's possible to determine if the wrong prescription lens was implanted?
I saw some paperwork AFTER my surgery with the word Lenstar. And, the lens he used is Tecnis Eyhance monofocal. That was on the surgical notes paperwork from the surgery center because it was not in my file with this doctor.
Here's an excerpt from the Tecnis Eyhance literature:
*Prior to surgery, the surgeon must inform prospective patients of the possible risks and benefits associated with the use of this device and provide a copy of the patient information brochure to the patient.
Some autorefractors utilize only the central part of the IOL to calculate the refraction of the eye and that is the region where the TECNIS EyhanceTM deviates from the monofocal design which could result in a wrong estimation of the refraction. Manual refraction with maximum plus technique is strongly recommended."
Okay I'm not a doctor but I've had to learn more in the past 5 months than any person would care to --- especially with one bum, blurry, burning left eye and the other eagerly awaiting its own cataract surgery which sadly won't be any time soon.
Are most patients told which specific lens the doctor is going to use as well as the vision expectations in numbers? I was only told by my surgeon that my distance vision would be corrected and I'd keep using my reading glasses. I was good with that. Well I'm not good now.
Sorry for this long posting. I didn't know how to shorten it without leaving off important facts. If anyone could offer advice I would greatly appreciate it. I really just want to understand what happened. But I'm hitting road blocks all along the way. Which makes me even more suspicious. Thank you!
0 likes, 69 replies
Lynda111 Trix317
Edited
I hope the Mayo Clinic can help. you. Let the forum know what they tell you. BTW, since you're in the Southeast. the Bascom Palmer Eye Institute in Miami, FL is one of the world's best.
Trix317 Lynda111
Posted
Thanks Lynda --- I will definitely keep everyone posted. If I don't get enough answers next week, I'll keep heading south to Miami 😉
Trix317
Edited
Excellent info as always Ron. Thank you.
I had my appointment this week w/the Mayo doctor. Totally impressed -- Very patient, kind, listened, answered all my questions and explained things to me. He didn't get into details about my cataract surgery other than the surgery looked good and the lens was in place. And, good choice of a standard monofocal lens.
He said that approximately 85% of cataract patients obtain good visual outcomes post cataract surgery and 15% do not. I am in the 15%. He said it can happen. Even to him. And if it ever happens to one of his patients he performs Lasik on them free of charge (which is impressive since it's expensive and insurance does not pay for Lasik). He wants his patients to be happy with their vision. Very ethical. I did not get any of this treatment from my cataract surgeon or any subsequent doctors in my area. They wouldn't even answer my questions.
I'm wondering if he was referring to selecting the proper IOL calculation formulas...?
RonAKA Trix317
Edited
Have you had a refraction done to determine where you actually ended up with the eye compared to what was targeted?
Trix317 RonAKA
Posted
Do you mean have I been to an optometrist for an eyeglass prescription? If so, no I hope to go next week. Just got back from Florida. Additionally, I haven't received my eye test results from my appointment last week so I want those too.
RonAKA Trix317
Edited
The refraction will tell you if there has been a miss on the power of the IOL, or if something else is causing the blurry vision. When the surgeon said you were in the 15% perhaps that was a reference to a miss. Knowing the cause is important, so steps can be taken with your second eye, to minimize a reoccurrence.
Trix317 RonAKA
Edited
Hey Ron --- Yes I believe that is what he was referring to with the 15%. He didn't specifically mention an off calculation by name, but he did say despite doctors best efforts, patients can have a poor visual outcome. And considering everything else in my eye looked normal, I assume that's what he meant. (But I also sent him an email to verify).
I am going to him for cataract surgery in my other eye once this one is healed. Probably early next year.
I will look at the numbers once I have all the information and report back.
Thanks again -- you have been such a tremendous source of information and education.
Guest Trix317
Edited
Looking forward to the results of the optometrist visit and if that will confirm that the blur issue is just a larger than expected refractive error that could he fixed with glasses, contacts, lasik, or exchange.
Trix317 Guest
Posted
Thanks David --- "larger than expected is right" 😉
The Mayo doctor said it can be fixed with glasses or Lasik (but insurance doesn't pay for Lasik. He said he would absolutely not do an IOL exchange. Too risky -- especially since I had YAG laser a couple months ago.
Also he will not proceed w/cataract surgery on eye #2 until this eye is completed healed. Of course, my original surgeon's office wanted to do mine 2 weeks later in spite of the issues w/eye #1. They got annoyed that I had to cancel.
Trying to get in this week for an optometrist appt.
Lynda111 Trix317
Edited
I'm glad you liked your Mayo Clinic cataract surgeon. You had complained of burning eye pain. What did he say about that? Also, what he say about halos in your vision?
Trix317 Lynda111
Posted
He said there was no more inflammation -- so no iritis. The burning eye was likely caused by preservatives in the steroid drops. I had been taking them for a few months (prescribed by another doctor) and was even down to one drop a day. Said to get off them immediately. Additionally, I had been using preservative free artificial tears but had no idea there were preservatives in the steroid drops. Not that I even thought about it.
I don't have halos post cataract but I did have them pre-cataract. I still have glare and photo sensitivity but I believe that's from my eye still recovering from all of the irritation of the steroids. My poor eye been through the ringer between the surgery, the YAG laser and the Iritis.
He gave me a sample of Ivizia drops. I really like them and you can purchase over the counter. No RX needed. And continue w/night time PF gel drops. I've been using TheraTears PF Night time gel drops.
Lynda111 Trix317
Edited
Ok. It seems like you are on the mend now. Having the right dr makes all the difference. Maybe your experience can help others.
Trix317 Lynda111
Posted
Thanks Lynda --- I certainly hope it will help others. That's why I'm writing so many details. Knowledge is power. And yes having the right doctor is absolutely key. I did have to lower my expectations though upon finally getting the proper information. I had no idea that a lens calculation could be off post surgery. It was a real eye opener -- (pun intended).
I would also add, don't go by online reviews. Or referrals from friends. Talk to a lot of people. Not just the ones with fabulous results. Any surgery can be hit or miss of course, but knowing a doctor is willing to follow up, be honest and communicative is vitally important. I've gone through 5 months of stress, pain and misery all because my highly well respected surgeon/ophthalmologist with tons of 5 star reviews in a major city had no interest in any of the above.
trilemma Trix317
Posted
There are not important calculations post surgery IMO. The next thing is measurement.
Gonna try that soon, or did you get measured, but you did not pick up the numbers?
RonAKA Trix317
Edited
The whole topical drop treatment for cataract surgery is controversial. On antibiotic drops some prescribe them before surgery and some do not. Those that do not say it is because they do not want to risk the development of bacteria that are resistant to the antibiotic. Some do an injection of antibiotic during the catarct procedure and skip the post surgery antibiotic drops.
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The surgeon I went to says there are advantages to the name brand drops over the generic drops. For the antibiotic ones he prescribes Vigamox post surgery four times a day for 7 days after the surgery only, and you throw away what is left. For those that are allergic to Vigamox, he prescribes Tobramycin, 4 times a day for 7 days.
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For a steroid he prescribes Durezol once a day for three weeks and then discontinues it. Too much steroid treatment can cause other issues like high intraocular pressure. If you opt for generic drops like prednisolone you take them three times a day for three weeks.
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I guess my point is that there are options for drops, but you may have to pay more for the name brands.
Trix317 trilemma
Posted
I'm not sure exactly what I had done because I'm still waiting for my Florida doctor's office to tell me the name of the tests as well as the numbers.
In the meantime, I need to go to the optometrist this week.
Trix317 RonAKA
Posted
Good to know Ron ---
I had the Prescription triple combo compounded eye drops. Started them 2 days before surgery and 3 weeks after 4X/a day. Steroid/NSAID/Antibiotic.
Also told me to use PF artificial tears 4X/a day. I felt like I was swimming at sea. Every time I emailed my doctor's office through the health portal from h-LL to say I had eye pain , their automatic response was "just keep using the PF artificial tears 4X/a day. 😕
Lynda111 RonAKA
Posted
Yes. There is no one correct eye drop regimen for cataract surgery. It's the surgeon's own personal preference.