Questions about 2nd YAG procedure

Hi Ahmed, sorry to hear this. Are you having follow up for this? What did your opthamologist suggest if there are any underlying causes for these symptoms and what treatment can help?

First, I want to let you know that I sympathize with what you're going through. I had a similar experience, and it was one of the most frustrating things I've dealt with.

I had YAG done very shortly after my cataract surgery, and I went from having zero glare to seeing HUGE streaks/spikes of light off any point source of light at night. Like you, I also see streaking at certain angles during the day.

I aggravated my surgeon over this to the point that she sent me for a corneal consult, which found no problem, and then she told me there was nothing more she could do.

Counting the cornea specialist, I had 3 eye doctors tell me that the YAG opening was large enough. Finally, my regular optometrist that checks my glasses prescription sent me to an ophthalmologist that has handled some strange cases.

Both my optometrist and the new ophthalmologist agreed that my positive dysphotopsia might be caused by the light bouncing off the edge of my implants (which was obscured before the YAG). They also noted that the eye experiencing worse symptoms has a really nasty posterior vitreous detachment, so maybe that is bouncing the light in a strange way, making that eye's streaks even worse.

Whatever the cause, I was given Vivity pilocarpine eye drops to use once a day, preferably before driving in the evening. The drops constrict the pupil. There are some risks to using these drops, but I had the new eye dr and my retina specialist give me the OK to try them.

The pupil constriction totally cures my light spikes. I have no side effects from them. They have given me my evenings back. Another bonus is that I have monofocals, and when I use the drops, I can read up close without glasses.

I highly recommend asking an eye doctor about pupil constricting drops for dysphotopsia. They have changed my life. Before these, I was furious daily over this, and I was trying to figure out how to get a lens exchange, even considering the risk of doing so with open capsules.

I made some illustrations when I was seeing different doctors to illustrate the severity of my issue. If my lights look similar to yours, maybe they'll help explain to your doctor what you're suffering with. Doctors seemed quicker to help me once I started bringing the pictures in.

Is it possible that you have astigmatism in your right eye?

There is a bit of residual, but it's corrected by glasses. The glasses don't change the lines. I think the difference between my "lines" and the astigmatism simulation is that my lines are perfectly straight and clear - they have a rainbow quality that I'm not good enough at photoshop to simulate. The astigmatism simulations seem to have a smeared quality. I had really bad astigmatism before the toric lenses were put in, and my experience wasn't like what I'm seeing now (it also wasn't like the astigmatism pic, but I think that was due to the severity.

I was also checked for irregular astigmatism, but the doctors didn't find any.

That is EXACTLY what I see. Thank you for the images! All I hear is that they have no idea what the issue is and have not seen this before. How could that be? Neither of the 2 "cataract experts" I consulted with even mentioned it as a possible reason for my issues.

I am starting on the search to find a knowledgeable. I will probably have to call and ask if they have any experience dealing with positive dysphotopsia. I had the same issues before the YAG that were exacerbated post-YAG.

Unfortunately, I had a weird reaction to Pilocarpine (weird tingling in my extremities). Tried it twice and decided against it. I use Brimonidine infrequently at night. It's not 100%, but does provide some relief.

Alcon Acrysoft IQ Toric:

My optometrist found residual astigmatism (that the Opthamologist never found. 0.75 & 0.50. I find that highly annoying that my Optometrist found what the people who performed the procedure did not. Even after I asked if any of the haloing could be residual astigmatism. I too got glasses which help for my distance clarity. However, they do not help with streaking/starbursts.

My plan is to consult with my Optometrist and see if she has any recommendations for another opinion.

apologies for the late response

he is actually lost for a explanation to the cause of the problem

blames astigmatism , i had lasik 23 years ago and my cornea is too thin for any further correction

Thank you for those words of support

it will soon be 12 months since the disastrous Yag with no improvement in my vision

i also have a vitreous detachment , with lots of floaters , a vitrectomy was suggested by the opthamologist who done the Yag , i refused

i have also been prescribed pupil dialating drops. They unfortunately don't make much of a difference and cause headaches

my light streaks revolve mostly around sources of White light and will swirl , i won't be surprised if the floaters are causing the swirling effect as the floaters are permanently swirling around , I've had them for years and they not bothersome at all

for a brief moment my brain tends to remove the swirl but it returns as the light source is constantly changing

PRK is sometimes used instead of Lasik if the cornea is too think for Lasik.

at this stage , unless I'm guarenteed a positive outcome will i have any further procedures done as I'm afraid of loosing my eyesight which will be more depressing than my current situation

i forgot to add that the only time i experience No positive dysphotopsia from any light source is daytime outdoors during overcast , including rainy weather

not a single light streak from on coming cars , does anyone have a theory as to why the positive dysphotopsia does not occur during overcast weather

About all I can think of from my photography days is that the light is much brighter and has more contrast when it is sunny out. Your pupils will be a bit more open in cloudy weather. But, most have more issues when the pupils open up....

Hi Brook , i just returned from a consult with a Retinologist , did you perhaps have Lasik performed many years back ?

the days when a blade was run across your eye to create a flap compared to laser used to create the flap nowadays ?

The Retinologist noticed that the edges of my flap are not perfect and they could be the cause of the positive dysphotopsia

i have now been referred to a cornea specialist

weighing up if its worth the cost of a consult together with scans based on your experience with the cornea specialist