Really poor night vision after cataract procedure
Posted , 9 users are following.
So 2 weeks ago l had cataract procedure done on my left eye. After a few days I noticed the sharpness and clarity in my eye, but in the evening or in dim light my sight went really bad ie it is worse than before the procedure. Prior to the procedure I could see at night even thought it was slightly unclear but now its really bad, I rang SpaMedica up and told them. They called me in for a check up and said that they were happy as the lens hasn't moved nor is it damaged in anyway, they said its probably swelling and will get better. But another week on its still the same. I wasn't convinced with their answer at the time as l kept thinking if it was swelling then surely there would be consistency ie blurry in day and night. But in the day its pretty much clear with a very slight doubling on fine lines in the distance. Besides this slight issue the daytime eyesight is good, but soon as light goes dim lm nearly blind, I'm waiting for my right eye to be done so when l put the right side glasses on and compare, the right eye which is awaiting cataract procedure it is much much sharper when wearing glasses than the new iol lens in my left eye. Worse thing is that I've checked on various forums and the Internet and no one else seems to have had this loss of vision at night time following the cataract operation. I had the normal iol put in. Has anyone else had this problem. What should I do now, I even asked if they had put the right strength lens in and they said they had took all correct measurements. Any help would be appreciated. Thanks
1 like, 39 replies
wahid39326 javed98811
Posted
hi
so is your night vision any better now ?
as i am having operation next week but am unsure now after your experience
i too am in uk , birmingham , planning on nhs lens
through optegra
javed98811 wahid39326
Posted
Y
javed98811 wahid39326
Posted
Yes, since the 2nd tag laser the night vision has improved, the consultant said the 1st yag was done too small and slightly off centre. He said it wouldn't be perfect but would improve it significantly, which it has done.
john20510 javed98811
Edited
Do you know the exact name and brand and type of lens they put in, Did they discuss it with you before hand , is it possible they put in a cheap lens with low contrast , before you have the other eye done find out the exact lens they put in and find out if it has any night time problems and if so go with a different lens
RonAKA john20510
Posted
" is it possible they put in a cheap lens with low contrast"
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At least in Canada I am not aware of any such cheap lens that might be used. The contrast sensitivity loss issue is associated with the more expensive "premium" EDOF or MF lenses. The simplified reason is that the lens is presenting more than one overlapping image to the eye. The out of focus versions of the image cause the loss in contrast sensitivity due to the haze around the prime in focus image. The basic monofocal lenses are least likely to have contrast sensitivity issues, as they only present one sharp image to the eye.
paul64056 javed98811
Posted
Hi javed .... I had double monofocal lens replacement 11 days ago and my experience so far matches yours to the letter.
I did not have cataracts and the aim was to remove the need for glasses for distance.
General recovery has been as expected and distance vision during the day is now good .. but when I step outside in the dark it's all blurry with no hard edges on anything from just a yard onwards and much worse than before surgery.
It's like I have been wearing prescription glasses for short sight during the day, and then I walk outside at night and forget to put them on.
It doesn't make sense why everything is very good in daylight and so poor at night
I guess from your story, I am in for a tough time getting to the bottom of this
thanks
Paul
RonAKA paul64056
Posted
At three weeks and 6 weeks you should get your eyes checked by an optometrist. When you get your refractive eye test (which is better? A or B?) you should get a sphere and cylinder correction diopter. That will tell you if you have the right power of lens and if there is residual astigmatism. The check at 3 weeks is to see if there is something significantly wrong that needs more immediate attention. The check at 6 weeks should be suitable to select eyeglasses with. Your eye should be fully healed by then.
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If you got monofocals you should have good vision down to about 2' and the best at longer distances.
javed98811 paul64056
Posted
Hi Paul.
Eventually I got referred to Manchester, they stated that I still needed a -0.25 lens, even though they do all the checks etc there is still the chance that it won't be precise. So that helped and THE YAG laser was too small and slightly off centre, so he zapped it again. Immediately I started to notice a difference. So in essence it was a repeat YAG and an additional corrective lens that sorted it. Can I just ask why you didn't just have laser treatment if you didn't have cataracts as that is usually the procedure. Anyway good luck.
paul64056 javed98811
Edited
Thank you Ron ... I have my next post Op Optometrist check on 9th July.
On my first week check, she said that both eyes are healing well.
She checked my prescription and said that both eyes might need a small laser top up correction, but we must allow the eyes to settle over a longer period.
The prescription she described sounded about right for what I am experiencing, ie distant vision in the day time felt good without being very good. However at night it all goes out the window as it becomes very poor and distant vision is blurry from just a few yards.
Its concerning as I would not be able to drive at night with this level and before the surgery I could.
When I described the night vision problem she did not sound like it's something anyone has raised before which I found surprising and worrying all at the same time.
She said that I still might need a small laser top up correction and there is a slight astigmatism in both eyes which would also be corrected, which COULD also resolve the blurry night vision issue. However it wasn't said with any real conviction or factual evidence.
Is there something in her explanation that might explain my issue and will it be resolved by the laser top up ? I guess that's the million dollar question.
The main reason that makes me think this is something permanent is, I don't understand why my vision in the day that is encouraging and good, is not matched in dim fading light and awful at night outside.
Surely vision should be equal day and night
thanks for chatting .. are you an Optometrist ?
regards
Paul
RonAKA paul64056
Edited
I am not an optometrist but with both myself and my wife having gone through cataract surgery in the past couple of years, I have learned a bit about the process. The numbers that you really need to figure out what is going on are the refraction numbers. That will tell you how much sphere error you have and how much astigmatism (cylinder) there is.
paul64056 RonAKA
Posted
Thanks Ron .. I'll let you know how it goes.
I'm thinking of asking for a direct comment from the surgeon now, rather than waiting for for the next Optometrist check on the 9th July.
As I think he might reassure me more and also potentially it might be something that needs addressing now rather than later ... just to be cautious.
anyway thanks for lending an ear.
best
Paul
RonAKA paul64056
Posted
The issue with my surgeon is that he does not bother to do a full refraction test. He just uses the auto refractor machine (hot air balloon or barn image off in the distance). It is not as accurate as a full refraction test. But, it is early, so your eye will still be healing.
RonAKA paul64056
Posted
The big difference between day and night is the size of your pupil. The issue you have almost seems to be related to pupil size. The younger you are the larger your pupil can open up. You could ask the surgeon how pupil size at night might impact the vision quality. I'm wondering if your pupil is opening up more than the size of the IOL. They all tend to be about 6 mm in size. A young person's pupil may open up larger than that. And, if the IOL is off center the vision loss may be worse still.
paul64056 RonAKA
Posted
thanks Ron .. would love to be young but I'm 60 in December :0)
RonAKA paul64056
Posted
Yes, but that is young compared to me. I am going on 73! At 60 average pupil size is around 4 mm in the dark, so that should not be an issue unless the lens is not centered properly.
paul64056 RonAKA
Posted
I called them and said I was concerned and would like a comment from the actual surgeon. They said having looked at my circumstances it's still natural at this stage that the eye is getting used to dealing with light and at this stage they do not see it as a concern and to wait until 9th July appointment and discuss then if still an issue.
Not convinced by their response and still think the current night time issue is fixed and could be discussed now.
Let's hope they are right and the eye does start to manage dark light soon.
catch u later
paul64056 RonAKA
Posted
Hi Ron .. unusual thing I stumbled upon yesterday as I sat down in a dim room with little light. Things were blurry as expected, however by accident, I started to use my index fingers on both hands in the outside corner of both my eyes and gently stretched and manipulated them (bit like impersonating a Chinese man !) and I noticed I could make things much sharper. This has given me confidence that this is a general prescription issue, and once they perform the free top up laser treatment to the correct prescription (and correct the remaining astigmatism) I should see not only a dramatic improvement in the day but also at night.
The prescription is not improving or getting worse each day, so seems to be stable now where it is. So it's looking like I will need the laser top up. After all, I can't walk around permanently impersonating a Chinese Man !!
Feeling a bit more hopeful that as I can see clearer images in dim light, albeit manipulating my eyes a bit, I know it's possible to see much clearer in both the day AND night.
Here's hoping ! roll on 9th July for my next appointment.
regards
Paul
RonAKA paul64056
Posted
One of the tests I have had at the surgery pre-screening was to look through a paddle with a bunch of holes in it. May be somewhat equivalent to stretching your eye. Not sure of the significance of that test.
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But squinting in general improves vision when you have uncorrected near sighted vision.