Very frustrated with doctors after cataract surgery. Drastic change in prescriptions

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I had cataract surgery 6 months ago, and chose monovision basic lenses. I was told I would need to wear glasses due to astigmatism, because I couldn't afford the toric lenses.

Right eye is dominant for far vision. Left eye for near. After the left eye surgery, I was happy that I could see so far with the right eye, but I was quite surprised that I only had about 6 to 8 inches of clear vision in the left eye. I really thought I would have a long range of vision in the close eye, so was quite surprised I only had a small window of vision. I wanted intermediate vision and the ability to see the computer and phone. It was much closer than they had planned, without clear vision at computer distance. There was a void where the one eye stopped seeing and the other eye started, and it was right at the computer range. Doctor #1 did the surgery, and Doctor #2 handled the after-care. #2 told me that the lens must have been mismarked. He said I needed a lens exchange, but they don't like to do that, so I would need PRK.

I have had a blurry like a film over my eyes from day one, and they kept telling me it was dry eyes. It feels more like a film that moves around. On the two week checkup from the second surgery, I was told that I needed YAG laser because I had “wrinkles” in the capsule behind the new lenses. My eyes hurt so badly and I had constant pain. More steroid drops, and nothing helped. I was told to get glasses and all my problems would go away.

I was hesitant to get glasses, because I believed there was a major issue that wasn't being addressed. I did a lot of research and realized I have anisometropia....2 diopters difference between the two eyes, and my brain just wasn't adapting to it. They assured me that glasses would solve all my problems, quite surprised that I had learned I had two diopters difference. I reluctantly chose frames at the doctor's optical dept. and without even selecting which lenses I wanted for the glasses, I was told the total AFTER Medicare insurance paid for $165 of the charge, my part was well over $800 for one pair of glasses that I was told I would only need to drive on long distances, since I had 20/30 vision. I refused to pay that much for glasses, and I left!

I went to another optical place and ordered glasses, and when they arrived, I jumped backwards from the shock. I simply couldn't wear them, because they weren't clear and I had double vision, and depth perception issues, due to the two diopter difference. I was able to get a refund on those glasses, because I knew they were now considering PRK surgery, and I didn't want an outside optical store to be dealing with the obvious issues I would have to make new lenses for the glasses.

I made an appt to see doctor #2 who deals with issues, and when I arrived, they told me they cancelled the appointment. What? Because Dr. #1 wanted to see me. I waited in exam room and a totally different doctor came in and said they were going to fit me with a contact to decide what works best for PRK surgery. I wanted the doctor who solves problems, and got a totally different doctor. They put me in a contact, that I later realized did nothing to change my distance, but only corrected astigmatism! What was the purpose of that? I started to feel like they were playing games with me, and avoiding me seeing doctor #2, because he is great at fixing a major issue.

I was becoming desperate for help, since my vision was becoming worse, and computer viewing only made it worse, because I didn't have any clear vision looking at the computer, since there was the void where one eye stopped and the other eye started. I need astigmatism correction since I was having so much eye strain, but glasses are expensive, and I wasn't ready to pay a lot of money, knowing they would have to be changed later, since nothing was being resolved yet. So, I ordered glasses online for an inexpensive quick fix, until I could figure out what they were going to do. Those glasses were just as bad as the first ones, but I could see a little better. Right lens was very thick and very distorted, but I was so desperate to correct the astigmatism.

I went back to the surgeon, doctor #1, and he had an attitude!! He acted like I was a problem patient that he didn't want to deal with! I told him I was very frustrated, and he said my newest glasses were the issue. I told him I'm totally open to the glasses being a problem, but I had so much more than glasses going on. They checked them and saw that the progressive lenses were rotated incorrectly, yet never offered to fix them, even though they had an optical department. He knew I only ordered them for a quick fix and was upset because their glasses were so expensive. He told me that's not his problem, even though he owns the clinic! I told him my eyes were getting worse, and he had no idea why. He always insists that I have dry eyes, even though drops do nothing to improve my eyes, and the film over my eyes was never addressed.

I thought we were going to discuss PRK surgery, since the other two doctors said I need that. He said he was shooting for 1.5 diopter difference in my eyes, but for some reason it turned out to be 2 diopter difference, and he didn't know why. He assured me the lens was NOT mismarked, like the other doctor told me. I told him I just think my brain isn't adapting to such a difference in the eyes, once I put on glasses. He wasn't concerned in the least that I was having double vision, a film over my eyes, eye pain, eye strain, and couldn't see with the glasses. He said I couldn't have PRK surgery because my insurance wouldn't cover it. I was shocked! I said, “I thought YOU would cover it, since this is not what I wanted!”. He said, “Why should I cover it? I did your surgery. I'm not covering it, and your insurance won't pay for it.”. I asked about the YAG surgery for the wrinkles behind the lenses, thinking that possibly was adding to the multitude of problems I'm having, and he said, “Oh, everybody needs that after cataract surgery, but didn't offer to correct that either!

His solution was for me to order “cheap” single vision glasses....even though I NEED progressive lenses. "Get cheap single vision for distance, and wear readers for close up reading!" What??? I told him there is no way that would work. He said, “Of course it would work!”. I told him I would be losing intermediate vision all together, and because one eye is for distance and one eye for close up, the readers wouldn't work! He assured me it would. Well....it doesn't work, because I can't see up close with readers. I still haven't even ordered glasses, and I'm actually using my OLD glasses I had prior to surgery because even though my vision isn't great, it at least helps with the astigmatism needs.

I just felt like they were covering something, so I got my records and saw that in the beginning, my records showed that I had “guttata—rare” on the record file. It later no longer showed up, so I didn't know if they were hiding something, or if the guttata was no longer there. I read that it's spots on the cornea and the only way to cure it was a cornea transplant. If cataract surgery is done if you have guttata, it makes your vision progressively worse, which is exactly what is happening to my vision. I decided to seek a different opinion, and I went last week to a new doctor. She told me that most people my age have guttata and that wasn't an issue. Totally opposite what I read online.

She gave me a completely new prescription, and changed a -.50 to a +.50. I now have 4 different prescriptions and have no idea which one to use to get new glasses.

Here are the prescriptions I've received in the past 6 months.

SPHERE CYL AXIS ADD

#1 Notice the 2 diopter difference

R -0.75 +1.50 015 2.50

L -2.75 +1.50 150 2.50

#2 This was when he told me to get cheap distant single vision and readers.

R -0.75 +1.50 10 NA

L -2.50 +1.25 170 NA

#3 Went for a second opinion and this is the newest prescription.

R +.50 -1.50 95 +2.75 SLAB OFF

L -1.50 -1.50 70 +2.75

I just sat down today to figure out which prescription to use, and I'm flabbergasted at the difference. Any thoughts on why the Sphere went from a minus .75 to a plus .50? Were the first prescriptions totally wrong, and is that why I couldn't see with the glasses? How can there be such a drastic difference in the refractions? I just want to be able to SEE better!

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  • Posted

    Wow!

    It sounds as if you are living a nightmare, Sam. I feel really bad for you.

    You probably have already considered looking for:

    a) a doctor that you like, trust, and actually helps you. Perhaps a public health

    clinic could help since money is an issue.

    b) competent legal advice. Attorneys often offer pro bono clinics and personal

    injury attorneys sometimes work just for a cut of a settlement.

    If doctors from the same clinic offered contradictory advice and you have

    suffered as a result, you might be entitled to compensation. That's not legal advice.

    It's just common sense.

    The lack of empathy from doctor #1 is simply breathtaking.

    A competent law firm might be able to convince this medical practice (especially doctor #1)that it is in their best interest to do whatever they need to do to improve your vision because it's going

    to be much more expensive for them if they don't do the right thing.

    I wish that I could give you a solution for your vision problems, but I really cannot

    suggest YAG, eyeglasses, lasik, lense replacement, etc. because I lack the expertise

    to do so.

    All I can do is wish you the best in finding a solution for your awful predicament.

    Report Reply
    • Posted

      Thank you! It's comforting to see that others are a bit shocked at this also. I've talked to several optical people at different locations, and they are all more than mildly surprised at what all has happened. My first shock was the price of glasses. Doctor #2 was very upset over that price, and stated that he tells them all the time the prices are too high. I feel strongly that they have kept me from seeing doctor #2. He started the clinic years ago, and apparently built a wonderful clinic. He decided to stop doing surgery when he reached a certain age, and doctor #2, fresh out of school, bought the clinic from him, so #2 is "only" an employee now, and appears to be quite outspoken and truthful, because he doesn't like what he is seeing. It appears that things have changed quite a bit from what doctor #2 told me. I became a bother to #1, because he simply wants to only do an assembly line of cataract surgery, seeing one person right after the other, and doesn't want to be bothered with issues. My second shock was when doctor #1 said to buy "cheap single vision glasses and get readers". He said, "Of course you won't have astigmatism correction, but then you won't have double vision.". I know nothing about the optical business, but I know enough to see that there is no way that would work because my eyes are seeing at totally different dimensions. Optical people I've spoken to said they could put a prism in, (which doctor #2 doesn't want to do) or do a "slab off", which is what the second opinion doctor wrote in the prescription. I have no idea what that is. My 3rd shock was the fact that the prescription changed so drastically from a minus to a plus and the axis drastically changed. I simply don't know which prescription is now correct. I may make another attempt to see doctor #2 again. I truly wish I had never had cataract surgery at all. I even wondered if I needed it, since I still have blurry vision, and it may be caused from the guttatae or dry eyes. Eye drops simply never improve my vision, so I don't know why they keep insisting it's dry eyes. I've been on several types of steroid eye drops, Doxycycline, which messed up my stomach, and many different kinds of eye drops. If anyone understands how a minus can change to a plus in the sphere part of the prescription, I would love to know how and why that change can work.

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    • Posted

      You've got to do something.

      Trying to see the relatively nice doctor #2 again is worth a shot.

      Good luck to you, Sam.

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  • Posted

    move from -0.75 to +0.5 means that eye became more far sighted than necessary.

    looks like your astigmatism is all over the place for every prescription. good that you didn't get toric iols.

    sorry you are having to go through this.

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    • Posted

      From the research I've done, I would also assume that it became more far sighted, but it hasn't. That change is in my distant eye, so it seems that now they are trying to bring that vision closer slightly. So I don't know if it is an error or not. Not understanding much about it, it appears that since that eye is my far eye, that it should have been a plus from the beginning to bring the correction closer to the other eye, with glasses. The double vision was happening because there were 2 diopters different. So, they changed the near eye out farther, but not as far as it was. And why did the axis change so drastically? Understand that this is extremely confusing to me, because I don't have a handle on the minus and plus corrections.

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    • Posted

      why the astigmatism is fluctuating is really puzzling. are you using contact lenses?

      i have 2 diopter difference as only one eye is operated and the unoperated eye is -2. i don't have double vision but it is irritating.

      i think more diopters are needed for near vision hence the small range. when i wear +2.5 my vision range is 8 to 16 inches but the vision quality is very high.

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    • Posted

      I don't have enough understanding about the astigmatism change. Unless the doctor was attempting to rearrange all of it to give me more clarity. I'm so reluctant to use that prescription to get glasses because it's so different than the other one. No, I'm not using contact lenses. I was only given a contact to supposedly figure out how far out to do the PRK surgery, but they only corrected the astigmatism and not the distance.

      That's great that you get high quality vision with having that much of a distance in your eyes. You might want to consider not getting the other eye done until you absolutely need it done. I wish I had done that, because then I would have had better distant vision in the close eye. I don't have any distortion or double vision without glasses. The issue of double vision happens once the mono-vision is corrected with glasses. I did a lot of research while I was searching for an answer, and I learned that 2 or more diopters cannot tolerate a correction with glasses, and can only be corrected with contact lenses. I even asked doctor #1 if it was correct that anisometropia cannot be corrected with glasses, and only contacts, and he affirmed that, yet they prescribed glasses for me!! That's when he told me to get the cheap single vision distant glasses and readers, saying that progressive lenses are a challenge to correct....yet, he was not willing to do anything about it!

      I have reason to believe he's trying to cover his own rear, because of the guttata. My file mentioned that, saying it's rare, so I did some research on that, and it is an indication of Fuch's Dystrophy. Pronounced Fooks. It's little water droplets on the surface of the cornea that causes swelling, and the only cure is a cornea transplant. I read that if you have Fuch's Dystrophy and cataracts, you need a cornea transplant at the same time the cataract surgery is done, otherwise, the disease will progress rapidly and vision will decline. This is exactly what I'm experiencing! I can't see well in the morning, and if this is the cause, it's because the cornea swells, and gets better later in the day. It also causes the film effect I mentioned that the doctor refused to address. I'm suspecting that doctor #2 discovered in my record, at my 2 week check-up, that this is what is going on, and that is why they are keeping me from seeing him, hoping I will just go away. After my last visit with doctor #2, the "guttata--rare" is no longer on any of my reports at that clinic, even though the last exam last week showed it's still there. I've given them 2 pages of symptoms that are simply being ignored. The doctor I saw last week for the second opinion simply just blew off the fact that I have this guttata on my cornea, saying that it's common. I've read repeatedly that it's not common, and only happens in about 4% of people. I have little faith in doctors, because I believe they cover for each other, and I suspect that might be happening, so I may have to go out of the area to get another opinion.

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  • Posted

    There are two different formats for eyeglasses Rx, positive cylinder and negative cylinder. Opthalmologists tend to use the positive cylinder format and optometrists the negative cylinder format.

    There are easy conversion calculators online to convert between the two formats.

    So the listed Rx are really the same if you convert one format to the other, the eyes themselves have not changed just one doctor used a different format for the Rx for the same eyes...

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    • Posted

      That's very interesting information. I don't totally understand it, but I wondered if the last doctor changed it all to come to the same conclusion, just going in a different direction. Do you think this would eliminate the issue with the double vision with the last prescription listed? In the two glasses I had, the right lens was very think causing a great deal of distortion in my vision. Would this most recent prescription avoid the thickness of the lens also? I'm so glad you explained it the way you did. I knew my eyes hadn't changed, but the prescription is so different I was reluctant to use it. Thank you!!!

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  • Posted

    HOLY SH.T! Sam, I normally just sit and lurk on this site, but I was so appalled at what I was reading that I just had to add my two cents. I'm hoping that Sue.An soon responds because she's so helpful/knowledgeable about the tech end of all of this. Soks, too, is great. We're lucky that this is such a helpful and educated community.

    I totally agree with the suggestion to get legal advice. Normally, my first reaction is never to say, "SUE!" because medicine is not a guaranteed service, but Doc #1 sounds not only like he's just hoping you'll go away if he ignores you long enough, but incompetent. The callousness of his answers just leaves me nearly speechless. Please make sure to keep copies of all of the documents that you can. You know that Doc #1 is going to work hard to cover his buns.

    I hope that you have/or will have a doc who can help correct all of this. It really makes me wonder how some docs are able to keep their licenses.

    I wish you nothing but the very best. Please keep us informed.

    I

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    • Posted

      Thank you! I'm amazed at all of it myself. I'm hoping someone in this group knows something about Fuch's Dystrophy and can share some information on that. My gut is telling me that the Guttata showed up, and it was ignored, until after the surgery, when doctor #2 saw it and made note of it. After that is when I've not been allowed to see him again. I am wondering if, because of that, they are totally reluctant to do the YAG laser or PRK because if it is Fuch's Dystrophy, it could create more issues. I was hoping the second opinion would shed some light on the issue, but that doctor told me the Guttata is very common, even though everything I read says it's not. I've read that cataract surgery should never be done without a cornea transplant, because only doing the cataract surgery will make the vision worse, and that's why they should be done together. What's interesting is that this was never even mentioned to me, and I only discovered it when I got my records, because I suspected they were trying to keep some information from me, since they are so unwilling to help in any way. I may be totally off base with the Guttata and Fuch's Dystrophy, but my vision fluctuates so much. I'm still open to it possibly being only dry eyes, but I think it's so much more than that. I appreciate the support and any information any of you are willing to share with me. I called the Academy of Opthomologists awhile back, asking if I had a right to obtain my doctor's surgical notes, explaining about the issue with the anisometropia. A person from the ethics department called me back and was interested in what they were going to do about it. She highly suggested that I contact her if nothing was done to correct it, so I will be calling back asking for her advice on how to deal with this. She said at the time, "You just had cataract surgery to improve your vision, and now your vision is worse? Seems to me they have some work to do here.".

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    • Posted

      You have the right, by law, to obtain copies of your FULL medical record from ANY doctor you see. Depending on the state you are in, (some states have a shorter time period) once you submit a written request for records, the Doctor office must give you those records within 30 days or they are in violation of HIPAA law. The office may charge you a small copy fee per page and for mailing, again depending upon the state.

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    • Posted

      Yes, I knew about the medical reports, but wasn't certain about the doctor's notes and surgical notes. I have the medical reports, and still need to get the surgical report. I have all of my medical records from every doctor I've seen in the past 20 years, but I never see doctor's or nurse's notes. Are those kept from the patient? My cataract surgery was done in a different location than the doctor's office, so I plan to get those this coming week.

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  • Posted

    I wish I had some answers for you. But I really don't. My doctor out here at Barnet, Dulaney, Perkins did the astigmatism for free. They cover that part for free. No special insurance, they just do it for free. I chose to see distance in both eyes and got dollar store readers and I am great. The YAG does cause blurry eyes and it is a covered procedure if you have it cause it is due to the actual surgery. Happens to a lot of people. I have spots on my right eye also and it has taken me quite a few months to adjust beings having the cataract removed made the spots 10 times more noticeable. It has been 5 months now and I have adjusted. I think the doctors should give everyone a choice of both eyes for distant or both eyes for close up. Having one eye for distance and one for reading can cause a lot of issues with some people. I just wonder why they didn't include the astigmatism. I think that would have helped a lot. Maybe one more doctor for another opinion. Never hurts. Please keep us posted. And try to enjoy your weekend. I know it is fustrating when our eyes don't work right. Been there. Would rather lose a leg. Kind regards, Ruby

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    • Posted

      Thanks Ruby! I did a lot of research prior to my cataract surgery and read that many doctors correct the astigmatism as you mentioned, during the cataract surgery. I was asked many times prior to surgery by someone who schedules the surgery, if I wanted to think a little longer about making a decision to have the expensive toric lenses, that would correct the astigmatism. I told her many times, because I'm retired and don't have the income to justify $3000 to $5000 for the other lenses. She kept putting off scheduling, wanting me to really think about it. I felt like I was constantly being "up-sold" because she was obviously on commission and was pushing the more expensive lenses. After reading more about it, I read an article written by a doctor saying it was crazy to put people through cataract surgery without also correcting the astigmatism to give them clear vision! That made so much sense to me, and he said it was simple to do and only took a minute or two longer during the surgery to make some small cuts into the cornea. Just prior to surgery, I asked the surgeon if he could do that, and he acted offended that I would suggest it, and said that needed to be arranged long before surgery if that is what I wanted done. It's all about money and if they can make thousands of more dollars in another way, why would they assist in correcting astigmatism to help people? It was the same when I was "up-sold" on the glasses for over $800 after insurance would pay $165. That was nearly $1000 for a pair of glasses that I was told I would only need for driving long trips, to take the strain off the near sighted eye. It's sad to think that medical treatment involves being sold things for a higher profit for the doctors, when they could very easily assist people in so many ways. I'm so glad your doctor was kind enough to give you the astigmatism correction.

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    • Posted

      I went to another firm first to get my cataracts done and they too wanted 3,000 an eye to correct astigmatism and demanded I do the laser. I am on disability and after the 2nd gal said 4,000 and eye at the same place, I said I need time to think about it. went to Barnet Dulaney out here and the actual surgery doctor said they were trying to hard sell me. Imagine that. I felt so good and cried. Then I went with them for the surgery. He said they are all different and some will try to get that money. I got lucky and I was blessed. Yes I had issues for 2 months but now it has been 5 and I am happy. Wore contacts for 45 years and now just dollar store reading glassed.Actually the same ones I was using before with my contacts in. But no expense for contacts or solution anymore. So sorry you are having this problem and only wish you the best. Ruby

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