What does astigmatism look like?
Posted , 7 users are following.
I had cataract surgery 4 days ago with a Clareon monofocal set to -1.25 D myopia for monovision. My reading vision is getting better day by day, but I am seeing a light shadow of text immediately to the right of each letter. It is offset by about the width of the vertical strokes that make up the text letter. I am hoping it is caused by the eye still healing and will go away, but I am thinking that this may be astigmatism. My surgeon was not enthusiastic about using a toric lens as he says my astigmatism is irregular. Since he did not seem confident, I did not push him to use one.
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So I am wondering if others have seen this in the case of having astigmatism? His estimate of residual astigmatism was -1.0 D. I will post a follow up comment with an image somewhat similar to what I am seeing. The source claims it is what you see with astigmatism. The effect as it currently is certainly makes it much more difficult to read small text as it kind of turns into a horizontal blur. With larger text it just shows up as a bit of a shadow to the right of the high contrast image.
0 likes, 23 replies
RonAKA
Edited
This is an image somewhat similar to what I am seeing when looking at text.
valerio01538 RonAKA
Posted
That was exactly the effect I had in the early days. I remember complaining to my doctor, and he explained that, my lens was very hardened (according to him, I waited a long time to have the surgery), so, in the phacoemulsification process, he had to use ultrasound for a long time and, with that, the cornea became a little more inflamed, producing a false astigmatism, so he asked me to take a break, and the shadows really went away. I also saw shadows in black text on a white background, but it was strange, because I remember being confused, because the shadow seems to change sides...
RonAKA valerio01538
Posted
My cataract was not that advanced, but I certainly do have the double vision issue with text. I was thinking I did not see this on the first eye, but it was corrected for full distance so I did not see text clearly at all. This eye should give be vision down to 12" or so and I am seeing the shadow effect quite clearly. It makes reading smaller text hard as it is blurred with the shadows. Mine seems to be very consistent with the shadow just slightly off to the right. Hoping my experience will be the same as yours and it will go away with some more healing time. The strange part of this is that I was simulating monovision with a contact before surgery in this eye and was not noticing anything like this, even though I had -1.25 D cylinder. It was supposed to have gone down to -1.00 D with the cataract surgery. Hoping it has not gone the other way!
valerio01538 RonAKA
Edited
Hi!
I see you've followed through with your idea of Clareon set to monovision. As I understand it, everything went well, except for a shadow in the letters. What I can say is, with Symfony, I had the same problem. The shadow was much more visible when the letters were light on a dark background. For example watching a subtitled movie on a big screen, if the scenes were dark, the shadow in the subtitles was there. I don't know if the same thing happens to you, but from what I remember, the strange thing is that the shadows changed inclination and even sides, depending on the distance, and it also affected my reading up close. The good news, which I hope is your case too, after about 2 weeks they improved a lot, and now after more than 3 months, the shadows are gone.
RonAKA valerio01538
Posted
Thank you for the comment. For now I am going to continue hoping that it will go away. I can see the faint grey duplicate letter immediately to the right of a dark letter on a white background. I would expect to see the same with white on black. Hopefully the eye still has some swelling which will go away as it fully heals. The image that I posted as an example, and is still in moderation, is white letters on a black background and is pretty close to what I am seeing.
RonAKA
Posted
I have been monitoring my recovery from cataract surgery on my left eye intended for near vision by using a Jaeger eye chart. I started out the day after surgery at about J9. Today after 5 days I was able to read the smallest J1 in full daylight (cloudy day). My only remaining issue seems to be this blur caused the the secondary image just to the right of the main image of each letter.
valerio01538 RonAKA
Edited
J1 having spent only 5 days of surgery and still with the vision affected by shadows in the letters, it seems to me an excellent result! Are you using an official standardized jaeger chart or one you got from the internet and made your own print? I'm asking because I made a homemade print of some jaeger charts available on the internet, but the quality is bad and, even with a lot of light, I can't read above J5, while, in what my surgeon uses for the tests (which is something standardized with good quality), I can read 2 lines above (J3)...
RonAKA valerio01538
Posted
I printed the All About Vision pdf from the net, with the printer set at "Actual Size". Yes, it is not the best of quality, but I can read the smallest No 1 paragraph. If I can get rid of this shadow on the right of each letter I will be really happy...
soks RonAKA
Posted
actually you are able to read it because it is high quality due to monofocal. it is probably a bit out of focus as J1 would require lot of of diopters.
how is the video quality on phone?
RonAKA soks
Posted
What is strange about it is that there does not seem to be much of an out of focus effect. I can read quite well down to 12" or so, and it does not change with distance. It seems to be more of a clarity issue because the shadow on each of the letters. I can read most text on my iPhone 8+. However, when it is white text on a black or coloured background it is hardest to read. At times it almost seems like there is a tear film on my eye that is causing the clarity issue. It is worst in the morning when I get up, and then seems to get more clear as the day goes by. I am still on the Vigamox and Durezol drops so I don't want to use any other drops like artificial tears to see if that helps.
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All in all I seem to have quite similar vision to what I was getting with my contact lens simulated -1.25 D myopia monovision.
brooketastic RonAKA
Posted
I have a tiny bit of residual astigmatism after my toric impants (my astigmatism was off the charts before).
I had shadowing or "ghosting" a little worse than your picture in my dominant eye. I'm about 8 months post surgery now, and happy to report that the shadowing is gone. I'm not sure exactly when it disappeared, but I'm going to guess about 4-6 months out.
The only real issue I notice with my residual astigmatism is a very very slight loss of clarity at distance. Without my glasses, I read 20/20 minus 2-3 letters. With glasses to correct astigmatism, I get 20/15.
RonAKA brooketastic
Edited
Thanks for the input. I think the effect is reducing some, but I still see it. Hopefully it will totally go away as it does affect the clarity for reading. I can read small print, but not quickly.
ad12345 RonAKA
Posted
Do you see any difference between Acrysof and Clareon?
RonAKA ad12345
Edited
With respect to clarity and colour differences between the eyes, I see no difference. However it is not really an apples to apples comparison as I have monovision. The first eye with the AcrySof IQ came out at 0.0 D Sphere and -0.75 D Cylinder. The second eye with the Clareon was targeted to -1.25 D Sphere and -1.0 D Cylinder. However, I have had no refraction test of the second eye, so I don't really know what I got exactly. What I can say is that watching a HD TV from about 6 feet I see no difference in colour or contrast. The near eye has a slightly softer image though because of the intentional myopia. Both eyes are excellent overall. Stunning in fact compared to with cataracts!
RonAKA
Edited
I had my three week follow up appointment with the surgeon on Tuesday. The shadow vision/double vision effect has significantly reduced, but is still there. The surgeon agrees that it is probably the residual astigmatism. He had the gall to suggest he could pull out the three week old Clareon lens and replace it with a toric. This was after he flip flopped a couple of times on whether or not a toric would be suitable with my irregular astigmatism. I had gotten frustrated with him and finally made the decision that if he was not confident in using a toric, I was not going to do it. I decided not to "get into it" with him again and just said that an exchange was not happening. He does not remember specifics about a patient and obviously does not keep good enough notes to refresh his memory.
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In any case he suggested that Lasik would be a good option to correct the astigmatism and recommended a few clinics to have it done after my eye fully heals. I have a 6 week appointment scheduled now with my optometrist where I will find out what my final refraction is, and see how significant the astigmatism is. All he did was the automated hot air balloon on the horizon machine check to determine that I had an on target -1.25 D residual for monovision. After the refraction is done and get an accurate number I will decide on whether or not to pursue Lasik. I have to admit that my vision is pretty good already, and it may be a hard choice on whether or not to spend $2,000+ on Lasik and further abuse my eye to reduce the astigmatism perhaps from -1.0 to -0.5 D. It may not be worth it. In bright sunlight I can fairly easily read the J-1 Jaeger line of text. In his office light I could easily read the J-3, and most of the J-1 if I tried really hard. It is just not comfortable with the shadow effect on letters. I have a pair of progressives that are a correct match to my right distance eye, and are probably very close to my close left eye. The are -1.25 D sphere and have -1.25 D cylinder. They do provide a modest increase in vision, but I have not worn them since my surgery. I probably will get some progressives eventually for night driving though. I have not tried night driving with my "new eye", but I expect it will be fine. I looked at the full moon last night and was amazed as to how bright and almost blue white it looked compared to the yellow version I used to have.
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My thoughts at this point are to see what the optometrist advice is. I have been seeing him for many years and trust him. If anyone has thoughts on the Lasik option I wouldn't mind hearing them.
Bookwoman RonAKA
Posted
Personally, I wouldn't do Lasik. Things can always go wrong, so why take the risk? At the very least I'd wait quite a while and see how you adapt to your new vision, which sounds pretty great!
RonAKA Bookwoman
Posted
Yes, the first step is to simply wait (and hope!) until the eye is fully healed.
valerio01538 RonAKA
Posted
In the summary of your update, I feel that the good news outweighs the bad! I told you that the shadows in the letters would decrease and maybe even disappear, that's how it was with me. I believe the anxiety level is lower now, so just give it time...
RonAKA valerio01538
Posted
Yes, you were correct in that the effect has diminished as time has gone by. For a while I was not seeing as well with the IOL monovision compared to what I was seeing with my cataract eye and a contact to simulate monovision. Now vision is about equal or a bit better. The biggest difference between what I see now compared to the simulated monovision is the my distance vision is better now. It is clearer now probably due to the cataract being gone.
RonAKA Bookwoman
Posted
My surgeon gave me the pitch that Lasik would be safe and effective. I asked if it would be appropriate for just correcting a small amount of astigmatism. He said that the smaller the correction the safer and more predictable it is, and indicated that it is most risky for those getting very high diopter corrections done, as much more tissue has to be removed to change the curvature of the eye.
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Other than for some google "research" I will not seriously consider it until I see what my actual refraction comes out at for astigmatism. These places offer a complimentary screening evaluation for Lasik and I may go that far before making a final decision if there is enough astigmatism to be a concern.