Cataract Update

I mentioned earlier this month that I received a new prescription for my eyeglasses and the prescription had changed. The new prescription is higher than the one I received last year so I asked the ophthalmologist (cornea specialist) why it changed and he said it was because it took time for my vision to settle after cataract surgery though I found it odd that my vision was at -15 three months after surgery then -18 a year later.

I recalled what a Resident doctor told me during my last visit, that a growth, referred to as a "secondary membrane," had formed over the implanted lens so I contacted the clinic and asked if that was the reason my vision had changed. I was told it was unlikely the cause but asked if I was having issues with the new prescription. At that time I hadn't received the new eyeglasses but when I did receive them, something didn't seem quite right with the left lens. I believed that the prescription was too high which I reported to the ophthalmologist and offered to give me another eye exam. During the next exam the results were pretty much the same.

Image credit: by 74images

YAG Laser

During the same visit, the ophthalmologist and I discussed me having posterior capsulotomy treatment (YAG laser surgery) to remove the membrane behind the intraocular lens and thought maybe it would help but not by very much. I asked what needed to be done and if there were any risks. He explained the procedure and told me it would take place in the clinic and that I could receive the treatment that day then return in a couple of weeks for another refraction.

I agreed to the procedure, my eyes were dilated and I sat in front of the machine while the doctor zapped a red light (laser) into my eye. The procedure took no more than 10 minutes. Afterward I had to stay in the clinic for about 30 minutes to ensure that I didn't have any side effects such as raised eye pressure or inflammation. I didn't experience any issues but I did end up having a headache and a lot of stringy floaters.

I returned to the clinic two weeks later for another refraction and the results were pretty much the same. It was really disappointing as well as frustrating because I can't see clearly out of my glasses. I don't understand it. The ophthalmologist suggested that I consider gas permeable contact lenses because they might give me better vision than eyeglasses. So, I guess I'll get new contacts in hopes they will help improve my vision.

Update:

I guess my vision is still changing because I am able to see a little better with the new glasses or maybe my eye have adjusted. And as before most of my vision comes from my right eye. It could

It has been over 18 months since my last eye surgery and in that time there had been no vision issues. But in November of 2020, just before Thanksgiving, I started experiencing new flashes but in my right eye. They aren't the type of flashes I used to get in my left eye which looked like streaks of light or lightning flashes that would appear at the top of my vision. The flashes in my right eye are a bit difficult to explain, but they remind me of the lens flare effect or  flashbulb effect you would see in photographs (example of lens flare in the photo below). They appear at the center of my vision and they have a blueish hue. They appear suddenly then quickly dissolve from the center outward. 

Photo by Tygarfield

When I experienced the first flash I thought it happened because I sat up too quickly after bending down so I didn't worry about it. I didn't expect to see it again but it happened again, several more times. They started to appear more frequently and by the end of December they were occurring almost every day for at least 6 times a day.  Then I started to worry, because I thought about retinal detachment and wondered if the flashes were occurring in my macula which is the central part of my vision. I've also read in the past that macular degeneration can occur in some cases of pathological myopia.

In January (2021) I saw my ophthalmologist and explained as best as I could what was happening. He asked me how often I saw the flashes and how long they lasted. I told him about how they would appear frequently on some days but not everyday and how they lasted for about a second. He examined my eyes but he didn't find any signs of possible detachment which was good. I scheduled an appointment to return to the clinic in April and during this appointment he still didn't see anything wrong which was again a good thing, but there was still no answer as to why I was experiencing these flashes or sparks in my right eye. He said there was no sign of tugging, but he wanted me to return to the clinic in three months since this was an ongoing  issue. I was scheduled to return to the clinic the first week of July but since there was nothing new happening with my eyes at that time I decided to reschedule the appointment for August but in June I did see the cornea specialist. 

My appointment with the cornea specialist was a follow-up exam for my left eye which received the IOL (intraocular lens due to cataract surgery) in 2019. I spoke to the cornea specialist about the flashes in my right eye and he said that what I was describing sounded like migraine flashes (which I've heard before the last time this happened) and upon examining my eye he said that everything looked normal to him. At this appointment I also received a new prescription for glasses which revealed that my prescription had changed again, but not for the better, which is something I'm really concerned about.

It's funny how I see these flashes so often but each time I go to the eye doctor nothing happens. I wonder if the doctor thinks it's all in my head. Phantom flashes.

Recovery

When I left the hospital the vision in my left eye was crystal clear as everything appeared to be so much brighter than before, even brighter than the vision in my right eye. I really didn't have much pain other than light sensitivity and slight itching. In fact my eye wasn't even red and there was no detectable scar. When I returned to the clinic the next morning to see the cornea specialist he said that my eye looked really good, so good that it was hard to tell that I had even had surgery because there was barely any swelling.

Healing went very well and quickly. The only issue I experienced was seeing a shower of tiny black floaters in my eye a few days after surgery. I had an upcoming appointment for later that week but I didn't want to risk waiting if it was something serious so I went to the emergency room. 

The Residents in the E.R. examined my eye also thought there might have been a tear in my retina because of the floaters and possibly because of some other abnormalities within my eye. When the E.R. ophthalmologist arrived and examined my eye he informed me that there was no tear. He said the floaters I was seeing had probably already been there before the cataract surgery and that they were more noticeable because I could see out of my eye again.

I was happy to hear there was no tear but I know I hadn't seen those type of floaters before. Not even after my first eye surgery or even before the cataract developed, but two weeks after my visit to the E.R. the shower of floaters went away completely.

When I stopped taking the the prednisolone acetate drops there were no side effects, such as the ones I experienced last time -  the pain, swelling and redness. This was probably due to continued use of the ketorolac drops which are used to reduce eye irritation after surgery but whatever the reason I'm glad there was no withdrawal.

It has been almost six months since cataract surgery and my vision has been very stable with no issues at all.

Two years ago, on the day before I had surgery for retinal detachment, my doctor informed me that I would develop a cataract in my left eye due to one of the procedures of the surgery which was the  vitrectomy (the removal of the vitreous from the eye). Cataracts form quicker when the vitreous is removed from the eye, this is because oxygen reaches the lens faster.

I admit I wasn't clear on exactly what a cataract was. For years not only did I think a cataract was a growth over the eye but I also thought it was something that only happened to people over the age of 60 years old. I later learned that a cataract is not a growth but clouding n the lens of the eye that can happen to anyone, at any age for a number of reasons.
I did hope that I wouldn't develop a cataract because I didn't want to deal with another vision issue but of course within in nine months after the surgery it did happen just as the doctor had said.

The Experience

I started to notice that the vision in my left eye was becoming slightly foggy. It was as if I was looking through dirty eyeglasses. At the early stage I thought that my glasses were smudged so I would constantly wipe them off in frustration but then I realized what was happening. 

He did explain that once the cataract started to interfere with my vision, if I chose to have surgery, that the clouded lens would be surgically removed and replaced with an artificial lens (intraocular lens implant or IOL). He said the surgery would take place in an operating room and that it would only be 10 to 15 minutes long if there were no complications. He also told me that the new lens would give me better vision and that he would try to get the left eye close to the vision in my right eye because of the 8 diopter difference between the two (if that makes sense). 

I asked the doctor how fast do cataracts progress and he said it's according to the situation. I read about cataract progression and found that for age related cataracts it usually takes a number of years for vision to become completely impaired but for me the cataract seemed to progress rapidly over a number of months.

As the cataract progressed my vision became more blurry though most of my vision came from my right eye. I explained in an earlier blog that since the vision in my left eye was distorted that most of my vision comes from my right eye due to my brain ignoring the distortion. For a while the same was true with the cataract until my eye became so foggy that I could no longer ignore it. 

Things like reading became difficult as I tried my best not to strain my eyes through the haze. There was a lot of burning, itching and tears as well. By the end of the year (November 2018) my retinal ophthalmologist suggested that I go back to the cornea specialist because the cataract was really seemed to be affecting my vision.

I saw the cornea specialist again and he agreed that my vision was getting worse. He said that he would schedule my surgery when I was ready. The idea of another surgery worried me because I feared re-detachment which I read could happen during cataract surgery and even though I knew I would eventually have to have surgery I just wasn't ready.

In about a month after seeing the cornea specialist the vision in my left eye went from blurry to white. I could barely see anything even when using both eyes so I called the clinic and scheduled my appointment for the surgery and prayed that everything would go well.
 

I did my usual research of what I would experience during the surgery and felt a little better about it because it didn't seem too bad, but it was still surgery. I even watched a cataract surgery video on YouTube and saw that the surgery didn't look as scary as other eye surgeries.

After Surgery Update

In April of 2019 I had cataract surgery. Everything went very well and my vision is actually much clearer than it was before, though I have the distortion due to the scar on my retina from detachment two years ago.