Extreme glare from peripheral vision causing headaches and eyelid heaviness

[desm0nd]

33 years old, I have a Symfony IOL in my right eye put in 2015. Had a ton of side effects, especially after I had a YAG, so in January 2021, I had the Tecnis ZCB00 put in my left eye. I really like the vision I get at intermediate and distance, and I wear glasses for close up stuff / computer use.

I have been experiencing a ton of issues with it, most concerning is a ghosting and glare on my peripheral. The ghosting can be ignored, but the glare is killing me. When I wear sunglasses outside, it gives me a huge headache / eye fatigue from the glare that comes from the outside peripheral. My eyelid feels really heavy. When I don’t wear sunglasses, I don’t experience this. Its weird that it actually feels better to not wear sunglasses then it does to wear them.

I’ve seen my surgeon, he says its dry eye, I’ve been using the drops and warm compresses but it doesn’t seem to be helping.  

Just wanted to get a second opinion. I have a meeting scheduled with my family doctor for a referral for a 2nd opinion but wanted to post here to see your thoughts.

Thanks!

[John C Hagan III, MD, FACS, FAAO]

Please clarify: the eye that is problematic that you describe starting paragraph 2, are you talking about the Left technis ZC  or the RE Symphony?  Once I understand I will answer.  

[desm0nd]

Sorry Dr Hagan, the eye I am describing is the Tecnis ZCB00 which was put in my left eye in January 2021.

[John C Hagan III, MD, FACS, FAAO]

No your problem is not at all suggestive of dry eyes. If it was then blinking frequently or putting in an artificial tears should clear your vision for a seconds to several minutes and hourly artificial tears should clear the problem completely.  Where do you live.  While most cataract surgeons are very skilled, not many of them specialize in second opinions on post surgery complications or IOL exchanges. Every large city and most departments of ophthalmology have a cornea/refractive/IOL surgeon that deals with unhappy post ops.  Another local cataract surgeon that might be a friend of your first surgeon will not likely be the best source of a second opinion.

[desm0nd]

Thanks for your reply. What do you think it could be? I'm wondering if it has something to do with my eyelids since I had a cataract in this eye for 5 years, I wonder if I am squinting more and perhaps my eyelid is rubbing on my eye causing irititation. Maybe edge glare from the IOL? Honestly at this point it's just a guessing game.

I am located in Toronto Canada and so we have a lot of different hospitals around here. I had my surgery done at private clinic. My family doctor is going to refer me to one of the hospitals around here for my 2nd opinion.

[John C Hagan III, MD, FACS, FAAO]

Toronto has a world rock star in Ophthalmology in Ike Ahmed, MD. He is mostly glaucoma, but I'm sure the group he is in has a top class  IOL problem person. I'm pretty sure it is not your eyelid.  The problem you are having is called "dysphotopsia" and I've done studies on it, including some based on people posting here.   Dysphotopsia can occur with any type of IOL but is more common in  multifocal IOLs of any type.