Dysphotopsia

[linda803]

Had catarac surgery on my left eye may 27, 2016, and on my right eye June 17th, I have Dysphotopsia in both eyes, my doctor says I see the outer side were the cuts were made, My vision is 20/20 And he tells me it may go away, I have to learn to live with it, So I give up, I guess as long as I can see, I have no choice but to live with it, not impressed, Next month I go to a nerologis for my neck, Believe me I'm getting a second opinion,  fed up with doctors

[Zolton58]

I don't have an answer.  I have just recently had cataract surgery and have negative dysphotopsia in both eyes.  I didn't have cataracts I had Plateau Iris.  Im only 9 weeks out in my first eye and 5 weeks out in my second.  It really varies as to how severe it is.  Sometimes it feels like it takes up 50% of my vision depending on the light.  Sometimes it's not too bad.  I'm also having what I thought were ocular migraines but now I'm thinking that it's just another facet of the dysphotopsia.  
I hear your frustration in feeling heard or that anyone or any doctor gives a hoot.  Sometimes its really upsetting but you're kinda on your own.  
Just wanted you to feel heard.

[JohnHaganMD]

While some people experience negative dysphotopsia that lasts for years, in most cases it's gone or much better by 3-5 months.

[Zolton58]

Thanks for the input.  I guess it's a" hurry up and wait" situation.  I'm going to try getting glasses with bigger frames.  Seems to hide the shadow a bit.

[JohnHaganMD]

Good luck.  My wife had positive dysphotopsia after her surgery that lasted about 8 weeks.

[Zolton58]

BTW:  I need to find a preservative free moisturizing drop that isn't too viscus.  I don't want to deal with the blurry vision in addition to everything else.  I like the blink but it's difficult to find it without preservatives.  I have tried Thera tears and Refresh plus preservative free.  There are a lot of products out there and I don't like pouring random liquids in my eyes.  Not sure how else to try them out.
Any suggestions?

[JohnHaganMD]

Yes, order Blink Preservative Free on line. Pops up immediately with search, multiple places to order.

[Zolton58]

Thank you.  Yes, I have ordered them and am waiting for their arrival.  The blink seems to be the least invasive of the drops in my opinion.  I hope they're the same as the ones with preservatives as far as viscosity.  
Thanks for always responding!!

[JohnHaganMD]

Most physicians feel preservative free not essential unless use 4 or more time/day or have proven sensitivity to common preservatives (e.g. BAK).

[JohnHaganMD]

The optom said you did not have rebound iritis.    The most gentle thing you can use are preservative free artificial tears and warm compresses with something like a Bruder Eye pad.  You can order preservative free tears on internet.  That is all i can say about your problem.

[Zolton58]

I went to the optomolegist MD today.  I do have rebound inflammation again in my right eye and now in my left.  They, once again, put me back on Prednisolone 3x daily for two weeks and then I return for a recheck.  I don't hold much hope this time either as that this is what I did before with a careful taper.  The inflammation was back within 4 or 5 days.  You were right.  My optometrist didn't see it.  They say that there were only trace white blood cells but obviously enough other signs to retreat me.  In addition to my eye site getting worse.  
Thank you for encouraging me to go to the MD.

I'm very discouraged and afraid.

[JohnHaganMD]

An optometrist does not have the training of on eye MD ophthalmologist but should be able to see.  This is not rare, unusual but not rare. Try another slow taper. If you flare up again ask for a referral to a retina specialist to be sure no low grade infection. You could still end up smelling like a rose.

[Zolton58]

I'm afraid to hear what the prognosis is.  I guess I was hoping this would all turn out alright.  Are you saying that the chances of that aren't very good?

[JohnHaganMD]

Far more likely you will be okay but just take longer to heal.

[Zolton58]

Thank you!   I know you don't have a chrystal ball but its nice to hear that the odds are good.  I am just really relieved to have found the rebound and an answer as to why my vision was becoming so blurry again.  I have also considered going down to the University of Washington if this doesn't turn out satisfactorily after this round of steroids.  They said there were "trace" amount of white blood cells.  
Again, I have you to thank for my going back to the ophthalmologist.

[JohnHaganMD]

yes U of WA would be a good place to go if you have 'rebound' after second round of steroids.  Since it will take some time to get in (unless it's an emergency) you might want to make arrangements to be seen in say 4-6 weeks if you are still having problems. If you are happy you can always cancel UW.

[Zolton58]

Just a reminder that this is my third rebound in my right eye :(

[JohnHaganMD]

Okay, I would head for UW to be sure not low grade infection, retained particles of cataract, etc.

[Zolton58]

I also am so tired and have been loosing weight.  I force myself to eat but nothing tastes good.  I just haven't been myself which hasn't improved.  Perhaps gotten worse. I've been attributing this to stress but now I'm questioning that.  
I've been back on the steroids less than 24 hours now but I'm seeing no improvement in my vision.  Perhaps the opposite.  I suppose I need to give this a few days.

[JohnHaganMD]

Your call.  I would start working on an outside opinion from a quality referral center like UW.

[Zolton58]

I called the UW and spoke with a person that took all my information and referred me to a Harbor view clinic.  She said all the Drs. are all affiliated with UW. She said that I should hear from them Monday or Tuesday.  I guess that's all I can do right now.  She also said that if I feel anything getting emergent I can go to Harborview ER and they will call in one of those Drs.

[JohnHaganMD]

That is good, sounds like they might be able to see you next week.  I'm familiar with Harbor View. One of my family got PhD in Cellular and Molecular Biology from UW.

[JohnHaganMD]

=

[Zolton58]

I'm wondering about rebound inflammation.  I've been hearing about it.  I have been off the steroids about 2 weeks now.  I've been making progress with my vision slow but moving forward.  Around a week ago I started trying to find eye drops without preservatives.  Everything really bothered my eyes.  It would take a long time for them to calm down.  My vision started being much ore blurry again.  Very similar to right after my surgeries.  
I also came down with a bug, low grade fever for 24 hours and now a easy cold.  All these variables accusing at the same time kind of clouds the issue.  My question is about rebound inflammation.  I'm wondering if that's what I'm experiencing.
I saw my optometrist yesterday and he said that he didn't see any white blood cells or proteins.  He did agree that my vision clarity had declined a bit.  He didn't really have an explanation.  He said the retina looked good.  He thought steroids would be "overkill"  I was glad of that.
Could this just be rebound inflammation plus a reaction to my virus.  
Disappoint that my progress went the wrong direction.  I'm 9 weeks out on my right eye and 6 weeks on my left.
Thanks!!!

[Zolton58]

I apologize for all the typos!!  I should have done a better job of editing.  I did not find an eye drop that my eyes can tolerate either.  I used the blink happily for a while but my Dr thought I should stop using that as it was starting to really irritate my eyes.  
It is a nasty cold not an" easy" one.

[JohnHaganMD]

At 9 weeks post op eye 1 and 6 weeks eye 2 your eye should be white, comfortable, and your vision good and ready for glasses. Since you are not in that category you should be referred back to your surgeon for a complete evaluation: this means a careful refraction to see your best vision, an Eye MD checking for rebound inflammation in the front of the eye, dilation of the pupils, exam of the posterior segment including a macular OCT to rule out macula edema (swelling).   This is a surgeon's responsibility and included in your surgical fee.  Some surgeons don't like to accept this responsibility, they just want to operate, collect the fees and farm all the care out to an optometrist. that is not the way good care works and you shouldn't accept it.

[Zolton58]

They did fit me for glasses.  I saw the surgeon and they dilated my eyes on June 26th.  They said everything looked good  They say my vision is 20/20.  I was checked by the optomotrists on July 1 and then again Tuesday as I was complaining for blurriness and irritation.  This new round of blurry irritation starts about a week ago.  He said Tuesday that my macula and my rentna looked good.  Yes, I do feel blown off but I also recognize that I am very anxious at this point.

[Zolton58]

Right now my biggest complaint is a feeling of irritation and itching and as the day progresses more blurry vision.  I can't tolerate any of the drops and now I'm afraid to start dumping stuff into them.  I feel like that's part of what started this

[Zolton58]

Also, the solution to rebound inflammation is?  Steroid drops?  I've already been on them 8 out of 10 weeks in my right eye and 4 weeks on the left.  I've been off them for 2 weeks now almost exactly.