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Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3176
Experience:  Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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I had cataract surgery and multifocal lens transplants inserted.

Customer Question

I had cataract surgery and multifocal lens transplants inserted. This was done June, 2010. Since the surgery, one of my eyes feels like it has a hair in it at all times. The same eye drys and seems to stick to the back of my eye lid and stays red and irritated. Most days I wake up with matter on my lids and lashes on the same eye. I have very blurry intermediate vision and night vision still consits of halos (like a huge spider web) around car and street lights. Light is generally now very intensive and blinding. My doctor says I need to wait at least a year to allow my brain to acclimate itself to the vision change and that it will clear itself up. I'm having my doubts. Should I see someone for a second opinion? Is there a possibility that the wrong RX corrections were inserted in my eyes? Thank you. Jess Brooks
Submitted: 3 years ago.
Category: Eye
Expert:  Dr. Dan B. replied 3 years ago.

Hello and thanks for your question. Do you know the name of the lens that was put into your eyes?

 

How often are you using the tears and are you using them daily?

Customer: replied 3 years ago.
I'm not sure of the brand. I seem to recall it started with the letter O (as in Oscar). I use the tears when my eye feels like it's stuck to the back of my eye lid. I spent a lot of time in the cold recently and my lens actually fogged over like eye glasses. I used a hair dryer on my eyes and the fog cleared up. That's crazy!
Expert:  Dr. Dan B. replied 3 years ago.
Does your vision always seem foggy in the morning and improves after a little while?
Customer: replied 3 years ago.
I put a warm cloth on my left eye each morning to clear the crusted matter. My vision seems to get better within 5-10 minutes in that eye. I just found the brand name for the lens is Tecnis (not too close to O). After I get some relief from the scratching, I put two drops of lubricant in my eye and it's good for a while. The foggy vision is from being out in the cold and then coming in to the warmth. Very similar to how regular glasses fog over.
Customer: replied 3 years ago.
Are you going to respond?
Customer: replied 3 years ago.
Tecnis
Customer: replied 3 years ago.
Doctor, I am confused about where your response or questions will be sent. I have the JustAnswer page open (for about 25 minutes) and I'm also getting questions sent to my email address. Which one will you be communicating to?
Expert:  Dr. Dan B. replied 3 years ago.
I apologize I had to step away from my computer for several minutes but I'm here again and I will be typing my answer to your concerns. Please stand by.
Customer: replied 3 years ago.
Thank you. No apology necessary. I don't think I mentioned that I continue to have what appears to be little drops of moisture or water in my vision. It's similar to the shape of a tad pole or a rain drop running down a window pane in my lens (both sides). I also tend to get heavy eyes as if I'm about to dose off but I'm not sleepy. Lots of problems and symptoms. Sorry about that.
Expert:  Dr. Dan B. replied 3 years ago.

As far as your sensation of having a hair in the eyes, many people have dry eyes without ever knowing it. And then, when an eye undergoes surgery, it is always more dry after the surgery than before it.

 

Dry eyes can be due to many different factors. Different medicines such as psychiatric medicines, antihistamines, cold medicines and others can contribute to dry eyes. Allergies in the eyes can also contribute (make dry eyes worse). Some people have an innate deficiency in making their own tears (these people may also have other dry mucus membranes, such as their mouth, nasal passages, or genitalia). Many people have an inflammation in the eyelids called blepharitis which causes the tear film that is supposed to coat the front of the eye to not function as well, and then the eyes dry out. People with blepharitis have morning tearing, burning, and often eyelash mattering. Their symptoms get better as the day progresses, but then they get intermittent blurring when they use their eyes heavily in activities such as reading, watching TV, computer use or driving.

Because blepharitis is so under-diagnosed and the treatment for it is relatively benign, you might consider starting this treatment, while concurrently continuing artificial tears. In order to treat blepharitis, everyday in the morning you should do two things: 1. hot compresses and 2. eyelid scrubs. You should do hot compresses for 5-10 minutes over each eye at the same time. It should be as hot as you can tolerate without burning your skin, massaging the eyelids while they are on there. Then, use either commercially available preparations or a dilute baby shampoo solution to scrub your eyelashes on all 4 eyelids. The commercially available preparations are called Ocusoft or Sterilid which are both over-the-counter eyelash scrubbing treatments. These cost more money but are quicker to use. Otherwise, the cheaper alternative is the dilute baby shampoo (4-5 drops Johnson's shampoo in 1/4 cup warm water), you will take the wipe (or dip a qtip in the dilute baby shampoo solution) and use that to scrub right on the eyelashes of each eyelid for 15 seconds. That will take 60 seconds when done to all 4 eyelids. The scrubbing is done right on the eyelid margin, where the eyelashes come out. After that, just splash some water on the eyes and you're done.

It does take about 3-4 weeks of doing this consistently every day before it really kicks in, so don't stop it thinking it's not working. Also the eyes are still significantly dry during this 3-4 weeks so use the artificial tears you bought 4x/day in both eyes (one drop per application). After 4 weeks you should be able to start tapering off of the tears to as you need them.

Just doing the artificial tears, hot compresses and eyelid scrubs alone would likely start to help you after three or 4 weeks--but remember it could take this long of doing it everyday before you see a significant effect, so don't stop it thinking it's not working.

If you are a person that doesn't make their own tears very well, then you may also benefit from a prescription drop called Restasis, which actually modulates a person's immune system to help them make more of their own tears. This drop actually requires constant usage on a daily basis for up to 10-12 weeks before its effect kicks in (takes awhile to change the immune response in the body).

Because there are numerous reasons for dry eye, if not all the reasons that exist in one patient are treated, it can seem as though the ones that are being treated are providing no benefit. If you've tried these recommendations and still don't feel better then you should consider seeing a corneal specialist for a dry eye evaluation.

 

As far as your intermediate vision, halos, and difficulty night driving, some of the halos and difficulty at night can be entirely related to the dry eye. Once this is treated sufficiently, some of those symptoms may disappear. That being said, these complaints are very common amongst persons who have these multifocal lenses implanted into their eyes. In fact it is the number one reason why persons choose to have the lens removed from their eye. Your doctor is right in that it can take up to a year for the brain to "learn" how to use these lenses and for the halo effect to disappear, but unfortunately for some people it never happens. The fact that this lens has been in your eyes for the past 8 months and you are still having considerable difficulty with it may be prognostic of your overall ability to tolerate this lens. I would say, though, that if in the next couple of months things have not significantly improved as you've treated this dry eye, then I would speak to your surgeon about your options, which can include removing the lens and implanting a mono-focal lens which typically is associated with less side effects.

 

Does this information help address your concerns? Does this make sense? Do you have any other concerns that I haven't addressed?

 

I am happy to be able to help you today. I will also be happy to answer any other questions until you have the information you need.

 

If you would be so kind, please help me get credit for my efforts in answering your questions and press the ACCEPT button for this encounter; this allows part of the funds that you have deposited to the website to be released for my efforts to assist you. This does not end our conversation, however-we can continue to discuss any of your concerns without further charges until you are satisfied.

 

Any positive feedback and/or bonus you may feel prompted to provide would be welcomed and is appreciated. Thanks for your inquiry!

 

My opinion is solely informative and does not constitute a formal medical opinion or recommendation. For a formal medical opinion and/or recommendation you must see an eye doctor.

Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3176
Experience: Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
Dr. Dan B. and other Eye Specialists are ready to help you
Customer: replied 3 years ago.
Your answers are basically what I expected to read. Thank you for your time today and for the expert advise.
Expert:  Dr. Dan B. replied 3 years ago.
You're welcome. Good luck to you.

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