Hi. I'm online and happy to answer your question today.
Hi. Thanks for the very detailed question. I'm sorry that your doctor didn't seem to be concerned about your condition. Let's go through your issues one at a time.
You do not have angle closure glaucoma. It is not uncommon for the pressure in the eye to be elevated after cataract surgery. This might be caused by one of the fluids placed in your eye during surgery to protect the inner lining of your cornea. This fluid can temporarily block the outflow of aqueous out of your eye and cause elevated eye pressure. A reading of 40 is high but not high enough to panic about in an eye with a otherwise healthy optic nerve.
As you noted the eye pressure had come down to almost normal, 24, when retested. I assure you that the short time your pressure was elevated did no appreciable damage to your vision or your optic nerve.
You pain and discomfort may have been related to a couple of things. You might have had a corneal abrasion (scratch on the eye), which happens during cataract surgery sometimes, and the pressure may have been causing some discomfort/nausea. If there was an abrasion it usually heals within 24 hours, and as you already noted, your eye pressure came down nicely toward normal in a short time, which was to be expected.
Now. The red blotch. That is most likely a subconjuctival hemorrhage. This is like a bruise on the eye. During surgery there is some bleeding, sometimes even with "no shot, no stitch, clear cornea" cataract surgery. This will, like a bruise elsewhere, resolve without problem. It's nothing to be concerned about.
Your doctor is correct about the driving to the post op day #1 visit. 99.5% of patients can drive themselves. Of course, with your post op difficulties, that was not true in your case.
I am sorry that your doctor or his staff have been unable to communicate with you affectively. It sound that they were very busy or something. Your post op experience, while not the "routine" is by no means outside of the expected for cataract surgery. When everything is said and done I am willing to bet that you will have an excellent visual outcome.
I applaud your initiative to research your condition when your "trusted source" was not forthcoming. However, you need not worry as you do not have angle closure glaucoma, your pressure did not require treatment, as you can see by it coming down on its own, and you are not at any greater risk of having glaucoma like your father due to this brief, commonly occurring, spike in eye pressure after your cataract surgery.
I am sure that any ophthalmologist would be willing to take over your care with no concerns about getting in the middle of your post op experience. You will be fine and, really, have nothing to be concerned about other then your disappointment at how your surgeon and his staff handled your questions.
So. What is the take home message? You will be fine and, truly, have nothing to be worried about. Continue to use your post op drops as directed and enjoy how white white things look and how bright colors are now that your cataract is gone :o)
And, now, the obligatory word from our sponsors: :o)
Also, the Combigan is a drop to lower your pressure. The Post op visits number 2,3 &4 were just to make sure your pressure and other issues were getting better. They are extra visits that you doctor does not get paid to do by your insurance company or medicare -- I bet there are no lawyers who would do that :) Based on the timing and number of post op visits and your eye drops you were getting excellent medical care by your ophthalmologist, even if he didn't communicate what he was doing very well to you.