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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 10901
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I am diabetic and have glaucoma. My A1c is 6.7. I am on Combogan

Resolved Question:

I am diabetic and have glaucoma. My A1c is 6.7. I am on Combogan twice daily and Travatan once daily at bedtime. My IOP is currently 16 in both eyes. I had cataract surgery and IOL implant in the right eye on January 13. Since the surgery the right eye vision has been blurred. My eye surgeon did an OCT scan and said everything was fine with the retina. He also checked the position of the IOL to make sure it didn't shift and that was OK. I just got a new prescription for my eyeglasses and that didn't help. Also there is no damage to the optic nerve caused by the diabetes or glaucoma. Can you shed any light on what might be causing the blurred vision?
Submitted: 5 years ago.
Category: Eye
Expert:  Dr. Rick replied 5 years ago.

Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

In the affected eye, what is your best corrected visual acuity? Do you have any changes on Amsler grid testing?

Dr. Rick :

hi

Customer:

I relaay don't know off hand the best corrected acuity. I don't recall having amsler grid testing. Please explain what that is.

Dr. Rick :

An amsler grid is a piece of paper with lines (either white on a black page or black on a white page) and a spot in the middle that you look at one eye at a time with your reading glasses on. It would show wavy spots/blind spots etc with some types of macular pathology

Customer:

NO, i didn't have that test.

Dr. Rick :

Ok.....

Dr. Rick :

With your new glasses can you see road signs in the distance with the affected eye only? Can you read with that eye?

Customer:

I can see road signs but they are blurred if I close my left eye and look only with the affected eye. I cannot read with that eye alone.

Dr. Rick :

Ok. Well, in light of a normal eye exam, retinal evaluation and OCT with decreased vision after uncomplicated cataract surgery the most likely cause of your visual problems would be issues with the tear film.

Dr. Rick :

I think it would be good to do a 3 or 4 week trial of natural tears, warm compresses and baby shampoo lid scrubs.

Dr. Rick :

The best treatment for this condition daily lid scrubs combined with warm compresses. I like to use baby shampoo for lid scrubs. In the shower, place the shampoo on your index fingers, close your eyes, raise your eyebrows (to stretch the skin on your eyelids) and scrub back and forth along your eyelashes for 3 to 5 minutes. The hot water in the shower helps to soften the plugged oils in the glands while the mechanical scrubbing with your soapy fingers removes the oils.


 

Customer:

What exactly is the tear film andd would that not have shown on the OCT?

Dr. Rick :

I would also use natural tears 4 times a day or so while doing the above warm compresses and lid scrubs

Dr. Rick :

no. The OCT examines your retina in this case. The front of your eyes are covered in a thin liquid layer of tears. When there are problems with this it is like getting oil on your windshield in a rain...messes everything up

Dr. Rick :

does this make sense to you?

Customer:

Yes it does make sense and I will try doing as you recommend.

Dr. Rick :

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Dr. Rick :

Ok. Glad to be of help. Have a good weekend.

Expert:  Dr. Rick replied 5 years ago.
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