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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7745
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I have worn glasses since I was 11 and have had multifocal

Resolved Question:

I have worn glasses since I was 11 and have had multifocal since my mid 30's. Two and a half weeks ago I had refractive lens replacement. When I went to see the ophthalmic surgeon the next day, for my post op check-up, he said that my right the lens was replaced in, showed up as not having an astigmatism when they did the measurements even though my prescription for my glasses showed that I did. Instead of checking it again he went ahead and put in a "normal" lens. Now I am having trouble seeing at distance and my vision is sometimes blurred my eyelid tends to be a little lazy. Will this pass in time, if so how long might it take or is it necessary to go back for him to redo the eye. He was extremely eager to do my other eye in the next week, but if I can't see properly out of the eye that he has done why should I trust him to do my other eye? Also he did not tell me that I would need sunglasses so I went for the first two weeks without sunglasses and now that I have purchased some I can't see out of them clearly even though they are polarized. Could I have done any damage?
Submitted: 3 years ago.
Category: Eye
Expert:  Dr. Rick replied 3 years ago.

Dr. Rick :

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

Dr. Rick :

Hi. Welcome to the chat room

Customer:

Hello, are you able to answer the questions I have sent in?

Dr. Rick :

First, let me address the eyelid. One of the risks of cataract surgery is that the muscles that lift your lid will get "stretched". This, in many cases, resolves on its own but, in other cases, it needs to be repaired.

Dr. Rick :

Now to the lens choice/astigmatism.

Dr. Rick :

The reason your surgeon went ahead and trusted his intraoperative measurements of astigmatism more then your known glasses Rx is that your astigmatism may be due to your lens (which is taken out during cataract surgery) and not your cornea (the "dome" over your eye). So, in that case, the correct thing was done.

Dr. Rick :

Has your surgeon or her staff done a refraction (which is better, one or two?) since the surgery? And if so, do you know what your vision was at the end of that test?

Dr. Rick :

As to the use or not use of sunglasses......no damage can be done by wearing or not wearing them.

Customer:

Yes they have don that test. They said that I have astigmatism.

Dr. Rick :

One of the reasons to do your other eye so soon is that if there is a large difference in your prescription between you natural eye and your postop eye they may not be able to work together...

Dr. Rick :

Ok. But were you able to see 20/20, 2/40/20/100 etc at the end of the test, with the phoroptor in front of your eyes? (that big eyeglass testing thing with all the knobs on it)

Customer:

The funny thing is that for the past 20 years I have tried without success to wear contact lenses, but now that I only have to wear one I am able to wear it with ease

Dr. Rick :

Was your goal to be completely free of glasses after the surgery?

Dr. Rick :

Ok....that is what I thought.....you must be very nearsighted....

Customer:

Realistically I knew that I would have to wear glasses for reading

Dr. Rick :

true.

Customer:

But what about the blurred vision I am dealing with

Dr. Rick :

so, do you remember how well the doctor could get your vision at this point in your operated eye with the above test?

Customer:

Before the op he said it would be very good but I would probably have to wear glasses only for reading

Dr. Rick :

Yes. But I am trying to learn more about the blurred vision you are now dealing with....

Customer:

If I open up my eyelids with my fingers the vision vastly improves

Customer:

But if I try to open my eyes wide there is no change in my vision

Dr. Rick :

Yes. but during the refraction on your operated eye, how far down the eye chart could you read? 20/20, 20/40 etc?

Customer:

before the op? top to second top line

Customer:

after the op? second third botXXXXX XXXXXne

Customer:

but I don't think I could do that now

Dr. Rick :

Ok. That means things can be improved.

Dr. Rick :

You may not be able to be 100% free of distance glasses with just this surgery. If there is significant residual astigmatism your doctor can do few things to improve things. One thing is limbal relaxing corneal incisions

Customer:

I just went and got my contact lens box for my right eye would having the prescription help at all

Customer:

Is that a permanent solution

Dr. Rick :

sure.

Dr. Rick :

yes, it is a permanent solution.

Dr. Rick :

how about your left eye contact box too....just the first numbers . I don't need the base curve or diameters

Customer:

BC 8.5 SPH

Customer:

SPH+3.75 CYL -0.75 AX 90

Dr. Rick :

is this your Rx after your surgery?

Dr. Rick :

In the operated eye?

Customer:

No this is for my left eye that hasn't been operated on I don't have the right lens prescription anymore

Dr. Rick :

Ok. I would have thought from your history that you had minus contacts (nearsighted) not farsighted....

Customer:

But they were pretty much the same with toric lens

Customer:

No this is what I wear

Dr. Rick :

Ok. No problem.

Dr. Rick :

After the refraction of your post op eye what did the doctor say?

Customer:

He didn't say too much except it looked fine and to keep putting the drops in my eyes for the next three weeks

Customer:

Do you think the healing process is still continuing and that my eye will heal on its own

Customer:

By healing I mean will my sight improve over time

Dr. Rick :

Yes, there is still healing going on at this point and your final amount of refractive error (astigmatism etc) may be different.

Dr. Rick :

Yes, especially if the decreased vision is from common swelling of the cornea that can occur with surgery.

Dr. Rick :

That being said.....I agree with you on one thing: Hold off on doing the other eye until this one is finished healing. What is the rush? Especially since you are having no issues with wearing contacts in only one eye.

Customer:

Would you suggest I leave off having surgery until my eye heals more. If I did have surgery I, at this stage would leave me unable to see properly for perhaps weeks

Customer:

About the blurry vision will this improve over time or did you say this is caused by the astigmatism

Dr. Rick :

Yes, it could. You would have two blurry eyes at once......Like I said, why rush?

Dr. Rick :

There should be some improvement as the swelling goes down, but if you have residual astigmatism, then that -- of course -- would not go away with time. That is where additional treatments, such as limbal relaxing incisions, PRK, Lasik etc come in.

Dr. Rick :

It does sound like your surgeon is very honest and well trained.

Customer:

Strange you should say that. He is a professor and I though what you do.

Customer:

One last question

Dr. Rick :

I am a retina specialist, however I did teach at a University Ophthalmology program in Texas for a number of years :o)

Customer:

Why is it that since surgery I can now wear a single contact lens. Whereas before to wear two at the same (not in the same eye of course haha) I would suffer from dry eye, protein build up and only be able to wear them for a day before my eyes would become irritated sore and dry. Now I can wear the same contact lens for 2 weeks no problems

Dr. Rick :

That is a very good question. And I, truly, don't have a very good answer. Perhaps all that clean living you have been doing over the years is starting to pay off? lol!

Customer:

Bahahahahaha! I don't think so. Perhaps you could pass it on to some of you colleagues and someone could do research on it and one day give me the answers. I has been a pleasure chatting with you. Thank you for all your answers. Have a great day :)

Dr. Rick :

I, too, have enjoyed chatting. Best of luck to you and have a great day.

Dr. Rick :

 


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Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7745
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Expert:  Dr. Rick replied 3 years ago.
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Expert:  Dr. Rick replied 3 years ago.
Let me know if there is anything else you would like to discuss pertaining to this issue.

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