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Dr. Stan
Dr. Stan, Ophthalmologist
Category: Eye
Satisfied Customers: 2701
Experience:  Johns Hopkins Fellowship Trained, Certified and Licensed Medical Physician and Surgeon
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I am a 74 year female. After Vitrectomie in August of last

Customer Question

I am a 74 year female. After Vitrectomie in August of last year I ended up wit double vision. Prisms added to my reading and distance glasses helped for doouble vision. After waiting for 7 months and having a cataract surgery done I started to wear glasses, where the prisms are built in. I am borderline as per doctor for surgery vs. glasses with the muscles.
This double vision gives me some insecurity especially with hiking. We lead a very active lifestyle and I am wondering if I could not do some myscle exercises my self, but I am sure I would need supervision in the beginning. Where can I go to?
I live in southern Colorado near Walsenburg, 50 minutes from I-25 at 10,000 altitude.
I would appreciate your advice.
Submitted: 3 years ago.
Category: Eye
Expert:  Dr. Stan replied 3 years ago.
Hello,

Welcome to Just Answer:

Sorry for your difficulty with the double vision. If the double vision has not significantly resolved with added prisms, vitrectomy and cataract surgery, it is possible to improve your vision with orthoptic eye exercises including pencil push-up for strengthening eye muscle, convergence and/or acommodation. It is also possible that shape of the eye ball since vitrectomy and cataract surgery has progressively changed that rechecking of the glasses refraction is necessary for possible new adjustment of the prism strength (either down or up). It is also possible that the lens implant place in the eye(s) after cataract surgery developed scar tissue (film or opacity) that introduces distortion or scattering of eye incoming light, and preventing significant resolution of the double vision. In general, such lens implant scar tissue or film can be resolved with yag laser treatment by the eye doctor. In the meantime, I suggest that request that your eye doctor to demonstrate or teach you some orthoptic eye exercises. One of the exercises involves holding a pencil at arms length with the pencil tip at the level of the tip of the nose in front of you. Then, slowly move the pencil closer to the nose while focusing at the tip of the pencil with both eye (with or without the glasses on) until you begin to see double image of the tip of the pencil. At that point you return to the arm stretch position and repeat that process again. You should perform this eye muscle strengthening exercise up ten times at each routine, 2-3 times daily. In addition, you use preservative free tear drop such as Refresh plus or Genteal tears 2-4 times daily to prevent dry cornea and allow better cornea refractive index, especially as a good amount of light bending which affects image focusing as it enters the eye takes place at the tearfilm/cornea interface.

It was a pleasure to assist you. Please, allow me get credit for my time and effort in assisting you and press the ACCEPT button for this assist. I will be glad to answer additional questions until you are satisfied. Thank you so much.

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Please note that this answer is for information only. It cannot be substituted for the visit to or the recommendation of your doctor.

Dr. Stan, Ophthalmologist
Category: Eye
Satisfied Customers: 2701
Experience: Johns Hopkins Fellowship Trained, Certified and Licensed Medical Physician and Surgeon
Dr. Stan and other Eye Specialists are ready to help you
Customer: replied 3 years ago.
Should I consider muscle surgery? It was interesting: about 7 months after vitrectomie the ophthalmologist was ready for muscle surgery. A that moment the retina specialist suggested I have cataract surgery first. 2-3 months after cataract surgery all of a sudden the ophthalmologist recommended glasses vs. surgery. In addition he told me that I am boderline between surgery or treatment with glasses for double vision. I am not very happy with glasses. I am thinking back and forth what to do at the age of 74 but very active lifestyle, skiing, hiking, living at 10,000' and even with glasses it takes a lot of effort to look into the world.
Customer: replied 3 years ago.

Should I consider muscle surgery? It was interesting: about 7 months after vitrectomie the ophthalmologist was ready for muscle surgery. A that moment the retina specialist suggested I have cataract surgery first. 2-3 months after cataract surgery all of a sudden the ophthalmologist recommended glasses vs. surgery. In addition he told me that I am boderline between surgery or treatment with glasses for double vision. I am not very happy with glasses. I am thinking back and forth what to do at the age of 74 but very active lifestyle, skiing, hiking, living at 10,000' and even with glasses it takes a lot of effort to look into the world.

I would appreciate if you could comment to this question: yes or no for muscle surgery.Thank you.

Comment: yesterday justanswer send me automatically to another doctor after 15'.

Expert:  Dr. Stan replied 3 years ago.
Hello,

Thank you much, and sorry for the reply delay. I suggest that you consider a follow-up evaluation with a strabismus ophthalmologist for closer evaluation of the refractive deviation in all cardinal eye positions to determine if eye muscle surgery is more appropriate for better correction and comfort. It is possible that you may need eye muscle surgery if the deviation or refractive error is larger than prism glasses can fully correct and stable. Considering your previous eye surgeries, it is important to first exclude the presence of scar tissue on the cataract lens implant, and rechecking the optimal prism correction before evaluation and consideration of eye muscle surgery. Thank you so much, and God bless.

Please note that this answer is for information only. It cannot be substituted for the visit to or the recommendation of your doctor.




Customer: replied 3 years ago.

I was very satisfied with your answer and I understand what your functions are. It's good to hear an additional inforamtion, especially if your own doctor does nto talk a lot. I paid already, but the other doctor, due to the fact that your 15 minutes had expired and Just Answer transferred me to this other doctor. Again, I liked your information a lot but don't know if I have to pay again?

I have no additional questions and will see both doctors for retina and the ophthalmologist again, also for cataract surgery follow-up. I will definitely discuss muscle training even at the age of 74. Medicine discovers that even older people might improve conditions. I am only concerned, that my brain will get mixed up, in case the strabismus should change, glasses remain the same, etc. But I will write down all these questions and continue with my present doctors and be more demanding in getting answers. Thanks again. Helga Klepp

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