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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7755
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I had an IOL, monofocal, 18.0 D, Alcon AcroSof, installed 4

Customer Question

I had an IOL, monofocal, 18.0 D, Alcon AcroSof, installed 4 days ago as part of a cataract removal in my right eye. I now perceive more light and more color, which is great. But focus is not good at any distance.

If I stare at a small LED light from a few inches away, I see the light. But as I back away, it turns into a circle of dots, and the light in the center disappears. So there's the halo. But this affects my vision on everything I see. Only when I form a pinhole with my fingers and look through that can I see a sharp image.

If I didn't have some remaining good vision in my left eye, I wouldn't be able to drive, bike, or even clearly see well enough to grocery shop. Can anything at all be done about this?
Submitted: 11 months ago.
Category: Eye
Expert:  Dr. Rick replied 11 months ago.

Dr. Rick :

Hi. I'm Dr. Rick and I have two decades of ophthalmology experience. I'm online and happy to answer your question today.

Dr. Rick :

Are you available to chat?

Dr. Rick :

I see that you are offline. I will switch to Q&A format. This format works a lot like 'text messaging' but an email is sent to each of us anytime something is posted to this thread. We can continue to work on your question there..... :)

Expert:  Dr. Rick replied 11 months ago.
Our chat has ended, but you can still continue to ask me questions here until you are satisfied with your answer. Come back to this page to view our conversation and any other new information.

What happens now?

If you haven’t already done so, please rate your answer above. Or, you can reply to me using the box below.
Expert:  Dr. Rick replied 11 months ago.
Did you surgeon mention any complications during the surgery?

What drops are you using right now?

Are you having any pain in that eye at the moment?


This is not an answer, but an Information Request. I need this information to answer your question. Please reply, so I can answer your question. I look forward to helping you.
Customer: replied 11 months ago.

I'm just back now. What else do you need to know?

Expert:  Dr. Rick replied 11 months ago.
Hi Ric,

Greetings from your Southern Neighbor :)

Did you surgeon mention any complications during the surgery?

What drops are you using right now?

Are you having any pain in that eye at the moment?
Expert:  Dr. Rick replied 11 months ago.
One more question: Are you having any nausea?
Customer: replied 11 months ago.

No nausea or pain.. I'm actually in the US, near Reno, NV

Customer: replied 11 months ago.

I must have mistyped my age. I'm 62, not 52

Customer: replied 11 months ago.

If you didn't get the message: Vigamox and prednisolone. Not complications mentioned. No pain now; just occasional dryness for which I use Alcon Tears Naturale

Expert:  Dr. Rick replied 11 months ago.
Oh....your server shows that you are in Canada....

Thank you for that extra information. Those are the exact same drops I prescribe post-op....

Ok. Well, first of all I want to say that you have nothing to worry about.

You are probably experiencing the normal amount of intraocular swelling that occurs after cataract surgery and, possibly, a bit of swelling of the front of your eye (corneal edema)

It is good that the colors are better and things are brighter...that means you are on the right track.

It is also possible that, a few months from now, when your eye is all healed up, you might need a very thin set of glasses to give you crystal clear distance vision.

So. What is the take home message? What you are experiencing is normal. Cataract surgery doesn't give you perfect 20/20 vision immediately...you have to give your eye time to recover from the stress of the surgery.

Everything will be fine. Keep using your drops as directed and....just give it time.

Does this make sense to you?

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.

Thanks in advance,

Dr. Rick MD FACS


Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7755
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Customer: replied 11 months ago.

Dr. Rick - That sounds like welcome news. I saw my surgeon the day after the procedure and he asked me to read some letters on the projected eye chart. I could see anything and let him know. I had assumed it was because the pupil was still dilated. The next day, when the pupil was back to normal size, I realized that I still see no better, which is my condition today. My surgeon mentioned no details of the healing process, so I will pepper him with *many* questions on Friday when I see him.

BTW - I use a VPN connection and have started connecting via Vancouver. I'm trying to make it not so easy for the NSA to watch everything I do ;)

Expert:  Dr. Rick replied 11 months ago.
Ric,

That is an excellent...hard to believe what they do, eh?

"Absolute power corrupts absolutely"

One other thing I forgot to mention. The fact that you can make a pinhole with your fingers and see clearly means that your problem is refractive in nature and not a physical issue with your eye or your surgery.

As that old guy said on Kung Fu: Patience, Grasshopper ;-)

Have a good week.
Customer: replied 11 months ago.

Dr. Rick - If you have to to reply one more time, that would be great.

My doctor put in an IOL, monofocal 18.0 D from Alcon. Vision is blurry at all distances. But with a +2 lens correction (from reading glasses), distance vision is razor sharp. I would probably need + 3 to 4 for reading correction.

I am now one week post-surgery. Is it reasonable to assume that my vision has more or less stabilized? If so, it would seem I should have had a 16.0 D IOL instead of the 18.0, which is too much correction.


 


What do you think, and what are my options at this point. I see my doctor on Friday of this week.

Expert:  Dr. Rick replied 11 months ago.
Ric,

No. Things do not stabilize that fast :) Healing takes time....

I usually do not give glasses until 2 or 3 months post op....once again: Patience, Grasshopper ;)

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.

Thanks in advance,

Dr. Rick MD FACS
Customer: replied 11 months ago.

Hello Dr. Rick. I'm rated you as excellent and submitted a tip. I think administratively that this is all I need to do.


 


My next appointment with the ophthalmologist is September 6. At the last appointment (Friday, 8/23), I was measured as needing a +1.5 Diopter correction for distance. I'm having trouble understanding why the pre-op measurement came up with an 18.0 D IOL when it seems like a 16.5 would have been correct.

Is there any real chance that my vision in this eye will change 1.5 diopters? Right now, if I cover my other eye, vision remains very blurry in the IOL implant eye. I'm trying to be patient, and I hadn't expected 20/20 post-op, but this vision seems so fuzzy that it can be hard to get through the days. I look for the slightest improvement every day, but have not been able to detect anything.

Expert:  Dr. Rick replied 11 months ago.
Ric,

The Administration is perfectly OK with you mashing the excellent feedback button as often as you wish...and I won't be upset if you give me lots of bonus' ;-)

That is not how the powers of IOLs work....it is a complicated formula to pick the IOL power...and is not simple relationship to your glasses Rx.

I sure would not even consider having the +18 diopter lens explanted and a different one put in its place....

Give things time.....

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