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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7842
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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Hello, Dr. Rick,I had cataract surgery one month ago for

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Hello, Dr. Rick, I had cataract surgery one month ago for right eye and half month ago for left eye. Both eyes have serious starburst and also have very long light streaks in two directions. I can't dirve completely at night. My vision is good at daytime. My Dr. said laser surgery could treat light streak, but starburst would remain. Do you know the reasons for these problems and there are any methods that can treat these problems? Except light problems, I found both eyes had several small black floaters after surgery. I have had floaters for several years, but these black floaters are definitely different from before, thery are completely black. For the worse, I found a big one since yesterday. When this big black speck floats in my vision and I look at computer, the diameter of the speck is about 0.5 centimeter, looks like it consists of several debris. I haven't talked to my Dr. about black floaters because I concerned the light streak problem and forgot it. Are these floaters dangerous for my eyes? My next pointment with my Dr. is in one and half week. Is it OK I talk to my Dr. about floaters in next appointment?

Submitted: 12 months ago.
Category: Eye
Expert:  Dr. Rick replied 12 months ago.
Hi. I'm Dr. Rick and I have two decades of ophthalmology experience. I'm online and happy to answer your question today.

What type of intraocular lens did you have placed in your eyes?

Were there any complications during or after surgery that your surgeon has mentioned?

What drops are you currently using in each eye?

Do you have any medical problems or take any medication?

What type of laser surgery was your doctor talking about? Does Yag laser posterior capsulotomy sound familiar?

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 12 months ago.

1.I just know they are standard lens.


 


2. No.


 


3. Prednisolone Acetate Ophthalmin Suspension USP for left eye. already stop to use any eye drops fot right eye.


 


4. No.


 


5. I don't know what type of laser surgery. My Dr. means the capsules that hold lens have folds and laser surgery can cut these folds.


 


Thank you.


 


 


 

Expert:  Dr. Rick replied 12 months ago.
Thank you for that extra information.

It is possible that your light streaks and star bursts are from issues with the capsule. The laser treatment your surgeon is talking about is very safe and might take care of these issues.

As far as the floaters are concerned, they are not dangerous for your eyes and, yes, it is OK to talk with your doctor about them on your next visit. Meanwhile, here is some information about floaters that you may find helpful:

You are likely experiencing a PVD or posterior vitreous detachment, a common event that happens in many people.

You have a thick gel material in the middle of your eyes called the vitreous. Over time as it liquefies, this gel material collapses on itself, forms little clumps that you can see as dots, lines or bugs. As these clumps form the vitreous pulls away from the wall of the eye. In the process it can stimulate the retina -- causing the flashes that you may see.

It is recommended that you see your ophthalmologist to look at the retina to make sure there are no problems such as a retinal hole or tear. In most cases, there are no problems, but this exam is precautionary and allows for preventative treatment of any lesions that are found.

If you notice a sudden increase in floaters, flashes of light (like a lightning storm), or a shadow/veil in the periphery of your vision, this can be worrisome for a retinal detachment. You would need to contact your ophthalmologist promptly in that case.

What can you do about the floaters? Well, floaters don't go away, and they don't really get worse. Over time they tend to "sink" out of your central vision and you brain "filters" them out so you don't notice them so much anymore. They almost never cause significant visual problems except, of course, if they cause a secondary retinal detachment as discussed above. The only way to decrease or remove the floaters is with a major surgery called a vitrectomy. As a retinal specialist for almost 2 decades I've only done this procedure to remove floaters in a handful of cases.

Here is a video of the actual surgery to remove floaters:
http://www.retinavitreous.com/video%20files/intro_floaters.html


In January 2013 a new drug, called Ocriplasmin, was approved by the FDA to dissolve vitreous strands in a particular eye condition called vitreomacular traction. Perhaps someday this drug could be used to also remove floaters…. Only time will tell.
Customer: replied 11 months ago.

Dr. Rick,


Thanks a lot for your help!


If possible, could you please help me for two more questions when you are available?


1. I know there are high ratio of people with cataract surgery will have "second cataract". They need laser surgery to treat it. If laser surgery treats my light streak problem now, is it still possible for me to have "second cataract" or not? It seems that the principles of two surgeries are similar.


2. Why are the floaters I got this time completely different from those I got before? The floaters I got before surgery look like spider-web, transparent coagulated liquid. They are still a little transparent, like mist. But the floaters I got this time are deep dark specks, completely nontransparent.


 


Wish the new drug removing floater come early.


 


Thanks again.

Expert:  Dr. Rick replied 11 months ago.
1. No. You will not get a posterior capsule opacity ("second cataract") after this laser for the glare issue.

2. That is an excellent question. It is probably that things have just "clumped up" more since your surgery so the floaters are denser. If you didn't recently have such a good eye exam I might think it might be from blood inside your eye. However, from what you have posted I do not think you have to worry about these changes in the morphology of your floaters.

My pleasure.

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: 7842
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
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