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Ask Dr. A.S. Desai Your Own Question
Dr. A.S. Desai
Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2434
Experience:  MS Ophthalmology with 13 years of surgical expereince
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I recently had cataract surgery in both eyes. about 6 weeks

Resolved Question:

I recently had cataract surgery in both eyes. about 6 weeks after the last eye was operated on, I was fitted with glasses and vision was brought up to 20/20 in each eye. Less than two months after that, I went for exam and the first (left) eye that was operated on had lost vision and was now 20/2400. Macular Degeneration is rampant in my family, but the dr. said her saw dots in the back of my eye, but that mac degen was not actually there.
Submitted: 5 years ago.
Category: Eye
Expert:  Dr. A.S. Desai replied 5 years ago.

Welcome to Just Answer

Post -operative dimness of vision can have different causes and only a thorough eye exam would help to make a proper diagnosis.

Did the eye doctor mention anything about macular edema?

Was any specific eye drop started following the eye exam?
Expert:  Dr. A.S. Desai replied 5 years ago.
Did the new glass prescription improve the vision in the left eye to 20/20 or was it less than that?

Was the intraocular pressure recorded at this visit? Was it within normal limits (10-20 mm of hg)
Expert:  Dr. A.S. Desai replied 5 years ago.
I guess with the given information a general list of conditions which can cause delayed reduction in vision post-operatively , can be discussed. But it is very very unlikely to be from pre-existing macular degeneration(ARMD). ARMD is a very slowly progressive condition which if present prior to surgery, would not have given 20/20 vision in the immediate post-op period. On the contrary it is not possible for ARMD to surface post-operatively within a span of 6 weeks and cause such a drastic reduction in vision. So ARMD is a very very unlikely cause of reduced post-op vision in the left eye.

One of the most important causes for delayed reduction in post-op vision is cystoid macular edema. Not sure if this is what the ophthalmologist saw at the last visit. But this is a treatable condition and vision is likely to get restored with use of flurbiprofen or nepafenac eye drops, 1 drop 4 times a day for 3 weeks.

The other cause could be delayed onset uveitis( inflammation within the eye) or delayed endophthalmitis( very very unlikely due to absence of acute eye symptoms such as severe redness, pain in the eye). Both are not likely to be missed on routine follow up exam.

Posterior capsular opacification (PCO) is another common condition which causes deposits behind the intraocular lens and cause vision to be foggy. Is treatable with non-invasive laser treatment in the office.

I would suggest that you should go ahead with the scheduled eye exam after 3 months and go ahead with the new glasses if the vision is better with the new one. At the next visit you can enquire about the possibility of the above.

Thank you and best wishes.

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Views expressed are for information purpose only and cannot substitute a visit to an ophthalmologist
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