Positive dysphotopsia

Posted by tillymack @tillymack, Jul 5, 2025

I’ve been coping with various light aberrations - streaks, starbursts, halos, glare and the Maddox rod effect - since monofocal IOLs were implanted in 2023-24. Apparently, these symptoms can be caused by PCO or positive dysphotopsia (or both). Positive dysphotopsia can be difficult to diagnose, at least in some cases. If these symptoms are caused by PCO, the treatment of choice would be the yag procedure. If caused by positive dysphotopsia, the best approach would be an IOL exchange, often with the LI61AO. I’d very much like to hear about the experience of others in this situation. For example, was either a yag or IOL exchange successful in improving such symptoms, and if an IOL exchange was performed, which IOL was chosen for this purpose? Many thanks for reading my post!

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elliott1953 | @elliott1953 | Jul 14, 2025

In reply to @tillymack "Hi Elliott, I'm glad to hear you're doing well and symptoms of PD are fading and..." + (show)

Yes, thank you Tillymack and best wishes to you. I wake up everyday and just so grateful for the improved vision. On to other age-related issues, like osteoarthritis, and probably hip replacement surgery shortly.

68wolf | @68wolf | Sep 28, 2025

In reply to @carolmarlene "YAG laser made my positive dysphotopsia worse. After having YAG it is very difficult to do..." + (show)

@carolmarlene
I experienced glare after yag procedure. The doc gave me the option of a 2nd yag which shexsaid might improve glare, but no downside. She was wrong. Glare became worse, and i have light scatter streaks esp at night. A lens exchange is too risky. I’m learning to live with this and hope to neuroadapt over time. Second yag was 6 months ago. Good luck.

snowy1926 | @snowy1926 | May 17 9:39pm

I had cataract surgery in 2019. Severe starbursts pain and photophobia. Some improvement over the last 7 years.
Still don't drive/walk at night or in low light conditions. I now have a pco and require a yag capsulotomy.
Should I go ahead with this.

snowy1926 | @snowy1926 | Jul 12 6:38am

In reply to @snowy1926 "I had cataract surgery in 2019. Severe starbursts pain and photophobia. Some improvement over the last..." + (show)

@snowy1926
I also had cataract surgery in 2019 with sever starbursts pain and photophobia. I don't drive or walk at night. I have a PCO and at this stage have declined the have a YAG as it may make the dysphotopsia worse. I definitely don't want to repeat the of those first few years. Be very wary.

efuller585 | @efuller585 | Jul 14 5:00pm

In reply to @mauigirl17 "I also have PD, going on 4 months now. I just returned from a visit at..." + (show)

@mauigirl17 hello - could you please tell the name of the doctor? I am so, so tired of dealing with the discomfort and limitations of this. Thank you.

mauigirl17 | @mauigirl17 | Jul 14 6:31pm

In reply to @efuller585 "@mauigirl17 hello - could you please tell the name of the doctor? I am so, so..." + (show)

@efuller585 This is a very old post from 1 year ago, but I saw William Dupps at the Cleveland Clinic. While at the time I found him very helpful, when I attempted to follow up with him via MyChart 3 months later, he never replied to me. I was really disappointed that he blew me off because I had spent over $1,500 to travel to the clinic to see him. I sent several follow-ups and finally gave up because I never got a response. I have now had positive dysphotopsia for 16 months. Fortunately, it has settled down a bit. Certainly it has settled significantly from where it was at the beginning, but not enough where it doesn't bother me. It is a daily problem. I have not yet done my other eye. In the last few months I started looking at other doctors and did 3 consultations near my home in Milwaukee. I finally found someone that I really like with a lot of experience. Although I'm terrified, I'm considering a light adjustable lens in my right eye. It's a round silicone lens that can be adjusted after insertion. He doesn't think that I have to worry about PD happening in the other eye and he is hopeful it will alleviate the PD in my left eye. Thinking maybe my left eye is working too hard because my right eye is bad. (I currently have a Vivity square edge toric lens in my left eye which caused the PD.) If it doesn't help, I may do a lens exchange in my left eye. This doctor was the first in the nation to do the light adjustable lens. Fingers crossed. I change my mind every day because I'm terrified!

tillymack | @tillymack | Jul 15 9:10pm

In reply to @mauigirl17 "@efuller585 This is a very old post from 1 year ago, but I saw William Dupps..." + (show)

@mauigirl17 Your post reminded me of an educational video by Dr. Shannon Wong on the topic of positive dysphotopia which might be of interest.

mauigirl17 | @mauigirl17 | Jul 15 11:54pm

In reply to @tillymack "@mauigirl17 Your post reminded me of an educational video by Dr. Shannon Wong on the topic..." + (show)

@tillymack I have seen that video before. The doctor I saw in Cleveland also recommended reverse optic capture, but with my research I found that it is more for negative dysphotopsia. 3 other doctors I consulted with here in Milwaukee said that would not work properly for PD. I am super hopeful for my upcoming procedure on my right eye. It's been 16 months and I've finally decided I can't put it off any longer. My doctor is hopeful that it will help with the PD in my left eye.