Positive Dysphotopsia after Cataract Surgery

Posted by bobbyo @bobbyo, Oct 30, 2021

I’m 62 and had my left eye cataract done in December 2019 and still have significant peripheral light streaks and night glare and starbursts while driving (positive dysphotopsia). Makes me a little “white-knuckled” when night driving and is maddening overall. Local surgeons are not inclined to consider an IOL exchange and neither am I, at this point.
With that, has anyone:
- experienced dissipation of dysphotopsia symptoms as time passed?
- tried photochromic contacts or glasses and had success?
- other actions that helped you?

Thanks for any input!

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Hi John,
Nighttime driving is still problematic with glare from headlights and streetlights. I've accepted the fact that this is how my eyes reacted to the lens. Since it's been 15 months for my right eye and now going on 10 months for my left eye I don't think it will change.
Daytime outside I'm fine. Inside during the day in bright window lighting I sometimes get a glare.

I guess I've somewhat adapted (or accepted it I guess) and it doesn't seem to bother me as much.
My vision otherwise is fine so I try to focus on that.

Wishing you the best!

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@john2805

Hi Marshgirl.

I had my surgery on 22nd June 2023. I have dysphotopsia and it is so difficult everyday. Did you situation improve, how are you managing?

warmest regards
John

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Hi John,

I’d started this discussion 2 years ago due to prolonged PD in my left eye. I made a comprehensive entry on May 21 with status of each eye, if you are interested.

Quickly, left eye with it’s square-edged Alcon SN60 from 2020 surgical implant remains problematic with temporal light streaks. I did try miotic drops without success.
HOWEVER, the right eye I had done Jan 26, 2023 with a more rounded-edge IOL made by Bausch and Lomb has FINALLY improved! At the 4-month mark (May 21), I’d reported disappointment as I was still dealing with PD. I don’t know if it was more healing/scarring, neuradaptation or both. Anyhow, at what seemed like a long period, I’m encouraged!

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@bobbyo

Hi John,

I’d started this discussion 2 years ago due to prolonged PD in my left eye. I made a comprehensive entry on May 21 with status of each eye, if you are interested.

Quickly, left eye with it’s square-edged Alcon SN60 from 2020 surgical implant remains problematic with temporal light streaks. I did try miotic drops without success.
HOWEVER, the right eye I had done Jan 26, 2023 with a more rounded-edge IOL made by Bausch and Lomb has FINALLY improved! At the 4-month mark (May 21), I’d reported disappointment as I was still dealing with PD. I don’t know if it was more healing/scarring, neuradaptation or both. Anyhow, at what seemed like a long period, I’m encouraged!

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Thank you Bob. I am lost and scared at the moment

Very best and warmest wishes.
John

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@marshgirl

Hi John,
Nighttime driving is still problematic with glare from headlights and streetlights. I've accepted the fact that this is how my eyes reacted to the lens. Since it's been 15 months for my right eye and now going on 10 months for my left eye I don't think it will change.
Daytime outside I'm fine. Inside during the day in bright window lighting I sometimes get a glare.

I guess I've somewhat adapted (or accepted it I guess) and it doesn't seem to bother me as much.
My vision otherwise is fine so I try to focus on that.

Wishing you the best!

Jump to this post

Thanks you Marshgirl.

In a way it is encouraging to know what we can adapt or as you said accepted.

Warmest regards,
John

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Hi.

I wanted to add my case here for data points on to this thread.

I also just had cataract surgery in my left eye (two weeks post-op). Right eye was not touched and won't be, until medically necessary. I am in my mid 40s. Left eye had a retinal detachment with macular off, some years ago with vitrectomy, gas bubble insertion and scleral buckle. I am highly myopic in this eye; the power that was put in the left is a little less then half of what it should be, so it would be more balanced with the right, uncorrected.

Monofocal lens: CT Lucia 602 (Zeiss).
Abberation: PD: Arcs of light, concentric half circles of light which move through the visual field as you make your way across the light source. It is triggered by lights on the side, lights overhead, light hitting the corner just so, etc. I've been able to see all corners of the IOL and the whole IOL (exterior circle) in its entirety. This happens, daytime, nighttime, indoor and outdoor. I have tried pupil constriction via shining a bridge light in my eye while the arc(s) is / are happening and then pulling it away. As I pull the bright light away, the arc is waiting for me (it doesnt fade back in).

I am not able to get dilated, as of yet, as I am waiting for a full 6 weeks before that can happen. However, initial observation of lens locations looks ok.

Following this thread as I will give myself the needed time to completely heal (~2-3 months), observe and then, unfortunately, may need to look for a way to potentially remediate, if not. I cannot imagine living life, forever, like this as I have a long ways to go. It is quite difficult (especially at night where there is more chances for it to happen and it becomes more intense due to not much surrounding light, throughout).

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Hi, I am new to this group, but so glad I found you all. I thought I was the only one with these horrible symptoms of glare/halos/starbursts/floaters. I actually had surgery with multifocal lenses a few months ago and my doctor said that if he exchanged them for monofocal lenses, the positive dysphotopsia symptoms should go away over time. Well, that has not happened. I have lost my job because I worked at night, lost my career, and I cannot go out of the house at night at all. I have no income and cannot pay my bills. I am single with no kids or family and I I feel like a prisoner in my own home. I am planning to go to the Jules Stein Eye Clinic in Los Angeles, California where I live. They are supposed to be a top notch place and I am praying that someone there can help me. Has anyone with these kinds of positive dysphotopsia symptoms healed and got their vision back over time??? I really need some hope. Thank you! Janismarla

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@visionsupportgroup

Hi, I am new to this group, but so glad I found you all. I thought I was the only one with these horrible symptoms of glare/halos/starbursts/floaters. I actually had surgery with multifocal lenses a few months ago and my doctor said that if he exchanged them for monofocal lenses, the positive dysphotopsia symptoms should go away over time. Well, that has not happened. I have lost my job because I worked at night, lost my career, and I cannot go out of the house at night at all. I have no income and cannot pay my bills. I am single with no kids or family and I I feel like a prisoner in my own home. I am planning to go to the Jules Stein Eye Clinic in Los Angeles, California where I live. They are supposed to be a top notch place and I am praying that someone there can help me. Has anyone with these kinds of positive dysphotopsia symptoms healed and got their vision back over time??? I really need some hope. Thank you! Janismarla

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Hi, so you had surgery a few months ago where multifocal lenses were put in both eyes and have already had those exchanged for monofocal lenses. How long ago was the last surgery for the monofocal lenses? Did you go to the Jules Stein Eye Clinic in Los Angeles? If so, what did they say? I sure hope you find a resolution that takes care of these symptoms for you.

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@bobbyo

Ok, I guess the lack of entries on post cataract dysphotopsias might show that they are, in fact, rare. That’s, certainly, good for the many people who have had cataract surgery, In reading online, seems that the data shows long term positive dysphotopsia occurs in about only 1.5% or so of patients. I’m thinking that this percentage is low as some post operative patients say, “well, my vision is fine except I can’t drive at night anymore because of the lights.” Also, when my surgeon tells me “dysphotopsias are very rare”, this gives me no solace since I am “1 for 1” (I had one eye done and got dysphotopsia 100 percent of the time).

With that, I’ll update what I’ve found out and done lately:
- I tried the photochromic contact lens in my eye in attempt to decrease the severe streaks and halos. The result was poor. I, actually, had worse halos/light glare and acuity was also worse
- Since, I have a very slight astigmatism, my optometrist gave me the very lowest power toric and it helps me a little to see street/highway signs. I’m, also, trying yellow glasses to try to calm the glare/halos/streaks at night driving with limited success.
- I explored the prospect of an lens exchange, but local doctors are strongly against it saying risks of a worse outcome are not worth it.

ALL of the above are related to my LEFT eye, the one on which I had cataract surgery in late 2019. As said previously, I put off surgery for RIGHT eye cataract this fall because of fear it will end up the same as my left. I continue to research surgeons in Pittsburgh area who know how to avoid the dysphotopsia problems of my first IOL implant. Thanks for any input.

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Bobby, I am 1 month post left eye cataract surgery also in the Pittsburgh area and vision is worse than prior with double vision and peripheral positive disphotopsia. I was told to hang in there bc it usually improves over time. I also postponed surgery for my right cataract and hoping to find answers. Not sure you’ll still see this but hoping to hear where you are with yours at the current time. My procedure was 12-5-23. I am so very disappointed and no answers from the doctors really. In fact, won’t even call me back.

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@kittymorg22gmailcom

Bobby, I am 1 month post left eye cataract surgery also in the Pittsburgh area and vision is worse than prior with double vision and peripheral positive disphotopsia. I was told to hang in there bc it usually improves over time. I also postponed surgery for my right cataract and hoping to find answers. Not sure you’ll still see this but hoping to hear where you are with yours at the current time. My procedure was 12-5-23. I am so very disappointed and no answers from the doctors really. In fact, won’t even call me back.

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Kitty,

As I said in my earlier report, I insisted on a B & L round edge IOL for the right eye in January 2023 and FINALLY got rid of the PD about 4 months after surgery.

As I said, I am very glad I did insist on the round edge option. As expected, the left eye with its square-edged, Alcon SN60 IOL remains unimproved.

My hope is that if your IOL was properly measured and placed, your PD and double-vision will settle down.

Note: As I waited for my right eye cataract surgery last January, my long-standing double-vision had worsened badly. But, after I got the new IOL in that eye, my double-vision subsided to a large extent. I had each eye corrected for distance, so maybe that “equalization” helped lessen double-vision.

Hope that’s helpful and hang in there.

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@kittymorg22gmailcom

Bobby, I am 1 month post left eye cataract surgery also in the Pittsburgh area and vision is worse than prior with double vision and peripheral positive disphotopsia. I was told to hang in there bc it usually improves over time. I also postponed surgery for my right cataract and hoping to find answers. Not sure you’ll still see this but hoping to hear where you are with yours at the current time. My procedure was 12-5-23. I am so very disappointed and no answers from the doctors really. In fact, won’t even call me back.

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Eye doctors are too eager to perform cataract surgeries. I’m sure it’s a big money maker for them. I had cataract surgery in 2022 in Melbourne, FL and have had problems ever since. Prior to the surgery, I had nearly perfect eyesight. I should’ve gone for a second opinion before trusting a very greedy ophthalmologist.

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