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, yes that fibrosis is the lens scarring into place in the capsular bag. The flickering that most experience in the few weeks post-op is normal and it is actual movement of the lens till it scars in place. But unfortunately my flickering is persistent 5 months later. In the videos I did it looks like my lens is moving but I think its catching light on the edge and rings of the square edge lens and makes it look like its moving. My surgeon has referred me to a specialist that I meet tomorrow to talk more about this. My surgeon says it could be loose zonules but it would not cause the pulsating vision so it is a separate issue from the PD.

I can't agree with you more about the industry shift to a material and design that was suppose to prevent PCO but created a worse problem. I to had PCO immediately. At least that can be addressed with a clinical YAG procedure vs possible surgery.

Will update if I learn more tomorrow.

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@bobbyo

Thank you. I can really empathize with you. You hear some people say after cataract surgery, “I see better than when I was 20!” or “I see perfectly.” You want it to be you (I want that to be me!). I have seen other doctors in my Pittsburgh, PA area for these problems, but they have no easy answers. I try to research online groups/forums. I, also, research cataract surgeons in other parts of the country (or, even outside the US) that have more experience with post cataract surgery problems and positive dysphotopsia, in particular. I don’t feel like I’m ready to travel in search of the “holy grail”, at least, yet.

My optometrist gave me miotic drops to shrink the left pupil a few months ago, but that was of no help. He is not really a proponent of their long term use because of side effects. So, I am going to try the photochromic lens (Acuvue Transitions) when my optometrist gets them to see if it calms these dysphotopsias at all.

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Hi Bobbyo
Iam also in the Pittsburgh area.I had both eyes done about 3 weeks apart.I had the Toric lens put in,Right eye for distance and left eye for close.I can see a bundle of line type streaks going from 10 to 4 oclock on any light source at night.It is in both eyes.My vision is really good but streaks bother me at night.I read on other forums that a cause can be a wrinkle on the back of pocket that lens is in.Some people have had success with a YAG laser being used to smooth out wrinkle.Iam thinking I would like to get a second opinion on what i should do.

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@blawnoxboy

Hi Bobbyo
Iam also in the Pittsburgh area.I had both eyes done about 3 weeks apart.I had the Toric lens put in,Right eye for distance and left eye for close.I can see a bundle of line type streaks going from 10 to 4 oclock on any light source at night.It is in both eyes.My vision is really good but streaks bother me at night.I read on other forums that a cause can be a wrinkle on the back of pocket that lens is in.Some people have had success with a YAG laser being used to smooth out wrinkle.Iam thinking I would like to get a second opinion on what i should do.

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I definitely had an, almost immediate, Posterior Capsular Opacity (PCO) after my cataract surgery. I believe my was a “clouding” of posterior capsule due to fibrosis. My symptoms were blurrying vision and considerable starbursts around car headlights. In online reading, I see “wrinkling” can also occur to the capsule after cataract surgery. The YAG seems to be much-used and highly successful remedy for PCO, but any eye procedure has its risks. Yes, I’d get a second opinion for sure.

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I had my surgery done in my right eye May 2, 2022. On June 3, I went to see a musical with bright lights and noticed a distinct ray coming out from 2 o’clock down to 8. Then I noticed it on the drive home. Distracting because I kept testing it. I hadn’t been driving at night so I hadn’t noticed the problem. I went to see my ophthalmologist who fit me in did all the test said everything looked perfect and shrugged his shoulder. Advised getting a second opinion from a very intelligent colleague of his. Turns out it is my friends husband. I spoke and described my problem to him last night and both of these highly trained idiots (holding back what I really think of them) acted like they never heard of this problem before. I had to go to the internet to get Some piece of mind that I am not the only one experiencing this problem. Now I have a name for the issue and can send them some articles to educate them. Very infuriating.
Thank you all for all the great advice.

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@cmannconso

I had my surgery done in my right eye May 2, 2022. On June 3, I went to see a musical with bright lights and noticed a distinct ray coming out from 2 o’clock down to 8. Then I noticed it on the drive home. Distracting because I kept testing it. I hadn’t been driving at night so I hadn’t noticed the problem. I went to see my ophthalmologist who fit me in did all the test said everything looked perfect and shrugged his shoulder. Advised getting a second opinion from a very intelligent colleague of his. Turns out it is my friends husband. I spoke and described my problem to him last night and both of these highly trained idiots (holding back what I really think of them) acted like they never heard of this problem before. I had to go to the internet to get Some piece of mind that I am not the only one experiencing this problem. Now I have a name for the issue and can send them some articles to educate them. Very infuriating.
Thank you all for all the great advice.

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If you haven't checked all the entries in this discussion group, check sbvrd’s entries and resource recommendations over the last few months. They are really informative.

For my part, I’d say that since your surgery was just 5-6 weeks there may still be fibrosis occurring with lens and neuroadaptation taking place that will allow your symptoms to “settle” and streaks to be no longer noticeable.
Many sites say 15% of patients have dysphotopsia immediately after surgery but drops to 3% after one year.

As said, I’ve had it since December 2019 (2.5 years) so, I’ve been exploring all these other treatments/surgeries.

It IS disappointing and infuriating that your ophthalmologists/surgeons don’t even seem to recognize the condition. I’d find one that does. Good Luck!

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Thank you I gave read them all and feel more settled about the situation knowing I am not alone!

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Are halos normal 6 months after cataract surgery? I get headaches while reading and driving now.

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@thedishie

Are halos normal 6 months after cataract surgery? I get headaches while reading and driving now.

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Did the halos start the day after surgery, or did they develop in the following weeks/months? I developed starbursts and halos within a couple weeks/months of my cataract surgery. I, additionally, had the Positive Dysphotopsia (characterized by chronic temporal light streaks from external light sources) immediately after the cataract surgery. My doctors diagnosed the PCO (posterior capsular opacity) or “secondary cataract” as the reason for my starbursts and poorer vision. Many post cataract patients get a posterior capsulotomy to correct secondary cataracts (usually, done with YAG lazer). Procedure takes only a few minutes in doctor’s office. Guess I’d say I hope your halos are because of a developing PCO that can be corrected with an easy procedure by your doctor. Go to see them and good luck!

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@bobbyo

Did the halos start the day after surgery, or did they develop in the following weeks/months? I developed starbursts and halos within a couple weeks/months of my cataract surgery. I, additionally, had the Positive Dysphotopsia (characterized by chronic temporal light streaks from external light sources) immediately after the cataract surgery. My doctors diagnosed the PCO (posterior capsular opacity) or “secondary cataract” as the reason for my starbursts and poorer vision. Many post cataract patients get a posterior capsulotomy to correct secondary cataracts (usually, done with YAG lazer). Procedure takes only a few minutes in doctor’s office. Guess I’d say I hope your halos are because of a developing PCO that can be corrected with an easy procedure by your doctor. Go to see them and good luck!

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Thanks for responding bobbyo! I had the halos from the get-go. The doctor blows off the issue.

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@thedishie

Thanks for responding bobbyo! I had the halos from the get-go. The doctor blows off the issue.

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That makes me angry that they treated you like that. Mine did the same. A shrug of the shoulders. It is just their ignorance showing.

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