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Old 05-11-2006, 10:30 AM   #1
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Pupil Dilation after cataract surgery

I had cararact surgery on my right eye 2 weeks ago. My right eye is still dilated and does not respond to bright light. Yesterday, my doctor said (during 3rd follow up after surgery) that it may remain dilated but it "won't be a problem". I can't believe he said that. It is very debilitating in sunlight and my squinting is causing me headaches. When I asked him why it remains dilated, he brushed off my question with "We're not sure." Getting good straight information from him is like pulling teeth. He gave me some PILOCARPINE HYDROCHLORIDE drops to use 4 X day til i see him again in 5 days. Does anyone know why an eye may remain dilated after cataract surgery?

 
Old 05-11-2006, 06:17 PM   #2
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Re: Pupil Dilation after cataract surgery

My doc is like that too...noncommital when asked questions. Due to the high rate of lawsuits they tend to get that way now.
I've had lots of laser surgery on my left eye and I've been told that my eye is dialated all the time too. But my optho specialist won't even admit that, he says it's very minor.
Not so say other docs.
I wonder if anything bad really happened to your eye after treatment or surgery, whether you can actually bring a lawsuit, since the doc makes you sign off on wavers for each procedure they do.
bTW Ned how is your vision after the cataract surgery? I have to have it too and hear that vision is good right after its done?

Last edited by Cher2005; 05-11-2006 at 06:25 PM.

 
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Old 05-11-2006, 06:40 PM   #3
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Re: Pupil Dilation after cataract surgery

My eye has never been right since I had the cataract surgery. I had the lens implant. After I had it, I had circles around all the lights. So the doc said he could puncture the capsule (whatever that is) and now I have lines everywhere when it's dark. I can't drive in the dark at all. Now the other eye needs to be done, because I can't see a blessed thing out of it, and I'm afraid to have it done. I know I won't pass the mva test in 2008 if I don't have it done. Ask a lot of questions before you let them do it.

 
Old 05-12-2006, 07:45 AM   #4
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Re: Pupil Dilation after cataract surgery

Cher, in response to your question, my vision is not yet (after 2 weeks) very good. it is still a little blurry and the doc says that's because a cloudy film has developed on the membrane behind the new lens. he said he can correct that with a laser 'at the appropriate time' .... whatever that means.
I, too, had heard from some people that vision improvement was almost immediate after cataract surgery, but that has not been my experience.
Last night I asked my son to look at my eye and tell me what he saw. Each time I looked at it in a mirror, I couldnt' tell whether my vision was distorted or my pupil is not longer in the center of my iris. He confirmed it for me..... it 'appears' that my pupil has moved up toward the top of my iris!... no longer in the center! Now i'm experiencing worry, concern, anger, fear...... I'm supposed to see the doc again monday. i'm beginning to seriously doubt that i have a good physician.

 
Old 05-13-2006, 07:56 AM   #5
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Re: Pupil Dilation after cataract surgery

Helen & Ned. There is a membrane or capsule that holds the lens in place. When the natural lens is removed, an IOL is placed in this capsule. It is quite common for the membrane to become cloudy, as the lens did before. Don't know why. Since the capsule can't be removed, it has to be punctured. I can understand your reluctance to have the other eye done. I have cataracts and don't want either one done (although one day I might have to.)

 
Old 05-13-2006, 08:44 AM   #6
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Re: Pupil Dilation after cataract surgery

KeelaC, thank you for your post. You seem to have much clear concise information about eyes. Have you studied in this field? Obviously you have done much research.
When you say the capsule must be punctured, i didn't understand for what purpose? my doc said he could correct the cloudiness w/ a laser later. does he use the laser to puncture the capsule?
thanks for your help.

 
Old 05-13-2006, 11:10 AM   #7
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Re: Pupil Dilation after cataract surgery

The laser punctures the capsule.
The procedure is called a YAG, which stands for Yttrium aluminium garnet, which is the type of laser (more or less) used.
Certain types of lens implants are more prone to cause "posterior capsular opacification," or clouding of the lens' capsule.
I have 2 different types of lenses, and will need the YAG, but I'm putting it off because no eye procedure is without risks.
There are some new lenses on the market that have a different type of edge that seems to not cause the cloudiness of the capsule. The 2 I have read about are the Tecnis and the ReZoom, but I'm not sure how much is the decrease in the likelihood of having the cloudiness with these lenses. There are probably more new ones in development too.

 
Old 05-13-2006, 11:42 AM   #8
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Re: Pupil Dilation after cataract surgery

thank you 'seriousperson'!
every piece of information helps me know more about what is going on (which is something i can't get out of my doc)
i appreciate your response.

 
Old 05-13-2006, 05:01 PM   #9
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Re: Pupil Dilation after cataract surgery

you're welcome. I check this board at least every few days, so if you post another question that I've already researched, I'll share what I've learned.
However, cataract surgery is a rapidly changing field, so my knowledge has a short shelf life.

 
Old 05-14-2006, 05:57 AM   #10
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Re: Pupil Dilation after cataract surgery

Ned, all I know I learned online, so I'm no expert on anything.

 
Old 05-18-2006, 06:18 PM   #11
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Pupil Dilation, Other Problems After C. Surgery

I'm having my worst eye done, cataract, May 26. The day of the measuring, I saw the lens I'll be getting, acrylic because I'm diabetic, already have a lot of damage from that, two retinopathy procedures, too late to save reading vision of one eye, and macular degeneration. At first he said I might get 10% improvement from cataract removal or maybe even 50%, until my retina surgeon wrote to him that I may not understand the "limitations", but I'm just an optimistic person. And she probably just didn't want to be left out? Has a very busy practice and I've really liked her.

Anyone know of any special problems for diabetics? The consent forms warn that there's no guarantees, that in a worst case scenario a person could end up blind in that eye, so I'd be afraid to have my other one done, too. They say I have thick cataracts. I'm assuming those warnings are on everyone's consent forms, right? And since someone here asked, I THINK I've heard or read that lawyers can file suit anyway.

A lady I used to talk to said she had damage from an aging retina specialist using too large a laser, went to a university hospital and they were able to repair it, told her what he'd done wrong. She was lucky to get it fixed.

Do they tell you not to drive for a week, or just the next day when you go for the first checkup? I'll not know until then how it went.

One of the drops prescriptions is to be re-filled 4 times. Meaning just if you need it, for some complication?

Last edited by Eagle; 05-18-2006 at 06:26 PM. Reason: a word wrong

 
Old 05-21-2006, 04:12 PM   #12
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Re: Pupil Dilation after cataract surgery

KeelaC, are saying that the doctors know or should know that the implant may become cloudy? I wonder what reason they would give for not telling us ahead of time, so we can make an informed decision.

 
Old 05-21-2006, 10:41 PM   #13
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Re: Pupil Dilation after cataract surgery

Miss Helen,
The implant doesn't become cloudy; the capsule in which the implant is enclosed becomes cloudy.

Eagle, I don't know much about diabetes, but whether you were nearsighted or farsighted before the surgery has a lot to do with how long it takes to see well after.
Generally, the surgery makes you farsighted.
So, if you've been very nearsighted for 50 years, the brain has to learn to see all over again in a world where what was clear is now fuzzy and what had never been seen is now visible.

 
Old 05-22-2006, 01:30 AM   #14
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Have Been Far-Sighted, Presbyopia, Oh Dear!

Quote:
Originally Posted by seriousperson

Eagle, I don't know much about diabetes, but whether you were nearsighted or farsighted before the surgery has a lot to do with how long it takes to see well after. Generally, the surgery makes you farsighted.

So, if you've been very nearsighted for 50 years, the brain has to learn to see all over again in a world where what was clear is now fuzzy and what had never been seen is now visible.
SeriousPerson, what are you saying, if a person has had the normal presbyopia, that makes older people hold a book farther away, that may get worse?

Matter of fact, maybe presbyopia is only about reading, not distant vision. I don't know. Anymore, I sometimes can't recognize a person across a fairly large room.

Before cataract surgery, you're looking through an increasingly opaque lens, which has been blocking some of the light from the macula and retina, as I understand it, affecting detail vision, reading.

I don't know if that could be called nearsightedness. Using a small flashlight right on the page usually helps me more than a magnifying glass if I have to read something. Sometimes I use a magnifying glass if the print's too small, 400X and still can't read it. Retina and macula degeneration besides the cataract. I think Diabetes just damages the retina more than normal aging, if I understand things completely correctly. One can also have scar tissue from having the leaking tiny blood vessels laser-sealed in retinopathy.

They do tell you about clouding, especially if you know to ask, having heard something, that the replacement lens can get cloudy after a while and need to be polished with the laser, or the membrane may have to be punctured, as an experienced someone here has pointed out.

But without the surgery you would eventually be blind, correct, whoever said that about informed choice? The cataracts would get completely opaque? Various treatments cause them to grow faster. (Get dense faster?) Right now I'm looking through them and things are blurry, distant vision with my better eye not as good as before, may not be able to recognize someone across a large room, I may have already said, or a friend in a car I'm meeting on the street. There's also glare on their windshield and it's dark in there.

Last edited by Eagle; 05-22-2006 at 01:37 AM. Reason: Line Spacing

 
Old 05-23-2006, 08:33 PM   #15
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Re: Pupil Dilation after cataract surgery

Nearsightedness typically begins in childhood or adolescence.
Things in the distance become blurry, but things up close are still sharp and clear (hence the term 'nearsightedness').
If you have not worn glasses for this condition most of your life, or have never had a problem reading the eye chart with the big E (until cataracts), then you are not nearsighted.
If your eyesight for reading started to go bad apart from the cataracts, that is, if it seemed your arms weren't long enough to hold a book at the place where you could focus on the words, then you are farsighted (assuming the blurryness in the distance had not yet occurred).
If you had neither of these problems before getting cataracts, then you had 'normal' vision (not near- or farsighted).
Cataract surgery will generally leave you farsighted, and you will need reading glasses. This is not a big deal unless you do a lot of close work. Even then, it's correctible with glasses.
If you have been nearsighted all your life, the adjustment to farsightedness can be difficult. But you will arrive.

 
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