It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Eye & Vision Message Board
Post New Thread   Closed Thread
LinkBack Thread Tools
Old 04-02-2012, 11:00 AM   #1
Junior Member
(female)
 
Join Date: Jan 2012
Location: St. Louis, Mo
Posts: 40
legalbeagel HB User
Question R eye nearsighted/L eye far sighted after cataract surgery

I had vitrectomy surgery June 2011, on R eye, then Feb 2012 had cataract removed on the same eye caused by the vitrectomy surgery. I got the standard monofocal lens for the R eye. I've always been nearsighted in both eyes with lots of astigmatism. After cataract surgery on R eye, it is now not nearsighted anymore but farsighted in its vision, and the non-surgical L eye is still nearsighted with astigmatism. I assumed that the surgeon would "tweak" for lack of a better word the R eye lens implant so that it would work as well as possible with the L eye which remained farsighted and astigmatism. However, that is not the case as there is such a disparity between the two eyes. The surgery eye focuses far sighted; the non-surgery eye focuses nearsighted. My optometist did his best with new eyeglass lenses to try to pull the two different eyesights together as much as possible and had to leave the rest to my brain to sort it out, if it could, he said. I get disorientated in my vision - kind of times like looking thru a fish bowl; when take glasses off the R and L eye go crazy trying to adjust and I have momentarily double vision; can't read items or price tags on grocery shelves up close, have to back up far away, and even then can't read it all; book reading is a little harder, and a computer screen is very difficult to read. I go back to the surgeon tomorrow Tuesday April 3 for a check-up and I'd like to ask him about the differences in my eyes and was the R eye lens implant tweaked to accommodate the non-surgical eye, but don't know how to ask it, or if I'll understand his technical answer. Sorry for short notice on this post but if anyone can answer right away so I know what to ask the surgeon that would be great. Thanks.

 
Sponsors Lightbulb
   
Old 04-02-2012, 12:23 PM   #2
Senior Member
(female)
 
Join Date: Apr 2011
Location: lake tapps wa
Posts: 109
tubint HB Usertubint HB Usertubint HB Usertubint HB User
Re: R eye nearsighted/L eye far sighted after cataract surgery

I am almost exactly in the same situation as you. Had erm retina surgery may 2011, and 2 weeks ago had cataract surgery in the retina surgery eye. My good eye is a +1, which is a little Hyperopic=far sighted. My new IOL in my cataract eye put me at approx. -.50 which is a little myopic= near sighted.

#1) I was told that it can take a couple of months for the two eyes to adjust to such a drastic change. ( I have only needed reading glasses prior to the retina issue, and then was 20/200 and worse for the past year).

#2) First thing I would ask him is what "refraction/diopter" your non-surgery eye is and what is your surgery eye post cataract surgery. This will tell you the Diopter spread, and hopefully it wouldn't be more than 2 diopters apart.

I am having problems walking down the aisles in stores, etc. where the aisles of stuff feel like they are rushing up on me. My two images are not merging well together and it is an aweful, drunk-like feeling. Since I am only 2 wks. post cataract surgery I am trying to take my mind off of it and hoping my brain works it out...otherwise, don't know what plan B is yet.

Anyways, get some specifics from your Doc and ask what his plan is. Keep me posted please !!! Good luck, I hope this was of some help.

 
Old 04-02-2012, 02:23 PM   #3
Junior Member
(female)
 
Join Date: Jan 2012
Location: St. Louis, Mo
Posts: 40
legalbeagel HB User
Re: R eye nearsighted/L eye far sighted after cataract surgery

Thanks for quick response! I understand the feeling of things rushing up on you, however, I don't get it in aisles but at times when cars pass me they look so close to me that I think they are going to hit me. I then pull my car to the right to "get out of the way" when, in fact, they are in their own lane, and not drifting into mine at all. I am so new to this eye situation that I don't believe when the surgeon talks to me tomorrow morning regarding the refraction/diopter issue that I would understand. I'll need plain English to grasp this; not medical terminology. When my optometrist fitted me for eyeglass lenses 3 weeks ago, he did not hold back his astonishment at the difference in my two eyes and that I should find out what the surgeon did to try to accommodate the eyes to work better together. Can you break down what you told me regarding refraction/diopter into a simpler understanding for me and what is a diopter spread? Thanks!

 
Old 04-02-2012, 04:54 PM   #4
Senior Member
(female)
 
Join Date: Apr 2011
Location: lake tapps wa
Posts: 109
tubint HB Usertubint HB Usertubint HB Usertubint HB User
Re: R eye nearsighted/L eye far sighted after cataract surgery

Quote:
Originally Posted by legalbeagel View Post
Thanks for quick response! I understand the feeling of things rushing up on you, however, I don't get it in aisles but at times when cars pass me they look so close to me that I think they are going to hit me. I then pull my car to the right to "get out of the way" when, in fact, they are in their own lane, and not drifting into mine at all. I am so new to this eye situation that I don't believe when the surgeon talks to me tomorrow morning regarding the refraction/diopter issue that I would understand. I'll need plain English to grasp this; not medical terminology. When my optometrist fitted me for eyeglass lenses 3 weeks ago, he did not hold back his astonishment at the difference in my two eyes and that I should find out what the surgeon did to try to accommodate the eyes to work better together. Can you break down what you told me regarding refraction/diopter into a simpler understanding for me and what is a diopter spread? Thanks!
It took me a while to "get this diopter thing) also,,,but I have it now. Basically When your Cataract surgeon picks a lens "target" to hit (=strength of lens) it is determined by the tests he did on you. Then, someone needs to make a judgement call on the strength for your final outcome. He SHOULD have gotton you involved in that decision. You are like me and we are in the minority because most people get both eyes corrected with an IOL from cataract surgery, usually 5 weeks ish apart.

You and I are only doing one eye for a while (hopefully years) because our cataract was induced by retina surgery. That being said, our good eye has a "refraction" number of which your Cat. surgeon and your Optomitrist knows from the tests. The number 0 is called "plano" and that is best distance vision...any number in the + direction is hyperopic=more far sighted. any number in the - direction from 0 is myopic= that eye is more in the nearsighted direction (can read better, etc.)

Those numbers represent diopters--You don't want more than a 2 Diopter spread because that means your eyes are visually "fighting" each other because one wants to see distance things clear and one wants to see near things clear.
This is basic stuff your Doctor should go over with you if you ask. I'm not saying this is your problem with your eyes not working together properly, but it is common and very well may be...at least it's a real good place to start. You should get those numbers for your records anyways, and then you can always do more reading on it later.

I was told that it could take a couple of months for the eyes and brain to readjust to our new vision. I am no Doctor, so please verify everything I am saying. I too am trying to play detective and figure out why my eyes are not merging the images properly. The docs only spend a little time with it, and then we are on our own, unfortunately.

Hope I am helping and not confusing things more.

 
Old 04-02-2012, 07:12 PM   #5
Junior Member
(female)
 
Join Date: Jan 2012
Location: St. Louis, Mo
Posts: 40
legalbeagel HB User
Re: R eye nearsighted/L eye far sighted after cataract surgery

Thanks for the explanation of diopter – I think I’m beginning to grasp some of this. I know when I see the surgeon tomorrow it will be confusing but I may be able to frame a couple questions to find out what I suspect and will tell you now. Before he did CAT surgery on the retina surgery eye, he told me my good L eye was ready to have that CAT removed also. I knew I had a CAT in that good eye but I can see well out of it, and won't have surgery until it reaches the point it has to come out, maybe years from now, which my optometrist agreed with me on this. Since my surgeon told me the CAT in the good eye could be removed, I’m thinking he assumed he would eventually, probably quite soon, be removing the CAT from the good eye, which I never told him I would have him do, so when he implanted the lens in the retina surgery eye, maybe it wasn’t “tweaked” to where it could have been to coordinate with the good eye as he was thinking I would be back shortly for the CAT in the good eye to be removed by him and then the eyes would function better properly? I hope that was not the case but I would like to know that from him – how does one ask their doctor if they did surgery based on assumptions. My brain does it best to pull my two eyes together to function as best as they can, but the surgeon not possibly calibrating the lens implant in the retina surgery eye to work well with the good eye is causing visual problems, and since I won't get CAT surgery on the good eye for a long time, am I stuck. Thanks for your help, and I wish you well on your eye. I like the Healthboards blog as talking to others brings down the stress level.

 
Old 04-03-2012, 01:51 AM   #6
Senior Member
(female)
 
Join Date: May 2009
Location: NYC/Dubai
Posts: 228
earthworm88 HB Userearthworm88 HB Userearthworm88 HB Userearthworm88 HB User
Re: R eye nearsighted/L eye far sighted after cataract surgery

Hi Legalbeagel, tubint pretty much explained it well. She is right to think that the surgeon should explain all these to you since you will be the one living with your eyesight, and any future plans that he has for you need to be informed and consensus to be reached.

I just would like to say that there is no "tweaking" in the implanted lens. Unfortunately, it is what it is. There may be a very slight change as the eye heals from the surgery through reduced swelling of cornea etc, but the surgeon cannot go in to change the power of the lens unless it is as drastic as to remove the lens and implanting another one in. As Tubint also mentioned, there should be a reasonable discrepancy in power between the two eyes so that the brain can try to work with the two images. Not knowing how much power (prescription you wear on glasses) there is in each eye, it is hard to say whether you can adapt or not. But generally a period of time is required to adjust to this, the older one is, of course, the harder it may be, and the longer it takes also. Also, sometimes this can throw the muscle balance off as well and making binocular vision difficult on top of that. Unfortunately due to the wiring complexity in the ocular system, nothing is ever straight forward and not two people have the same "diagnosis" can have the same exact symptoms.

Also, your type of situation isn't uncommon ie one eye for far and one eye for near. Some patients want this type of arrangement when they do lasik surgery in order to avoid wearing glasses, again, time is required to adapt to this new change, and not everyone will succeed at the end. But the main issue is how much is the difference between two eyes. I suspect as you said that your non-operated eye has a lot of astigmatism, that may also be one of the issues as well.

Each of your eye receives an image from the outside world, and the brain sees both and will combine them (which also gives you depth perception), but if the images look different, the brain will get confused or try to combine them but not successful, then you may get visual disturbances and headaches. So a term you can look up is Anisoconia which basically means the difference in image sizes due to optics (large difference in power/prescription). From what I can see, there are about 2 options you have (assuming you can't adapt):
1) talk to you surgeon and plan to do cataract surgery on the left eye
2) manipulation of the optical lens (limited) to try to equalize the image sizes - only a few optometrists really know how to do this and usually through trials and errors to fine tune and costly, and hope the brain will "compensate" for the remaining difference in order to get both eyes to work together

I hope I am not confusing you further, and wish both you and tubint best of luck in resolving this issue.

 
Old 04-03-2012, 02:49 PM   #7
Senior Member
(female)
 
Join Date: Apr 2011
Location: lake tapps wa
Posts: 109
tubint HB Usertubint HB Usertubint HB Usertubint HB User
Re: R eye nearsighted/L eye far sighted after cataract surgery

Thank you earthworm, I have read some of your previous posts and know that you definitely know what you are talking about. It is just wonderful to have people like you sharing your educated opinion on this forum. Helps the rest of us who are struggling to find the answers since our docs can only give us minimum time at our appointments.

Thanks again ! BTW, I tried playing tennis with my husband this morning to try and train my eyes to follow the ball coming from far to near over the net. I did pretty well, but it was weird. Do you think doing eye "exercises" like this might help promote the eyes to work together faster ?

 
Old 04-03-2012, 05:18 PM   #8
Junior Member
(female)
 
Join Date: Jan 2012
Location: St. Louis, Mo
Posts: 40
legalbeagel HB User
Re: R eye nearsighted/L eye far sighted after cataract surgery

Thank you Earthworm for jumping in on the conversation. I appreciate your insight and information. Eye work boils down to, in my opinion, the doctor's instruments, his surgical skills, and his own personal judgment what will work best. I had another follow-up exam today and questioned why my eyes aren't focusing as well as they should and it all boiled down to the vitrecomy surgery I had that also created a cataract that had to be removed, and it all takes time for healing. He also said since the standard monofocal inserted is farsighted and my non-surgery eye is nearsighted with lots of astigmastism in it that the brain is trying to compensate, and that he did his best to get the eyes to work together. He told me I have to wait it out see how things improve. If things don't get better, there are alternatives but none that are to be done at this moment as he wants to wait it out. I’m most appreciative I have my eyesight; it is just when do you hit the end of the road for recovery. He sees a film starting to form on the lens implant. He called it a secondary cataract, which might never grow any further, but if it does and starts blurring my eyesight and making night driving difficult, then laser surgery is necessary. Thanks so much!

 
Old 04-03-2012, 10:12 PM   #9
Senior Member
(female)
 
Join Date: May 2009
Location: NYC/Dubai
Posts: 228
earthworm88 HB Userearthworm88 HB Userearthworm88 HB Userearthworm88 HB User
Re: R eye nearsighted/L eye far sighted after cataract surgery

You are welcome, Tubint. Keep in mind that not knowing the full scope of the issue, my recommendations are limited and can be erroneous at times. :-) It is so true that most appointments with the doctors often have this rush feelings and sometimes we walk out even more confused and frustrated.

Are you currently wearing your updated prescription? I understand your power discrepancy is only 1.50D difference? How long has it been now you are antimetropic? (two opposite sign of power) How's your retina prognosis?

To simply answer your question, any exercises are good if you are trying to train your eyes to work together IF it is truly a binocular function issue. :-)

Last edited by moderator2; 04-05-2012 at 04:22 PM.

 
Old 04-03-2012, 10:26 PM   #10
Senior Member
(female)
 
Join Date: May 2009
Location: NYC/Dubai
Posts: 228
earthworm88 HB Userearthworm88 HB Userearthworm88 HB Userearthworm88 HB User
Re: R eye nearsighted/L eye far sighted after cataract surgery

Quote:
Originally Posted by legalbeagel View Post
Thank you Earthworm for jumping in on the conversation. I appreciate your insight and information. Eye work boils down to, in my opinion, the doctor's instruments, his surgical skills, and his own personal judgment what will work best. I had another follow-up exam today and questioned why my eyes aren't focusing as well as they should and it all boiled down to the vitrecomy surgery I had that also created a cataract that had to be removed, and it all takes time for healing. He also said since the standard monofocal inserted is farsighted and my non-surgery eye is nearsighted with lots of astigmastism in it that the brain is trying to compensate, and that he did his best to get the eyes to work together. He told me I have to wait it out see how things improve. If things don't get better, there are alternatives but none that are to be done at this moment as he wants to wait it out. I’m most appreciative I have my eyesight; it is just when do you hit the end of the road for recovery. He sees a film starting to form on the lens implant. He called it a secondary cataract, which might never grow any further, but if it does and starts blurring my eyesight and making night driving difficult, then laser surgery is necessary. Thanks so much!
You're welcome, legalbeagel. Out of curiosity, were you able to get some concrete answer to your current prescription status in both eyes? Also, knowing that you were naturally nearsighted to begin with, why did your surgeon think to insert a monofocal that is farsighted?

Yes, it is quite common at a later point to see the posterior subcapsular membrane (separates the vitreous from the anterior chamber) hazes up and when it starts to disrupt the vision, YAG laser is used to pierce through this membrane, which is a really quick and painless procedure.

Good luck with everything, and wishing you a quick recovery!

 
Old 04-06-2012, 08:55 AM   #11
Senior Member
(female)
 
Join Date: Apr 2011
Location: lake tapps wa
Posts: 109
tubint HB Usertubint HB Usertubint HB Usertubint HB User
Re: R eye nearsighted/L eye far sighted after cataract surgery

Thank you Earthworm for your response. I am 2 wks post Cat. surgery with good eye +1 and Cat. eye now -.50, but with a little residual retina problems from previous ERM surgery last May.
I have never had eye issues, only 57, have worn 2.25 readers for 8 years, and developed the ERM last year out of no where.
My residual retina issues are:
retina swelling of 308 in the center where the fovea is trying to reshape, but 375 as the average center. These numbers stabilized the last few months , so proceeded with Cat. surgery as I declined to a 20/400 quickly after ERM surgery.

My problem so far is that my eyes are not focusing or merging images together in the range where I focus when I walk or shop in stores. Guessing 15 feet ish away. Is that about the depth of field I now have with the -.5 ? (guessing 5'-15')
If so, do you think the problem is that my good eye was used to doing all of the work for about a year while I was 20/200 and worse in my bad eye ? Hence, now it is struggling with the Cataract eye being somewhat better in that depth of field?

Might it have been better if I would have hit closer to Plano in the Cat. eye ?

Any thoughts would be helpful. Thank you Earthworm !

 
Closed Thread




Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off




Sign Up Today!

Ask our community of thousands of members your health questions, and learn from others experiences. Join the conversation!

I want my free account

All times are GMT -7. The time now is 01:44 PM.



Site owned and operated by HealthBoards.com™
Terms of Use © 1998-2014 HealthBoards.com™ All rights reserved.
Do not copy or redistribute in any form!