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Old 11-02-2010, 01:46 PM   #1
Join Date: Nov 2010
Location: SoCal, USA
Posts: 4
simming HB User

Quick summary: born with bilateral coloboma and cataracts in both eyes. My right eye is fairly useless as I only have peripheral vision. My left eye was good enough to get by on, without glasses, and even driving too (after extensive tests). However, about this time last year I got floaters in the left eye suddenly so I was referred by my GP to the eye clinic at the hospital. The first doctor had never dealt with eyes like mine (see attachment) and so referred me to the top eye surgeon at that hospital. He'd been trained at Moorfield's Eye Hospital (top in UK) and had seen a few cases like mine. He said the floaters showed no symptoms of other problems but recommended I get the cataracts sorted out - they did appear to have grown from the last time that somebody drew me a picture of what they looked like.

He said that the op would not be without risk as the zonules were weak and/or missing. Long story short we decided to operate on the weaker eye first to test the waters, but under a general anaesthetic and with two surgeons present instead of the usual one under a local. It was to be a monofocal IOL as the varifocal ones would be too difficult and error prone in my eyes. The op went ahead and was successful - I can see that my peripheral vision is sharper, more colourful, although I did get flares (which don't seem obvious anymore).

So we decided to do the left eye. Again, although the right eye was a useful reference, there was no guarantee that this eye would be the same. I was sent to a specialist opticians for a second opinion on the strength of the IOL (see attachments to see why). Again, two surgeons and under general anaesthetic.

Now, the operation itself went fine, and when I woke up there was only a clear plastic cover over my eye, not the dressing they put on the other eye. I suspect this was because I wouldn't be able to see much at all if they'd covered it. But at least I knew I still had sight the moment I woke up.

A 4-week course of drops followed, just like before. Acular, Chloramphenicol (2 weeks), and Maxidex. I had a check-up with the surgeon 3.5 weeks after the op and at that time things were okay - not great, but okay.

Firstly, the aim was for far distance to be correct and then need glasses for reading and computer work (middle distant). However, I ended up being able to read the computer unaided but needed glasses for near and far. Not great, but it's not an exact science when the pupil is displaced. I was also getting ghosting and massive flare issues. But here is where it went downhill. After the drops stopped I was warned that there would be some vision change. It did. Now I can barely read anything. No strength of reading glasses in the supermarket will allow me to read a book. Computer work is very hard (I'm about 5 inches away from the screen as I type this). Far distance is a complete blur.

This morning, as scheduled, I went to the specialist opticians to get a new prescription (about 6 weeks post-op). She started doing the usual, but then said she was trying something much stronger, but gave up after a few more tests. She said she was going to phone the hospital to book me back in immediately (and she got an appointment tomorrow). Naturally this is rather worrying but all she would say was that I might have needed the anti-inflammatory drops a bit longer than normal and that there was no way my eyes should be uncorrectable in this way (an IOL miscalculation should be correctable). She did say that the lens was centred.

Before the op my vision was about 6/9-3. Now it's 6/36-. My right eye is the same pre- and post-op at 6/60+. In terms of decimals, right eye sph 0.75 (I think, can't quite read what she's written) and left eye sph 2.5 cyl 050 axis 50. There are lines above the numbers if that means anything. Pre-op the left was 0.50/050/50 (there are a couple of other bits I can't read, and the 050 might be 0.50).

Does anybody know what could be wrong? Obviously I'll be seeing an eye doctor tomorrow; I don't know if it will be the surgeon but I suspect I will very soon if not tomorrow. What should I ask? Am I worrying over nothing? If it comes to it, is explantation a possibility? If further surgery is required I may ask that I be transferred to Moorfields.

I'm still using Lumigan in the left eye which the surgeon recommended after my first op (not on that eye) showed high pressure - 30 whatevers instead of mid-teens whatevers. No other medication.

Sorry for the poor quality jpeg, it's the best picture I could get. The three white spots are the lights reflecting.

Any help or advice greatly appreciated.
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File Type: jpg eye.jpg (5.2 KB, 0 views)

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Old 11-02-2010, 01:48 PM   #2
Join Date: Nov 2010
Location: SoCal, USA
Posts: 4
simming HB User
Re: Coloboma/cataract/IOL/blurry

I've no idea why the asterisks came up but I was referring to the removal of the IOL and replacement. By the way, phacoemulsification was used with lens capsule intact (I think that's what I mean!)

Old 11-02-2010, 02:06 PM   #3
Join Date: Nov 2010
Location: SoCal, USA
Posts: 4
simming HB User
Re: Coloboma/cataract/IOL/blurry

A couple more things: I used to have trouble with sunlight: that's gone away, although conversely dark is very dark. I don't have any shadows across my sight or curtains or other symptoms that indicate the usual risks.

The flaring is best described as looking at the side of a jewel, or an old filament lightbulb. Lots of lines heading out from the light but then stopping with a ring at the edge. The flare ranges from 11 o'clock to 3 o'clock. The ghosting is up and to the right. I also have rainbow lines under lights, seemingly one for several lights, which starts around the 9 and heads down/right to 5. But the odd thing is a wiggle in the line, like a kid's drawing of a lightning bolt. Having said about the flaring from 11-3, there are a couple of "stray" rays, one of which intersects the rainbow line exactly at the wiggle and splits into two rays. (No I'm not on any pyschadelic drugs)

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blurry, cataract, coloboma, iol

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