Im only 40 and i was detected early onset of cataract last april 2014(i still can read that time. And by march this year, doctor says the left eye is seriously blinded by cataract thats why i can oy see a shadow of my toe(s). No history of cataract in the family. Normal sugar. Normal cholesterol. No hypertension. Exceptionally healthy except my eyes 😬 so frustrating.
Yup, it is frustrating to have cataracts at a younger than normal age, I was diagnosed at 49 with a problem cataract in one eye with no obvious cause (no trauma, no diabetes, no other eye health issues, etc), which went from 20/25 to 20/60 best corrected in a few months and 20/100 or so by the time I finally had surgery 2.5 years later (my other eye had good vision so I postponed surgery, but I got both eyes done when I had it since I traveled to Europe from the US to get the Symfony which wasn't approved here and the difference between the two eyes felt odd so I didn't want to have to go back if I couldn't adapt to it). I've run into a few people younger than normal for cataracts with no obvious reasonn for it, it happens unfortunately. The odds are your surgery will go fine, the problems being described on this page are extremely rare, most people have no issues at all. If you have questions in general about cataracts&surgery you might start a new thread rather than using this page.
Oops, I didn't notice you had posted that you have had one eye done and have the flickering issue, I thought you were just commenting on also having a cataract younger than usual. I'll note however that your surgery was recent, and the first 6-8 weeks or so the lens is still healing within the capsule. It is possible that the lens isn't firmly healed yet within the capsule and that its movement may be causing your issue, if so it may go away in the next few weeks. From the power of the lens it seems likely you weren't highly myopic (nearsighted) before this so its unlikely you have the iridodonesis issue I have. Zonule issues are also not common in younger folks like us when there are no signs of it beforehand to suggest any risk of it, but rare things happen.
Dear Softwaredev,
I really enjoyed reading your precise analyses of the flickering problem which describes my situation with my left eye operated for cataract 3 months ago. I see the flickering the worst when I read close up, and when I watch the computer screen - like just now. Looking at something farther away is much less of a problem. My eye doctor told me to wait 3 months before judging the result, and that the implant would be sealed by tissue growing closer to it, so that it become stable, and so that there is less chance of scattering light. I will confront him sometime in August before I have my right eye done. I am 63 - and even at that age I feel it is a bit early to have cataract operations. Anyway - also have blue eyes - being Danish (living in Denmark). The difference between my two eyes is a little bit problematic since the new lens makes for a much brighter light input - that would be one reason I want the right eye have the same treatment. But I AM nervous about having two flickering eyes.
My left eye have a fixed focus lens. My doctor deselected the correcting type and I deselected the multi-focus because of known problems with lower light transparency and concentric ring vision when observing a point source of light. My next lens will also be fixed focus. I know the type and make if anyone is interested.
THANKS for your input softwaredev. :-)
I wrote a long time ago about flickering light in an eye soon after the operation; I had a little flickering window at several herz (can hardly find what I wrote so dont remember the estimated frequency!), usually in the morning. I thought this forum might like to know that, in my case, the flickering completely disappeared. So at least some flickering is temporary, like your opthalmologist advised. lykke til! Peter
Thanks for your thoughtful and valuable input. It's the most plausible explanation I've heard for the flickering. FYI I've noticed that if I stay totally motionless the flickering stops, so sounds like it fits with iridodonesis diagnosis.
Yesterday I had my appointment with a very experienced older cataract doc, who doesn't use multi-focal or adaptive IOLs. His reason they don't work as well as advertised and cause a lot of problems. He told me he had recently seen a patient who had Crystalens IOLs in both eyes and was having problems similar to mine. He did surgery to place piggy back lenses in both of her eyes.
That's what he recommended for me. In his opinion it's less risky than lens replacement, especially since it's been 8 1/2 months since my surgery and he feels the IOL will have been now so firmly imbedded. This was news to me that waiting would make the lens replacement more difficult. Since the piggyback lens has a significantly is a larger diameter (6.3 mm vs 5.0 for the Trulign), it seems to be in line with the idea that the small diameter of the Trulign was causing the glare halos etc.
Bottom line with no guarantees, of course, it sounded like he felt ding the piggy back had a good chance of reducing the glare halos, rays etc, but was considerably less certain about it doing anything for the flickering. I'd still have to decide whether to use the opportunity of the piggy back to correct the distance vision or stay with the pretty good intermediate distance vision I have now.
Since it was my first visit with him and I wanted to hear what he had to say without preconceived ideas, I did not bring up your input about the cause of the flickering, but certainly will if/when I have another appointment with him.
I'm in the process thinking about his input, but definitely leaning toward going ahead, with what he suggests, just to try to get on with life. He's a busy guy, who's going on vacation, so nothing's going to happen for while.
Boy I'd sure like to talk to the patient that had the piggy back lenses put in to see how it turned out for her.
Apparently the flickering is your only symptom, no glare of halos?
Will post again when I further input and, of course, the results if I go ahead with the piggy back surgery.
re: "if I stay totally motionless the flickering stops"
Yup, if I force myself to focus on one spot on the screeen and not move my eyes, the flickering stops. That does seem to indicate that it relates to movement of *something*.
re: "no glare of halos"
I have no issues with glare at all, I mentioned above that wearing computer reading glasses helps but I guess I didn't mean there was problematic glare that I was noticing, but more that since they are designed to cut down on glare I figured they were cutting down on stray light entering the iris a bit.
Overall my night vision is better than I can remember it ever being before cataracts. I do see halos from headlights and other point sources, but they aren't problematic since they are very light, transulcent, I see though/past them and don't really think about them. The only issue I have now is the flickering, though oddly the first few months when I tried to read hardcopy the text would actually jiggle up and down, with less flickering. Over time the text stopped visibly jiggling but the flickering got worse. I assume that was a change in how my brain was interpreting its input. That is part of why it seemed like it had to involve some sort of movement of something. It seems like its perhaps a few herz, I hadn't tried to pin down the frequency.
You could try seeing if you can use a phone's video camera (or a standalone camera) to record your eyes when you are experiencing the flickering. I did it while trying to read, and the iris movement as I said was very noticeable on the video. It took a few tries to figure out where to hold the phone (out of the way so I could read, but pointing to get the eye), perhaps someone else might assist. I could see the iris movement on the phone, but it was easier to see it uploading it to the computer and watching on a large screen.
If you have other dysphotopsias I had read that a piggy pack lens may help. I suppose its possible if the flickering light is partly due to reflections that it could have an impact. You might ask a doctor to look at the lens with your eye not dilated, or dilated with a non-cycloplegic, and see if when you move your eye if the lens bag jiggles. As I said I hadn't bothered doing that since the recommendation is to give more time to neuroadapt first.
If it is loose zonules leading the capsular bag itself to jiggle, one surgeon suggested there is the chance that suturing the lens to the scleral wall could help, but I gather that isn't easy and any eye surgery has risks, the trauma could make things worse. It sounds like its best to give it more time to neuroadapt. I hadn't encountered any suggestions for what to do if it is the iris.
I was considering the idea of finding the sort of colored contact lenses for halloween to see if they are dark enough to block out the iris (the normal colored contacts seem unlikely to do so) to see if that makes a difference just to diagnose the issue. I hadn't checked in detail to see how dark they are, and to be sure they cover enough of the iris but not the pupil. Unfortunately even plano lenses here in the US need a prescription so I'd have to bug an eye doc to try this, and its mostly academic if there aren't good treatment options.
I should have given this link to a page where an eye surgeon who'd had 20,000+ surgeries (the sort more likely to run into rare side effects) mentioned the link between iridodonesis and flickering:
http://en.allexperts.com/q/Ophthalmology-Optometry-979/2012/1/flickering-vision-4.htm
I will try the video idea.
My first doc said he could not see that the IOL was moving/ jiggling.
The new doc who is recommending the piggy back operation can't do it right away and in the mean time is suggesting I try pupil restricting drops (again). The first doc suggested them and it didn't much, if any affect as far as I reacll on the flickering. This is a different strength and differentt brand, which I will start trying this evening.
Have you tried them?
BWT I was myopic, but not very (-2.75), still am, if less so (-1.25) with IOL and have dark brown eyes.
btw, I posted a link to a page with the doctor referring to flickering & iridodonesis but links send a post to the moderator, presumably for the weekend, it should be the first google hit if you search for "flickering iridodonesis". That page just refers to it being more prevalent in lighter colored eyes, but I imagine that even brown eyes let in some stray light, I guess the question would be whether there are darker striations, black perhaps, that would lead the iris jiggling to vary the stray light coming in.
I haven't tried pupil restricting drops (or the opposite), since I hadn't really noticed a difference based on the bightness of light (and the implied pupil size). The only thing that helps a bit at computer distance is computer reading glasses that I think cut down on stray light. At hardcopy distance trying to read is headache inducing even with those so I don't really try. Oddly my phone is a little better than hardcopy at the same distance, fortunately I'm only reading brief emails of web searches on it very occasionally.
As I mentioned, if they dilated the eye before the surgeon looked at it then there is a chance that would have reduced the movement because almost all dilation drops are cycloplegics which cut off accommodation, tightening the zonules and reducing any jiggling. I found a couple of clips on the net with surgeons referring to needing to look for phacodonesis, jiggling of the natural lens, either without dilation or with a non-cycloplegic dilation drop (they exist, but aren't as effective so they aren't used by default). I assume the same is therefore true of an artificial lens.
It crossed my mind that since the flickering feels to me somewaht like a twitch, maybe acts like a twitch, wether some muscle relaxing or nerve relaxing drug (like possiblly botox?) might be effective in stopping it.
It turns out that eyelid twitching, myokmia, is one of the most common issues eye doctors hear. It sounds like it usually doesn't cause any sort of visual impact, but in some rare cases it can be enough to move the eyeball itself. Its usually the lower eyelid, and often people don't feel it but can spot it in the mirror if they look very closely (but its not something others would notice since its hard to spot).
I had actually wondered if that might have been a factor since I finally noticed I had the issue soon after cataract surgery, though it cleared up in my case so even if it might have been a contributing factor at first, it isn't now. Fatigue is one of the causes of it, and I had travelled to Europe with an 8 hour time difference and lots of connecting flights leading to 30 hour travel times, so in hindsight it wasn't surprising that the issue had popped up again after surgery.
I'd noticed it once or twice in the past when I wasn't sleeping enough, before my cataract surgery, and hadn't had a visual impact from it, but I figured perhaps the artificial lens might be impacted differently, perhaps being looser. In my case when I did have it the twitching was pretty much constant, but it resolved within a few days, but some people can have it for a long time (it took weeks this time around, perhaps party due to stress from having eye issues). One of the treatments for it is a small shot of botox to paralyze the muscle, but I'd never needed to try that. It would only be applicable if the issue were actually a muscle twitch. It was difficult to see, I had to get the lighting right in the mirror to notice it, and I couldn't seem to get a good camera video of it.
It turns out even the natural lens jiggles to a stop when the eye moves, there was a paper last year by Pablo Artal and Juan Tabernero on: "Lens Oscillations in the Human Eye. Implications for Post-Saccadic Suppression of Vision", which explains the brain actually ignores input from the eye for a fraction of a second whenever it moves to allow for movement and jiggle time. I figure that if there are loose zonules or something that the artificial lens is jiggling longer and the brain isn't tuning it out, if its the lens capsule jiggling and not the iris.
Want to take the video of my iris you suggested. Don't have a smart phone only an "elderly" Canon digital camera. Not sure if Windows media player will be able to slow it down enough. I would like to see your video so I could compare it to mine, if I'm able to take it and, of course, would be more than willing to show you mine.
Not sure how we could do this, via emails maybe?
Noticed there already is a video showing iridodonesis on you tube. In case you haven't seen it, I found it by googling iridodonesis. Is that what yours looks like?
Sure seems to me, since you can actually can your iris jiggling, that would be the most likely cause of your flickering.
BTW thanks for the link. I'm not as hopeful that it will fade with time (as that doc), as I'm almost up to 9 months and haven't seem any change/reduction.
Hi Peter 1110
I think I may have seen a message from you some time after my last message was posted saying I`d find the lens details? I managed to start
a new thread just for Dysphotopsia and lens types but think its gone as I couldn`t see it again.
The other postings from the group have been sent to me but I lost track
of what had happened to you. I didn`t manage to find the details but will get them from my GP when I see her next.
I have become really fed up as I haven`t see the surgeon again who performed my procedure and last saw a temporary Ophthalmologist
as the department is short staffed. I had waited almost three hours
and the dept was closing;the temp doc was leaving that day.
Its interesting reading about the various drops members are given. I was given several lots of drops but not told what they were supposed to
do and had to cancel the last appoinment. The next appointment isn`t
until October.
The video sounds interesting, I`ll have a look at the messages again.Sorry, this has to be the most boring messageI have ever written.
Best Wishes
Alice
Had my 2nd appointment with the doc who suggested doing the piggyback operation.
In the meantime was able to get in touch with his patient on whom he did the piggyback operations. She's happy with the results, but UNFORTUNATELY she did not have any flickering or as far as I can tell, the other visual problems I have, she just wanted to see close up without glasses instead of in the distance. Kinda bothers me that he would suggested the piggyback for me, just because she had the same Trulign lens I have, even though her complaint was completely different.
After much discussion, he's now offering to try to do a lens replacement (with larger diameter conventional lens), but said he's nervous about being able to get the old lens out without doing damage (apparently he had problem trying to do so before) since it's been in my eye for 9 months now. So he wants to reserve the right to back out, if he runs into trouble and do the piggy back instead.
He also mentioned a Dr Olsen in Utah who's an expert on dysphotopsia and I looked him up and found his write up. http://tinyurl.com/pmghwje Reading that it's not at all encouraging that the operation, which ever way it turns out will likely do anything for the dysphotopsia and my vision could actually turn out worse.
So while I've more or less agreed to give a try (the surgery would be mid-Sep), just to do something, to try to get on with life, I remain very nervous about it being the correct decision, so nervous it's giving me really bad insomnia.
Anyone have any luck doing anything proactive that has reduced or elimianted flickering/dysphotopsia?
Hi Peter,
Are you living in Denmark - then we could communicate directly. I have flickering sight on the eye i had operated for cataract 3 months ago. I have come to the conclusion that I will have to live with it because it is a matter of adapting the brain to this rather than trying to change the lens. A very qualified doctor (who operated me) has convinced me that the changes reg. flickering is a brain-matter - and that it IS possible to work with in this way - i.e. disregard the flickering. He knows of no changes of lenses to other types that would give a better result. So I have decided to have my second eye done with the same doctor and the same type of lens (standard).
I live in Seattle in the States, but think we still couldn't use email to communicate directly. Thanks for your valuable input.
The fact that you have a standard lens and have the flickering makes me more doubtful that switching from the Trulign to the standard is likely to help. Do you have glare from the (same) side as the flickering? And nighttime rays and halos around bright objects? Or just the flickering?
I experienced something like a limiting dark half-moon in the extreme side away from my nose. This has receded to next to nothing over the past 3 months. I do not see nighttime rays and halos around bright objects - just fleckering when reading (book or screen). Looking steadily at an object there is no flickering.
My flickering also stops if I remain motionless.
OK - same issue then. My approach will be to worry no more- live my life, and forget about the flickering :-)