so i had recently had a IOL op in right eye for posterior cataract, the day after when first opened my eye there was a big black arc in vision and horrific light sensitivity, its now 2.5 months later and its still the same, my surgeon on follows up said everything looks perfect and lens is perfect etc and it should go away but it hasnt, he described it as entropic phenomenon ...so i accepted would have to live like this and went to get eye exam for new specs, halfway through the optican stopped and said look at the screen, sure enough pic of retina with a clearly visible black arc, i will try and attach the pic, my surgeon doesnt seem very interested, i assume lens is wrong size for my eye or not in the right place ?
wow! I don’t know what that is, but I am, unfortunately, familiar with eye surgeon not taking responsibility for what they’ve done, and just passing you off. Get a second opinion!! Can’t advise this strongly enough.
thanks for reply and yes will do , v frustrating when something as important as the eyes …
I am not a medical professional, but I would guess that you have what is called negative dysphotopsia (ND). Positive dysphotosia is streaks of light or flashes. ND is essentially shadows. It is related to the lens position in the eye. One issue with IOLs is that they are thinner than the natural lens, so they may sit further back in the eye. Here is an article that you can look at, but it is quite technical. My quick read of it is that successful resolution can mean moving the lens from the normal location in the capsule (bag) where the natural lens was, and the IOL is normally located, to the sulcus area in front of the capsule. Other methods seem to involve using a different method of fixing the location of the lens. These are not routine procedures and you would have to search for a specialist that may undertake it. This article provides some contact information on those who have provided their opinion on the issue in this article. You may want to try contacting them if the condition does not resolve by itself. I noticed that one expert says they don’t do anything until 6 months post surgery, as up until that time it may resolve by itself.
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CRSToday The Persistent Problem of Dysphotopsias September 2018
thank you so much for taking the time to write back and yes i have researched ND as it fits so well with the arc etc, but when i researched this has never shown up in a retinal image as an physical arc and is just therefore categorised as a weird phenomenon that happens on occasions, i am seeing surgeon in am and was hoping that this was proof that lens is not right or positioned incorrectly. Do you think the pic i uploaded is normal ? if so i don’t really have any comeback with surgeon , thanks for taking the time as its so difficult to get decent advice and all i want is to get my eyesight back to a normal state, for 2.5 months i am struggling with being out and about generally and i cant walk around with 5 pairs of glasses etc to cover every scenario, my eyes were 90% better than this pre op…nightmare…
Best
Marc
I am not a medical professional and can’t comment on the image. What I have seen written is that optometrists and cataract surgeons are not able to see dysphotopsia so they have a hard time treating it, or in some cases believing it exists. It does seem unusual that you are seeing it in a photo, with the claims that it cannot be seen. But, your optometrist should be able to see the IOL position in your eye and comment on whether or not it is located correctly. Another surgeon should also be able to give you a second opinion.
ok thank you v much, the optician said immediately its not right and go back to surgeon and no point in you buying prescription glasses until sorted and thats the point i am at so fingers crossed surgeon agrees tomorrow, concern is nothings changed in 2.5 months and a month ago surgeon reviewed me and told me everything’s perfect…
Really appreciate your comments, thank you
At first I thought “oh, negative dysphotopsia”, however the picture looks to me (but I am not an eye doctor!) like a decentered IOL. In any event, let us know what the surgeon says!
I think your other options are that the lens is not centered in the bag, or is at an angle, or I have heard others here report that the lens is not fully in the bag. They make an incision to remove the natural lens and put the IOL in. Before it heals the lens could come partly out in some cases. The lenses have little “legs” called haptics that could also poke out of the incision causing the lens to be out of position. All of those kind of issues should be looked at sooner, rather than later.
thanks, will let you know, ND feels like an IBS style broad brush for we don’t really know, other than its a bit fffed up…am hoping this is more straightforward …cheers, appreciated
thanks again, will report back tomorrow