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Medical Forum / Diseases and Disorders / Glaucoma / May 2004lensectomy - no impant
I had a baseball related trauma to my right eye back in August 03. See "High IPO from Silicone Post" for details. I had my lens removed and after 3 surgeries,everything seems to be stable. My surgeon elected not to implant a lens when my oil was removed on 4/22/04. His thought was to leave the eye alone because everything was stable and he did not want to risk any setbacks by going back into the eye. I have worn contacts my whole like(age 41) and natively have 20/300 in both eyes w/o contacts and correctable to 20/20 w/contacts before the accident. My surgeon said because I am so nearsighted that my lens probably was not doing much for me. My question is other than a super strong contact lens I will need, what else could I expect with my vision without a lens? If I put on reading glasses with +3.25 my vision in my bad eye clears up dramatically, but when I put on my precription glasses it make it worse. I would have thought my glasses would also improve my vision somewhat. Any ideas out there? > I had a baseball related trauma to my right eye back in August 03. > See "High IPO from Silicone Post" for details. I had my lens removed [quoted text clipped - 17 lines] > > Any ideas out there? Yes...if you were a high myope (very nearsighted), then your old prescription glasses contain thick concave lenses (the lens is shaped like an hourglass...thicker at the edge than in the center). With no implant in your eye, you are now a hyperope (farsighted), which means you need a plus powered lens which is convex (shaped like a magnifying glass...thicker in the center than at the edge). Readers, like plus 3.25 are convex, although most people who are aphakic (have had a lensectomy with no implant) need more like +8.0 to +12.0 to clear their vision. Glasses won't work for you because you now have a very significant difference between your two eyes. The only way to correct your vision well for both eyes together would be to wear a contact in your surgical eye (or both eyes)...one will be plus powered and one will be minus powered. Good luck. --Rick Cohn, MD Glaucoma specialist Winter Park, FL > ... Glasses won't work for you because you now have a very > significant difference between your two eyes. Why won't glasses work, since there is a lens for each eye? Looker ( a glaucoma sufferer) > > ... Glasses won't work for you because you now have a very > > significant difference between your two eyes. > > Why won't glasses work, since there is a lens for each eye? > > Looker ( a glaucoma sufferer) Because through a minus lens things look smaller and through a plus lens things look larger. If an image looks too different in size between two eyes this will cause double-vision and headaches. --Dr. Cohn There is a possibility oof accommodation to the difference, perhaps. I have had one nearsighted and one far sighted eye all my life, and have never had double vision etc. Sometimes a contact is usedforpeople in one eye, also. Or, are you saying the lens status under discussion is a much greater discrepancy? Carolyn >>>... Glasses won't work for you because you now have a very >>>significant difference between your two eyes. [quoted text clipped - 7 lines] > between two eyes this will cause double-vision and headaches. > --Dr. Cohn  SignatureA contented malcontent. http://www.equalizers.org > There is a possibility oof accommodation to the difference, perhaps. I > have had one nearsighted and one far sighted eye all my life, and have [quoted text clipped - 4 lines] > > Unlikely one will accomodate to this...the reason your difference between your two eyes doesn't bother you is explained in your own comment: you've had this all of your life. It is much easier to deal with different refractions between two eyes if it has been since childhood...it's entirely different if this is created as a result of surgery in adulthood. --Dr. Cohn Thanks, as I suspected.. carolyn >>There is a possibility oof accommodation to the difference, perhaps. I >>have had one nearsighted and one far sighted eye all my life, and have [quoted text clipped - 6 lines] > > --Dr. Cohn SignatureA contented malcontent. http://www.equalizers.org Ok, I just went to the optometrist and I am a +6(like I thought in my surgically repaired eye). I am a -10 in my good eye. We have encounterred another issue. Double vision was expected because of a larger image in my +6 corrected eye, but the double vision is not over the same focal point. The image is left and lower that the image in my -10 eye. The optometrist is thinking it is either my muscle in my eye(although it tracks objects with no problem) from the surgeries or it is because the eye has not been asked to be productive in 9 months that it may have to be retrained. Any ideas out there? E-mail if you would like more detail. > There is a possibility oof accommodation to the difference, perhaps. I > have had one nearsighted and one far sighted eye all my life, and have [quoted text clipped - 14 lines] > > between two eyes this will cause double-vision and headaches. > > --Dr. Cohn ANY IDEAS OUT THERE???????????? > Ok, I just went to the optometrist and I am a +6(like I thought in my > surgically repaired eye). I am a -10 in my good eye. We have [quoted text clipped - 28 lines] > > > between two eyes this will cause double-vision and headaches. > > > --Dr. Cohn > ANY IDEAS OUT THERE???????????? > [quoted text clipped - 12 lines] > > ideas > > out there? E-mail if you would like more detail. ----Boy, I don't respond for a day or two and you guys sure get huffy!!! Anyway, yes, your optometrist is correct. Diplopia, or double vision may result from a muscle imbalance (somewhat common if you had a "block," an injection around the eye to numb it up right before surgery) but, as you mentioned, the eye may have drifted from underuse. You may need prism in your glasses on top of the contacts. Also, covering one eye should remove the double vision, which can be done during important tasks like reading. --Dr. Cohn >----Boy, I don't respond for a day or two and you guys sure get >huffy!!! Yeah, and we want our money back! Oh, wait. ;) Leigh -- Consequences, shmonsequences, as long as I'm rich. - D. Duck I wouldn't get too excited about this guy's "huff" ... he's talking about double-vision in a forum about glaucoma. Methinks he has more to worry about than his vision .... SignatureThis message and all attachments have been scanned by the most current version of McAfee virus protection software. > > ANY IDEAS OUT THERE???????????? > > [quoted text clipped - 22 lines] > done during important tasks like reading. > --Dr. Cohn Are you saying the block(which I had in all 3 surgeries to numb the head) could be the cause? Will patching the good eye help strengthen the muscles in my surgerically repaired eye? If it is related to the block, can that be temporary? My eye muscles track normally, just the bad eye is off alignment. My optometrist mentioned about seeing a muscle specialist when my vision improves a little more(it only about 20/100 now). He also mentioned vision therapy as an option. What do you think? > I wouldn't get too excited about this guy's "huff" ... he's talking about > double-vision in a forum about glaucoma. Methinks he has more to worry about [quoted text clipped - 26 lines] > > done during important tasks like reading. > > --Dr. Cohn > Are you saying the block(which I had in all 3 surgeries to numb the > head) could be the cause? **yes** Will patching the good eye help strengthen > the muscles > in my surgerically repaired eye? **no, but it will temorarily eliminate double vision.** If it is related to the block, can > that be > temporary? **yes, but it may take weeks or months to resolve.** My eye muscles track normally, just the bad eye is off > alignment. > My optometrist mentioned about seeing a muscle specialist when my > vision > improves a little more(it only about 20/100 now). He also mentioned > vision > therapy as an option. What do you think? Seeing an eye muscle specialist (a pediatric ophthalmologist) would be a good idea. Vision therapy is crap. --Dr. C I also have a larger irregular pupil in my bad eye. Can this cause doublw vision by itself? > > Are you saying the block(which I had in all 3 surgeries to numb the > > head) could be the cause? **yes** [quoted text clipped - 13 lines] > > therapy as an option. What do you think? Seeing an eye muscle specialist (a pediatric ophthalmologist) would be a good idea. Vision therapy is crap. > --Dr. C > I also have a larger irregular pupil in my bad eye. Can this cause > doublw vision by itself? > >If you close the other eye and you still have double vision, then you have what is called, "monocular diplopia," which is NOT due to a muscle imbalance. Monocular diplopia is always refractive in nature, coming from a cataract, an opacified membrane behind the lens implant, or light hitting the edge of the lens implant. The latter is often the case in patients with dislocated lens implants or in situations where the pupil is irregular and stays dilated. This may be what is going on in your case, but I couldn't say without looking at your eye. Hope that helps, Rick Cohn, MD I have no IOL and my vision in binocular diplopia. My IOL wont be done until 10/04. My surgeon wants me to wait. I see out of my bad eye images to the left and lower, My choroidal folds(which are getting better) are distorting things a bit(tilt with some wave). This were due to the hypotony that was there before my iris was repaired in 1/04. Silicone oil was removed 4/04. So it is either my eye muscles or the nerve blocks*like you said earlier, or maybe something else such as what I was asking. I am just trying to cover all of my possibilities. Any more thoughts? > > I also have a larger irregular pupil in my bad eye. Can this cause > > doublw vision by itself? [quoted text clipped - 9 lines] > Hope that helps, > Rick Cohn, MD >> I also have a larger irregular pupil in my bad eye. Can this cause >> doublw vision by itself? [quoted text clipped - 9 lines] > Hope that helps, >Rick Cohn, MD It sure does help. John |
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