Medical Forum / General / Vision / August 2006
Cataract Surgery and Flickering Vision
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Fidelis K - 10 Aug 2006 21:14 GMT I had the surgery yesterday adn went to see the surgeon today. I'm happy with the result but the only thing that bothers me is ocassional flickering vision. Flickering usually happens when I read (the operated eye is set for a reading distance). According to the surgeon, the flickering comes from reflections off the edge of my IOL and should go away once my IOL is settled down inside my eye and as my brain learns how to respond to the IOL He also added that some people see shadows instead of flickering.
So, is the flickering vision something that I should not worry too much? Granted, it's been only one day since the surgey, but I cannot help thinking, "How wonderful it would be without the flickering?" :-)
acemanvx@yahoo.com - 10 Aug 2006 21:17 GMT > I had the surgery yesterday adn went to see the surgeon today. I'm happy > with the result but the only thing that bothers me is ocassional flickering [quoted text clipped - 7 lines] > Granted, it's been only one day since the surgey, but I cannot help > thinking, "How wonderful it would be without the flickering?" :-) Maybe itll go away. Give it time and see. By the way, you made another thread here:
http://groups.google.com/group/sci.med.vision/browse_thread/thread/4bbda99d2b922 40a/95baf7ccafba867c?lnk=raot#95baf7ccafba867c
Check out the replies!
sdavies6 - 10 Aug 2006 21:18 GMT I'm curious about your surgery. Was it a real cataract, or a Clear Lens Extraction? What kind of viison did you have before? How good is the vision in the non-operated eye? Is the Mutlipiece a monofocal or a multifocal lens?
>I had the surgery yesterday adn went to see the surgeon today. I'm happy >with the result but the only thing that bothers me is ocassional flickering [quoted text clipped - 7 lines] > Granted, it's been only one day since the surgey, but I cannot help > thinking, "How wonderful it would be without the flickering?" :-) Fidelis K - 10 Aug 2006 23:46 GMT A monofocal was implanted was due to real cataract. The operated eye was 20/100 and the n.o. 20/70 with contacts.
> I'm curious about your surgery. Was it a real cataract, or a Clear Lens > Extraction? What kind of viison did you have before? How good is the [quoted text clipped - 13 lines] >> Granted, it's been only one day since the surgey, but I cannot help >> thinking, "How wonderful it would be without the flickering?" :-) acemanvx@yahoo.com - 11 Aug 2006 00:38 GMT > Does anyone knows how visual acuity measured with the Snellen Chart > corresponds to a minus diopter?
> For instance, what is the diopter for 20/70?
> Thanks. I do. I have been researching this for some time and have seen the results of many people, almost always myopes. I have even made a formula that attempts to show how blurry youd see from an objective point! The math is based on the blur circle on the retina caused by defocus in diopters.
Someone at 20/70 is likley to be -1.5 diopters myopic. Take spherical equivalent if astigmastim is in the mix.
-.25 diopters results in minimal blur and doesnt cost a single line. Sometimes half a line at most. Only malingering people make a deal out of this.
-.5 diopters results in a reduction of a single snellen line. If 20/20,
then your UCVA would be 20/25. Correction is not needed.
-1 diopters is the smallest amount of blur that people start to complain about and the lowest prescription that justifies very low dependance on glasses, such as for driving. Normal people go most of the time without correction. UCVA generally is 20/40 to 20/50
-2 diopters blurs enough for part time glasses wear. Can easily go without glasses around the house and for intermediate distance. UCVA is
20/100 to 20/150. Alot of websites say its 20/200 but I disagree. One problem is many snellen charts have nothing between 20/100 and 20/200 so someone could be just shy of 20/100, yet be put down as 20/200.
-3 diopters starts getting bad. My research shows it to be 20/200 to 20/300, but some websites say its 20/400 but I disagree on it being this bad.
-.75 diopters will NOT blur to 20/70 in a normal healthy eye. Many people see 20/30 with such a low minus and dont need correction.
-2.5 diopters will almost always blur more than 20/70 unless you have 20/10 BCVA or you cheat and squint.
Great thread! Im sure the optometrists here can share their experience on the average snellen score for a given myopic prescription of -.5, -1. -1.5, -2, etc.
sdavies6 - 11 Aug 2006 01:06 GMT So, if I wear a -12, and that is not corrected to full strength, probaly a 12.5 or 13 would be, what is my distance reading. If I'm not mistaken, I can be considered legally blind in that eye (thankfully, it is one eye, the other is damn near perfect), without a correction.
>> Does anyone knows how visual acuity measured with the Snellen Chart >> corresponds to a minus diopter? [quoted text clipped - 45 lines] > on the average snellen score for a given myopic prescription of -.5, > -1. -1.5, -2, etc. acemanvx@yahoo.com - 11 Aug 2006 01:47 GMT > So, if I wear a -12, and that is not corrected to full strength, probaly a > 12.5 or 13 would be, what is my distance reading. If I'm not mistaken, I > can be considered legally blind in that eye (thankfully, it is one eye, the > other is damn near perfect), without a correction. If you are near -13 in that eye, you would be seeing about or nearly 20/4000 without correction! A -12 correction would cost you 2 lines if you are -12.75 say instead of 20/30 BCVA at -12.75 youll be 20/50 at -12.
serebel - 11 Aug 2006 02:31 GMT > So, if I wear a -12, and that is not corrected to full strength, probaly a > 12.5 or 13 would be, what is my distance reading. If I'm not mistaken, I > can be considered legally blind in that eye (thankfully, it is one eye, the > other is damn near perfect), without a correction. Careful who you get your advice from. Ace is a retard with no training or experience in anything.
sdavies6 - 11 Aug 2006 03:00 GMT Thank you, I'll take that into consideration. Of course, if you read my post, you'll see that I did not ask anyone for advice.
>> So, if I wear a -12, and that is not corrected to full strength, probaly >> a [quoted text clipped - 5 lines] > Careful who you get your advice from. Ace is a retard with no training > or experience in anything. acemanvx@yahoo.com - 11 Aug 2006 04:11 GMT > Thank you, I'll take that into consideration. Of course, if you read my > post, you'll see that I did not ask anyone for advice. Dont mind Serebel, he is a loney old man who denies two of his lasik "quirks" and likes to call others "retard"
I am not a doctor and whatever I say is my opinion :)
"Snellen numbers are pretty worthless at that level. Ace is the only one who cares, and his "20/4000" answer is as good as any, because he doesn't realize how those measurements would vary from one person to another, one room to another, one examiner to another."
Make a 20/4000 letter(preferabily an E) measuring 68 inches and youll get a measure. There is an objective way of measuring defocus blur using the "blur formula" which ive developed. If you keep the variables constant, the only difference will be in the ability to interpret blur which can be made quite constant by training those with poor blur interpretition.
"I was just wondering; nothing anyone says regarding the definition of blindness or what my visual acuity is, makes a difference. I am still left with a bad eye that is worthless without a contact lens, and then pretty good, and a good eye, which is . . . good."
How did one eye get so bad? Were you born like that? How far can you count fingers in that -12.5 eye? Probably about a foot and a half.
Robert Kopp - 11 Aug 2006 06:53 GMT > "I was just wondering; nothing anyone says regarding the definition of > blindness or what my visual acuity is, makes a difference. I am still > left > with a bad eye that is worthless without a contact lens, and then > pretty > good, and a good eye, which is . . . good." If you're a jeweler, you've got it made.
 Signature Robert T. Kopp http://analytic.tripod.com
sdavies6 - 11 Aug 2006 22:40 GMT I was born with two good eyes. Starting late high school and progresively ever since, I'm now 56, one eye becoming myopic and the other stayed good. My eye doctor has no idea why and I've heard it is unusal, but not so unusual as to be a candidate for the textbooks. Without my contact lens I couldn't see the numbers of fingers a foot away, at least, not clearly.
>> Thank you, I'll take that into consideration. Of course, if you read my >> post, you'll see that I did not ask anyone for advice. [quoted text clipped - 27 lines] > How did one eye get so bad? Were you born like that? How far can you > count fingers in that -12.5 eye? Probably about a foot and a half. Mike Tyner - 11 Aug 2006 03:27 GMT > So, if I wear a -12, and that is not corrected to full strength, probaly a > 12.5 or 13 would be, what is my distance reading. If I'm not mistaken, I > can be considered legally blind in that eye (thankfully, it is one eye, > the other is damn near perfect), without a correction. Snellen numbers are pretty worthless at that level. Ace is the only one who cares, and his "20/4000" answer is as good as any, because he doesn't realize how those measurements would vary from one person to another, one room to another, one examiner to another.
The only definition for legal blindness is vision less than 20/200 in the _better_ eye, _with_ correction. There's no "legal" definition for uncorrected vision, at least for disability determination and the "blind" exemption on your tax form.
I know you didn't ask for a definition or a critique but hey, it's a public newsgroup.
-MT
>>> Does anyone knows how visual acuity measured with the Snellen Chart >>> corresponds to a minus diopter? [quoted text clipped - 45 lines] >> on the average snellen score for a given myopic prescription of -.5, >> -1. -1.5, -2, etc. sdavies6 - 11 Aug 2006 03:52 GMT I was just wondering; nothing anyone says regarding the definition of blindness or what my visual acuity is, makes a difference. I am still left with a bad eye that is worthless without a contact lens, and then pretty good, and a good eye, which is . . . good.
>> So, if I wear a -12, and that is not corrected to full strength, probaly >> a 12.5 or 13 would be, what is my distance reading. If I'm not mistaken, [quoted text clipped - 65 lines] >>> on the average snellen score for a given myopic prescription of -.5, >>> -1. -1.5, -2, etc. Dr Judy - 11 Aug 2006 17:25 GMT > So, if I wear a -12, and that is not corrected to full strength, probaly a > 12.5 or 13 would be, what is my distance reading. If I'm not mistaken, I > can be considered legally blind in that eye (thankfully, it is one eye, the > other is damn near perfect), without a correction Despite Ace's claims, uncorrected acuity is a very poor way to predict refractive error. His estimate of 20/70 uncorrected converting to -1.50 would be accurate +/- 1.00 , giving a range of -0.50 to -2.50.
At -12.00, any formula for conversion breaks down and unaided acuity, if needed, should be measured.
You are mistaken about the legally blind bit. Legal blindness is defined only with reference to best corrected acuity, not unaided acuity. If your eye, with best glasses possible, see better than 20/200, it is not legally blind.
"Legally blind without glasses" is a meaningless term.
Judy
> >> Does anyone knows how visual acuity measured with the Snellen Chart > >> corresponds to a minus diopter? [quoted text clipped - 45 lines] > > on the average snellen score for a given myopic prescription of -.5, > > -1. -1.5, -2, etc. sdavies6 - 11 Aug 2006 22:40 GMT Fortunately, I am not legally blind. With the lens I am corrected to around 20/40 or so. My right eye needs no correction.
>> So, if I wear a -12, and that is not corrected to full strength, probaly >> a [quoted text clipped - 68 lines] >> > on the average snellen score for a given myopic prescription of -.5, >> > -1. -1.5, -2, etc. Ace - 12 Aug 2006 06:25 GMT Dr Judy:
> Despite Ace's claims, uncorrected acuity is a very poor way to predict > refractive error. His estimate of 20/70 uncorrected converting to > -1.50 would be accurate +/- 1.00 , giving a range of -0.50 to -2.50. The problem is, if someone said he was 20/70 I would have no idea if he has a refractive error or a neurological pathalogy resulting in low vision. The other way around where if this person gives me his prescription, then I can convert. If someone says he is 20/70, I will ask for more information. If he says he is myopic then I can estimate him to be -1.5 If another person says he is -3 and wants to know his UCVA, its 20/200 to 20/300, but usually closer to 20/200.
> At -12.00, any formula for conversion breaks down and unaided acuity, > if needed, should be measured. This would be about 20/3000, not that anyone should go without correction for vision this bad, would be scary! Even at my -4.5 and 20/600 its an inconvinence at best without correction except for reading, eating, showering, sleeping or if im doing nothing.
> "Legally blind without glasses" is a meaningless term. We call it functionally blind and this is when you are off the charts or worse than 20/400 then you cant really function without correction. Low myopes under -3 can function reasonably well without correction and very low myopes of -1 usually only wear glasses for driving or watching movies.
"Fortunately, I am not legally blind. With the lens I am corrected to around 20/40 or so. My right eye needs no correction."
Sounds like mild amblyopia in the worse eye. What does the blur look like in comparsion to the right eye? Is it anything like myopic blur or some strange distortion like everything is smeared or appears dull and of poor contrast? Someone said amblyopia blur was much like peripheral vision in his other normal eye. Its not just blur, you cant really focus on anything.
"I was born with two good eyes. Starting late high school and progresively ever since, I'm now 56, one eye becoming myopic and the other stayed good. My eye doctor has no idea why and I've heard it is unusal, but not so unusual as to be a candidate for the textbooks. Without my contact lens I couldn't see the numbers of fingers a foot away, at least, not clearly."
Has any medical reason been ruled out? Sounds like unilateral pathalogical myopia, a degenerative disease/condition where myopia goes out of control and only slows or stops in your 30s or 40s, some very severe cases it never stops and myopia has been reported in the literature to exceed thirty(30) diopters! pathalogical myopia is usually bilateral and a serious condition that results in low vision and blindness if myopia gets too high, the likehood of retinal, macular and other complications become certain at some point. Your -12 is more on the mild-moderate side of pathalogical myopia, severe cases can hit the -20 point! Some pathalogical myopes are born myopic, I know one that was born -10 and is now -20 with poor corrected vision and sees pratically only light perception without correction! At -12 you can barely count your own fingers from a foot away. Would you be able to count them at all from a foot and a half away?
sdavies6 - 12 Aug 2006 15:36 GMT My doctor has ruled out pathological myopia. She doesn't seem too concerned about future problems of retinal detachment,etc. I have a great deal of confidence in her, and if she's not alarmed, neither am I. However, she always prefaces our conversations with the statement that she cannot rule out that it will contiue to get worse, nor does she have an idea why it happened. Nevertheless, it has taken around 35 years to get to a minus 12 ,and it appears to be fairly stable.
There is no doubt whatsoever that it is myopia. In your previous post you said that it sounded like amblyopia and you said it sounded like myopia; can't be both!
> Dr Judy: >> Despite Ace's claims, uncorrected acuity is a very poor way to predict [quoted text clipped - 58 lines] > barely count your own fingers from a foot away. Would you be able to > count them at all from a foot and a half away? Ace - 12 Aug 2006 23:51 GMT I was thinking amblyopia because you can only be corrected to 20/40 in that -12 eye. If it is not ambylopia, then it is some sort of retina or neurological problem, very common in extremely high myopes. Optometrists say myopia in the double digits often results in reduced BCVA, 20/30, 20/40, 20/50 or worse.
If you are -12 in contacts, doesnt this mean youd be -15 in glasses?
As for pathological myopia:
http://www.visionww.org/drswindsor-myopia.htm
http://www.webmd.com/hw/health_guide_atoz/hw122243.asp
High degree myopia (sometimes known as pathological myopia or degenerative myopia) is a chronic, degenerative condition which can create problems because of its association with degenerative changes at the back of the eye.
You can find lots of articles about pathological on google
What is pathological myopia? Myopia of more than -6D is a degenerative disease and is called pathological myopia or high myopia.
This is a degenerative disease. Why premature degeneration in such young subjects? unknown but with a definite hereditary pattern. Posterior half of the eyeball including the vitreous shows degenerative changes. Usually starts in early childhood. Myopia usually exceeds -6D.
Most people have mild myopia and there are no serious problems.
However, rarely, the eyeball continues to grow and myopia becomes progressively worse. This is called pathological myopia. People with this type of myopia are at an increased risk of developing certain other eye problems, which can sometimes lead to blindness. For example, a few people with severe myopia may get retinal detachment, which is when the retinal lining separates from the back wall of the eye. This requires urgent surgical treatment to prevent permanent loss of vision.
*your eyeball(for one eye) kept growing and your myopia got progressively worse and became extremely high at -12 contacts(about -15 in glasses) and you can barely count your own fingers from a foot(can you still count them from 18 inches?)
sdavies6 - 13 Aug 2006 00:40 GMT I don't think I can only be corrected to that vision. For some reason, my eye doctor has chosen to not give me a full prescritpion. She explained it to me once before, and I've forgotten her reasoning. I assume, if I wore a minus 13 lens, I would have 20/20.
I would have to wear a very thick lens, too thick for comfort and an obvious mismatch with the other lens, which would be plain glass. I do not think that's an option.
>I was thinking amblyopia because you can only be corrected to 20/40 in > that -12 eye. If it is not ambylopia, then it is some sort of retina or [quoted text clipped - 42 lines] > in glasses) and you can barely count your own fingers from a foot(can > you still count them from 18 inches?) Ace - 13 Aug 2006 03:56 GMT > I don't think I can only be corrected to that vision. For some reason, my > eye doctor has chosen to not give me a full prescritpion. She explained it [quoted text clipped - 4 lines] > mismatch with the other lens, which would be plain glass. I do not think > that's an option. Well if you are over 40, he may have given you monovision. Another reason is that -12 is the highest "available" contact, past that and youll need an expensive custom made contact(can be soft or RGP) Were you ever 20/20 in that eye before it became so bad? Did you get an over-refraction over that -12 contact to see how much undercorrection is occuring and your BCVA? Wouldnt you be more than -15 in glasses if you are more than -12 in contacts?
sdavies6 - 13 Aug 2006 04:27 GMT I was 20/20 in that eye, as a kid. I didn't notice any change in vision until I was around 17 or so. A few years ago I was at minus 11, and not corrected 100%. I guess, I could have gotten a minus 12 a few years ago. I didn't know minus 12 was the max for production line contacts.
>> I don't think I can only be corrected to that vision. For some reason, >> my [quoted text clipped - 16 lines] > is occuring and your BCVA? Wouldnt you be more than -15 in glasses if > you are more than -12 in contacts?
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