Post-Cataract Surgery: Managing Uveitis and Vision Fluctuations

Q: Post-Cataract Surgery: Managing Uveitis and Vision Fluctuations

Hello, Afu： After cataract surgery, the management of iritis should be based on clinical symptoms, and whether vision will be affected can only be determined through clinical follow-up. <br>If the attending physician believes they cannot manage the case, they should refer you to

After the second eye examination following cataract surgery, there was an occurrence of iritis, and now the first eye is also inflamed?

In March of this year, after undergoing cataract surgery on the left eye, I experienced good results except for some flashes of light.
Thirty days later, I had cataract surgery on the right eye, which went well initially.
However, a week later, my vision began to deteriorate.
After a follow-up visit, I was prescribed eye drops, but my condition did not improve, and my vision continued to decline.
In the morning, it felt like I was looking through a fog, but my vision slightly improved in the afternoon.
However, I noticed small black spots and some floaters in my vision.
By evening, my vision would improve somewhat, but the next day (currently), the cycle repeated.
After another follow-up, I was diagnosed with iritis and prescribed 0.1% eye drops and oral steroids.
It has been five days, and my vision continues to fluctuate from morning to night.

I would like to ask:
1.
How long does it typically take to recover with this treatment approach?
2.
After recovery, will my vision be affected?
3.
If the current treatment does not show improvement in a few days, should I consider transferring to a specialized ophthalmologist in Taipei for uveitis treatment?

Afu, 60~69 year old female. Ask Date: 2021/05/20

Dr. Gao Pilin reply Ophthalmology

Hello, Afu: After cataract surgery, the management of iritis should be based on clinical symptoms, and whether vision will be affected can only be determined through clinical follow-up.
If the attending physician believes they cannot manage the case, they should refer you to an appropriate specialist; otherwise, the attending physician should be able to provide treatment.
Online responses can only serve as a reference; it is essential to seek medical care at a healthcare facility if necessary.
I hope to have the opportunity to assist you.
Gao Pilin

Reply Date: 2021/05/20

More Info

Post-cataract surgery complications, such as uveitis and fluctuating vision, can be concerning for patients. Your experience of visual fluctuations, including the presence of floaters and changes in clarity throughout the day, is not uncommon after cataract surgery, especially when accompanied by uveitis (inflammation of the uveal tract). Here’s a detailed response to your questions based on your situation:
1. Duration of Treatment and Recovery: The recovery time for uveitis can vary significantly depending on the severity of the inflammation and the individual’s response to treatment. Typically, with appropriate treatment, including corticosteroids and anti-inflammatory eye drops, patients may start to notice improvement within a few days to a week. However, complete resolution can take several weeks to months. It's essential to follow your ophthalmologist's recommendations closely and attend all follow-up appointments to monitor your condition.

2. Impact on Vision Post-Recovery: After successful treatment of uveitis, many patients experience a return to their baseline vision. However, some may have residual effects depending on the extent of the inflammation and any damage that may have occurred during the episode. It’s important to have realistic expectations; while many recover fully, some may experience slight changes in vision or persistent floaters. Regular follow-ups will help assess any long-term effects on your vision.

3. Referral to a Specialist: If your current treatment does not yield improvement within a reasonable timeframe (usually a week or two), or if your symptoms worsen, it would be prudent to seek a referral to a specialist in uveitis or a retina specialist. They can provide a more in-depth evaluation and may offer advanced treatment options. In major cities like Taipei, there are specialists who focus on inflammatory eye diseases, and they can provide targeted therapies that may not be available in general ophthalmology practices.

In addition to these points, it’s crucial to maintain open communication with your healthcare provider. If you notice any new symptoms, such as increased pain, significant vision loss, or changes in the appearance of floaters, report these immediately. Managing uveitis effectively often requires a combination of medications and lifestyle adjustments, including avoiding triggers that may exacerbate inflammation.

Lastly, ensure you are adhering to prescribed medications, including any steroid treatments, as these are vital in controlling inflammation. If you have concerns about side effects or the effectiveness of your current regimen, don’t hesitate to discuss these with your doctor. They can adjust your treatment plan as necessary to optimize your recovery.

In summary, while the journey through post-cataract surgery complications can be challenging, with appropriate management and specialist care, many patients can achieve significant improvements in their vision and overall eye health. Stay proactive in your follow-up care, and best wishes for a smooth recovery!

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