Post-Cataract Surgery: Addressing Glare, Halos, and Shadow Issues

Q: Post-Cataract Surgery: Addressing Glare, Halos, and Shadow Issues

Hello Mr. <br>Chiu： Your issue requires a clinical examination to determine if there is a displacement of the intraocular lens or other causes. <br>The digital shadow may be caused by astigmatism; if it is astigmatism, you might consider trying corrective glasses.

Post-cataract surgery glare (halos) and shadowing of text issues?

Currently, I have significant cataracts in my right eye (dominant eye) that are affecting my work and daily life.
I underwent cataract surgery on March 4th, using a multifocal intraocular lens (non-toric lens).
The refractive error of the operated eye increased from -7.55 diopters to -12.00 diopters.
Post-surgery, the refractive error of the operated eye is +0.50 hyperopia with 0.75 astigmatism.
Approximately seven weeks after the surgery (on March 15th), I noticed that in dim lighting conditions, if there is a significant light source at the temple area, an arc-shaped light appears near the lower left of the operated eye, close to the tear gland near the nose.
If I shift my gaze towards the light source, the arc-shaped light disappears.
I researched online and it seems this could be due to the displacement of the intraocular lens? Or could there be another reason for this?
Additionally, I have noticed that when reading text, there is a shadow-like effect, especially when looking at numbers, which affects my ability to recognize them.
What could be the cause of this? Is there a possibility for improvement? I would appreciate your assistance in clarifying these concerns.
Thank you.

Qiu Xiansheng, 40~49 year old female. Ask Date: 2022/04/15

Dr. Gao Pilin reply Ophthalmology

Hello Mr.
Chiu: Your issue requires a clinical examination to determine if there is a displacement of the intraocular lens or other causes.
The digital shadow may be caused by astigmatism; if it is astigmatism, you might consider trying corrective glasses.

Reply Date: 2022/04/15

More Info

After cataract surgery, it is not uncommon for patients to experience visual disturbances such as glare, halos, and shadow effects. These symptoms can be particularly pronounced in certain lighting conditions, such as dim environments or when facing bright light sources. In your case, the appearance of an arc of light in the lower left quadrant of your vision, especially when looking at a bright light source, could indeed be related to the positioning of the intraocular lens (IOL) or other factors associated with the surgery.

Potential Causes of Visual Disturbances Post-Surgery
1. Intraocular Lens Positioning: If the IOL is not perfectly centered or is slightly tilted, it can lead to visual aberrations, including halos and glare. This is particularly true for multifocal or extended depth of focus lenses, which are designed to provide a range of vision but can sometimes produce unwanted visual artifacts if not positioned correctly.

2. Corneal Changes: Post-operative changes in the cornea, such as swelling or irregularities, can also contribute to glare and halos. These changes may be temporary but can affect visual clarity and comfort.

3. Pupil Size: The size of your pupils can influence how much light enters the eye and how it interacts with the IOL. In low-light conditions, larger pupils may allow more light to enter, which can exacerbate glare and halos.

4. Residual Refractive Error: The change in your refractive status post-surgery (from -7.55 to +0.50 with astigmatism) indicates that there may be residual refractive error that needs to be addressed. This could contribute to shadow effects when reading or viewing text, as the eye may struggle to focus properly.

5. Visual Processing: After surgery, your brain may take time to adjust to the new visual input, especially if there has been a significant change in your vision. This adjustment period can sometimes result in temporary visual disturbances.

Recommendations for Management
1. Follow-Up with Your Surgeon: It is crucial to maintain regular follow-up appointments with your ophthalmologist. They can assess the positioning of the IOL and determine if any adjustments or additional treatments are necessary.

2. Visual Rehabilitation: If glare and halos persist, your doctor may recommend visual rehabilitation strategies or specific glasses that can help mitigate these effects.

3. Consider Additional Procedures: In some cases, if the IOL is significantly misaligned or if there are other complications, additional surgical intervention may be necessary to reposition the lens or address other underlying issues.

4. Monitor Symptoms: Keep a detailed log of when and how often you experience these symptoms, as this information can be valuable for your doctor in determining the best course of action.

5. Patience and Adjustment: It is important to remember that the visual system may take time to adjust after surgery. While some symptoms may improve over time, others may require intervention.

Conclusion
In summary, the symptoms you are experiencing after cataract surgery, including glare, halos, and shadow effects, can arise from various factors related to the surgery and the intraocular lens. Regular follow-up with your ophthalmologist is essential to monitor these symptoms and determine the best course of action. With appropriate management, many patients find that their visual disturbances improve significantly over time. If you have ongoing concerns, do not hesitate to reach out to your healthcare provider for further evaluation and support.

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