Dry eyes after cataract surgery

[Abbynormal]

Hello, world of fellow sufferers! I am a 68 year old female, retired RN. I have never had symptomatic dry eyes but have always been contact lens intolerant. I have been, and remain very active, enjoying SCUBA, jogging, gardening, and have my own motorcycle. I have worn glasses for nearsightedness since second grade, so was very excited to think of vision without glasses.
At the end of July ,2012, I had cataract surgery with Restor IOL implants. I have been miserable since day one! Not only are my eyes terribly dry and painful, but the inadequate tear film results in poor vision with distortions, blurring, and glare. now I can't even read well without "readers". I have been an avid reader all my life, but am now unable to read well or comfortably. My activities of daily living have been very negatively impacted by this surgery that was supposed to improve my quality of life!
I am aware now that some of the visual distortion is probably a result of the Restor lenses, and if I had it to do over, would have made a wiser choice of lens implants.
I began Restasis on August 8. I use Ocusoft Retaine drops for temporary relief and also have tried systane and soothe preservative free drops. None seem to work for very long. I am driven to use drops for comfort every 30 minutes to 2 hous, depending on how dry the air is and if I am able to close my eyes for rest occasionally. Warm or cold compresses give brief symptomatic relief.
I also take 1 gram of omega capsules, Premarin cream, and eye related vitamins
Fortunately, I am now able to sleep through the night, so perhaps the overall condition is improving. However, at this point,I truly wish I had kept the cataracts!

[Blinks]

Hi Abbynormal, So, so sorry to hear about your cataract experience and all that you are going through. I have had some similar issues since my (failed) cataract surgery last year and the dry eye is improving even though my vision is poor. My doctor recommended omega-3 so I take 4 Theratears Nutrition gel caps plus all kinds of antioxidants -- from food sources and some supplements. Also used TheraTears lubricant eye drops and Theratears Liquid gel (at night). There was tremendous relief once I eliminated all drops with preservatives. The TT drops helped me the most during the worst of it. Also found using a humidifier, staying well hydrated and wearing some type of close fitting glasses indoors helpful. There are moisture chamber goggles in the shop on this site; I've tried inexpensive safety glasses as they fit over readers and afford protection from dryness. Not very attractive, but at home, this is a no brainer. I'm using Oasis Tears Plus now.

I asked my doctor about wearing night time moisture goggles like Onyx or TranquilEyes but he wouldn't recommend them I suspect because he didn't know about them. During the worst of it, at night I wrapped the plastic eye shield (from surgery) with plastic wrap and taped it over my eye after applying ointment or gel drops to make a little moisture chamber while sleeping. It seemed to help.

Like you, I miss reading which I very much enjoyed. Have you tried audio books from the library? I know, it's not the same, but can help. Wearing wrap around sunglasses outdoors also protects from dryness. My dry eye just exploded after the surgery. Pre- and post-op, I was prescribed Nevanac drops, which contain BAK. There is an alternate preservative free NSAID eye drop many cataract surgeons prescribe. Struggling through has been a challenge due to the distortion, poor vision and dry eye. Just as you, I expected improvement.

If the distortion is bad, maybe a second opinion with a really good cataract surgeon is worthwhile. Have you looked into a lens exchange (remove the IOL and implant a different one)? The IOL is "in the capsule", and after 6 months in the capsule, a lens exchange is much more difficult. My cataract surgeon wanted to do the exchange but after a second opinion, it was not recommended due to other pre-existing issues. Good to check out all the options and weigh them very carefully.

Sending you all positive wishes.

[Abbynormal]

Blink, thank you so very much for your quick response to my post! It's so nice to know that I am not suffering alone! Although compared to many on this site, I don't have troubles at all! It's wonderful to hear that your dry eye is improving as it gives me hope and assurance that I will not remain in this mess forever!

I do stay well hydrated, and will use the humidifier when I close the house this winter. I have "wrap around" sunglasses that I jog in and I have been wearing them anytime um outside. In the house, in familiar surroundings, I often walk from one room to another with my eyes closed.

I have an appointment with my local optometrist this month, which will be 3 months post op, and plan to ask for a referral to another , different, ophthalmologist at that time for a second opinion regarding dry eye treatment and possible lens exchange. They really don't like to do the exchange, and I am very nervous about it too. I assume that with mor eye surgery I would be back to square one with the dry eye miseries. Initially, I couldn't even sleep at night, am now able to sleep well. Hate to start over.
I would love assurance that the distortion and glare from the Restor lens will eventually resolve, as now I feel,like I am a prisoner in my home, unable and fearful to resume my normal activities.

Thank you again for the support.

[georgiav]

Please know that you are not alone. Although I had LASIK surgery prior to Cataract surgery, the Cataract surgery is what did me in. In addition to all the eye pain, I also have horrible vision from another so-called "premium" IOL called the Crystalens (what a misnomer--the old fashioned monofocal IOLs are much better). They advertised it saying you would be able to see "near, far, and everywhere inbetween" ... instead I see horrible at ALL distances!

I also did not realize that having a YAG capsulotomy performed would make explantation near impossible, or I would never have had that done--so please make sure to take this into consideration yourself. I was 37 years old (now 42) and that's a long lifetime with pain and horrible vision. I sympathize with all the sentiments you have expressed as another "premium" IOL implantee.

[Blinks]

I wish we could predict these things better. I know the feeling of being "on home detention" and the fear factor. Hopefully you'll gradually begin to notice improvement as I did. Has your surgeon provided any outlook? Like you, I went through a really dreadful time with visual distortion and it was so subtle that it took me awhile to realize why I was feeling nausea and unwell.I kept thinking it might be the flu coming on. The nausea would kind of wash over me like a wave and I would have to lie down and not move. Very disorienting and unpleasant.

Finally one day I was in a library with a black and white checkerboard tile floor and it looked like it had upward erupting bubbles - like an Escher drawing only I knew the floor was flat. Then I realized my brain was having trouble with visual distortion. I started to notice vertical lines (windows, doors) would appear off plumb. It frightened me, but over time it gradually diminished completely. The brain must adjust somehow. There were days when there would be deep pain behind the eye, like a muscle cramp but the doctor could offer no explanation. That has completely diminished. Sometimes my eyes would feel a cramp like they were crossing, an uncomfortable sensation, and that too has completely stopped.

May want to ask your optometrist about anti-glare glasses or tints that may possibly help to tone down glare. I have some inexpensive amber tints that go over my eyeglasses and they do help. Also since surgery is stressful, I try very hard to eat lots of antioxidant foods and green leafy things, avoiding sodium and sugar to help reduce inflammation and improve dry eye.

Let us know how it goes. If you'd like to send a private message, you can click on my name and you'll see that option. Sending you all good wishes!

[abbygirl]

I can relate to all of you!! I have been posting and reading on this site for quite awhile now and it has really helped me thru the really rough times. I have had cataract surgery and Toric IOL's implanted. I have had a terrible time with all of the issues you are having. The surgery in my left eye went terribly wrong and it has taken over 2 years to get a grip on my symptoms. It does get better but it takes time. I don't want to get into the specifics on this site (I have posted lots) but would be happy to talk/PM any of you that would like some support. It is scarey!! Good luck to you!