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Michelle from Bellmawr, United States of America, asks:
It's been 2 years that started with a severe corneal ulcer. Downhill all the way. At first they suspected a super infection. This was never proven, but I had severe inflammation that could not be controlled for close to a year. I've had 3 implants and 2 emergency surgeries. Scarring, retinal detachment, cataract, glaucoma and corneal perforation. Last surgery was for the perforation - another implant, took out a large cataract, and put a lens in. Within one week, they are shocked. Said it looks like something they would see a year from now, not days after surgery. I'm in pain from all the effects of this. The large white spot on my eye that really hurts, is getting very hard, like plastic, and then settles down but seems to turn into discharge. I'm not sure if this is good and healing, or if I should rush right back. Any info is appreciated. And I should add these are wonderful caring doctors. They are dumbfounded. Thank you.
Dear Michelle, thank you for your query. It sounds like you have had a tough time with your eye, having had to undergo multiple operations, including cataract extraction, corneal transplant, and glaucoma filtering surgery. With difficult corneal inflammation, it is important to exclude fungal infection, herpetic infection, and autoimmune corneal melt. I am sure that the team of eye specialists looking after you (which should include a cornea specialist) will have already looked into this for you. If not, please ask them to perform the necessary blood and ocular tests. What you describe could be a sign of early perforation. My advice is to go back to see your eye specialist in the next day or so. Good luck!
David from Ennis, United States of America, asks:
After having cataract surgery, I was told I would have to wear glasses for reading only. Seven months later, the proper glasses, which were to be issued from the Doctor's In-Office glasses center, had not been issued. The reason given each of the three times I called for an appointment was the same: "The eye glass specialist would call me to make an appointment." Meanwhile, I have experienced watery eyes, a burning while reading and vision impairment while not wearing glasses. I rescheduled an appointment, by means of my insurance company. At this appointment my vision was rechecked and the prescription required now is in fact different than the first prescription. I was told this was because of some debris behind the implant and that I would have to have a second surgery. My question is: "How would debris get in behind the implant?"
Dear David, thank you for your query. If your cataract surgery went well, then it is likely that the debris referred to is posterior capsular opacification. This can easily be treated with a 5-minute laser procedure (called laser capsulotomy) in the doctor's office. As the glasses prescription can change yet again after laser, you may need to wait a few more weeks before making a new pair of prescription spectacles.
Barbara from Sacramento, United States of America, asks:
Double vision since the day after cataract surgery. Little improvement with prisms in eyeglasses. It is intermittent with or without glasses. If nerve damage, will there be hope of reversal of double vision?
Dear Barbara, thank you for your query. When you experience binocular double vision, this is usually due to misalignment of your ocular muscles. This misalignment can occur due to a problem with the ocular muscles themselves or a problem with the nerves that supply these muscles. Monocular double vision, on the other hand, is likely to be due to an ocular problem such as cataract or posterior capsular opacification.
The fact that your double vision is intermittent suggests that it is binocular in nature. It is difficult to comment on whether the double vision will reverse without actually examining your eyes. As treatment may involve either prisms alone or surgery or a combination of both, it is definitely worthwhile for you to consult with an ophthalmologist who has a special interest in ocular motility disorders.
Russell from Brea, United States of America, asks:
I went to the eye doctor last week and I have 20/400 in the right eye. Does that mean I am considered legally blind? My other eye is 20/25.
Dear Russell, thank you for your query. Your right eye certainly has poor vision. However, to qualify as being legally blind, both eyes must have poor vision. Because your left eye is still seeing very well, you are therefore not considered to be legally blind.
Joe from Orland Park, United States of America, asks:
On March 15th 2015 I had surgery for a detached retina
which was successful. However, I have been having problems with my cornea. On June 9th 2016, I had a cornea transplant and the procedure was successful. However, I have about 20% cloudy vision and I keep getting abrasions. Doctor says my eye is just not healing properly. Doctor says that this usually happens to patients with diabetes and I do not have diabetes. Why is the eye not healing? Also I might add that through this whole ordeal I have never had any pain.
Dear Joe, thank you for your query. I am sorry to hear about the problems you have had to face with both the retinal detachment and the cornea transplant.
Unfortunately, without examining your eyes, I am not able to tell you why your eye is not healing. What I will say though is that your eye has undergone two major surgical procedures, and so will take time to settle. From your description, it sounds as though your corneal epithelium is not healing properly, although corneal abrasions are normally accompanied by pain.
One suggestion that I have is to take Vitamin C as it can aid in the healing process for the corneal epithelium.
Allen from St George, United States of America, asks:
My wife, Barbara, has:
- map-dot-fingerprint corneal dystrophy of both eyes
- posterior vitreous detachment of both eyes
- combined forms of age-related cataract of both eyes
- pseudophakia of both eyes
- posterior capsular opacification (PCO) in right eye
She had cataract surgery on April 28th and May 10th, 2016. Today's date is October 18th, and her vision is more problematic than before surgery. Her corneal map-dot-fingerprint dystrophy disease is worse since. The corneal eruptions are sloughing off and causing the usual scratchiness and discomfort. One or both eyes cloud-up and she has intermittent pain in one or both eyes.
We are using Refresh Advanced, 5% Sodium Chloride Solution and Ophthalmic 5% SCS ointment. Her vision is inconsistent, both for far and near. It seams the map-dot-fingerprint dystrophy disease is worse after cataract surgery, though the Corneal Specialist said that the surgery would have no affect on it.
We do not know what to do!
Dear Allen, thank you for your question. I am truly sorry to hear of your wife's predicament. Recurrent corneal erosion syndrome from corneal map-dot-fingerprint dystrophy (also known as corneal epithelial basement membrane dystrophy) can be difficult to manage. Barbara is already on the correct lubricant and hyperosmotic eye medications.
It may be worthwhile taking oral Vitamin C as well as the oral antibiotics, minocycline or doxycycline, as they may have a stabilizing effect on the corneal epithelium. Phototherapeutic keratectomy (PTK) may be a good option, because this laser technique removes the areas where the epithelium and basement membrane are worst affected, which then allows healthy re-epithelialization of the cornea to occur.
Good luck, and I hope Barbara's eyes settle soon.
Supriya from Kolkata, India, asks:
My right eye is counting fingers at 1 metre and less than N36. May I get any certification?
Dear Supriya, thank you for your question. The answer to your question depends on whether both of your eyes are visually impaired or only your right eye. If only your right eye has poor vision, then you are not considered to be partially sighted. On the other hand, if your right eye is your better eye and only sees counting fingers, then you are almost certainly eligible to be certified as a blind person.
Joann from Nashville, United States of America, asks:
I have uveitis (6 years) and take Lisinopril. I had a bad reaction and want to know if you know of a blood pressure medication I can take. I will be on these long term as my family all have essential hypertension. I have problems urinating, pains in my stomach and blood pressure usually 120/80 with the above medication. Now I have weakness, tingling in hands, tiredness, heaviness in legs and pale stools, all side effects of Lisinopril with Ketorolac. I also use Pred Forte eye drops as well as steroid injections into eyes as needed. Blood pressure off the chart now. Any suggestions would be greatly appreciated, on what blood pressure medication I should be on.
Dear Joann, thank you for your question. Ketorolac is known to reduce the anti-hypertensive effect of lisinopril, which is an ACE-inhibitor. To control your essential hypertension, you may need another class of anti-hypertensive medication, of which there are several. These include diuretics, alpha-blockers, beta-blockers, calcium channel blockers, and angiotensin II receptor antagonists. Your family doctor should be able to advise on the appropriate blood pressure medications for you to be on based on your medical history.
Another possible side effect that you must watch out for when receiving steroid as part of your uveitis treatment, is elevated intraocular pressure resulting in glaucoma. It is therefore important that your eye pressures are measured on a regular basis.
Jo from Birmingham, United States of America, asks:
Shortly before moving to Alabama I lived in Georgia. The MD there said I should have a keratectomy prior to having cataract surgery. Now, here in Alabama the MD here is saying just the opposite. Cataract surgery first then the keratectomy. Please which should be first?
Dear Jo, thank you for your question. With the current advances in laser refractive surgery, such as wavefront technology for photorefractive keratectomy and laser-assisted in situ keratomileusis, my opinion is that you should undergo cataract surgery first. Good luck!
Disclaimer: Replies to your questions are only general in nature, and in no way are to be considered as replacement for a proper ophthalmology consultation and examination. If you require a more specific evaluation, please consult your ophthalmologist for a full eye examination.
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