Why is my vision still blurry after surgery?

Answers by Mitchell Gossman, MD, an ophthalmologist at Eye Associates of Central Minnesota, located in St. Cloud

My friend had such good vision after cataract surgery. Why is my vision still blurry after my surgery?

Cataract surgery can be blurry after cataract surgery due 1) healing that may still be occurring, 2) a need for glasses, 3) pre-existing conditions other than cataract, and 4) complications after surgery.

Healing that may still be ongoing:

It’s common for the vision to be blurry right after surgery due to swelling in the cornea and the pupil still being dilated. Complications during surgery can also cause this but would be discussed with your ophthalmologist. The worse the cataract, the more likely it is for vision to take longer to recover.

A need for glasses:

After cataract surgery, the glasses prescription is almost always different from before surgery. It is possible to choose some lens implants that increase the chances of seeing well without glasses, most of which cost extra out of pocket and are not covered by insurance. It’s wise to ask about these lenses before surgery if the choices aren’t offered to you. Sometimes it’s beneficial to remove the glasses lens for the eye that just had surgery, this would be discussed with your ophthalmologist.

Pre-existing conditions:

If you suffer from other eye disease besides cataract, it is possible that the eye chart visual acuity or overall satisfaction will not be as good as with a completely healthy eye. Most of the time these conditions are known to your ophthalmologist, and you were advised to not expect perfection or “20/20 vision” after surgery, but it’s a good idea to ask anyway what results to expect. It’s also possible for the cataract to make it more difficult to examine the back of the eye, so unknown eye disease can be discovered after surgery.

Complications and issues after surgery:

There are some complications and issues that can crop up after cataract surgery that can affect your vision:

• Persistently cloudy cornea. This may be due to the cataract being very severe or a pre-existing condition of the cornea such as Fuchs dystrophy. In severe cases it may be necessary to undergo cornea transplantation.

• Cystoid macular edema. This is swelling of the central retina and is the most common complication of cataract surgery. There are some eye conditions that make this complication more likely, and this is typically discussed before surgery, but sometimes it happens randomly without known cause. This condition is usually, but not always, treatable.

• Cloudy posterior capsule. The lens implant sits upon a clear membrane called the “posterior capsule”, and it’s very common for this to become cloudy. Usually this occurs many months or years after surgery, but it can happen sooner than that and it’s a simple condition to diagnose and correct.

• Retinal detachment. This is easily diagnosed so long as there’s a good view of the back of the eye, and it is an emergency to correct.

This is not a comprehensive summary of all things that can cause blurry vision after cataract surgery, but usually it’s a simple cause that can be remedied, so if you’re not feeling like you understand what’s happening, don’t be shy about asking, but in most cases, your ophthalmologist will anticipate your questions and explain everything in understandable terms.

Find out more

Mitchell Gossman, MD., is an ophthalmologist at Eye Associates of Central Minnesota. The office is located at 628 Roosevelt Road, Suite 101, in St. Cloud. To make an appointment or to learn more, call 320-774-3789 or email info@eaofcm.com.