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Cataract Surgery - Undilated pupils

 
 
Rich
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      05-11-2007, 01:03 PM
I had Cataract Surgery two days ago. Everything went well and I can see
very well out of the operated eye.

One problem I have noted is that the pupil remains extremely closed, and
I have very little vision in low light. (Is there a better term than
"undilated"?)

At a follow up visit to the Doctor, I asked him about it and his comment
was "they give you some medicine to close the pupil up after surgery; it
probably hasn't worn off yet".

OK, it's now 48 hours after surgery and that pupil is still very tiny.
I will be calling my doctor's office later, but I would like some
independent advice:

"How long should I expect this to last? Is this at all a common
occurrence?" (I haven't seen it described in any of my readings on
cataract surgery).

I'm also anxious to determine what my final visual acuity will be, and
with my pupil acting like a pin-hole, I suspect what I'm seeing now may
be better than what I'll finally be seeing.

Rich
 
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William Stacy
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      05-11-2007, 04:02 PM


Rich wrote:

> I had Cataract Surgery two days ago. Everything went well and I can
> see very well out of the operated eye.
>
> One problem I have noted is that the pupil remains extremely closed,
> and I have very little vision in low light. (Is there a better term
> than "undilated"?)


Constricted.

>
> At a follow up visit to the Doctor, I asked him about it and his
> comment was "they give you some medicine to close the pupil up after
> surgery; it probably hasn't worn off yet".


Ask him what that medicine was.

>
> OK, it's now 48 hours after surgery and that pupil is still very tiny.
> I will be calling my doctor's office later, but I would like some
> independent advice:
>
> "How long should I expect this to last? Is this at all a common
> occurrence?" (I haven't seen it described in any of my readings on
> cataract surgery).
>

I'm assuming your other pupil is significantly larger by comparison?

> I'm also anxious to determine what my final visual acuity will be, and
> with my pupil acting like a pin-hole, I suspect what I'm seeing now
> may be better than what I'll finally be seeing.
>

You might be right on that. I'm hoping your pupil dilator muscle or its
nerve haven't been damaged, which could cause this. What post-op drops
are you using?
 
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Rich
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      05-11-2007, 05:08 PM
William Stacy wrote:

>> At a follow up visit to the Doctor, I asked him about it and his
>> comment was "they give you some medicine to close the pupil up after
>> surgery; it probably hasn't worn off yet".

>
> Ask him what that medicine was.


OK, I will do that

>


>> "How long should I expect this to last? Is this at all a common
>> occurrence?" (I haven't seen it described in any of my readings on
>> cataract surgery).
>>

> I'm assuming your other pupil is significantly larger by comparison?


I would say it is larger, depending on light conditions. But the
operation eye remains small, even in dim light (twilight, for example)

>
>> I'm also anxious to determine what my final visual acuity will be, and
>> with my pupil acting like a pin-hole, I suspect what I'm seeing now
>> may be better than what I'll finally be seeing.
>>

> You might be right on that. I'm hoping your pupil dilator muscle or its
> nerve haven't been damaged, which could cause this. What post-op drops
> are you using?


Zymar (antibiotic) four times a day
Acular LS (anti inflammatory) twice a day)
Pred Forte (don't remember its purpose) four times a day

Rich
 
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William Stacy
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      05-11-2007, 06:15 PM


Rich wrote:

>
> Zymar (antibiotic) four times a day
> Acular LS (anti inflammatory) twice a day)
> Pred Forte (don't remember its purpose) four times a day
>

Those are good, the pred forte is the main anti-inflammatory one. None
of these should constrict pupils. Make sure your hands are clean and you
shake the pred each time you use it, or it won't work well and the
resulting iris inflammation could cause a constriction. The reason I'm
mentioning handwashing is once in a while a person will get some other
chemical or drug on their fingers and into the eye inadvertently...
 
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flam tap
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      05-11-2007, 06:18 PM

"Rich" <(E-Mail Removed)> wrote in message
news:(E-Mail Removed)...
> William Stacy wrote:
>
>>> At a follow up visit to the Doctor, I asked him about it and his comment
>>> was "they give you some medicine to close the pupil up after surgery; it
>>> probably hasn't worn off yet".

>>
>> Ask him what that medicine was.

>
> OK, I will do that
>
>>

>
>>> "How long should I expect this to last? Is this at all a common
>>> occurrence?" (I haven't seen it described in any of my readings on
>>> cataract surgery).
>>>

>> I'm assuming your other pupil is significantly larger by comparison?

>
> I would say it is larger, depending on light conditions. But the
> operation eye remains small, even in dim light (twilight, for example)
>
>>
>>> I'm also anxious to determine what my final visual acuity will be, and
>>> with my pupil acting like a pin-hole, I suspect what I'm seeing now may
>>> be better than what I'll finally be seeing.
>>>

>> You might be right on that. I'm hoping your pupil dilator muscle or its
>> nerve haven't been damaged, which could cause this. What post-op drops
>> are you using?

>
> Zymar (antibiotic) four times a day
> Acular LS (anti inflammatory) twice a day)
> Pred Forte (don't remember its purpose) four times a day
>
> Rich


After my wife had her cataracts removed she was required to take Cyclogyl
once a day for a week just to keep the operated-on eye dilated. Supposedly,
that helped the IOL to settle in. I don't understand why your treatment
would be so opposite.

Patrick

 
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Rich
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      05-12-2007, 12:35 PM
William Stacy wrote:
>
>
> Rich wrote:
>
>>
>> Zymar (antibiotic) four times a day
>> Acular LS (anti inflammatory) twice a day)
>> Pred Forte (don't remember its purpose) four times a day
>>

> Those are good, the pred forte is the main anti-inflammatory one. None
> of these should constrict pupils. Make sure your hands are clean and you
> shake the pred each time you use it, or it won't work well and the
> resulting iris inflammation could cause a constriction. The reason I'm
> mentioning handwashing is once in a while a person will get some other
> chemical or drug on their fingers and into the eye inadvertently...


Thanks for the advice on shaking the Pred. I think I've been doing
that, anyway.

Spoke with my Doctor Friday night. He is puzzled about the constricted
pupil, but advises me not to worry (although, I'm not sure what basis he
has to tell me "not to worry"!) He will try something to dilate the eye
on my follow up visit next week. I asked him about potential nerve
damage, and he was quite sure that there wasn't; said that the iris
would fail wide open, not closed.

At this point I am functional with the eye the way it is. Long term, I
would be VERY upset to lose my low-light vision! I have to give careful
thought before surgery on the other eye, if we don't know what caused
the constriction in this eye.

I think I'll do some research on the mechanism of the iris.

Thanks for much useful information.

Rich
 
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