Sensation of speck in the eye after lens replacement. Don’t panic: what to do if cataracts are defeated, but the eye cannot see after surgery

Emrullah Tasindi, Prof., Member of the Board of ESCRS Istanbul, Türkiye

Over the past 10 years, eye surgery has undergone significant changes; we have practically gotten rid of the old, limbal incisions. With the help of special equipment, today we can make very small incisions (2.2-1.8 mm), but we continue to improve in this direction, taking into account the fact that patient expectations and our requirements have increased significantly.

The most serious complications are endophthalmitis and cystoid macular edema. Unpleasant sensations in the eye after surgery are one of the biggest problems in ophthalmology today. To see well, our tear film must be stable. All three components of the tear film - aqueous, tear and lipid - must interact with each other. The tear film performs a number of functions: protection, cleansing, antimicrobial, nutritional, and one of the most important – hydration. If the tear film is disrupted, it means the patient cannot see well. The tear film is the first step on the path to full vision. All components of the ocular surface must work in harmony to ensure full function. Indicators of the condition of the ocular surface are: stability of the tear film, surface mucoproteins, vascular condition, in particular hyperemia, density of conjunctival goblet cells, epithelial permeability, sensitivity of the eye to pain and touch, frequency and quality of blinking. If any of the components are not functioning properly, this can be diagnosed using a fluorescein tear film break-up time test. Its violation indicates dry eye syndrome.

After cataract surgery, many patients experience foreign body sensation and eye irritation. Typically, these symptoms are a consequence of dry eye syndrome, which develops as a result of disruption of the integrity of the nerves of the cornea. Dry eye syndrome can be a complication after cataract surgery. Our goal is to achieve the greatest possible improvement in visual acuity after surgery. Reducing the sensation of a foreign body in the eye, burning sensation, and other unpleasant symptoms will minimize the blurred vision that occurs due to dry eye syndrome.

Also, topical ophthalmic medications can dry out the eye. When the ocular surface becomes disrupted, we interfere with the coordinated regulatory circuit and initiate changes in the ocular surface cells. In addition, surgery and concomitant treatments increase the level of inflammatory factors in the tear film in patients at risk. After surgery, a clinically significant proportion of patients experience dry eye syndrome for a month. In 1/3 of patients these symptoms last longer than one month.

The causes of dry eye syndrome can be a variety of factors, ranging from allergies, intoxication and ending with surgical intervention. There is a category of patients who are at increased risk. These are patients who already have symptoms of the disease; patients who use artificial tears; patients who have had blepharoplasty; patients with blepharitis. In these cases, after cataract surgery we can expect the appearance of dry eye syndrome or an exacerbation of an existing disease.

What should be the approach to a patient with dry eye syndrome? We can use a variety of medications for treatment: traditional artificial tears, enhanced medications, topical moisturizing gels and ointments, topical anti-inflammatory medications, mechanical tear blocks, and systemic treatments.

After surgery, patients usually take topical steroid medications. Adding topical cyclosporine A for a short period of time will not help in such cases: it takes 1.5 months for the properties of cyclosporine to begin to appear. Therefore, we are left with no choice other than topical artificial tears to prevent the signs and symptoms of tear film deficiency, resulting in improved patient satisfaction.

If the patient already has dry eye or risk factors for its development, topical cyclosporine may be used preoperatively to reduce the risk of postoperative complications. But this treatment must begin a month before the operation. After surgery, treatment with fluoroquinolone antibiotics, non-steroidal anti-inflammatory drugs and steroids is indicated. This is necessary to prevent other complications such as cystoid macular edema and endophthalmitis.

In the last 5 years, much attention has been paid to inflammation of the tear fluid. In order to stop this process, you need to use anti-inflammatory drugs. We use corticosteroids in the postoperative period, but if the patient has problems due to long-term use of them, lotoprignol and tobonate are suitable for the treatment of inflammatory dry eye syndrome - the only ether steroid that gives few complications and does not increase eye pressure.

You can also use non-steroidal anti-inflammatory drugs, such as Indocollir, which stops the activity of cyclooxygenase, reducing post-operative inflammation, pain and discomfort. In addition, during the intraoperative period, nonsteroidal anti-inflammatory drugs help prevent miosis, prevent increased intraocular pressure, and reduce the possibility of developing cystoid macular edema.

However, the use of non-steroidal anti-inflammatory drugs, while helping to ensure a favorable outcome of the operation, in many respects does not contribute to the treatment of dry eye syndrome. Preventing inflammation on the relatively healthy surface of the eye is one thing, stopping inflammation in dry eye syndrome is another.

Let's return to tear fluid dysfunction. We need to stop eye irritation, for this we need tear substitutes. An ideal tear substitute should have a stabilizing effect, improve hydration of the ocular surface and maintain moisture. Hyaluronic acid is optimal for this purpose. There are a number of hyaluronic acid-based tear substitutes on the market. We use Artelak brand drugs in Turkey mainly after cataract surgery. Another drug of choice as a tear substitute is Artelac Nighttime (carbomer and triglycerides) to stabilize the tear film. Carbomer very well increases the stability of the tear film, water reduces the disturbances that occur in its aqueous layer, carbomer binds to mucins. Therefore, it acts on all three components of the tear film. So we can use artificial tears, topical cyclosporine and steroids.

The development of dry eye symptoms after cataract surgery can be clinically significant and significantly impact the patient's quality of life. If dry eye syndrome is diagnosed in a patient before surgery, this may become a contraindication to it: it must first be treated. In addition, dry eye syndrome is the most common non-surgical complication after surgery. Surgery traumatizes the surface of the eye and damages the tear film. Thus, dry eye syndrome affects the outcome of surgery.

The second most common cause of dry eye syndrome is LASIK surgery. Since 1991, I have performed such operations on more than 20 thousand patients, and the biggest problem is dry eye syndrome. It affects visual acuity, disrupts the stability of the tear film; in such patients, goblet cell density is reduced, blink rate and corneal sensitivity are reduced. Presumably, dry eye syndrome is caused by deinnervation of the ocular surface during flap creation. The nerves enter the cornea at the 3 and 9 o'clock positions, and damage occurs at these locations during LASIK, which reduces the sensitivity of the cornea. Most often, the occurrence of dry eye syndrome is noted immediately after surgery. After 3 months the frequency decreases, after a few months it increases slightly again. Sometimes this can last for several years. According to the results of the study, dry eye syndrome after LASIK surgery is one of the most common postoperative complications.

Dry eye syndrome causes visual impairment. Patients should be screened and treated for dry eye syndrome before surgery. In this case, you need to use local steroids and an immunosuppressant (cyclosporine). In all patients with dry eye, we must determine the level of disease, evaluate symptoms and clinical signs, and treat according to the severity of the condition. If a patient has dry eye syndrome before surgery, it is necessary to treat it, otherwise it becomes a big problem for both surgeons and patients.

Operation Cataract removal takes no more than 15 minutes, but the postoperative period is an integral part of the treatment.

Full recovery usually takes 6 months, this period may vary depending on the patient’s condition, his age, ability to regenerate, degree of illness, lifestyle and compliance with the postoperative regimen.

The rehabilitation period also depends on the method used to perform the operation.

According to statistics, after laser surgery, recovery is faster and easier than after ultrasound.

Basic rules for rehabilitation after surgery

With the right approach, following all instructions and daily routine, the postoperative period will pass quickly and without complications.

Compliance with the regime

Adequate rest and moderate activity are necessary, this means 8 hours of sleep. In the first days, it is not recommended to go outside (if necessary, you can only go outside wearing a special bandage).

High-quality nutrition is very important; the menu should be varied and rich in fiber, vegetables and fruits. You can eat dairy products, lean meats, and definitely broths.

This will help avoid constipation; it is not advisable for the first 10 days.

If there is a predisposition, then at first it is necessary to carry out prevention, it is permissible to use a little herbal laxative.

Sometimes the attending physician prescribes a diet based on individual characteristics, which must be followed.

It is worth refusing to bend in any direction, if you need to pick up an object from the floor, doctors recommend that you first sit down without bending your torso, then bend over a little.

Do not lift heavy objects or carry heavy objects - this can lead to increased intraocular pressure and sometimes hemorrhage.

During the first 7 days, go outside only wearing a gauze bandage. Do all manipulations on time, namely dressings, instilling drops, regular visits to the doctor, and if there are any signs of complications, attend an unscheduled appointment.

After surgery to remove cataracts, the eye begins to see after 2 hours, but vision loses its sharpness, fogginess and blurriness of objects are possible. That's why Doctors prescribe wearing glasses for the rehabilitation period.

Lens diopters can vary greatly from each other, and experts insist on individual production; it is strictly forbidden to rent glasses or buy ready-made options. This may cause vision impairment.

Carrying out hygiene procedures

The operation, when the cataract is removed, in the postoperative period involves observing the rules of personal hygiene.

This measure will prevent both viral and bacterial infections, which are the cause of complications.

Daily washing should be done without using cosmetics, with warm, running water, with your eyes closed.

You should bathe in the shower; hot baths should be avoided. When washing your hair, tilt your head back as much as possible to prevent shampoo from getting into your eyes.

Using a special bandage

This is a necessary measure after cataract removal. After surgery, the doctor applies a special bandage. It performs a protective function and is removed only the next day.

Then the patient independently washes the eye daily using furatsilin solution. Cover your eye and blot it several times with a sterile cotton swab.

Then apply a protective gauze bandage. Fold a sterile napkin in half and carefully fix it on your head with a bandage; for better fixation, you can additionally use a plaster.

Using eye drops

During the rehabilitation period, the doctor prescribes medications:

Visiting your doctor

It is necessary to come for examination to a specialist the next day after the operation, then after 10 days for a second examination.

But at the first signs of inflammation, complications, severe pain, or sensation of a foreign body, it is worth visiting an ophthalmologist unscheduled.

Also, if you experience the following symptoms, you should immediately consult a doctor:

How to properly apply eye drops during rehabilitation

You should lie on your back, tilt your head back a little. Then pull back the lower eyelid with your index finger without using force and drop 1 drop.

Do not touch the dispenser to your eye, keep the bottle upright. If you need to repeat the procedure, you should wait 1-2 minutes and repeat the manipulation.

Remove excess liquid with a clean, sterile napkin and wipe the skin without touching the eye or pressing on nearby tissue.

What not to do in the postoperative period after cataract surgery

The operation was performed and the cataract was removed; the postoperative period requires some restrictions:

What to do if complications occur

It is important to know! If, however, water or foam from a cosmetic product penetrates into the operated eye, then it is necessary to immediately rinse with a specially prepared furatsilin solution.

If there is slight redness, it usually goes away after applying the drops.

Inflammatory processes - these include inflammation of the conjunctiva, blood vessels of the eye, and iris. You need to see a doctor. A specialist prescribes anti-inflammatory drops, and within a few weeks the eye returns to normal.

High intraocular pressure - the patient experiences pain in the eye sockets, which may develop into a headache. There is pain in the eyes, and a feeling of heaviness when closed.

The doctor prescribes drops; they stabilize the functioning of the circulatory system of the eyeball.

Hemorrhage is reddening of the white as a result of a ruptured vessel.– occurs extremely rarely, is accompanied by pain and possible visual impairment. You should consult a doctor immediately.

Retinal edema - occurs due to mechanical impact, accompanied by unpleasant sensations and a blurry image. Therapy with eye drops is necessary.

Retinal detachment – ​​patients with myopia are at risk, but if you follow all the rules for care after surgery and use drops, this complication can be avoided.

Displacement of the lens - occurs when lifting heavy objects and during active physical activity during rehabilitation. Requires immediate surgical intervention.

What further eye care after cataract removal?

After the rehabilitation period is completed, it is necessary to treat your vision with care and follow the following recommendations:

If you follow all the rules in the postoperative period after cataract surgery, you can avoid complications. This will allow you to recover faster, as well as improve your visual acuity, maintaining your health for a long time.

This video will tell you about cataract surgery and the postoperative period:

This video will tell you about the prohibitions in the postoperative period after cataract removal:

Thanks to new medical technologies, cataract surgery is considered a simple surgical procedure that carries minimal health risk patient.

But the highly qualified surgeon and the use of modern equipment do not exclude possibilities for the development of postoperative complications.

Why does the eye not see as well as it should after cataract removal?

As a rule, complications are observed in patients who have had cataracts, complicated by concomitant diseases(diabetes mellitus, immune system damage), or did not follow medical recommendations for eye care after the procedure.

The likelihood of side effects increases with old people- with age, eye tissue loses the ability to quickly regenerate.

In some cases, spontaneous complications are observed that are not associated with any of the above factors and develop due to the individual characteristics of the body or for unknown reasons.

What should the eye look like after surgery?

Any, even minimally invasive, surgical intervention does not leave its mark on the body, so the procedure for removing cataracts causes discomfort in patients. After its implementation, there may be pain of varying intensity, inflammation and swelling of the eyelids, slight redness of the eye.

You can get rid of puffiness limiting fluid intake and foods that cause swelling.

Before the patient's eyes there may be light veil- This usually occurs due to local inflammation or tight sutures. These symptoms are normal go away on their own within a few days and do not require medical intervention.

Advice. Despite the fact that vision is restored almost immediately after surgery, patients It is recommended to limit visual load: It is prohibited to drive a car, read small text, work at a computer for a long time, watch TV or use mobile gadgets.

Reasons why vision has not been restored

In order not to miss the development of complications and to seek medical help in a timely manner, patients in the postoperative period need Monitor your health closely.

If any alarming signs or severe discomfort appear, you should immediately go to the doctor.

Manifestations of complications include:

• severe swelling, which does not pass within 2-3 days after operation;
• hemorrhage- characteristic red spots or streaks appear on the cornea;
• severe tearing, appearance purulent secretion;
• intense pain in the eye, temple or eyebrow area;
• ghosting, flashing, or darkening In eyes.

Attention! Apply any drugs without consultation doctor categorically forbidden- self-medication for postoperative complications can aggravate the situation and lead to complete loss of vision.

What complications are possible after lens replacement?

All complications after cataract removal are divided into intraoperative(which occurred during surgery) and postoperative.

First are usually observed with insufficient qualifications of the surgeon and include damage to the cornea by ultrasound or laser, rupture of the ligaments of the lens or its capsule, etc. Depending on the degree of tissue damage, patients require medical or surgical treatment.

Postoperative complications are observed more often and can be associated with both medical errors and concomitant pathologies or spontaneous changes in eye tissue.

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Secondary cataracts are indicated by “floaters”

Secondary cataracts develop after surgery to eliminate the primary, but the mechanisms of disease occurrence are completely different.

Reasons secondary cataracts are cellular reactions in systemic pathologies, endocrine disorders and other ailments; On the back of the lens capsule, epithelial cells grow, forming a dense film.

With this complication, the patient gradually restored vision deteriorates, fog and midges appear before your eyes. Secondary cataracts are diagnosed after examining the structures of the eye using special equipment. Method of treatment - laser correction(destruction of overgrown cells).

Increased intraocular pressure

A common complication that develops due to incomplete leaching of the gel-like agent that is injected into the eye to protect its structures from surgical damage. Patients develop mild corneal swelling, when looking at a light source appear rainbow circles, there is a slight decreased vision. The diagnosis is made based on the patient's complaints and measurement of intraocular pressure using a special tonometer. Treatment medicinal(instillation of drops into the eyes for the treatment of glaucoma).

Photo 1. It is more convenient to measure intraocular pressure using a pneumotonometer. The photo shows the CT-80 model from the manufacturer Topcon.

Pink fog or Irvine-Gass syndrome

Macular edema(Irvine-Gass syndrome) occurs due to the accumulation of fluid in the macula (the central part of the retina). Symptoms of the disease include deterioration of central vision, distortion of objects, photophobia, as well as the appearance before the eyes of a characteristic pinkish veil.

Diagnosis of Irvine-Gass syndrome requires examination of the fundus using a microscope or optical tomograph. Patients with this diagnosis are prescribed anti-inflammatory drugs in tablets or injections, in the absence of treatment results - surgical intervention.

Reference. Irvine-Gass syndrome rarely leads to complete loss of vision, but restoration of functions eyes occurs slowly over several months.

Corneal edema

Complications can develop both as a result of interference in the structures of the eye, and due to increased intraocular pressure, infection or allergic reactions.

Patients have redness of the eye, sensitivity to light, blurred vision, sharp pain and tearing.

To make a diagnosis, the doctor must examine the eye using ophthalmological equipment and, if necessary, take tear fluid and tissue for analysis. Treatment of the disease is carried out using antibacterial or antiviral drugs, regenerating drops, physiotherapy.

Postoperative astigmatism: myopia or farsightedness

The causes of postoperative astigmatism are inadequate quality of the instruments used to perform the operation, too much tension on the sutures or increased intraocular pressure.

Astigmatism can be suspected by deterioration of vision in the postoperative period - depending on the type of disease in patients myopia or farsightedness appears of different intensity. The diagnosis is made based on an ophthalmological examination of the eye using special equipment. Therapy - wearing specially selected glasses or contact lenses.

Lens displacement

The consequence of incorrect actions by the surgeon during the operation, which causes ligament or capsule rupture. With this pathology, patients experience double vision, flashes or darkening before the eyes, mild swelling and pain.

The diagnosis is made based on examination of the fundus. Surgical treatment: Doctors lift the lens and then fix it in its normal position.

Retinal detachment: if black spots appear

Retinal detachment most often occurs in patients suffering from myopia, as well as after eye injury in the postoperative period. Symptoms of the disease - appearance before the eyes spots, flies or flashes, later - veils, which blocks the field of view. Diagnosis requires a comprehensive examination and measurement of intraocular pressure. The damage can be repaired only surgically.

Expulsive bleeding

Expulsive bleeding occurs due to rupture of a large artery located in the choroid of the eye.

Most often observed in patients with concomitant diseases, including hematopoietic pathologies, diabetes mellitus, glaucoma, atherosclerosis, cardiovascular disorders.

Expulsion bleeding is a complication that develops during surgery and requires immediate sealing of the resulting damage.

The eye is very painful and watery - suspicion of Endophthalmitis

Severe purulent-septic damage to the eye due to infection in the tissue during (or after) surgery. Symptoms include severe pain, sharp decrease in vision, corneal edema, tearing and department purulent contents. To identify the disease, the patient's tear fluid and a sample of the vitreous are taken for analysis, after which treatment is prescribed - antibiotics and antiviral drugs, nonsteroidal anti-inflammatory drugs, in severe cases - surgery.

More than 1.7 million Russian citizens suffer from cataracts. Every year in our country more than 180 thousand operations are performed on this occasion. Proper rehabilitation after cataract removal is an important part of vision restoration.

Postoperative period after cataract removal - stages of recovery after surgery

Rehabilitation after extraction depends on the type of intervention. Patients who have undergone ultrasound or laser phacoemulsification recover most quickly.

The rehabilitation period can be divided into three stages:

1. First stage. 1-7 days after surgery.
2. Second phase. 8-30 days after surgery.
3. Third stage. 31-180 days after surgery.

On first stage the patient notes a clear improvement in vision, but the full effect of cataract extraction appears later.

• First stage characterized by an acute reaction of the body to intervention. After the anesthesia wears off, pain of varying intensity may appear in the eye and periorbital area. To relieve pain, the ophthalmologist most often prescribes a non-steroidal anti-inflammatory drug in a standard dosage.

In addition to pain, the patient first stage In the postoperative period, swelling of the eyelids is often a concern. Restrictions on diet, fluid intake, and sleeping position help overcome this phenomenon without the use of medications.

• Second phase The postoperative period is characterized by unstable visual acuity and requires a gentle regimen. Reading, watching TV, or working on a computer may require temporary glasses.

Throughout second stage During the recovery period, the patient is prescribed eye drops according to an individual regimen. Usually the doctor selects anti-inflammatory and disinfectant solutions. The frequency of administration and dose of the drug are gradually reduced.

• Third stage The postoperative period takes a long period of time. During the entire five months, some restrictions remain in place. If the patient has undergone ultrasound or laser phacoemulsification, then by the beginning of the third period, vision is restored to its maximum. If necessary, you can choose permanent glasses (contact lenses).

If extracapsular or intracapsular cataract extraction was performed, then complete restoration of vision is likely only at the end of the third stage after removal of the sutures. Then it will be possible, if necessary, to choose permanent glasses.

It is advisable for patients to communicate restrictions after cataract surgery both verbally and in writing. Following the recommendations can help restore vision and avoid complications from surgery.


Restrictions apply:

1. Visual stress.
2. Sleep mode.
3. Hygiene.
4. Physical activity.
5. Lifting weights.
6. Thermal procedures.
7. Use of decorative cosmetics.
8. Nutrition and fluid intake.
9. Drinking alcohol and smoking.

• Intensive visual loads It is advisable to avoid the entire rehabilitation period.
• Watching TV and working on the computer are acceptable the very next day after surgery, but their duration must be limited to 15-60 minutes.
• Read It is possible in good lighting, but only if there is no discomfort from the eye.
• From driving a car It’s better to give up for one month.
• Restrictions in sleep mode relate mainly to posture. You should not sleep on your stomach or on the side of the operated eye. Such recommendations must be followed until one month after the intervention. The duration of sleep also affects vision recovery. In the first days after cataract extraction, most doctors recommend that patients sleep at least 8-9 hours a day.
• Restrictions in hygiene help prevent water, cosmetics, and foreign particles from entering the operated eye. In the first days, you need to wash your face carefully and without using soap or gel. It is best to gently wipe your face with damp cotton wool. In case of contact with water or cosmetics, the patient should rinse the eyes with an aqueous solution of furatsilin 0.02% (chloramphenicol 0.25%).
• To prevent contact with eyes foreign particles In the first days after surgery, the patient is recommended to wear a two-layer gauze bandage that tightly secures the eye when closed. You should not stay in dusty, smoky rooms for a long time after cataract extraction.
• Physical exercise can provoke an increase in intraocular pressure, displacement of the intraocular lens, and hemorrhages. Intense and sudden movements must be limited for at least a month after the intervention. Some sports are permanently contraindicated after cataract extraction. For example, you cannot engage in cycling, diving, or riding a horse.
• Weight lifting in the postoperative period is limited. The first month the maximum weight of the load is 3 kilograms. Later it will be possible to lift up to 5 kilograms.
• Thermal treatments may contribute to hemorrhages. For at least a month, the patient is recommended to avoid visiting the bathhouse, sauna, exposure to the open sun, and washing his hair with hot water.
• Decorative cosmetics It should not be applied to the face for 4-5 weeks after cataract extraction. In the future it can be used with caution.
• For a few weeks in nutrition limit spices, salt, animal fats. To combat swelling in the first days after surgical treatment, reduce fluid intake.
• Drinking alcohol and smoking It is recommended to exclude it for at least a month. An important point is the fight against passive smoking.

To monitor vision recovery in the postoperative period, the patient must undergo regular examinations by an ophthalmologist. In the first month after surgery, such visits are recommended weekly. Further consultations are carried out according to an individual schedule.

Possible consequences and complications of cataract surgery

The negative consequences of cataract extraction are associated with:

1. Individual characteristics of the body.
2. Violations of doctor's recommendations after surgery.
3. An error by the ophthalmologist during the intervention.

The most common complications that develop after cataract removal are:

1. Secondary cataract (10-50%).
2. Increased intraocular pressure (1-5%).
3. Retinal detachment (0.25-5.7%).
4. Macular edema (1-5%).
5. Displacement of the intraocular lens (1-1.5%).
6. Hemorrhage in the anterior chamber of the eye. (0.5-1.5%).

• Secondary cataract may develop during extracapsular cataract extraction, ultrasound or laser phacoemulsification. The incidence of complications is lower when using modern microsurgery methods. The material of the intraocular lens also influences the occurrence of secondary cataracts.

Secondary cataract can be successfully treated with surgical or laser capsulotomy.

• Increased intraocular pressure often observed in the first days after surgery. Usually, using special eye drops for 2-4 days is sufficient. In case of persistent increase in indicators, a puncture of the anterior chamber of the eye is performed.
• may require surgery. The extent of damage determines the limitation of visual fields. There is a high probability of retinal detachment in diabetes mellitus and myopia.
• Macular swelling(Irvine-Gass syndrome) is typical after extracapsular cataract extraction. Diabetes mellitus and violations of postoperative recommendations increase the risk of developing this complication.
• Intraocular lens displacement(decentralization or dislocation) is most often caused by errors by the ophthalmologist during surgery. Decentralization requires surgical intervention with significant displacement (0.7-1 mm). Dislocation is always an indication for surgical treatment.
• Hemorrhage into the anterior chamber of the eye is a consequence of a doctor’s error or failure to comply with restrictions by the patient in the postoperative period. In most cases, conservative therapy is sufficient. The anterior chamber is irrigated less frequently.

Prevention of cataracts - how to avoid the disease?

Most of the factors contributing to the appearance of cataracts cannot be modified. Thus, old age and hereditary predisposition are the most common causes of the development of the disease. It is impossible to influence these parameters.


Prevention of cataracts is possible in patients with diabetes. Achieving compensation for carbohydrate metabolism reduces the risk of developing lens opacities in such patients.

I am 65 years old. I am a doctor. In 2013, he removed a cataract in his right eye. In 2016 - on the left. Both operations were performed at the Lege artic clinic on Federative Avenue. Both lenses are from the same company, AcrySof IQ.

The postoperative process went well. Vision was perfectly restored. Two months after the operation, a feeling appeared in the right eye that something was interfering. I went to the clinic, where after an examination they discovered demodex. A course of treatment was prescribed. Another two months passed, but there was no effect. The feeling of a foreign body that interferes with life does not go away. I went back to the clinic. They replied that everything was fine. The operation went great, you have a symptom of “dry eye”. Drop Artelak into the right eye.

Another 2 months have passed. The sensation of a foreign body persists only in the right eye. There was constant tearing from this one eye. Currently, in addition to the feeling of “disturbance” in the eye, double vision has appeared when reading. When you close one or the other eye, the picture is clear and reading is a pleasure. When reading with two eyes, reading is impossible due to double vision. We were sent for a consultation to the Eye Surgery Center. There I had an optical coherence tomography scan of the retina. Diagnosis of OD AMD, “dry” form.

Considering all of the above, I want to ask. Can you continue to live with this feeling of “getting in the way”? By and large, this is not fatal. Maybe after 2-3 years I'll get used to it. I will read less. Listen more. I'm asking for advice.

Asked by: Vladimir

Answer from a cataract specialist

Hello.

Foreign body sensation is unlikely to be associated with demodex and is more often associated with dry eye syndrome. However, to rule out other causes, it is better to see an ophthalmologist. To reduce discomfort, you can try artificial tears (this is a group of drugs that improves the properties of the tear film and has no side effects). Examples of drugs: Hilocomod, Systane, Oftolik, Natural Tear, etc. Drip at least 4 times a day in both eyes for at least two months. However, it is recommended to find out the cause of your problem at an in-person appointment with an ophthalmologist.