After cateract surgery two days ago my vision became much much clearer.
However I noticed a slightly flickering or juddering when I move my
eyes in a horizontal saccade (jump).

Can someone please explain the cause and give me a reference to some
material online about this?

Dear izzily-ga:

	Although the researchers here are good at finding published
information, we are no substitute for a doctor, in this case, an
Opthalmic surgeon.

	That said, here is what I have found:

From: 

http://health.indiamart.com/eye-care/post-operative-care.html


“  Alarming symptoms: In case of any pain, injury, decrease in vision
or flashes of light in the operated eye, contact your surgeon”


This site concurs:

http://www.piedmontbettervision.com/documents/procedures/cataract.html

“Post Operative
After cataract surgery, you must usually wear a patch for the next 24
hours. The patch is typically removed the next day which is usually
when the first return visit will be scheduled for. Several more follow
up visits will be made over the next four to six weeks. Recovery time
is generally minimal. Your eye may be mildly inflamed and feel a
little scratchy and irritated for a couple of days after the
procedure.

Although cataract surgery is generally successful, complications that
may occur are bleeding, swelling, inflammation, infection or retinal
detachment. Contact your doctor immediately if any of the following
symptoms should occur following surgery:

•	Loss of Vision
•	Marked increase in eye redness
•	Light flashes
•	Multiple new spots before your eye
•	Nausea, vomiting, or excessive coughing
•	Pain that can't be relieved by over-the-counter pain medication”


From:

http://www.laser-eyes.com/serv07.htm

“COMPLICATIONS:

As with any surgical procedure, the possibility of complications
always exists. In spite of advances which have increased the safety of
cataract surgery and in spite of the best efforts of expert surgeons,
complications can still arise. Possible complications range from minor
irritations of the eye to total, irreversible loss of vision. It is
important to know that the chances of having an excellent result after
surgery is over 95%. Fortunately, the more serious complications are
the rarest ones. The more common problems are usually treated with
drops.

HOWEVER, GLAUCOMA, RETINAL DETACHMENT, INFECTION, MACULAR EDEMA,
HEMORRHAGE INSIDE OR BEHIND THE EYE, MALPOSITION OR INABILITY TO PLACE
AN INTRAOCULAR LENS, LOSS OF THE NUCLEUS, VITREOUS, OR CAPSULE,
ABNORMAL PUPIL OR LID, DOUBLE VISION, ACCELERATION OF DIABETIC CHANGES
IN DIABETIC PATIENTS ONLY, AND OTHER KNOWN OR UNKNOWN PROBLEMS WHICH
CAN OCCUR AT SURGERY OR ANYTIME AFTER SURGERY AND CAN LEAD TO LOSS OF
VISION OR LOSS OF AN EYE. IF YOU HAVE ANY OF THE PROBLEMS BELOW,
PLEASE CALL US AS SOON AS POSSIBLE. DO NOT WAIT!

1) INCREASED REDNESS OR IRRITATION.
2) INCREASED PAIN.
3) INCREASED BLURRING OF VISION.
4) FLASHING LIGHTS, FLOATING OBJECTS, OR LOSS OF PART OR ALL OF YOUR
VISION.
5) ANY UNUSUAL CHANGE IN VISION OR NEW OR UNUSUAL SYMPTOMS - PLEASE
CALL US!”

From:

http://www.ranzeyemd.com/eyediseases.htm

“
RETINAL DETACHMENT
The retina is a layer of nerves lining the back of the eye which
senses light and transmits images through the optic nerve to the
brain. When the retina is pulled out of its normal position, it is
called a retinal detachment. This is a very serious condition, causing
blurring of vision and possibly leading to blindness if left
untreated.
As the eye ages, the vitreous gel that fills the eye may pull away
from the retina. If it pulls away hard enough, this may tear the
retina, allowing fluid to pass through the tear. Symptoms of a retinal
detachment may include flashing light or new floaters in the visual
field, or a gray "curtain" moving across the visual field. These
symptoms do not always indicate retinal detachment, however a complete
exam by an Eye M.D. will determine the cause of the problem.
Treatment of retinal tears is accomplished with laser surgery to seal
the retina to the back wall of the eye. This is an outpatient
procedure performed in the Eye M.D.'s office. There are several
surgical options for treatment of retinal detachment. An Eye M.D. will
discuss the various options and determine which is best for a
patient's circumstances.”

Here are some other links, that may help you:

http://www.djo.harvard.edu/meei/PI/riskcatsurg.html

http://www.nei.nih.gov/health/cataract/cataract_facts.htm

http://www.ascrs.org/eye/catafaq.html

http://www.kellogg.umich.edu/conditions/cornea/cataract.html


Google search strategy:

cataract post surgery symptoms


I would suggest, that you call the Doctor who did the operation. I
hope this information helps you.

Sincerely,


Colin

---

Request for Answer Clarification by izzily-ga on 14 Jun 2002 10:39 PDT

Thanks very much for all of those links and I appreciate your concern
over me talking to a doctor.

In my haste to post here for the first time I omitted to add that:

I was examined ny surgeon the next day and (a) everything looked to
be coming along nicely (b) he had never come across the symptoms
before.

He's a VERY experience surgeon but I have some unusual features to my
vision which perhaps makes my case rather arcane.

I had searched for a specific mention of this saccade effect but could
find nothing. 

What I would really find useful is something which tied the following
together:

saccade + (some indication of "wobble" "flickering" or some such) together
with perhaps post cateract surgery.  

My particular concern is that this condition is related in some way to
retinal damage / edema(odema) so that might be added to the search.

---

Clarification of Answer by colin-ga on 14 Jun 2002 11:46 PDT

Hi:

	Glad to follow up. Emedicine.com has an interesting article on
Retinal Detachment, and Rhegmatogenous which involves the saccade
effect.


http://www.emedicine.com/OPH/topic410.htm



The following paper is in PDF format, but if you want to view in HTML,
Google will translate the PDF file automatically for you. Use the
following Google search query:

saccade flicker retinal damage

It is rather technical, but talks a lot about the similar problems to
yours. It will be the third link down.

http://www.lea-test.sgic.fi/en/assessme/function.pdf

Changing my Google search strategy to:

post cataract surgery  wobble

I found an article that may help. This article might help ease your
(understandable) worry, this is an excerpt from:

http://faculty.washington.edu/vismatt/eyeknowwhy/complica.htm


“Refractive Wobble - This is very common, and is a 'mild' complication
as long as it is very small. Refraction may change in the + or -
direction slightly, but no definitive trend is detectable. This occurs
in 45% of RK eyes (PERK) and is much higher in PRK. You should be
aware that all eyes (whether they undergo refractive surgery or not)
do tend to change very slightly as you age so 'refractive wobble' is
not considered a 'significant' complication.”

Can your surgeon measure/observe the wobble?


This seems to not be a common complication of cataract surgery.  I did
extensive searching, as you did, and there is not much linking the two
together. I do hope this helps, however.


Regards,


Colin

---

Request for Answer Clarification by izzily-ga on 14 Jun 2002 15:38 PDT

Thanks very much.  I don't know if I'll get the answer from all of 
your links but I appreciate you finding them for me.  

The "wobble" in the link about implants is, I think, a "wobble in time"
- if you were to plot refractive index over time it says you might
see a woblle on the line as the RI goes up and down slightly. Mine is
more of a spatial wobble.

Anyway, I will read these links with interest. Thanks for all of the research.

---

Clarification of Answer by colin-ga on 15 Jun 2002 05:07 PDT

You are most welcome.


Colin