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After Cataract Operation The Eye Drops Causing A Sharp Stinging Pain For A Few Minutes After Application

Posted on Wed, 3 Jul 2024

Question: Hi,

I just had an operation to remove my cataract yesterday. I was prescribed Maxidex eye drops to be used 4 times daily for a month. However, the eye drops cause a sharp stinging pain for a few minutes after application and cause tearing of the eyes and bloodshot eyes. Is it safe to continue their use and is this a usual reaction to the eye drops?

Thank you,
Regards

Answered by Dr. N K Mishra (13 hours later)

Brief Answer:
Use different steroid drops

Detailed Answer:
My dear,
Thanks for sending your query to us.
This is a steroid drop and is used for at least 4weeks as advised to you.
There is ,at times a pH difference between the eye drop and tears,this causes a stinging sensation,not lasting for more than a minute.Tbough this is absolutely fine but patient compliance,and ease of administration is also important.
I would advise you to go for a different steroid of same composition,to be continued for a month.
Products of different pharmaceutical companies have different specifications and will be easy to put in.You will have to check modality in your area,as to how to procure these steroids.
I hope I have answered your query fully,any difficulty, please do get back to me for any clarification

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. N K Mishra (2 hours later)

Thanks Dr. Misra,

I will ask to see if I can change the steroid drops.

I also noticed that the left of my left eye now has less peripheral vision that the right eye and is dark at the left corner peripherally but when looking directly to the left the view can be signed. Is this normally to be expected after the new lens implant?

Thank you,
Regards.

Answered by Dr. N K Mishra (2 hours later)

Brief Answer:
This usually doesn't happen.

Detailed Answer:
My dear,
Thanks for getting back to us.
This usually is not reported by our parents.Since this is initial phase and your eyes are getting used to a new setup, usually everything settled down in about a week's time.If the issue still persists,mention this to your doctor on your next visit and then the surgeon may like to dilate the pupil and examine the retina periphery in detail,which is now clearly visible after cataract surgery.In case any peripheral degeneration are evident,they may be tackled at this stage.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. N K Mishra (2 days later)

Dear Dr. Misra,

Thank you for the information and advice. I will have my eyes checked if the issue persists.

Is it expected that the artificial lens will offer the same peripheral field of view as a natural lens given that it is less flexible and can't adjust its shape as well as a natural one? Can an artificial lens be removed if absolutely necessary and are they harder to remove than a natural lens?

I also checked my eye pressure which was at 23, whereas previously it was at 19 and 17. At what level does the eye pressure become a concern and what could be the treatment? I may have been experiencing some pain in the right eye, which seems to extend into the forehead and even neck areas.

Thankyou,
Regards.

Follow up: Dr. N K Mishra (23 minutes later)

Dear Dr. Misra,

I just have a related query. Is it possible that the artificial lens could have been implanted with a bias in a certain direction? I am able to see my nose with only my right eye open but with only the left eye (artificial lens) I can't really see my nose which means that the lens might be slightly favouring a central vision?

Thank you,
Regards.

Answered by Dr. N K Mishra (33 minutes later)

Brief Answer:
Keep an on intra ocular pressure

Detailed Answer:
My dear,
Thanks for getting back to us
We consider iop upto 21 to be ok,21-25 keep under observation and treat iop beyond 25.
There is usually a transient rise in iop following surgery,which soon settles down.So we make a note of iop on your next visit to the doctor.
As far as the peripheral vision is concerned,you see from the central part of your pupil,which is well covered by your natural as we'll as artificial lens
It's very rare for us to remove the artefecial lens,i personally have removed 2 in my 40 years of surgical practice.They are removed in cases of dislocation or infections .
We put in far more lenses than we take out so for us it's easier to put in
In case you have a multifocal lens put in then there is a issue of central
Or peripheral vision.In monofocal lenses these are not issues.
The surgery has now been more than a week,many of your issues will be settled on your next follow up visit
Any further query, please do get back to us.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. N K Mishra (2 days later)

Dear Dr. Misra,

Thank you for the detailed information.

On the issue of peripheral vision, I noted that I was given a toric lens and wonder if this could affect the peripheral vision.

I think that the eye drops could be causing gastrointestinal upset. Is this a known side effect particularly for antibiotic eye drops?

Thank you,
Regards.

Answered by Dr. N K Mishra (4 hours later)

Brief Answer:
Toric lens is supposed to give a better vision in your case.

Detailed Answer:
My dear,
Thanks for getting back to us.
Toric lenses are to take care of a cylindrical power,which you already have preoperatively, thereby giving you a better post-op vision.
This has technically no peripheral vision issue.
The antibiotic eye drops do not cause any gastro intestinal effect because by the time they reach your intestine they are thoroughly diluted,unless you have an allergy to the compound,in which case you should have a issue earlier.
At this post op stage we do not need antibiotic drops,only steroid drops are continued in our hospitals, though all surgeons have slightly different approach.
Please do get back to us in case of any further query in this regard.

Above answer was peer-reviewed by : Dr. Vaishalee Punj