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Suggest Treatment For Higher Order Abberation In Eyes

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Posted on Tue, 27 May 2014
Question: I am 71. In the last 9 months, I have had cataract surgery and vitrectomies on both eyes. Quite successful except that I have double images or ghost images. this is in both eyes even with one eye closed. My new prescription for spectacles gives me a sharp image..........but still have the double images. My opthomologist says I have a Higher Order Abberation and that I just need to live with it. He recommends no further surgery ( lasik or otherwise) as he feels risk not worth the reward. I have varilux physio lenses. I suspect there must be some opthomologist that specializes in HOAs and is knowledgeable about the characteristics of all the specialty lenses, such as Zeiss, etc that could help me find a better lense that would solve my problem. However, I am not having any luck finding an ophthomologist in the Greenville, SC area that is that specialized. I am willing to go up to 500 miles to see the right doctor. How do I find a OPthomologist that specializes in HOA and specialty lenses? any other suggestions?
doctor
Answered by Dr. Dadapeer K (48 minutes later)
Brief Answer:
Need to undergo evaluation to find the cause.

Detailed Answer:
Hello Sir,
Welcome to Health care Magic

It seems from the history that you are having problem of seeing double images or ghost images and you have undergone cataract surgery and vitrectomy on both the eyes in the last 9 months. Your ophthalmologist has told you that you are having higher order aberrations.

Aberrations are caused by irregularities in the refractive medium which cause distortion of light resulting in symptoms like ghost images, double images, loss of contrast, loss of sharpness of image, glare....

The lower order aberrations are usually the common refractive errors like astigmatism ,myopia....

The higher order aberrations are less common and are usually caused by Irregularities of the corneal surface which occurs in severe dry eyes, corneal scars...
Irregularities in the retinal surface as in macular edema, macular degeneration, epiretinal membrane....
Irregularities in the lens or in the intraocular lens as in subluxation of the lens or tilting of the lens...

Since you have undergone cataract and vitrectomy surgeries, first thing to be done is to rule out the retinal causes like macular edema which is common following vitrectomy surgery. If it is so it can be corrected by the treatment of macular edema.

The corneal problems causing aberrations can be corrected by use of spectacles or by use of contact lenses.

Hence first thing to be done is evaluation for causes of aberrations as mentioned above. The retinal causes for aberrations can be evaluated by ocular coherence tomography and the corneal causes can be evaluated by orbscan or wavefront analysis.

The modern lenses are effective in preventing corneal aberrations and if spectacles are not able to correct contact lenses will correct them.

The retinal causes need evaluation and treatment.

Hence I advice you to consult ophthalmologist first retina specialist and later cornea specialist if needed for examination and treatment accordingly.

If you know few more details like
Visual acuity without spectacles and with spectacles
Refractive power of glasses
Indication for vitrectomy

If you can give me the above details, I can answer you more accurately.

Hope I have answered your question and the information is helpful to you.

Thank you
With regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
Dr.
Dr. Dadapeer K

Ophthalmologist

Practicing since :2003

Answered : 5709 Questions

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Suggest Treatment For Higher Order Abberation In Eyes

Brief Answer: Need to undergo evaluation to find the cause. Detailed Answer: Hello Sir, Welcome to Health care Magic It seems from the history that you are having problem of seeing double images or ghost images and you have undergone cataract surgery and vitrectomy on both the eyes in the last 9 months. Your ophthalmologist has told you that you are having higher order aberrations. Aberrations are caused by irregularities in the refractive medium which cause distortion of light resulting in symptoms like ghost images, double images, loss of contrast, loss of sharpness of image, glare.... The lower order aberrations are usually the common refractive errors like astigmatism ,myopia.... The higher order aberrations are less common and are usually caused by Irregularities of the corneal surface which occurs in severe dry eyes, corneal scars... Irregularities in the retinal surface as in macular edema, macular degeneration, epiretinal membrane.... Irregularities in the lens or in the intraocular lens as in subluxation of the lens or tilting of the lens... Since you have undergone cataract and vitrectomy surgeries, first thing to be done is to rule out the retinal causes like macular edema which is common following vitrectomy surgery. If it is so it can be corrected by the treatment of macular edema. The corneal problems causing aberrations can be corrected by use of spectacles or by use of contact lenses. Hence first thing to be done is evaluation for causes of aberrations as mentioned above. The retinal causes for aberrations can be evaluated by ocular coherence tomography and the corneal causes can be evaluated by orbscan or wavefront analysis. The modern lenses are effective in preventing corneal aberrations and if spectacles are not able to correct contact lenses will correct them. The retinal causes need evaluation and treatment. Hence I advice you to consult ophthalmologist first retina specialist and later cornea specialist if needed for examination and treatment accordingly. If you know few more details like Visual acuity without spectacles and with spectacles Refractive power of glasses Indication for vitrectomy If you can give me the above details, I can answer you more accurately. Hope I have answered your question and the information is helpful to you. Thank you With regards