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What causes pressure in forehead, eye and earache post a cataract surgery?

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Posted on Mon, 4 Apr 2016
Question: What is preventing my new Crystalens from flexing? After sleeping 4 hours it flexes properly so my distance and intermediary vision is perfect for a short while. Upon rising, within 45-60 minutes it flexes to close mode and my vision for intermediary and distance is terrible until the next morning. Refraction stays the same -1.75 although eye sees anywhere from 20/70, 20/50, 20/150 to 20/2100. Surgery was 7 weeks ago and the waking up and being able to see is only for the past 5 days. I had other eye done and it is perfect after three weeks. I feel pressure in forehead above that eye, in the eye, ear and cheek so wonder if I have a sinus infection. I had rare earache three days post surgery and some eye tearing a few weeks later. What further diagnostic steps are needed to solve this frustrating problem? My doctors have never seen this before after thousands of surgeries. No inflammation in eye and healing nicely.Doctor thought maybe lens is floating on ball of tissue.
doctor
Answered by Dr. N. K. Misra (17 minutes later)
Brief Answer:
IOP monitoring needed

Detailed Answer:
My dear, i thoroughly read and reviewed your query
Thanks for emailing your query to us.
The only issue remaining at the moment is post operative rise of iop and its variations which are to be monitored and target dress is around 15.These pressure variations can cause changes in vision.
post opanti inflammatory drops should continue.
A detailed retinal examination should also be done to rule out any retinopathy.
Any further query in this regard please do get back to me.
hope this info was helpful.

regards
Above answer was peer-reviewed by : Dr. Naveen Kumar
doctor
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Follow up: Dr. N. K. Misra (27 minutes later)
Any idea why I need to sleep four hours before I can see perfectly at all distances before the accommodation of the lens actually works in a flatten position but then gets stuck during the day in the flexed position?
doctor
Answered by Dr. N. K. Misra (7 minutes later)
Brief Answer:
Iop monitoring

Detailed Answer:
My dear,
Thanks for getting back to us.
The lens does not move around in the bag where it is implanted,there is almost no movement of the lens.In situations like this we always try to concentrate on what direct findings we are getting.
As the lens is flexible it streches the bag where it has been implanted and is more or less fixed
I am also expecting that there is no systemic issue like diabetes or uncontrolled bp.
Instead of flexing and movement of lens there are various factors which lead to unstable vision.Diabetes, bp and glaucoma being at the top of list. hope i answered your query.
feel free to get back to me for follow up queries.

regards

Above answer was peer-reviewed by : Dr. Naveen Kumar
doctor
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Follow up: Dr. N. K. Misra (26 hours later)
I have RK 25 years ago, dry eyes, no corneal edema cuz Right Eye only perfect when wake up. Pressure stable, no retina issues or inflammation. Dominate eye switched after surgery to Right dominate. Eye dull ache and forehead, sinuses constant.If Crystalens is slightly floating what will ever stop it? I'm trying Muro 128 in case edema which I doubt cause perfect D, I and CLU for hour then swifts constantly all day and Close Up is poor by nighttime after lots of reading.Supposed to be monovision with R eye for CLU.
doctor
Answered by Dr. N. K. Misra (41 minutes later)
Brief Answer:
Dry eye,iop moitoring

Detailed Answer:
My Dear,
Thanks for getting back to us.

As it appears, two factors to watch for. One is dry eye for which lubricant eye drops should be used and IOP rise for which you are using Combigan eye drops .

Continue with these and get pressure monitored periodically..Another couple of weeks and you should be fine.

Regards
Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Answered by
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Dr. N. K. Misra

Ophthalmologist

Practicing since :1977

Answered : 1280 Questions

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What causes pressure in forehead, eye and earache post a cataract surgery?

Brief Answer: IOP monitoring needed Detailed Answer: My dear, i thoroughly read and reviewed your query Thanks for emailing your query to us. The only issue remaining at the moment is post operative rise of iop and its variations which are to be monitored and target dress is around 15.These pressure variations can cause changes in vision. post opanti inflammatory drops should continue. A detailed retinal examination should also be done to rule out any retinopathy. Any further query in this regard please do get back to me. hope this info was helpful. regards