Negative dysphotopsia improves with occlusion of contralateral eye

ORLANDO — Samuel Masket, MD, has spent a lot of time thinking about negative dysphotopsia and how to improve it.

In a presentation at Cataract Surgery: Telling It Like It Is, Masket related findings of a 25-eye pilot study in which patients with ND scotoma in one eye were treated with occlusion of the opposite eye.

Eighty percent of patients reported subjective improvement in their ND symptoms.

“In fact, we saw 65% subjective improvement, and the range was 50% to 95%,” Masket said. “Then we tested this in normal pseudophakes, and they didn’t notice any change in the vision in the fellow eye when we covered it. It happens only in the patients with ND.”

Taking that idea a step further, Masket wondered, “What if the patient has only one eye?”

Masket queried his colleagues worldwide, and nobody had ever seen negative dysphotopsia in a one-eyed patient.

“I thought that was really astonishing,” he said.

Masket and colleagues followed up with patching studies, but there was no lasting effect and people did not like the patch.

“Then the idea came, why don’t we use peripherally opaque contact lenses to block the temporal light? We all agreed that temporal light was the stimulus for ND,” he said.

With the contact lens, patients did demonstrate a therapeutic response, but they were not well tolerated.

“We are hoping that opaque contact lenses will be helpful to get people to neuroadapt,” he said. – by Patricia Nale, ELS

Reference s :

Masket S. Negative dysphotopsia. Presented at: Cataract Surgery: Telling It Like It Is; February 6-10, 2019; Orlando.

Masket S, et al. Correspondence: Neuroadaptive changes in negative dysphotopsia during contralateral eye occlusion. J Cataract Refract Surg. 2019;45(2).

Disclosure: Masket reports his spouse makes and markets patching devices.