Lens Dislocation After Cataract Surgery: 5 Signs You Need to See Your Eye Doctor Right Away

Cataract surgery is one of the most common surgical procedures performed worldwide. During cataract surgery, your cloudy natural lens (cataract) is removed and replaced with an artificial intraocular lens (IOL). Cataract surgery is safe and effective, but it’s still a medical procedure. That means complications can happen. 

One risk of cataract surgery is dislocation of the artificial intraocular lens. A lens can dislocate soon after cataract surgery or sometimes years down the road. Lens dislocation requires immediate medical attention. 

Here are the signs of lens dislocation and what you should do next. 

What are the symptoms of intraocular lens dislocation?

Intraocular lens dislocation can cause eye symptoms and vision changes. But some people never experience any symptoms. These people only find out they have an intraocular lens dislocation during a routine eye exam.

Still, if you’ve had cataract surgery in the past and you notice any of these symptoms, even for short periods of time, see your eye doctor as soon as possible.

1. Blurred vision

Blurred vision is a typical sign of a lens dislocation. This happens because the lens is no longer in the proper position, so it’s unable to focus light properly onto the retina. This leads to blurry vision. Blurred vision may fluctuate throughout the day.  

2. Double vision in one eye

If the artificial lens moves a little bit, you can develop double vision but only in one eye. You might also see “ghost images” in that eye. This visual disturbance makes it seem like there’s a second but incomplete image around what you’re looking at. But both double vision and ghost images disappear if you close the eye that has an artificial lens and look out of your other eye. 

3. Seeing the edge of the lens

You may actually be able to see the edge of your artificial lens if you have a lens dislocation. You may only see the edge of the lens in certain situations, like if you’re lying down and gravity allows the lens to settle into one position. You’re also more likely to see the edge of your lens in dim light when your pupil is more dilated. You may also only see the edge of light intermittently, when it hits your lens in a certain way. 

4. Eye pain

Lens dislocation can cause eye pain. The dislocated lens can start to rub the iris (the colored part of the eye), which can lead to painful inflammation and increased eye pressure. Some people also experience headaches associated with eye pain. 

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5. Halos and glare

Glare sensitivity and halos around lights can be signs of a dislocated lens. These symptoms may be familiar to you since they’re a common symptom of cataracts. See your eye doctor if you experienced glare sensitivity or halos before your surgery and now they’ve returned. This could be a sign of a dislocated lens.

How does lens dislocation happen?

There are two ways that the artificial lens can dislocate:

• Damage to the bag holding the lens: The intraocular lens rests inside a bag. If the bag tears, the lens can move into the vitreous cavity, which makes up the back segment of the eye. 

• Damage to the eye fibers: The bag and the lens are held in place by fibers called zonules. The zonules attach to the bag on one end and the eye on the other end. If the zonules rip or tear, both the bag and the lens can move out of place.

You’re more likely to develop lens dislocation if you have a history of anything that may have weakened or damaged your zonules, such as: 

• Retinal surgery

• Receiving eye (retinal) injections

• High myopia

• Pseudoexfoliation

• Uveitis

• A connective tissue disease like Marfan syndrome  

• Eye injury or trauma

How common is lens dislocation after cataract surgery?

In general, lens dislocation after cataract surgery isn’t very common. In studies, the rate of lens dislocation after cataract surgery ranged from 0.2% to 3%. 

Lens dislocation can happen right after surgery or years down the line. If a lens dislocates within 3 months of cataract surgery, it’s called an early dislocation. After 3 months, it’s referred to as a late dislocation. In studies, the average time between cataract surgery and lens dislocation was about 7 years. 

What should you do if you think you have a dislocated lens?

You should see your eye doctor as soon as possible if you have symptoms of a lens dislocation, even if it’s been years since your cataract surgery. Your eye doctor can determine if your lens has dislocated or if another eye condition is causing your symptoms. 

How do you diagnose a dislocated lens?

Your ophthalmologist will perform a complete eye examination to diagnose a dislocated lens. They’ll check your vision and your eye pressure. They’ll use drops to dilate your pupil and determine the exact location of the intraocular lens. Your eye care professional may perform an ultrasound of the eye as well to give a picture of the location of the lens. 

Is a dislocated lens serious?

Yes, this is a serious condition. If a dislocated lens isn’t fixed, it can lead to problems, such as high eye pressure that can lead to eye pain and permanent vision loss. The lens can also rub on the iris and cause inflammation in the eye. If the lens falls to the back of the eye, it can lead to retinal damage, including retinal detachment. 

How do you treat a dislocated lens following cataract surgery?

It depends. If your lens has only moved a little bit and you have no symptoms, your eye doctor may recommend frequent follow-ups to make sure your lens doesn’t move further. 

Otherwise, your eye doctor may be able to reposition your lens with surgery. Other times, the lens cannot simply be repositioned and needs to be removed entirely and replaced. Depending on the anatomy of the eye and the type of dislocation, your ophthalmologist may decide to position it in a particular part of the eye and attach (or fixate) it to parts of the eye, such as the sclera (wall of the eye). Your eye doctor may also have to remove the clear gel (vitreous) in the back of your eye during lens replacement. 

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Written by:

Nishika Reddy, MD

Nishika Reddy, MD, is an attending physician at the University of Utah. She provides comprehensive and cornea medical care at the Moran Eye Center and serves as clinical assistant professor.

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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