Dear Dr. SerVaas: I had cataract surgery one year ago on the right eye. The surgeon advised that there was a small tear in the pocket where he would ordinarily insert the man-made lens and thus had to put it in the front part of the eye.The vision in the eye is blurred, and I am unable to read an eye chart using just that eye. Is there any remedy for this condition? Sure would be nice to be able to put on makeup without wearing my glasses!

P.J. Sumner
Placitas, New Mexico

Dear Reader: Indianapolis eye surgeon Dr. Francis Price, Jr., responds to your letter as follows:

"You seem to have two problems with your vision. One is that your vision is blurry, and one is that you cannot see up close to put on your makeup without glasses. The latter problem is a result of where your vision is focused after surgery. Making the lens implant power stronger so you can see clearly up close and not farther away is determined at or before the time of surgery. Once the lens implant is placed in the eye, the focusing distance at which you see clearly can only be changed by changing the lens with a new one, placing a second or piggyback lens in your eye, or having a surgery such as LASIK in which the surface of your eye is reshaped to change the focus. There are some lens implants that allow you to have both distance and near vision at the same time, but usually this is with some loss of clarity of vision or the possibility of glare and halos at night. These multifocal lenses have to be placed at the time of cataract surgery.

"The issue of blurred vision and the placement of the lens implant in the front part of the eye is a more complex difficulty. Lens implants in the front part of the eye are more likely to be associated with secondary inflammations or irritations in the eye which can lead to blurred vision from either edema and cysts in the retina (the film in the back of the eye) or degeneration of the cornea, the window or front part of the eye. In either case, your doctor can do some noninvasive tests to determine if you have one or both of these problems. In some cases, eye drops can treat the problem. In others, further surgery may be needed to either remove and exchange the implant or perhaps replace the cornea."