If you are seeing rings of light around headlights or streetlights after surgery, you are not alone. Here is what is happening and what to expect.
"Doctor, I am seeing halos around lights at night. Is that normal?"
I hear this question frequently, especially in the first weeks and months after cataract surgery. The short answer: in most cases, yes, it is expected and it gets better. But the full answer depends on your lens type, your eye health, and how much time has passed.
Halos after cataract surgery have several possible causes:
Multifocal lenses split incoming light into multiple focal points. Some of that split light creates concentric rings around bright light sources, especially at night. This is an inherent property of the optic, not a defect.
Mild corneal edema in the first days after surgery can scatter light. This resolves as the cornea heals, usually within the first week or two.
If halos appear or worsen months to years after surgery, the cause may be a cloudy capsule behind the lens. A YAG laser capsulotomy resolves this in minutes.
If the eye's prescription is not perfectly on target after surgery, light may scatter slightly. This can often be addressed with a minor enhancement or glasses for specific activities.
Highest likelihood of noticeable halos, especially initially. Most patients adapt within 3-6 months. The tradeoff for excellent near, intermediate, and distance vision without glasses.
Significantly fewer halos than multifocal. Vivity's X-WAVE technology stretches light rather than splitting it, resulting in a smoother visual experience at night.
Lowest risk of halos. Single focal point means no light splitting. Some transient halos possible from corneal healing or PCO.
This is exactly why I spend so much time during the consultation discussing lens selection. Understanding this tradeoff before surgery, not after, is critical. For a detailed comparison, see Vivity vs PanOptix.
Here is the part most explanations miss: your brain is remarkably good at filtering out visual noise.
In the first weeks after multifocal lens implantation, halos can feel prominent and distracting. But over time, your visual cortex learns to suppress the out-of-focus light rings. This process, called neuroadaptation, typically takes 3 to 6 months.
Most patients who notice halos at one month report that they are significantly less noticeable, or completely gone, by three to six months. A small percentage of patients continue to notice them, but they rarely describe them as bothersome enough to affect daily life.
The key is managing expectations before surgery, not after. If you know halos are possible and temporary, they feel very different than if they catch you by surprise.
Contact your surgeon if:
I do not discourage multifocal lenses. I recommend them often, and most patients are thrilled. But I want every patient to understand that the trade for glasses freedom is a slight change in visual quality, particularly at night. If that sounds acceptable, it probably is. If it sounds concerning, we should talk about it before surgery, not after. An informed patient is a happy patient.