Positive and Negative Dysphotopsias: Causes, Prevention, and Best Strategies for Treatment

Purpose of Review To explore the etiology and incidence of pseudophakic positive dysphotopsia (PD) and negative dysphotopsia (ND) and summarize strategies to prevent and treat its occurrence. Recent Findings PD is managed with intraocular lens (IOL) exchange for lower refractive index or treated edge lenses or by use of photochromic contact lenses. PD related to presbyopia-correcting IOL designs is prevented with patient screening and education and mitigated post-operatively by optimizing visual acuity, treating ocular surface disease, and facilitating neuroadaptation through virtual augmentation. Consider IOL exchange if these measures fail. ND is managed with manipulation of the optic and the anterior nasal capsule through multiple surgical and procedural techniques. New IOL design and peripheral ring contact lenses are promising treatments. Summary Pseudophakic PD and ND are unique entities presenting independently of one another and demanding individualized prevention and treatments. A multifaceted approach will cater itself to the best treatment per patient.