IOL glistenings and disability glare

Abstract Glistenings are small fluid‐filled microvacuoles that appear within the intraocular lens (IOL) optic when it is placed in an aqueous environment. Subsurface nanoglistenings are much smaller fluid‐filled gaps from the surface of the optic of the IOL and they may give the IOL surface whitish coloration when the light is directed at the IOL at the angle of incidence of 30° or greater. It has been proposed that the optical quality of an IOL is not significantly affected by the level of glistenings. However, glistening was shown to degrade vision by inducing glare symptoms (straylight) rather than by lowering visual acuity; straylight elevation demonstrates a proportional relationship with the number of glistenings. Retinal straylight, even presenting in low levels, can cause increase in halo size, elevation in luminance detection threshold, and reduction in contrast sensitivity, being a reason for persistent visual complaints. The magnitude of retinal straylight can be clinically determined by the level of disability glare. Moreover, glistenings are not unique to adults and have been reported in paediatric patients Thus, patients having undergone cataract surgery in childhood should undergo a periodical ophthalmic follow‐up for evaluating visual quality and disability glare, and subsequently as determined by grade of glistenings.