What percentage of multifocal lens patients get halos, starbursts, glare

or other visual anomalies?

Short answer: Depending on the study and how “bothersome” symptoms are defined, roughly 15–40% of multifocal IOL patients report noticeable halos, starbursts or glare after surgery, with about 5–15% finding them persistently troublesome enough to affect daily activities or consider further treatment.

Why these symptoms happen (briefly)

Multifocal intraocular lenses (IOLs) split or diffract light to give you more than one focal point (distance + intermediate + near). That optical design is excellent for reducing dependence on glasses, but it also increases the chance of positive dysphotopsias —visual phenomena such as:

  • Halos (rings around lights)
  • Starbursts (spiky rays from point lights)
  • Glare (excess brightness or washout, especially at night)

These are more common with multifocal and some extended depth-of-focus (EDOF) lenses than with standard monofocal IOLs.

Reported rates from clinical studies and surveys

Overall occurrence (any level)

  • In a study of patients with trifocal IOLs, 41.4% reported halos , 13.8% starbursts , and 10.3% glare at “moderate” or “severe” levels on quality‑of‑vision questionnaires.
  • Other series of diffractive multifocal/trifocal lenses report that roughly 20–40% of patients notice some degree of halos or glare , especially in the early postoperative period.
  • A meta‑analysis of diffractive trifocal IOLs concluded that positive dysphotopsias are a recognized trade‑off , with a substantial minority of patients reporting them, though many adapt over time.

How many find them “bothersome”?

  • In the same trifocal IOL study, when patients rated symptoms as “quite a bit” or “extremely” bothersome, halos were bothersome in 14% , glare in 15% , and starbursts in a smaller percentage (around single digits).
  • Across broader multifocal IOL cohorts, about 5–15% of patients describe halos/glare as significantly bothersome long‑term, with some impact on night driving or low‑light tasks.
  • Severe dysphotopsias (rated as “severe” by patients) have been reported in around 17% of patients in some multifocal/EDOF series, though definitions vary.

Multifocal vs monofocal

  • Compared with monofocal IOLs, multifocal IOL patients have:
    • More halos, starbursts, and glare overall.
* **Less improvement in self‑reported general vision** in some surveys, yet **higher overall satisfaction** with spectacle independence.
  • Monofocal IOL patients typically show a larger reduction in halos and glare after surgery than multifocal patients, but they usually need glasses for near and sometimes intermediate vision.

Time course: do these symptoms improve?

  • Many patients experience the strongest halos/glare in the first weeks to months after surgery.
  • Neuroadaptation (your brain learning to “tune out” some of the extra images) often reduces how noticeable or bothersome these symptoms become over 3–6 months , sometimes up to a year.
  • Even when patients still technically “have” halos on testing, they often care less about them as daily function improves.

Who is more likely to notice problems?

Risk tends to be higher in people with:

  • Large pupils in dim light
  • Pre‑existing corneal irregularities or higher‑order aberrations
  • Significant dry eye or ocular surface disease
  • Very high expectations for “perfect” night vision
  • Certain lens designs (older diffractive multifocals vs newer trifocals/EDOF)

Careful pre‑op screening and choosing the right lens design for the individual can lower the chance of troublesome symptoms.

What can be done if symptoms are problematic?

If halos, starbursts, or glare are affecting quality of life:

  • Optimize the ocular surface (treat dry eye, eyelid issues).
  • Allow time for neuroadaptation if still early post‑op.
  • Consider glasses with anti‑reflective coating for night driving.
  • In persistent, severe cases: options can include laser refinement , IOL exchange , or adding a piggyback lens , depending on the cause and lens type.

Bottom line (for decision‑making)

  • If you choose a multifocal IOL , it’s reasonable to expect:
    • ~20–40% will notice some halos/glare/starbursts at some point.
    • ~5–15% will find them bothersome enough to impact activities like night driving.
    • Most patients still report high overall satisfaction , mainly because of reduced dependence on glasses.

Discuss your personal risk factors, night‑driving needs, and tolerance for possible visual phenomena with your cataract/refractive surgeon before selecting a lens type. TL;DR: Around one in five to two in five multifocal lens patients notice halos, starbursts or glare; roughly one in ten (or fewer) find them persistently bothersome.

Information gathered from public forums or data available on the internet and portrayed here.