Vision great, then not-so great - normal?

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Vision great, then not-so great - normal?

Postby mrb » Tue Jul 31, 2007 2:07 am

I had wavefront lasik two weeks ago today. Prior to surgery, my eyes were:

-6.50
-6.75

The surgery was normal and about 8 hours after the surgery, everything was super sharp and I was on cloud 9. I went to bed and awoke the next morning to find that things were now much blurrier than the night before.

At my day after appt. the doc told me I was about 20/60 and told me to try +1 or +1.25 for distance viewing and +2.25 or +2.50 for near vision. I told her of the crisp vision the night before and was told that this was normal and that all was progressing well, and she was very certain that I would end up with "zero prescription".

I have another follow up this Thursday, but I'm not noticing much improvement yet.

I guess my big question is regarding the great vision I had immediately after surgery that "vanished" overnight. Is this indeed normal?

Thanks in advance...

MrB
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Postby LasikExpert » Tue Jul 31, 2007 3:13 am

You could have the induced hyperopia (farsighted, longsighted) vision you describe if you had edema (inflammation) at the outer edge of the treatment area where the Lasik flap is created. Edema can be caused by or exacerbated by temporary Lasik induced dry eye. Both are consistent with having excellent vision on the day of surgery and reduce vision the next morning.

If your vision is good with corrective lenses, then your problem is only refractive error and this may resolve with continued healing. If it does not resolve your doctor may recommend enhancement surgery, but that decision is about three months away...if needed.

Follow your doctor's directions and report any sudden vision changes.
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Thanks!

Postby mrb » Tue Jul 31, 2007 2:55 pm

Glenn -

UPDATE: Just to be clear, the fact that my vision is pretty good with the drugstore reading glasses doesn't rule out that this is edema?

First, let me say how great this website and especially the forum are.

Second, thanks for the quick response and info. I'm hopeful that the scenario you described is accurate and would explain how very confident my doc was about me ending up with "zero prescription".

I'll keep the board posted so that others might learn something from my experiences...

Thanks again...

MrB
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Postby shazza » Tue Jul 31, 2007 5:45 pm

Glenn is the expert, so maybe he'll have a better answer.. but the fact that you can see better with reading glasses is very consistent with edema. I asked the same question of my doctor on my 1-week appt, and he said that edema--swelling--changes the shape of your cornea.. much like being shortsighted would.
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thanks shazza...

Postby mrb » Tue Jul 31, 2007 6:05 pm

Thanks shazza.

That's good to hear that there appears to be a good possibility that I will get back to the awesome vision I had a few hours after my surgery.

I have an appt. Thursday and will report the results!

Thanks again,

MrB
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Postby LasikExpert » Tue Jul 31, 2007 7:35 pm

The thing about edema is that it is not always across the cornea evenly. If the edema is more central, it can cause a myopic shift and the patient is more nearsighted. If the edema is at the periphery, a hyperopic shift can occur and the patient is more farsighted. If the edema is irregular, then astigmatism is the likely result. As the inflammation resolves the edema will often change irregularity, causing poor vision quality and even ghosting or starbursting.

It is possible you were overcorrected, but until a few months have passed and the eyes have settled down it is going to be difficult to tell. Your doctor, who has actually examined you, believes the issue is limited to edema. For now edema seems like a reasonable diagnosis. If 3-4 months of uneventful healing have passed and you are still hyperopic, then overcorrection would be the more appropriate diagnosis.
Last edited by LasikExpert on Mon Aug 06, 2007 7:45 am, edited 1 time in total.
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Thanks Glenn...

Postby mrb » Tue Jul 31, 2007 9:32 pm

...for the info.

I'm sure that if I had slept through the first night and not experienced the great vision, I wouldn't be worried at all right now.

It was just very strange to go to sleep with "perfect" vision and then wake up with blurriness. I'm keeping my fingers crossed for edema!

Thanks again,

MrB
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UPDATE: Not so great...

Postby mrb » Thu Aug 02, 2007 10:33 pm

Well, I had my 2 week (and 3 day) appt. this afternoon.

The good news is that there are no problems with my eyes, no edema, no problems with the flap etc.

The bad news is that I guess the doc overcorrected and I'm not budging. She said the goal was to overcorrect, then have me "regress" back to 20/20 or a tiny bit nearsighted. Unfortunately, I appear to be stuck where I am.

She said that it's still early, and too early to tell whether I'll have no regression at all, but she was very up beat (much more than me!) that even if I didn't regress, she could do a "tweak" to fix the problem.

I've got a ton of questions about the "tweaking" process, and the odds that a second go at it will yield better results than the first, but I've got to let today's news sink in before I post them...

MrB
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Postby LasikExpert » Fri Aug 03, 2007 3:36 am

Deliberate Lasik overcorrection to accommodate expected regression is a common technique to avoid enhancement surgery.
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Overcorrection...

Postby mrb » Fri Aug 03, 2007 1:09 pm

I keep reminding myself of that!

It appears that at least for the moment, my eyes don't want to play along and regress like they were supposed to.

The doctor expressed some surprise that after 2+ weeks there has been no regression; however, was quick to remind me that it's still early...

Thanks again,
MrB
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Postby mbalk » Tue Aug 07, 2007 5:21 pm

just wondering how things are going a week since last post. have you noticed any regression. last night I had definite changes of regression in my deliberately undercorrected eye and it really felt good.my slightly overcorrected eye isnt changing and it really bothers me. I still am so impatient that all I want is to go back in and make my good eye less corrected so I am comfortable, even if it means wearing glasses for clear distance vision. michael
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Still waiting for regression...

Postby mrb » Tue Aug 07, 2007 10:24 pm

It's been just a bit over 3 weeks now and still no sign of regression that I can tell.

This might be one for Glenn, but I [i]think[/i] that my odds for regressing are diminishing the further away I get from the surgery. That's definitely the impression I got at my last appointment as the doc starting to talk about going back in and "tweaking" for the first time since my surgery...

I'm definitely disappointed, but I keep reminding myself:

1. It's still somewhat early and there's still a chance that I'll regress
2. The doc seems very confident that I'll end up in the right place either by regressing or adjustment
3. Even though at times I think I'd like my bad nearsightedness back vs the small amount of farsightedness I now have, when push comes to shove I'd probably take where I am now over where I was when I started...
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Postby LasikExpert » Wed Aug 08, 2007 12:05 am

Regression is virtually assured, but it is difficult to say if it will be enough to bring you back to plano. It is still early. Your surgeon will probably not seriously consider enhancement surgery until about 3-6 months postop...and you can always do it later.
Glenn Hagele
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On cloud 9 only for it to change

Postby firemom » Wed Aug 08, 2007 11:51 pm

Will be 4 weeks out tomorrow. Day after surgery was 20/25, which was great as I was blind as a bat. However 2 weeks later I was 20/40 in the right eye. This really has me scared. I want the 20/25 back. Vision is great up close in that eye its distance. I think I could deal with it better if it were close which I could use reading glasses, and not need them for all of the distance.
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6 Weeks after.

Postby mrb » Thu Aug 30, 2007 7:15 pm

I thought I'd post an update, so that folks can get the complete story.

I had my 6+ weeks checkup today. The bad news is that I still haven't regressed at all and continue to be "stuck" where I was after surgery.

The good news is that if there are no changes in a month, I'll be in a position for an enhancement at about 4 mos after my original surgery.

I had the doc give me a recap of her take on my situation. Here's the summary:

1. Based on the parameters entered into the laser, I was overcorrected from -6'ish to about +1 - +2.
2. Normally, it was expected that I would regress back towards plano, but I seem to be a pretty rare case where there's very little, if any, regression.

The main question I asked and I'd be curious to the expert's thoughts:

Since I didn't regress after the first go, is it likely that I won't regress after the enhancement - answer: It's likley that my regression behavior will be the same the next time

Thanks,

K
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