Am I experiencing Aniseikonia or am I just paranoid?

Research your concerns in this forum or post your questions if you have had Lasik, IntraLasik, PRK, LASEK, Epi-Lasik, RLE, or P-IOL within the past three months.

Am I experiencing Aniseikonia or am I just paranoid?

Postby MikePRK » Wed Dec 12, 2007 7:51 pm

I am currently 4 weeks post PRK in my left eye. My numbers pre-surgery:

31yr/Male
LEFT: Sphere: -1.00 Cylinder: -1.00 Axis: 080
RIGHT: Sphere: -.50 Cylinder: -.50 Axis: 098

I opted to only get the left eye done because the prescription in my right eye was so minimal. I know the prescription in my left eye was small also, but I didn't understand how unpredictable the results could be and was under the impression that I would have perfect vision after the procedure. In fact, at my pre-op consultation, I asked if the outcomes would be similar to wearing contacts and he(not the surgeon) said I shouldn’t even compare the results to contacts or glasses because it would be much better and that he was 20/15 after his Lasik procedure. It’s amazing what I’m seeing in hindsight and at this point, I am not sure if I made the right decision.

For the majority of the last three weeks, I have been able to focus my PRK'd left eye when I cover my right eye. I'm excited about the fact that I can focus the left eye so that vision is clear, but everything looks and feels as if it's further away. The issue I seem to be experiencing is that if I hold the focal point so my left eye is clear and uncover my right eye, my right eye is blurred. Also, with my left eye focused and both eyes open, my vision turns to double as if I’m crossing my eyes. If I look at something right in front of me and focus with my left eye, the object turns to double and has about 1 to 2 inches of separation between the two images. I have tried my best to converge the two images together, but as they come closer together, the image on the right becomes clearer and the image on the left becomes blurred. I can’t seem to bring the two images together while keeping them focused. I am right eye dominant so I think I naturally focus my vision to my right eye, so my left eye ends up always being blurry.

Could I have been overcorrected and am now farsighted in my left eye? At my 3 week post-op visit, I met a third new doctor for the checkup. Based on my descriptions, she agreed she thought I was farsighted before making me read the line chart or examining my eye through the lamp. She said that all patients, both Lasik and PRK, are farsighted after the procedure and just don’t notice it as much as I do because both their eyes are farsighted. For me, it has been very debilitating and disorienting because my left eye is out of focus at all times. In fact, my sight is actually better if I covered the left eye since the double/ghosted/blurred vision from the left overcasts into the natural vision from my right eye. I asked for a prescription for the farsightness so that I could at least read and work on the computer, but she said my vision was fluctuating and my prescription would change on a daily basis. She did say I was 20/20 in the left eye after reading the chart but that was with my right eye covered. I highly doubt my left eye is 20/20 with both eyes open. Overall, my vision is worse now than before the procedure.

Could I be experiencing Aniseikonia? At my 1 week post-op, I mentioned the term to the 2nd doctor handling the checkup and she said, “everyone has Aniseikonia…anyone who has different prescriptions in each eye has it…you had it before the PRK since you were more nearsighted in your left eye than your right.” If that is the case, why is my vision so much worse now?

My question is whether or not it is true that everyone is farsighted post-op with both Lasik and PRK? Does it sound like I was overcorrected? What, if anything, can I do at this point?

Sorry for all the questions as I think I've been going crazy. Basically, I'm just wondering if what I'm experiencing is normal and that I should just wait it out? Or, should I seek a 2nd opinion from another surgeon?

Thanks for any feedback.

Mike
MikePRK
 
Posts: 3
Joined: Wed Dec 12, 2007 5:52 pm

Postby LasikExpert » Sun Dec 16, 2007 6:06 am

You need a refraction (which is better, one or two?) to determine your current refractive error. If you are actually overcorrected and hyperopic, your PRKed eye is working overtime just to keep up with your other eye. Read about Lasik eye strain for details.

Some people are very sensitive to an imbalance in refractive error. Your brain became accustomed to imbalance the other way, now you are asking it to deal with this imbalance.

The accommodation and convergence issues you have defined are consistent with your brain trying to figure out what has happened. Fortunately neuroadaptation tends to resolve these issues with time
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
LasikExpert
Site Admin
 
Posts: 3309
Joined: Fri May 12, 2006 6:43 am
Location: California

Postby MikePRK » Mon Dec 17, 2007 6:41 pm

My next appointment is the 2-month post-op and is not for another 3 weeks…should I visit a regular Optometrist for a refraction test? The vision center that performed the procedure said they would do one at the 2-month post-op, but felt it was too early to give me any numbers at the 1-month post-op as they said my prescription is fluctuating on a daily basis. I tried to schedule a consultation appointment with a cornea and eye surface disease specialist, but they said they wouldn’t do second opinions on Lasik (I assumed this included PRK) patients unless it had been at least a year since the procedure.

There is a paragraph in the link that you provided where it talks about ranges of accommodation for focusing near, mid, and distance vision. Based on the example, I have to accommodate my left eye(PRK’d) just to be able to see clearly at the 8-10 range. At the same time, my right eye is also accommodating so everything is blurry to the right eye. Basically, using the numbers in the example, it appears that when my right eye(dominant) is focused for 1-3 range, my left is focused for either the 4-7 or 8-10 range, which makes everything that I’m actually looking at to be blurry.

I guess I am one of those people that are more sensitive to an imbalance in refractive error and it seems that regression is the only light I can look for at the end of the tunnel. I did ask about CLAPIKS to the doctor handling my 1 month post-op and mentioned that I heard it would be performed at about 3 to 4 weeks post-surgery, but she said it was still too early to determine if it was needed and that she had done CLAPIKS on patients as far as 2 years after surgery.

At this point, I’m still not sure what to believe. In the last week, my vision has seemed to improve a tiny(more like miniscule) bit, but I’m not sure if it’s actually getting better or if my body/mind is getting better at dealing with it and trying to compensate for it. This must be the neuroadaptation that you mentioned. In the last week, my vision has seemed to fluctuate in which eye it wants to use to focus. It almost seems like my brain doesn’t know which eye to use to focus since it can’t focus both at the same time.

I remember reading somewhere that the epithelium re-grows in the first week of PRK recovery, but then thickens and polishes in the months following. Assuming I am currently hyperopic, would the thickening of the epithelium reduce the amount of hyperopic and shift me towards myopic?
MikePRK
 
Posts: 3
Joined: Wed Dec 12, 2007 5:52 pm

Postby LasikExpert » Fri Dec 21, 2007 2:11 am

MikePRK wrote:My next appointment is the 2-month post-op and is not for another 3 weeks…should I visit a regular Optometrist for a refraction test?


The refraction will give you a reference point in your recovery, but you probably should not consider this as the final result.

MikePRK wrote:The vision center that performed the procedure said they would do one at the 2-month post-op, but felt it was too early to give me any numbers at the 1-month post-op as they said my prescription is fluctuating on a daily basis.


That is correct. You would get your refractive error at a moment in time, but it is obviously not yet stable. It may help explain some of your vision quality issues, but is not your final result.

MikePRK wrote:I tried to schedule a consultation appointment with a cornea and eye surface disease specialist, but they said they wouldn’t do second opinions on Lasik (I assumed this included PRK) patients unless it had been at least a year since the procedure.


This sounds like a policy created after too many early-recovery patients who were simply experiencing the normal fluctuations associated with refractive surgery. I'm sure that you can find a corneal specialist that will see you, but s/he be evaluating a moving target.

MikePRK wrote:...it appears that when my right eye(dominant) is focused for 1-3 range, my left is focused for either the 4-7 or 8-10 range, which makes everything that I’m actually looking at to be blurry.


This is an imbalance that will probably resolve as your eyes learn how to use your new refractive error (or lack thereof). You can expect some eye strain and even headaches, nausea, etc., while everything adjusts.

MikePRK wrote:I guess I am one of those people that are more sensitive to an imbalance in refractive error and it seems that regression is the only light I can look for at the end of the tunnel.


Fortunately that light is probably not an oncoming train! You are so early in the recovery period that much of what you describe may resolve with healing.

MikePRK wrote:At this point, I’m still not sure what to believe.


Belief is not so much the requirement as is patience. You really cannot consider your vision to be the final result until at least 3-6 months postop.

MikePRK wrote: In the last week, my vision has seemed to improve a tiny(more like miniscule) bit, but I’m not sure if it’s actually getting better or if my body/mind is getting better at dealing with it and trying to compensate for it.


Probably a combination of both, and that is exactly what you should expect.

MikePRK wrote:This must be the neuroadaptation that you mentioned. In the last week, my vision has seemed to fluctuate in which eye it wants to use to focus. It almost seems like my brain doesn’t know which eye to use to focus since it can’t focus both at the same time.


Your brain will undoubtedly learn how to resolve your new vision.

MikePRK wrote:I remember reading somewhere that the epithelium re-grows in the first week of PRK recovery, but then thickens and polishes in the months following. Assuming I am currently hyperopic, would the thickening of the epithelium reduce the amount of hyperopic and shift me towards myopic?


Hyperopia (farsighted, longsighted) is notorious for regression. The epithelium often builds up to create more balance across the cornea and this can cause regression of hyperopic effect.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
LasikExpert
Site Admin
 
Posts: 3309
Joined: Fri May 12, 2006 6:43 am
Location: California

A 2-Month Post-Op update

Postby MikePRK » Fri Jan 11, 2008 12:33 am

I just got back from my 2month (exactly 8 weeks) post-op and thought I would provide an update.

First, I would like to thank Glen for taking the time to respond as he has given me the greatest gift of hope.

I made sure to specifically request to see my surgeon today and it turns out I was exactly right. I am currently +1.50 overcorrected in my left PRK'd eye which is what has been causing my symptoms of Aniseikonia. Apparently, out of the thousands of procedures my surgeon has done, he said I am the first rare case he has had that my eyes reacted unexpectedly to the procedure. I think what this really means is that I was overcorrected for regression, but I'm one of those rare cases where I did not regress. This was actually not surprising to me as my prescription was so minimal to begin with. Additionally, I am a bit upset at how much I was overcorrected as going from -1.00 to +1.50 is a 150% overcorrection and that just does not seem right. However, I am very happy that at least they have identified the problem and are willing to address it.

They started me on CLAPIKS and fitted me with a +1.50 contact lens and gave me Acular to drop 4x a day. WOW, I can see again!!!! After 2-months of my body trying to deal with this, it's amazing how great it feels to be able to see normal again. I am a bit upset at the Optometrist doctor that handled my 1-month post op as I had expressed the same concerns at that time only to be brushed off as if everything was normal. Today, although we started the CLAPIKS, my surgeon said I am a bit further out in term of time of where he would have preferred to start me on the treatment. Everything I have read on CLAPIKS also suggests that it should be started 2 to 4 weeks post surgery. Why didn't they take me seriously and identified this at 1 month? How hard would it of been for them to take a few minutes and do a refraction test? So far, this whole thing has costed me money, 2 months of out my life, and my left eye is worse now than it was before.

This has definitely been a learning experience to say the least. Not only has this experience exercised my patience, but it has taught me to trust myself. I realize that doctor's generally have to deal with people's hypochondria in falsely diagnosing themselves, but much like relationships, no one else can truly understand or realize what I am experiencing. Personally, I can tell when something is out-of-place with my body and unfortunately for me, I was right.
MikePRK
 
Posts: 3
Joined: Wed Dec 12, 2007 5:52 pm

Re: A 2-Month Post-Op update

Postby LasikExpert » Fri Jan 11, 2008 5:13 pm

MikePRK wrote:First, I would like to thank Glen for taking the time to respond as he has given me the greatest gift of hope.


Thanks for the kind words. I'm glad to be of service.

MikePRK wrote:...I am the first rare case he has had that my eyes reacted unexpectedly to the procedure.


On rare ocassions the corneal tisse will ablate more with each pulse of the laser and this can cause an overcorrection, although a greater than two-for-one ratio seems very out of the ordinary.

It is also possible that mistakes were made, but I'm sure your doctor has reviewed the data from the laser to affirm that all the right numbers were input.

MikePRK wrote:They started me on CLAPIKS...


For those who are interested, read our article about CLAPIKS.

Please keep us informed of your progress.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
LasikExpert
Site Admin
 
Posts: 3309
Joined: Fri May 12, 2006 6:43 am
Location: California


Return to Just Had It

Who is online

Users browsing this forum: No registered users and 1 guest