18 days post-op, healing time for astigmatism?

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18 days post-op, healing time for astigmatism?

Postby Olof_LASEK_Sweden » Mon Apr 14, 2008 7:33 pm

Hello,
Questions with numbers
I was going to make a longer diary style post, but I want to wait for some more healing before that.

However, I have got fairly intrigued today and will go ahead with this little question:

1. How long does astigmatism take to heal vs the myopia in an eye post LASEK?? ( my data at the end of the post )

I made the discovery today that I could "concentrate and focus" on my bedroom cieling lamp armature with my left eye and see almost as good as with the right eye. Then I relax the eye and it goes blurry again. It is easiest to do this after drops.

My story is that the left eye went ahead the first day, but then the right has been far ahead, although suffering from one big ghost and one little ( closer one ). The big ghost is now closer to the original as of this weekend, and seems to become more faint. I am encouraged to think it is only edema and thus temporary and part of the healing. The left eye has been making no progress the last week it seems, and the right is now better even outdoors, where the left was "leading" before.

Looking at my eyechart at home my right eye is now 20/35-20/40 and the left, well I'd say when I do this concentration and tensing the face muscle thing ( not squinting ) it improves to 20/40, but relaxing it is 20/60.

Doing an on-line astig test, I was almost able to "concentrate it away" right after drops.

2. So, is this observation a good or a bad sign?

3. Does the astig healing take much longer than the myopia in the very same eye? In the info from the clinic it says healing time is longer for combined errors ( myopia with astig ).

4. Is it good or bad or without importance for the eye ( healing ) to do this concentration excercise?

My data ( how do I make a sig, I don't see where I attach it ?):
36 yo
LASEK with MMC 27 March 2008
Schwind Esiris Laser
Pre-Op:
R:Sph -3.0 (No astig) Visus:1.2
L:Sph -3.0 Cyl -0.75 90 Visus 1.0

PS. Having come to 20/40 on one eye only 18 days post-op, it seems I am so far not in the quick healing crowd from what I read on the forums, but in the *fairly* quick crowd at least. DS.
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Re: 18 days post-op, healing time for astigmatism?

Postby LasikExpert » Mon Apr 14, 2008 9:05 pm

Olof_LASEK_Sweden wrote:1. How long does astigmatism take to heal vs the myopia in an eye post LASEK??


LASEK has an up and down healing pattern. The epithelial cells are mortally wounded in the LASEK process and will need to die, slough off, and be replaced. This process is relatively rapid, but irregular. For the first 2-6 weeks after LASEK it is possible to have temporary astigmatism and relevent symptoms including poor vision quality and ghost images.

Olof_LASEK_Sweden wrote:I made the discovery today that I could "concentrate and focus" on my bedroom cieling lamp armature with my left eye and see almost as good as with the right eye. Then I relax the eye and it goes blurry again. It is easiest to do this after drops.


Try the same test with low light and then bright light. I suspect that what is happening is that your pupils constrict when you focus(normal and common) and this blocks the light that would have traveled through the astigmatism from entering the eye and being "seen". If pupil size does not seem to make any difference, then you are apparently "focusing around" the refractive error.

Olof_LASEK_Sweden wrote:2. So, is this observation a good or a bad sign?


Mostly neutral. It sounds like you have the normal symptoms of the early healing process after LASEK. You won't know for sure if you are overcorrected or undercorrected for a few weeks or even months more.

Olof_LASEK_Sweden wrote:3. Does the astig healing take much longer than the myopia in the very same eye? In the info from the clinic it says healing time is longer for combined errors ( myopia with astig ).


If the astigmatism is due to the epithelium, this will likely resolve over the next few weeks. If the astigmatism is pre-existing that was not resolved with surgery or induced by surgery, it may not resolve with healing or may take much longer to resolve with healing.

Olof_LASEK_Sweden wrote:4. Is it good or bad or without importance for the eye ( healing ) to do this concentration excercise?


Mostly neutral. Such focusing can cause headaches and other symptoms of eye strain, but you are not likely going to damage your eyes by the simple act of focusing.
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Re: 18 days post-op, healing time for astigmatism?

Postby Olof_LASEK_Sweden » Tue Apr 15, 2008 5:24 pm

Thanks for the reply Glenn! :D My left is certainly on a healing streak at the moment it seems, it was unchanged to worse the previous week.

LasikExpert wrote:
Olof_LASEK_Sweden wrote:1. How long does astigmatism take to heal vs the myopia in an eye post LASEK??


LASEK has an up and down healing pattern. The epithelial cells are mortally wounded in the LASEK process and will need to die, slough off, and be replaced. This process is relatively rapid, but irregular. For the first 2-6 weeks after LASEK it is possible to have temporary astigmatism and relevent symptoms including poor vision quality and ghost images.

Now that things seem to be morphing, and mostly for the better, I feel more encouraged. Day 10-15 were the toughest so far because of little or no improvement and bad ghosting ( right ) and blur ( left ).

The non-MMC LASEK it says in the clinic's material it takes a wopping 1-18 months to heal ( sharp vision, side effects gone ). It says the MMC should only be used for strong errors where a greater degree of swelling was excpected. Well, I guess there are different schools and the surgeon operating in the chain in my town thinks differently - the nurse told me they do the MMC variant on any myopia greater than -2 diopters! The MMC it says in the material, will make the healing quicker as a general rule. I have not read up so much on MMC myself.

What got me worried last week was that the nurse seemed a little surprised at my slow improvement and said most are done healing in 6 weeks. I was worried since I has such a long distance to go, already having "used up" two healing weeks.

Anyhow, I had read on this and other forums about very varying healing times and big improvement leaps taking place e.g. 4 months out and the like. This was reassuring.

LasikExpert wrote:
Olof_LASEK_Sweden wrote:I made the discovery today that I could "concentrate and focus" on my bedroom cieling lamp armature with my left eye and see almost as good as with the right eye. Then I relax the eye and it goes blurry again. It is easiest to do this after drops.


Try the same test with low light and then bright light. I suspect that what is happening is that your pupils constrict when you focus(normal and common) and this blocks the light that would have traveled through the astigmatism from entering the eye and being "seen". If pupil size does not seem to make any difference, then you are apparently "focusing around" the refractive error.


Observations today, day 19 post-op:
It doesn't seem to vary so much with light. Today I was able to focus on a tree outside the kitchen window just by looking actively at it. No need to tense face or concentrate on focusing. It varies during the day, but today vs yesterday, it is not so dependent on recent eyedrops, and as a general easier to do.

I was almost going to go for the refractive focusing theory, HOWEVER:
All along I have had a strong ghost all along on the left eye, equal in strength to "the original" and close to it, at 1 o' clock, making it hard to determine which one is real when looking at e.g. the LED of the TV. I noticed it in the gym on a red text on white background, and also other colored texts on those white machines. When I do the focusing thing, the ghost dissapears. I relax the eye, and it comes back. What gives?

ALSO, I can overfocus and make it blurr again (!), coming back via sharp when relaxing. Doing the same thing with the LED on the TV, I can force the ghost into the original LED-light with focusing, I overfocus and it comes out in the exact same place. Relaxing again, it comes back via perfect ( no ghost ).

What is going on here, is it astig, aspheric focus, or something else?? How can unfocussed aspherically cause an almost perfect ghost ( which I confused with blurr sometimes )??

I am encouraged today by the greater ease of gaining this focus, especially easy at long distance. Even being able to "cross the line" like described above. I think it gets the left to 20/30 or the like when I do it right. I think I can only do it when I cover the right eye, i.e. it doesnt benefit me so much when looking with both eyes. Perhaps the "relaxed" focus is a little less blurry on the left with both eyes open, I don't know. I am also encouraged that as a general, the healing seems to be ramping up, even though I am not getting of the steroid drops until April 27th. For a lot of people ( as I've learned through the forums ), getting off "the roids" is what really speeds up healing and takes away ghosts, etc.
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