post-op problems with dominant eye

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post-op problems with dominant eye

Postby Mary Ray » Thu Jan 18, 2007 11:16 pm

I had my lasik done 8 days ago, and the vision in my dominant (left eye) is terrible. When I went in for my one week check-up yesterday the doctor tried every lens possible and nothing worked. He did a slit lamp test and then did some kind of tunnel vision test and I could see perfectly, thus ruling out anything behind the eye (or something like that). My left eye is swollen as I can feel it, and my husband can even see it upon close examination. The doctor said the eye was over-corrected, and he would reevaluate in two weeks. I am in Brazil, and since there is quite a language barrier I would like a little expert advice that I understand. The physician is one of the most reputable in Rio and I have confidence in his abilities, but not in my Portuguese. Is it possible that my non-dominant eye will take over dominance, and if so should I have it corrected to 20/20 since he left it a little myopic to avoid total dependence on reading glasses. Thanks for your time
Mary Ray
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Joined: Thu Jan 18, 2007 7:24 pm

Postby LasikExpert » Fri Jan 19, 2007 12:06 am

I'm sorry to hear of your problems after Lasik. Medicine has a language of its own; add to that additional languages and confusion is bound to occur.

When you say your eye appears swollen (edema) you probably are referring to the area around the eye ball including the upper and lower eye lids. This is called the orbit. Orbital edema can cause pain and changes in refractive error. It is possible that this edema is interfering with your vision.

Edema at the cornea (clear front of the eye) would be difficult for you or your husband to see, however an eye doctor can see edema upon examination. Corneal edema would very likely cause refractive error. Corneal edema is often irregular and that irregularity can present as skewed vision, poor night vision, and blur.

Temporary dry eye after Lasik is rather common. Dry eyes can cause or exacerbate corneal edema and edema can cause or exacerbate dry eyes. It can be a difficult cycle.

I assume that you were myopic (nearsighted, shortsighted) before surgery. The undercorrection you mention indicates that you were seeking Lasik monovision to reduce the effects of presbyopia. Presbyopia is when the natural lens inside the eye is less able to change focus to see objects near. This is when reading glasses or bifocals become necessary. Monovision with contact lenses or Lasik can be a good workaround for presbyopia.

Your doctor's diagnosis of overcorrection from myopia to hyperopia (farsighted, longsighted) may be accurate, but it may also be temporary. The edema could induce enough refractive error to make you hyperopic.

The combination of hyperopia and presbyopia tends to provide poor vision quality at all distances. This may be why your doctor was not able to find corrective lenses that resolve all your vision problems.

You may also be dealing with what I call "Sudden Presbyopia" as your eye learns to come with the changes provided by Lasik.

Your doctor can determine if dry eye is contributing to your symptoms and there are many methods of Lasik dry eye treatment to relieve this problem. A moist eye is a good healing environment. Using reading glasses is an inexpensive way to deal with what may be a temporary refractive error problem.

You need not worry at this point about your non-dominant eye becoming dominant. Eye dominance is not about which eye sees better. It is about which eye looks directly at an object (dominant) and which eye looks at an object at a slight angle (non-dominant). You may want to review our dominant eye test.

At the moment what you probably need most is patience. Until the edema resolves it will be almost impossible to know how close your correction was to the intended target. Even then there can be changes during the normal six month healing process that will change your refractive error.

The symptoms you describe are not exactly common, but they are also not unknown. Over the next few days and weeks you can expect changes in your vision quantity and quality. Please keep us informed of your progress.
Glenn Hagele
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