lasic and PRK with bad vision, very frightened

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lasic and PRK with bad vision, very frightened

Postby GeneralPatientInquiry » Sun Jun 04, 2006 4:07 pm

I had lasic on one eye, PRK on the other 4 full days ago. On the lasic eye, my long vision is not as good as it was with my contacts and I have lost all short and mid vision. I had been tested for reading glasses just prior and my doctor said I didn't need them at all, nor had I any trouble reading with my contacts on== I nver took them out. Now, I only see black blurs on a page and can't read a computer screen or see to iron, cook, etc. with my lasic eye. On my PRK eye, the contact bandage was removed today and my vision remains completely blurry both short and long vision. My Doctor seems surprised and has no explaination and offers no reassurances. He tried to say that I just need reading glasses but then I explain over again that I was tested just prior and that I was reading perfectly clearly prior to surgery with my contacts on-- not taking glasses off to read-- plus it is worse than just blurry words--everything within ten feet is blurry in both eyes. From what I read on line, this is not typical for either procedure and I am starting to become very frightened.

The doctor also said that perhaps my PRK eye was dominent and they didn't know it and when it clears up my reading and short sight would come back-- by my reading vision in both eyes was tested a week before surgery and I'm sure that would be on my record if it were true and I'm sure I would have noticed if I could not read at all with one eye.

I was -4.0 in both eyes, near sighted. Even when the Dr. tried reading glasses on me I still can't see the words clearly.

Any insight? Should I see another doctor? Is this normal?

Thank you,
This post is a reprint of a previously requested inquiry received by USAEyes.org via email.
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Postby LasikExpert » Sun Jun 04, 2006 4:11 pm

My first words of advice are to not panic. There will be plenty of time for panic later. Right now you need to keep your wits about you so you can make solid and reasonable decisions.

Poor vision at this stage for your PRK eye is pretty much the norm. In PRK the outermost layer of cells of the cornea (epithelial) are removed. Although these are the fastest growing cells in the human body, they do take time to grow, thicken, and smooth. You should have functional, but poor, vision for 3-5 days after the contact bandage is removed, fair but not excellent vision for 1-3 weeks after that, and your crisp vision will not arrive for anywhere from 2-8 weeks after surgery. For PRK, you need to be quite patient.

The LASIK eye should have very quick visual recovery, so what you are describing is probably close to what you will initially get. There may be some swelling, and this will cause a temporary refractive error that should stabilize within 2-3 weeks.

All your described problems can be exacerbated by surgery induced dry eyes. We have a detailed article on dry eye treatment. Moist eyes may reduce your poor vision problems and will always create a better environment for healing.

I believe that what you are experiencing is either overcorrection into hyperopia (farsighted), something I call "sudden presbyopia", or a combination of the two.

Hyperopia simply means that the optical power of the eye focuses objects behind the retina, not on the retina. Hyperopia may be temporary due to healing responses and swelling, but may also be the initial outcome of your surgery. A prescription of your current vision (not the 20/20 chart, but an actual prescription) would indicate if you are hyperopic.

You should read about "sudden presbyopia".

A second opinion is always a good idea, if nothing else, for peace of mind. Either you will learn that your current doctor is doing everything as he should and you can continue your care with him, or you will find that your doctor is responding inadequately and you need the care of a different surgeon. It is not knowing that causes the anxiety. Once you know exactly what is happening and the probable outcome, you can respond appropriately. I suggest you seek a second opinion from a nearby teaching hospital.
Glenn Hagele
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I am not a doctor.
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