Halos and Starbursts

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.

Halos and Starbursts

Postby dallasjetfan » Thu Apr 12, 2007 7:09 am

It has been 6 days since my surgery. I have 20/15 daytime vision. I am sure it is close to that at night, but I have halos and starbursts while driving on cars and street lights. I have a week until my second post-op visit with my doctor. I have a couple questions. One, what are the chances these nighttime problems go away? Two, will I need or can these be corrected?

So far, I couldn't be happier with the daytime vision. I have never been able to see this well. I am concerned with the nighttime vision though. I have had no burning or dryness. It feels like my eyes are totally healed, but I am guessing they are not. So, I am hoping for much improvement with my nighttime vision. Any thoughts?
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Postby dallasjetfan » Fri Apr 13, 2007 5:15 am

Does anyone have any ideas, suggestions or comments?
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Postby eyespy » Fri Apr 13, 2007 2:54 pm

YOu are very early in your healing process. Those things sound normal. The fact that you saw 20/15 is a great start.

It takes time to heal.
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Postby dallasjetfan » Fri Apr 13, 2007 4:36 pm

My left eye seems a little blurry and reduced eyesight on day 7. Can the eyes fluctuate in how well they see from day to day during this process?
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Postby yawny » Sat Apr 14, 2007 8:45 am

It is normal for your vision to fluctuate, from day to day, even from hour to hour. I am 3 months post lasik, and this still happens to me. The night stuff should get better with time, as well.
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Postby JPD » Sat Apr 14, 2007 7:28 pm

dallasjetfan wrote:My left eye seems a little blurry and reduced eyesight on day 7. Can the eyes fluctuate in how well they see from day to day during this process?


It could be dryness. Even if your eyes don't "feel" dry, that could still be the culprit. Keep up with the eye drops, and don't be afraid to try something stronger, like Refresh Celluvisc or Theratears Liquidgel. I've tried both and they have worked wonders for me.
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One Month Update!!

Postby dallasjetfan » Mon May 07, 2007 4:09 am

Although I have had a great experience so far, I still have starbursts and prisms at night around car lights and street lights. Why do I only have those problems with those types of lights?
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Re: One Month Update!!

Postby JPD » Mon May 07, 2007 3:28 pm

dallasjetfan wrote:Although I have had a great experience so far, I still have starbursts and prisms at night around car lights and street lights. Why do I only have those problems with those types of lights?


I'm at three months, and I still have those problems as well. I think you're at approximatly one month, correct? I can't answer your question as to why you have those problems only around certain kinds of lights, but I can tell you that even at one month you're still early in the healing process. Even though for many people these problems are gone by the one month mark, they will take much longer for others. Both you and I seem to be in that boat together. I don't mean to scare you by saying this, but even though it's very likely this problem will clear up, there is still a chance that it may never improve. That is a fact I'm trying not to face at this point, and hoping I finally have improvement over the next three months. As with most Lasik issues, just follow your doctors instructions and be patient.
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Re: One Month Update!!

Postby LasikExpert » Mon May 07, 2007 4:42 pm

dallasjetfan wrote:Although I have had a great experience so far, I still have starbursts and prisms at night around car lights and street lights. Why do I only have those problems with those types of lights?


Starbursts (long spikes) emitting from light sources at night indicate a healing issue. The flap has probably not adheared to the underlying corneal surface enough to give a smooth transfer of light through the cornea. See Lasik flap healing for details.

Although you mention only car lights and street lights, you probably have a similar effect from other light sources as well. Even reflection, such as highway signs, can cause the effect.
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Postby peakaboo » Tue May 08, 2007 2:49 am

I'm 9+ months post customvue lasik and still have starbursts at night. Unfortunately, I don't think these will ever resolve for me as I have extremely large pupils, but I knew this going into the surgery. My next followup is in two days and I'll see if glasses for night driving are a possibility. I don't think my vision is bad enough to warrant an enhancement, but I'll ask and see what the surgeon thinks.
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Postby LasikExpert » Tue May 08, 2007 7:18 am

Has your doctor prescribed Alphagan P eye drops to reduce the size of your pupils? If yes, do they make a difference?
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Postby Terabethia » Fri May 11, 2007 2:39 pm

I just thought I would add a little hope for you here. I am currently about 2 months post-op. For about 6 weeks, I had perfect daytime/indoor vision, but I had pretty decent halo's and starbursts at night. I too mostly only saw this with traffic lights and street lights, but as Glenn (I think...) mentioned, I also had halo's from the glare on street signs. It was more of an annoyance than a driving problem, but at first the starbursts were so large it looks like I was driving through a firework show!

Around 6 weeks I noticed that these were getting a lot better and now, at almost 8 weeks, they are almost completely gone. I still have some, but as each day passes they get smaller, and disappear at farther distances.

One thing I can say... try your best to keep up with eye drops. This has been really tough for me because I don't feel like my eyes are dry. So since I don't have my eyes burning as a reminder, I have to force myself to remember to use them. Cause as someone above said, just because they don't feel dry, doesn't mean that they airn't. The entire healing process is like 6-12 months, even if you are feeling fine after a couple of weeks.

Good luck, I hope you have the same good outcome as I did. I am very happy with the results now :lol:
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Postby eyespy » Fri May 11, 2007 3:40 pm

I guess my question fit's well in this thread.

Why would I have lower light vision problems now due to larger pupils after surgery, but before I had perfect night vision? My pupil size is the same.
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Postby LasikExpert » Fri May 11, 2007 4:17 pm

You pupil is the same, but your cornea is different after Lasik. For full details, see our article on Lasik Night Vision Problems.

Current Lasik laser technology has limitations on the size of the area it can treat. In wavefront-guided mode, only about 6.0mm of the center of the cornea receives full correction (optical ablation zone). Beyond this 6.0mm is a blend zone that transitions from full correction in the center to no correction at the outermost edge.

Think of the transition zone as the onramp to a freeway. As you get closer to the freeway you get closer to full speed. If easier, you can think of the cornea after Lasik as a target with the center fully corrected and each ring as you move out from the center less and less corrected.

If the naturally dilated pupil expands beyond the size of the optical ablation zone it is possible for light that travels through the transition zone to get past the iris, through the pupil, and reach the retina at the back of the eye to be "seen". This light will not be fully focused because it is traveling through an undercorrected portion of the cornea. The underfocused light through the transition zone mixes with the fully corrected light through the optical ablaion zone and presents as a halo around a light source.

Despite these facts, pupil size alone is a very poor predictor of who will and who will not have night vision problems. Some patients with pupils larger than the optical ablation zone do not have night vision problems. There seems to be a correlation between the amount of correction, amount of tissue removed, angle of the transition zone, curvature of the cornea before and after surgery, and several other issues that are not fully understood.
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Postby JPD » Fri May 11, 2007 5:20 pm

LasikExpert wrote: There seems to be a correlation between the amount of correction, amount of tissue removed, angle of the transition zone, curvature of the cornea before and after surgery


For those that have had Lasik, the flap is another reason correct? Because if the reasons stated above along with pupil size are the only reasons, then we would see equal amounts of night vision problems between PRK and Lasik patients, correct? But we don't, unfortunately I think Lasik is about double that of surface ablations.
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