6 month post op- night vision getting worse - NEED ADVICE

Post your questions and start your research in this forum if more than three months ago you had any type of surgery to reduce the need for glasses and contacts.

6 month post op- night vision getting worse - NEED ADVICE

Postby Hillwood20 » Mon Feb 11, 2008 4:20 am

Here is my story:

I am a 28 yr. old female who had conventional Lasik in August (6 months ago). I was told that custom was not necessary because of my small prescription -1.25D.

The first 5 weeks after surgery, things looked great. Mild dry eye that resolved and excellent vision. Around week 5, I started seeing my floaters all the time. These are floaters that I knew that I had before surgery, but my brain used to eliminate. Now, I see them all the time and there is constant movement in my vision (going on 5 months).

More disturbing however is the quality of my low-light vision. Initially, I had no problem, but over the last 2 months (4mth-6mth), it has become increasingly more troublesome. I have starbursts, halos, but the most distracting is double vision (ghosting) around objects. Foe example, I am not able to watch tv at night because my eyes water trying to focus on the predominant image.

1.) I was treated for "dry eye" although was told that I wasn't really all
that dry, and during this time things became worse, not better.
2.) I was then given pilocarpine drops which at the height of constriction
worked wonders, but they would give me headaches, initial myopia,
and seemed to make my pupils larger when not in use. My doctor
said that Alphagan P would not be enough of a constrictor and would
eventually become ineffective so he did not prescribe those.
3.) The one thing the resolves many of these issues (almost entirely) is
wearing my old prescription glasses (but also eventually ends up in
headache).

Here are my stats:

1.) 10 mm microkeratome created flap
2.) Large pupils 7.5-8.5 mm in low light (although this is what they tell me
now), before surgery they told me I was 6.5
3.) 6.5 mm ablation zone
4.) 510 micron corneal thickness before surgery
5.) - 1.25 in both eyes prior to surgery, am told that I am plano now,
although feel that I may have been slightly overcorrected

Based on all my research, I am pretty convinced that my double vision is the result of a large pupil outside the treatment zone (spherical abberation) based on the observation of visual changes and help by my old prescription glasses.

My questions:
1.) Is this a reasonable diagnosis? (I of course am in the process of
seeking multiple second opinions, which is why I will value yours as
well).
2.) Could wavefront enhancement help to rectify these problems?
3.) Why did this problem get worse between 4-6 month mark?
4.) Is there any reason that it could continue to get worse or anything I
can do to ensure that it will not?
5.) If I do get an enhancement, what is the safest way (PRk, flap relift,
flap recut, etc.)
6.) Any tests that are absolutely a necessity to have before the risk of an
enahancement (wavefront, topography, artemis, etc.)?

I very much appreciate this board and your willingness to read through and help with my problem. Things are looking bleak although I continue to seek out answers.

Sincerely,
Hill
Hillwood20
 
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Postby floatanddry » Mon Feb 11, 2008 2:12 pm

There is also research on RGP lenses helping you in your situation. If you would like to find out more on this post your email address and I'll send you a note with what I know. You can't do private messages on this board which is why your email address would be helpful.

FD
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Postby croanster » Thu Feb 14, 2008 10:22 am

Hi there Hillwood20 – I have similar symptoms to you. My vision is ‘ok’ in bright daylight. It’s nowhere near as sharp as I think it should be but good enough to read the 20/20 line. The darker it gets and the more tired I get, the more my vision deteriorates resulting in double vision and increasing blur. Light sources are never round – they are more football shaped.

I have fairly large pupils as well and suspected as you that the ablation zone was not large enough (or my pupils are too big?). I get some starbursting and a little bit of glare.

I went to my optometrist (not affiliated with my surgeon) and got a new pair of glasses made up. (actually got 2 pairs with slightly different scripts). The strongest pair I got has a lens +0.25 sphere -1.0 cylinder at 30 degress. With the glasses on lights are round at night again and I don’t get any double vision at all and things look crisp and clear. It’s how I imagined I’d be able to see after lasik. The optometrist told me – “that is a significant amount of astigmatism and should be corrected”.

The glasses don’t affect the starbursting or glare either way so I’m stuck with that but being longsighted previously, I didn’t expect a ‘perfect’ result. I did however expect to see the world in focus and without double vision at night. I hope I can get it fixed.

I’d suggest you go see an optometrist and get some new specs to see if it makes a difference – at least you’ll have a better idea what’s going on.

Good luck!
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Postby mbabylash » Sun Feb 17, 2008 1:34 am

I have the same problem after custom lasik in Dec. I have large pupils and a high correction though so I guess it is worse for me. I have heard from multiple people that custom RGP help alot. I have bad starburts, halos, double images, at night. I also have some problem in lower light. I am going to try RGPs in the next few months. Hopefully they will help me and hopefully you too if that is what you decide.
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Postby lboogie » Mon Apr 14, 2008 8:17 pm

Hillwood --
What have you found out? I am having increased starburts at 4 months post-op too.
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