Glenn, Is .50 diopter too little for a touch-up?

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.

Glenn, Is .50 diopter too little for a touch-up?

Postby GrandpaJohn » Thu Jun 12, 2008 4:50 am

I am now 3 1/2 months post Lasik Surgery. 51 yrs old. My close and midrange vision is pretty good now. Use reading glasses for small print. My distance is very fuzzy in the morning but seems to gets less fuzzy by the afternoon. I dont know why.

My lasik doctor doubted I have any residual astimatism causing the fuzzy distance vision since when I put in eye drops my vision is sharp for like 3 mins. So he said I have dry eyes that is causing the distance to be fuzzy. I have been on restasis for going on 5 weeks now. I do think it is just starting to help me some, my eyes are feeling better and I plan on staying on it for at least 6 months.

I went to a different eye doctor today to get a 2nd opinion of my post lasik progress. This eye doctor said I should be very glad with my results and recommends against a touch-up. He also said I might continue healing more since my eyes are still tender and clear up with drops. He used a dye to test for dry eyes and said I indeed have dry eyes but not severe.

My pre surgery eyes were L -7.00 -1.50 R -4.75 -1.25
My test results today were L -0.50 -025 R -0.50 -050

This doctor said that was excellent results and I should be very happy. Yes I am, I was blind before, couldnt see past my hand in front of my face without glasses or contacts. He said my eyes will probably heal some more and to continue the restasis. He also doubted the Lasik Surgeon would do a touch up on such a small residual diopter. He said if I did get a touch up I might not like the results because I could lose my current good midrange for computer and tv use, etc. He also said the left over astimatism shouldnt effect my vision much, that it was acceptable. He said after 6 months to get retested and if needed get a pair of slight prescription sunglasses for driving and that would probably be best in my case.

What do you think? Is .50 too little to consider for a touch up? Would a lasik surgeon do a touch up on that amount? If I had the .50 removed in touch up, would or could it ruin or diminish my midrange?

Thanks Very much for this site, its been helping me during this journey.
GrandpaJohn
 
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Postby BAM17 » Thu Jun 12, 2008 2:57 pm

Hi GP John,
I will just give you where I'm at...since it's kind of similar...

3 months post op. now. I was -7 x -.50 left and -6.5 x -.50 right.
now -.75 and -.25

I still have some bluriness in the left eye which troubles me. My doctor said he doesn't think its regular or irregular astimatism (topography looks good) he thinks it's just severly dry. I am on Restatsis, Flax Seed Oil, tears, and gel at night. I decided to get myself a pair of glasses to help at night, and when my eyes are tired. It has helped me to feel more comfortable. I'm not going to get any enhancements at this point. Although I do recognize that my vision was "crisper" with contacts, I also don't miss "peeling" my contacts off my red, sore eyes after working a 12 hour day. At this point, I've decided that the majority of my daily activities are "glasses-free" but that there will be times that I need to put my glasses on. Who knows....in 5 or 10 more years, technology may advance and be able to help us more than they can right now. I'd rather wait until that point than risk going into being farsighted! I also can't deal with another flap lift right now...and more dryness. I've worn glasses since I was 5...I told my husband that when I make it to the after-life, the one thing I look forward to is having perfect vision! So...that's my story. I think as your dryness eases..you will have sharper vision...and I think that can improve within the next couple of months. I know within the last week or so, I've noticed a lot of improvement. Keep the faith and keep us updated!
BAM17
 
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20/30 might be just right for me

Postby GrandpaJohn » Fri Jun 13, 2008 7:22 pm

Yea wow, your before and after is almost identical to mine. Even the dry eyes after. I am on restasis, nite gel, hourly drops in daytime and I take omega fish oil 3 times a day.

The eye doctor this week said I actually have 20/30 vision. The place I had the lasik surgery done said I am 20/20 but my eye doctor said that is not really acurate and I know from my actual real world experience he is correct. I do feel better about getting a 2nd unbias opinion. And from what I have read on the net, 20/30 really isnt a bad outcome from Lasik plus maybe it will get a little better at my 6 month and 1 year. Also I am hoping the restasis will start kicking in and help with the dry eye, they do feel more comfortable this week.

As I get more educated on this I think that if I would have got 20/20 for distance that maybe my midrange would have suffered and I wouldnt be happy with that. I do most my work and leasure inside rooms not out in the big scary world LOL. I suppose a truck driver would want the oposite outcome.

Thanks again for your kind input and thoughts. Much Appreciated. Hope all goes well with your recovery.
GrandpaJohn
 
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Postby rosecmd » Sat Jun 14, 2008 5:09 pm

Don't have a second surgery. 1/2 a dioptor nearsighted is a great result, especially for someone 51. If you tried to remove that, you would end up with worse near vision and you would be hit with full on presbyopia and you may even end up overcorrected into farsightedness which would be horrible. You just need to wait some more months to fully heal. You'll likely see more improvements from your first surgery as your dry eyes continue to heal, six months, a year, it will all improve.


My original lasik for -3 nearsightedness was July 2007, I was overcorrected into farsightedness so was maybe +.75 in one eye and +1 in the other. It stunk - my near & mid range vision were crap as far as I was concerned. I could see a flea at 100 feet, but my life is mostly indoors and I had poor indoor vision. I had an enhancement February 2008, so it's been 4 months now. I had very dry eyes the first go round, and that complicated the second surgery (don't let anyone tell you it's a "touch up" - it's eye surgery, it's a big somewhat risky deal). I was nervous about my second surgery but had such odd vision that I went for it. It was hard, I had "reggedy flaps" due to the dryness and that made healing more painful (narcotics needed) plus there is the risk of epithelial ingrowth with flap lifts. My near & mid range vision after the hyperopic corrective second surgery were fantastic, but my distance vision was awful. That's par for the course and over time, that all adjusts. Now, at 4 months out, my distance could still be crisper, I still have dry eye (Restasis, flax oil, gel, drops, patience, etc.) that I know will get better. My mid range is great, and as my distance vision improves, my near worsens to what my natural presbyopic should be (I'm 48). I needed +2 reading glasses before the second surgery, +1 right after, then +1.5s, and I've just gone back to my +2s, although I might be able to get by with +1.75s.

Take what you got, which is a pretty good result, and just wait out the full healing process. Lasik is always a trade-off for us middle-aged folks, if you try to improve one aspect of your vision, another will worsen. Pick you poison, as they say.
rosecmd
 
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Postby GrandpaJohn » Sun Jun 15, 2008 1:43 am

Thanks so much for taking time to explain to me why I shouldnt get an touch up. You made me LOL when you said you could see a flea at 100 feet. I can't see that flea but I can hear him walking~!!!

The more I think it over the more I think I should be happy with what I got. As you said in 6 months to a year I should have more healing. At that time I will get my vision rechecked and if still needed get a pair of prescription sunglasses for driving. I have missed my exit on the freeway because I couldnt read the sign in time. Of course these California freeways are crowded.

I also think and hope that alot of my problems will get better as the restasis and healing work out more. I do know that I don't miss my contacts or glasses. Contacts were just too uncomfortable after a few hours and glasses leave lots of periferal vision blurry. (maybe spelt wrong, but you know, my side vision was non existent in glasses) And of course when it rained they were a mess, etc. Its just so nice to get up at night and be able to see. At this point its almost like a miracle considering I wore glasses since I was like 10 yrs old.

I just want to make the right decision and it really helps to get opinions from others who are going through the exact same process and can understand totally what the heck I am talking about. I sure wouldn't want to do an enhancement and lose my midrange. Its not perfect but its good enough for this cowboy. I reckon I don't have to see that flea. As long as I can see my wife, kids and grandkids I will be fine.

I am grateful for this forum and you kind people. Hope & pray you all have good recoveries. Thanks very much. Grandpa John
GrandpaJohn
 
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Postby BAM17 » Sun Jun 15, 2008 3:03 am

YES....Rosemd....thanks for your input, and advice. And your flea comment made me laugh so hard I choked on the water that I was drinking!

B.a.m.
BAM17
 
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Postby rosecmd » Mon Jun 16, 2008 1:30 am

Happy to help...you know, I really value my near & mid-range vision and it's worth it if you spend most of your time using those two aspects of your vision to sacrifice a little in terms of distance. I did not understand prior to my original lasik that I would lose my good near vision and not be able to see up close. I deal with it, but really hate to have to wear reading glasses to see the food on my plate and my kids' faces. I hindsight, I would have kept my progressive lenses and my -3 nearsightedness.
rosecmd
 
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Me 2... desired or intentional??

Postby Mr.UnPerfect » Mon Jun 16, 2008 3:53 am

My distant eye is also at -0.50. I am also in the 50's 56. My comment is this. Are we saying the doctors are intentionally undercorrecting to give better midrange or are they off their mark and just saying it's close enough and accept it.

I did not mention enhancement to my doctor, but told him it would be nice to have a sharper distant vision and all he said was " if we make changes to how you see now (I guess he was refering to near/mid vision) everything changes. I am 13 months out and still have fluctuations in vision, and still have some dry eye. He put me on Lotemax and Restasis and I will go back in 1 month (it 's already been one month on the meds) total of two months.

I have a + 1 lens for my mono vision (near) eye only. This gives me very good distant vision at night. Here is the KEY. If I put that lens on and look at the computer screen or a calander at two feet it is a little blurry. However with my undercorrected -0.50 eye its is clear. So I think this is what we are talking about and maybe what my doctore meant when he said if you make a change othe's change also. Or as Rose said pick you poison. Very good far and not so good midrange or not so good far (more noticeable at night usually) and preety good nearer and midrange.
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Postby GrandpaJohn » Mon Jun 16, 2008 7:47 pm

Mr UnPerfect. Thanks for your great input. It is good information and makes total sense. Feedback like yours lets me know that I shouldnt push for a touch up. And since your vision is still not totally stable that lets me know that even though I am at 3 1/2 months my vision can still get better as I heal more and stay on restasis.

Thanks for your useful input. John
GrandpaJohn
 
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punctal plugs

Postby noodles » Fri Jun 20, 2008 6:25 pm

hi, my scenario is identical to all of you. although i'm 42, pre op and post op correction is about the same. I am about .50 in each eye an my doctor also recommends no futher surgery. I use glasses for driving at night or in very unfamiliar places where I need far lead time on the signs, and during some large room presentations at work. have dry eye as well and am on Restasis for about 6 months. it has significantly reduced dry eye, but it is still there (worse in one eye) so my vision isn't as sharp as when I put drops in for the first few minutes, and they burn periodically. my question is have any of your doctors talked about things like punctal plugs with the restasis or do they just suggest using it and then supplementing with drops when you get the burning or stronger dry eye symptoms. I just wonder if I got plugs would the combination eliminate the dry eye or are there more risks with plugs, etc. any thoughts
noodles
 
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Postby BAM17 » Fri Jun 20, 2008 7:21 pm

Hi Noodles,
I actually have a plug in my left eye, but not in my right. The one in my right eye kept poking out and it always felt like there was something in my eye. My doctor even tried to put one of the dissolvable ones in....but it still popped out and was bothering me. I've never had a problem with the one in my left eye. I finally just decided the right eye doesn't want one in there...so I gave up and left it out. I haven't noticed a difference between my eye that has the plug, and the eye that doesn't have the plug. I'm on Restatsis, flax seed oil, lots of water during the day, and preservative-free tears. I still get the burning at night, but it is improving little by little. I'm hoping the vision in my left eye will improve as the dryness improves. Hope this helps.
BAM17
 
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Thanks

Postby noodles » Fri Jun 20, 2008 9:07 pm

Thanks, BAM17, how long ago did you have your surgery?
noodles
 
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