Lasik and mild eye/neck pain

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Lasik and mild eye/neck pain

Postby Mike » Fri Sep 15, 2006 2:13 pm

I had lasik around a 6 weeks ago and since then on one eye I have a mild pain. Also, on the back of the neck stiffness and mild pain. If I bend
down I can feel that something is heavy on one eye.. It is continuos and throughout the day. If I do not watch TV or do not work on computers (like weekends)
then it will sort of go away; not completely, but most of the time. The other eye is fine. Do not have dry eye symptons and doctor agrees with that.

The doctor says that the healing is different in different people and different in different eye, so to give more time.

Somehow I feel it is not the healing issue. I am not sure what else to do. The feeling of stiffness and mild pain is through out the day. I am starting
to feel depressed now.

I had -3.5 and -3 before.

Any ideas/suggestions?

Thanks in advance.
Mike
 
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Joined: Thu Sep 14, 2006 5:58 pm

Postby LasikExpert » Fri Sep 15, 2006 6:16 pm

My educated guess is that your problem is related to accommodation/convergence.

Accommodation is when the natural lens of the eye changes focus to see objects near. Convergence is when the two eyes move toward each other (cross-eyed) as you accommodate. Also, the iris (colored portion of the eye) tends to constrict to make the pupil slightly smaller.

When you are focusing on the television (mid distance) or the computer screen (near distance) the muscles used for accommodation and convergence are straining. This can cause eye ache, head ache, muscle pain, nausea, vertigo, and a whole host of problems that one may not normally associate with focusing the eyes.

When you were myopic (nearsighted, shortsighted) before surgery, focusing on objects close was not quite as difficult because your eyes were naturally focusing on objects close. Even with corrective lenses, there is a slight advantage to being a little nearsighted when you are looking at something close. Without your previous myopia, your natural lens is attempting to make a much greater change to see objects near than when you were myopic.

Now that you have removed the myopia with surgery, the eye has a different range that it needs to accommodate.

For the sake of demonstration (and these numbers are only for demonstration) let's say that the range of focus of your eyes is 1-10. 1-3 is for near focus, like your computer. 4-7 is for mid-range, like your TV, and 8-10 is for distance vision. In the 8-10 range your eyes are almost or totally relaxed. To achieve clear vision in the 4-7 range, you must accommodate. To achieve clear vision in the 1-3 range, you must accommodate and converge.

Before surgery, your myopia provided a mechanical advantage (gross over-simplification but you get the idea) for the 1-3 range. You actually had to accommodate and converge less before surgery than now. Before surgery your myopia would have provided a slight advantage in the 4-7 range. Not much, but a little. Now that you don't have myopia, your accommodation and convergence must work full time, not part time.

If accommodation and convergence is the issue, you should have no problems with distance vision, a bit of problem with mid vision, and a lot of problems with near vision.

Now let's complicate things a bit.

If you are at or around age 40, you would also have effects from presbyopia. Presbyopia is when the natural lens of the eye is less able to change focus. Presbyopia would make focusing on objects mid and near even more difficult.

Another possible problem is that you have been overcorrected into hyperopia (farsighted, longsighted) vision. Now your range is -3 to 10 and your eyes must first accommodate an additional 3 steps to get back up to where you want to go down to.

Yes, you can still see the Snellen 20/whatever test if you are slightly hyperopic.

Here is an idea that may help. Purchase or borrow a pair of reading glasses with the lowest power available, and use them while working at the computer. See if this helps the problem.

Ask your doctor to provide both a manifest refraction (which is better, one or two?) and a cycloplegic refraction. The cycloplegic refraction will paralyze the natural lens so it cannot "focus around" any hyperopia. A cycloplegic refraction will give your true refractive error when your eye is in a natural state.

Please report back your findings. My bet is that you are slightly hyperopic and slightly presbyopic.
Glenn Hagele
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Postby Mike » Fri Sep 15, 2006 7:42 pm

Thanks a Lot.

I have the followup appointment and will ask for both - a manifest refraction (which is better, one or two?) and a cycloplegic refraction.

I am 37 years old. What are the possible solutions for - hyperopic and slightly presbyopic.

I guess for hyperopic - a followup correction? What about for presbyopic?

Will the pain ever go away? It is really depressing.

Thanks...
Mike
 
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Joined: Thu Sep 14, 2006 5:58 pm

Postby LasikExpert » Fri Sep 15, 2006 9:38 pm

Age 37 would be consistent with my theory of presbyopia. At that age presbyopia would probably not be enough to where you would normally need reading glasses, but could have an effect when your eyes suddenly no longer have myopia.

I suspect that with the use of low power reading glasses you will immediately find the pain to be less. I also suspect that over the next several weeks to months your eyes will adjust to the new range for focus.

Hyperpia can be corrected with contacts, glasses, and enhancement surgery may be appropriate. You will need to discuss this with your doctor.

There is no "cure" for presbyopia, but you can use reading glasses, bifocals, leave a little myopia, or try monovision.

Be sure to call your doctor's office in advance and let them know you want the more comprehensive examination. They may intend to only give you a Snellen test and check your healing. Advance warning will be sure they schedule for the extra time.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
LasikExpert
Site Admin
 
Posts: 3309
Joined: Fri May 12, 2006 6:43 am
Location: California

Postby Mike » Tue Oct 10, 2006 3:47 pm

I had the followup visit. However, by now the neck paid/pressure/tension is much better. Mostly did not get it for the last 10 days or so. Even when I got it it was temporary for 30 minutes or so.

The doctor has given me glasses; Looks like it is +0.75 now in one eye and -0.25 in the other. He said he expected some regression but looks like it did not happen. He says it is too early to tell - sometimes it happens between 3 to 6 months period.

However, since I do not get those pains and I can read properly without those +0.75 glasses, do I need a correction ? or just let it go? Not sure what to do..

Thanks for the great information in your website.
Mike
 
Posts: 22
Joined: Thu Sep 14, 2006 5:58 pm

Postby LasikExpert » Wed Oct 11, 2006 7:06 am

Whether or not to have enhancement surgery is just like whether or not to have initial surgery. It is a matter of potential benefit against potential risk.

At age 37 your small amount of hyperopia (farsighted, longsighted) vision is probably not too problematic. It appears that your natural lens has learned how to "focus around" the hyperopia, but that ability will soon be limited. In 3-8 years as presbyopia becomes more problematic the hyperopia will exacerbate the situaiton.

You may want to discuss your doctor's policy regarding enhancements and determine how long you can wait before making this decision.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
LasikExpert
Site Admin
 
Posts: 3309
Joined: Fri May 12, 2006 6:43 am
Location: California

Postby Mike » Wed Oct 11, 2006 10:30 pm

I am not sure if I understand your reply properly. Does it mean that I need the glasses in 3-8 years time to just read? If I get prespobia
around that period then I need the reading glasses anyway right? But at that time I will not be needing the glasses for other activities -
I need not wear it all the time .. correct?

Thanks
Mike
 
Posts: 22
Joined: Thu Sep 14, 2006 5:58 pm

Postby LasikExpert » Wed Oct 11, 2006 11:17 pm

In a few years you will have two problems. One is the small amount of hyperopia (farsighted) vision that you have today and (I assume) will have in the future. The other problem will be presbyopia.

Presbyopia is when the natural lens of the eye cannot change focus for items near. Many people simply wear reading glasses when near vision is necessary.

The combination of hyperopia and presbyopia tends to provide poor vision quality at all distances. This may not be as problematic for you because you have relatively low hyperopia, but it will be an issue. Although reading glasses will be helpful, you may find that your motivation to have enhancement surgery to resolve the hyperopia is much greater when you are also dealing with presbyopia.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
LasikExpert
Site Admin
 
Posts: 3309
Joined: Fri May 12, 2006 6:43 am
Location: California


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