Overcorrection/dbl vision/ghosts

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Overcorrection/dbl vision/ghosts

Postby Kper » Tue Aug 11, 2009 11:11 pm

Had Wavelight IntraLase (whatever all that means) 12 days ago. I'm a 44 yr old male.
Pre-op I was -2.50 left and 1.50 right with some astigmatism. I also had a 30 year old injury to the left eye (scar) that was out of my line of sight and deeper than the cut for the flap. The flap for the left eye was reduced in size to the smallest size the doc said she could comfortably go. Initially, I thought she did that to avoid the scar but later learned the flap was cut through the scar anyway. She also said she was going to go just a bit deeper with the flap because of the scar.

My right eye is fabulous! Vision is crisp and newspaper print is readable at about 12 inches.

The left eye not so good. I knew right away it wasn't right.
My vision is blurry at all ranges and reading is near impossible. My first night time drive revealed I had double vision noticeable at a distance. For instance, tail lights at about 100 yards have a second image directly below the first about 12" on the vehicle (at 100 yards). Once within 30 to 40 feet of the vehicle I notice a ghost at the 4 to 5 o'clock position.

After my first visit with staff that insisted I was 20/20 and to give it time, I demanded a visit with the surgeon who put me through a battery of tests and revealed I was over-corrected +1.00. She also suspects that, because of the scar, I have some swelling (edemaaround the scar. She put me in corrected lenses to prove her point about the over-correction and objects were still fuzzy - I suppose from the double vision of sorts.

Are over-corrections a result of miscalculations or are they really just the way the eye responds to treatment regardless of whether or not the surgeon had it spot on? Funny thing is I could see the green light pretty well with my left eye and knew I was right on it, but with the right eye couldn't see much of anything.

Now I am on Muro 128 to help reduce any edema and Acular LS to help regress my vision.

I know giving advice via a forum like this not practical, but all I'm seeking is professional opinion.
Do my symptoms "sound" temporary considering what I have said?

Is there any way to tell how much regression I can realistically expect from the Acular?

After 3 months of healing, providing I have not regressed far enough, is an enhancement back the other way risky?

Thanks!
Kper
 
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Re: Overcorrection/dbl vision/ghosts

Postby Kper » Tue Aug 11, 2009 11:26 pm

I should note that I have been on the Muro and Acular for about 5 days with no noticeable improvement... other than my brain blocking out my left eye and using my right eye predominately.
Kper
 
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Re: Overcorrection/dbl vision/ghosts

Postby Kper » Thu Aug 13, 2009 1:19 am

Nothing?

Would it be reasonable to say I should focus fairly well at about 1/4 mile with a +1.00?

The headaches, left eye strain and fatigue is killing me.
Kper
 
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Re: Overcorrection/dbl vision/ghosts

Postby LasikExpert » Thu Nov 12, 2009 7:53 pm

Kper wrote:Are over-corrections a result of miscalculations or are they really just the way the eye responds to treatment regardless of whether or not the surgeon had it spot on?


Both are possible, but the corneal scar may have contributed. The more dehydrated the cornea, the more efficient the laser energy and the more tissue that is removed with each pulse. It is possible that the corneal scar disrupted normal fluid flow through the cornea and thus your cornea was drier. It would not take much difference off the norm to cause a 1.00 diopter change. One diopter is about 12 microns of tissue removal. A human hair is about 60 microns thick. Then again, it may have had nothing to do with the pre-existing scar.

Kper wrote:I know giving advice via a forum like this not practical, but all I'm seeking is professional opinion.
Do my symptoms "sound" temporary considering what I have said?


The overcorrection will likely be diminished by the treatment plan and controlling the would response, but it is not highly likely that you will get a full one diopter change. A bit of residual overcorrection is a reasonable expectation.

Kper wrote:Is there any way to tell how much regression I can realistically expect from the Acular?


Only in hindsight. You can know how much Acular did, but not how much it will do.

Kper wrote:After 3 months of healing, providing I have not regressed far enough, is an enhancement back the other way risky


This depends upon where your eyes settle. Hyperopic (farsighted, longsighted) correction is more difficult than myopic correction, but you will will need a small correction. Your doctor better understands how your cornea reacts to the laser energy and can adjust to compensate. Enhancement surgery may be considered appropriate, but the relative value will depend on many factors.


Kper wrote:Would it be reasonable to say I should focus fairly well at about 1/4 mile with a +1.00?


No. At age 44 you undoubtedly have presbyopia, which is when the natural lens within the eye is less able to change focus for near objects. The combination of hyperopia and presbyopia tends to produce poor vision quality at all distances.

Kper wrote:The headaches, left eye strain and fatigue is killing me.


This is very consistent with hyperopia and presbyopia. Your eye is attempting to "focus around" the hyperopia. You have some ability to do this, but the ability is limited by your presbyopia. The eye is working hard to correct the situation and this can lead to headaches, poor depth perception, physical fatigue, even nausea and vertigo. See our article about Lasik and eye strain.
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