RK left eye 1986/ Poor vision with glasses! No one can help

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.

RK left eye 1986/ Poor vision with glasses! No one can help

Postby koko » Sat Nov 18, 2006 3:42 pm

Hi, I'm new to this message board, but certainly not alone in my problem, I see. I had RK surgery done in New Orleans in 1986 on my left eye only (thank God). I couldn't wear contact lenses because of dry eyes. Now I'm farsighted in the RK eye with virtually no night vision. Even with glasses I can't see to read with that eye, and although it is technically 20/30 corrected, everything looks slightly distorted all the time. Pre RK, the vision was 20/400 with astigmatism. Now I have one eye that is -3.50 and the other that is +2.25 ("sphere") on my newest RX for glasses. I got an opinion at Emory Eye Clinic in Atlanta and was advised to "wait for new technology" and in the mean time get a rigid, gas permeable contact lens for the RK eye. However, my eye is more dry than ever since the surgery, so I don't consider that an option. The DR. recommended Restasis....I feel hopeless. He couldn't believe that with the difference in the lenses that I wasn't having headaches or double vision, but I guess I'm fortunate there.....I'm glad to have found this forum. :shock:
koko
 
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Location: Atlanta, GA

Postby LasikExpert » Sat Nov 18, 2006 7:28 pm

Many individuals who had Radial Keratotomy (RK) many years ago have experienced a shift in visual acuity toward hyperopia (farsighted, longsighted) vision. Some of this shift may be natural.

Many people become less myopic (nearsighted, shortsighted) in the fifth and sixth decade of life. If you compare today's prescription for the right eye (without RK) to the prescription in 1986, you may find a significant difference. Your right eye may have become a little less myopic, but since you had your left eye previously corrected with surgery, it has become hyperopic. I doubt that natural hyperopic shift would explain all of your current situation, but it may be responsible for some.

Hyperopic shift is obviously a part of the problem, but the greater issue is undoubtedly presbyopia.

Presbyopia is when the natural lens of the eye is less able to change shape to focus on objects near. Presbyopia usually becomes problematic at about age 40. The combination of hyperopia and presbyopia often provides poor quality vision at all distances. The answer to this problem is to correct the hyperopia.

Your current hyperopia would be vastly improved with glasses, but due to the physics of hyperopic correction you would be much better corrected with a contact lens. New contact lens materials that allow more air to pass through the lens make contact lens wear much more comfortable. Even the new technology rigid gas permeable (RGP) contacts are much more comfortable than those in the past. A scleral lens can sit over the cornea, needing to touch only the outer white part of the eye.

If you are fully presbyopic, an alternative that may be appropriate is Refractive Lens Exchange (RLE).RLE is the same as cataract surgery. The natural lens is removed and replaced with an artificial lens that is calculated to correct your hyperopia. If your cornea is stable, RLE may be an appropriate method to resolve your refractive error.

The fact that you do not have great difficulty with depth perception, headaches, nausea, or vertigo with such a significant difference in visual acuity from one eye to the other is quite remarkable. I don't think you would consider yourself "lucky" with this situation, but you are fortunate that you do not suffer these problems.

Restasis is an anti-inflammatory that is FDA approved for the treatment of dry eye. We also have a detailed article about Dry Eye Treatment that you may find valuable. It relates mostly to Lasik, but the management techniques apply to just about all situations.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
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I am not a doctor.
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Postby koko » Sun Nov 19, 2006 4:01 am

Thank you so much for your prompt reply. I am almost 45 yrs. old. In your opinion would you "save" the RLE for the day when it may be necessary for cataracts? Is it too invasive to do right now for my current situation? I seem to be able to tolerate glasses for the most part, although I know this situation is far from ideal. I also experience a lot of "floaters." The scleral lens sounds very promising and I will look into it. My right eye is dominant. Is there any harm in that it is doing the majority of the work? I rely on it for near and far vision, and for acuity. My left eye seems useless at this point. My newest lenses are Varilux progressives and my right eye is corrected to 20/10 with excellent reading/up close vision. This website is wonderful and you are providing a much needed service that I greatly appreciate! Thanks again. P.S.: Is there a chance that I'm dealing with "haze?" Also, my pupils are very large and I've been told that in dim light I'm seeing through scar tissue. Could this also be happening in regular light?
koko
 
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Joined: Fri Nov 17, 2006 7:43 pm
Location: Atlanta, GA

Postby LasikExpert » Sun Nov 19, 2006 6:38 am

I suspect that you will be very happy with the new technology contact lenses. See your doctor with an open mind and try what s/he recommends. Don't be surprised if a disposal soft lens works great.

RLE is probably best suited for someone who is fully presbyopic, but with your amount of hyperopia. refractive error imbalance between eyes, and history of RK for mild myopia, it seems that it may be an appropriate surgical option. RLE is invasive and carries real risk, as does all surgery. You will need to discuss in detail your specific risks with your doctor before you make a decision.

Depending upon the size of your RK incisions, their locations, and the size of your naturally dilated pupils, it is possible that light disturbed by the RK incisions is reaching your retina and being "seen". This often presents as very well defined starbursts.

Depending upon the size of the central untouched area of the cornea and the size of you pupils in a well-lit area, you may have some disruption from your RK incisions in the daylight as well. This too would probably present as well defined starbursts.

Unless there is something medically wrong with your eyes, at this point undiagnosed corneal haze does not seem likely.
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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