Double vison

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Double vison

Postby Button1 » Sat Jan 20, 2007 1:27 am

I can't find the original thread where I asked this question so I'll have to repost. Sorry about that.

Anyway, I am nearly 6 months post Custom Intralase LASIK and have been experiencing double vision with numbers and letters at a distance. It happens with both eyes open and with one open at a time. Things quickly come back into focus but it's pretty annoying. I have no problems with dry eyes (my three month check-up showed "excellent tear film.")

Any thoughts?
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Postby DemEyes » Sun Jan 21, 2007 11:08 pm

Have you been tested for muscle imbalance...overconvergence for example?
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Postby Button1 » Sun Jan 21, 2007 11:25 pm

DemEyes wrote:Have you been tested for muscle imbalance...overconvergence for example?


No...but I didn't have this problem before the surgery.
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Postby LasikExpert » Mon Jan 22, 2007 4:30 am

DemEyes wrote:Have you been tested for muscle imbalance...overconvergence for example?


Button1 mentioned that the doubled vision occurs with only one eye open. A convergence issue would thereby not likely be the problem.

Doubled vision with only one eye open tends to indicate astigmatism or an irregular cornea, however your statement that things come back into focus quickly would indicate that this is related to accommodation. Accommodation is when the natural lens of the eye changes shape to change focus, however we may be getting ahead of ourselves. Please clarify your symptoms.

With the left eye covered, are you able to experience doubled vision?
Yes, No, Sometimes
If Yes or Sometimes, does the doubled vision resolving with focus?

With the right eye covered, are you able to experience doubled vision?
Yes, No, Sometimes
If Yes or Sometimes, does the doubled vision resolving with focus?

With the both eyes open, are you able to experience doubled vision?
Yes, No, Sometimes
If Yes or Sometimes, does the doubled vision resolving with focus?
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Postby Button1 » Tue Jan 23, 2007 12:20 am

That would be:

Sometimes and yes for the first and second question and yes and yes for the third.

I mentioned this to my doctor at my last visit and he didn't say anything.
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Postby LasikExpert » Wed Jan 24, 2007 7:16 pm

I believe you may have a combination of issues contributing to your symptoms.

Doubled vision or ghosting in one eye indicates an irregularity. This is commonly regular astigmatism that is induced or not fully corrected by surgery. The reason you gain clarity with focusing may be because of pupil size reduction. When we focus, our pupils tend to constrict. A constricted pupil would likely block light that travels through an irregularity at the edge of the cornea, such as astigmatism.

Doubled vision with both eyes open may indicate a convergence issue. When focusing on an object close, the eyes point together and converge (cross-eyed). If there is an alignment problem, then it may resolve with focusing not because of the focus, but because of the eye alignment.

If this problem persists, you should seek an accommodation and convergence specialist. A strabismus expert may be the best choice. Strabismus occurs naturally and would likely be covered under your major medical insurance.
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Postby Button1 » Thu Jan 25, 2007 12:33 am

Thanks for the info, Glenn. But does this mean that my problem was caused by the Lasik, since I didn't have it before the procedure??
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Postby LasikExpert » Thu Jan 25, 2007 12:52 am

The ghosting in a single eye is probably astigmatism. It could be astigmatism that was not fully resolved by surgery, astigmatism induced by surgery, or astigmatism induced or exacerbated by Lasik related dry eye. One would need to compare preop and postop evaluations to be sure.

The two-eye alignment issue is not quite so simple. There is nothing about the surgery that would normally cause a misalignment, but if it did not exist before surgery and does exist after surgery, then it is very likely it was caused by surgery or is a previous condition that was borderline and was exacerbated by Lasik.

I suspect that at least part of what is happening is caused by the change in accommodation and convergence/divergence because your eyes are trying to adjust to the new range of vision. You may want to read about Lasik eye strain. There is a lot of detail about convergence that may be helpful.
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Postby David White » Tue Jan 30, 2007 4:49 am

LasikExpert wrote:The ghosting in a single eye is probably astigmatism. It could be astigmatism that was not fully resolved by surgery, astigmatism induced by surgery, or astigmatism induced or exacerbated by Lasik related dry eye.

Interesting stuff. 5 months after LASIK my left eye has no ghosting but my right eye has a very noticeable one. It remains with both eyes open, I assume it's the ghosting from the right eye that I am seeing with them both open. But with my right eye closed, my left eye sees no ghosting.

I didn't realize that LASIK could induce astigmatism, I'll have to ask about that at my 6 month checkup. The ghosting does go away with eye drops but only for a very short time.

The ghosting in my right eye also goes away if I partially close my eyelids from the top - not close to a full squint but just a small partial closing - does that indicate anything ?
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Postby LasikExpert » Tue Jan 30, 2007 5:51 am

Your symptoms could be from astigmatism in the right eye or a bit of dry eye. Your eye doctor will be able to provide a current prescription that will indicate if you have astigmatism and will be able to examine your eyes for signs of dry eye problems.
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Postby Mike » Tue Jan 30, 2007 3:50 pm

Hi.

Can the astigmatism ( and hence the double vision) be corrected with glasses?

thanks
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Postby LasikExpert » Tue Jan 30, 2007 7:04 pm

If it is regular astigmatism then it will be able to be corrected with glasses or contact lenses. If it is irregular astigmatism (a bumpy corneal surface) then glasses may correct it, however contact lenses may be required. Since you mention a single doubled image it would appear that you have regular astigmatism.
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Postby Button1 » Tue Feb 06, 2007 11:41 pm

Had my 6 month check up yesterday and my doctor said everything looks great and my vision is actually 20/20 in both eyes (but I notice that my right eye is MUCH weaker, which it was prior to surgery as well.) I asked about the double vision and he really couldn't explain why I was having it and said the surgery itself couldn't cause it....he did mention the fact that the eyes cross as we look close at things and then go back to normal to look far away, however. And since I am wondering just what the problem is (and if there is actually one at all) I noticed at work that this only happens with both eyes open and when my right eye is open and left is closed, not all three as I previously thought.

Anyway, I seemed to have healed well and don't need an enhancement which I am very happy about!!
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