Seeing "dots" at night...anyone else?!

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Seeing "dots" at night...anyone else?!

Postby freakonaleash » Tue Mar 27, 2007 4:05 am

I had Lasik (Bausch and Lomb laser) April 2006. Mild myopia before: -2.25 and -2.50. Great daytime results, but at night with my right eye only I am seeing, stationed right below any bright light, a pattern of dots. About 14 to 16 of them on average; more if the light is big and bright,. less if dimmer. Little dots all in rows. Weird, huh? I have not heard anyone else reporting this. Any idea what is going on? My surgeon called Bausch and Lomb, even, and they weren't sure. He is saying it's a residual amount of prescription (he did some hocus pocus with temp. lenses and frames that reduced the appearance of the outermost dots a *tiny* bit) but I am concerned and don't want to have the recommended enhancement until I am sure of what is causing these dots. Does anyone know what this is, or am I crazier than I thought? I'll also add that I had very little trouble with dry eyes. Thanks!!
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Re: Seeing "dots" at night...anyone else?!

Postby LasikExpert » Tue Mar 27, 2007 2:51 pm

This is a new one for me, unless what you describe as dots is described differently by others. Individual and clearly defined dots could indicate very dry eyes or material in the interface of the Lasik flap. I assume that your doctor has tested you for dry eye and you report you had very little trouble with dry eye. I also assume that your doctor has visually inspected the area where you see the dots.

Was your flap created with a laser or mechanical microkeratome using a blade?

Do you know if the hinge of your Lasik flap is superior (top of your eye) or nasal (toward your nose?)

Will the dots disappear if your pupils are artificially constricted?

Are the row of dots parallel, perpendicular, or at an angle to the horizon?

Are the dots in a square grid or do they radiate like the spokes of a wheel?

Do the dots have even spacing between each?

Were the dots visible immediately after surgery or later?

Has the quantity or quality of the dots changed in the last year?

Is any particular type of artificial light better or worse? An example would be that older car lights are less, newer car lights are move, florescent lights are the worse, incandecent lights are the best, etc.

Is there any special testing your doctor has performed, such as retro-illumination, wavefront diagnostic with and without pupil dilated, Pentacam, optical coherence tomography (OCT), Artemis very high frequency (VHF) digital ultrasound? If yes, what was the result?

Have you been evaluated by a corneal specialist?

Have you been evaluated by a retina specialist?

Do you take any medication of any kind on a regular basis?

Do you take any supplements of any kind on a regular basis?

What other personal health issues have you had over the last year?
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RE: Seeing dots at night...anyone else??

Postby freakonaleash » Tue Mar 27, 2007 4:25 pm

My flap was created with a microkeratome, and it was a superior (top) flap. They haven't artificially constricted my pupils, other than shining a flashlight at them in a dark room, which likely didn't constrict them. The dot patttern is in straight rows, not straight down but angled slightly to the left. Maybe a can find a way to draw it for you and email it. It is in a rectangular grid pattern. It is mostly even spacing, though some the dots away from the center seem to "melt" together, the way lines of clouds sometimes do in the sky. This all became visible after the post-op "foginess" disappeared. Since appearing, they have remained unchanged. The dots appear more or less the same regardless of light source - even red or green stoplights work - only that with brighter light I see more dots, with dimmer light I see fewer (the dots at the outermost edges of the grid fade). Lights under "shades", such as lamposts or sign lights, do not produce this effect, of course. I think my surgeon did OCT; he had these red, green, and yellow "maps" of my eyes. I had to look at a cross shaped pattern and stare and be very still and open my eyes VERY wide. I thought I had been told that this test really should be done with dilated eyes after the first time, but maybe they didn't want to dilated me because I had my daughters with me, but the second trip I took my husband to drive but they still didn't dilated them. For the record, I was told from the beginning that I had nice, small pupils. They said they were looking for HOA and said after 1st test they didn't find anything, repeat test a couple of months later said there was a "hint" of an HOA (I think they didn't find a thing). They did some other test where I had to look at a pic of a hot air balloon on the horizon down a road. Sorry I don't know more about the tests. I haven't seen a corneal specialist or a retina specialist, only my Lasik surgeon. After first meeting about this, my surgeon mentioned maybe seeing a retina specialist, but we didn't see why we should pay for the specialist when we paid the Lasik people for after-care. He also mentioned debris under the flap, but said he didn't think that was it. You haven't asked me where I had this surgery done, so I will assume you don't wish to know unless you do ask. I am confused and getting scared and I feel desperate to find out what's really going on here. I am grateful for all of your help. Thank you!!
Oh, I forgot..I take buproprion and Lithium on a daily basis, as well as Zyrtec. They said none of these should be a problem. Zyrtec is prescribed for 10mg. a day, but I usually only take 5. Thanks again!!!
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Re: RE: Seeing dots at night...anyone else??

Postby LasikExpert » Tue Mar 27, 2007 10:16 pm

freakonaleash wrote:I think my surgeon did OCT; he had these red, green, and yellow "maps" of my eyes.


It may be OCT, but that sounds like an Orbscan that will provide topography maps of the front and back of the cornea. Dilation is not necessary.

You should report the problem of a light grid to your general physician. You may get a referral to a retina specialist or a second opinion ophthalmologist through your major medical insurance plan.

Debris is an obvious thought, but debris is rarely so nicely patterned. It's possible, but unusual.

Where you had the surgery is not an issue in researching answers to your questions. If you need a second opinion, I will gladly help locate someone nearby, but your doctor would be able to do this too.

Zyrtec is an antihistamine for allergy symptoms. Buproprion is a norepinephrine reuptake inhibitor. Both can cause dehydration and dry eye issues. I cannot find anything in the medical literature regarding these meds and Lasik.

It doesn't seem I'm of much assistance. I think an OCT or Artemis would do a good job of showing foreign objects.
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RE: Seeing "dots...

Postby freakonaleash » Tue Mar 27, 2007 10:54 pm

You suggested I report my light grid to my general physician, but isn't he going to say, well this was obviously caused by your Lasik, so go back to your surgeon? This was caused by my Lasik, of that I am sure. And yes, now that you have said it, it was an Orbscan that he did. Will my Lasik place even have the equipment to do the OCT or the Artemis? I'm sorry to keep bothering you about this, and I really appreciate your help. The doc says this is a residual amount of prescription and he want to do an enhancement but I'm worried he is saying this for lack of a better diagnosis. Why do I have to be the only person I have ever seen reporting this? Is there any chance this could be a decentered ablation? Thank you!!!
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Postby LasikExpert » Thu Mar 29, 2007 3:08 am

You never need to apologize for posting your concerns in this forum. That is why it is here.

The Artemis is quite rare. I think there are around two dozen in the US and not all are available for clinical use. OCT is more common and may be able to provide the information needed.

Of course the timing indicates this was caused by Lasik, but it is such an unusual event that it is necessary to eliminate all other possible causes and contributors. Also, this is going to be a very stressful time. Seek and keep care in that regard too.

A decentered ablation would not provide the symptoms you describe.

This is a case study that should be published in the medical journals so others can benefit from what is known about your experience, and you can benefit from what has been learned from anyone else who may have had this kind of problem. I've not heard of it and I can't find it in the journals, but with millions of Lasik surgery it seems likely that someone else has ran into this. It is possible that you are the only one (dubious honor), but that is not probable.

Please email me directly. Perhaps I can direct you to a researching corneal specialist who may have the equipment and expertise to diagnose and treat. This would also be someone who can put your symptons "on the wire" to other surgeons and compare notes.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
LasikExpert
Site Admin
 
Posts: 3309
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RE: email me about "dots"

Postby freakonaleash » Thu Mar 29, 2007 1:18 pm

Glenn,
I click on the email icon but nothing happens :( I'm anxious to get some info. from you; my email address is on my profile, if you could send me yours. Thanks!!
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Location: Richmond VA

Postby DryEye » Thu Mar 29, 2007 1:42 pm

When I wake up in the early am or get up in the middle of the night(dark) I see some weird flashy like (similar to what we see sometimes on TV when light reflects on some object on an angle...someone's Tie, Basketball floor, etc.) on the lower portion of my eyes for a minute or two. If I awake after my eyes take light in it doesn't seem to be there. This started happening about 3 months after CustomVue.
Also, news wires I watch all day long on my computer screen are not as crisp outside the center portion of vision. Again, had tests done and they say all is normal.
There has to be an answer other than being told I am just more sensitive than others by my original lasik doc. - One of the reasons I seeked other opinions, which I am glad I did.
I've brought it up to various docs I have seen and have had tests done, but none seem to have an answer or seem to be concerned.
Some thoughts were dry eye, possibly HOA's, circulatory
I know this stuff wasn't there before lasik and I don't think its normal.
As for money & time being spent since the procedure - Crazy!
I guess time will tell hopefully for the better.
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