double vision prk

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double vision prk

Postby GeneralPatientInquiry » Wed May 31, 2006 5:16 am

Glenn. I have had PRK, 5 1/2 weeks ago. We have discoursed on the newsgroup alt.lasik.eyes, and I posted a reply for you, but you haven't yet seen it.
I see my surgeon tomorrow. I suspect that the monocular diplopia which I am experiencing is due to an irregularity on the corneal surface, as it clears for about three seconds with application of a viscous eyeage drop "Refresh Tears" as you sugggested. I did have trouble with the contact lens bandage after 4 days post-op, but the surface apparently closed up promptly, after re- installing another lens at days 6 thru 8.
My query is: Is monocular diplopia a fairly common part of the corneal healing process, and it is generally transient in nature ie, in what percentage of post-op cases who experience this resolve, and what percentage have more permanent issues with it. I will be greatly relieved to hear you say that only 1% of those who experience this have long term difficulties

Thanks greatly

Stuart
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Postby LasikExpert » Wed May 31, 2006 5:18 am

If you are going to have a problem with PRK, this is the one you want to have.

From what you have related, it would appear that your epithelial layer has not quite reformed and remodeled. This can take a few months to fully resolve. Monocular diplopia, or as it is more commonly called; ghosting, is common as the epithelial cells regenerate. The problem is often exacerbated by dry eyes. The fact that you can get excellent vision with a high viscous eye drop indicates that this is a healing issue that will resolve on its own with no additional treatment beyond management of dry eye, if dry eye actually exists.

Let us know what your doctor finds at your appointment.
Glenn Hagele
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Postby GeneralPatientInquiry » Wed May 31, 2006 5:21 am

Thank You Glenn;

After looking at some research articles on the histological review of rabbit and rat corneal healing post PRK, I am inclined to agree with your reply.
It is interesting in that the replies to this question varied depending on who I was asking.
An Optometrist, who uses the contact lens approach to treating monocular diplopia post-PRK sounded somewhat pessimistic, although he admitted, most of his patients were months or years post-PRK and he say very few at a month or so after the procedure.
He very clearly suggested I not get any further surgery, and to see a contact lens expert.
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Postby LasikExpert » Wed May 31, 2006 5:23 am

Stuart,

A contact lens can be an appropriate approach to your problem. As you recall, a bandage contact lens was applied immediately after PRK surgery. This was to provide protection and possibly some refractive error correction. A contact lens can help smooth the epithelial layer, however even the very best of contacts can reduce the time for full recovery. If the vision is disruptive enough to limit your daily activities, discuss using a contact lens with your surgeon. If you can put up with the irregularity, you can wait for the eye to do it on its own. If after another 2-3 weeks you do not see significant improvement, a contact lens for smoothing purposes would probably be a requirement for a short period of time.

You are quite correct that diagnosis, prognosis, and treatment can be very different depending upon who you ask. There is that old saying that if you are a hammer everything looks like a nail. It seems to apply to healthcare. Yet another reason to not go to a urologist when you have an eye problem!

Glenn
Glenn Hagele
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USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
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Postby GeneralPatientInquiry » Wed May 31, 2006 5:24 am

Thanks very much Glenn. I feel much much more confident now. What I didn't realize was that the actual haze, which is fairly pronounced in my case, can actually bend the incoming light to the point of causing ghosts. Hence, as soon as the haze resolves, so should the ghost effect, I think.

Stuart
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