Night Vision and Severe Astigmatism

If you are thinking about having Lasik, IntraLasik, PRK, LASEK, Epi-Lasik, RLE, or P-IOL eye surgery, this is the forum to research your concerns or ask your questions.

Night Vision and Severe Astigmatism

Postby jocelyne » Mon Jul 09, 2007 2:36 pm


I'm in the process of going for a few consultations with some different doctors and would like some advice.

Here are my stats from my first consultation:

Right: -5.5 -2.25x010
Left: -5.75 -2.75x170
Pupil Size: 7.5mm
Cornea thickness: I don't remember, but she said it was average thickness whatever that is...

The first consultation I went to I only spoke with their technician and she said the doctor would probably want to perform PRK and that I would most likely regress and require additional surgery to correct a diopter. Apparently with my prescription, they'll have to take off quite a bit of cornea and PRK allows them to save as much as they can, which is important since I'll be needing an enhancment. (enhancement is included for the first 3 years) Does PRK sound like the best choice for my pupil size and level of astigmatism??

My second vision is with this whole night vision thing. With large pupils and bad astigmatism, I am certainly at risk. For this reason I started looking at all the "this is what my vision looks like after lasik" websites that showed pictures of car headlights at night time with halos and blurrs around them. WELL what a wake up call for me....that is what my night vision looks like now. As far as I could remember, that's what night vision is like, and I always just assumed that's what everyone's night vision looks like. I wouldn't call my night vision problems severe, because I still drive at night all the time, but I would say I get starbursts around things like street lights and stop lights that are fairly transparent and spaced out, but that extend for about 1/2 of my visual area.

My real question is, will refractive surgery make this worse?? Could it possibly improve my situation?? If I ended up with the same level of night vision problems I wouldnt be too concerned, since I've been able to live with it until now.

Any advice would be great. Also, if you have night vision "problems" pre-lasik/prk let me know!!

Thanks :)
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Postby houstonman » Mon Jul 09, 2007 2:39 pm

I cant help that much since im not a doc... however as far as the night vision issue my doc was telling me something in the ball park of my pupils or whatever were too big and anywhere else I would have halos and ghosting for sure however he has this machine that can go wider than others and would exclude me from having any sort of ghosting. Not sure exactly what hes going to do or how but It made sense, heh.
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Postby lvziggy » Mon Jul 09, 2007 5:08 pm


When you say you have night vision problems now, is that because you wear toric contact lenses? I had PRK done in March and am thrilled with the results. Before my surgery I had a prescription similar to yours but with a little less astigmatism. But I did wear toric contact lenses and those made me see the halos and starbursts at night. I didn't see them if I just wore my glasses. My pupils are a little on the large side too, 7, I think. That's one of the reasons my dr. thought I would do better with PRK than Lasik. I have very little problem seeing at nite now that I had the surgery. Very mild halos and only on certain lights. I would definitely recommend having PRK inspite of the longer healing time.

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Postby jocelyne » Mon Jul 09, 2007 9:14 pm

I have the starbursts and glare with my contacts and with my glasses. It's harder to tell if I have them without either, but I think I do. Without my glasses on, lights definitely are a hazy blob, but it may just be because of my nearsighted-ness. If I squint a little bit, the hazy blobs do look like starbursts. I was at another consultation today at another clinic and actually left pictures off the internet of what my night vision looks like and they are going to consult with the surgeon. The optometrist originally suggested LASIK but after I pressed on about my concerns she eventually told me about the PRK option to reduce the risk of night vision problems.

I also found out something a bit unsettling...I have dry eye apparently. I have certainly have had discomfort with my contacts in the past, especially if I have been wearing them for a while. She said she could see some "dry spots" near the bottom of my eye.

I was really concerned by this. If I already have dry eye symptoms and if I already have night vision issues, doesn't this make me at particularly high risk of having both of these issues exasperated by surgery?? She suggested that I start on eye drops right away and gave me some Refresh Tears. I've also only been out of my contacts for about 3 days. I am willing to tolerate some temporary dry eye after surgery, but I would be upset if it was so bad that I couldn't function or read for extended periods of time (I am a full time student) or if the dry eye problem was permanent.

How dry is too dry to move forward with surgery??

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Postby jocelyne » Mon Jul 09, 2007 9:43 pm

as far as that fancy "machine" may be talking about the Baush and Loamb (sp?) Zyoptix, which will be used for my surgery. Both locations I visited have one and recommended it for my procedure.
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Postby Betty39 » Tue Jul 10, 2007 1:45 am

The dryness issues are a MAJOR concern. I did not have any dryness issues that I knew of pre-lasik. They told me later perhaps I was "boarderline." I ended up with very painful, dry eyes. They are improving but only with Restasis, plugs and it has been 9 months of hell. There are many more out there with long term lasik induced dry eye.
You need this treated before you do any type of eye surgery. And even then you would probably do better with a surface ablation technique like PRK.
Also, anyone with severe lasik induced dry eye can tell you, this isn't like your average dry eye. This a very chronic and painful condition that can be very harmful to your eye health if it is long term. Everyone (almost) gets temporary dry eye from this surgery. If you already have dryness issues you are more likely to have severe, often debilitating, dry eyes.
Not to scare you...just be very careful and forwarned in your decision. They surgeons play it down but it can be horrible.
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