Astigmatism & Such

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.

Astigmatism & Such

Postby DryEye » Thu Jul 05, 2007 7:36 pm

Is anyone suffering from leftover astigmatism from original procedure?
If so, where & how do you notice it during the day/night?
Is anyone suffering from anything else post initial lasik and where and how do you notice it?
Thanks!
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Re: Astigmatism & Such

Postby JPD » Thu Jul 05, 2007 8:14 pm

DryEye wrote:Is anyone suffering from leftover astigmatism from original procedure?
If so, where & how do you notice it during the day/night?
Is anyone suffering from anything else post initial lasik and where and how do you notice it?
Thanks!


I have ghosting around letters and numbers on things such as on TV or digital clocks. It appears, like all my problems, to be cuased by dryness. Eyes drops make them go away. I used to get them on things like street signs, but since my tear production has improved those are now gone. I still have the same amount of astigmatism now I did before hand, basically none.
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astigmatism

Postby noodles » Wed Jul 11, 2007 4:47 pm

Hi DryEye,
I have some astigmatism and have the same things JPD mentions. Ghosting/double vision & the LCD/Digital letters/numbers thing. Mine too is caused by dry eye from what my doctor can tell to date, and it continues to get better as time goes on and my tear production improves and eyes/brain get used to focusing, etc. I am at around 4 months post op, and I'm still seeing improvements -- very gradually, but still improvement. Are you having issues with dry eye and/or similar experiences?
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Postby DryEye » Wed Jul 11, 2007 6:05 pm

My eyes are dry, but the tests show astigmatism
I notice it more in my right eye.
The drops makes things more crisp and clear, but at 13 months out the drops are probably smoothing out imperfections on the cornea along with relieving the dry eye.
The things I noticed not right from the start haven't gotten better.
It took me seeking out one of the best docs in the business to tell me what was wrong.
My advice to anyone would be not to waste their time or money on docs that aren't in the top of this industry.
They are the ones who do the most, see the most, do the research and have the most data to give one better advice and more than likely better results.
Anyone can take a virgin cornea and do this surgery, especially with the forms they all make everyone sign, but that doesn't make it right.
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Postby JPD » Wed Jul 11, 2007 7:35 pm

DryEye wrote:My eyes are dry, but the tests show astigmatism
I notice it more in my right eye.
The drops makes things more crisp and clear, but at 13 months out the drops are probably smoothing out imperfections on the cornea along with relieving the dry eye.
The things I noticed not right from the start haven't gotten better.
It took me seeking out one of the best docs in the business to tell me what was wrong.
My advice to anyone would be not to waste their time or money on docs that aren't in the top of this industry.
They are the ones who do the most, see the most, do the research and have the most data to give one better advice and more than likely better results.
Anyone can take a virgin cornea and do this surgery, especially with the forms they all make everyone sign, but that doesn't make it right.



It sounds you definately have residual astigmatism then. My tests show basically no (same level as pre-op) astigmatism, yet I still have a ghosting problem. My very low astigmatism level is the exact same as before Lasik, and it was never enough to bother correcting with glasses or contacts, and I never had any sort of ghosting. It's caused by dry eye for me.

I'm curious though, did you used to have severe dry eye? After more then a year for you to still have dry eye is definately not normal. I would think you'd be recovered by now, unless your previous dry eye was severe. What does your new doctor say about when he expects your dry eye to recover? I'm also curious why you needed to see one the best doctors in order to find out you have astigmatism? The standard tests should all reveal that. Optometrists diagnose astimatism every day, why couldn't your old Opthemologist find that? It's weird.

I agree that everyone should only see the top doctors if they decide to have this surgery. One advantage for me living in Southern California, is we have many of the top Lasik doctors in the country right here. It's not a sure fire guarentee though. My doctor is considered excellent by reputation and he's been doing Lasik/PRK since the beginning, and is one of the most experienced in the entire country. Yet, I'm still here reporting problems. Fortunately, it looks very probably that nothing should be permenant. Before my Lasik, I had a few doctors in mind, and if I had it to do over again I would most likely pick someone else. However, I honestly don't think that would have led to any better results. I would mainly choose someone else becuase I've found out that a few of the other doctors provide better post-op care then what I've gotten. Where as the procedure by my doctor was top notch.
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Postby DryEye » Wed Jul 11, 2007 7:41 pm

I was able to wear my contacts all day long and only really feel dryness toward the end of the day. My right eye would feel more dry than my left.
Having to go to other docs to figure out what exactly was going on kind of plays to my point of seeing only the best - they know more and see more.
I saw better before and as for what I do from here time will tell.
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Postby JPD » Wed Jul 11, 2007 7:47 pm

DryEye wrote:I was able to wear my contacts all day long and only really feel dryness toward the end of the day. My right eye would feel more dry than my left.


Actually I meant what was your dry eye like right after Lasik? I'm sure it's much better now, but I was wondering if it was severe right after Lasik, which could explain why you still haven't fully recovered. But it sounds like you may have had a minor dry eye problem before your surgery which could also explain things.

Good luck with your new doctor. Having one of the best should likely fix you up. Because not only do those guys know how to do things right from the start, they are normally experienced in fixing other doctors mistakes.
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Postby DryEye » Wed Jul 11, 2007 7:52 pm

The procedure gave microstriae, dry eye unresolved astigamtism and increases HOA's - maybe something else that no one has told me thus far???
Sounds like you picked a great surgeon and you need a great co-manager or the ability to be able to contact that surgeon and notify him somehow of your issues. It can only make him better.
I know of one that is certified on this site that has a superb reputation amongst his peers and from what I saw and have experienced thus far excellent customer service and followup.
Does that mean he bats 100% all the time - No - But, he more than likely bats better than most in the industry.
Thanks -
Hopefully, things will work out for me in time with what i decide to do.
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Postby Betty39 » Wed Jul 11, 2007 9:47 pm

Even those with NO dry eye pre surgery (like myself) and those who only have mild to moderate dry eye after surgery (like myself) can have it be long term and chronic, (again, like myself)
My vision since surgery has been very good. The dry eye is my only issue. It never effected my sight. But yet here I am 9 months post op and it continues even though improved.
I have seen a great corneal specialist who put me on Restasis several months ago and that has helped a lot. But I am definitely not like I was pre-surgery when I could wear my contacts till the wee hours of the morning with no dryness issues.
It is a known complication of this surgery to have long-term persistant dry eye. We all hope that is not our fate. But it is good to prepare just in case.
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Postby JPD » Wed Jul 11, 2007 10:41 pm

Betty39 wrote:It is a known complication of this surgery to have long-term persistant dry eye. We all hope that is not our fate. But it is good to prepare just in case.


I agree with you, but that phrase also presents some problems. What exactly is meant by "long term"? Does it mean permanent, or a certain time frame, because it's very vague? I presented this question to Glenn, and he told me his organization defines it as any problem persisting past 6 months. So you fall into that catagory, and based on the rate I've progressed thus far I believe I will fall into that catargory also once I pass the 6 month mark. Glenn also told me that his group found that only about 3% pf patients ever fall into this long-term catagory. If that in fact is true, then I personally couldn't consider long term dry eye to be a major issue in regards to Lasik. I still don't know if 6 months is the industry standard regarding "long term". My doctor was very upfront about it and told me it would take a minimum of 6 months, but more like 6-12 months before my tear production was back to normal. If that's the case then my doctor seems to think the majority of people have long term dry eye. This the reason he tells all his patients to use artificial tears for a minimum of 12 months regardless of whether their eyes "feel" dry or not.

Even though I believe I will fall into the USAEyes definition of long term dry eye, it seems it will be within my doctors range of "normal". As long as it's not permenat, I guess I will be happy.

One last thing, I was like you. I would wear my contacts 16 hrs. a day 7 days a week and never have any sort of dryness. After lasik I was probably moderate dry eye, and I believe I'm now mild dry eye. Then again, I believe mild is where most post Lasik patients start, so it's a longer road for you and I.
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response

Postby noodles » Wed Jul 11, 2007 10:58 pm

JPD, how long ago did you have your surgery?
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Postby Betty39 » Wed Jul 11, 2007 11:16 pm

"If that in fact is true, then I personally couldn't consider long term dry eye to be a major issue in regards to Lasik"


I beg to differ here. I know in my case and MANY others out there (go to the dryeye zone site on the web) Lasik induced dry eye is a MAJOR issue effecting a lot of unfortunate people out there. I've read that it's the #1 permanent side effect. Some people have been this way for years. It's rare but if it happens to you the fact that it is rare is of little comfort.

Hopefully all of us here will not be unfortunate enough to have this be permanent. But it is on the consent form that it could be.
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Postby JPD » Wed Jul 11, 2007 11:59 pm

Betty39 wrote:I beg to differ here. I know in my case and MANY others out there (go to the dryeye zone site on the web) Lasik induced dry eye is a MAJOR issue effecting a lot of unfortunate people out there. I've read that it's the #1 permanent side effect.


I completely understand you disagreeing, but I have to respectfully say, you're looking at it the wrong way. You're looking at the total number of people effected. If you do that, then yes it's a lot of people. But when the numbers are this big you have to look at the percentages. I'll explain what I mean. Let's say there have been 15 million Lasik surgerys(I think that is roughly the correct number). 3% of that is 450,000. That is a crap load of people, and I can understand why it looks as though there are an overwelming number of people with Lasik induced dry eye. However, look at it the other way. The 97% who DO NOT have this problem equal 14,550,000. When you compare 450,000 to 14,550,000 you have to see huge disparity, and that is why you must look at the the percentages. That is roughly 32 to 1. That's 31 good outcomes for every 1 bad. I think that's pretty good, and I wouldn't consider that a major problem. I agree, if you're that one guy, then it sucks to be you. If you look only at numbers then even the most routine surgery's(appendectomy for example) would look deadly. If you look at the total number of people killed in car accidents each year you would never drive again. But if you look at the percentage it is of total number of drivers, and compare it to the total number of drivers NOT killed each year, then you realize it's okay to go out and drive. The perception of results will always be skewed if you look at total numbers of problems. Even if dry eye only occured .00001% of the time, eventually enough procedures will be done that the .00001% will be a huge number as well.

I don't know the long term rate for dry eye REALLY is 3%, I just got that number from Glenn, so I have to think it's very close. If it's accurate, then that is a very low percentage. You have to look at the percentages.

Betty39 wrote:I've read that it's the #1 permanent side effect. Some people have been this way for years. It's rare but if it happens to you the fact that it is rare is of little comfort.


You're correct, it is the most common problem. That's one of many reason's a surface ablation is superior to Lasik.
Last edited by JPD on Thu Jul 12, 2007 12:31 am, edited 2 times in total.
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Re: response

Postby JPD » Thu Jul 12, 2007 12:25 am

noodles wrote:JPD, how long ago did you have your surgery?


4.5 months.
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Postby Betty39 » Thu Jul 12, 2007 12:34 am

Well, actually I look at this the only way I can, through eyes that have been dry for 9 months! And I guess all the percentages don't really mean a thing if you are the one that has a complication, for you it is a 100% complication rate.
I also read that it can take up to 5 years for Lasik induced dry eyes to return to normal. I hope that in the next 5 years neither one of us will be a statistic any longer :)
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