Newbie - mild astigmatism

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Newbie - mild astigmatism

Postby DM » Tue Apr 17, 2007 9:41 pm

Hi everyone.

I'm now aged 44 and my eyesight first 'deteriorated' in about 1988 when I first stared using a computer for work. Since then I've used a computer for 8+ hours a day every day.

My oldest available prescription (October 1995) shows Right sphere +0.50, cyl -1.00, axis 5, Left +0.50, -1.00, axis 180.

My most recent prescription (May 2005) shows Right sphere +0.50, cyl -1.00, axis 5, Left +0.50, -1.00, axis 178.

So my eyesight isn't "bad" but it's bad enough for me to notice. In particular I've used glases since 1988 for reading, driving and the computer and TV. My eyes are also a bit sensitive to bright sunlight (I choose reacto-light lenses). I can read, drive and watch TV without glasses but it's not 'comfortable'. In particular I find night driving tough as the red tail lights are blurred without glasses. However, I find that glasses are a problem more generally because of my very regular use of telescopes or binoculars for astronomy and bird watching and I don't want to 'mess-up' my eyesight as far as those 'eyesight dependant' hobbies are concerned!

I tried contact lenses (5 + years ago) but my eyesight was worse with the lenses than without and it took me ages to get the lenses on my eyes so I stopped trying them.

I had a consultation for laser surgery recently and they said I was a good candidate and recommended Lasik. I chose Wavefront Interlase - Lasik.

In reality I guess I have a few weeks to think things over and hoped I might get some feedback from some very knowlegeable people. In particular I wonder if the risk actually far outweighs the 'potential' benefit. I know this may ultimately be a personal thing but wondered if I might get reletively little return for what is a potentially far larger risk?

I understand things could be fine and there are no problems and complications, but equally, I could end up with far worse eyesight which I would obviously consider to be a failure. But my concern is the possibly marginal improvement when weighed against the 'standard' risk of eye surgery.

I hope you can give me some words of wisdom!
DM
 
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Joined: Tue Apr 17, 2007 11:28 am

Postby scottymace » Fri Feb 15, 2008 3:20 am

I'm basically in the same boat. A local center is having a $999 for both eyes sale. My 'scrip is similar to yours:
Right sphere +1.50, cyl -1.25, axis 155,
Left sphere +0.75, -0.75, axis 020 (there's another column with "ADD" as the heading, and that value is +1.25 for both)

Similar to yours, I can "see", just not comfortably. That sale price is calling me hard. Should I do it?

Scotty in NE Ohio
scottymace
 
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Words of wisdom and experience

Postby Mr.UnPerfect » Sat Feb 16, 2008 2:42 am

Never ever, never, never, never ever, never, never, never, never ever, ever, ever ,ever ,ever ,never never ever, never ever, never ever, never,NEVER, NEVER, NEVER, NEVER EVER, NEVER EVER, NEVER EVER, NEVER, NEVER, NEVER, NEVER, EVER, EVER, EVER, EVER,, NEVER, EVER. NEVER, EVER, EVER, EVER ,EVER,,NEVER EVER, NEVER, NEVER EVER,

GO FOR THE CHEAPEST DEAL WHEN IT COMES TO YOU EYES.......

DO YOU UNDERSTAND...OR DO I HAVE TO REPEAT IT AGAIN.......

NEVER EVER , EVER, EVER, EVER NEVER EVER........UNDERSTAND..

BOB ............................
Mr.UnPerfect
 
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Location: Houston, TX

Postby Pappy » Sat Feb 16, 2008 2:57 am

DM,

As it is a highly personal choice and really it comes down to risk versus possible reward.

One thing to note while your vision acuity may end up good. All Laser surgeries will result in some loss of fine detail either temporarily or permanantly.

For your astronomy hobbie this might be detrimental.

Personally I chose to have the surgery,I sail tons and have always been irresponsible with contacts, never taking them out, so always wearing glasses and being blind as a bat without them made it so it was always a concern of "whoops" lost them in the drink.

For some one who can see fine and wants more comfort to expose them selves to the possibility of loss of best vision, night vision issues, high order aberations, possible dry eye complications as well as short term infections. I'm not you but I would do a ton of risk vs reward research before going through it.

One thing that I found through my research which I find at odds with your docs assesment was that a 1 diopter was about the "minimum" most doctors would consider laser surgery on. I guess it's how you rate "excellent candidate" to me it would seem you would be a marginal candidate.

In any case what ever you decide to do I wish you the best of luck.
Pappy
 
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Re: Words of wisdom and experience

Postby Pappy » Sat Feb 16, 2008 3:02 am

Mr.UnPerfect wrote:Never ever, never, never, never ever, never, never, never, never ever, ever, ever ,ever ,ever ,never never ever, never ever, never ever, never,NEVER, NEVER, NEVER, NEVER EVER, NEVER EVER, NEVER EVER, NEVER, NEVER, NEVER, NEVER, EVER, EVER, EVER, EVER,, NEVER, EVER. NEVER, EVER, EVER, EVER ,EVER,,NEVER EVER, NEVER, NEVER EVER,

GO FOR THE CHEAPEST DEAL WHEN IT COMES TO YOU EYES.......

DO YOU UNDERSTAND...OR DO I HAVE TO REPEAT IT AGAIN.......

NEVER EVER , EVER, EVER, EVER NEVER EVER........UNDERSTAND..

BOB ............................


I can agree with this sentiment :)
Pappy
 
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Both are marginal lasik candidates

Postby Mack » Sun Feb 17, 2008 1:23 am

Pappy is right. Correcting any net refractive error less than 1 diopter with lasik is not a good idea. Responsible lasik docs would agree with this. Both DM and Scotty have scripts (rewritten for + cylinder) that show about a net +1 diopter of hyperopic astigmatism with zero or less than half diopter of spherical error. Correcting that with precision to plano and zero cylinder without risking loss of BCVA (best corrected visual acuity), increased higher order abberations, increased dry eye symptoms, increased light sensitivity, loss of contrast sensitivity, etc. is not something lasik is all that good at. Lasik is very good at correcting simple myopia up to -6 or so. Adding the complications of cylinder error and hyperopia creates a bigger challenge for lasik to be able to deliver precise results. I'm a +5 h-lasik survivor with now about +0.5 sph and -0.5 cyl. 20/20 both eyes uncorrected, but not as sharp as I had prelasik. even with minor correction. Specs for such a minor correction for me do not really help improve visual acuity in all lighting conditions. Since both of you are looking for precision over minor scripts, I'd say forgo the risk and use contacts or specs when you really need them.
Mack
 
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Location: Seattle

Another option

Postby Mack » Mon Feb 18, 2008 5:52 am

After thinking about this issue a bit more, might I offer a possible option for you to consider for correcting your minor hyperopic astigmatism. After about 5 years after my primary +5 lasik in 1999, I was left with residual refractive error of about +1.25 sph and -1.25 cylinder (astigmatism) in both eyes and had to wear trifocals to manage at all distances with reasonable acuity. Then I discovered light touch CK and a local surgeon who has done amazing things with this relatively new technology fixing not only straight hyperopia up to +3.0, but also high amounts of hyperopic astigmatism. It doesnt work for myopic correction at all. CK got my refractive errors down to about +0.5 sph and -0.5 cyl in each eye. 20/20 uncorrected with both eyes. Depending on lighting conditions, the error is less.
You can learn more about CK at Refractec.com, the inventor of the technology and maker of the RF probe that is placed just under the surface of the cornea around the periphery. The probe delivers a pulse of RF engergy at a number of points that form a circle. The RF heat shrinks the collagen tissue and pulls the edges of the cornea down steeper, effecting hyperopia correction.
When CK was first introduced about 7 years ago, its effects were more temporary, but improved probes and application technique have made its efficacy very much better.
There is much misinformation about CK out there as to what range of error it can correct, whether it can correct astigmatism and whether its effects are temporary or permanent. I've engaged the CEO of Refractec personally. He admits the early version of it was more temporary with the collagen tissue "relaxing" over time and returning to more of its original shape. But as more data has come in on CK results over time, there are now patients with 3 years of stable results and no regression. I am at 2 years with no regression. The CEO said nobody really knows for sure how long the effects of CK will last for a given patient. For many it will likely be many years, perhaps to the end of their natural lifetimes, since the big majority of CK patients are over 50.
Many lasik doctors still dismiss CK as temporary and some think it cannot treat astigmatism. I believe Glenn Hagele, the LasikExpert on this website is in that camp. My own original lasik doc (thru his office manager) told me it generally induces more astigmatism, instead of correcting it. That's all very much old-school thinking and nothing could be further from the truth. Let's face it, they want to sell you lasik, which they know and love the best.
The vast majority of CK patients have natural 20/20 distance vision and get it in one eye for monovision so they can throw away their readers. But it can do much more than just that. My CK doc has helped many folks with astigmatism scripts as high as +6. The beauty of CK is that it's so much less invasive to the eye compared to any form of lasik or PRK. There is no cutting of any kind, no flap, no ill effects of a suction ring, no destruction of the epithelium, no disturbing the central optical zone, etc. It's virtually painless and afer about 3 weeks, the effects stabilize. There is a little edema the first 3 days or so, with visual acuity fluctuation, similar to lasik.
If I were you, I would investigate what nearby clinic, university or refrative surgery center is doing CK and find a doc who has been working with it the longest, but especially one who also knows how to use it to successfully treat hyperopic astigmatism as well. Good luck.
Mack
 
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