lasik difficulties

Research your concerns in this forum or post your questions if you have had Lasik, IntraLasik, PRK, LASEK, Epi-Lasik, RLE, or P-IOL within the past three months.

lasik difficulties

Postby knight » Tue Sep 12, 2006 10:38 pm

Had lasik 10 weeks ago and have a lot of problems.I have double vision
(ghosting),blurry vision in low light,starburst and glare at night and daytime and halos. Starbursts,glare and halos have improved very little.
Have been back to lasik center several times and they said these problems will go away. They also said I have some regression.I have read a blurry 20/20 on a couple of occasions.
I am 40 yr old nearsighted and astigmatism perscription was considered average for doing lasik.
Do these problems just take a long time to go away or will an enhancement fix?
How long does dry eyes take to go away?
knight
 
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Joined: Thu Aug 24, 2006 8:59 pm

Postby LasikExpert » Wed Sep 13, 2006 4:10 am

Sorry to hear of your problems. There is probably more than one issue affecting your current vision.

You did not provide your prescription before surgery, but since your doctor has diagnosed regression, I assume that your myopia (nearsighted, shortsighted) vision was greater than 6.00 diopters. Regression is common with larger refractive error correction or with unusual healing.

The fact that you have regression indicates that you currently have some myopia that is not being corrected by glasses or contact lenses. Even a small amount of uncorrected myopia can cause starbursting, halos around light sources, and poor distance vision quality.

I am assuming that your multiple image vision (ghosting) is in each eye individually, not only when both eyes are open.

If your astigmatism was not fully corrected, astigmatism was induced during surgery, or you have uneven healing, multiple images would be expected and they would probably get worse in low light environments. You also probably notice the ghosting even more when you are looking at an LED light, especially if the LED is red.

Dry eyes will be an underlying problem for all your vision difficulties. Dry eyes can cause astigmatism and exacerbate already existing astigmatism. Dry eyes can cause edema (swelling) of the cornea that can induce regression and astigmatism. We have an article about Lasik Dry Eye Treatment that you may find interesting.

Have you had a manifest refraction (which is better, one or two?) since your surgery? If you have, what is your current prescription? If you are able, please also provide your prescription before surgery.

If you have a small amount of myopia, don’t be too fast to have enhancement surgery to remove it. At age 40 you are right at the edge of dealing with presbyopia. Presbyopia is when you are not able to change focus to objects near and require reading glasses or bifocals. A small amount of myopia can actually be a good thing. You may want to read about monovision. Of course, you would want to correct the astigmatism to be able to reduce or eliminate the multiple images.

You probably need a pair of glasses or contacts that fully correct your current refractive error. These will help you function until your healing is complete and you can make a decision about enhancement surgery.
Glenn Hagele
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Postby knight » Wed Sep 13, 2006 5:55 pm

My last glasses perscription before lasik
R-350 -175 136
L-475 -1.00 5
Ghosting is in each eye. A green traffic light at distance will be over and under double vision.
As I get closer the double vision gets better.
I am using non pres. drops during the day and putting in MURO- 128 before going to bed as lasik doc said to do.
I didn't get my last refraction. Next appointment is in 6 weeks
I am on my second pair of glasses and my eyes have changed since the last pair,vision is a little worse in right eye. Wished I had seen this web site before I had lasik.
Thank you
knight
 
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Postby LasikExpert » Wed Sep 13, 2006 6:49 pm

Thanks for the good words about our website. We are here for you now.

With your low initial refractive error you should not have had regression. This indicates that the change in refractive error may not be due to just Lasik regression. There are several possibilities that range from edema (swelling), alergic reaction, dry eyes, ectasia, undiagnosed keratoconus, or something that I have not considered. These more dramatic possibilities are not high probabilities. At a little over two months postop you may just have ongoing healing issues.

It is probably time for you to get a second opinion. I recommend seeking a corneal specialist at a teaching hospital. You may want to ask your current doctor for a referral, or find someone on your own.

A second opinion doctor may tell you the same thing as your current doctor, but you will have the peace of mind that you are on the right track. If you are not on the right track, the second opinion doctor will be there to show the way.
Glenn Hagele
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USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
LasikExpert
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Postby knight » Wed Sep 13, 2006 9:02 pm

Yes, I have been to a cornea specialist that does lasik to get a second opinion. He said I had some regression and he didn't see any sign of ectasia.This was 2 weeks ago. He told me to come back if my vision gets worse so he can make sure I don't have ectasia
So far lasik has been more trouble than glasses.
knight
 
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Joined: Thu Aug 24, 2006 8:59 pm

Postby LasikExpert » Wed Sep 13, 2006 11:26 pm

I highly recommend that you take up the specialist's offer for a return visit or two. S/he can monitor changes in your eyes. So far you are getting (relatively) good news. If it is just regression it will at some point settle down and you can wear glasses, contacts, or consider enhancement surgery.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
LasikExpert
Site Admin
 
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Postby knight » Mon Sep 18, 2006 4:38 pm

I had no pain or burning in my eyes after lasik.Would that mean the nerves in my eyes were badly damaged from lasik?
I continue to use non pres. drops even though my eyes don't always feel dry.
knight
 
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Joined: Thu Aug 24, 2006 8:59 pm

Postby LasikExpert » Mon Sep 18, 2006 10:53 pm

The reason Lasik does not hurt is because of the Lasik flap, but not for quite the reason you may think.

When the laser removes tissue from the surface of the cornea, the eye responds with a full wound response. That means some amount of pain, swelling and all the usual discomfort associated with a wound. When the laser removes tissue in the deeper stromal layers of the cornea, the eye is "fooled" into not realizing it has had surgery. Successful Lasik normally means that there is little or no pain; not because nerves are damaged, but because the area where the laser removes tissue does not elicit a wound response.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
LasikExpert
Site Admin
 
Posts: 3309
Joined: Fri May 12, 2006 6:43 am
Location: California

Postby knight » Wed Sep 27, 2006 12:29 am

Is it normal to have a change in depth perception after lasik?
I noticed this right after lasik. Everything looks bigger and more distant t
than before. Is it because the problems I have with regression cause this?
I still have not had any improvements with my vision.It is about the same a little worse at times. I go back to lasik center soon for my 3 month post op. I hope they can help me.
knight
 
Posts: 13
Joined: Thu Aug 24, 2006 8:59 pm

Postby LasikExpert » Wed Sep 27, 2006 6:45 am

Spectacles tend to minimize objects. Your entire field of vision needs to fit in the width of the lens. Some minification is common. If you wore glasses with small lenses, the minification would be even greater.

It is normal for someone who wore glasses almost exclusively before Lasik to experience things looking larger. This same effect often occurs when someone who normally wears glasses wears in contact lenses.

To some degree we judge the distance to familiar objects by their size. If a Buick looks the size of a Mini, then you know the Buick is distant. If suddenly a Mini appears the size of a Buick, then it appears to be closer.

The brain is very good at adjusting to this situation. The difference is probably not very noticeable now.
Glenn Hagele
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USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
LasikExpert
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Postby knight » Wed Sep 27, 2006 10:45 pm

My last pair of glasses had smaller lenses. I have been wearing glasses for 30 years.I am not noticing it as much as I did right after lasik, but I do still notice it.
knight
 
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Joined: Thu Aug 24, 2006 8:59 pm

Postby LasikExpert » Thu Sep 28, 2006 6:42 pm

If you have depth perception problems at near distance, such as you reach for the door knob and hit the door, you may have an imbalance of refractive error between your two eyes. This is exactly what monovision creates by design, but may be a consequence of your current refractive state. A current prescription will provide you this information.
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
LasikExpert
Site Admin
 
Posts: 3309
Joined: Fri May 12, 2006 6:43 am
Location: California

Postby knight » Fri Oct 13, 2006 5:47 pm

Had 3 month post op exam and my eyes have not settled yet.
Right eye about -1 and left is a little under-1, astigmatism in both.
I still have all my problems with night vision or even a cloudy day outdoors I can't focus as well as on a sunny day.
Starbursts and glare are very bad, I see them night and day.Even a small reflection is big glaring starburst. Driving is more difficult at night as the starbursts from car lights block my vision. I am still wearing glasses ,and they help my night vision and double vision but they don't help the starbursts much. Lasik doc said I would need an enhancement but he isn't clear about an enhancement fixing all the problems. The lasik I had was conventional lasik. I read that pupil size measurement must be accurate.
When I saw the cornea specialist 2 months ago they said my pupil size was 6mm and my last visit to lasik center they said my pupil size was about 3to 4mm in both eyes.
Is this why I have had bad results?
Should enhancement be done with custom or conventional?
Will an enhancement fix or possibly make it worse?
I am still trying to be patient and optimistic about this whole ordeal.
knight
 
Posts: 13
Joined: Thu Aug 24, 2006 8:59 pm

Postby LasikExpert » Fri Oct 13, 2006 7:58 pm

Your symptoms are not typical. Your preoperative prescription was relatively low and regression would not be expected. It is possible that you were undercorrected, but two doctors have diagnosed regression.

Even if your pupils are 6.0mm (that is about normal), the treatment zone on virtually all current lasers is 6.5mm with a minimum width of about 5.5 for astigmatic correction. Starbursting during daylight indicates that the problem is not related to pupil size.

Some of the halos and doubled vision can be explained with your residual refractive error. Much of this would be corrected with glasses, however contact lenses may provide better correction. Discuss with your doctor if contacts would be appropriate.

Without knowing why your vision is so poor, it is difficult to predict what enhancement surgery will provide. Undoubtedly it can reduce your refractive error, but glasses are reducing your refractive error and you describe that vision as being inferior.

These symptoms would be more consistent with dry eye.

Did you have IntraLasik, which is Lasik using a laser to create the flap (also called All Laser Lasik), or did the doctor use a mechanical microkeratome with a steel blade to create the flap?

Can you please provide your full current prescription.

Have your doctors said anything about irregular astigmatism?

In what community are you located?
Glenn Hagele
Volunteer Executive Director
USAEyes

Lasik Info &
Lasik Doctor Certification

I am not a doctor.
LasikExpert
Site Admin
 
Posts: 3309
Joined: Fri May 12, 2006 6:43 am
Location: California

Postby knight » Sat Oct 14, 2006 12:05 am

Lasik flap was done with blade.
They only told me that I was about -1 in both eyes and I didn't get details of the astigmatism.
I still have good close vision and the glasses help it even more.
Does astigmatism have an effect on close vision, and is that why the glasses help?
It has been hard to get clear answers out of them.
I am in the Cincinnati Ohio area.
I hope that everyone thinking about lasik finds this web site before they decide to have it done or not.
Thanks for all the replies.
knight
 
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Joined: Thu Aug 24, 2006 8:59 pm

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