why is it only clear after putting in eye drops? thanks :)

[yasmin182]

hi everyone, hope you are well. i am in england, and i had customvue lasik almost 3 weeks ago. finding this website has been great as there are not many this side of the pond!

within 10 days of my op though my vision was not very clear. the optometrist checked my eyes with the 1 or 2 method and said i had regressed -1.25 and -1.00.

1. my Q however is why is it that when i put my eye drops (for dry eyes) in my vision is crystal clear for a few seconds sometimes minutes??? why is this?

2. is it possible to detect regression this early? my optometrist has said that i will need an enhancement and with regards to enhancements-

3. what is the minimum thickness you need in order to progress with an enhancement? i know that 250 microns needs to be left but how much needs to be there before you can begin and how much on average is lost?

4. if there isn't enough corneal tissue, is it possible for LASEK to be done instead of LASIK for an enhancement.

5.and i'm not sure if this seems weird, but my eyesight seems clearer outdoors during the day, is this normal?

i am sorry if the questions have been answered before but i have used the search facility but have not been able to answer my queries.

thank you very much to everyone for your time and responses, i reallllly appreciate them :)

[David White]

I can't answer your questions, but if it makes you feel any better 3 weeks out I also see clearer after putting eye drops in so it might just be one of those things.

[LasikExpert]

1. my Q however is why is it that when i put my eye drops (for dry eyes) in my vision is crystal clear for a few seconds sometimes minutes??? why is this?

The tear film is an important layer of the cornea. It provides the smoothest surface. If the tears are deficient, the relative roughness of the underlying layer will provide degradation in vision. When you put in eye drops you create that smooth tear film layer and the quality of your vision returns to normal. As those drops dissipate, your vision quality is reduced. You apparently have Lasik induced dry eyes, which is common and commonly temporary.

2. is it possible to detect regression this early? my optometrist has said that i will need an enhancement and with regards to enhancements-

Regression is when the refractive error after Lasik or similar laser eye surgery moves back toward its original amount. It is detectable the moment it occurs.

3. what is the minimum thickness you need in order to progress with an enhancement? i know that 250 microns needs to be left but how much needs to be there before you can begin and how much on average is lost?

The amount of tissue that will be removed (ablation) for primary or enhancement surgery can be reliably predicted within a pretty good margin of error. It is based upon the amount of refractive error correction desired.

Calculations for flap thickness, ablation depth, and corneal thickness can determine how much residual cornea remains after surgery. The thickness of the untouched cornea can be measured intra-operatively immediately after the flap is lifted to affirm that preoperative calculations are correct.

4. if there isn't enough corneal tissue, is it possible for LASEK to be done instead of LASIK for an enhancement.

Many patients are able to have PRK or LASEK on the Lasik flap, however your individual circumstances would need to be evaluated to determine if this is the most appropriate technique for enhancement surgery.

5.and i'm not sure if this seems weird, but my eyesight seems clearer outdoors during the day, is this normal?

Absolutely normal at this point in recovery, but not normal later.

When in bright light your pupil size diminishes. The light that reaches inside the eye and is "seen" travels through a smaller area of the cornea and lens. Since all corneas and lenses have irregularities, the smaller the surface through which the light passes, the less the irregularities degrade vision.

The human eye is like a camera in that when the iris is constricted and the pupil is small, there is a greater range of focus. Items close as well as items distant are in focus.

The outermost edge of the cornea is where the edge of the flap is located, and this edge can cause irregularities until healed. When the pupil is large you have a greater surface of irregularities through which the light passes, and are more likely to have a negative effect from both the flap edge and the edge of the laser treatment zone.

It is common for vision to be better in bright light (small pupils) than in low light (large pupils) during the normal six month healing period. If this issue is problematic and does not resolve with healing, discuss with your doctor the exact nature of the problem and how it may be resolved.

[David White]

5.and i'm not sure if this seems weird, but my eyesight seems clearer outdoors during the day, is this normal?

Absolutely normal at this point in recovery, but not normal later.

When in bright light your pupil size diminishes. The light that reaches inside the eye and is "seen" travels through a smaller area of the cornea and lens. Since all corneas and lenses have irregularities, the smaller the surface through which the light passes, the less the irregularities degrade vision.

The human eye is like a camera in that when the iris is constricted and the pupil is small, there is a greater range of focus. Items close as well as items distant are in focus.

The outermost edge of the cornea is where the edge of the flap is located, and this edge can cause irregularities until healed. When the pupil is large you have a greater surface of irregularities through which the light passes, and are more likely to have a negative effect from both the flap edge and the edge of the laser treatment zone.

It is common for vision to be better in bright light (small pupils) than in low light (large pupils) during the normal six month healing period. If this issue is problematic and does not resolve with healing, discuss with your doctor the exact nature of the problem and how it may be resolved.

Thanks for answering that, it was fascinating. Especially as it's the same for me. Looking at distances outside, my vision is remarkably good - better than it ever was with glasses or contacts. But inside it's marginal - liveable and satisfactory but clearly not what it is outside. Of course, I'm only 20 days off of my surgery. Your explanation explained a lot.

[LasikExpert]

I'm glad to be of service. Be sure to look at our article about Lasik dry eye and treatment.

[yasmin182]

thank you glenn :) i really appreciate you taking time to answer my questions. thank you once again!!

[yasmin182]

how is your recovery going David? also out of ALL the people who have read the post, thank you for actually taking the time to put pen to paper, or fingers to keyboard :)

[David White]

how is your recovery going David? also out of ALL the people who have read the post, thank you for actually taking the time to put pen to paper, or fingers to keyboard :)

I think it's about normal. I'm an impatient, immediate gratification kind of person so I have to remind myself it's only been three weeks :)

My distance and reading vision is really good. My mid range (TV distance) is so-so. Certainly good enough but a little blurry and with some ghosting. As with you, I get much clearer vision for the 30 seconds or so after eye drops. Based on Glenn's response, this seems totally normal so I'm just going with it and assuming it will improve.

Make no mistake, though - if they could have put me in a machine beforehand and showed me what I currently see as my final vision and asked if I wanted it, the answer would definitely be YES. It's not perfect and maybe never will be. But it's easily good enough to offset the irritation of glasses and/or contacts.

Have things improved for you since your initial posting ?

[yasmin182]

i don't think much has improved. it's been a month now since treatment and i have my monthly check-up on thu. i think we are very similar, my reading vision is great, distance vision is definitely better than middle vision, which is blurry.

talking about the drops, when i first used them everything was clear for about 2 secs now it's clearer for a minute or two. so i don't know... i hope it means they're working. although after my week check-up i was told i had regressed, so i don't know because then i use the drops and everything is clear!

i also must agree with you, life without glasses and contacts is bliss! but things are hard at work, can't see anything mid vision, which is VERY hard- being able to keep tabs on 30 kids is not easy :)

anyway keep me posted on your progress? btw sorrry for the lack of punctuation :P