Morning Blurriness

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Morning Blurriness

Postby Butterfly » Thu Jul 03, 2008 7:28 pm

I had LASIK 7 weeks ago. Before LASIK my vision was approximately -8 diopters in both eyes. My vision 4 weeks post-LASIK was 20/25 in the right eye and 20/50 in the left with some astigmatism. I'm happy with that result. Here's what I am not happy about.

Every morning I wake up with very blurry vision that lasts for several hours. By noon, my vision is clear and remains crisp all through the afternoon and evening. (The measurements above were taken in the late afternoon.) I am thankful for the predictability of the pattern, however, it is still disturbing. It's like looking at the world through jello. I make sure that I'm up and about at least 2 hours before I have to drive a car. Everything is blurry, but it's most annoying for near and mid range. Reading glasses help SOME, even for the distance. I don't understand why. My doctor does not have an explanation for the daily "fluctuation" I am experiencing and we are hoping that it improves with time. Frankly, I don't realize much improvement other than from the first week, which was awful. Weeks 2- 7 may have had gradual improvement.

My doctor says the flaps look good and I'm healing fine. He is puzzled by what he calls my "farsightedness". I don't understand why he calls it that. My distance vision is never perfectly clear. He attributes the cause of whatever is wrong on the length of my laser treatment. It was 55 seconds on each eye. He mentioned that most of his patients are around 20 seconds.

I wonder what is going on. Is it just edema, that will take more time to resolve? Is edema something the doctor could see? He sees nothing wrong, but like I said, my appointment was in the late afternoon, when my vision was clear.

Because I have a history of IOPs in the low 20s, I wondered if perhaps the blurriness was related to high IOP. My pressures were checked and in the normal range, again in the late afternoon. But, with my newly thinned corneas, can one rely on the new IOP readings?

Thanks in advance for any insight or suggestions!

I have a follow-up appt. in 3 weeks.
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Postby mike01 » Fri Jul 04, 2008 3:52 pm

Do eye drops help clear things up in the morning? Have you tried using an ointment or gel while sleeping?
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Postby Butterfly » Fri Jul 04, 2008 4:21 pm

I use artificial tears 6-8 times a day even though my eyes do not feel particularly dry. I put the first drops in before I get out of bed. The drops do not have an immediate clearing effect on the morning blurriness, like they do when my eyes are dry.

Haven't tried a gel for sleeping. It would be worth a try just to rule out possible dryness. Thanks!
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Postby LasikExpert » Tue Jul 08, 2008 6:46 pm

Do let your doctor know of your difficulties. This sounds like normal healing issues, but can indicate something else. If the nighttime gel lubricant resolves the morning blurriness problem, then you may have defined the problem yourself.
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Update - 10 weeks post-LASIK

Postby Butterfly » Thu Jul 24, 2008 1:26 am

I had my follow-up appt. with the ophthalmologist yesterday. I have a new understanding of what my problem may be.

First let me say that I am 49 years old and was just teetering on the need for progressive lenses before LASIK. I am still having morning blurriness every day for a couple of hours. I get around the house by using +1.5 readers during that time. My doctor explained that I was overcorrected and am now farsighted. He says that there is still some ability for my eyes to accommodate and that's why my vision clears as the day progresses.

My current refraction is:

Right + .50, -.50, 150
Left +1.50, -1, 10

Those are afternoon measurements. He feels if he took the readings in the morning or if he paralyzed my eye muscles, I would be more farsighted.

He is beginning to talk about enhancement for the left eye only. We will see if my eyes are stable in 6 weeks and discuss it at that time.

Does the explanation of farsightedness causing the morning blurriness make sense to anybody else? I think I can buy it. I used to think that farsightedness would mean very clear distance vision (which I certainly do NOT feel I have. I am 20/30 and 20/40.)

Is it true that if an enhancement gets rid of the farsightedness and astigmatism, I can hope for better than 20/40 in that eye. Or, will it get worse? I'm having difficulty understanding why I'm not 20/15 or 20/10 if I'm farsighted.

Not sure if I am going to want the enhancement or not. The past 10 weeks of morning blurriness have not been fun, but getting some midrange vision back would sure be nice. Also, as I age, should I expect the morning blurriness to extend further into the day as I lose my ability to accommodate.

On the bright side, my flaps are healing fine. Also, dry eye and edema don't seem to be an issue.
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Re: Update - 10 weeks post-LASIK

Postby LasikExpert » Thu Jul 24, 2008 3:04 am

Butterfly wrote:Does the explanation of farsightedness causing the morning blurriness make sense to anybody else?


Absolutely. Accommodation is the ability of the natural lens within the eye to change shape and thereby change focus. As we get older accommodation becomes more limited, usually presenting as the need for reading glasses or bifocals. The reduction of accommodation due to aging is called presbyopia.

Your eyes are attempting to "focus around" the hyperopia (farsighted, longsighted) vision you now have. It appears that they are more able in the afternoon than morning.

Your doctor will undoubtedly do a cycloplegic refraction (which is better one or two?) with the natual lens paralyzed to determine your actual hyperopia.


Butterfly wrote:I used to think that farsightedness would mean very clear distance vision...


Which would be correct, however you are also presbyopic so you don't have good near vision. Hyperopia and presbyopia often give vision that is poor quality at all distances.

Butterfly wrote:Is it true that if an enhancement gets rid of the farsightedness and astigmatism...


It is certainly possible, but what is probable for you will depend upon your true hyperopic state and will be based upon your doctor's overall evaluation.

Butterfly wrote:Not sure if I am going to want the enhancement or not.


Ask your doctor if a pair of soft contact lenses that provide full correction or even a little myopia would be appropriate. You can try the vision you would target with enhancement surgery.

Butterfly wrote:Also, as I age, should I expect the morning blurriness to extend further into the day as I lose my ability to accommodate.


At some point you will not have the ability to see near objects without reading glasses, bifocals, or vision correction that makes you slightly myopic. You may want to read about Lasik monovision.
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