pain and poorer vision in right eye

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pain and poorer vision in right eye

Postby thestarvingpoet » Wed Aug 13, 2008 9:41 pm

I had lasik on July 15th with the zyoptix laser. I had a very high prescription with fairly mild astigmatism - -9.0 in my right eye and -6.5 in my left. The operation was pretty standard, the surgeon had no negative comments, and after the initial hour or two of stinging pain, I had no problems. I went to bed that night seeing quite clearly. When I woke up the next morning my vision was significantly worse. When I arrived for my follow up, I commented on this, and was told that I had excessive inflammation. The surgeon saw me again, and ended up irrigating under my flaps (very unpleasant!). I was then put on 60 mg oral prednisone for 4 days, and my steroid drops continued at once per hour. I returned the following day, and saw the surgeon again. He noticed a bit of improvement, and requested that I do pulse drops (one drop, and five minutes later another drop) every hour to make sure that the drop was taking. My vision steadily improved over the following week, and the doctors I saw (I was in about once/day for the week) were all very positive. Finally 12 days after surgery I was allowed to stop the steroid drops (after tapering off). My vision was around 20/30. I had quite a bit of dryness (due to the steroid drops) - it was worst in the morning, and improved throughout the day. The optometrists assured me that my vision would improve as the dryness cleared up, and it has.

Now to my current problem. I went back to my home town this past weekend for a wedding. It was hot (36 C), dry, and very windy all weekend. I was careful to liberally apply drops. On Sunday I noticed that my right eye wasn't seeing as well as my left. I thought this was probably due to the dryness, and wasn't too concerned. On Monday my right eye continued to be a little worse, plus I started to have a random pain in it. I say random, because it doesn't seem to be constant. Sometimes it's when I blink, sometimes it's when I look up and to the right, sometimes it's when I put drops in, sometimes it's when I put my sunglasses on or lay on my right side. It's been happening for the last 3 days. I had another follow up appointment yesterday. My left eye remains strong at 20/20, but my right is a very fuzzy 20/30 - I was able to guess the letters, but that's all it was. I was able to see better with refraction. The optometrist took a lot of time looking at my eyes through the slit lamp, and noticed a fair amount of dryness remaining. When I mentioned the random pain in my right eye, he said that it was most likely due to the dryness, and it should clear up. I've been applying my drops more often (approx every half hour), and I haven't noticed an improvement in this pain.

Is pain something that is associated with dry eye? I didn't have any pain prior to this, and I'm concerned due to the fact that I was in a windy dusty environment for two days. I understand that as I had a higher prescription I'm at a 20% chance of regression - and I'm wondering if my poorer right eye is the start of this? The pain has been making me worried, so I'm hoping someone can alleviate my fears!
thestarvingpoet
 
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Re: pain and poorer vision in right eye

Postby LasikExpert » Thu Aug 14, 2008 1:47 am

thestarvingpoet wrote:Is pain something that is associated with dry eye?


Absolutely. The long period of dryeye problems has undoubtedly caused dry spots on the eye and these spots will often present pain. A breeze can tirgger the pain, movement of the eye, movement of the eye lids.

thestarvingpoet wrote: I didn't have any pain prior to this, and I'm concerned due to the fact that I was in a windy dusty environment for two days.


The environment obviously exacerbated an existing problem. Changing your environment should help.

thestarvingpoet wrote:I understand that as I had a higher prescription I'm at a 20% chance of regression...


Or a 100% chance of 20% regression. It would be very unusual not not have regression when you start with 9.00 diopters of myopia. You may want to read about Lasik and regression.

thestarvingpoet wrote:...and I'm wondering if my poorer right eye is the start of this?


It is possible, and your vision with refraction indicates that some of your visoin problem is due to refractive error. It is a very good sign that you can see better with lenses. Dry eye, however, would be consistent with pain and the variable vision quality.

thestarvingpoet wrote:The pain has been making me worried, so I'm hoping someone can alleviate my fears!


You may want to read our article about Lasik and dry eyes and absolutely read our article about dry eye treatment. The more you know the better you are prepared for these changes.
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Re: pain and poorer vision in right eye

Postby thestarvingpoet » Thu Aug 14, 2008 5:55 pm

Thanks for the info Glenn.

Good news is the pain seems to have stopped. I was having issues up until I went to bed last night, but so far nothing this morning. It was odd because it often seemed the drops exacerbated the pain - although that could just be that my eyes were in a different position when I put in drops.

I will wait to see if my eye improves, but I would assume it's the start of regression, as it has not improved noticably over the last several days. However, my surgeon said before surgery that there would be lots of room for retreatments if necessary - which is good.
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Postby LasikExpert » Thu Aug 14, 2008 8:58 pm

I'm glad to hear the good news. Pain after Lasik can be a frightening experience, even if benign.
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Postby thestarvingpoet » Thu Oct 02, 2008 7:03 pm

I just thought I'd give an update. I went in for my 3 month checkup and have had no change. My right eye is still at about 20/40 and my left eye at 20/20. For day to day vision I see at 20/20 or 20/25 so I'm quite happy. I have some dryness - especially at night, but I just keep a bottle of drops near the bed and apply them if I wake up.

All in all I'm quite happy to have gone from such a terrible prescription to near-perfect vision!
thestarvingpoet
 
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Location: Calgary, Canada

Postby LasikExpert » Fri Oct 03, 2008 12:57 am

The nighttime lubricating gels may be a good alternative to regular artifical tears.
Glenn Hagele
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USAEyes

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I am not a doctor.
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