Double/Triple Vision

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.

Postby nedzie » Fri Jun 27, 2008 9:57 pm

I had my 2 month checkup yesterday. My surgeon finally mentioned that I have some remaining astigmatism in both eyes, my right eye being much worse. He said he would like to look into doing an enhancement on this eye, but not for another 2 months or so, just to make sure everything is all calmed down.

On the other eye, he said the remaining astigmatism is so slight, that I may not want to mess with it. He said to wait until the other eye is enhanced, and see if the results are good enough that I'm happy. He said with every procedure, there are obvious risks.

Why would the initial procedure not take care of the original astigmatism completely?

Is an enhancement to remove the remaining astigmatism something that is fairly common and successful? Or is this just a crapshoot?
nedzie
 
Posts: 15
Joined: Wed May 07, 2008 3:52 am

Postby 3lix0r » Sat Jun 28, 2008 1:40 pm

nedzie wrote:I had my 2 month checkup yesterday. My surgeon finally mentioned that I have some remaining astigmatism in both eyes, my right eye being much worse. He said he would like to look into doing an enhancement on this eye, but not for another 2 months or so, just to make sure everything is all calmed down.

On the other eye, he said the remaining astigmatism is so slight, that I may not want to mess with it. He said to wait until the other eye is enhanced, and see if the results are good enough that I'm happy. He said with every procedure, there are obvious risks.

Why would the initial procedure not take care of the original astigmatism completely?

Is an enhancement to remove the remaining astigmatism something that is fairly common and successful? Or is this just a crapshoot?


This sounds very similar to what I've experiencing.
I'd like to reiterate nedzie's question.

Thanks all
3lix0r
 
Posts: 23
Joined: Thu May 15, 2008 1:18 am

Postby nedzie » Tue Jul 15, 2008 10:04 pm

Glenn, do you have any input on these last questions?
nedzie
 
Posts: 15
Joined: Wed May 07, 2008 3:52 am

Postby LasikExpert » Wed Jul 16, 2008 6:26 pm

nedzie wrote:Why would the initial procedure not take care of the original astigmatism completely?


To change 1.00 diopter of myopia (nearsighted, shortsighted) vision, the laser removes about 12 microns of corneal tissue. The average human hair is 60 microns thick. Astigmatism of .50 diopter (enough to be noticed) would need about 6 microns of tissued removed. The largest of the soft pliable epithelial cells that cover the cornea is about 5 microns in diameter.

In other words, if the surgery misses as much as one cell, you could be off the desired treatment by around 0.50 diopters. That is a bit of an oversimplification, but it may give you some concept of the narrow margins of Lasik.

Quite simply, the laser treatment was not able to remove the precise amount of tissue to provide the effect desired - and we are not even including issues like corneal hydration, swelling, etc.

nedzie wrote:Is an enhancement to remove the remaining astigmatism something that is fairly common and successful? Or is this just a crapshoot?


Much depends upon the type of astigmatism (regular or irregular), the amount, and the location. Your doctor can provide you with this information, but only you can decide if the current vision is so problematic to you that you are willing to have additional surgery.

You need a detailed conversation with your surgeon.
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 nedzie » Wed Jul 16, 2008 6:58 pm

We are going to have a detailed conversation in another month or so to weigh the risk vs reward. I'm pretty sure it's not a regular astigmatism, because my vision cannot be corrected back to what I would consider "normal" (the vision I had with contacts prior to the surgery) with refraction. Having to accept my current vision for the rest of my life is just extremely depressing. Sadly, I've gotten used to the fact that I just can't read anything more than about 20 feet away, and this can't even be fixed with glasses or contacts.
nedzie
 
Posts: 15
Joined: Wed May 07, 2008 3:52 am

Postby LasikExpert » Wed Jul 16, 2008 8:01 pm

If the cornea is significantly irregular it may be that phototherapeutic keratectomy (PTK) will be recommended to smooth the surface. It may also be that standard PRK on the Lasik flap will be suggested. Even rigid gas permeable (RGP) contact lenses at night can reshape the cornea enough to provide clear vision through the day. Something else that may help is CLAPIKS. You may want to direct your doctor's attention to our article on this technique to resolve irregularities.

Keep your mind open about the different options, but most certainly you want to give your eyes as much time as necessary to resolve this problem as much as they are able.
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 nedzie » Mon Aug 25, 2008 1:33 am

I had my 4 month checkup, and my surgeon spent a long time with me this time explaining what he thinks is causing my issues. He acknowledges that I do have some very slight irregular astigmatism, so slight that he's shocked that it's causing the double images. He said he sees patients with post surgery corneal irregularities like mine all the time and no one else has my symptoms. I have something called Fenestrated Sheen Macular Dystrophy, which I believe is a retinal disease, that he thinks may by causing some issues. He doesn't want to jump into an enhancement just to do it, he wants to be confident that the risk of opening the flaps and going through the healing process all over again is worth it. He wanted to try soft contact lenses with minimal prescription to see if they take care of smoothing the corneas enough to eliminate the double images. If that doesn't work, he will then try hard lenses. If that doesn't work, then he said we can try an enhancement.

Well I just popped the soft lenses in, and I CAN SEE AGAIN!!!! My left eye is perfect, better than ever before, and my right eye still has a very slight doubling effect. I can't explain the excitement of seeing again, everything is so bright and crisp!! I am supposed to see him in 2 weeks.

If he could only scan my eyes with the contacts in and input that info into the Wavefront Laser and shape my corneas the way they are with contacts....is this even possible?? I am absolutely thrilled that at least I can see again, even if it means I have to wear contacts again, but the whole reason I did LASIK was to not have to wear them anymore. I wonder if there's anything that will make him confident enough to do an enhancement, but the fact that he doesn't just do it to do it makes me very comfortable with whatever he thinks is best for me.
nedzie
 
Posts: 15
Joined: Wed May 07, 2008 3:52 am

Postby LasikExpert » Mon Aug 25, 2008 5:08 am

Congratulations on having back your crisp vision, even if it is with contact lenses. It appears that the problem is two-fold, one is that you need a small amount of refractive error correction and the other is that the corneal irregularities are contributing to the problem.

It sounds like your doctor is taking a very careful and considered approach. This is very important. Please bring up CLAPIKS to your doctor and discuss its possibilities. This is also a situation where Orthokeratology (Ortho-K) may be appropriate.

At least now you can see while you and your doctor work out the details of your treatment plan.
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 kslone » Fri Aug 29, 2008 9:09 pm

I started out with double vision and now I have counted up to 6 extra ghost images coming off.
kslone
 
Posts: 7
Joined: Tue Aug 26, 2008 8:51 pm

Previous

Return to Just Had It

Who is online

Users browsing this forum: Bing [Bot], Google [Bot] and 2 guests