Possible Dry Eyes, a bit of ghosting, etc

[davinci23]

Hi,

I'm had my Lasik Surgery (Advanced CustomVue) about 4 weeks ago. I'm now off the steriod (omnipred) as directed by the surgeon; only lubricating drops are being used. In the day time, vision is outstanding (right eye a tad better than left eye).

Currently at night, I'm seeing ghosts in the right eye at night. It wasn't there the 1st two weeks but appeared two weeks ago. A few days after it appeared, I went on Xmas vacation (wamer climate) and while I was gone I used Systane Ultra at a rate around every 15-20 mins. In a few days the ghosting became very very minimal and the only issue I saw LED lights that had light scatter in very low light. When I came back home to the colder climate, within 24 hrs, the right eye got the ghosts back at night. Coincidence?

The ghosting in the right eye is most apparent with white letter on black background at night. An example of a ghost is an outdoor store sign at night with a ghost slightly above and below actual lettering. Or lettering on TV shows. Sometimes blinking changes the ghost position momentarily.

So a couple questions:
1. Do this sounds normal at the 4-week stage? and can dry eye be the cause of the right eye night issues?
2. Is there such a thing as too much lubricating eye drops (e.g. Systane Ultra) . Would like to lube up as much as possible.
3. Is Systane Ultra the right drops to be using or should I be utilizing some like preservative free (Refresh Tears)?
4. What is up with the weird light scatter with LED type lights in very low light? Its a minimal issue compared to the ghosting but still curious. Hopefully it'll go away with healing.

Regarding the left eye, I have a tad of astigmatism that only shows itself at night. This has been consistent since day one. Surgeon says that will go away with healing. Hopefully he is correct.

Thanks for any and all input....

[LasikExpert]

1. Do this sounds normal at the 4-week stage? and can dry eye be the cause of the right eye night issues?

Yes, very normal. Your eyes have just had microsurgery. They are healing. The steroid eye drops are controlling that wound response. The healing will be irregular in both time and place, meaning some areas of the cornea will heal faster than others and healing may have spurts of changes.

2. Is there such a thing as too much lubricating eye drops (e.g. Systane Ultra) . Would like to lube up as much as possible.

Excess tears will flow out of the eyes, but there is a delicate balance of three layers to tears. Constantly washing away that balance is not so good. You need to find a balance between proper lubrication and flooding the eyes. See Lasik dry eye treatment.

3. Is Systane Ultra the right drops to be using or should I be utilizing some like preservative free (Refresh Tears)?

Preservative-free only. Preservatives are a mild toxin to kill the bugs that would make the artificial tears spoil. In small amounts these toxins do not bother healthy eyes, but you are using large amounts and your eyes are compromised by recent surgery. You are toxifying your eyes by flooding them with preserved artificial tears.

4. What is up with the weird light scatter with LED type lights in very low light? Its a minimal issue compared to the ghosting but still curious. Hopefully it'll go away with healing.

Light travels in waves. Different frequencies of these waves are seen as different colors. Your corneas have a new interface where the Lasik flap was created, are inflamed due to the wound response, are dry, and are thereby changing the frequency of the waves of light as that light passes through the cornea and enters the eye. Some light sources are very problematic during the healing stages, such as fluorescent lights. The light emitted by common fluorescent lights is caught in these healing imperfection and scatters all over the place, reducing contrast sensitivity and vision clarity. LED lights, which have a very narrow frequency, tend to strongly show astigmatism and corneal imperfections. Continued healing tends to resolve these issues.

[davinci23]

Thanks a lot for the quick reply!!!

I'll switch to the preservative free only eye drops. Although they are a lot more expensive, these are my eyes so no big deal. Also, I'll find a more delicate balance regarding application of the eye drops. I'll start with 45 mins - 1 hour frequency and see how that goes. If you think that's too often, let me know.

Finally, thanks for the education regarding different light frequencies.... Interesting bit of info.

[LasikExpert]

The frequency of application of artifical tears is whatever is necessary to properly lubricate your eyes. Starting with one hour is good, but keep in mind your activities. Sitting at a computer is terrible on dry eyes because we tend not to blink as much. Driving with the window defogger actually turns on the air conditioner to dehydrate the air. Environment needs to be considered in addition to timing.

[davinci23]

5 1/2 weeks post-Lasik now.... The ghosting in indoor light and outside at night is testing my patience; sigh. Left eye is ghosting above actual and the right eye is ghosting below actual. Halos and Starbursts at night are still there but not as bad as week one.

I'm using Genteal Severe Dry eye gel about every 1 - 1.5 hrs now for dry eye (Preservervative free in the eye). Not catching any breaks since its cold as anything right now (low humidity).

Have my 6 week appt with my doctor next week. Lots of questions.

Right now if I could go back in time, I'd never have done this. Hopefully a couple weeks from now my opinion will change. Sorry just venting with frustration.....

[LasikExpert]

Left eye is ghosting above actual and the right eye is ghosting below actual. Halos and Starbursts at night are still there but not as bad as week one.

This is consistent with mild regular astigmatism. It may be residual astigmatism not resolved with surgery, induced astigmatism, or totally related to inflammation/dry eye.

Sorry just venting with frustration.....

Nothing wrong with venting and this is the place. The frustration you experience is why we work so hard to inform the public that Lasik is not always a 20-Minute Miracle and can be more of a six month process.

[davinci23]

Thanks as always for the quick response LasikExpert.....

Fingers crossed its just inflammation or dry eye....

The left eye ghosting is worse somedays than others. The right eye ghosting is fairly consistent except in very low light and then the ghost smears.

[LasikExpert]

What you describe is consistent with regular astigmatism, inflammation, healing, dry eye, or a combination. You will need to continue your treatment until all have resolved before you will be able to come to a conclusion on your outcome.

[davinci23]

6 Week Update

Its been 6 weeks post-Lasik.... Still have ghosting in both eyes in indoor lighting and outside at night. Halos are there but seem a tad better. Very bad dry eye though. Its almost like my eyes aren't making tears.

I had my 6 week appt with my doctor yesterday and I discussed the Halos, ghosting, and dry eyes with him. He indicated everything was normal and that some people heal faster than other. Sigh, I'm not in the middle of the bell curve.. :-(

The dry eyes are bad for me. During the day I'm using preservative free drops (Optive Sensitive) about every 30-45 minutes to get rid of the dry feeling. Stretching it to an hour or more really kills my eyes. At night I'm using Refresh PM ointment.

I was using Genteal Severe Dry Eye gel during the day but that seemed to have a rebound effect even though its preservative free so I switched to Optive Sensitive. I've been using that for a few days and no bad effects. One of my friends told me about Refresh Endura / Dry Eye Therapy but that one seems to be discontinued.