accommodative spasm and what else?

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accommodative spasm and what else?

Postby bubabu » Sun Jan 23, 2011 11:27 pm


I had a Lasik procedure done on 7/29/2010 on both of my eyes with myopia of -5.00, but because of my age (25) and the high diopters the correction made was -5.3. The procedure was done in Europe and I currently go to school in the USA. After the procedure I had micro vertical striae on the flap of my right eye, but it seemed like everything was under control and there were no additional complications because of it. I could see well with both of my eyes together and separately 20/20. It took me about 2-3 months for my near vision to normalize to the levels comparable to before the procedure but everything was going smooth up to two months ago.

I have no complaints about my left eye and it seems like it sees perfectly. However, in the beginning of December (so about 3 months after the Lasik) I started having a problem with my right eye. Initially I noticed a difference in the vision between the two eyes which bothered me a lot and created huge headaches to the point that I would start crying. Every time I read or focus my vision on something (be it close by or far away) I get muscle strain in and around my left eye and I get the feeling like it is "stuck" in one position and is not able to zoom in and out to the extent that my left eye can . I went to a local dr in the states (not the one that carried out the procedure because he lives in Europe) and the he said that both my eyes are 20/20 (with only slight astigmatism in the right eye) and that there was nothing abnormal in my cornea and that I just had to rest after finals and see how it goes. I rested for about a week with no reading whatsoever and nothing changed.

So after this visit I started studying my right eye more and the other thing that I am noticing and that was not there before my headaches started are ghostly images in my right eye. For example letters have a second image behind them in the "northwest" direction and it is easiest to see them on a digital clock, but the same phenomenon happens when I read black text on white background from nearby or on tv. I see the same phenomenon even with other objects which makes my vision blurry at all times. The effect becomes more prominent with the course of the day and becomes worse with artificial light and it never disappears (even early in the morning when I wake up). So pretty much it is really hard for me to read with my right eye and I see both blurry and a ghostly images behind the letters. This always causes my muscles to strain around the eye and the headaches start about 20 mins after I start reading.

After a week I went to the dr again to get my pupils dilated. The doctor said that I have overcorrection of about 1 diopter in both eyes and that I have an accommodative spasm in my right eye. His recommendation was to use reading glasses to alleviate the headaches for a couple of months and then take if from there. He said that the accommodative spasm should go away in 2 to 3 months. However, he never addressed the ghosting and blurry vision in my right eye although I mentioned it several times and never explained why do I have problems only in the right eye if both eyes were overcorrected by the same amount. And again he did not find anything troubling in the cornea. And he said that my eyes were very well lubricated and that the only drops I had to use were just the natural tears.

Now it has been about a month since my second visit to the dr and almost 2 months since the headaches and ghosting have started in my right eye. However, I am not seeing any change either in the headaches, the muscle strain, the ghosting or anything. I had about 2-3 weeks in which I was on vacation and did not have to use my eyes. So if I did not have to read or focus on anything I could get through the day without major headaches and just some muscle strain, but despite that the ghosting never disappears. I have recently started school again which makes it necessary for me to read and the severity of the headaches came back with all its strength.

In the meantime I emailed the Dr in Europe who performed the procedure and his opinion was that there is something else going on except the accommodative spasm. From the description of my symptoms he was convinced that "there is probably a micro haze (due to altered structure of the keratocytes in the core of the cornea) in the right eye which causes the ghosting. The micro haze combined with the intense reading triggered the spasm and that the spasm will not get better before the hazing goes away". And his treatment in such cases usually includes eye drops like Flarex for several months to take care of the ghosting and glasses to relieve the headaches.

Additionally I think that I see things a little darker with my right eye (not a striking difference, maybe a couple of hues, but it is still noticeable. But I am not sure if this is just a result of the blurred vision or an additional symptom.

In the end it has been almost 2 months since I have been in severe pain and the only diagnosis that I got from the dr that I visited twice was accommodative spasm but I am sure that there is something else wrong with the eye and I am not sure it has been addressed. So I am stuck with one dr which is close by, but according to me seems to disregard relevant symptoms and another dr which is not able to examine me because of the distance but has another opinion.

I am just interested to hear if any of the diagnoses sound more plausible and what would be your recommendation in this case. Is it only the spasm? or there is also something else wrong? If my eye has indeed haze is it possible for the dr who examined me to miss it twice (taking into consideration that there was an exam with dilated pupils.).

Thank you for the attention and I am looking forward to hearing other opinions!
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