6 weeks after Lasik, opinions on my problem.

[emporer]

Hi, I had standard Lasik on 9th July, its been 6 weeks now. Since having it ive had the usual fluxuation in vision ect but this seems to be calming down now, i'm very happy with general vision quality and clarity. My problem is glare, I have it in both eyes but my left is hardly anything at all and the right has huge glare. In daylight outside my vision is superb, can't complain, however indoors under artificial light I get glare of anything white or cream coloured, horrible glare in evenings watching tv etc. It feels like I have a smear of vaseline in my right eye if you get my drift, if I tilt my head back still focusing on something (like looking down) then the glare goes away. I have starburst and halo's but they aren't too bad at all. I can't remember my exact prescription but I was about -2.25 ish in both eyes I think with astigmatism in both although worse in the right eye which is the bad eye for this glare. I did notice as soon as the procedure was done that although my left eye was getting sharper by the hour, my right didn't do anything for the first day or so, it took a while to catch up with the left. Could this be the same with the glare in that my right eye just is taking longer to heal?

I had a checkup 10 days ago and the optometrist said everything was fine, although he normally expects improvement in glare etc after a month or so its not unusual for people to still have bad glare for a while.

I'm really in need of some reassurance as I keep wondering if i'm stuck like this! My dry eyes are getting better, only using drops 2/3 times per day now.

Anybody else have my problem?

[LasikExpert]

My problem is glare, I have it in both eyes but my left is hardly anything at all and the right has huge glare. In daylight outside my vision is superb, can't complain, however indoors under artificial light I get glare of anything white or cream coloured, horrible glare in evenings watching tv etc.

True glare (bright light arc) is commonly a side effect of the medications used to control healing after surgery. What you describe is not what a doctor would likely call glare and is probably caused by a very different circumstance.

Artificial light produces light of a different wavelength and "warmth" than natural light. Natural light tends to be of a wider range of wavelength than artificial light (think of the rainbow of light produced with a prism). When light passes through the healing cornea it can be disrupted by the interface where the Lasik flap was created. This disruption can affect some wavelengths more than others. Since natural light includes a wide range of wavelengths, the disruption is not so noticeable. If the light source is a narrow wavelength and it happens to also be the wavelength that is being disrupted by the healing cornea, all sorts of odd visual effects can occur.

What we hear most often is LED and florescent light causing problems. Vision can be fine, but when looking at a red or green LED the image is doubled. Walking into florescent light is like putting a shroud over your head, with loss of contrast and a overall haze. This is because the narrow wavelength of that particular color of light is being disrupted by the cornea. When that same wavelength is mixed in with many other wavelengths (natural light), the effect becomes diluted by all the other light. When only the disrupted wavelength is produced (artificial light), you get the full effect of the disruption.

These problems commonly resolve with continued healing. The amount of time required varies greatly from person to person.

[emporer]

Hi, thanks for the reply, its been just over 4 months now since the surgery. The glare issue I have is very much like a ghost or double image, I get it at all times of the day but outside in natural light its non existant, if I go indoors then i'll get this ghost/double image which is also a bit hazy, I feel it more from light coloured objects or the reflection of light off a shiny surface, in the evenings in totally artificial light its at its worst, the tv has a horrible ghost/double image, I feel in general that the starbursts etc have gotten a bit better since the beginning but this issue hasn't, maybe gotten a slight bit better if i'm honest but not enough for my liking. If i'm indoors at night and getting this gohsting when watching tv and a really bright scene comes on then the gohsting goes away like my pupil is getting smaller, then on a dark scene my pupil opens a bit more and the ghosting returns.

Ive been on some gel type drops and some fml steroid drops for a week now to no avail.

Is 4 months too early for me to bexpecting proper results?

Am I stuck like this :(

[LasikExpert]

You are not stuck like this, but you may need further treatment. What you describe are symptoms of uncorrected astigmatism. Do you have a current prescription?

[emporer]

Do you mean prescription before or after surgery? before the surgery I was around -2.25 in both eyes and have astigmatism in both eyes, not quite sure of the level of astigmatism but it was definately alot worse in my right eye which at the moment causes most of this glare/ghosting issue, I remember trying contact lenses about 6 years ago and my right eye was very problematic due to the astigmatism, the contact lens would continually slip and rotate on its axis causing a blurring effect, they said this was due to the astigmatism.

It does make alot of sense that its caused by the astigmatism as the issue is with both eyes but its alot worse in my right eye which has a much higher level of astigmatism.

I have another checkup next Friday so will get some figures on my prescription while i'm there.

Your replies are encouraging, thank you, it does feel sometimes that i'm going to be stuck this way for eternity!

[LasikExpert]

Your current prescription will be a helpful inidcator of the underlying cause of your vision problems. When discussing your symptoms with the doctor, do not define them as "glare". Discuss the actual symptoms (artificial light differences, doubled images, hazy image in florescent light, etc.).

[emporer]

Had my appointment today, I explained to them a bit better than before what my exact symptoms are, she didn't really say a great deal, I told her that the steroid drops didnt make any difference. I did a small experiment last night, I tried my old glasses on and could just about focus for a second or two at a time and the ghosting issue was very minor with them, I told the opthometrist today and she said they could give me glasses for this and measured my eyes again but didn't comment, I can only presume they measured ok?

Now, she did give me some drops, Alphagan, tried them today and what a difference, no ghosting issues at all within a couple of minutes, very nice. She did say that i've got at least a good couple of months healing to go (i'm 4 months in now), hope it does get better as it took my right eye a couple of days initially to see properly so maybe its just slow!

[LasikExpert]

Alphagan P is a glaucoma medicine that has the side effect of reducing pupil size. A reduced pupil will mask astigmatism and reduce ghosting. This is undoubtedly a good workaround to help your vision until you are fully healed.

[emporer]

Hi, thanks for the reply. The drops are working a treat, I can drive at night and watch tv properly etc, its like having my old vision back.

Do you think my ghosting issue will eventually correct itself? i've read some people can take a year or more to fully heal in extreme cases, i'm obviously hoping that it does and if i'm honest its definately got better since I had the surgery, previously I would get the issue in shops etc with artificial light and it was only outdoors that I had good vision, going around shops now is just perfect and although I do notice the ghosting during the day its very minimal, these days its only during the evenings and dark that I have the problem. I'm fairly sure its not getting smaller but the ghosting I think is getting slightly transparant, does that sound right?

If its just a waiting game then i'm happy not to be stuck like this, if I will eventually have night time vision like I have with these drops then i'll be over the moon!

[LasikExpert]

It is possible that the ghosting will resolve with healing, however it is also possible that additional correction will be necessary or that some of the ghosting will remain. You will really just need to let the healing do its work.

[emporer]

Hi folks, an update on my situation after todays visit to the opticians. Its been nearly 2 months since i've seen them and back then they gave me Alphagan drops which helped but i stopped them after a couple of weeks due to them giving me headaches etc. So now today they measure my eyes with a wavefront scan and some more things are coming clear, I have some very high HOA's, namely COMA, this is really bad on my right eye and about half as much on the left which goes in tune with the problems and the fact my right is much worse than the left. Anyway, looking up some info on the web and some images and it does seem as though this is definatley the problem. They are going to show my scans to the surgeon tomorrow and then get back to me with whatever he says. now i'm not sure if this can be corrected, some sites ive read say not although they were dated 2005 so i'm presuming (hoping) technology has moved on in the last 5 years! It is also clear that its been induced by the LASIK, the HOA's may well have been there pre surgery but now they are really showing up.

It does now seem apparant that this COMA HOA is the problem, can this be fixed with any meds? or by todays lasers? i'd be under the laser immediately if it could as its a living hell with this current vision.

[LasikExpert]

Coma simply means that the upper half of your refractive error is different than the bottom half (vertical coma) or the left side is different than the right (horizontal coma). Coma can often be resolved with wavefront-guided enhancement surgery, but you need to see what your doctor says.

[emporer]

Thanks for the reply. Looking around at this 'coma' HOA, it does seem the only way to fix the problem is with wavefront surgery, or in my case and enhancement probably. However, my optometrist has given me glasses to try and see if it soves the issue, not sure what prescription they are but after trying for 2 days its not made a bit of difference and the ghosting is there with the specs on or off. I think they are trying out this last thing before they offer me an enhancement.

What are they trying to achieve by going down this route?