Lasik Results - Week by Week

[Mike_in_VT]

Hi Everyone – The purpose of this post is to document (and share) my experience with Lasik over time, so that others can learn from my experience and I can learn from others. I submitted a posting earlier after week 1, but wanted this posting to be more like a journal with occasional updates over the 6-month period when things supposedly settle.

My basic story is this:

I am a 38 year old male and have been wearing glasses for 32 years with a mild/moderate prescription in the 3.0 – 3.5 range for nearsightedness with a slight astigmatism.

I had CustomVue Lasik three weeks ago on January 15, 2008, hoping to get the same “miracle” results that I had heard about from a number of friends and acquaintances. That didn’t happen.

For both 1 day and 1 week exams my vision was about the same 20/30 left, 20/40 right…not exactly what I had in mind. (I know prescription numbers are better, but I don’t have those).

Reading, which was never a problem before, started out horrible for the first week or so, and has now become marginally bearable. I still can’t read a newspaper or book for more than a few minutes at a time. I tried 1.0 reading glasses hoping that would help. It made the letters bigger, but not really any clearer, and mostly just made me feel woozy. So I don’t use them much.

I think my distance vision has improved a little bit since then, but I don’t really know for sure. It really seems to vary a lot--day by day and hour by hour. Rather than slow or no improvement, it seems like some days are good and some aren’t. I’ve hung an eye chart on my fridge to see how I’m doing, and the results are really mixed. Sometimes I can make out a couple letters on the 20/20 line, sometimes it’s all just a blur. I’m curious to see what I find out at my one month exam on 2/22.

I had the typical glare/halo problems at night for the first 10 days or so. There is still some minor halo effect, but not enough to really bother me and not enough to make me think the same thing wasn’t there before the surgery.

I don’t feel like I have dry eyes per se, but my eyes definitely don’t feel right. Sometimes it’s a tired feeling, sometimes scratchy, sometimes blurry/dizzy feeling. I hope that goes away. I know drops are supposed to help, so I use them every few hours or when my eyes are really bothering me.

All of these things are more of a nuisance than a real problem. My vision isn’t horrible – I can function OK without glasses – but I can’t see as good as I did when I had glasses. All the weird things going on with my eyes aren’t debilitating, but they are annoying and certainly weren’t problems before the surgery. Not being able to read really bugs me.

So after 3 weeks I’m really no happier with the results than I was at day 1. I’ll do my best to update this posting regularly over time. Comments and questions welcomed.

[Midwest Man]

Lasik surgery should be seen as a 6 month process and not an overnight miracle. I realize its difficult to be optimistic when your vision varies daily, but its highly likely thing things will improve for you over the coming months. Initially, my vision flucuated between 20/15 and 20/40 during the day, but has settled at 20/15 about 40 days out. Just hang in there with the knowledge that the odds are on your side.

[rosecmd]

Yes, three weeks isn't very long. Just wait it out...you might also try more vigorous dry eye therapy. What does your doctor say? Get some advice from your surgeon or doc....hang in there.

[Mike_in_VT]

As for the eye therapy, I use the drops probably 6-8 times a day. I learned from a previous posting that you shouldn't overdo the drops so you don't wash away too much of your natural tears.

I'm also taking 2-4 flax seed oil capsules daily, on the assumption that it might not do much good but it certainly can't hurt, either.

As for following the doc's advice, here's another area where things aren't ideal. Here in VT, there are two places to get the surgery (plus Montreal, but fewer people are doing that now because of the exchange rate), and both contract out the follow up care to whoever your optometrist is. So after my initial 1-day post-op visit, I don't see the surgeon again. My regular eye doc is competent enough (as far as I know) but my one-week follow up consisted of little more than a routine eye exam. When I asked her if/when things would get better or what I should do differently, she didn't have much to say other than I'd just have to wait it out and see what happens. That may be all she can realistically say on the matter, but I'd probably have more confidence in the process if I was meeting with my surgeon rather than just my doc who gets some marginal fee for follow up care.

[Mike_in_VT]

Just had my one month follow up today. (It's actually 5.5 weeks after the surgery, but who's counting?)

My vision has improved from 20/40 and 20/30 to 20/30 and 20/25. There is still some astigmatism in one eye also, says my doc. So things are getting better, but still not as good as when I had glasses. I guess there's still hope for improvement in the coming months.

Reading is also improving slightly, but there are certainly times when things go in and out of focus. Sometimes I can read just fine for a few minutes, other times not. The days of reading for a couple hours at a shot are definitely gone for now.

I just don't hope I end up in this zone where my vision seems too good for an enhancement but still poorer relative to when I had glasses. For me the glasses were a minor neusance--mostly related to sports and having my kids grab them all the time--but given a choice I'd take glasses and good vision over no glasses and mediocre vision.

Eye dryness doesn't seem to be changing much. I'm still using drops 6-8 times a day.

In sum, day-to-day vision is good, but not great, and eye discomfort continues. If I could do it all over again, I would not have had Lasik done.

My next follow-up appointment is at the end of April, at which time the doc says I should have a real sense of what my final vision will be like.

[Mike_in_VT]

I wish I had more to say after my last posting...everything is remarkably stable. Vision is still not great--in the 20/30 range--and my guess is that's where I'll stay. Reading, which was never an issue before lasik, continues to be a problem.

Still using eyedrops 6+ times a day, which doesn't seem to do anything other than give me crusty eyelids.

Does anyone see any improvement after 7-8 weeks, which is where I am now?

[ptmccain]

Did your eye doctor put you on Restasis? It takes up to six months to work, but worth looking into for fixing the tear production issue.

[rosecmd]

Mike, definitely you will see an improvement beyond 7-8 weeks. You have dry eye...honestly, I saw my best results 5 months after my initial lasik in July 07...by 7 months, my eyes felt normal. At your stage? I used drops myabe 30-40 times a day and gel at night. It took the Restasis about 2-3 months to really kick in. You say you have crusty eyelids...eyelid hygiene is a very important part of treating dry eye. It's essentially to keep your eyelid margins clean and free of crud, that is were the tiny little oil glands are and in order for your eyelids to spread/disperse the oil layer over your eye, those glands need to be kept clean. Also, warm compresses for 10 minutes twoce a day helps. The dry eye zone website has excellent advice about dealing with dry eye.

Stay patient....

[ronsivilllo]

Wow - so much of what you say is similar to me, especially) the summing up of how you feel about it all (i.e., expected better results, cannot say you would do it again.) I am 3 months out and deal with fluctuating levels of "sight" (I say sight with the idea that sight encompasses the overall subjective experience of seeing. Although I do not think my Rx is changing, the quality of the way my eyes feel from day to day fluctuates from a very minor irritant to discomfort enough to make me miserable and interfere with the quality of my life). Thus, for me visions is one thing, and sight another. I am not sure if the docs understand this - they look at only the objective measures but do not consider the subjective ones (which, after all, are the most important to the individual.) -- I have been on Restasis for just over 1 month and I remain (cautiously) optimistic that my eyes will start to feel good most of time, soon. -- I "see" the doc tomorrow, so maybe I'll get a better picture

[Mike_in_VT]

Restasis is new to me - I will ask about it at my next appointment, in about 1 month. In the meantime, I'll increase my drops to 8-10X/day.

I have been on vacation in Florida for the last ten days. It could have been the heat & humidity, or just the fact I spent most of my time on the beach instead of in front of a computer, but it seemed like my eyesight was definitely better down there. Now that I'm back in Vermont, everything seems the same as before.

[ronsivilllo]

Two weeks after my Lasik I spent 2 weeks in Thailand. It was quite warm, sunny, and rather humid. There is no doubt that I dealt with less dry eye issues there (humidity helps!) and less strain -- Also, bright sunshine is typically better for the post-Lasik patient as a lot of people suffer from decreased quality of vision in low-light (after Lasik). My guess is that your eyes and your sight was much better in Florida (and is back to the same in VT) because of the lack of humidity and less sunshine. Your eyes are strained more in low-light (which can make eyes hurt) and couple that with dry-eye, and you have an uncomfortable (and sometimes depressing) situation. -- For those who might be reading this and are comtemplating Lasik (and esp. if you live in a cloudy area with low-humidity in the winter) -- WAIT UNTIL THE SUMMER TO DO THIS! You will be assited naturally by more sunshine (and longer days) and more humid air. The Lasik providers do not tell you this (I would guess)as they prefer a steady customer base all year rather than a slew of people in the summer.

[LasikExpert]

Those who live in sunny California and sunnier Arizona may find the summertime not terribly humid.

While atmospheric conditions can affect comfort during the short-term, what is probably the greatest concern about such variables is allergy season and allergy medication.

Something else to consider.

[Mike_in_VT]

Well, here I am three months out, and I have to say everything has been about the same for the past two months or so. My vision remains OK, but not as good as when I wore glasses. I'm still doing the drops every couple of hours. If I were to go back in time, there's no way I would have had the procedure done.

Next up: my three month exam, scheduled for next Friday. My question now is, what do I need to know about an enhancement? Do my chances improve any if I were to go through Lasik all over again? What kinds of questions should I be asking my doctor at this point?

A lot of folks say give it 6 months or more...but for me, my vision has been about the same since week 1. The only thing that is any different is the level of discomfort, which has declined significantly (but again, is still more than my good-old-glasses-wearing days).

[Mike_in_VT]

One other thing I should add is that my reading vision has improved. Of course I never had any problems at all with reading pre-Lasik, but now I've gone from having real difficulty reading to only occasionally having difficulty with reading/near vision. By that I mean there are times when I look at things close up (e.g., pocket change), and it takes a few seconds for everything to come into focus.

[BAM17]

Hey Mike,
Do you have any left-over astigmitism? I'm wondering if that could be an issue. Do you need glasses to get by right now? Let us know how you make out at your appointment. What about a second opinion? You are a little young for the "sudden presbyopia" that I've read on this site....what did you MD say about your difficulty with seeing things closeup? I'm in NH (one state over from you!). I am still having a few issues too...but hope that they will improve over time. It's hard to be patient though. My thoughts are with you. I hope you start to see some improvement.