Focusing Issues

[Cactusgod]

Hey guys,

I've developed a new(er) symptom over the past month that seems to have gotten worse. I'm having trouble focusing my eyes to work together. Imagine, if you will, that you are just sitting around and zoning out whilst daydreaming. My eyes feel like they'd like to be in that "zoned out" state. My strain is coming from (I believe) having to keep the eyes together and NOT let them zone out.

Now, I have a perfect left eye and I went from a horrible right eye that couldnt see the big E on the eye chart, to an eye with rather blurry 20/20. My thoughts are that even though its been a year and 3 months since my surgery...my brain may finally have started recognizing my eye as useful, thus the strain of using it really for the first time and this is where the strain is coming from. (After all, the eye is a muscle right?) I'm not sure exactly. My doctor told me that he believes all of my symptoms, including the focusing one, will go away but unfortunately he didnt specify any length of time. They did mention though that my eye is PLAINO or PLANO? Not sure exactly how that is spelled. But from what I gather that means there was no over or under correction?


Any thoughts or advice anyone has is greatly appreciated.

[LasikExpert]

Plano means no refractive error - your eyes see 20/20.

Since you had one eye that was significantly worse than the other, your brain could have decided to ignore the information coming from that eye. This is called ambyopia, but it really does not sound like this is your situation. Amblyopia would mean that the eye that had surgery would not have the 20/20 vision you are now able to see. That is good news.

What it does sound like is that you are having an accommodation and convergence difficulty. Accommodation is when the natural crystilline lens within the eye changes shape and thereby changes focus. Convergence is when the eyes point to the object of focus even if you need to become cross-eyed to see an object very close.

It is not surprising that you are having some difficulty with accommodation and convergence considering that with one eye nearsighted and the other plano your eyes have probably not been doing this as would a normally sighted person. You may want to read our article that includes information about accommodation and convergence.

If you are at or past age 40 you may be dealing with the effects of presbyopia, which is when accommodation becomes more difficult. The linked article above has information about presbyopia too.

You may want check around to see if there is an accommodation and convergence specialist in your town. It is likely that this expert would be an optometrist (not ophthalmologist), so you should start with optometry as your resource.

[Cactusgod]

Just for the record, I am 21 years of age.

I was thinking that could be the issue. Although my right eye in general has begun exhibiting a really odd symptoms. For instance (and if you have ANY answer for this I would be SUPER appreciative)

If I cover my left eye and look around with my right eye for a little while, my eye starts to see little tinsy black spots (like the black static on a TV) and then a black dot sort of starts to form in my field of vision. Then, it goes away, and a ,in a few seconds, returns. Etc. I don't see any of this with both eyes open.

The other odd thing is that I went months without any issue, which is why I assumed that its my brain recognizing my eye.

I mentioned this to my Lasik Doctor and he essentially passed over the information and suggested that all of the focusing issues and such should pass with time.

Any ideas?

Thanks a lot for the information!

[LasikExpert]

The black dots in the one eye are not a focusing issue. They may be as relatively benign as floaters, or a sign of a more significant problem. Contact your Lasik doctor's office at your earliest convenience and relate the pulsing black dots. If they do not think this warrants an examination, seek a second opinion. I suggest the second opinion be from the ophthalmology department of a university affiliated teaching hospital.

[Cactusgod]

Thanks. I appreciate all of the help! I'm a tad bit concerned... I've actually had an eye exam by an optometrist on August 23rd (before I realized this issue). Is there any specific test that you think might be beneficial in diagnosing this problem? It's hard because I'm not exactly wealthy here and going in for different tests and eye exams are brutal when I've gotta pay for everything.

Also, I don't really have a teaching hospital anywhere nearby, a few hours actually, so to take a trip would be pricey!

Also, Glenn, if you get the chance I have another post that is called "Symptoms 8 month post Lasik" which also mentions some other symptoms I have encountered and may or may not give you more insight into this current situation.

I can't tell you how much I appreciate you taking the time to answer my questions!

[LasikExpert]

It is reasonable to argue that the symptoms you descirbe regarding pulsating spots are not directly related to Lasik surgery but that are an unrelated medical problem. As a medical condition, treatment would likely be covered under general medical insurance. You should express your concerns and symptoms with your general physican to see if continued care would be covered by insurance.

[Cactusgod]

I'll definitely do that. Unfortunately I'm a recent college graduate who applied for insurance but was denied originally because of the restasis and a few other things that I was taking at the time. So..I'll have to hope and see.


By the way, I just thought of a better way to describe what my eye is doing. Its similar to when the doctor is going to start the surgery, and they put that thing on your eye and you lose all sight in it. Sort of like when you press in on an eye for a long period of time and then open it. You see those little disturbances and then the black spot across your eye starts to spread until you cant see anymore. Thats how it happens to me, except I can still see, theres just a black spot in the field of vision. (When the one eye is open)

[LasikExpert]

When you press on your eyes you raise the intraocular pressure (IOP). This spike in IOP stresses the optic disc at the back of the eye. Long-term elevated IOP can cause permanent optic nerve damage.

The Lasik flap has the ability to provide false information to the devices that read IOP. It may be necessary to use the device in an area outside of the Lasik flap to achieve an accurate reading.

If you are having problems with high IOP it is likely possible that eye drops will resolve the issue and/or the direct cause may be resolved. Verification of IOP may be appropriate.

You may want to see your surgeon again.

[Cactusgod]

Ok, so..

I went to a new doctors office (Northeast Eye Institute in Scranton, PA...Great great people working at that place) and it was found that I still had a minor prescription in my right eye (the eye I had the surgery on). So, my doctor decided that I should try out a contact lens in order to see how my eye reacts to it and if an enhancement would help. She suggested that my eye was having trouble focusing through the prescription, and that this contact lens is not perfect, but pretty close to what I would expect with an enhancement. I seem to be having less focusing issues, but my right eye still sees the doubling (when looking at things far away) and I still get minor headaches and eyestrain and such. I've been wearing the contact since October 10th.

My question is...Since, like you said, my brain and eyes aren't really used to this process...is it realistic that I could heal over the next few months, or years, or is there a certain point where I have to accept that my brain won't get used to it? I'd imagine that going almost my whole life without my eyes working together will be quite a challenge for my brain to eventually(hopefully) overcome.

Also, if this contact lens doesn't correct the double vision and such, do you think that the enhancement would?

Thanks!