Thursday, March 24, 2011

Custom Wavefront LASIK & Monovision

Question: I had Monovision LASIK Custom Wavefront Surgery done 4 months ago today. I still have halos around lights at night or early morning. It seems my close up vision eye interferes with my distance eye yet alone they work okay. I have also noticed that the distance of the "blended vision" has become worse. I know there are focus fluctuations. Can you let me know if it can take more than 4 months to even out? Do the halos really go away? If so, how long do you know it has taken some people? Is it possible to have the surgery re-done, (maybe there is a precise measurement the wavefront missed) It always seems I need to rub my eye to clear the vision. I don't mind waiting longer, but I'd like to know if more time is needed or is this as good as it gets (is the healing done by now)? I hear so many wonderful things and experiences with LASIK but to date I am disappointed with mine. Is there a slight adjustment that can be made to bring the 2 visions closer together.

Answer: There are many considerations here especially as we do not know your age, your correction or the overall health and condition of your eyes-especially your tear film integrity. First, you are adapting to a change in your vision that occurs from having Wavefront LASIK alone. Having more of the aberrations corrected or altered, rather than what you have been used to in eyeglasses or contacts sometimes requires some "neuroadaptation". Almost always this occurs within the first 3-4 months after treatment. Second, you do not say whether you had been wearing a monovision correction in contact lenses prior to your LASIK procedure. If you were, then there is no adaptation to the monovision expected. If you were not, once again there is typically an adaptation period of as long as 2-3 months where your brain is learning to use the "blended" vision in a different cortical vision pattern. Third, given that you are in need of monovision correction, it is probable that you are presbyopic and thus of an age where dry eye problems occur. We know that LASIK causes a temporary dry eye condition for some patients for as long as 6 months. Many of your complaints may very well be related to tear film instability from dryness. You should absolutely return to your LASIK Surgeon and review just as you did here, the problems, symptoms and complaints that you have. There are quick simple tests to see if you are failing to adapt to monovision correction, including just inserting a soft contact lens in the "near" corrected eye in order to demonstrate full distance correction and temporarily eliminate the monovision effect to determine if that is contributing. It is also relatively easy to observe tear film instability on examination as well. Please be confident that there are solutions for both of these possible problems in order to get you to where you need to be. If your LASIK Surgeon is either unwilling or unable to resolve this for you, seek a second opinion with a top LASIK surgeon.

Important Note: The information presented on the See With LASIK Blog or provided in response to a request for information in the Ask LASIK Surgeons section on is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to LASIK. In particular a response to an inquiry made on the Ask LASIK Surgeons section of is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and LASIK surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

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