Tuesday, May 31, 2011

LASIK Surgery and Dry Eye after 5 Years

Question: I had LASIK Surgery in 2006 at the age of 43. Since that time I use REFRESH TEARS® however these days my eyes actually hurt. Then after some time they are okay. What could cause this?
Answer: It is a bit unusual that some 5 years after your LASIK surgery you continue to require artificial tear eye drops-REFRESH TEARS®-unless you had a preexisting dry eye condition or are now in an environment or have some other systemic or eye health reasons that are causing you to have a dry eye syndrome. That said, it is impossible to know from your description whether the discomfort you experience is related to a chronic dry eye, some other ocular surface problem or even some other eye problem or condition. It is important that you schedule an appointment with a top LASIK surgeon and perhaps one who is also a Cornea Specialist in order to review your situation carefully. If in fact your symptoms are due to a chronic dry eye, then there are several additional treatment options in addition to artificial tears that may be helpful. These include Restasis® eye drops that actually help you produce more of your own natural tears and insertion of tiny tear duct plugs that act to help you retain more of the tears you do produce.

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 seewithlasik.com 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 seewithlasik.com 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.

Monday, May 30, 2011

LASIK Surgery and Epilepsy Medication

Question: I have some peripheral vision loss due to the use of Vigabatrin. I don't use this medication any more is there any possibility that LASIK Surgery may be able to help me.

Answer: LASIK Eye Surgery is used to help patients suffering from nearsightedness, farsightedness and/or astigmatism see clearly at distance with a reduced dependence on or even no need for eye glasses or contact lenses. LASIK Surgery does not have any indication for resolving or reversing visual field defects. Vigabatrin, which is also known as Sabril®, is an anticonvulsant medication used to treat epilepsy. It was FDA approved in 2009 and is potentially helpful for the 30% or so of patients who otherwise have treatment resistant epilepsy. Because of the substantial risk for permanent visual field defects, Vigabatrin can only be prescribed by physicians who participate in the SHARE (Support, Help and Resources for Epilepsy) program. The purpose of SHARE is to monitor patients for the development of visual field defects, and to stop the drug as quickly as possible if these develop. The field defects are permanent, but stopping the drug may limit the damage. If you are an eyeglass wearer with a high degree of correction and the eyeglasses restrict your visual field, and if this compounds the visual field loss from the Vigabatrin, if your eyes and general health are otherwise adequate it is possible that you might be able to have LASIK Surgery and experience some functional benefit. The best way to determine if this might be the case is to have a consultation with a LASIK Surgeon who can then confer with your neurologist about whether this might be possible. You should know that the fixation light in the laser that patients view as part of any Laser Eye Surgery treatment does “flicker” and has on rare occasion been a problem for some patients with epilepsy who are not otherwise well controlled.

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 seewithlasik.com 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 seewithlasik.com 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.

Saturday, May 28, 2011

LASIK Enhancement after 12 Years

Question: I had LASIK in 1999 and had perfect eyesight up until a few years ago (other than needing reading glasses a couple years after the LASIK...I'm now 56 years old). My distance eyesight is now not perfect but sufficiently bad enough for me to again require prescription glasses (although I don't wear them much). The question I have is this: Is it okay for me to have another LASIK procedure to correct my vision?

Answer: The answer really depends on whether the reason for your decreased distance vision is actually due solely to a change in your refractive error, such as increased nearsightedness, whether the shape and thickness of your cornea allow you to be a good LASIK candidate and whether your overall health and eye health are in order. If the answers to these questions are found to be favorable after a consultation with a LASIK surgeon, there should be no reason to not have another LASIK procedure to correct your vision. It is critical however that you have an examination with a top LASIK surgeon as it is possible that some of the nearsightedness you might be experiencing could be due to some other eye condition or problem such as a beginning Cataract.

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 seewithlasik.com 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 seewithlasik.com 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.

Eyeglass and Contact Lens Problems

Glare and halos are a common and annoying problem for a good number of eyeglass and contact lens wearers according to the global NSIGHT (Needs, Symptoms, Insight, Global Eye Health Trends) study. Halos are the appearance of rings around sources of light while glare is the difficulty seeing in the presence of bright light. The majority of patients who experienced these symptoms reported they were most likely to experience halos or glare in the evening or late at night. The symptoms were commonly associated with bright lights, headlights, being in the dark and nighttime driving.

NSIGHT, which was gathered from 3,800 eyeglass and contact lens wearers data, uncovered how often and to what degree patients experience glare and haloes, as well as how disturbing these visual symptoms and problems are for patients. The data demonstrated the following:
  • About half of the spectacle and contact lens wearers surveyed reported suffering from the symptoms of halos (52% and 56%, respectively) and glare (47% and 50%, respectively) more than three times a week; 
  • More than four out of five patients who experienced these symptoms found each symptom bothersome (84% and 89% for halo and glare, respectively); 
  • Spherical aberration, which can contribute to optical distortions in the visual system, can create halos and glare. Spherical aberration is a type of image blur caused by light rays striking the lens periphery where they are bent too much -- over refracted -- compared with rays coming through the center of the lens.
The NSIGHT study findings indicated that the severity of symptoms associated with halos and glare is sufficient enough to impact patient satisfaction with the usual vision correction methods, such as eyeglasses and spectacles, and patients expressed an interest in an intervention that more adequately addressed these symptoms.

Top LASIK surgeons have been routinely measuring both high and low order optical aberrations such as spherical aberration, and offering patients Wavefront Guided Laser Eye Surgery or Custom Wavefront Optimized LASIK to reduce and correct spherical aberration for LASIK Surgery patients.

Tuesday, May 24, 2011

Common Refractive Errors

Question: What exactly are the differences between nearsightedness, farsightedness and an astigmatism?

Answer: Nearsightedness or myopia, farsightedness or hyperopia and astigmatism are three common refractive errors of the eye that cause blurred vision.

Myopic Eye


Myopia results either from the eye being too long or the cornea-the clear dome shaped lens in the front of the eye-being too curved. In either case the myopic or nearsighted eye focuses light in front of the retina resulting in blurred vision whereby objects and images far away are blurred-and objects that are closer are clear.



Hyoperic Eye



Hyperopia results either from the eye being short or the cornea being too flat. In either case the hyperopic or farsighted eye focuses light behind the retina resulting in blurred vision whereby objects and images up close are blurred-and objects that are far away are clearer.




Astimatic Eye


Astigmatism typically results from the cornea being unequally curved vertically as compared to horizontally so that it is shaped more like a football rather than a basketball.





Astigmatism causes the eye to have two different focal points and thus blurs objects more in one direction that the other i.e. it distorts vertical objects more that horizontal or visa versa. 
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 www.seewithlasik.com 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 http://www.seewithlasik.com/ 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.

Wednesday, May 18, 2011

LASIK for Irregular Astigmatism

Question: I was wondering what laser eye surgery treatments are available for irregular astigmatism. I have approximately 1 diopter of myopia myopia with approximately 2.75 diopters of astigmatism. I have to wear rigid gas permeable (RGP) contact lenses because spectacles don't correct my vision adequately. Also I have had previous cataract surgery. Does that stop me from having any corneal surgery or will it harm the results?

Answer: The simple answer to your question is that Custom Wavefront LASIK is often used to correct irregular astigmatism. However, it is quite important to first determine why you have the irregular astigmatism. If you had the irregular astigmatism because of some serious trauma to the eye or perhaps an infection-and it resulted in scarring-this may or may not pose a problem in having Laser Vision Correction. If the irregular astigmatism is due to some underlying eye health issue, particularly some corneal disease or degeneration, this would be a problem for having Laser Eye Surgery for astigmatism correction. If the irregular astigmatism were a side effect of the cataract surgery, and were stable, then it is quite possible that Custom Wavefront Laser Eye Surgery could be used to correct the astigmatism. And-there are several other clinical questions that need to be investigated and answered. As you can see the answer to your possible options really depends on having a thorough evaluation and consultation with the best LASIK Surgeon in your area who is also preferably a top Cataract Surgeon. Your next step is to schedule a consultation so a Cataract and Refractive Surgeon can examine you and walk you through your possible options.

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 www.seewithlasik.com 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 www.seewithlasik.com 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.

LASIK Enhancements-Can I have LASIK Again?

Question: I have had LASIK surgery before, now I am having trouble seeing again, can I have LASIK again?

Answer: In order to know whether you can have a LASIK enhancement many things must be considered. First, what was the original attempted correction in terms of power and depth, the health, thickness and shape of your corneas and stability of your prescription. It might be important to know the type of treatment you actually had such as Custom Wavefront LASIK and how long ago you had it. This information will be of use to a LASIK surgeon who evaluates the current status of your vision and eye health. It is important to determine whether your current decrease in vision is actually due to a refractive error such as nearsightedness, farsightedness or astigmatism or some other eye condition or problem. Your next step is to schedule a consultation with the best LASIK Surgeon in your area and provide as much background about your previous treatment history, eye health and vision as possible. From this information and a thorough consultation it will be possible to determine whether a LASIK enhancement is necessary and a good course of treatment for your vision correction.

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 www.seewithlasik.com 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 www.seewithlasik.com 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.

Tuesday, May 17, 2011

LASIK after PRK-Is it Possible?

Question: I had PRK done in one eye in 1995-then I had LASIK in the other eye a few years later.The PRK eye is 20/40-50 and the LASIK eye is 20/20. Is it possible to have LASIK on the eye with the previous PRK to bring it to 20/20 and what would be the cost?

Answer: First, there is never a guarantee that anyone will ever see 20/20 after any Laser Eye Surgery procedure. Second, you should know that the visual results with PRK as compared to LASIK are virtually identical-thus you first need to determine why you only see 20/40-50 with the first eye to have Laser Eye Surgery. What was the level of best corrected visual acuity with eyeglasses or contacts in that eye prior to Laser Vision Correction? Was it 20/20? Next, did you ever achieve better than 20/40-50 after the initial PRK in the first eye-and did it them regress-or did you not achieve 20/20 to begin with? If you were treated with PRK in 1995 this was the very first year Laser Vision Correction had been FDA approved and it was not initially capable of treating astigmatism. If you had preexisting astigmatism in 1995 and did not have an astigmatic keratotomy (AK) to correct it-then you still have an uncorrected refractive error that could impact your vision. As you see there are many questions that need to be answered regarding your vision. If you eye health, overall health, corneal shape and thickness meet the criteria for LASIK then it is entirely possible that if you have some residual refractive error your have a LASIK surgery procedure to treat the uncorrected optical prescription. Your next step is to schedule a consultation with a top LASIK Surgeon who will take all the necessary measurements to determine the status of your eye health and vision and recommend the possible options that would provide good results.

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 www.seewithlasik.com 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 www.seewithlasik.com 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.

Monday, May 16, 2011

LASIK Surgery after RK

Question: Can LASIK Surgery be performed when someone has had RK surgery previously? My RK was done around 1994 and I'm right back where I started.

Answer: In most instances it is possible to have LASIK Surgery or other type of Laser Eye Surgery after RK if you meet the basic candidacy requirements in terms of eye health, overall health, motivation and expectations. For someone who has had previous RK there will need to be a careful and thorough evaluation of the cornea in terms of integrity, stability and possibly scarring as well as its shape and optical aberrations. Sometimes, depending on the number, position and the depth of the incisions of the previous RK, LASIK surgeons prefer to perform PRK rather than LASIK. The results are essentially the same for each type of Laser Eye Surgery for correction of nearsightedness, farsightedness and astigmatism. You should choose a top LASIK surgeon and arrange a consultation where all necessary measurements can be taken and evaluated. A careful examination must be done in order to be sure that the reason your vision has regressed is solely due to the lack of stability of the RK procedure. This will be the first step in your consultation in order to best guide you on the most effective choices you might have.

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 www.seewithlasik.com 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 www.seewithlasik.com 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.

PRK and Blurry Variable Vision

Question: I recently got PRK done on my eyes. Lately I have noticed that my eyes get blurry throughout the day. The best example I can come up with is its like I had been swimming all day and opening eyes under the water. What I have also noticed is that they get blurry when I put any kind of drops in my eyes such as the anti-inflammatory drops or my moisturizing drops. I wouldn't worry about it if it wasn't for the fact that my eyes didn't do this after the procedure. I'm just wondering when I can expect this to clear up so I can get to seeing clearly.

Answer: You do not state how long ago you had the PRK procedure and you don't disclose the degree of refractive error-assumed to be nearsightedness-that was corrected. Both of these factors may be relevant. First, PRK is a type of laser eye surgery called surface ablation-that is, the leaser energy is delivered to the surface of the cornea. That is different than LASIK, which is a lamellar procedure whereby the laser energy is delivered in between layers of the cornea. Surface ablation procedures such as PRK typically have a slower visual recovery. Depending on the degree of myopia to be corrected it can take as long as 3 months for high prescriptions to yield totally stable results. Generally, the higher the prescription corrected the longer the visual recovery time. This is because it takes a fair amount of time for the cornea to "remodel' and for the top layer-the corneal epithelium-to return to its preoperative normal structure. it just takes time.

Second, in all types of corneal surgery-PRK or LASIK, but even greater with PRK, we are causing a significant temporary disruption of the tear film. The tear film is an important optical component and can cause variable foggy filmy vision to occur if it is not stable. Keeping the eye lubricated-very lubricated facilitates the healing and visual recovery. It could simply be that you have a temporary tear film deficiency and dry eye causing your symptoms. Last, in some small number of cases it is possible that during the postoperative healing phase a condition called "corneal haze" can develop. Typically corneal haze is asymptomatic unless it is quite severe. So there are several possibilities that may or may not be contributing to your symptoms. It is worthwhile for you to schedule a visit with your eye surgeon in order to determine which if any of these are causing your blur and what can be done about it as well as how long it might last.

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 http://www.seewithlasik.com/ 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 http://www.seewithlasik.com/ 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.

Friday, May 13, 2011

Laser Eye Surgery for Near Vision

Question: I am 42 years old and it has become very difficult to read to the point that now I simply cant read at all without reading glasses. My eye doctor fitted me with a progressive prescription 2 years ago however recently my eyes have become more strained when I attempt to wear them all day. Would I be a candidate for laser eye surgery to correct this problem and hopefully do away with having to rely on glasses?

Answer: Laser Eye Surgery for Laser Vision Correction is appropriate for people with health eyes but suffer from nearsightedness, farsightedness or astigmatism. The condition you describe whereby you have lost the ability to focus up close and read is more likely to be presbyopia, a normal change as we age where the crystalline lens of the eye loses its elasticity. Procedures such as LASIK are mainly recommended for patients who have decreased distance vision although for some people who need a little extra help reading, a technique called monovision LASIK may be appropriate if they are also in need of distance vision correction. If you primarily wear your glasses for near vision you would not typically be a good LASIK candidiate.

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 http://www.seewithlasik.com/ 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 http://www.seewithlasik.com/ 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.

Monday, May 9, 2011

LASIK Flap Thickness-Is Thin Better?

Top LASIK Surgeons are always seeking ways to improve the safety, efficacy and predictability of LASIK. Researchers from the University of Utah compared LASIK results when using two different “flap” thicknesses to see if there were any clinical advantages in visual acuity, contrast sensitivity, higher order ocular aberrations or quality of life. Researchers reporting in the April 2011 edition of the Journal of Refractive Surgery compared the visual results of a group of 94 patients who were treated with LASIK using a different “flap” thickness in each eye so that 47 eyes had one thickness and 47 eyes had a different thickness. After three months it was concluded that both “flap” thicknesses used for LASIK treatment provided similar clinical results. There were no statistically significant differences between the flap thicknesses in terms of overall visual acuity, increase or decrease in aberrations or contrast sensitivity and all patients reported a significant improvement in the quality of life.

Saturday, May 7, 2011

LASIK and the Military

LASIK and PRK are being widely adopted by United States military service members to help them refine their edge in combat situations. The Army and Air Force operate a Department of Defense Center of Excellence for Refractive Surgery, such as LASIK and PRK, known as Wilford Hall Medical Joint Refractive Surgery Center at Lackland Air Force Base in Texas. The Wilford Hall Medical Joint Refractive Surgery Center performs over 4,000 refractive eye surgery procedures per year and is the busiest of the Air Force Refractive Surgery Centers. The military refractive surgery center programs are considered “readiness” enhancers for military personnel going into combat so that their performance is better than what they could achieve with glasses or contact lenses.


"If you can see the enemy 100 miles sooner than the enemy can see you, you have the advantage," said Lt. Col. (Dr.) Charles Reilly, the consultant to the surgeon general for refractive surgery. "We're about giving you the advantage in combat. We want to give you what we call the "combat edge" in vision. Just like when you upgrade avionics systems in an F-15 or an F-22, you want your radar to be able to see the enemy long before their radar can see you. That's how we look at vision. We're upgrading the 'avionics' of the human weapons system."

Military personnel are expected to perform their duties in a widely varying range of conditions, many of which are inconvenient or incompatible with the wearing of eyeglasses or contact lenses. Environmental conditions of sand, rain and windstorms can make eyeglasses and contacts a real hindrance, to say nothing about the general performance limitations imposed by optical devices.

Army Staff Sergeant Stanley Arnold is a combat tactics instructor in Ft. Huachuca Arizona and wore eyeglasses for 18 years before having LASIK at Wilford Hall. "One of the things I don't like about glasses is that it takes away from my peripheral vision," said Staff Sergeant Arnold. "Now, I know I'll get my peripheral back and that makes me feel better with deploying. Being an infantryman, I know for a fact when I leave (instructor duty) I will deploy eventually. I'm very happy with it. I'm on cloud nine."

Friday, May 6, 2011

LASIK after RK (Radial Keratotomy)

Question: About 4 years ago I was told by a very reputable LASIK doctor that that I was not a good candidate for LASIK. I had RK in around 1992 and have had my astigmatism come back, rather severely, in both eyes over the past 5 years. I now wear RGP contacts which can only correct my vision to 20/60 at best. Is there a chance that some of the latest advances in LASIK technology can help improve my vision? Does having the corneal scars of RK make LASIK not an option? I really would love to see better and get out of contacts once again.

Answer: LASIK after previous RK can be performed in many, but not all, instances. RK can structurally weaken the Cornea and often lead to progressive changes in vision. RK can sometimes result in both regular and irregular astigmatism. The fact that you wear RGP lenses and can only be corrected to 20/60 vision is not a favorable prognostic factor and suggests that the overall integrity of your Cornea may not be the best.

Whether or not you are a LASIK candidate-or a candidate for ANY type of Laser Eye Surgery for vision correction-is going to depend first and foremost on the health and integrity of your Cornea. The newer techniques used for advanced surface ablation and even LASIK can often be appropriate for the post RK patient, but only with good corneal integrity. The use of Custom Wavefront Guided or Wavefront Optimized LASIK can often be helpful in reducing the aberrations that can be caused by RK, but again only where the Corneal is structurally sound. Your best next step is to find a top LASIK Surgeon who is a full scope Refractive Surgeon and consults on both routine and complex cases, and perhaps is even a corneal specialist, and schedule an examination and consultation. You need to understand why your vision is only correctable to 20/60 with RGPs and whether your Cornea is structurally intact before considering any type of additional surgery.

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 www.seewithlasik.com 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 www.seewithlasik.com 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.

Thursday, May 5, 2011

LASIK for Nearsightedness and Farsightedness

Question: Can LASIK correct my vision for nearsightedness and farsightedness in same eye?

Answer: LASIK can correct both nearsightedness and farsightedness. However, there may be some confusion or misunderstanding about the refractive condition of your eyes. People who are nearsighted cannot see clearly at distance, but can see clearly up close. People who are farsighted cannot see clearly up close but can see clearly far away. So, technically you cannot be both nearsighted and farsighted in the same eye. Perhaps you are referring to one of two conditions. If you are nearsighted and wear eyeglasses to see at distance and are approaching or over 40 years old, you may be losing your ability to focus up close-this is called presbyopia, not farsightedness. Presbyopia is a normal loss of focusing so that near vision is difficult. For some patients, a technique called monovision LASIK can be used to help provide clear vision at distance and help with close vision. The second possibility is that you have “mixed astigmatism” so that one focusing meridian in your eye is “farsighted” and one focusing meridian in your eye is nearsighted”. Many, but not all instances of mixed astigmatism can be treated with Laser Eye Surgery for Laser Vision Correction. Your next step is to find a top LASIK Surgeon in your area and schedule a consultation. Once they have taken all of the necessary measurements and provided a thorough examination and consultation they will be able to tell you whether you are a good LASIK candidate.

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 www.seewithlasik.com 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 www.seewithlasik.com 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.

Wednesday, May 4, 2011

LASIK Surgery Vision Expectations

Question: My original prescription was -5.75 and -6.25. I had LASIK on March 23 and I am now 20/40. It really bothers me. I had trouble driving and my eye doctor wasn't going to give me glasses until I told him I was afraid about car accidents. He told me "there are lots of people with 20/40 vision" and reading signs "isn't that big of a deal”. I need to have this redone. I have haze around windows during the day and large starbursts at night. This isn't what I expected and this doctor doesn't seem to care. Can I wear contacts again?

Answer: First, rest assured that if in fact you were a good candidate for LASIK in terms of overall health and eye health the results of LASIK Surgery for correcting your level of nearsightedness are quite good. The vast majority of patients having LASIK are often able to pass the 20/40 driving standard at their first post operative visit and the final uncorrected level of vision is typically in the 20/20-20/30 range by about 90 days after their treatment. At the time you made this inquiry you were about 40 days post your treatment which is not really sufficient time for your eyes to have fully healed and recovered to the final level of vision. One never performs a LASIK enhancement before the 90 post operative healing period has passed as the vision is simply not stable. Further, your attempted correction is of a moderate amount of nearsightedness which requires a somewhat deep treatment level which also can require a bit of time to achieve the visual recovery.

All of that aside, starbursts and haze are not typically expected a month or so after treatment. You do not state whether you had preexisting aberrations such as spherical aberration before your LASIK and you do not state whether you have had a conventional LASIK or a wavefront guided or wavefront optimized LASIK surgery. The symptoms that you describe could be related to the presence of spherical aberration which was either present or induced by the treatment itself given the degree of myopia that was corrected. This should be readily measureable in the doctor’s office using a clinical instrument called an aberrometer which is part of the preop and follow-up process.

If you are dissatisfied with the information being provided by your LASIK surgeon it is entirely appropriate to find a top LASIK surgeon for a second opinion in order to determine exactly what is going on and what to expect. This is not unreasonable at all.

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 http://www.seewithlasik.com/ 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 http://www.seewithlasik.com/ 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.

Monday, May 2, 2011

Multiple Laser Eye Surgery Enhancements

Question: I had a Laser Eye Surgery when I was 18 years old and a correction or enhancement surgery when I was 20 years old. Now I am 30 years old and my eyes are 1.5 D weak and I have problems with TV and driving. Is it possible for me to have Custom Laser Eye Surgery to correct this? Is there any serious risk?

Answer: You do not state what your original attempted correction was for your initial Laser Eye Surgery. You also do not state how much of an enhancement you required just two years after your initial treatment. So it is somewhat difficult to know what is really happening with your eyes. It is possible that when you were first treated some 12 years ago that your prescription was not stable and this is why you needed an enhancement. The fact that in 10 additional years you say that you need another 1.5 D of correction is disturbing. Again, whether it is environmental, work related, health related or somehow related to the shape of your cornea it is important to make sure that there is no underlying pathology that is creating the instability. You do not state whether your vision was or is correctable to 20/20. All of these things need to be addressed prior to even considering a third corneal laser procedure. It may be possible to have yet another Laser Eye Surgery but you really need to be under the care of a top LASIK Surgeon as you require very careful examination and evaluation to understand why your vision has deteriorated. Once that is determined he or she can take the appropriate measurements to determine whether it is possible or advisable to have any more surgery as you run the risk of making your corneas too thin and weak and inducing undesirable shapes in the cornea with multiple procedures. You best course of action is to find a top LASIK Surgeon who has experience in all types of Laser Eye Surgery for vision correction and schedule a consultation.

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