10-months post Lasik- does tear film ever improve let me have sharp vision?!

[Ccoughlin]

I'm frustrated - - I still can not see sharply, so I'm wearing glasses most of the time. Will this ever improve? hopefully? I don't see many signs of hope/improvement from post-Lasik people here, so I wonder if it ever gets better. I wish I had just the dry eye but sharp vision (like my husband had with Lasik years ago), but I have both and it sucks!

I've wondered about getting scleral lenses, but that is a big investment, and I don't want to pay for that if this will possibly improve in the next year or so.

Any advice / long-term view would be welcome.

Thanks,
Chandra

[robster]

The thing you have to remember about this forum(as with any forum related to health issues) is that when people do get better they often disappear never to be heard from again. The visions sharpness and dry eye are not necessarily separate issues and could very well be inter-related. My right eye(the bad one) is not as sharp vision wise as the left particularly when it gets really dry but it's definitely better than it was a year ago and I'm 18 months post-LASIK so don't give up hope.

[Rebecca Petris]

Do you have sharp, consistent vision with glasses?

[patientpatrick]

Chandra,

To rebecca's point, does your vision improve while wearing glasses? And is it consistent? I know that dryness made my vision fluctuate a lot. Dr Latkany has a TNT test which you can try at home. place something you can read at a fixed point and walk backwards till it becomes blurry. Then put some eyedrops in. If it gets clearer even for a moment, then the vision distortion is more likely due to dryness than refractive error.

In regards to whether or not things get better... that's something I struggle with every day. While I have appreciated all the support many have given me from this forum, hope is something that I haven't quite made my mind up on yet. It's wonderful to be hopeful, but false hope is only more depressing. I am approaching 15 months post-op and while do feel better than I did a year ago the improvement is marginal. to be honest I think i felt better 6 months ago than I do now. Which I find rather strange because It's only been in the last 3 months that I have been on Restasis, been quadra-plugged, and have been super diligent with my warm compresses, lid massage and hygiene.

Regardless though, I believe any improvement would require a lot of work and commitment.

I really do hope people improve and move on with their lives and leave this forum and never look back. Kinda sucks when you think about it. If I got better, I'd never leave this forum. I'd be constantly posting what treatments I did, when the miracle of relief happened, and most importantly that hope does exist. If people are getting better and moving on, i find it very sad that they don't let us all know. Depressing I know, I've been trying really hard to keep my hopes up.

P

[Ccoughlin]

Rebecca,

When I put on -0.50 glasses, my vision is perfect and it reminds me of what I used to have in contacts before Lasik 10 months ago. Crisp and perfect. Also, when I put in drops, it still clears up almost completely for a few seconds. I'm pretty certain that my lack of sharpness is due to dry eye. What do you think - should I wait on sclerals and hope for the best, that it might continue to improve? It seemed like it was getting better, and then Minnesota in Winter hit and it's pretty bad right now.

[Rebecca Petris]

Personally I wouldn't be pursuing sclerals right now. You're in the early, worst part of lasik dry eye and the worst time of year. Time's definitely on your side!!

BUT - I'm talking about dry eye, not vision.

Now I kind of hate to say this but:

If a -0.50 gives you beautiful crisp vision, CONSISTENTLY, and you test out well in that prescription in the dr's office, that would point to your being slightly undercorrected, or having regressed slightly after surgery. The fact that drops clear you up BRIEFLY does not prove dryness is blurring your vision because the drops themselves are adding refractive medium to your eyes for the brief time they're sitting nice and thick over your corneas - think of the drops as liquid glasses that drain away. They'll do that for anyone, dry or not.

If you're undercorrected/regressed I... hate to sound discouraging but I wouldn't expect time to change that at this point. A certain not insignificant percentage of LASIK patients are not fully corrected, and many regress during healing especially if they're very dry. I get frustrated with the medical people stringing patients along too long sometimes on the hope that it's really about dry eye and when their dryness is better they'll see great, when in fact their refractive outcome from the surgery was simply suboptimal. I'm not trying to diagnose you or contradict what you've been told, just putting a well known possibility on the table.

If it were me, I'd be biting the bullet and wearing those -0.50 glasses full time right now so that I don't have blurred vision compounding my overall problem and contributing to my frustration. (Besides, the glasses cut down slightly on tear film disturbance.) It's just insult to injury, being in pain AND not being able to see clearly.

[Ccoughlin]

Rebecca,

As discouraging as it might be...what you said makes sense. The only time I seem to get "perfect" vision is right after drops. So, I guess the only way to test this theory is to see if I can replicate a moment of great distance vision w/o any drops happening right? Food for thought. At this point, I just hope that the dry eye clears up so that I can cut my losses and wear some decent contacts for sharper vision.

Are there any, besides sclerals, that are more affordable & still comfortable for me someday? I've heard people mention acuvue oasis & TrueType lenses. Can these be tried with dry eye? I just don't want to spend the money on sclerals.

I can't stand this double whammy - hazy vision & dry eye both! Do most people just have the dryness & not the other? I must be regressing. My dr offers an enhancement, but I think that would be crazy to go through this all again!

Personally I wouldn't be pursuing sclerals right now. You're in the early, worst part of lasik dry eye and the worst time of year. Time's definitely on your side!!

BUT - I'm talking about dry eye, not vision.

Now I kind of hate to say this but:

If a -0.50 gives you beautiful crisp vision, CONSISTENTLY, and you test out well in that prescription in the dr's office, that would point to your being slightly undercorrected, or having regressed slightly after surgery. The fact that drops clear you up BRIEFLY does not prove dryness is blurring your vision because the drops themselves are adding refractive medium to your eyes for the brief time they're sitting nice and thick over your corneas - think of the drops as liquid glasses that drain away. They'll do that for anyone, dry or not.

If you're undercorrected/regressed I... hate to sound discouraging but I wouldn't expect time to change that at this point. A certain not insignificant percentage of LASIK patients are not fully corrected, and many regress during healing especially if they're very dry. I get frustrated with the medical people stringing patients along too long sometimes on the hope that it's really about dry eye and when their dryness is better they'll see great, when in fact their refractive outcome from the surgery was simply suboptimal. I'm not trying to diagnose you or contradict what you've been told, just putting a well known possibility on the table.

If it were me, I'd be biting the bullet and wearing those -0.50 glasses full time right now so that I don't have blurred vision compounding my overall problem and contributing to my frustration. (Besides, the glasses cut down slightly on tear film disturbance.) It's just insult to injury, being in pain AND not being able to see clearly.

[Pat83]

Hi !
After my first surgery 2 and a half years ago (I had -4.75), my view was perfect for a while then went back down to -1.00 (after like 2 weeks).
Contact lenses were not an option as I tried contact lenses on dry eyes and.... OMG even though I had worn contact lenses for over 20 years, wearing them with dry eyes was torture.... so I had to take them out.
I did ask the doctor to go through surgery again (free of course, you're supposed to be guaranteed), and now I have perfect view on the right side and -0.25 on the left. Seriously if your dr offers enhancement, I would tell you to go for it because dry eyes is a tiring problem, so no need to add further frustration to it with blurry vision !!!

Pat

[Ccoughlin]

Pat,
I would consider that, except that I'm totally scared about making my dry eyes even worse with more surgery. Did your get better after the 2nd surgery?

Hi !
After my first surgery 2 and a half years ago (I had -4.75), my view was perfect for a while then went back down to -1.00 (after like 2 weeks).
Contact lenses were not an option as I tried contact lenses on dry eyes and.... OMG even though I had worn contact lenses for over 20 years, wearing them with dry eyes was torture.... so I had to take them out.
I did ask the doctor to go through surgery again (free of course, you're supposed to be guaranteed), and now I have perfect view on the right side and -0.25 on the left. Seriously if your dr offers enhancement, I would tell you to go for it because dry eyes is a tiring problem, so no need to add further frustration to it with blurry vision !!!

Pat

[Pat83]

It's pretty hard to compare, since I was undercorrected the first time and didn't have glasses adapted to it, I was so annoyed by that that I didn't focus as much on the "dry" aspect as now (seriously when your vision gets worse day by day and the doctor's saying there might not be enough tissue left to do it again, you start panicking !!). But I DO remember having to use drops many many times a day (also because as Rebecca said, drops also clear vision very briefly), I do remember irritated and dry eyes.
So the dryness didn't appear with the second surgery, but it's very hard to tell if it worsened or not. For me it was not a significant change, but again as you know, results are very different for each person.... But vision improved significantly, which means that now even if my plugs fall out, if I lubricate correctly with drops I have almost perfect vision all day. Oh yes and halos (if that's what you call the blur around a light source... sorry I'm not a native English speaker) improved too.
HOWEVER, since I had only very little tissue left, my second surgery was risky, and the doctor told me just after the operation that he was glad it was over.... His hand was shaking when we shook hands.... So before considering doing it, I think you should really ask what the risks are, if you have enough tissue left, if the doctor feels comfortable with it etc....
As Rebecca said I'd wear the glasses you have full time for now, it does lightly reduce tear film disturbance (I have sharp enough vision but I still put -0.25 glasses on when looking at the screen for a long time or when I'm tired), and at least you'll see sharp !

[robster]

Going to have to say that having another laser procedure on your eyes when you already have dry eye is only going to make the dry eye far worse not better. I'd think very carefully before considering a re-treat if you already have LASIK induced dry eye.

[Pat83]

Going to have to say that having another laser procedure on your eyes when you already have dry eye is only going to make the dry eye far worse not better. I'd think very carefully before considering a re-treat if you already have LASIK induced dry eye.

I agree that dryness will definitely NOT become better. I guess the fact that it will worsen a lot or not depends on the person as well as the technique used by the doctor. My second operation was much shorter than the previous one (used less machines) and the doc said many things that had been done by machines the first time had to be done manually the second time because of the lack of tissue. Would be nice if other people who got surgery twice could add here to know if they felt a bigger dryness difference than I did.

[Rebecca Petris]

At this point, I just hope that the dry eye clears up so that I can cut my losses and wear some decent contacts for sharper vision.

Sounds like a plan. Sorry I don't know latest info on best contacts to try with dry eye... definitely different experiences for different folks. I would just make sure not to start trying too early.

My dr offers an enhancement

Udder no sorghum stenches wassail lever. Just my personal opinion of course... I would never adversely judge anyone who chose differently. It's all about risk/benefit and how important something is to you.