Visual symptoms started 3 months after lasik and won't go - don't know what to do

[phenix01]

Hi all

I have been suffering of starbursts and glare for some time now and seeking help/advice form those who may have gone through a similar situation.

I had lasik done 1 year ago; for the first three months everything was perfect: I could drive at night, go out at night, with no issue.

At the 3 months post-op mark, my eyes started to feel dry and visual symtoms at night appeared (starbursts and glare around lights). Went to see my doc who said my eyes are mildly dry and inserted punctual plugs. The dry eyes still got worse gradually from 3-month to 6-month post-op, and so did the symptoms. At the 6 months mark, I even had visual symptoms during the day!

Fast forward, it has now been 12 months since the operation and nothing has changed. My surgeon has no clue what causes the symptoms, saying my eyes aren't dry, although I do feel the dryness. I went for a second opinion: the doctor again didn't really see any dry spot but still put me on Restasis + fish oil supplements + warm compress once a day. I have been doing all this for 2 months now with no improvment so far.

I do suspect the visual symptoms are due to dry eyes since I do feel the discomfort and since the visual symptoms did not occur right after lasik, but gradually with the dry discomfort.

I am really hoping there is a way for my vision to get back to how it was. Anyone has some insight to share?
Also, can dry eyes really cause big starbursts around light at night and glare during the day?

[dede29]

If your symptoms are gone upon applying eye drops, then it is likely due to dry eyes. Otherwise, it still may be due to dry eyes (but less likely) and of course it may be due to the way of how your cornea changed/healed from the LASIK procedure.

In case you had a forme fruste keratokonus (back side of your cornea, which can be seen with a Pentacam for example) and they still performed the LASIK procedure, it may trigger this disease, but I think this is extremely unlikely.

I'm not a professional, but I have read a lot about such issues.

Just out of curiosity: Are your star bursts symmetric (each stroke having the same length?).

[phenix01]

dede29,

To answer your question, in dim light conditions, I only see the bottom part of a starburst, When it's darker however (at night) I see the full starburst which is fairly symmetric.

Also using drops might make it better for 1 second but nothing more.

Is it really likely that this is due to a bad healing of my cornea and that it started 3 months post-op? Shouldn't doctors see this?
In other words, is it possible to develop high order aberrations (HOA) 3 to 6 months after lasik?

[dede29]

Do you have any Pentacam pictures you can share?

What I rather think happened is: Lasik may have induced some HOA, which were corrected by your nice nice tear film first. Later, since you got dry eyes, the irregularities on your cornea may now have a negative effect of your vision. Ask your doctor to tell you about the state of your cornea (ask for a back and front topograghy, can be done with a Pentacam/Orbscan etc.). A slit lamp exam will not tell your doc anything (in case this is the only thing he did).

You could try RGPs. If they fix your visual symptoms, then it is very likely that your problem is on the front side of your cornea (either irregular or dry eyes).

[phenix01]

dede29,

Thanks for answering. I do not have pentacam pictures but will ask for those.

I thought HOA were under the flap, I don't understand how the tear film could correct that. Could you explain?

In terms of dry eyes/irregularities to the cornea, if my eyes get better, how long should it take for visual symptoms to go away (assuming dry eye is the issue)?
I'm asking because, although my eye did feel very dry up to this month to the point where I had a hard time working past 6pm (I spend my days in front of a computer at work), lately I have been on vacation and away from computers most of time. That coupled with Restasis, my eyes feel pretty good during the day, sometimes a bit dry at night. Yet no improvement so far in terms of starbursts.

What confuses me also is that when my pupil is not dilated during the day (or a bit dilated but still small) I still do get mild visual symptoms (glare on bright car lights, starburst on the bottom side of indoor lights during the day).

I going to ask for RGPs. Thanks for the help, I'm just hoping I won't have to go through an enhancement.

[dede29]

pehnix01: I have read about tons of complaints that are similar to your symptoms from other people that had a LASIK procedure.

In case your cornea is warped and irregular (as a consequence of your Lasik), a healthy tear film may fill up the minor gaps/holes on your cornea's front. From what I know, only RGPs can potentially fix larger issues (if they don't go away on your own...), since RPGs help to create an even surface on your cornea (tear film fills up even more complicated gaps/holes), see http://dixonopticians.co.uk/wp-conte...08/diagram.jpg. This may be a similar problem, which you may now have. Normal contact lenses usually cannot correct such issues (if they do you are very lucky). It should be also noted that most eye docs do not have the correct skills to fit such special RPGs. Often you need to find a real expert (which is not easy), as this goes beyond fitting "normal RPGs".

If your doc did a poor lasik, i.e., did remove too much/less cornea tissue or not evenly, then you can end up with star bursts/glare/monocular double vision/halos, etc.

Lasik is plastic surgery! This means there is no way to predict what your final result will be (returning to myopic eyes, ghosting, star bursts, etc.). Lasik centers often downplay thoses issues and particularly dry eyes.

In my opinion, Lasik (or whatever technique is available) is pretty dangerous, i.e., you may even go to the best doc world wide and there will still be no success guarantee for you. It's like playing the lottery. This is a little like scarring your skin by purpose and hoping that everything will heal smoothly.

I highly recommend to not DO any further enhancments or surgery and ignore whatever your LASIK doc tries to tell/sell you. In my option, you can end up even worse. I suggest that you just browse the Internet a bit and form your own opinion about LASIK complications. A good starting point is the following website: http://www.visionsurgeryrehab.org/image-gallery/ and the complaints written up in the forum.

I would ask for Pentacam results prior AND after the procedure and show it to a skilled doc who can analyze the results. I would not necessarily trust your LASIK doc. Get an unbiased opinion.

There is no way to predict if your symptoms ever go away on their own, but RPGs may be a good fix for you. If you are lucky, you can maybe fix your issues with normal glasses, for example in case you became a little myopic, again.

I hope I could guide you to the right direction. As I said, I'm not a professional. Just formed my opinion from reading a lot.