1 year, 5 months post lasik...

Dry eyes are not as bad anymore, but I still have plugs in all four ducts.

20/20 as far as accuity goes.

During the day: The only time of day that I find some level of normalcy in is late morning and mid-afternoon when the sun is up high over my line of sight. Otherwise, the sun is extremely painful to my eyes in the morning and even more so at sunset. There were times in my past when I enjoyed sunsets, but now they actually cause me pain. Even when just looking in the general direction of the sun. Headlights from halogen bulbs still produce starburst effects during broad daylight which I simply don't recall ever seeing before surgery. Far too distracting for them to have existed before.

Night time...starbursts and halos all around. Looks like some kind of acid trip, except when I then look at a street sign, the text is crystal clear.

Doctors have not been able to determine why. I can't help but think they all have some kind of code that prevents them from being truthful for fear of negative industry backlash of some kind. But, they somehow seem to do a great job of convincing you to buy more glasses, drops, take fancy photos of your eyes, etc., to get your insurance money and co-payments....only to leave you with the same results (no improvement and deductible payments not covered by your insurance). Just like the surgeon who wrecks your life, these secondary doctors mostly don't know how to fix or help it either. RGP lenses didn't do anything for me (at least the test lens he put on me didn't). I would like to find a doctor who will see me who is already outwardly against lasik.

Halos and starbursts are a strange thing in that apparently, most people see some level of them as well. What I can't figure out is how to determine what level of intensity it is that non-surgical eyes are seeing vs. my own. Is there anyone on these boards that can describe this?

I was told by my surgeon that he sees no reason that I should be experiencing these complications. A friend of mine keeps suggesting that I was over corrected, so I am seeing lights 'closer up' than before and this might be causing the effect. Is there any reason to consider this as a possibility?

Then, during a search on the boards this evening, I found one from 2001 that suggests "residual micro-roughness", which I found interesting (posted below). I can follow the logic in this because I have a pair of sunglasses that has a very small scratch in the center of the lens which causes its own little halo/burst effect when I look through that scratch onto light sources.

All in all, I do my best to ignore my complications, but it is a daily battle that has never left me....every single day for 1 year 5 months.

Here's the post I read....


----------------------

splicesite
Veteran

Posted Fri August 17 2001 01:46 PM Hide Post
this is a complex topic.
The haloes you are seeing during the day are actually what is properly called 'glare'. This is a common lasik complication and believe it or not but nobody knows what causes it nor has any suggestion for treating it. Many people seem not to be bothered by it, but others it bothers profoundly. It seems to be permanent in most cases. Plese do a search on 'glare' or 'daytime'.
The most likely cause of this glare is residual micro-roughness caused by the laser, or some other source of light scatter in the cornea. The lasik glare effect can be duplicated almost precisely by taking a plastic eyeglass lens and rubbing it ever-so-slightly with the finest grit sandpaper you can find, so that you cannot actually see the scratches you have made but the glare caused by the scratches is apparent when looking at bright light sources.

What you experience at night is this same glare but possibly combined with the above mentioned effect caused by dialation of your pupil, an independent light effect that has a distinctly different quality from 'glare'. This effect is properly termed 'halo' (or 'starburst'). This effect can be helped with certain drugs with a very limited effectiveness, or with rigid contact lenses to a moderate extent.

Posts: 125 | Location: Rochester, NY USA | Registered: Thu March 01 2001

Rob,

What you are describing is exactly the same thing that most of the rest of us have experienced to one degree or another since our surgery."Micro-roughness" is an irregular cornea, induced by surgery, referred to often as "irregular astigmatism."

An RGP lens is frequently the only way to deal with these "higher order aberrations." Just because one doctor could not figure it out doesn't mean you should give up. There are others who may be able to help.

Have you tried pilocarpine or Alphagan P to constrict your pupils at night? If this works, the probable cause of your aberrations is that your pupil is dilating larger than the ablation zone from your surgery, in which case, contact lenses should help. I'll leave it to Dr. Hartzok to explain the mechanics of how they work.

I also have huge sparklebursts during the day, as well as glare and ghosting. This is the result of a 3.4mm ablation with a 4.0mm daylight constricted pupil. I wore sunglasses every moment I was out of doors the first two years after my surgery. I couldn't stand the sunlight, or even the glare on a cloudy day. A sunny day with snow on the ground was the worst. That seems to have passed with time and is no longer much of an issue.

I generally don't editorialize, but I really feel this needs to be said. JUST BECAUSE A DOCTOR CLAIMS TO BE ANTI LASIK, IT DOESN'T MEAN HE OR SHE HAS THE EXPERTISE TO HELP YOU. I cannot tell you how many people have sought out vocally "anti-Lasik" optometrists, only to be extremely disappointed that all they got was an earful and some pricey, but useless, contact lenses. You need to find someone who is exceptionally skilled in fitting difficult corneas. My former OD claims to be very anti-Lasik, but when he stuck off-the-shelf regular RGPs in my eyes, he had to pry them open to remove them. The pain was so intense I wanted to scream. He had no clue what he was dealing with, although he certainly talks a very good line.

You may have to travel to find someone who is "right" for you. Fitting RGP lenses to aberrated corneas is a PROCESS and requires patience, dedication and a strong commitment to success on the part of both patient and physician.

I apologize if anyone is offended by my comments. I have no use for politics where facilitating rehab options is concerned. Someone who shares your point of view may reassure your psyche, but unless that person possesses the skill and expertise you need to restore your vision, why bother?

I've lived with my sh*tty vision for nearly seven years and there is no rehab for me. Trust me, I really do understand your frustration and your desire for answers to questions we shouldn't even be having to ask.

quote:

A friend of mine keeps suggesting that I was over corrected, so I am seeing lights 'closer up' than before and this might be causing the effect. Is there any reason to consider this as a possibility?

No.

quote:

RGP lenses didn't do anything for me (at least the test lens he put on me didn't)

Trial lenses are only helpful when fitting post-ablation corneas IF the lenses are a close approximation of what well-fitted RGP lenses are designed to do. The vast majority of fitters do not have an inventory of post-RS lenses to give an accurate representation of your vision. As Barbara mentions, generic RGPs in the wrong hands can be a horrible experience. Patients and their fitters then erroneously assume that RGPs are not an option.

Patients who frequent this web site have to understand: The majority of fitters are ill-prepared to provide RGP services to refractive surgery patients. By and large, RS patients are the most challenging work we face.

Hi Barbara and Dr. Hartzok,

Thanks for your further clarifications, and for your understanding.

Alphagan didn't help my situation when I tried it. So, I will keep looking into finding a well-fitted RGP lens.

I'll let you know what results I have after my next appointment.

Best,

Rob

Rob,

Alphagan didn't help me either, and gave me lots of nasty side effects. However, although I was ultimately unable to wear them, the RGP lenses with which I was fitted cleared up many of the aberrations.

Even in the trial lenses, when I went outside and looked up at the night sky, I could see stars and only one moon! My inability to tolerate lenses is primarily due to some kind of structural damage to the left eye from an "enhancement" five months after Lasik.

Good luck, and please keep us posted.