Dr. Hartzok,

I forgot to add in my long story that I was diagnosed with a convergence insufficiency several months ago and I did pencil push-ups to cure the CI. I returned to the binocular vision specialist's office (he's very well-known), and he told me I had cured the CI. I told him I was still having the problems, and he basically said he didn't know what to tell me.

So you know, I wake up with and go to sleep with the symptoms. This fact seemed to mystify the CI doc, as though it meant my problem was probably not eye-related. Of course, what else could it be related to?

Thanks again,
Josh

Ahh....

Convergence insufficiency is usually not a simple muscle weakness. It has always been my understanding that pencil push-ups are inadequate since the proper therapy procedures must be done while maintaining control of and feedback to the binocular system. Pencil push-ups do not provide the necessary sensory system awareness.

The convergence insufficiency was probably present before LASIK but the loss of peripheral vision correction following surgery allowed the latent condition to become manifest.

I will get you a name.

Josh,
I agree with Dr Hartzok. The change in visual environment can lead to a loss of binocularity. A brittle system can decompensate and create a lot of discomfort after LASIK. The lenses that you wore pre-op had optical effects that you were adapted to and helped your CI. A full blown developmental optometrist can help you with that. Go to http://www.covd.org to find one. Also, cervical and upper back problems can radiate to the brow area. A good chiropractor and massage therapy can help if that is contributory. None of the "specialists" that you have seen would be thinking along those lines, they use different models.
Peter Guhl, OD, FAAO, FACOP
Yorktown, VA

A friend on another forum has had success fixing this problem with macro lens RGP's.His symptoms of nausea,dizziness and headaches is exactly like mine and Josh's.It's the only thing I hadn't tried.I will be looking into it.

One bit of advice; don't get hung up on these two descriptors - macro and reverse geometry.

Macro refers to RGPs that are larger than the corneal diameter. They can work but a lens does not have to be that large to provide relief. Fit is all that matters.

Reverse geometry refers to RGPs where the peripheral curves are steeper than the central curve. Many but not all patients who have had myopic RS will need a reverse geometry lens but the actual lens curves are solely dependent on the post-surgical corneal anatomy. Again, fit is all that matters.

I saw my OEP today about RGP contacts.Using a machine checking what I think was the topography of my corneas,he tells me in his own words that the edges of my corneas are as wavy as circus mirrors.When I asked why I wasn't seeing the waves,I'm told it's because my brain is trying desperately to make sense of the distorted input causing the dizziness,headaches and nausea.I have had a busy day and will write further on this later as the eye strain is too much at present.

After private messaging him,he is still suffering the symptoms so it did not totally eliminate them.Any help at all would be better than none so I am going ahead with the RGP's when they come in.

Engel,

I am also closely tracking our friend's success, or lack thereof, with RGPs.

As an update to anyone out there, Dr. Hartzok gave me the name of a leading eye doctor here in Manhattan. I have been diagnosed with severe binocular vision problems that will probably take months of therapy to remedy, but I want to thank Dr. Hartzok particularly and all of you generally for giving me the resources to pursue my recovery as aggressively and vigorously as possible.

Dr. Hartzok, God bless you. Happy Holidays to you all. I will keep you all posted.

Josh