Bill Nixon
I had laser in situ keratomileusis (LASIK) performed in November of 1996. My refractive error in both eyes was -9.0 diopters (D). My pupils are very responsive and readily open to 9.0 mm in low light. The ablation zone used for my surgery was 5.5 mm. Presently, my vision in moderate to low light is extremely hazy, with marked loss of contrast and detail. Halos, star bursts, and glare add to the side effects, which together make it impossible for me to drive during evening and early morning hours. A teacher, I have dramatically scaled back my involvement in after-school activities because of my fear of having to drive at dusk and dawn. I now avoid attending theater performances, movies, concerts, church services, and dinner parties due to my inability to see well under low-light conditions. I have grown fearful of the night, feeling hostage to it. Psychologically, LASIK proved to be a devastating blow.


Additionally, my corneas remain tender following surgery, making contact lens wear problematic. I still suffer from morning edema of the corneas and pain throughout the eyes, and excessive tearing while I sleep is common. Fortunately both the edema and pain have begun to resolve themselves in the past nine months. Custom-made contacts with imprinted irises proved ineffective, as did pilocarpine which caused severe brow aches and extended periods of blurred vision after instillation. At present I wear soft contacts under regular glasses for my best corrected vision. Glasses, alone, do nothing to help. Dramatically increased numbers of floaters in both eyes also seem to disperse light and cause difficulties under bright conditions.


While it has come to my attention that many refractive surgeons screen for pupil size, it is also true that many do not. Regardless, I do not believe that there exists a shared set of parameters that are used to determine the eligibility of patients who, like myself, have both large pupils under low-light conditions as well as moderate to severe myopia. It is true that many individuals with large pupils also have light complexions, light eyes, and light hair, being of Northern European descent. Such individuals are genetically predisposed to have large pupils, and thus they are more frequently poor candidates for refractive surgery as ablation zones are severely limiting. (Ask any individual with a 9mm pupil under scotopic conditions.)


I doubt that I will trust any surgeon enough to ever again touch my eyes, much less to accurately "inform" me of the potential risks involved in further treatment. It isn't only that I continue to question the knowledge and technique of these men and women, but more importantly their motives.

Bill_nixon@ccmail.odedodea.edu