Blurred vision in low/dim light after Smile

Hi,

I recently had Relex smile surgery on both my eyes and would like to share my experience of the same. Before I detail about my post-op experience let me first mention my pre-op lens prescription and the surgery details.

My pre-op lens prescription was,

    Left eye   :  -9.5D + -1D astigmatism

    Right eye :  -7.5D + -1.5D astigmatism

Surgery details

    Left eye   : Relex Smile + Xtra

    Right eye : Relex Smile

    Date         : 25th Feb 2019

I had Smile procedure on the right eye and Smile + Xtra on the left eye as my cornea was a little weak on the left. The Xtra procedure was performed after Smile and took just another 2 minutes or so. Surgery went pretty smooth although I remember moving my eyes when my surgeon was performing the Xtra procedure(left eye) after the Smile and the doctor had asked me to stop moving them. There was no burning or itching sensation immediately after the surgery or infact I never had any burning or itching on either eyes. Doctors had placed a contact lens on both eyes and asked me to visit the next day. The lens on my left eye was very uncomfortable and it was causing an irritation while the right eye never had any issue with the lens. Next day after the check-up lens were removed and I felt immediately relieved. Wore the dark shields for that entire week and didn't strain my eyes much.

For my next check-up a week after the surgery I noticed that right eye was clear while left eye was blurred. Reading was pretty difficult at this point and vision in low light was very bad. Using the mobile phone was also a challenge as I couldn't focus correctly. All these along with glare/halos/starbursts which only became more evident the following week when I resumed work and started using computers on a low light environment. I continued my eye drops regimen religiously for another 3 weeks.

4 weeks past surgery my condition hasn't improved much or at least not so much that is actually evident. Here are my feelings /sensations 1 month post-op.

Feelings/sensations 1 month post-op

1. No trouble using mobile phones.

2. Reading is comfortable.

3. Full visual acuity in bright sunlight.

4. Blurred vision in low/dim lights only in left eye.

5. Glare/halos/starbursts on both eyes but more severe in left.

6. Vision becomes clear for a couple of minutes after applying lubricating drops then becomes blurred again(only in left).

7. Poor lighting in my work environment makes it working on the computer very difficult as I could see halos around any bright objects on the screen.

8. Interestingly the trouble working on computer screen is reduced if I constrict/contract my eyes and then things become clear.

9. Dryness because of excessive computer usage so I apply lubricating drops every hour.

10. Sometimes I have a feeling that something's there in my eye, again only in left eye.

So above mentioned is the state of my eyes and my condition 1 month post-op. Please let me know if these are normal after Smile surgery and will they improve over the course of time. Now I would like to post my queries here in this forum and hope someone could please clarify them for me.

Queries

1. is this Xtra procedure same as "Corneal Collagen Cross-linking with Riboflavin" aka c3r.

2. How is healing different for Smile and Smile + Xtra

3. I remember doctor asking me to stop moving my eye during Xtra. Can it create any complication.

4. Have full visual acuity in both eyes in bright sunlight but getting blur in left eye alone in dim/low light conditions. Why this difference. Is it related to Xtra procedure done on my left eye.

5. Nearby objects are clear(no blurring at all) with left eye while farther objects are blurred. Near and far objects are clear with right eye. Does it mean a residual power in my left eye.

6. Having halos/glare around bright objects in screen while working in low light conditions. Will this improve over time?

7. I don't see any improvement over the period of 1 month. My condition is pretty much the same as it was a week after the surgery. Is this normal.

8. Is it true that people who had higher myopia heal slower. Even so why's my vision in right eye clear however left not so much.

9. Can the blurriness be fixed by a prescription glass until healing is complete.

10. Was travelling on a bus at night. It was pretty dark inside and after a while I noticed that I could read all signboards outside and much farther away very clear using both eyes. Why did that happen.

Thank you for the response.

Original Post

Dear Pottermon,

Feelings/sensations 1 month post-op

3. Full visual acuity in bright sunlight.

4. Blurred vision in low/dim lights only in left eye.

5. Glare/halos/starbursts on both eyes but more severe in left.

These three items probably relate to the effective diameter of your treatment. The left eye had a greater degree of myopia and probably has a smaller optic zone which may be why your issues are more in the left eye.

6. Vision becomes clear for a couple of minutes after applying lubricating drops then becomes blurred again(only in left).

Any corneal procedure can result in an alteration of your normal tear film. The drops temporarily clearing your vision suggests some disruption in tear film. In addition, reshaping the curvature of your cornea (significant flattening, in your case) has altered the relationship between the corneal surface and the upper eyelid. Your eyelid acts similarly to a windshield wiper. Misalignments between a windshield wiper and the windshield will not result in an even wiping effect. The edge of your eyelid does not magically conform to the new corneal shape so the eyelid does not create an even tear film. An uneven tear film reduces clarity.

7. Poor lighting in my work environment makes it working on the computer very difficult as I could see halos around any bright objects on the screen.

Have you tried increasing the intensity of your computer screens internal illumination?

8. Interestingly the trouble working on computer screen is reduced if I constrict/contract my eyes and then things become clear.

I would question whether you have any residual refractive error. This could also explain why your left eye is not seeing as clearly.

Queries

1. is this Xtra procedure same as "Corneal Collagen Cross-linking with Riboflavin" aka c3r.

Yes.

2. How is healing different for Smile and Smile + Xtra

Xtra is supposed to prevent your cornea from developing ectasia.

3. I remember doctor asking me to stop moving my eye during Xtra. Can it create any complication.

This should not have been an issue.

4. Have full visual acuity in both eyes in bright sunlight but getting blur in left eye alone in dim/low light conditions. Why this difference. Is it related to Xtra procedure done on my left eye.

5. Nearby objects are clear(no blurring at all) with left eye while farther objects are blurred. Near and far objects are clear with right eye. Does it mean a residual power in my left eye.

This could be a number of things. It could be residual (under or over correction) refractive error. It could also be related to a smaller optic zone in the left eye versus the right. It could be both. It should not have anything to do with the Xtra procedure. Bright light shrinks your pupil, elongating the depth of focus which can effectively minimize mild refractive errors.

6. Having halos/glare around bright objects in screen while working in low light conditions. Will this improve over time?

7. I don't see any improvement over the period of 1 month. My condition is pretty much the same as it was a week after the surgery. Is this normal.

I wouldn't expect it to improve significantly.

8. Is it true that people who had higher myopia heal slower. Even so why's my vision in right eye clear however left not so much.

9. Can the blurriness be fixed by a prescription glass until healing is complete.

Healing is a highly relative term. The closest case we can make for healing to be complete is when all "clinically measurable" aspects of your post-surgical condition have stabilized. If all those measurable aspects are stable, then you are left with a new condition and the first step is to determine if prescription glasses can resolve your vision problems.

10. Was travelling on a bus at night. It was pretty dark inside and after a while I noticed that I could read all signboards outside and much farther away very clear using both eyes. Why did that happen.

I don't know.


Add Reply

Likes (0)
×
×
×
×