Daytime halos and glares - Relex SMILE

Good day everybody.
I had my Relex Smile surgery 6 weeks ago, to correct myopia (-4,5 both eyes) combined with astigmatism.
Technically everything went well, negligible residual prescription and I can read 20/20ish.
Nevertheless I’m experiencing disabling side effects that are heavily affecting my career and my personal life.
I see halos around light colored objects during the day, as well as big glares from every reflective surface. Every light source such as headlights and traffic lights have haloes in daylight, and they get worse at night.
I see halos on screens, especially around light text on black background.
No significant improvements after week one.
I also have dry eyes, at the beginning I wasn’t able to use a PC mostly for this reason, but now I feel is getting somewhat better.
Dry eyes are not the only cause of my issues because halos never go away even right after artificial tears instillation.
The optical zone of the treatment is larger than pupil and well centered, this has been confirmed from a third party, non refractive ophthalmologist.
Aberrometry (cornea and total eye) do not show anything significant.
Surgeon can’t explain my symptoms and he is going to ask for advice from international experts.

Any idea on the possible causes. Does someone have my same daytime issues after SMILE or LASIK?

This is really affecting my life, please share your thoughts about possible causes

Thank you
Original Post
quote:
The optical zone of the treatment is larger than pupil and well centered, this has been confirmed from a third party, non refractive ophthalmologist.


When you say the "optical zone of the treatment is larger than pupil and well centered, this has been confirmed from a third party, non refractive ophthalmologist." - how was this doctor measuring your pupil and treatment optical zone? Did he/she use a topographer? Any other device?
Dr. Hartzok

thank you for quick reply.
She looked both at topography and slit lamp, but I'm not sure about how she assessed pupil size.
I will ask this question to her since I have a follow up on Nov 6th.

On the other hand some of my problems with reflections and halos are exacerbated in full light condition, expecially in the hours of the day when the sun il low on the horizon (after sunrise, before sunset) reflections get worse. I see halos from light objects when the sunrays hit and bounce on them, even in full daylight.
Halos around light sources are present both day and night, getting worse at night.

Also tried drops to shrink pupil but they don't help much in low light and don't help at all in daylight.

Yesterday news is that I'm scheduled for a corneal OCT in surgeon clinic next Monday
Yes. From what you are saying it doesn't suggest a problem with the treatment zone being too small.

A corneal OCT is a good idea as it might reveal issues at the interface of the anterior and posterior treatment zones. I am wondering if there may be inflammation and hazing at the interface. Are you on any type of steroid eye drops?
Dr Hartzok,

Thanks again for your support.

Yes, I'm taking steroid drops since my surgery.

In 3 wks post op visit, given my symptoms, surgeon prescribed me another steroid treatment 3 times/day, ramping down to 2 times and fillally 1.
Just now I decreased the quantity from 2/day to 1/day

With the slit lamp the surgeon has not been able to see any significant haze, maybe the OCT will reveal something meaningful.

Looking online I found tons of people with night time issues (I have these as well), but my daytime symptoms seem to be rare with Lasik/Smile.

In your long experience with this forum have you ever came across something similar?

I'm really scared this could be permanent
Went to surgeons clinic on Monday.

He performed an OCT, but he hadn't found nothing explaining my daytime symptoms.
The interface was evident, but very regular and smooth. Bowman's membrane also looked smooth.

He's going to send all to an expert in London (the biggest expert for SMILE).
I'm now really scared that nobody can finally found the root cause. Not having a cause means not having a solution for sure.

I went to my optometrist who actually refused to sell me a pair of lenses because of the small refraction (I should be around -.5 D plus some resuidual astigmatism in the right eye)
Do you think these lenses could help significantly my symptoms?

I've found other people, both SMILE and LASIK patients, having my same kind of problems with glares in daylight. I know that SMILE is a relatively new approach, but in the case of LASIK, what could be the possible cause in your experience? Is there any solution? Is there an healing path to follow?

Thanks again for your time
quote:
I went to my optometrist who actually refused to sell me a pair of lenses because of the small refraction (I should be around -.5 D plus some resuidual astigmatism in the right eye)
Do you think these lenses could help significantly my symptoms?


Marce77,

I apologize for the loss of continuity of my responses.

When you saw the optometrist who didn't want you to get the glasses, did he/she actually show you what the improvement might be if you wore the glasses? (This is best done with loose lenses in a trial frame.)
Dr. Hartzok,

you don't need to apologize, thank you for being available to spend your time trying to help us.
Yes, I weared a pair of trial glasses
Well, in the optmoetrist studio, where lights are soft and everything is studied to reduce visual disturbances, they do sharpen a little bit my vision that was anyway good. My problem arises with light sources and sunlight reflections, so maybe I need to do the trial in the real world instead.

I want to share with you another symptom that in my opinion has the potentiality to help explain some of my disturbances.

Daylight. Approaching car with LED day headlights on - made up of a bright stripe of white LEDs. When the car is distant I see 3 distinct stripes of LEDs, collapsing to a blurred one when the car gets near. This in my mind carries the signature of a diffraction effect. Have you ever come across such a symptom? It is likely generated at the interface? The interface of SMILE has the peculiarity of having 2 surfaces carved by femto laser facing each other - could this be a factor?

Thanks again for your time
marce77 posted:
Good day everybody.
I had my Relex Smile surgery 6 weeks ago, to correct myopia (-4,5 both eyes) combined with astigmatism.
Technically everything went well, negligible residual prescription and I can read 20/20ish.
Nevertheless I’m experiencing disabling side effects that are heavily affecting my career and my personal life.
I see halos around light colored objects during the day, as well as big glares from every reflective surface. Every light source such as headlights and traffic lights have haloes in daylight, and they get worse at night.
I see halos on screens, especially around light text on black background.
No significant improvements after week one.
I also have dry eyes, at the beginning I wasn’t able to use a PC mostly for this reason, but now I feel is getting somewhat better.
Dry eyes are not the only cause of my issues because halos never go away even right after artificial tears instillation.
The optical zone of the treatment is larger than pupil and well centered, this has been confirmed from a third party, non refractive ophthalmologist.
Aberrometry (cornea and total eye) do not show anything significant.
Surgeon can’t explain my symptoms and he is going to ask for advice from international experts.

Any idea on the possible causes. Does someone have my same daytime issues after SMILE or LASIK?

This is really affecting my life, please share your thoughts about possible causes

Thank you

I am 4 weeks post lasik now. I was -5 each eye. I have 20/20 vision now but I am experiencing exactly the same symptoms as yours. 

I see It's 10 months now sice your original post. Did the halos and glare go away? If yes, after how long? If no, did they improve? Could you know the reason behind this?

Thank you

Hi marce77,

I read your posts with high interest since I do experience exactly the same symptoms as you describe. I am too very interested in whether your starbursts and halos have improved in the meantime . Any follow up experience would be very much appreciated!

I hope you’re eyes are better by now. I‘m right now 21 days post op. So I do actually have both hope and the strong will to know what I will have to deal with in the future.

BR,

Ben

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