Headaches/Nausea for Months Post-LASIK -- Please Help

Hey out there,

I have spent extensive time on the D'eyealogues message board telling my story, and I have received some helpful suggestions. I am hoping that I will receive some more here.


I had LASIK surgery on 1/20/05 -- very reputable surgeon, large city. Before surgery, I was moderately myopic (-3.50, both eyes), but I had no other problems with my eyes. I also had absolutely no history of neurological problems or of headaches of any sort (aside from an occasional allergy headache or maybe a headache if I'd had one too many). I saw 20/15 the morning after surgery and, to this day, I still see 20/15 (even closer to 20/13 in my left eye). I still have minor astigmatism in my right eye, but it's really quiet minor. I have never had any problem with halos, starbursts, double vision, dry eyes, and the other typical problems that attend LASIK.

So what, you might ask, is the problem? The problem is, simply, headaches and nausea. For the first couple of months after surgery, I had crushing headaches and nausea literally every waking moment. Of course, my surgeon said that LASIK had "nothing to do with it" and sent me to a doctor to test for migraines (as noted above, I have absolutely no history of headaches). Well, to compress eight-plus months into one post, I have bounced from GP to neurologist to neuro-ophthalmologist, etc. Various theories, most b.s., have been advanced. Finally, I found a couple of doctors who said that these types of symptoms can result from LASIK (rarely). I am still having a lot of problems with headaches and nausea on a daily basis (a bit better, but still pretty bad).

To add to the bizarre element, I also have warm/cold sensations in my extremities (occasional burning, but generally just some mild tingling). In other words, sometimes things "feel" colder than they are.

My headaches are only very rarely burning or sharp. They are bilateral and are experienced more as a constant, boring pressure than as any sort of sharp pain. They are almost solely in the brow (over both eyes and between the eyes). At times, I also feel painful tension in the neck and shoulders.

My headaches did not really respond to any sort of medication. I was prescribed Butalbital, an anti-nausea medication, and valium (yes, valium) for the tension-type elements and Imitrex and some other migraine drug for the migraine element. A neuro-ophthalmologist prescribed me Amitriptylin and Neurontin (both anti-depressants that are also used for the relief of chronic pain). Both made me feel like a zombie, so I just decided to stop them.

I had two CT-scans, two MRIs, had my blood tested for the obvious culprits like anemia, blood pressure, neurological tests, field-of-vision tests, scans of my optic nerve, etc. I even went to a specialist to rule out sinus problems as a culprit. After a few months, I sort of gave up on the medical profession. However, recently I returned for some more testing.

Last week I saw three doctors. The first was an ophthalmologist whom I originally saw back in April. He was the first doctor to tell me that my problems were "absolutely" caused by LASIK, that he had seen problems like mine before, and that the problems would resolve, but it could be up to a year, or even two. This guy's theory is really quite simple - your brain becomes used to a signal over time (in my case, since I was 12, my visual signal was being refracted through some sort of corrective lens), the signal suddenly is changed, the brain basically becomes overstimulated as it tries to adjust to the new signal, and the result of this overstimulation is headaches, dizziness, vertigo, whatever.

Well, I did not stop there. The next day, I went to a very renowned neuro-ophthalmlogist. For the first time, I was given what are known as cycloplegic drops to measure my true refraction (not sure I understood the science perfectly). I measure out at about +.75 in the left, +.25 in the right. With the drops, they had me right around plano (straight 0s), which ruled out some sort of overcorrection error that might have been hidden away (apparently, my "true" prescription could have been a higher number of overcorrection and the cycloplegic drops stop the eyes' accommodation mechanisms from working so as to measure the true, true prescription). I was given various neurological tests, and they actually tested my thyroid for the first time (normal, of course). So, I managed to stump him; he's talking about Botox to try to control the headaches even though he's "mystified" at the root cause. Apparently, he's supposed to talk to my ophthalmologist, so I'll be curious to hear the results of that conversation.

I still did not stop there. I saw still a third doctor, a psycho-pharmacologist (also trained in neurology) who has been helping me deal with the anxiety side of things. He is NOT working with me on the physical symptoms, just on controlling the anxiety associated therewith. But, at any rate, he had spoken with two of his doctor buddies, one of whom runs a major eye/neurology department at a large hospital, the other of whom is some sort of leading light in a similar area. BOTH of those doctors stated that my symptoms are "not that shocking" as a result of LASIK, and both opined that the rate of such symptoms could be as high as 2 or 3 percent. Now, needless to say, I was shocked by this news. I don't know about any of you, but plenty of my problems stemmed from believing, or being told, that I was "nuts" and was making things up, even though I'm a perfectly mentally sound 28-year-old with no history of ANY medical problems (including psychological) before the wonderful world of LASIK intersected with my world.

Certain people are recommending that I try soft contact lenses to put myself back into mild myopia and to even out the eyes. I am a bit scared to mess with the balance, especially given the torture I've endured, but if part of the problem is sensory overload, plus contact lenses would perhaps be helpful. I am really wondering if (a) there's anything I could be missing and/or (b) there's anything else I should try. At this point, all I can think of is an alternative remedy like acupunture. To summarize, to the best of eye and brain doctors' diagnostic abilities, there is no organic disease present - all bloodwork and brain scans are a-okay, and I'm a 28-year-old with really no adverse medical history. So there you have it.

I apologize for the length of this post, but I did the best I could to compress a lot of months of pain into one message.

Again, I would be greatly obliged if I were to receive any suggestions or ideas. Thank you.

Josh
Original Post
Josh, if your headaches and nausea are indeed a result of a problem adjusting to your overcorrection... then perhaps some contacts to make you slightly myopic would be comforting?

You have a testable hypothesis here!

Sometimes I whip off my glasses and walk around the house in blurry land just so things don't look so distorted. A sensory overload can indeed be bad, especially if it's bad sensory information.

The situation with your eyes in combination with tingling in your extremities makes me think that you may have some sort of neurological problem that remains undiagnosed. Conditions such as MS, for example, can cause such symptoms and be variable/unpredictable. MS can also affect your optic nerve, causing optic neuritis, headaches, and trigeminal neuralgia. MS is usually associated with blurry vision which you claim not to have. Josh, try taking a really really hot bath and/or exercising extremely hard and see if this makes your
vision blurry. If so, you could have MS and treatments are available.

Another testable hypothesis.

You could also be having tingling in your extremities because you're taking certain classes of antidepressants. Ask your psychiatrist about the peripheral numbness and tingling as a potential side effect of any drug you're currently taking.

Testable hypothesis number three.

Test the hypotheses one at a time so that you can isolate the variables.

Keep us posted, because we'd like to hear that you're feeling better.
Whoa, Josh, before you freak out that you have MS or some other dreadful diagnosis, a consult with an OD is in order. While you may have temporarily alleviated some of the convergence issues, there is no "cure" for convergence insufficiency, only management of the condition, and your difficulties may go beyond the knowledge of the doctor you consulted. The symptoms you describe are consistent with convergence and binocularity disorders, which may well have been present before your surgery, but which could easily have gone unnoticed.

Dr Hartzok has been researching resources in your area and one of us will be in touch with you for referral information. Please check your email later today.

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