Multiple Issues: Ghosted/double vision/glare/Microstriae after LASIK

Hello,

First off, I want to thank you for supporting people who have issues post-LASIK. This has been some of the most difficult weeks in my entire life, and I've dealt with a variety of health issues throughout my life.

I had a ThinFlap LASIK procedure around 2 1/2 weeks ago using the Allegretto Wave technology Laser. The day after surgery, I was seeing 20/15 out of both eyes. My left eye was pretty much perfect, but my right had/has a lot of issues:

Ghosting (above everything I look at). Worse with objects with light and as an object moves further away, the worse it becomes. Notice this still with objects that are close, and with reading. Night time driving is pretty much impossible - I see above and below ghosting from my right eye. Night time driving further exasperated by the next symptom.

Starbursts- Light bursts out in all directions from head lights. Starbursting seems to shoot out from the middle.

Glare - Trajectory again seems to be above everything I look at. When I look at a computer screen, I see 1 1/3 computer screens (glared and ghosted above) - same with a TV, (except worse because it's further away). At night this is awful.

Sub-conjunctival hemorrhage - Right eye definitely had that going on (top part of eye).

Microstriae - Have received conflicting opinions on this - but all docs I have seen agree I have them.

Since my procedure, my symptoms in my right eye have improved 1%. The 1% is me getting used to it vs. any actual improvements. The hemorrhage seems to slowly be improving. My right eye seems to tire more easily and I find myself squinting.

I have seen a second refractive surgeon and my normal eye care doctor - all seem to provide different takes on the Microstriae in my eye. The original doctor has stated that while he doesn't think the Microstriae are effecting my eye, they are on the top area of my pupil but not in the axis of my eye. The second doc confirmed they are not on the axis and didn't think they were producing the above symptoms. My normal eye doctor said the Microstriae were actually covering the top 1/3 of my pupil and could be the issue. All seem to think that nothing should be done about the Microstriae except waiting and hydrating with non-preservative drops (around 2 times an hour).

There are a few things I notice that help my eye:

If I cover the top 1/3 of my pupil, I see clearer, the blur/ghosting goes away almost entirely. My vision comes across as dang near perfect (except the fact that I have an obstruction, my hand, covering the top 1/3 of my eye) Smile

Prescribed "temporary" glasses - These seem to help with the ghosting close up but not as much at a longer distance. They do a tad for the glare and starburst problems from a distance. I would say overall they help about 50% as far as my ability to function normally.

The doctors all agree there is a bit of astigmatism. The Axis point has varied in my exams (from 80 to 100 to 180 at my latest. I had an astigmatism in both eyes prior to the procedure but the astigmatism in my right eye is now at a different point (top).

So I'm left with a possibility that a number of things are causing my problems:

A. Normal Swelling/procedure post op healing (it's been two and a half weeks)
B. Microstriae
C. Left over/newly created Astigmatism
D. Dry Eye (when my eye is wet it doesn't seem to help any of my issues above). My eyes are definitely dryer but not anything I would call extreme.
E. A combination of the above

My list of concerns/Questions is:

  • My doctor seems happy that I am seeing 20/15 and discounting the fact that my life has been a living hell seeing ghosted double of everything. Studies seem to indicate that the longer you wait with wrinkles, the harder it is work with them surgically and repair them. I'm worried that if the Microstriae are the issue, every day is just cementing in the problem further and further.

  • I find it odd that the glasses correct some of the ghosting but not all. The further away something is, the less the glasses do. The glasses help the glare far less then the ghosting but do provide some improvement. They do nothing for the starbursting.

  • I have seen no improvements in my eye for 2 1/2 weeks

  • Does wearing glasses impede my eyes ability to heal correctly to a point where I wouldn't need the temporary glasses?

  • Two doctors and one technician found a different axis point, Cylinder, and Sphere within a week. I understand that your vision fluctuates after the procedure so this might not be surprising.

  • Are there questions I should be asking my doctor to find out more details?

  • Am I nuts to be seeking a third opinion by someone out of state or a doctor that specializes in post-op issues?


    I appreciate any insight and I fully plan on providing updates (if that is advisable) so future people can learn from my experience.

    Thank you!
Original Post
quote:
Originally posted by Tatty1:

Microstriae - Have received conflicting opinions on this - but all docs I have seen agree I have them.

I have seen a second refractive surgeon and my normal eye care doctor - all seem to provide different takes on the Microstriae in my eye. The original doctor has stated that while he doesn't think the Microstriae are effecting my eye, they are on the top area of my pupil but not in the axis of my eye. The second doc confirmed they are not on the axis and didn't think they were producing the above symptoms. My normal eye doctor said the Microstriae were actually covering the top 1/3 of my pupil and could be the issue. All seem to think that nothing should be done about the Microstriae except waiting and hydrating with non-preservative drops (around 2 times an hour).

If I cover the top 1/3 of my pupil, I see clearer, the blur/ghosting goes away almost entirely. My vision comes across as dang near perfect (except the fact that I have an obstruction, my hand, covering the top 1/3 of my eye).

If the microstriae are within the pupil, they are affecting your vision. Has no one suggested lifting the flap to help smooth out the microstriae?

  • Does wearing glasses impede my eyes ability to heal correctly to a point where I wouldn't need the temporary glasses?

    No. Wearing glasses will not alter the healing process.



  • The microstriae seem to be part of the issue. I understand there may be hesitancy on the part of your surgeon to lift the flap, but that may be help to your vision.

    You didn't say how nearsighted you were prior to your procedure and anything regarding the size of your pupils. If you were significantly nearsighted with relatively large pupils that, combined with the microstriae, may be the bulk of your vision frustrations.
    Well this is where the conflicting opinions arise. The day after my surgery, the original doc noticed them and said they could be causing the problems but did not suggest doing anything about it. In fact, I didn't have a follow appointment booked until 1 1/2 months later. Upon calling repeatedly, I was told that the wrinkles were not on the axis of my eye, which is why they weren't lifting and re-hydrating. Upon getting back in for a follow up much sooner, I was told the wrinkles looked "improved" and would "likely" heal on their own, therefore no lift and re-hydrate would be done.

    My second opinion doctor did not believe the wrinkles were on the axis of my eye and therefore would do more harm then good to re-lift. Again, the advice was to let heal on it's own or wait for an enhancement (which I guess he assumed wrinkles would heal on own and maybe the enhancement to clean up left over astigmatism.. or possibly try to iron out wrinkles plus enhancement at the same time).

    My normal eye care doctor (now the third doc I've seen), while not a refractive surgeon, stated that yes, the wrinkles were on the top 1/3 of my pupil but again stated that leaving them to heal on their own was for the best. The glasses were the temporary fix for the astigmatism left over but as stated previously, do not fully help.

    It doesn't seem like a coincidence to me that I cover the top 1/3 of my eye and everything gets better.. Yet, no doc seems to want to relift... My concern is the longer I wait, the harder this becomes. I'm still only at 2 1/2 weeks.

    As far as prescription Prior to the procedure I was:

    PWR: -2.00
    CYL: -0.75
    AXIS: 020 (Right Eye), Axis 140 (Left eye)

    I was not told anything about my pupil size so unfortunately I have no information on that.

    Is it possible for microstriae to be on my pupil but NOT on the axis of my eye? This seems contradictory but I'm not a doctor.
    quote:
    Originally posted by Tatty1:

    Is it possible for microstriae to be on my pupil but NOT on the axis of my eye? This seems contradictory but I'm not a doctor.


    If the microstriae are within the pupil, then light passing into your eye is also passing through the microstriae and that has the potential to obstruct your vision. The axis is simply the dead center of your line of sight and the center of your vision. Microstriae do not have to be on the visual axis to affect your vision. Essentially, anything within the pupil can impact your vision.

    I am assuming here that your left eye is fine and that all of your symptoms are associated with the right eye. Is that correct?

    Did either of your second opinion doctors perform corneal topography?
    My left eye is pretty much perfect - a little residual glaring and very minor ghosting but nothing that I would say is vastly different then prior to the procedure. If my right eye was like my left eye, I'd probably be a very happy patient right now!

    The main thing that both doctors did was have me look into a machine and stare at some lighthouse or farmhouse - I'm not entirely sure what the procedure was called. The second doc did have me look into a machine that had lights on the top, left, right, and bottom. No one ever said they were performing corneal topography. I looked at images on google and I'm pretty sure I only had this done prior to my LASIK and nothing after.

    My normal eye care specialist did a test where they looked into the back of my eye (had to hold my head at an angle and look into a space until the light went green and took a picture.

    My main fear is that I have read that Microstriae can resolve on their own but also that it gets harder to get them out the further you wait.. So I'm kind of conflicted as to what I should do..

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