Hi All,

Can anyone share information as to why night vision is poor after refractive surgery?

Not so much in terms of GASH, but the subject of not being able to see contrast and details in low light, it is awful. Do we know what causes this symptom?

Thank you.
Original Post
Loss of contrast sensitivity occurs frequently as a complication after LASIK. The loss is attributed to higher-order aberrations (HOAs) induced by the surgery, itself, but not necessarily those that cause GASH.

I have no functional night vision, and my contrast sensitivity in low light and daylight is also affected. I did find that when wearing my scleral lenses, my daytime contrast was better, but night vision did not improve due to the plethora of other HOAs. Dr Hartzok may be able to explain the clinical aspects of loss of contrast sensitivity.
Thank you Barbara. I wanted to know how many surgeries did you have? Was it only one and did you have the "enhancements" done later on?

I did come across that HOA's are the underlying reason.

Higher Order Aberrations

A wavefront of light will pass through a perfect eye in a flat plane. When it passes through one with irregularities in the cornea, crystalline lens, tear film, aqueous humor, and vitreous humor, it produces distorted, three-dimensional shapes. These deviated shapes are known as higher order aberrations. Presently, experts have identified more than 60 higher order aberrations, including comas, spherical aberrations, and trefoils.

These imperfections worsen a person's quality of vision and result in the following vision problems:

Glare, Halos, Blurring, Double Vision, Ghost Vision, Starbursts, loss of contrast, and difficulty seeing at night.

Now, refractive surgery causes these, why haven't "they" found a way to improve them. I'm sure it is a question we all like to hear.
I had one enhancement on the left eye before I knew how deep the ---- was. I have massive HOAs in each eye, as well as a scar from stage IV DLK in the center of the right cornea. I also have a very small ablation zone, smaller even than my constricted pupils. So basically, I'm a -10.5 outside the corrected area. I have severe GASH, loss of contrast, unstable corneas (they are very thin), and a thousand floaters.

When will industry find a way to avoid them? I have my doubts.
Did you mean deep ablations by using "----"? or did you mean like a profane word?

How was your DLK diagnosed? Seems this symptom goes un-noticed at times or looked over.

Not sure if you follow my story hear, but I had significant microfolds on both flaps centrally and that the original surgeon did not want to correct and I was told "give it time". I went home that day and did quick research and he should have dealt with them immediately.

I had the "vaseline" vision very bad in the left eye. Right eye was messy too with a rag bag of other issues. I was told I had interface haze from another doctor after the first practice "dismissed" me as a patient leaving me out on the streets. Wonderful huh?

A long year went by and I had a PTK procedure to "remove" the chronic microfolds and then had the surface of the stroma "polished" with a technique using a BSS to mask the surface and then the excimer laser ablates the peaks sticking up in the BSS masking agent. That was 7 months ago. I have a new layer of "epithelium" and a smooth surface of the stroma and my vision is a mess. It makes no sense. Oh, I had an Artemis done. It is called an Insight100 from ArcScan in the states here.
By ---- I meant the entire miserable situation in which I found myself. My DLK was diagnosed at stage IV after TEN days...the surgeon refused to see me after the one-day visit until I went there and insisted. Treatment was too late to prevent scarring. In 2003, I also had an Artemis scan. That's when I found out how really bad things were. The Artemis software was unable to interpret the results as the software hadn't been written to extrapolate out that far. It was rewritten.

I follow everyone's story here...and am familiar with yours. I'm sorry you have had to go through all this. I will email you later today, but for now...

I don't know whether expertly fitted lenses will help, but if you are interested, I may be able to help you find an expert fitter.
Your story is heartfelt. People think it is not a big deal, I try to teach them and they just struggle to understand.

You mentioned you were a myopic -10.5, I had a -4.50. If you do not mind, do you know your total cornea thickness how it is now? I think you mentioned your flaps were cut at 200 Microns.

Question for you;

Were you part of the FDA investigations and or "stories" told to them years ago at hearings?

What ever happened to the progress of that? Seems the trail or roadmap of those hearings went stale.

We really need a group of specialists/researchers to look into our cases and many thousands out here. Is no one interested in these complications and helping find "real" solutions?

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