Starburst in daylight!

I have recently noticed car lights when on during the day even cause me to see starburst! This is not as bad as nightime, of course, but I have virtually stopped driving at night because of this. During the morning hours going to work, daylight is upon us, but lots of cars have the lights on. I have been so consumed with dry eyes that I guess I had not noticed this. I am 8 months post op.

I do know I have GASH at night, but in the daytime???? Is this the way it goes for others? Phyllis
Original Post
A lot of the new cars have daytime running lights that are on all the time so more and more you'll see headlights in daytime traffic.

I expect the halos at night and just try to not drive but during the day it's a bit disconcerting because you don't expect all those car headlights.
Sparky,
Pupil size has something to do with haloes and ghosting because my doctor did the flashlight test and the Snellen eye chart went from blurred to crisp. We discovered my pupils are 7mm vs. 5.2mm ablation zone - I definitely see around the treated area so it's no wonder I cannot drive at night.

I also have blinding glare and starburst bouncing off others cars on sunny days. I also get glare off candles in restaurants...but not off halogen lights?

Perhaps you are correct when you say the GASH symptoms are always there but we only notice them at night. Can you invent a device for testing this? Why is type of light important?

[This message has been edited by April (edited 09-18-2000).]
I was told pre-operatively that I have "small pupils," (4 mm undilated, 6 mm dilated). And I did NOT have any light reactions until three weeks after my initial surgery (6/29/2000). But I have come to learn from this BB that I now have typical GASH symptoms.

By daylight I react to car lights and traffic lights; even more disturbing is the bright sunlight bouncing off car windows. By night I have starbursts and general difficulty seeing when driving, which I suspect comes under the "loss of contrast sensitivity" category.

[This message was edited by gloomsburg on December 13, 2001 at 05:36 PM.]
I have posted previously that i have problems with headlights during daylight hours. It is not a starburst problem but a "shimmering" coming from certain headlights. I have gotten used to this over the last eight months. My doc said it was because of a rough edge at the ablation zone that has not yet fully healed. This shimmering is distractive, but not real annoying. The only time I have starbursts at night is when my tear film is wrecked.
Phyllis,

I have horrible GASH, but really have not even tried to figure out what is causing mine because I have had so many other things wrong with my eye. I see halos and starbursts around car headlights during the day, but it is much worse at night. I don't even attempt to drive at night with my bad left eye, loss of depth perception, blurry vision etc. I haven't even asked about my pupil size, though before I had surgery my doctor told me my pupils were large, but not "too" large?! I am 7 months post-op.

Leslie
Stacey's post describing "shimmering" more closely defines what I see during daylight hours. I know this has been there all along, but I am only now noticing it. It is getting darker in the morning on my drive to work and most people have their headlights on. It is about 7:30 a.m. so it's dusky, especially on cloudy days.

I also have "streamers" coming out from indoor lights. My ceiling fan in the living room has 3 lightbulbs on it. Sometimes when I look at it, each bulb will have a stream of light coming "from the bulb" and go downward and finally just fade out at the bottom.

As I said, my dye eyes are getting better (knock on wood) and for the first time in 8 months I am noticing this other stuff. I'll learn to deal with it. I don't drive at night unless it's closeby and familiar. It is nice to have the dry eyes feeling better, even if everything "shimmers."
Phyllis
I am 4 weeks post-op. I am seeing huge starbursts at nite and also seeeing shimmerings headlights in the daytime. I have a problem with dry eyes and just started Doxycycline. Can someone explain to me the connection between "poor tear film" and starbursts?? Thanks
I also see starbursts around reflections and direct light during the day. It is definitely more noticeable in high contrast situations which are more common at night. A bare light bulb against the black is the most noticeable situation. I don't know if I just didn't notice earlier because of my other problems, but I feel it may have started about the same time I developed an increase in floaters. These were a result of pilocarpine drops, not lasik directly.
Could the starbursts be a symptom of vitreous detachment and not lasik problems? Anyone else experience an increase in floaters about the same time as daylight starbursts?
I found out that Polaroid polarized glasses help me with the reflections and starbursts from car lights in a sunny day , I even wear them at night , they make the starbursts and halos smaller and eliminate the haze cloud i see around lights which is the more annoying thing in my GASH.
These glasses are better than regular sunglasses for me, they are not excellent because they are very dark and everything gets darker at night but they sure help me escape a little bit from the visual hell.
Does anyone know if a sucessful fit with macrolens/scioptic etc.. can correct the glare and daylight haloes and starbursts too ?
When you are wearing one of those lenses , do they make your cornea refraction turn into something closer to prolate again ?
Also, pinholes work for me with SOME kind of lights only, like halogen, fluorescent and weak light bulbs & car front lights (that's 90% of the lights), but in very strong and bright lights , I see a cloud of haze that looks like a cloud of insects and when i try to look at it trough the pinhole they I see a weird pattern of floating starbursts and the moving cloud of insects turn into something like frozen prism of those weird starbursts .
It's weird because those starbursts are not like the regular ones, they dont touch the lights they just keep like flying above them without touching them (at least most of them dont).
If I'm wearing sunglasses and constrict my pupils with a flashlight they are gone tough.
jahndaniel,
I am in the early stages of Macrolens fitting, but I can say with certainty that the lenses eliminate ALL of my daytime vision anomolies and about 90% of my nighttime problems. The only problem that I notice at night is a "haze" around light sources. This is not large and is not particularly bothersome, especially since all of the other problems (typical GASH) are eliminated. I may have seen this haze in my pre-LASIK days with soft contacts but can't remember.

I should point out that I don't think there's anything unique about Macrolenses with regard to eliminating GASH. Standard RGPs also corrected these problems for me but were hard for my dry eyes to tolerate. Time will tell if my eyes will be able to tolerate the Macrolenses long-term. Also, it is possible that some of my problems were a result of uncorrected refractive error. This is corrected with the Macrolenses, so it is impossible to say whether the elimination of my problems is due to the RGPs themselves or to the refractive correction they give me, or a combination of both.

------------------
Patti Brankov
After my surgery I had halos at night and during the day. The nighttime halos all blur together making it next to impossible to drive. I avoid going out at night. I was hoping this would improve at time went on.

Lately, during the day and especially at night my left eye (with the pain in it) sees starbursts against the bright lights where it only saw halos before. And one line shoots farther out then the others then drags down.

I guess I didn't know these changes could happen after the initial surgery.
Meledie,

I too was getting only halos/glare for about two months post-lasik. Then, very suddenly, I noticed starbursts. I couldn't believe it. I thought I was lucky not to have starbursts. Well I have them now. They have gotten progressively worse. I did chat with one person who had the same problem and he thought the seasons/weather had something to do with it. He noticed that these effects are worse in the winter and better in the summer.

How long after your LASIK did you start noticing them? Do they subside when your eyes are illuminated?

Bob
I went for a number of months thinking, "at least my daytime vision is ok." But then I started noticing the starbursting during the day off headlights and reflected sunlight. It seems to only get progresssively worse. Now I see it on a TV screen or computer screen, if there are white letters on black background.

I'm wondering how many of us who notice this also have dry eye? Could somehow the dry eye be causing changes in the cornea that scatters light, even in the daytime?
I started this post almost 2 months ago Millard, and I have dry eyes. To me, the starburst, etc. have gotten worse as time goes on. Most people report symptoms getting better after a few months. It seems like mine were getting worse, or at least I noticed them more after a few months. At 10 months, I am just very pessimestic about GASH, dry eyes, the whole "ball of wax" (maybe I should say the whole ball of eye drops.
Phyllis

Good question about the dry eyes causing problems with our corneas.
I guess we should suspect corneal erosion as a possible cause. Does anyone know how this is detected, or where one can go to get it diagnosed? I'm in a bad situation because my surgery was done outside the country, and I have to find medical support locally, which is hard. I do have very bad dry eye, particularly at night, and this might be what is happening to me.
Well the good news is I don't have corneal erosion. I was told I would know it if I did (quite painful). However I do have SPK, despite using drops during the day, oinment at night, and using a humidifier in the bedroom. Anybody got any other suggestions to get rid of the SPK?
I posted earlier in the thread concerning worsening starbursts. I would like to add that I have not been plagued with dry eyes. My day vision remains very good.

I can't figure out if my pupils are, for some reason dilating more now, or if I am ablation zone is changing in some way. But it is something of a shock to have started out with virtually no starbursts and now having very big ones.

Bob
pknapp, bob luce, and others: keep me on the list.

Until week #3 post-Lasik, I experienced no light effects; at that point, I started noticing glare, but in daytime only . . . specifically, car lights and sunlight reflecting off car windows. Earlier in this thread, the word "shimmering" was introduced and it fit my experience exactly.

Between weeks #6 and 9 post-Lasik, the nighttime effects also set in: halos and starbursts. They've not gotten worse, as best I can tell, after week #9. I've been accommodating to them by restricting my life activities. Needless to say, that does not make me happy.

So now, 5 months later, I'm just trying my NEW OD's latest suggestion of using driving glasses (FYI: because I had monovision, my two eyes were "corrected" to different goals). At last week's visit the NEW OD assured me that there were no signs of "corneal erosions" or "dry eyes" under the slit-lamp examination. Therefore I was hopeful after last week's visit that the "driving glasses" would matter significantly. But they have not.

For example, I needed to walk tonight between buildings on campus for a distance of about two city blocks. Even though I chose to wear my "driving glasses" for the walk, the halos and starbursts were extreme. And the drive home was not any easier tonight than it had been without them for the past several months.

I'm not convinced that my problems are seasonal, but they are related to the amount of ambient light. For instance, I've done better when the moon has been out, rather than tonight, when it is not. Moreover, in my house, in the daytime, I've experienced these phenomena when looking at the microwave time clock against its dark background in a kitchen when the morning sun was no longer shining through the window.

I supposedly do NOT have large pupils. I DID and DO have a subjective feeling of "dry eyes," which I am still treating pretty aggressively -- but one week ago they were, by NEW OD standards, looking healthy by his criteria.

Sorry for the length of the post, but SE helps to keep me in balance. I think that PaulaC is onto something here, and I want my experience to be counted!

glooms
My halos have turned into starbursts. And my starbursts have turned into something with this god awful arcing thing coming out of it. If I cover up my left eye the arcing thing goes away.

Even the tiny light on my electric toothbrush holder is beyond weird when I see it each night.

There are two sets of numbers on my microwave timer unless I cover up my left eye and then it still has halos.

And on Halloween the crescent moon had seven tips to it. It starbursted out just like a headlight.

I recently watched my first widescreen DVD with all that black around it. I saw two screens just like I do with that white Snellen eye chart against black.

Words on T.V. and on the eye chart are doubled unless I cover up my left eye.

And in the morning when the lights are dim I can't seem to see as well anymore.

Also, my vision fluctuates during the day. The mornings are awful when I first wake up.

Driving at night (not behind the wheel that's for sure ... but in the passenger seat) the world is like some kind of bizarre firework's display.

Because I ended up with so much pain from the surgery (I have trigeminal neuralgia) I never focused on these issues. But they do indeed seem to be getting worse as time goes by.

This is indeed the gift that keeps on giving. Anybody know where I can take it back???
Fellow starburst sufferers.

I am doing my post-op with my own optometrist. I haven’t seen my surgeon since the LASIK was performed almost four months ago. I suspect that only a corneal mapping will pick up any abnormalities that could cause these worsening starbursts. Have any of you been seeing your original surgeon and gotten any help at all? Do they have any ideas on what could cause this to happen? Has anyone else gotten a second opinion?

I am getting a 4-month post op exam next week (with my optometrist) and hope to be scheduling an enhancement if my refractive error is stabilized (I am +1.5 overcorrected in the left eye, +.5 in the right). I hope that my surgeon can shed some light (no pun intended) on my worsening condition. Oddly, my starbursts are at their worse when I have my glasses on (which gives me 20/20 vision). Without the glasses they are still there but not as bad. Just a couple months ago when I took my glasses off I had no starbursts at all and only tiny ones with the glasses on.

Before the starbursts started, I had fairly dramatic halos (still do). I went to a different LASIK surgeon for a second opinion. He did a corneal mapping and everything was okay (he says). Coincidentally the starbursts had just started a couple days before that exam. I didn’t make too much of it because I thought it was a fluke or something. But the corneal mapping didn't pick up anything at that time.

I am totally puzzled. And I am quite depressed about this.

Bob
I started a new post called Discovering Astigmatism. At this point I think, it is important to separate GASH induced by large pupils at night from GASH during the day, i.e. when pupils are well below the flap cut. If you get GASH during the day, it's astigmatism (regular or irregular), once the pupil expands over the interface GASH comes from the interface and from the remaining 'day' astigmatism. Unfortunately no one relied to my post yet, I am really interested to see if this is correct.
As many of you have noted, symptoms like glare, halos, starbursts, etc can be noticable by day or night. These symptoms mean there is something within the cornea causing the light entering the eye to be disrupted a little (or a lot).

If you notice this only at night, it is usually due to pupil size. As the pupil gets larger in dark environments, you start to see through the edge of the (LASIK reduced) optic zone of the eye. An extreme way to simulate this is if you look through the edge of an eyeglass lens... you notice double vision, halos, etc.

If you are experiencing this during the day, there is something disturbing the optics of the cornea: irregular astigmatism (i.e. irregularity in the smoothness of the cornea), haze or opacity to name a few. If the cornea doesn't heal as planned, there can be haze, scarring etc. A way to simulate this is to take a spectacle lens and rub a brillo pad at the center. All of the scratches are difficult to look through.

Someone else was talking about cornea erosions and sodium fluorescein staining. A corneal erosion is when the top layer of corneal tissue separates from the rest. An analogy is sort of like a blister, you know that layer of skin that lifts from the rest of the epidermis (and painful). As mentioned above, it is very painful and I can practically diagnose it by the chief complaint, before I even look at the eye. Though the eroded cornea will stain significantly, an erosion would be quite obvious to an optometrist without staining.

Other corneal conditions like SPK can cause various amounts of staining too.

Dr. Joe
My $.02

I think daytime starbursting can be due to epithelial problems, which may in turn be related to dry eye condition. As far as I understand it, the epithelium is the only part of the cornea that regenerates. My daytime starbursting started, if I remember correctly, around 4 months or so post operation, and gradually worsened. I would imagine that any irregular astigmatism induced by the operation would have an almost immediate effect, and not take 4 or more months to appear, and then keep on developing. I know in my case my dry eye led to SPK, and the last OD I saw said I had "unevenness" in my epithelial layer. My topographies did look rather different too. I have heard the terms epithelial hypertrophy and epithelial hyperplasia applied to post lasik eyes, but I'm not entirely sure what these conditions are about or how they develop. Maybe someone with medical knowledge could enlighten us.

I would also guess that any "shimmering" one notices would be somehow due to a tear film issue, but beyond that I don't have a clue.

Millard
Count me in your starburst during daylight club! I never noticed this thread before. This was also something I didn't notice for months and months after surgery. I'm one of the 8mm pupil size people,which I'm sure has something to do with it.
thanks...my daytime problems are getting worse too. These are NOT tear film issues, i had upper plugs placed a few days ago and my left eye has been like a tiny aquarium overflowing with tears, and this did not help daytime GASH at all. It in fact made it worse! Go figure!

So has anyone had this problem specifically and noticed improvement with RGPs (ASIDE from nightime GASH issues)? The above post where macros are mentioned to help seemed like the person had not previously been too bothered by Daytime GASH.

Also it doesnt matter how big or small my pupil is, the daytime glare is the same intensity.

And yes I noticed a lot of very weird floaters right around when the daytime effects started to get distracting (6 months). These floaters are invisible unless bright light hits them, then they are percieved just as patches of fog that continue to move after my eye has stopped moving.
I have never in my life experienced floaters like this, only the little well focused ones that have been my friends throughout my life. These are big evil stealth floaters. They aggravate the already bad daytime glare effect tremendously.

Stupid lasik.
What i wouldnt give to have my old blind but smooth eyes back.....
. . . here is an older thread which I am "popping to the top" for you.
(That just mean's I'm posting on it again, so it will rise to the top of the Forum list.)

You will see that several of us on SE discovered changes in our daytime processing of lights, as well as in nighttime phenomena such as starbursts, and that these started weeks or even months after our Refractive Surgeries.

Msfit32, you are still relatively early in the healing process. I hope that for you, things will get better over time. Sadly, for Phyllis and Millard and Stacey and others, including me, we seem to be stuck with these poor outcomes.

glooms
WOW, I have had some problems, but not as bad as you folks....thank-you so much for answering me gloomsburg and my heartfelt sympathies for those you are so adversely impacted in your lives by vision difficulties.....
I must say that I am a little miffed by my surgeons cavalier attitude towards my questions and concerns.....I am hoping for the best, though......
Best of luck to all who have or are suffering from complications.....
I'm under the category of not having these problems show up until over 4 months after surgery. The only luck I've had recently is that they SEEMED to have stablized now. I pray that they don't get any worse!!

Thanks for your sympathy Msfit32, best of luck to you as well Cool
Sorry to bring up this old thread but I have all of these problems too. The wrist part is a steaking and ghosting of light/images when blinking. This happens day and night: sleel as constant irritation and dryness which is worst through the night or waking in morning, I find I am constantly blinking and my vision seems to fluctuated depending on my tear film, this is the same for the daytime starbursts too. no eye drops Iv used seems to help, warm compressed fine very temporary relief. Has anyone been given an explanation of these problems or had treatment to help? Thanks for any help guys
Yes well the vision problems of light streaking, ghosting and daytime starbursts started about 2 months after surgery. I notice these all the time but seem worse when my eyes are dry/irritated. I have has corneal scans and wavefront analysis which have all come back normal. I had surgery in August 2012 and have 20/20 vision. I really feel these problems are down to a tear film problem but not getting anywhere for a correct diagnosis of the problems.
Unfortunately some of the ghosting and starbursts come with the territory and yes, those symptoms can worsen if you have an abnormal tear film. Corneal topography and wavefront rely on light reflecting off the cornea (topography) or reading the pathway of light through the cornea after bouncing off the retina (wavefront analysis). In either case, a poor tear film can affect the readings. If the topography and wavefront analysis were normal, then the tear film must have been fairly intact at the time of the measurements.

What has your doctor said about your tear film? What have you done to address improving the tear film?

How nearsighted were you prior to LASIK?
If I have my eyes wide open I don't experience the visual problems but if my eyes are partially closed or during a blink this is when I notice the vertical light steaking and double vision: I don't know of this is because the tear film meniscus is at this point concentrated on my cornea abs this is what causes the refractive error? When I use drops or is my eye water the problem seems to be worse. The only time I don't notice it is when I wake up in the morning with very dry eyes and no tears. As soon as my eyes tear or use a drop I notice it again. Before surgery I only had a minor precription for an asigmatism. As far as treating the problem it seems to be aqueous deficient dry eye they are treating even though I know I have blocked mebomiun glands through self expression. I don't know how available the probing or lipid low system is but feel that might be only thing to offer improvement as all over things seem to have been tried

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