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RE: Induced Astigmatism After Epi-Lasek Wavefront

azriel — Wed, 13 Jun 2007 19:33:49 GMT

As I see it, the problem with astigmatism as apposed to being straight myopic is this. Being straight myopic means that your distance vision is a little compromised.

Being astigmatic means that all vision is compromised as you can't clearly focus at any distance, either close up or distance.

That is why it is so difficult to come to terms with.

Regards

Ian

RE: Induced Astigmatism After Epi-Lasek Wavefront

otherparty — Wed, 13 Jun 2007 17:23:51 GMT

I had epi-lasek on the 24th of May, and have now a slight induced astigmatism inthe right eye. prior to surgery i was LE -4.75 (w/ 0.5 astigmatism) and RE -3.5 (w/ 0.25 astigmatism). At my 10 day check, i was LE -0.25 and RE 0 (w/ 0.5 astigmatism). Whilst this is only a slight increase in astigmatism in the RE, it is now clearly noticeable (and very irritating as my RE would otherwise have perfect vision). In fact, even though the LE is still slightly myopic, the vision is better than in the RE. I do hope this will improve with time. :crazy:

RE: Induced Astigmatism After Epi-Lasek Wavefront

scarlett — Tue, 12 Jun 2007 10:56:15 GMT

Thanks Ian for that reply.

It gives me a little hope that the astigmatism may reduce in time then.

RE: Induced Astigmatism After Epi-Lasek Wavefront

azriel — Mon, 11 Jun 2007 18:26:23 GMT

I have just noticed that you can't edit a post - strange!!

I wanted to add that you may want to look at Higher Order Abberations [url=http://www.lasermyeye.org/patients/learning/hoa.html] here[/url] as I mentioned it in my previous post and this could also be contributing to the lack of clarity in your vision also.

HOA's can be measured with a Wavefront Abberometer, one of the tests you have prior to surgery (look at the baloon and a your cornea is analysed by a number of red rings projected onto your eye). I seem to recall this is called an OPD-Scan.

Dr VanSoelen explained to me that HOA's "could explain difficulty seeing in low light, and that I have more HOA's in my Right Eye than my Left Eye."

My medical notes indicate that this could be corrected with further laser but "patient not keen on any further laser to right eye." Do you blame me? One laser application has caused me enough grief - in my opinion going back for a second round would not be in my best interest. It is something I will just have to learn to live with.

Speak to your DR on your next follow up visit if you have any concerns.

Ian (Aziel)

RE: Induced Astigmatism After Epi-Lasek Wavefront

azriel — Mon, 11 Jun 2007 17:57:45 GMT

Scarlet

An induced astigmatism is an astigmatism that is present post-op that was not present pre-op. It can be an increased astigmatism that existed pre-op or can be a new astigmatism along a different axis.

I could give you my opinion as to how this happens but it is best that I don't so here is a [url=http://www.lasermyeye.org/patients/learning/inducedastig.html] link[/url] that explains it.

As for the irregular astigmatism, It was something my private Opthamologist picked up. He found it very difficult to get an exact refraction in my right eye as my vision was sharper at two different axis points and blurry in between. He told me this is typical of an irregular astigmatism, the bad news is that the cylinder correction in your glasses can only correct along 1 axis not both.

Again, rather than giving you my opinion on this, have a look [url=http://www.lasermyeye.org/patients/learning/irregularastig.html] here[/url] for an explanation.

What I can and will comment on is that my astigmatism has progressively reduced over the past 12 months. The Dr at Optimax told me that Dry Eyes can contribute to the astigmatism (up to 0.50 of a diopter). It is my opinion that my astigmatism and other visual issues are prevelant because I haven't had a healthy tear film covering my eyes since epi-lasek.

Recurrent Corneal Erosions (RCE's) have also effected the vision in my right eye. The visual disturbance caused by RCE's has lasted anywhere from a few hours to a couple of weeks. This may also be contributing to my continual vision issues.

My induced dry eyes may also explain why my vision is not the best in low light and why driving on the motorway at night is like going to a fireworks display with starbursts everywhere. I now avoid driving at night at all cost - difficult when I catch a late night train home of an evening.

It is my opinion that the induced dryness may have hindered my healing and generally poor eye health which is probably why some of these complications have not resolved for me. I hope that with the passage of time, things WILL get better but after 20 months I haved started to realise this may be my lot in life - what a costly mistake this has been for me!

Regards

Ian (Azriel)

RE: Induced Astigmatism After Epi-Lasek Wavefront

scarlett — Sat, 09 Jun 2007 11:26:20 GMT

How do you know whether or not you have an irregular astigmastim? Would they volunteer the information or would I need to ask. I think I remember them saying that mine corrected nicely so not sure.

Did yours reduce at all Ian from the origianl astigmatim i.e., was it -.50 post op and has remained that or was it higher and it has got better.

pre-op I had -.25 which i would not have noticed.

What actually causes the induced astigmatism do you know?

RE: Induced Astigmatism After Epi-Lasek Wavefront

Keith9534 — Wed, 06 Jun 2007 21:24:01 GMT

[quote][b]azriel (06/06/2007)[/b][hr]

Keith, 22 May is very early days for you and there is a lot of healing to take place. You may find that in the next few months things will be just fine for you - I certainly hope this is the case and think it is really early days for you to be too concerned.

Regards

Ian (Azriel)[/quote]

Thanks for your kind comments.......its nice to see that despite all your own problems you have time for others

RE: Induced Astigmatism After Epi-Lasek Wavefront

azriel — Wed, 06 Jun 2007 21:08:11 GMT

Sorry for the typo in my previous post. I said Access instead of Axis. I have been using Microsoft Access today and simply got confused.

Ian (Azriel)

RE: Induced Astigmatism After Epi-Lasek Wavefront

azriel — Wed, 06 Jun 2007 21:06:00 GMT

I also have induced astigmatism (albiet minor (-0.50) in each eye). But it appears evident from an external eye examination that I have an irregular astigmatism in my right eye (ie, 1 that cannot be corrected with standard glasses as it runs on two different access).

It is also my understanding that higher order abberations also contribute to the inability to see clearly under low/poor lighting conditions, this was mentioned from my topography in my second last consultation. You may want to ask about this in your next consultation.

Make a list of any concerns that you have and discuss it at your next consultation.

The point that both of you make in this post is precisely the point I made in my thread "20 months post epi-lasik", that just because you can see the 20/20 line doesn't mean that it is clear and you are "another successful statistic".

Regards

Ian (Azriel)

RE: Induced Astigmatism After Epi-Lasek Wavefront

Keith9534 — Wed, 06 Jun 2007 20:42:14 GMT

[quote][b]scarlett (06/06/2007)[/b][hr]

Have been told i've pretty much got 20:20 vision but the astigmatism causes a ghosting which blurrs text.

Has anyone else had experience or can anyone advise (NICK??) on induced astigmatisms.

Thank You :)[/quote]

I would be interested also as I was told at my pre-op that I had slight astigmatism ( must have been very slight as I have never been told thison ANY eye test before?)

I have slightly blurred text vison in one eye ( the other is fine ) which I feel could be induced astigmatism

Like you I can read the snellen chart but its not clear sight.

I`m hopefull this will clear up as I only had LASIK on the 22nd of May....will bring it up on my 3rd visit next month....but wondering if taking FML/Excocin drops would help?

Induced Astigmatism After Epi-Lasek Wavefront

scarlett — Wed, 06 Jun 2007 11:36:28 GMT

Hi there,

I had Epi-lasek Wavefront at Optimax London 8 weeks ago.

Like most others had the 3 day discomfort (not pain I might add). Followed by the headaches, unbalanced vision etc.

I was prior to surgery -4.75 0.25 cyc in both eyes. I am now -0.25 0.25 cyc in my left eye and +0.25 -1.00cyc in my right so have had an induced astigmatism unfortunately.

Have been told i've pretty much got 20:20 vision but the astigmatism causes a ghosting which blurrs text.

I am on FML drops which dont seem to help the vision as when I previously came off these - the vision was much clearer - however I was put back on them 2 weeks ago to clear some slight haze that had developed (not visible to me fortunately).

I would be happy with my sight if it wasnt for the astigmatism. Feel quite cheated with that. The clinic have advised that it could still reduce in time but i'm not hopeful really. If it hasnt improved over the past 4 weeks (it was originally -1.25 1 week post surgery then at 1 month -1.00) then I cant see it changing now.

They said they would do a retreat if still there at 3 months - but the thought terrifies me - how do i know that wont make things worse - or increase some haze.

I feel very disappointed. Am also suffering with dry eye over night too (only past few weeks this has been though).

Has anyone else had experience or can anyone advise (NICK??) on induced astigmatisms.

Thank You :)