Blurry Vision in One Eye After Lasik

[DanLasikPatient]

This is a little similar to hleannie's 4 Nov. 2007 question in Eye Care (Expert) forum. We both seem to have had Lasik in both eyes, then had immediate blurriness in one eye we're concerned may last.

My surgery was yesterday. Immediately after I had sharp vision in the left and blurry in the right. I commented at the time and the doctor said the blurriness was from the eye drying out under the shield (it was lasered first)  as they did the other. My vision in both eyes fluctuated the rest of the day and I thought perhaps the right was improving. Waking in the morning today that was not the case. I was terrific in the left eye, very blurry in the right eye.

The doctor diagnosed a epiphelial erosion. I said (I'm condensing here) "well, wait, I had this blurry vision yesterday in this same eye right after surgery, it couldn't have been eroded then, could it?" He said, "no, that blurriness was from dryness, this is from an epiphelial erosion" but said that the dryness may well have led to the erosion (the cells, already traumatized a bit from the operation, got dried out and eroded, if I understood correctly). He put a protective contact lens in to help with the healing and minimize the potential for my eyelid to perpetuate the erosion and scheduled me back for the day after tomorrow because he wants to monitor it closely.

I asked him if perhaps instead something, laser-burned cells or some foreign material, got trapped under the flap, and he said no way, he could see that was not the case. He said he could see the erosion as well. He saw these with his scope device mounted on the examination chair (the kind of device where the patient leans forward and places his chin there and the doctor evidently looks at his or her eye under great magnification).

He says it could take a few days or even two weeks to heal, but the erosion and this current blurriness in the right eye is no reason to think I won't get results roughly equivalent to the left eye (which as I said seems great so far).

Does it sound like my doctor is right? I was thinking today about getting an urgent consultation from another Lasik surgeon, but my doctor sounds confident, if appropriately watchful, about my prognosis. I figure I'll see how it goes for the next day or so, and am crossing my fingers for some significant improvement by morning.

Dan

[John C Hagan III, MD, FACS, FAAO]

Good, hope your result is every thing you wished for.

JCH MD

[DanLasikPatient]

Vision in the right eye has improved a lot in the last 24 hours. It seems to be doing like my doctor said it would: the epithelial erosion will heal and the vision will improve.

I think of it as coincidence but I removed the bandage contact about 27 hours ago because it was giving me some discomfort. It had been in there five or six days and I didn't think my eyelid was going to exacerbate the erosion at that point and I was frustrated with it and everything else. I called my doctor's office today to ask if they wanted me to obtain and put in another, and he called back and asked how I was and said no, it'd be okay until he sees me tomorrow and he'll appraise things then. And keep doing all the drops.

Feeling much better about the results of the surgery and hoping for further improvement and no setbacks.

[John C Hagan III, MD, FACS, FAAO]

Erosions can be small microulcers, relatively large sloughing of the outer layer or small blister like collections of fluid under the surface of the retina.

Good luck.

JCH MD

[DanLasikPatient]

My doctor looked again and said the erosion was shrinking. I had supposed it was a hole in the epithelium like a crater, but he said no, the epithelium is intact but there's a damaged area that bulges or is otherwise irregular, and that is what is shrinking and smoothing. He didn't use the dye. He said it's coming along but scheduled me to come back again early next week. He reiterated that yes, it's blurry now, but that'll clear up and there is still every reason to expect I'll get vision on the right roughly equivalent to the left (which is wonderful). He's definitely willing to listen to and answer my questions and explain things to me.

The vision has not improved that I can tell. It fluctuates between blurry and blurrier. I don't think I'll go for a second opinion. I'm not aware that there's a timing urgency to do so. If the vision is not right once this erosion heals (knock on wood), then I'll consider what to do from there. Hopefully it'll clear up and be great after a few more days.

[John C Hagan III, MD, FACS, FAAO]

Does anyone that has had lasik want to comment?

JCH MD

[DanLasikPatient]

Well, I don't want you to undermine anybody. I am just worried about my vision and was equally looking for affirmation that such a complication would produce such an effect or equally a "wait a second, that doesn't sound right," to help me decide whether to go see someone else.  

[John C Hagan III, MD, FACS, FAAO]

We do not provide advise in the immediate post operative procedure no do we try and second guess or undermind treating physicians. If you are not comfortable with what you're told you can always get a second opnion.

JCH MD