significant overcorrection - double vision

I'm a 47 year-old female. I had PRK done 4 months ago. My prescription was -12.00 both eyes with -0.25 astigmatism on one eye.

I was put on Zymar and Pred Forte for the first week. Then I was told to use only Pred Forte after. My IOP went up to 26 after 2 weeks and started to use Combigan to bring the pressure down. The pressure did come down in a week. After I continued with the 2 drops for about 10 days, my IOP increased to 43. I was told to stop using Pred Forte then.

All this time, my vision was blurry but I managed to see with a pair of readers of +1.25 for about month and a half. One day at work, my vision started to change and I could not read small prints. I started to use a pair of +2.00. On February 5, my vision got worse again and a needed to get a pair of +2.50. On February 18, I had to get a pair of +3.25 ( the strongest one that I could get in the drug store). In the beginning of March, the pair of +3.25 was not good enough anymore. I went back to my surgeon, he had no explanation regarding the change and told me to continue with my Bion tears and Celluvisc.

I went to another doctor for a second opinion. He said an enhancement is necessary but it will have to wait until my vision gets stable. I am put on cyclosporine for my dry eyes and the haze that has formed over time without any steroid drops. He suggested me to get a pair of hard contact lenses fitted to help me see better.

My prescription was od +4.25  -1.25  180  and os +4.50  -1.00  040.

My question is why my farsightedness is getting worse. How bad will it get? What is happening to my eyes to make my farsightedness worse? Should I wait until my vision gets stable before I go for the contact lenses? Will the contact lenses do anything to my cornea? I'm concerned and frustrated. Please help.

[Michael J Kutryb, MD]

The second surgeon knows your case much better than I do and is telling you the situation.  You are obviously WAY overcorrected.  A cycloplegic refraction should be able to give you the exact refraction.  The surgeon will do a very careful review of the preoperative records is in order to try to find out if there was a problem with the measurements or the settings on the laser or perhaps everything was exactly perfect and there was just a tremendous over-response to the laser treatment. The good news is that the overcorrection should be able to be corrected with the laser but it is very, very important to wait as long as possible (like 6 months if you can) to make sure you are not trying to hit a moving target.  The refraction needs to be totally stable. Make sure that you don't have some type of corneal thinning or ectasia also before any more laser treatment.

MJK MD

[davtpt]

Becareful w/ your surgeons/ opthomologist... You as well as me are test specements to these people... They don't care how we end up... It's a sad but true fact... I learned this first hand...