My Rx is: +.50 -1.50 x45. Outdoors in the bright sunshine I see fine. Indoors I do not see nearly as well. My question is, is astigmatism less noticable in the bright sunshine, and more of a problem indoors?

My residual script is similar to yours and I've noticed exactly the same thing. Specs with the minor correction as measured in the low light of the testing room do little good in bright light. As lighting conditions reduce, the pupil opens up wider and more of the refractive defects left over by lasik degrade the focus. Specs definitely help in low light. Getting good lasik results with a smooth accurate ablation across the entire optical zone is hard to achieve, especially if you had astig or a higher script to start with. A custom ablation enhancement using wavefront might help a bit, but I'm not sure it's worth the risk of opening the flap again. For me it's been way too long anyway.

Tom,

I had approx. -3.50 astigmatism before refractive surgery. Have you ever heard of Alphagan P eye drops? Some people have been helped by it for low light situations. I might ask my surgeon if it would be safe to give it a try sparingly just to see if it helps.
Also, do you notice your eyes getting somewhat tired as the day progresses thus losing a little visual acuity?

Frank

Frank,
I've heard of these drops which constrict the pupil for several hours at a time. But I've never used them. I'd rather have the help of sharper focus with the aid of light specs for brief periods of need rather than having to mess with drops numerous times each day. Sometimes even using a small pocket flashlight helps enough. Being presbyopic means having to use reading glasses anyway for close work, so I dont mind that at all compared with my prelasik days of having to rely on thick glasses to function for everything. I do notice a little eyestrain if I dont use the specs over long periods when I need them, but for most daytime activities that only need distance vision, like golfing, I do fine with no correction. It's just a matter of getting used to it.

Tom,

First of all, thank you for sharing information. Being a refractive surgery patient can be challenging at times to say the least. My pre refractive surgery Rx was approx. -4.00, (sph.) -3.50 (astig.) each eye. Post op Rx +.50 -1.50. Pupil size: 6.00mm.
I can't seem to rid myself of my astigmatism. As the sun goes down and light diminishes so does my visual acuity. It's directly proportional.
I don't suffer from severe halos or starbursts, just poor low light vision, very poor. Is that what you experience without your glasses at night?
In a couple of weeks I'm going to try Alphagan P eye drops at night simply to satisfy my curiosity. I don't want to get my hopes up but I must find out if they help me or not. If by some chance the eye drops help, I will use them once or twice a week at night.

Frank.....Reduced visual acuity in low light conditions is made worse by both age and presbyopia. I didnt realize that as much as I do now after lasik...but as we age, the rods and cones in the retina lose sensitivity, plus presbyopia demands the use of plus correction to accomodate close up vision. After age 50, this all seems to accelerate. I started out +5.25 with -1.75 astig, so my lasik was considerably different than yours but we both wound up with similar residual refractive error (in average light). I'm about +0.75 sphere and -1.0 astig now. In good light both numbers seem to get cut in half. Getting completey rid of astig accurately seems much more challenging for lasik, especially when it is higher than one diopter or so. My astig actually grew back in completely with healing after the initial lasik and my enhancements at 6 months were designed to only resolve the residual astig, which they only got half of after the corneas healed again.
Astig just wont die it seems. The higher you start out with the more it wants to stay with you even if lasik carves it all away....it has more of a disposition to grow back, at least in part. From what I have read, this seems to be more of a problem with primary hyperopes like me than with myopes like you since the process of ablating flat corneas into spheres induces some astigmatism automatically. About 1/4 diopter of cylinder for every diopter of sphere.