wht shld one consider making a decision before going for enhancements?
at what degrees or refractive power shld one that go for it?
and ny otherse..?

any advice frm any docs?
dr trattler?

Theres many factors that dictate if one should get enhanced or not. Many doctors consider 20/40 to be the cut off or -1 diopters in the absence of astigmastim. Sometimes an enhancement may be too risky and its best to leave things be or get a thin pair of glasses. In the case of presbyopia, its actually a good thing to be slightly undercorrected. I know of a woman who was -1.5 diopters due to regression and she enhanced both eyes, now shes overcorrected and needs bifocals where before she only needed glasses for driving and movies.

Not a dr. but hope my opinion helps :)

is there a chance one might get more astig after lasik?

Lasik has been known to induce astigmastim. Over/undercorrections are also possible. In short, lasik or an enhancement has its risks. Many people decide to get a thin pair of glasses for occasional wear instead of enhancement. Surgeons dont even reccomend an enhancement if you end up 20/40 or better, good enough not to need glasses, not even to drive.

mymy... i'm so afraid i'm gona get more astig after lasik is there a high chance if i don't do wavefront

Hi, what was your pescription before lasik and what is it now?

my prescription before lasik is 375 on right and 425 on left with 50 astig on the axis of both
duno if its accurate when i checked with my doc he keep saying to trust him and the eye centre but my power for my glasses previously was 450 for left and 400 for right... weird they subtracted 25 degrees from both sides saying that was the average they took when they dilated pupils? huh? i don't get it... now i haven't really checked my degree yet... its been 2wks... the first checkup was 6/6 on left and 6/7.5 on right.

you mentioned they dilated your pupil. Did they use a cycoplegic agent? If so they did things right by going with your cycoplegic refraction so you dont get overcorrected. You were talking about an enhancement but your 20/20 in one eye and 20/25 in the other? Thats great! Better than my corrected vision with glasses! Hows your vision holding now? Are things clear from all distances? Do you have any astigmastim left?

>you mentioned they dilated your pupil. Did
>they use a cycoplegic agent? If
>so they did things right by
>going with your cycoplegic refraction so
>you dont get overcorrected. You were
>talking about an enhancement but your
>20/20 in one eye and 20/25
>in the other? Thats great! Better
>than my corrected vision with glasses!
>Hows your vision holding now? Are
>things clear from all distances? Do
>you have any astigmastim left?

wow why do u get so excited over my results when i myself am so pessimistic over it... for yr info im still getting blurred and hazy vision for near and far vision and especially at nite or when the light gets dim i can't see clearly... espcially so for when i go to classes to see lectures on the screen... and the starbursts and haloes are still there over light sources at nite... duno if they'll ever go away for all thse things...

what is a cycoplegic anyway? all i knw was that they dilated my pupils when i went for the various tests and also for the op itself... funny thing is for wavefront using the b & L technolas 217z100 there wasn't a need for dilation... wat the!? but since frm the test info gathered that i didn't require wavefront acording to the doc he said the abberometery of cornea or astig was pretty low at about 50 so didn't really need .. wavefront was more expensive too... and cuts off more cornea tissue... even for the technolas w/o wavefront it will still cut ooff more cornea than the ladarvision... so i decided on the ladarvision at first... then i changed mu mind to the wavefront which was using the technolas to have more accuracy and then back again after hearing or reading reviews and comments frm diff pple over the experiences with both...
right now i clearly hope i've made the rightr decision and does this doc of mine who is so adrift
well why do u still need glasses after yr lasik?
i haven't really checked on my current deg or power yet as i've missed the first wk check up (kept postponsing and postponing coz i was busy... really bad of myself cheating on my eyes haha) i'm suppose to see the doc on the 3rd day after op which i already did and then fisrt wk which i haven't and the n first mth which will be later...
i asked him whether i have any astig left and he advised me to check only after 1st mth as it will be a waste of money conducting the test and also refractive powers aren't stabilized yet. he said astig wouldn't be more than before.. i sure hope its true... as i doubt a lot.

"wow why do u get so excited over my results when i myself am so pessimistic over it... for yr info im still getting blurred and hazy vision for near and far vision and especially at nite or when the light gets dim i can't see clearly... espcially so for when i go to classes to see lectures on the screen... and the starbursts and haloes are still there over light sources at nite... duno if they'll ever go away for all thse things..."

Youve said it well. The snellen chart tests for quantity but not so much as quality. There are people seeing 20/30 or even 20/20 that still complain about their vision quality wise. Everyone gets excited when they hear someone got 20/20 after lasik and it takes explaining to see why he may still not be happy.

Your quality of vision is due to high order aberrations which become most appearent at night.
It may also be due to your pupils being larger than the lasered optical zone.

"what is a cycoplegic anyway?"

eye drops inserted to paralize your accomodation to rule out latent hyperopia or pseudomyopia. My manifast refraction may be -5 but I could be a -3 when I get a cycoplegic refraction soon. If I were to be corrected for -5 I would end up as a +2 hyperope when I get older and presbyopia sets in.

"right now i clearly hope i've made the rightr decision and does this doc of mine who is so adrift"

The decision to have lasik is up to each individual. Were you fully informed of the risks and expectations? If so you can rest knowing you were expecting all possible outcomes. Lasik is real surgury with real risks and one needs to weigh the risks vs. the convinence of reduced dependancy on glasses and improved UCVA.

"well why do u still need glasses after yr lasik?"

Lasik does not correct for presbyopia. Also many people dont end up with perfect vision after lasik and still wear glasses part time. Everyone will tell you lasik will reduce your dependancy on glasses. It wont give you perfect "eagle" vision but it will bring you closer to plano. You were probably seeing 20/200(6/60) or 20/300(6/90) without your glasses now your seeing near 20/20!(6/6) your vision without glasses is so much better and this is what the objective of lasik was to achieve.

"i asked him whether i have any astig left and he advised me to check only after 1st mth as it will be a waste of money conducting the test and also refractive powers aren't stabilized yet. he said astig wouldn't be more than before.. i sure hope its true... as i doubt a lot."

Ok go for the checkup after a month and report to us what your refraction is now. You can also ask for temporary glasses to see how much they help. Whatever improvement your glasses give is the best you can expect if you were to get an enhancement. If your seeing blurry from near, try reading glasses.

Hope this helps. Feel free to ask more questions.

>you mentioned they dilated your pupil. Did
>they use a cycoplegic agent? If
>so they did things right by
>going with your cycoplegic refraction so
>you dont get overcorrected. You were
>talking about an enhancement but your
>20/20 in one eye and 20/25
>in the other? Thats great! Better
>than my corrected vision with glasses!
>Hows your vision holding now? Are
>things clear from all distances? Do
>you have any astigmastim left?

wow why do u get so excited over my results when i myself am so pessimistic over it... for yr info im still getting blurred and hazy vision for near and far vision and especially at nite or when the light gets dim i can't see clearly... espcially so for when i go to classes to see lectures on the screen... and the starbursts and haloes are still there over light sources at nite... duno if they'll ever go away for all thse things...

what is a cycoplegic anyway? all i knw was that they dilated my pupils when i went for the various tests and also for the op itself... funny thing is for wavefront using the b & L technolas 217z100 there wasn't a need for dilation... wat the!? but since frm the test info gathered that i didn't require wavefront acording to the doc he said the abberometery of cornea or astig was pretty low at about 50 so didn't really need .. wavefront was more expensive too... and cuts off more cornea tissue... even for the technolas w/o wavefront it will still cut ooff more cornea than the ladarvision... so i decided on the ladarvision at first... then i changed mu mind to the wavefront which was using the technolas to have more accuracy and then back again after hearing or reading reviews and comments frm diff pple over the experiences with both...
right now i clearly hope i've made the rightr decision and does this doc of mine who is so adrift
well why do u still need glasses after yr lasik?
i haven't really checked on my current deg or power yet as i've missed the first wk check up (kept postponsing and postponing coz i was busy... really bad of myself cheating on my eyes haha) i'm suppose to see the doc on the 3rd day after op which i already did and then fisrt wk which i haven't and the n first mth which will be later...
i asked him whether i have any astig left and he advised me to check only after 1st mth as it will be a waste of money conducting the test and also refractive powers aren't stabilized yet. he said astig wouldn't be more than before.. i sure hope its true... as i doubt a lot.

Now i have this feeling of something piercing in my right eye... before actually it was the feeling of something stuck in my left eye.
i noticed after my right eye op i didn't feel anything, at least not as much as the left eye which i felt pain immediately after the op... unusual but it subsided...
I don't know if its because of this little thin red streak of line that appeared after the surgery on my right eye... looks like a blood vessel, dunno if its broken or some veins could have been burst... I'm going to ask the doc on my next visit
thought maybe you know a thing or two so that you can advise me? before i didn't have the red streak of line... going frm the side of the right eye towards the bblack color of the eye which is the pupil area i guess it stretches acroos the sclera...

"Youve said it well. The snellen chart tests for quantity but not so much as quality. There are people seeing 20/30 or even 20/20 that still complain about their vision quality wise. Everyone gets excited when they hear someone got 20/20 after lasik and it takes explaining to see why he may still not be happy.
Your quality of vision is due to high order aberrations which become most appearent at night.
It may also be due to your pupils being larger than the lasered optical zone."

do u think the side effects would subside..? i'm 21 now...

"The decision to have lasik is up to each individual. Were you fully informed of the risks and expectations? If so you can rest knowing you were expecting all possible outcomes. Lasik is real surgury with real risks and one needs to weigh the risks vs. the convinence of reduced dependancy on glasses and improved UCVA."

well i'm enjoying the freedom lasik has given me in terms of not having specs that slide down my nose as my face is rather oily at some pt of the day or when sweat or grime starts to generate and i don't like to wear so tight specs as its very uncomfortable.. like something clutching onto my ears.

"Ok go for the checkup after a month and report to us what your refraction is now. You can also ask for temporary glasses to see how much they help. Whatever improvement your glasses give is the best you can expect if you were to get an enhancement. If your seeing blurry from near, try reading glasses. "

what do u mean by glasses is the best i can expect if i get an enhancement? you mean if i go for an enhancement, then i wouldn't get 6/6 on both eyes?
and btw, you still haven't told me the risks of enhancements yet? are they similar to the original op?

sorry if I caused some confusing

"do u think the side effects would subside..? i'm 21 now..."

I sure hope so. Give it a little time.

"well i'm enjoying the freedom lasik has given me in terms of not having specs that slide down my nose as my face is rather oily at some pt of the day or when sweat or grime starts to generate and i don't like to wear so tight specs as its very uncomfortable.. like something clutching onto my ears."

right on! The main complaint I have about glasses is the lenses are always getting dusty or smeared
sweat also causes the lense of my glasses to smear.

"what do u mean by glasses is the best i can expect if i get an enhancement?"

no, what I meant is get a thin pair of glasses and see how much this helps any vision complaints you have. If glasses dont make much or any difference, an enhancement wont either. Personally, I would wait at least 3 months before considering an enhancement

"you mean if i go for an enhancement, then i wouldn't get 6/6 on both eyes?"

you already are 6/6 in one eye, an enhancement probably wont do a thing and besides the surgeon probably wont enhance 20/20 or 6/6 anyway.

"and btw, you still haven't told me the risks of enhancements yet? are they similar to the original op?"

sounds like it. I know for sure that its not without risks. Its like fine tuning but its still additional surgury netherless. I would be worried of overcorrection if you get enhancement when your pratically plano.

The best thing to do is enjoy your new vision and give it time to heal. Theres a reason why most people wait 3 months before considering enhancements.

How close to the vision to glasses are you seeing? Is it as good as glasses yet? very nearly as good?

"right on! The main complaint I have about glasses is the lenses are always getting dusty or smeared
sweat also causes the lense of my glasses to smear. "

also my facial anatomy isn't really able to support glasses ... i've a rather flat nose bridge and since young i've had this prob of my glasses being slanted to one side no matter how much i tried to adjust it just seemed still slanted...
tried contacts too but at some pt of the day one side would feel dry and like theres somethin stuck in my eye...

"sounds like it. I know for sure that its not without risks. Its like fine tuning but its still additional surgury netherless. I would be worried of overcorrection if you get enhancement when your pratically plano. "

what is plano?

"How close to the vision to glasses are you seeing? Is it as good as glasses yet? very nearly as good?"

no not as crisp... now its like whenever i see light sources there arehaloes and starbursts and also especially at nite vision is pretty blur or not as clear as when there is pure lighting...
i can't see the lecture notes in class clearly too
and on black surfaces with white fonts there is like this ghosting effect. then it takes me some time for me to get adjusted too...

how old are u btw ace?
thanks for all yr advice...
i hope my few thousand dollars isn't going down the drain...

"also my facial anatomy isn't really able to support glasses ... i've a rather flat nose bridge and since young i've had this prob of my glasses being slanted to one side no matter how much i tried to adjust it just seemed still slanted...
tried contacts too but at some pt of the day one side would feel dry and like theres somethin stuck in my eye..."

some of my glasses also were crooked due to one ear being lower than the other. The glasses im wearing now are actually quite good except the lenses are a dust magnet. I clean it and in an hour its speckled full of dust! Contacts suck for me, they dry both eyes, sometimes one eye worse than the other! They are never comfortable for more than an hour or two. Plus due to my low accomodation, I still need reading glasses *over* my contacts!

"what is plano?"

zero refraction. no myopia, no hyperopia, no astigmastim.

"no not as crisp... now its like whenever i see light sources there arehaloes and starbursts and also especially at nite vision is pretty blur or not as clear as when there is pure lighting...
i can't see the lecture notes in class clearly too
and on black surfaces with white fonts there is like this ghosting effect. then it takes me some time for me to get adjusted too..."

Seems decietive when ones seeing 20/20 and still has blurry vision. Hence the term high order aberrations. How large are your pupils? if they expand past the lasered zone, this explains the halos, starbursts and other optical effects. aberrations factor in as well. However give it 3 months then you can discuss the possibility of an enhancement with your surgeon. A wavefront laser on your 20/25 eye and only that eye if your surgeon finds it approperate. The wavefront may reduce some of your aberrations and if possible, expand your ablation zone. In the meantime, give it some time.

"how old are u btw ace?
thanks for all yr advice...
i hope my few thousand dollars isn't going down the drain..."

I am 23 here. I dont see any waste there, you indeed did achieve a huge improvement without glasses. If thats ok, I would like to chat to you by email, mines

One may wonder why im so interested. I am in the same situation but theres no easy way for me to reduce my dependancy on glasses. Whatever I do has compromises.

i've still having this feeling of something piercing at my right eye from the outer corners and i'm seeing alot of veins or blood vessels whatever you call it. There's one particularly prominent one too... didn't notice it before lasik
any idea? my next visit to the doc i'm gonna ask him though... every visit is $$$... :(

sure u can email me

Ill email you soon. I would of thought the price of lasik included visits to the doctor. Whens your next visit? Ask about derbris under the flap(if you got a flap) and also ask about the blood vessel concerns. Ask for a manual refraction to see how close to plano you are

wow 23 and u have hyperobia already... hmmm...

what do u mean by debris under the flap? and you mean lasik can be done without a flap?
is it another kind of procedure?

i've been noticing that especially in dimly lit areas or dark areas i can't see really well and its rather hazy... is it due to the higher order aberrations you were talking about?
if so, what is higher order aberrations?

and if by manual refraction you mean the snellen chart test? or some kind of machine that asks you to put yr eyes and focus on some computer image object whilst they fine tune some dial?

would it be possible for enhancements on a totally diff laser machine like the b & L technolas? when the first op was done on the alcon ladarvision 4000? do u think it'd be advisable to change machine ?
i chose alcon at first coz ladarvision removed 20% less cornea. however i didn't require wavefront which was on the b & l as my astig was low... now i 'm fearing my astig may have shot up... i don't have a thin cornea anyway... after conducting all those tests...
say if u choose wavefront for your enhancements later on.. what's the usual practice at your eye centre?
would the eye data they used be only for a specific machine? i doubt so rite..?

I emailed you, check your mail.

hyperobia? The correct term is presbyopic and some people say I dont have it. Either way the symptoms are like it anyhow.

"what do u mean by debris under the flap? and you mean lasik can be done without a flap?
is it another kind of procedure?"

PRK or epi-lasek. Youll have to ask your own surgeon if anything around or in the flap is responsable for the pain your experiencing.

"i've been noticing that especially in dimly lit areas or dark areas i can't see really well and its rather hazy... is it due to the higher order aberrations you were talking about?
if so, what is higher order aberrations?"

small imperfectations, mostly in the cornea. Theres tons of info about this, search google.

"and if by manual refraction you mean the snellen chart test?"

yes and they use a phororaptor and say is one or is two better.

reguarding enhancements, you have to wait 3 months before thinking about one, this is to give time for healing and your vision to stabalize. Yes enhancements can be done with wavefront but its premature to talk about them before the 3 month period.

"I emailed you, check your mail."

yes and i've replied you

"hyperobia? The correct term is presbyopic and some people say I dont have it. Either way the symptoms are like it anyhow"

wow presbyopic at such a young age?

"PRK or epi-lasek. Youll have to ask your own surgeon if anything around or in the flap is responsable for the pain your experiencing."

wow didn't know laser could be applied without creating a flap? how is that ever possible?
pt noted will ask him on my next visit.

"small imperfectations, mostly in the cornea. Theres tons of info about this, search google."

am i more likely to get higher order aberrations if i'm not having that much astig before lasik?

"yes and they use a phororaptor and say is one or is two better."

oh that would be on my next visit to the doc
just visited him yesterday and left eye was 6/9 right 6/7.5. haha actually i faked the nursed i told her its blur... she asked me to try again i said still blur.. as long as it wasn't really sharp those letters... i said it was blur... i wanted to give the doc the impression my eyesight isn't really perfect yet...

"reguarding enhancements, you have to wait 3 months before thinking about one, this is to give time for healing and your vision to stabalize. Yes enhancements can be done with wavefront but its premature to talk about them before the 3 month period. "

yea ok thanks for yr advice once again...

"wow presbyopic at such a young age?"

Some people say its impossible, others say most certainly. Others prefer to go by the name accomodative dysfunction which is very similar to presbyopia anyway. I have heard of extremes, people not needing reading glasses till they are 65 while others at 15! Ive seen a few people in their teens and 20s use reading glasses! The presbyopia doesnt bother me that much as long as I remain nearsighted, I can take my glasses off to read...

"wow didn't know laser could be applied without creating a flap? how is that ever possible?
pt noted will ask him on my next visit."

He will mention PRK and epi-lasek. Lasik is popular because of the fast healing time but PRK is making a comeback because not having a flap is nice :)

"am i more likely to get higher order aberrations if i'm not having that much astig before lasik?"

I dont understand this but I do understand that non-wavefront customized lasik will increase your high order aberrations. Wavefront will reduce the amount of aberrations induced and may remove some aberrations in highly aberrated eyes.

"just visited him yesterday and left eye was 6/9 right 6/7.5. haha actually i faked the nursed i told her its blur... she asked me to try again i said still blur.. as long as it wasn't really sharp those letters..."

well if your having trouble seeing those and have to guess on some and miss some, it shouldnt count anyway. The standard is getting more than 2/3 correct. Ive been passed as 20/25 but I guessed on most, missed some and got lucky on the others. Yes my vision with glasses is 20/30 but not everyone sees perfect even with glasses.

"yea ok thanks for yr advice once again..."

I hope things improve for ya! Do get a manual refraction next time ya visit the doctor. Do you still want to wear glasses if the doctor says you can? Like if they say you still have a little astigmastim left or something?

i'll be damned if if i've to wear glasses again. will be wasting my money on lasik

i think i'm gonna post in another forum on this red blood streak of mine.
my doc says its nothing and seems like he doesn't want to tell me somethin... but its been like permanently there since lasik... before it i didn't have it.

Is the red streak on the white part of the eye? As your doctor said, its not a big deal, should soon go away. As for needing glasses after lasik, alot of people do. Lasik "reduces" dependancy on glasses. It wont do anything for presbyopia and often, the person doesnt end dead on plano so he either gets a thin pair of glasses or takes another risk with an enhancement. Enhancements are risky, especially if you have presbyopia because of risk of overcorrection. Why is lasik a waste if instead of needing glasses all the time you only need glasses 10% of the time? How much would you say lasik reduced your dependancy on glasses?

do u think its some form of corneal scarring?
doc says its nothing