Are there any prescription drops that can improve night vision problems caused by lasik. I had Lasik done over 7 yrs ago, at first the blurred night vision was bearable; however, my night vision has steadily been worsening to the point where is difficult to drive. Starbursts and halos are the main source of difficuly.

Is there anything that I can do?

James

>Are there any prescription drops that can
>improve night vision problems caused by
>lasik. I had Lasik done over
>7 yrs ago, at first the
>blurred night vision was bearable; however,
>my night vision has steadily been
>worsening to the point where is
>difficult to drive. Starbursts and halos
>are the main source of difficuly.
>

>Is there anything that I can do?
the first thing I would suggest is an exam by a LASIK surgeon who can accurtely measure your night time pupil size and do a wavefront analysis of your vision. You may have increased higher order aberrations, such as coma and spherical aberration, and these can often be minimized by reducing your pupil size at night with a drop like Alphagan which they could presecribe for you.
Dr. Salz
Los Angeles
>

>James

>

>Are there any prescription drops that can
>improve night vision problems caused by
>lasik. I had Lasik done over
>7 yrs ago, at first the
>blurred night vision was bearable; however,
>my night vision has steadily been
>worsening to the point where is
>difficult to drive. Starbursts and halos
>are the main source of difficuly.
>

>Is there anything that I can do?
the first thing I would suggest is an exam by a LASIK surgeon who can accurtely measure your night time pupil size and do a wavefront analysis of your vision. You may have increased higher order aberrations, such as coma and spherical aberration, and these can often be minimized by reducing your pupil size at night with a drop like Alphagan which they could presecribe for you.
Dr. Salz
Los Angeles
>

>James

>

>Are there any prescription drops that can
>improve night vision problems caused by
>lasik. I had Lasik done over
>7 yrs ago, at first the
>blurred night vision was bearable; however,
>my night vision has steadily been
>worsening to the point where is
>difficult to drive. Starbursts and halos
>are the main source of difficuly.
>

>Is there anything that I can do?
the first thing I would suggest is an exam by a LASIK surgeon who can accurtely measure your night time pupil size and do a wavefront analysis of your vision. You may have increased higher order aberrations, such as coma and spherical aberration, and these can often be minimized by reducing your pupil size at night with a drop like Alphagan which they could presecribe for you.
Dr. Salz
Los Angeles
>

>James

>

You may have many options to reduce the night vision problems you describe. Each response depends upon the exact cause of the problem.

Halos around light sources at night and/or starbursts from light sources that did not exist immediately after surgery may be indications of simple refractive error. Even though you had LASIK seven years ago to reduce your need for corrective lenses, your eyes will continue to change after surgery just as they did before surgery. It may be that you now have a small amount of astigmatism, myopic (nearsighted) vision, or even hyperopic (farsighted) vision. These are simple refractive error that can be corrected with glasses, contacts, and possibly conventional LASIK enhancement surgery. An examination by an eye care physician would easily determine your current refractive error and provide you with a prescription for glasses or contacts.

The nighttime vision effects you describe may be reduced by the reduction of your pupil size. This would be especially true if you have astigmatism. Astigmatism is when your cornea is not shaped spherical like the top of a ball, but is elliptical like the back of a spoon. The “tip” of the spoon will focus light slightly off center. When your pupils are small, the iris blocks the light that passes through the tip from getting inside the eye and being “seen”. During the day or in bright light, this occurs naturally. At night, the pupil becomes enlarged and the poorly focused light passing through the tip of the astigmatism is able to enter the eye and is seen as a faint ghost image or blur. For more information on pupil size issues, see http://www.usaeyes.org/faq/subjects/lasik_pupil_size.htm

As Dr. Salz mentioned, an evaluation with wavefront aberrometry available through most good refractive surgeons would provide information about more than just your need for glasses, but would also indicate the existence of vision disturbances known as higher order aberrations. Depending upon the exact nature of your vision, it may be possible to have wavefront-guided LASIK enhancement surgery that will reduce your higher order aberrations and provide an improvement in vision. See http://www.usaeyes.org/faq/subjects/wavefront_custom_lasik.htm

The two eye drops that are most often prescribed to chemically reduce the size of your pupils are Alphagan P and pilocarpine. Alphagan P seems to be a much more gentle approach that works for most people in most circumstances, but on occasion the stronger pilocarpine may be necessary.

Depending upon your situation, you may be able to resolve your night vision problems with a pair of glasses to use at night, contact lenses, eye drops, conventional LASIK enhancement, or wavefront-guided LASIK enhancement surgery. To know which (if any) is best for you, be examined by your doctor.

Glenn Hagele
http://www.USAEyes.org

I am not a doctor.

Thank you for the advice.

Your assessment is correct. I am presently near sighted and have an agstigmatism of -2.0. Post op I had around -1.0 but over the years the prescription has progressively gotten stronger. I wore glasses for a 6 and recently switched to Ciba night and day (extended 30 day) wear contacts. I have tried other RGP and soft lenses but had to discontinue their use due to excessive dry eyes and distorted vision and general discomfort.

I plan on seeing a surgeon in the near future. I will post my results of the consultation.

Thank You
James