Here is a question for a Doctor.
I was nearsighted -4.25 left and -3.75 right. I had minor astig in my right, but that was barely perceptable. I had one enhancement four months after my original surgery. I am nearly one year post-op since the enhancement. My eyes are still somewhat dry since the surgery, but I use drops to lubricate.

My vision is 20/20 during the day, but I have a moderate degree of glare during the night. Headlights and streetlights are very annoying to look at. Halos are present around the lights as well. I've noticed a very minor level of ghosting off traffic lights. Pre-op I had pristine night vision with corrective lenses.

My Doctor prescribed Alphagan which does not improve the condition.

Are there any corrective procedures for this visual abberation? If not, are there any in development?

Will you please describe in laymans terms what how glare results from LASIK? I do not have exceptionally large pupils so I'm looking for other possibilities other than this theory.

Comments and advise are welcome.
Thanks, Aric

The most common cause for glare at night time is having residul refactive error (myopia, hyperopia, astigmatism). A person can see the 20/20 chart and still have some mild refractive error. So please first check to see whether a mild pair of glasses will help.
There are many other potential reasons for night time aberrations. There may be slight irregularity of the corneal surface, which will cause these symptoms. A soft or sometimes a hard contact lens would be the answer if this is your problem.
Another common cause is dry eyes - which can cause surface irregularities and night time problems.
Finally - another cause can occur when patients with significant degrees of myopia are treated with a small optical zone, and the patient has large pupils at night. Each laser treats the cornea differently to reduce the level of myopia. Some lasers treat with a smaller optical zone, such that there are areas of untreated cornea. This can lead to some night time problems as well.
Interestingly, reducing the night time pupil size with Alphagan will help for almost all of these situations. This is because reducing the pupil size minimizes the ability of aberrant light rays to make it to the retina. So taking drops to reduce pupil size does not provide a clue as to the underlying cause.

In summary

1. Get a refraction and see if glasses will eliminate the night time problems
2. You may need to try soft contact lenses or even hard contact lenses for driving at night. Obviously this is not desireable, but atleast it will help you determine the cause of the night time problems.
3. Of course, make sure your eyes are nicely lubricated, and see whether this helps
4. Finally, talk with your surgeon about pupil size, in case that is an issue.

Best of luck

Bill Trattler, MD
miami, FL