Successful LASIK 8 years ago..blind as a bat and was extremely happy. Was severely nearsighted and had astigmatism. Eyes corrected. Ecstatic.
Fast forward right eye had regressed to 20/200, had some problems with distance and no problems with close up vision reading or just looking in the mirror and putting on makeup. Went to doctor to discuss options..didn't want to wear an "occassional" contact in that eye because after wearing them for 20 years never wanted to do it again. Didn't want glasses either...Dr said I wasn't a candidate for a second LASIK procedure and actually cancelled the procedure while I was at the laser center. Felt relieved he didn't go ahead just to do it. Months went by, vision up close and distance is always fairly good in summer (extened daylight hours). Decided to postpone any surgery. Dr talked with colleagues said he could do PRK, said I might need reading glasses in the future, but I would see even better! Procedure done 17 days ago and I can't stop crying, every day I am so sorry I did this...can't focus. (Sorry if there are misspelled words while typing this...difficult to see computer keyboard) I would never have given up the clear crisp edges in my visual field within 15 feet. Now I can only see clearly out of both eyes at a distance. Putting on makeup is a struggle, looking in a mirror at 3 feet my face is blurry. Cups in cabinet are blurry, items on desk are blurry. I'm sick about this....did I sacrifice my close up vision for distance? God I hope not...My dr thinks I'm "overreacting". All I know is what I have LOST, the gain was not worth it. I pray every night that when I wake up it will be better and since going off the steroid drops 7 days ago, I can see my right hand clearly at a distance, whereas before it was a blob. Reading and writing is my greatest pleasure....now there is no pleasure in it, since I find the smallest task difficult to "focus" my eyes on. I hate even trying to read. please someone tell me that this is going to get better. I feel like I can't talk to my dr anymore, that is doesn't understand why I am traumatized. I would never have given up my close clear vision within 20 feet for this! I hate it.

It appears that you have two problems that are contributing to your vision problems. One will undoubtedly resolve with healing, the other undoubtedly will not.

PRK is very unlike Lasik. In PRK the outermost layer of cells of the cornea are removed. These are the fastest reproducing cells in the human body, but they do need to regenerate and the layer needs to thicken and smooth. This full process can take several weeks to a couple of months. As the epithelial cells resolve, the quality and crispness of your vision will improve.

The other problem is refractive error. It may be that you are slightly overcorrected into hyperopia (farsighted, longsighted) vision, but it seems most likely that your difficulty seeing objects near is due to presbyopia. Presbyopia is when the natural crystalline lens inside the eye is no longer able to change focus from distance to near. Presbyopia normally starts to interfere with near vision around age 40 and is a natural product of aging.

When your eye was nearsighted, your distance vision was negatively affected but your close vision would have been positively affected. Now that you are probably plano (no refractive error) you have the full effects of presbyopia.

Reading glasses is the obvious short-term solution. Use inexpensive reading glasses to get you by until about three months postop when you vision has settled. Your doctor can then determine you current prescription and determine if additional enhancement surgery is appropriate.

It sounds like what you are experience now is what every person who has no refractive error – whether it be naturally or via surgery - experiences after about age 40.

Glenn Hagele
http://USAEyes.org
Lasik Patient Advocacy & Surgeon Certification

I am not a doctor.

Thanks for your reply....Eight years ago when this same dr did my LASIK, he made my "right" eye my reading eye. I had absolutely no problem seeing seeing up close out of either eye. The right eye over 8 years did go from about 20/40 to 20/200 and it wasn't really causing me a great deal of distance problems and I did delay the surgery because I was seeing fine, but know in winter I have sight issues, but never close up issues. Since my right eye became worse over time and I was able to continue to have up close vision, could that still happen again? I cannot accept this, it is awful and can't believe that anyone would knowingly give up close vision to see at a distance...I would never have done this had I really understood what my doctor meant by "might have to have reading glasses." THIS SHOULD BE TRANSLATED TO, "YOU WILL HAVE DIFFICULTY SEEING INSIDE YOUR PURSE, READING YOUR MAIL, LOOKING IN THE MIRROR, EVERYTHING WILL BE BLURRY. I just threw away my everyday vision for nothing, I am so upset I can't stop crying. This is the worse mistake I ever made.

Many people prefer to have excellent distance vision at the expense of good near vision. They prefer to use reading glasses for near vision. This is a matter of personal choice. Obviously you prefer the near vision.

It is difficult to know if you will regress again. It is certainly possible, but impossible to predict.

I concur that telling someone the probable results (near vision will be diminished) is not the same as telling them the consequences of those results (you won’t be able to read, see inside your purse, or read the LCD on your mobile phone without reading glasses).

Glenn Hagele
http://USAEyes.org
Lasik Patient Advocacy & Surgeon Certification

I am not a doctor.

Debra, both Glenn and I have addressed your concerns in significant detail, and indicated that your apparent current hyperopia may well regress toward plano over the next few months, which is typical with PRK patients. As we also both mentioned, you will likely end up requiring reading glasses for really close-up work, but, then, so does everyone else (middle-aged or older) with normal emmetropic vision. The information Glenn and I have given you is not just our opinion, Debra, it is the accepted medical understanding of your expressed concerns -- something you can readily verify with some google searches of your own. In addition, although I do think your doctor should have communicated better with you, in my opinion, emotionally overreacting to your current concerns is not helping you.

Bryce Carlson

I am appreciative of both your advice....The terms you use are new to me and I am just now starting to understand this. I agree getting upset is not helping, it's hard when my headaches get worse everyday and the nausea is overwhelming. Today I became quite sick (literally) trying to adapt to this vision. I'm praying every day I go back to "plano" it sounds like this is what I need to do to regain my near vision. I'm encouraged you see this happen with PRK patients. Can my doctor re do the procedure and take me back to the way I was before the surgery or is this too dangerous?

Bryce or Glenn yesterday got a multi focus contact for my corrected PRK eye. It was as if someone turned the lights on and my close vision came back! The extreme difference was causing me to be nauseous, vomit and fall. Yesterday fell flat on my back and hit the back of my head on a heavy piece of iron. I can't take these results. Dr did corrects me to plano, said contacts will cause regression, will I get my close vision back (I mean being able to see clearly within 25 feet?) I am 21 days post op now and still ahve seen little improvement, except distance and night vision is remarkably improved, but I rarely if ever relied on that anyway . Will wearing the contact cause more damage? All answers are appreciated from all.

Sorry to hear about your fall. Contacts can reshape the cornea, but this may be exactly what your doctor is attempting to achieve. It is obviously the opinion of your doctor that contacts are going to be helpful. If you have any sudden changes in vision quality, be sure to give the doctor a call.

Glenn Hagele
http://USAEyes.org
Lasik Patient Advocacy & Surgeon Certification

I am not a doctor.

I insisted my doctor give me something so I could read, glasses weren't working and I have started a new job in the medical profession and couldn't see any letters on the page! The severe loss of near to mid vision, which was NEVER discussed is making me sick. Almost 4 weeks post op and my near to mid vision has not returned. The contact is the only way I can function, short of losing my job. I'm getting the strong impression my doctor isn't sure whats going on as he never gives me direct answers. I'll see him again on Tuesday. There was no benefit to this surgery, results removed my functional vision. What are my rights as a patient and what is the doctors obligation to me? I wake up every day with continual anxiety. I am trying to not be so emotional but losing my vision was not why I paid to have this surgery. Any advice on getting a second opinion? I know it's too early to consider and enhancement, but I can't live this way. Your contructive comments are greatly appreicated.

Yes, significant anisometropia (approaching a couple of diopters or more) can result in an aniseikonia that is quite disorienting and uncomfortable. The easy fix, however, is a contact lens in the problematic eye that brings things back into balance. This sounds like what your doctor is doing, and it is both safe and effective. Hopefully, in time your overcorrected eye will regress on its own (common with PRK) and you will end up with good, balanced uncorrected vision. If your overcorrection remains persistent, however, you might ask your doctor about CLAPIKS. CLAPIKS is a technique, using a contact lens and an NSAID such as Acular, that has had success in correcting (regressing) refractive surgery induced hyperopia.

Bryce Carlson