I had Lasik performed on both eyes one month ago. Since day one, my left eye has been fine. My right eye, however, has had continuous ghosting and double vision. Actually, if I am looking at a light from a long distance away, I experience triple vision, or worse. I was extremely nervous during the procedure, and am convinced that my right eye was not consistently focused on the red dot. I now wonder if its vision is ruined forever. My topographical map does not show anything horrible at this point, and it has shown some very modest improvement. Still, my vision remains the same. My Doctor says that my right eye vision is 20-30. That sounds great, but in reality, I am able to read only the bottom half of the letters on the chart--the top half of the letters are badly obliterated with the makings of ghosting and double vision. In an everyday setting, this translates into major blurriness from the right eye, and I am told that at this point it cannot be helped with glasses.

Questions:

1) Assuming my vision makes little or no progress, how long should I wait before undergoing a second procedure, if one is recommended?

2) If the laser cut too deeply (beside, but not directly on, my main center of vision), is there anything that can be done to correct this?

3) If the problem is deemed uncorrectable with further Lasik procedures, what does one do? I can't imaging living like this for the rest of my life. Is a corneal transplant a possibility? Would I qualify for one, given the fact that one of my eyes is doing well? Any further comments or direction regarding corneal transplants would be appreciated. I would like to think that I have some last resort such as that, if all else fails. (I wonder about how long I might have to wait to find an acceptable cornea, how much it would cost, etc.)

Thank you very much. I really appreciate your help.

You have very interesting questions - but before you start looking for these answers - you need to ge some very important information from your doctor and potentially a second opinion.

From your description, I would be concerned that you might have flap wrinkles that are distorting your vision. The only way to diagnose this is for your doctor or a second opinion doctor to tell you whether they are present. They will not be picked up with topography. You can ask your doctor to use fluoroscein dye - which will highlight any wrinkles that might be present. If wrinkles are present - they need to be removed as soon as possible. Hopefully you have been seeing your surgeon all along, but sometimes when assistants are doing the post-operative visits, they may miss these wrinkles.

If both your doctor and a second opinion doctor tell you that wrinkles are not the cause - then the next issue is whether a refaction can improve your vision. Your doctor should be able to perform a refraction and improve your vision to 20/20. If it does improve with refraction, then this tells you that you will need to have a touch up procedure.

Another cause can be dry eyes - and lubricating drops can help. your doctor should be able to tell you if dry eyes will be helpful.

Let me know how things turn out

Best of luck

Bill Trattler, MD
Miami, FL