I am roughly 50 days after surgery.. My surgeon neglected to give me any options other than distance correction for both eyes and that I would need readers after surgery. While I considered this an acceptable trade (without any other information ie monovision,blended etc) off. After surgery my short range vision is gone, my mid out 12 feet is a mess and I am on my way to a shrink to deal with this outcome. My surgeon says we can discuss options when I go back for my 4th visit on May 10th. Due to my age he said I would be getting into readers eventually (56) did not need prior to surgery. I take responsiblility for not researching this completely before the surgery. MY question is what are my options thru enhancement as I am having a hard time dealing with this sudden loss of near vision? Or would I be digging a deeper hole for myself. I went to my eye glass doc and he says I am slightly overcorrect in both eyes. And he is looking forward to selling me bi-focals or tri-focals.

dont rush an enhancement. Best thing to do is get bifocals. Give it some time. If you decide to get H-lasik, you may improve your intermediate or distance vision but still need correction due to presbyopia. I wish you had known about presbyopia and your myopia was keeping you out of reading glasses. How myopic were you before lasik?

Fred,
I too lost my perfect near vision after lasik and now having lots of problems with my left eye. And I'm a young mother of two small kids. I could read and work on the computer without glasses comfortably before lasik, but not anymore. And with my left eye's problems, reading on the computer is very difficult now. I cried a lot and had many sleepless nights the first few weeks. I also saw a shrink, but only once because I realized that no one can help me but myself. My vision is worse than the first 6 weeks after surgery, but emotionally I'm doing much better now. I try to be grateful that I can still see (even though my vision is pretty lousy to say the best). Feeling bad is normal but it's not going to help us. Your eyes are still healing, the overcorrection will reduce. Hang in there, you will be ok. Trust me, I've been through it all.

Are there any docs out there with options for my case.

Your best bet is to play around with contact lenses until you determine the best visual situation for yourself. Once you know where you want to be - your surgeon can perform an enhancement and get you there. This should hopefully solve your issues.

i hope this helps

Bill Trattler, MD
Miami, FL

Dr. your suggestion to try contacts to obtain my best vision- before enhancement ?? Did I understand that correctly?? And then the surgeon would due the enhancement based on that result? Also are their other options for getting functional near vision back thru lasik? At present use one strength readers for close-up and another set for working on computer. 50 days + out from surgery have been hoping to see some improvement.

Fred,

There are a few options for you now and in the future. What you are experienceing is what I call "Sudden Presbyopia". We have an article on this at http://www.usaeyes.org/faq/subjects/sudden_presbyopia.htm

I suspect that you are slightly overcorrected into hyperopia (farsighted, longsighted) vision. The best way to determine if this assumption is true would be with a manifest refraction (which is better, one or two?). This will give you an eye glass prescription and tell you your refractive state.

At your age you are going to be very presbyopic. Presbyopia is when the natural lens of the eye is no longer able to change focus on items near. This is when we need reading glasses or bifocals.

Before surgery you were myopic (nearsighted, shortsighted). Myopia can be described in two ways. One is that you cannot see things distant very well. The other is that you can see things close very well. Even with the optical correction of glasses or contacts, myopia gives you an advantage at seeing things close. Myopia can mask some of the effects of presbyopia. Surgery removed all of your myopia so any advantage you had over presbyopia is gone. You are now dealing with the full effects of presbyopia.

The combination of hyperopia and presbyopia provide poor vision quality at nearly all distances. If you are presbyopic and very slightly hyperopic, your near and mid-range vision would be very poor.

Enhancement surgery to either resolve any overcorrection into hyperopia, or simple make you more myopic, might be appropriate, however you have other options.

CLAPIKS is a technique of using eye drops to soften the cornea and rigid gas permeable (RGP) contact lenses to help reshape the eye. This is similar to Ortho-K, but with a more aggressive approach. We have a detailed article on CLAPIKS at http://www.usaeyes.org/faq/subjects/clapiks.htm with a downloadable surgeon’s protocol. Discuss CLAPIKS with your surgeon.

Conventional contact lenses can resolve any refractive error and can be used to make you a little more myopic in your nondominant eye to help with your mid-range vision. This is monovision and we have a detailed article about monovision at http://www.usaeyes.org/faq/subjects/monovision.htm

Enhancement surgery with Lasik would probably be the doctor’s obvious offer, but you may also want to investigate if NearVision CK is appropriate. It is more temporary than Lasik, but has some advantages. NearVision CK can be performed after Lasik, in most cases. For an article on NearVision CK, visit http://www.usaeyes.org/faq/subjects/ck.htm

Glenn Hagele
CRSQA
http://www.USAEyes.org

I am not a doctor.

I am one year after LASIK. After Surgery, my left eye is quite blurry and I can't read computer clearly due to the poor vision in my left eye. Now, the fact is I can read computer without glasses and I can still feel the vision in my left eye is improving