HI..I am a software professional. 12 years ago I underwent RK sugery. Everything was great till last 2 years. Now I have severe astigmatism Left eye +4.5 -1.0 105 & right +1.75 -0.25 155 . It seems to be increasing every 3-4 months.

I dont know what are my options know. Any answers will be appreciated. I live in fremont,CA

Thanks,
sugnani

You have a combination of four major problems that are converging to cause poor vision. One is an unstable cornea due to the previous RK. One is hyperopia (farsighted, longsighted) vision due to a shift in the shape of the cornea after RK. One is astigmatism. One is not mentioned, but my bet is that you are over age 40 and you are becoming presbyopic.

Presbyopia is when the natural lens inside the eye has become unable to change shape to change focus on objects near. This is when you need to hold reading material farther away to get focus or require reading glasses. Reading glasses are actually correction for hyperopia. They correct hyperopia by inducing myopia (nearsighted, shortsighted) vision.

The combination of hyperopia and presbyopia can provide poor vision quality at all distances.

Astigmatism is when the natural lens of the eye is not spherical like the top of a ball, but is elliptical like the back of a spoon. Astigmatism can cause slight blurring of images, ghost images, doubled vision in one eye, and is commonly worse in low light environments.

While it may be possible to have surgery to correct the hypeopia and astigmatism refractive error, no surgery will "cure" presbyopia. Also, if your corneas are unstable, any surgery to correct refractive error will last only until your cornea changes shape again. Surgery will not make your cornea more stable, but can make it more unstable.

Your first line of defense to this perfect storm of vision problems would be contact lenses. Soft contacts may help with the vision correction, but a rigid gas permeable (RGP) would probably provide superior vision correction and will add stability to your unstable cornea. Don’t be surprised if you require several contact lens fittings to get something that is just right. Fitting a post RK patient can be difficult.

RGP contacts may take care of the hyperopia and astigmatism, but they will not fix the presbyopia. Reading glasses are an obvious choice, but an alternative is monovision. Monovision is a technique of correcting one eye for near vision and one eye for distance vision and letting the brain work out which eye to use for which situation. We have a detailed article about Monovision at http://www.USAEyes.org and click on | Considerations | Which Surgery For You? | Monovision |

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

I am not a doctor.

Go see a VISX S4 IR Doctor in Southern California. One is in San Diego who is a clinical trial female doctor with VISX and the other is a famous TV star doing VISX trials as well.

I had it done in San Diego and I am pleased as can be with the outcome. I had about a +3.? in my right with a decentered optic zone. She fixed it and shot me for distance. I am 45 and I can see the computer now without glasses but a +1.25 is real nice. My distance is great, my night vision is extremely comfortable and safe againg. My indoor vision has improved as well. I only shot my right eye and my left I is tolerable.

Also LadarVision 6000 has some promosing technology which is just now entering the US. I would not hesitate if I were you to go shoot your bad eye with PRK. It is amazing to be able to see again.