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vision fluctuations


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#1 asmith

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Posted 15 March 2005 - 07:33 PM

Hi! I am almost 5 months post lasik. I continue to wake up with great vision and then it regresses to -1.50 in about an hour. It stays that way until the next morning. This happens every day. Has anyone else had this problem or could anyone tell me what to expect?

#2 Guest_DrG_*

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Posted 15 March 2005 - 10:06 PM

Hi! I am almost 5 months post lasik. I continue to wake up with great vision and then it regresses to -1.50 in about an hour. It stays that way until the next morning. This happens every day. Has anyone else had this problem or could anyone tell me what to expect?


That is interesting. I'm wondering if your cornea is changing shape in your sleep. Now, if you could get to my office within 15 minutes after awakening, I would take your topographies. :)

DrG

#3 sunsweet

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Posted 16 March 2005 - 12:43 AM

I have the same problem. Dr. G I would love the opportunity to have my eyes examine first thing when I wake up, then again later in the day. But most doctor offices are not open at 5:30 am. My guest is that some sort of dry eye or cornea eye pressure may be cause the fluctuations after you wake up. Is that possible?

#4 Guest_DrG_*

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Posted 16 March 2005 - 08:04 AM

Diurnal fluctuations in refractive error and visual acuity following RK surgery have been well-studied. Approximately half of patients experience diurnal changes of between 0.5 and 1.25 diopters following RK surgery, compared to 11% of normals. Diurnal fluctuations following laser refractive surgery have been less investigated. However, some inferences can be drawn from other studies, including the RK studies.

A recent study found diurnal axial length changes in the normal human eye. The axial length tended to show a peak at noon.
Diurnal changes in higher order aberrations have been found to occur in normal subjects, but the changes were not visually significant for the purposes of refractive surgery planning.
Diurnal variance in higher order aberrations was found to be much higher in keratoconus subjects compared to normals.
The measurement of intraocular pressure is reduced by about 3mm following excimer laser surgery, due to the decrease in corneal thickness.
All of the findings support the fact that the corneal tensile strength is reduced following refractive surgery, including laser refractive surgery, and as a result, the cornea may be more susceptible to the normally occuring diurnal changes in axial length and intraocular pressure.

If anybody wishes to enroll in a study, I'll be happy to conduct one. Dallas is very pleasant in the springtime. :)

DrG

#5 merryish

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Posted 04 January 2006 - 11:38 PM

New to the boards, and reading through everything! Just wanted to say:

Dallas is very pleasant in the springtime. :)

DrG


Sure - all three days of it! =) Talk about your bait and switch...

*g*

#6 Diopter

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Posted 05 January 2006 - 01:57 AM

All of the findings support the fact that the corneal tensile strength is reduced following refractive surgery, including laser refractive surgery, and as a result, the cornea may be more susceptible to the normally occuring diurnal changes in axial length and intraocular pressure.

BEEP, BEEP, BEEP -- there goes my PANIC button again.

I'll file this with the other 612 things to worry about for the rest of my life after refractive surgery -- I conveniently store them all RIGHT IN THE FOREFRONT OF MY MIND.

:(

Diopter

#7 Guest_DrG_*

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Posted 05 January 2006 - 07:57 AM

BEEP, BEEP, BEEP -- there goes my PANIC button again.

I'll file this with the other 612 things to worry about for the rest of my life after refractive surgery -- I conveniently store them all RIGHT IN THE FOREFRONT OF MY MIND.

:(

Diopter


Diopter,

Amy needs to put a padlock on the computer.

The above discussion is of slightly more than academic interest, and was only meant as a possible explanation for why some patients notice fluctuations in vision. This problem is especially acute for post-RK patients, having been known since the time the procedure became popular. With post-LASIK patients, the problem is far less acute. In fact, it is something I have rarely, if ever documented on topography.

Besides, the only weakening that is of consequence is that which leads to ectasia, and patients who develop ectasia also become more myopic. You are slightly hyperopic, my friend.




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