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Home > Archive > Lasik Eyes Surgery > March 2005 > corneal swelling?
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| godzilla 2005-03-19, 6:23 pm |
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Hey folks..
Had Vixs S4 wavefront w/ interlase on the 10th of Feb.. everything
went ok it seemed.
My left eye has been great.. even from the first day.. 20/15 or so..
My right eye seems pretty close to the left when I wake up.. but as
the day goes on, it ends up being 20/40 or so by the time I go to bed.
First week had antibiotic drops, steriod drops, and nsaid drops, and
tears.. now just on nsaid and tears..
No pain, no scratching..
Any idea what is going on with the right eye? I've called the doc
about it, but all I get is a tech that says 'don't worry'.. and
they'll see me at my 3 week appointment (btw, had a day after appt
that seemed ok).
-- godzilla at easynews
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| Glenn - USAEyes.org 2005-03-19, 6:23 pm |
| What you describe sounds like a normal LASIK recovery, considering
that it has only been a few days since you had the surgery. It is
also common for one eye to heal differently than the other.
Swelling can be caused by many things, including allergies, the
medications, and especially dry eye problems. Even though it may seem
like your eyes are fine, the nerves that would normally tell the brain
there is a problem have been disrupted and your brain may not be
getting the signal.
We have a detailed article on LASIK and dry eye at
http://www.complicatedeyes.org/dry_eye_treatment.htm that may provide
additional helpful information.
If you have a sudden change in vision, then contact the doctor's
office immediately. If your are getting a bit worried about this,
insist on seeing the doctor. Yes, the doctor will probably look at
you for 90 seconds and pronounce you fine, but that may give you the
peace of mind that you obviously do not have today.
Glenn Hagele
Executive Director
Council for Refractive Surgery Quality Assurance
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
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| godzilla 2005-03-19, 6:23 pm |
| On Tue, 22 Feb 2005 00:56:04 GMT, Glenn - USAEyes.org
<glenn.hageleSTOPSPAM@USAEyes.org> wrote:
>What you describe sounds like a normal LASIK recovery, considering
>that it has only been a few days since you had the surgery. It is
>also common for one eye to heal differently than the other.
>
>Swelling can be caused by many things, including allergies, the
>medications, and especially dry eye problems. Even though it may seem
>like your eyes are fine, the nerves that would normally tell the brain
>there is a problem have been disrupted and your brain may not be
>getting the signal.
>
>We have a detailed article on LASIK and dry eye at
>http://www.complicatedeyes.org/dry_eye_treatment.htm that may provide
>additional helpful information.
>
>If you have a sudden change in vision, then contact the doctor's
>office immediately. If your are getting a bit worried about this,
>insist on seeing the doctor. Yes, the doctor will probably look at
>you for 90 seconds and pronounce you fine, but that may give you the
>peace of mind that you obviously do not have today.
>
>Glenn Hagele
>Executive Director
>Council for Refractive Surgery Quality Assurance
>
>Email to glenn dot hagele at usaeyes dot org
>
>http://www.USAEyes.org
>http://www.ComplicatedEyes.org
>
>I am not a doctor.
Thanks for the quick reply!
And I agree it does sound 'normal'.. however, I am interested in the
pathology and physiology involved. Why does the eye have very sharp,
crisp vision in the morning, and then deteriorate through out the day,
only to return to normal when I wake up again? Whereas the left eye
seems to be very stable throughout the day.
-- godzilla
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| Glenn - USAEyes.org 2005-03-19, 6:23 pm |
| Without a doctor examining your eyes, the best I can do is an educated
guess.
At night, your eyes are closed and moisture has the ability to build
up. The environment that your eyes encounter during the day is full
of dirt, allergens, atmosphere, and other irritants that are absent at
night. Additionally, you are not blinking at night. Each time you
blink over a dry eye, the eye lid is causing irritation and
exacerbating already existing problems. Simply put, your eyes when
remaining closed are a very friendly environment for healing, and your
eyes when open and blinking is a hostile environment.
While it is possible that one eye would have this problem and another
would not with exactly the same treatment, it is probably even more
probable that you suffered a mild abrasion on the problematic eye.
When the microkeratome creates the flap of tissue, the flap is lifted
and "contained" within the metal microkeratome. This process can
scrape the epithelium and cause an abrasion. It is possible that you
already had some underlying epithelial problem that was exacerbated by
the surgery. It is quite common for minor epithelial problems to
exist without being able to be diagnosed preoperatively.
Poor epithelium, dry eyes, and constant irritation can individually
and collectively cause swelling of the cornea or an uneven surface
that would contribute to poor vision.
When you see your doctor next ask for a full explanation of the
problem, if one is available.
Glenn Hagele
Executive Director
Council for Refractive Surgery Quality Assurance
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
| |
| Bryce Carlson 2005-03-19, 6:23 pm |
| Several factors may be at play; however, from your description it sounds
like your OD eye has a slight undercorrection (either actual or "pseudo").
If this is the case, the reason your vision is better in the morning is
because the weight of your closed eyelid slightly flattens the cornea,
resulting in a reduction in any effective myopia. After a few hours, this
effect wears off as the shape of the cornea returns to normal. This effect
occurs in both eyes, but if your OS eye is already plano, this slight
hyperopic shift would not likely be noticeable. The reason I said "either
actual or 'pseudo'," is because a slight post-op edema, which is not
uncommon during the first few days/weeks after surgery, will also produce an
apparent slight undercorrection. In this case, the myopic shift is
temporary and will resolve as healing progresses. However, if the
undercorrection is real (i.e. is caused by under-ablation, not edema), it
will not resolve but can be corrected with an enhancement, if desired. Of
course, I haven't seen your eyes, so this analysis may not apply to you, at
all. As Glenn stated, if you are not comfortable with the progress of your
healing, do not hesitate to see your doctor for a look-see.
Bryce Carlson
"godzilla" <support@easynews.comm> wrote in message news:
>
> Thanks for the quick reply!
>
> And I agree it does sound 'normal'.. however, I am interested in the
> pathology and physiology involved. Why does the eye have very sharp,
> crisp vision in the morning, and then deteriorate through out the day,
> only to return to normal when I wake up again? Whereas the left eye
> seems to be very stable throughout the day.
>
> -- godzilla
>
>
>
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| godzilla 2005-03-19, 6:23 pm |
| On Tue, 22 Feb 2005 09:11:35 GMT, "Bryce Carlson"
<brycarlson@verizon.net> wrote:
>Several factors may be at play; however, from your description it sounds
>like your OD eye has a slight undercorrection (either actual or "pseudo").
>If this is the case, the reason your vision is better in the morning is
>because the weight of your closed eyelid slightly flattens the cornea,
>resulting in a reduction in any effective myopia. After a few hours, this
>effect wears off as the shape of the cornea returns to normal. This effect
>occurs in both eyes, but if your OS eye is already plano, this slight
>hyperopic shift would not likely be noticeable. The reason I said "either
>actual or 'pseudo'," is because a slight post-op edema, which is not
>uncommon during the first few days/weeks after surgery, will also produce an
>apparent slight undercorrection. In this case, the myopic shift is
>temporary and will resolve as healing progresses. However, if the
>undercorrection is real (i.e. is caused by under-ablation, not edema), it
>will not resolve but can be corrected with an enhancement, if desired. Of
>course, I haven't seen your eyes, so this analysis may not apply to you, at
>all. As Glenn stated, if you are not comfortable with the progress of your
>healing, do not hesitate to see your doctor for a look-see.
>
>Bryce Carlson
>
Bryce, Glenn.. thanks for the input!
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| theOmega 2005-03-19, 6:23 pm |
| He had IntraLase so it can't be an abrasion caused by the microkeratome.
| |
| Glenn - USAEyes.org 2005-03-19, 6:23 pm |
| Abrasion from Intralase is possible, but is not very probable. It is
probably more likely that the swelling is from the Intralase
procedure itself. The process of Intralase sometimes causes minor
corneal swelling for a short time after surgery. This can lead to
symptoms similar to those described.
Glenn Hagele
Executive Director
Council for Refractive Surgery Quality Assurance
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
| |
| godzilla 2005-03-19, 6:23 pm |
| On Sat, 26 Feb 2005 01:05:22 GMT, Glenn - USAEyes.org
<glenn.hageleSTOPSPAM@USAEyes.org> wrote:
>Abrasion from Intralase is possible, but is not very probable. It is
>probably more likely that the swelling is from the Intralase
>procedure itself. The process of Intralase sometimes causes minor
>corneal swelling for a short time after surgery. This can lead to
>symptoms similar to those described.
>
>Glenn Hagele
>Executive Director
>Council for Refractive Surgery Quality Assurance
>
>Email to glenn dot hagele at usaeyes dot org
>
>http://www.USAEyes.org
>http://www.ComplicatedEyes.org
>
>I am not a doctor.
I can tell ya the suction device hurt 500% more on the affected eye
than the good eye.. during the interlase that is.. not sure if that is
indicative of anything or not..
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| Glenn - USAEyes.org 2005-03-19, 6:23 pm |
| Yes, it is indicative of the surgeon being a bit rough with the
applanation plate. It is possible that this caused bruising similar
to being hit with a baseball at low speed. That actually is good
news, pain notwithstanding. Swelling due to trauma or due to the
Intralase flap goes away with normal healing.
Glenn Hagele
Executive Director
Council for Refractive Surgery Quality Assurance
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
| |
| Ragnar 2005-03-19, 6:23 pm |
| oh the pain! hehe...
King Kong wouldn't complain about the pain so much!
I wasn't crazy about that part of the procedure either. I wonder why
they don't squirt a lot more anesthetic onto the eye before doing
that.
On Sat, 26 Feb 2005 01:44:01 GMT, godzilla <support@easynews.comm>
wrote:
>On Sat, 26 Feb 2005 01:05:22 GMT, Glenn - USAEyes.org
><glenn.hageleSTOPSPAM@USAEyes.org> wrote:
>
>
>I can tell ya the suction device hurt 500% more on the affected eye
>than the good eye.. during the interlase that is.. not sure if that is
>indicative of anything or not..
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