I awoke being able to read my clock! Things had cleared up a little but it was still like looking though water. I was able to read the newspaper, though, and felt confident that I could drive. I took the kids to school, then headed to the pharmacy to get a supply of lubricating eye drops. The kind the laser center gave was for one-time use, and I knew I would go though those before the day was out. I picked up a bottle of Refresh Tears. Up until this point, I had no feelings of dry eyes, but I wanted to instill drops every hour regardless.

When I got to work, I wanted to pull a practical joke. Several people there are considering Lasik based upon my outcome, including the receptionist. When I arrived outside, I noted she was looking away, so I went up to the plate glass window just opposite of her and kicked it. That got her attention and as she turned around to look, I acted like I had just walked into it, and started feeling my way to the door. She was rolling of the floor when I got inside. Everyone quickly gathered to hear my tale, some saying I was a brave star for doing it, others saying I was an idiot! We will know who is correct in a few weeks. I went to see my local OD at 11:30 and he said things were looking great. He noted some corneal swelling, which was normal, and felt the steroid drops would soon take care of it and my vision would continue to improve. He measured me at 20/30 in each eye, though the vision from my left was much blurrier. None of the letters were clear or distinct, but I could at least see them. I was happy. I will see him again in a week, unless I start having pain. But he said the flaps all looked good and that I should be seeing 20/20 in a few days. Driving home was a minor challenge. I didn’t leave work until well after dark and there was a lot of ghosting around the streetlights. I was worried at first that I might have long term night vision problems, but I noticed that as I got closer to a light, it would clear up, while those in the distance were still blurry. Thus, it appears that the ghosting is simply due to focusing problems and not due to any corneal ablation problems from the laser. Even so, it is still early in the game.

Last night I went to bed early, about 9:30. When I awoke, I pulled a few hairs out getting the face shield and tape off. I think this tape thing is turning out to be the worst thing about Lasik now! At my age, I need every hair along my forehead I have! Anyway, the vision I had was fantastic. Things seemed sparkling clear and I said to myself, "So this is how it is supposed to be!" I was elated. The vision in my left eye was not as good, but the right eye was outstanding. I went to put in my steroid eye drops and got that milky and cloudy vision, and my pristine vision vanished. Indeed, it seemed my vision was worse than yesterday. Up close vision was still good, so I had no problems reading, but distance vision was certainly worse. Well, I was prepared for fluctuating vision, but to go from pristine to yucky in a moment was a little hard to take. Oh, well, I will hang in there.

I manage to drive to work ok and I had no problems with the computer. My eyes feel great – no pain or discomfort at all. The redness is still there, but my eyes do not feel dry. I continue to use the antibiotic and steroid drops, and I make it a point to use the lubricating drops at least once each hour, even though I do not feel the need. I have heard from others that it helps keep the cornea smooth, and that dry eyes may not appear until a week or two after surgery.

I am surprised that, at about 8 or 8:30 PM, my vision seemed to improve all of a sudden. I can read the LED clock from across the room! It would be nice if this marks the beginning of some significant improvement of my vision! As the room is dim, this is a good sign that I will have no long-term night vision problems with ghosting and halos.

I awoke again to some very nice vision. However, just like yesterday, after I put in the steroid eye drops my vision goes down hill. Driving to work is not a problem, however, but it would be nice to start to see some permanent improvement. I posted a message on Dr. Horn’s bulletin board about this and others tell me that as long as I am on the steroid drops my vision may stay somewhat bad. One person said his doctor told him that once he was off the drops his vision would change dramatically. Based upon the vision change I see after putting the drops into my eyes in the morning, I can believe this. Good vision or not, however, I will continue using the steroid drops. I was told to use them for 5 days, so I will use them through Sunday.

The bruising in my eye is clearing up slowly. It looks better today than it did yesterday. I called up the laser center and talked with a technician who felt that the bruising may be contributing a little to my vision, but that I still need to give it at least a week. I fully agree – I mainly called just for a show of support. The techs were all busy when I first called (I called during the lunch hour), but one got back to me within a few minutes – can’t beat that kind of support! The true test of a laser center is the post-surgery care.

In the afternoon I noted that if I looked at a distant object it would sometimes seem to snap into focus for just a tiny instant. If I can see permanently like I can for that millisecond, I will be a happy camper indeed. Thus, after 3 days, I have absolutely no regret about having this done.

Day 5 and the last day I need to use those yucky tasting eye drops. Actually, however, I am thinking it is the antibiotic drops that tasted so bad coming down my throat, as I used them without the steriod drops once and I got that taste, which I did not get when I later put in the steroid drops.

And, yes, I don't have to wear those eye shields anymore (I think I remember them saying I needed them only for the first 5 days). No more pulled hairs and sticky foreheads and cheeks.

Anyway, my vision does seem to be slowly improving. Though still not totally sharp and clear, I didn't get such a large drop in vision in the morning after putting in the drops that I have been getting. The bruising in my eye is getting better, so I don't look quite so much like a red-eyed monster. As before, I still have no hint of dry eyes nor of any eye pain. Also, I have noticed no night vision problems.

If my vision did not get any better than it is today, I would not exactly be happy, but as long I could wear glasses to sharpen up my distance vision, I would not complain or have any regrets about having the surgery. I certainly can drive safely and my close-up vision is excellent, so I can certainly function quite well and I no longer have to fear about losing my contacts or glasses and being helpless.

My left eye, which had a lot more astigmatism to corret, is lagging behind my right eye in healing just a little, but I have high hopes that things will sharpen up nicely there, too. The vision still fluctuates during the day, but that is to be expected for some time still.

Despite some assurances by my OD earlier that my vision would be a good 20/20 by now, it is not. I am guessing I get up 20/25 in my good eye (still around 20/30 or 20/40 in my left eye), but the vision fluctuates throughout the day and that “20/25” vision is accompanied by ghosted outlines of the objects. Actually, I think the vision in my left eye is a tad bit worse than it was, but it had a lot of astigmatism, so I have been expecting a degree of fluctuation or even regression. With the right eye, sometimes it seems like I am on the verge of crystal clear vision, then objects go back and have that ghosted or smeared look to them. Now, 20/25 vision is not bad, but the inability of objects to be distinct and clear is a bit unsettling. As others have reported, sometimes after I use the lubricating eye drops (I use Refresh Tears) things clear up a bit for a while. I did call up the laser center and spoke to a technician who assured me that things were going well and that several weeks or so of fluctuations was perfectly normal, especially given the amount of astigmatism I had. As before, they were very friendly and did the needed “hand holding”.

I did have a bit of the "dirty contact lens" feeling this morning, but most of that is gone now. I still have a fair amount of redness from the suction ring which, as I have said before, may also be contributing to the vision problems via swelling. It is clearing up each day, but I suspect remnants of it will remain for another week or two.

Some of my concerns about dry eyes, loss of up-close visual acuity, night vision problems, etc. have not materialized. I have been a little lax about using my lubricating drops, but I try to use them at least every two hours.

I have my one-week follow-up visit with the OD tomorrow. I will have him measure my refraction and verify that there is still some swelling that is responsible for my vision. My guess is that he will find there is still some swelling and a small amount of residual astigmatism, but nothing that either time, corrective lenses or an enhancement can not take care of. I am off of the steroid drops, but I will ask if he thinks I need to continue with them. I remain optimistic and, at this point, have no regrets about the surgery.

I saw my local optometrist today and he found everything pretty much normal and on track. The numbers are:

Thus, I am under-corrected by a small amount in the right eye with a slight amount of residual astigmatism, and I am more significantly under-corrected in the left eye with a significant, 105 degree change of cylinder (and I am not sure why the cylinder changed so much). The surgeon deliberately wanted to undercorrect my left eye to help put off the need for reading glasses (I am nearly 45), but she did not tell me how much she was shooting for. (I have noted that, indeed, my ability to read fine print up close is better than it was when I had the contacts). The optometrist felt that I might need to consider an enhancement in 3 months, though it is still a little early.

Even though the refraction looks good, my vision still fluctuates and belies the numbers. When I stepped outside the doctor’s office to return to work, my vision was very good. A short while later, it regressed back. I have learned from these bulletin boards to expect this, but to be seeing great for a few moments then revert back to somewhat smeared images is disappointing (but, being the optimist, I know that those few moments of great vision will gradually occur more and more frequently – I just have to be patient).

Here are some other findings from the exam. He found my uncorrected vision to be about 20/30 (right) and 20/50 (left) but, as I noted, my actual vision can vary from minute to minute. My corneal curvature (I don’t have the pre-surgery numbers available right now) are 4050/4075@90 (right eye) and 4050/4100@90 (left eye). He noted “well secured flaps; very mild edema; and slightly dry eyes”. His remark about dry eyes surprised me, as they seem fine to me. I have been using the Refresh Tears every few hours, and he told me to continue doing so.

So, in conclusion, I am very happy I was not over-corrected. I would much rather be moderately under-corrected than even slightly over-corrected. This way, enhancements – should they be needed – are easier. (I have heard, though, that the Nidek will be able to treat hyperopia in another month or so.) I am happy that I can be corrected to better vision with corrective lenses, though I still not did see the letters of the Snellen chart all crisp and clear like I could before. I attribute this to the residual swelling as opposed to any ‘damage’ from Lasik. Overall, I am pleased with the progress and, with the close-to-the-limits astigmatism I had in my left eye, I am undaunted that an enhancement might be required. I will continue to wait to see how things go and hope that the swelling will finally all go away and my cornea will settle down so that we can determine exactly where I are at. I will see the optometrist in three more weeks, by which time things should be pretty much stabilized, at least in my right eye.

Looking into my crystal ball, at the one month mark, I predict -.5D of sphere and no change in astigmatism in my right eye, and –1D of both sphere and astigmatism in my left eye, with an enhancement probably being warranted at about the 4 month mark. I have absolutely no medical experience to justify my predictions, but they are fun to make.

I have been posting almost daily reports thus far. At this point, I will cut back, reporting only when something significant happens. Of course, if you are reading this way in the "future", you can simply scroll down some more and see how things turned out!

Hard to believe how time is flying by. Just 11 more months to Christmas!

My vision remains pretty much the same. The redness in my eye from the suction ring is nearly all gone now. I would estimate the vision in my right eye is still right around 20/30, maybe 20/25 at times, with the left eye still probably around 20/40 or 20/50. Actually, it may be regressing a bit. I can definitely tell there is some residual astigmatism there, with just a little left in my right eye. However, I have no problems with driving, even at night, nor functioning in my normal, computer-dependent life.

Speaking of night driving, it may be a little bit better from a week ago. On Dr. Horn's bulletin board there was discussion on what is meant by "ghosting" and "halos" and such, so I think I may need to change my own definition to more closely match what is supposedly more commonly accepted. Thus, I do not see multiple images, as "ghosting" has been partially defined, but rather I see some halos, or actually some smearing of the images so that it looks like I am looking through a light fog. I also see some starbursts, in which I can see bright lines coming out from the center of the lights. I continue to attributed these things to my astigmatism and myopia, however, as lights that are farther away appear worse than those up close.

I have occasionally noticed a film over my eyes, especially the left one. This is not very often and a few blinks seem to clear it up. I also seem to have more dust or something in my eyes. I got a hair in my right eye last night. My wife removed it but commented that my eyes looked dirty. I rinsed them with some saline solution, but today I see things floating in there. I don't know if this is related to my surgery or not (I don't see how it can be, actually - it might be due to the windy weather simply kicking up dust). I wouldn't even mention it but I want to be as complete and thorough as I can be. I also have noted from others than changes often start to occur around the 2 week point, both good and bad, so I want identify any minor things now to see if they get worse in the future.

I am not sure if I am having some dry eye problems or not. My eyes seem to feel a bit more tired, which may simply be due to my staring at the computer so much. I look at it nearly all day at work, and I have been going home and working for several more hours on it doing detailed design work. I suppose I need to try to lay off the home work some.

This weekend I noticed an insert for the Laser Vision Institute in Altamonte Springs, FL, which is where I had my surgery performed. There was nice picture and write up of my surgeon, Dr. Nancy Tanchel. She has now passed the 2,000 Lasik surgeries point. I will try to copy the article and provide a link to it for any interested in the surgery in the central Florida area.

Despite what you may perceive as some negativism in the above, I remain pleased with my overall vision. I have shared messages with others and it does appear that people with astigmatism do seem to have more challenging recovery periods. Though I still expect that an enhancement will be necessary in a few months, I have little doubt that my minor problems will clear up. In the meantime, I am thankful that I can see well enough to function until that time that my vision finally stabilizes.

Three weeks without glasses or contacts! I am slowly getting used to not having to deal with either. Sometimes when my eyes are tired I have a moment’s thought that I need to take out my contacts, then I laugh and remind myself that I last took them out on Christmas Eve.

Anyway, my vision is still not perfect, but I am doing well and remain happy with Lasik. As I had monovision, I will report on my two eyes separately. First, the right eye. I think that I am seeing around 20/25 when outside, maybe even 20/20. In short, I am thrilled with the vision. I am having no significant night vision problems, either, though I still have some fogginess around bright lights at a distance. Indoors at work, however, things are still blurry, except if up close. When I walk down the hall at work I especially notice this. I can stand in the hall and look outside or down the hall (maybe 50 feet long). Looking outside, my vision is great, but looking down the hall, it is blurry. Up close, it isn’t bad, so this is not a presbyopia issue. All I can figure out is my pupil get a little larger when I look down the hall, which allows for more light distortion through the cornea. Inside my office or at home, I don’t notice this and things are fine. So, I guess it is with mid-distance objects that I have this problem with.

My left eye probably remains at around 20/40 or so, though it has fluctuated a bit over the week. Up-close vision is fine but, with the monovision, distant objects are blurry. Though frustrating at times, it is normal and is not due to any shortcoming with the surgery. Heck, three weeks ago I had so much astigmatism in that eye it was useless without glasses or contacts.

On the subject of astigmatism, I was laying in bed thinking about how I could solve the world’s problems and I looked over at the television, which was off. It has an LED that glows red when the set is turned off, and I noted some soft haze around it. I figured I could solve the world’s problems later, and started to study the patterns of light. I noted that, due to my vision, there were several pronounced rays coming out from the center of the LED. I closed each eye to observe the rays and noted these rays were mostly with my left eye (the one with the most pre-Lasik astigmatism and one with about .75D of residual astigmatism, as measured at 1 week). I got interested in what I was seeing so I got up and noted that of the two largest rays, one seemed to come out at 180 degrees and a smaller one at about 80 degrees (assuming that 0 degrees is straight up towards my head and 180 degrees is straight down towards my feet). I moved my head about and the rays changed position, so they were obviously caused by my eyes. When I turned on the room lights, the rays disappeared. They also reduced in intensity when I squinted, an action that effectively cuts down on pupil size, I suppose. I conjecture that the rays are caused by the residual astigmatism and/or corneal swelling that must still exist. Worst case, the two rays may represent some Lasik-induced irregular astigmatism but, at the three week point, I am not too worried about it yet. I mention this as I would be interested in hearing about others looking at small light sources in the dark, to see if others observe these rays and to see if they note them decreasing in size over time, and if they can relate them to astigmatism.

[Note from six months in the future: What I have now identified will remain a problem. Though the "ray" at 80 degrees will become less intense, the one at 180 degrees is very significant and remains a mystery for everyone. After getting the run-around at the six month mark form the laser center OD, I finally drew a picture of what I see, which you can view here.]

Some headaches I had at the 2 week point only lasted for a couple of days, but today they are back. I am still on the computer a lot, but not as much as I was, so I have no idea if the headaches are Lasik-related or due to overwork or what. Things have been a bit stressful here. My eyes do feel tired – or are they dry?? I have been using my eye drops!

I continue to deal with my monovision. Though I tend to like it, I still have concerns about it, which I posted on my web site. My issue is whether monovision will only be effective for a few years, after which it will no longer help and I will be stuck having to have not only distance correction in that eye, but up-close correction as well. I still have some months to decide, but it is a difficult decision to reach. I know y surgeon is in definite favor of monovision, so unless this .75D of residual astigmatism remains, she may be difficult to convince to enhance me!

In conclusion, while I still have some issues, I remain happy. I am certainly thankful to the various Lasik bulletin boards and their sponsors, and to the people who post there and are so kind to offer help and needed hand-holding, otherwise this might be a trying ordeal to of wondering why I didn’t yet have perfect vision.

Not too much has changed since my last report. I can tell that the vision in my right eye is a tad bit better when outside or when in my office looking a Snellen chart I download off the Internet and posted across on the opposite wall. At times I think I can almost see 20/15, but mostly it is a weak 20/20, which I believe would represent a real 20/25. Based on this slow progress, I just might make it to 20/20 in a few more months. I think it all depends on if that last little bit of astigmatism will go away that I know is still there. My left eye is good for reading, but is not much good for things over 5 feet away, unless I am outside in bright light, where it does ok. Again, I had monovision, so I am not expected good distance vision in this eye. I am grateful that I can read better now that pre-Lasik and that I won’t need reading glasses for a while, but it still remains a love-hate relationship (mostly hate, as when you use monovision, you don’t notice it, but when you don’t need it, you do notice it).

On the down side, I do not seem to have good vision in places that are not very well it. For example, if I go to a Sam’s Club or even look down the hallway at work, which is pretty well lit, things are blurry. I can stand outside a friend’s office who has a window and I will see great looking outside, but if I turn to look down the hall, things get blurry. Things also look good up close that are in his office. Others on the bulletin boards have mentioned this, too, and we are not sure what it is. As for night vision, I have no problems with my right eye. I see no halo’s or starbursts with my right eye. My left eye, however, is different. If I look at a point source of light, say, I see a huge ray of smeared or freaky-patterned light coming out at several distinct angles. The most noticeable ray comes out at an angle that is straight down, in the direction of my feet, with a lessor one going off to the right. These “rays” as I call them are quite pronounced and the one, in particular, is very long and bright. If I look carefully, the ray seems to be composed of several bands or segments that have an arrowhead appearance to them. It is impossible to describe them, so what I need to do is attempt to draw them. I only see this detail in a darkened room, though, which makes drawing them a little difficult! I can see the effects of this when driving, though, or looking at any brightly lit object. I will see a huge smear of light of the same color, mostly coming down, which blurs things. I have no idea if this is due to the astigmatism or not, or if it represents a flap complication, but I intend to bring it up with my OD at my 4 week checkup tomorrow.

I visited my OD today. As expected, my numbers have not changed too much. I felt going in that I was generally seeing 20/25 in the right eye and 20/40 to 20/50 in the left, and I was right on. Here are my refraction numbers:

This shows some slight improvement in the sphere of my left eye, and some interesting shifting in axis of my astigmatism.

I asked about the “rays” of light I was seeing though my left eye and he attributed it all to astigmatism. He had me look though a special disk that had a bunch of tiny holes in it and the vision cleared up dramatically. I still expressed concerns about these rays I was seeing being so huge compared. To me, with only -.75 diopters of astigmatism, I didn’t think I should be seeing what I was seeing. I had been wondering if my flap was not healing properly, but he said it was “well healed with clean edges”. Still, to have such a huge aberration in vision, I think more than simple astigmatism is at work here. He said I might wish to go back to the laser center to be examined there and have a corneal topograpy done, though he felt I was healing just fine and that this problem would go away. He had no real explanation for the dim light problem, other than residual astigmatism and nearsightedness. I mentioned pupil size, but he did not think that was it, since I see pretty good at night.

When I got back to my office, I call up the laser center and spoke with the surgeon’s nurse. She had never heard of the problems I was attempting to describe. She discussed what I had said with their OD, and he felt my problems were temporary but welcomed me to come over for an in-depth exam. So, in two more weeks I will get over there. I could have gone much sooner, but I am not in the slightest debilitated by this, and things might just improve a bit more in that time. No need to drive all that way if I don’t need to.

So, while I remain happy with my surgery, I do have a few little minor issues. The vision problem with the left eye isn’t really all that bad as I can see ok up close and, with correction, I think a lot of the problems I see would go away. In fact, the laser center’s OD suggested I might want to get some corrective lenses to use for now. Even so, I still recall seeing this ‘smearing’ of light even when my refraction was being measured. So, while my vision can be made sharper, the smearing remained. But, as this is my “reading” eye, and I can see 20/20 up close with it, I am not too concerned.

I do not expect to issue another report until after my next followup with the laser center's optometrist, unless something dramatic happens. Until then, I will hang out on the bulletin boards.

I went to the laser center to see their OD, Dr. Grant. I am concerned about the strange star burst (the ray of light) I am seeing in my left eye, plus I don’t fully understand why I have still have some problems seeing in moderately dim light. My worst fears are that I have irregular astigmatism in my left eye. I figure the room light problem, where things at a distance indoors are blurry, has to do with the treatment zone falling inside my pupil when it expands indoors. Outside in bright sunlight, my vision is marvelous, as I have previously reported.

At the OD, he did the normal tests and could find nothing wrong, saying I was progressing nicely. I tried to describe my problem better, and I mentioned the phrase ‘irregular astigmatism’. His eyes lit up and he said they had just received an Orbscan II, so he had me examined on that machine. Looking at the results, he commented that I had plenty of cornea thickness and that he could detect no irregular astigmatism. So, the bottom line seemed to be that I just needed more time to heal, though he did say he wanted to follow my progress as I was the only person he has known to have this start burst problem. (If you are just now starting to read, this ‘star burst’ is a pattern I see when looking at bright objects in dim light. The pattern is really just a single ray of light coming out in the direction of my feet. It is very long and spread out and causes object to smear out. Looking at the moon, for example, is impossible as the light smears out and obscures the moon. The effect is less in bright light, but it is still there.)

Incidentally, I went to the laser center this day with a friend who was having the surgery performed. The procedure for his right eye went great, but he suffered a very mild corneal abrasion when there was a problem with the microkeratome. At first I feared he had an incomplete flap cut, but he only had the slight abrasion. He healed up after a day and had the procedure successfully performed, and he is thrilled 100% with his results (but he had no astigmatism and moderate myopia). I did get to briefly chat with the surgeon, giving her the address of my web site, which she said she would check out. I also mentioned my problem, but she felt it would clear up over time.

I visited my OD today. As expected, my numbers have not changed too much. I felt going in that I was generally seeing 20/25 in the right eye and 20/in the left, but he measured me a little better. Here are the refraction numbers:

This shows some slight improvement over the 4 week readings, and the doctor noted that my combined vision is actually slightly better than 20/20, being a weak 20/15. However, these readins do not account for my blurry vision in dim and moderate light and, of course, that star burst/ray problem I have.

The doctor tried to see if he could get rid of the star burst by trying different spherical corrections but nothing helped. Then he mentioned it – irregular astigmatism. He wasn’t sure, as he had never seen a case like mine, but he wondered about it, which makes me wonder if the laser center OD misread the Orbscan (being so new), or if I have something else. Dr. Markle assured me my flap was pretty much healed and was clear such that it was not the source of my problem.

Anyway, at this 3 month mark, I can give a better assessment of my overall feelings towards my Lasik experience. I guess, had I been fitted with a set of lenses that would have simulated the vision I now have I would not have gone ahead with the surgery. On the other hand, I like my freedom from glasses and I am not excessively bothered by my start burst. The room light problem is a bit more distracting, but even that is not major. So, while I might have been better off in waiting another year or so for better lasers, I can’t say that I regret having the surgery. I do hope that, if my vision does not magically improve, that the new wave front technology will come out soon and will be able to make final corrections to my vision. For that, I am happy to know I have plenty of cornea left. So, I remain positive about Lasik.

I will have my six month exam in July. I am not expecting much difference in my vision at that time, but who knows? If I still have problems, I will go back to the laser center and insist on seeing Dr. Tanchel. I have fully confidence in her and I think she needs to be fully aware of my problem.

I have found that I visit the bulletin boards much less frequently that I once did. I guess this is normal, but I do mean to get back on a little more often. In any event, emailed questions are always welcomed.

I visited my local area OD last week. Dr. Markle was out so I saw a replacement OD who seemed to be in too much of a hurry to give my case much consideration. He was nice enough, but when he had trouble even getting a refraction on my left eye, he pretty much gave up and told me to return to the laser institute. I told him about my visual problem and he said he had never heard of such a thing and said he could find nothing within my eye or flap to account for it.

Actually, I have been wondering if my problem is related to a "floater" in my eye that I frequently detect. Especially when I am working on the computer where a white background is present, I can see a floater (if this is the correct term) that resembles a piece of lint or a small hair that is floating on the outside of the eye. It moves around with eye movements, so I don't think it debris inside my flap. Also, I do not always see it, though most of the time it is there. As I type this article, it is clearly there as a fairly long shadow - almost like a negative image of a lightning bolt coming down. The fact that the floater is aligned vertically has made me wonder if this might be having something to do with my vision problem. However, the OD was not able to detect this floater. He simply suggested I return to the laser center than called the next patient.

I called them up and said that I needed to see Dr. Tanchel with a vision problem. They tried to schedule me in to see their OD, and I said that was fine but I would like a surgeon to be there as I was having problems that the OD’s could not detect. I was scheduled to come over when Dr. Tanchel was off, but assured that another surgeon would be there that day.

When I arrived, I saw a new OD this time, Dr. Howard Bolos. First, a technician took my refraction on the machine and did an Orbscan. Dr. Bolos came in and, at the time, I didn’t know if he was an OD or an MD. He was very professional, but not at all sympathetic to my conditions. I attempted to describe to him my problem, first offering to sketch it out, but he cut me short and told me to simply describe it for him. Well, this is really difficult to do, and even here I have been struggling to describe what I see. But, finally, I got around to making a drawing for you to see, which you can view here. (I should have done this earlier and taken it with me.) Well, he looked at the Orbscan and said it was normal and proceeded to fine tune my vision. He ended the initial exam by giving me a prescription for my residual myopia, at which time I discovered was an OD. Below are the numbers, including my previous numbers for comparison:

This shows that my vision has been pretty stable over the last 3 months. A quarter of a diopter difference in my right eye vision is probably insignificant, and my left eye is remarkably unchanged. The doctor said my visual acuity was 20/20 in both eyes. I agree it may be nearly that in my right eye, but certainly not my left. Just because I could pick our a few letters on the chart does not mean I can see a good 20/20, and I notice a lot of difference between the vision of both eyes even accounting for my starburst or “smearing” problem.

H had looked at my eyes with the slit scan microscope and, after giving me the prescription, proclaimed that I was seeing great, that nothing was wrong, and that I should be quite pleased with my results being so good.

Uh, excuse me? I had an uncomfortable feeling I was about to be shown the door while he washed his hands of my problem.

In a very nice way, I asked that if my vision is practically perfect, then why am I seeing this "smearing" of objects in my left eye? If I am 20/20 in my left eye, how come I can't see a clear image of the moon at night - why is all smeared out?

He was clearly irritated at me for not allowing myself to be dismissed so quickly. Though I was quite ticked off inside, as he continued to insist I was fine, and he made it a point, several times, of telling the technicians that I was doing great despite what I was telling him, I kept calm and resorted to basically begging him to do more checking. He made a comment about me not believing the refraction numbers he was coming up with, and I had to reiterate that I did, in fact, believe the numbers, but that there was still something wrong and would he please try to figure out what it was. He asked me what I did for a living and I replied I was an engineer. He commented, in a half-joking way, that he knew that, as an engineer, I would not be satisfied until he had done everything.

Well, what he did next I absolutely hate! Yes, he dilated my eyes. Ugh. And he stuck in an extra drop for good measure, too! (I am joking here - but I do hate to be dilated as it takes so very long for it to wear off. In fact, in this particular case, I was initially dilated at about 10 AM and I stayed that way for over 10 hours, when it finally began to wear off.)

With my eyes dilated, the smearing was magnified. Everything I saw was being smeared. I was fascinated by the image of a stainless steel knob on the projector that projects the Snellen chart. The smeared image was almost perfectly formed. I could trace out the bottom curve of the knob’s smeared image with my fingers. This is in stark contract to a typical starburst image. If you can imagine a photograph, what I saw was as if the camera had been moved in a single direction during the exposure.

He looked very carefully inside and all he said he could see were some internal floaters, which he indicated were a normal part of aging. I asked if he could see any hair-like debris, and he said no. He then repeated that I was seeing great and should be happy and that if I had some minor problem, that it was probably less than what I had with contacts. When I asked what my condition might possibly be, he shrugged and said I must have some sort of unexplained optical aberration, or words similar to that. In other words, he couldn't find anything wrong and had no explanation for what I was seeing.

He irked me one more time when, as we were leaving, he once again told a technician that I was fine. I was nice and didn’t say anything. I mean, I can’t argue with the numbers, which are indeed great, but how can one convince another of something that they cannot detect by any diagnostic test they have?

So, I remain in limbo. I had hoped to see an ophthalmologist while I was there (either Dr. Tanchel or the other surgeon). If I have one major complaint against the laser center, it is that they so isolate the surgeon, you can't reach them. I understand that with hundreds of patients they can't tie up the surgeons when a technician or even the OD can help, but I guess to see the surgeon you either have to be undergoing Lasik or you must have some problem that requires a surgeon to handle (i.e. a loose flap). But, in my case, if the OD's can't find anything, I am not sure if an MD could. However, I would want to think that the surgeon would be interested in hearing about visual problems that cannot be explained, but how can they find out if their staff refuses to pass along information to them?

I think at this point I will return to see Dr. Markle in the near future and ask if he will personally speak with Dr. Tanchel. Maybe there is nothing she can do, but maybe she can learn something just the same. If my problem is related to my pupil size and the amount of astigmatism I had, then maybe she can change her screening criteria. I do know that the additional postings that Dr. Horn has made about the Nidek and its treatment zone has changed my opinion of the Nidek for patients with larger pupils and astigmatism.

Earlier I mentioned the floater I was seeing. Though it is frequently present, it really does not seem to be causing my problem. If it did, then the smearing should get better/worse as the floater moves around. I cannot detect that this is the case. I have no idea if the floater is on the eye or in the eye. I briefly explored this with Dr. Bolos, and he said he could not see any sort of hair-like object anywhere. So, this object remains a total mystery, as well as the source of my visual problem.

So, at six months, there are still unanswered questions and my quest to find out what is wrong has not yet ended. If this is a permanent problem, so be it. As I have said before, I am hardly debilitated. It does interfere with night driving, but not quite to an unsafe level. For my normal daily activities, it is not a problem. So, while I wish I had ended up with better results, and if I were to do it over again I would have gone with a different laser, I am not overly regretful and would continue to recommend Lasik to others. However, at this point, I may do the previously before unthinkable - post my problem over at surgicaleyes.com! Yikes.

It is hard to belive that nine months have now passed. To those who are still reading this, I am impressed! This has been far longer than I ever thought it would be. I have been fortunate to communicate with a number of readers and it has been good hearing from you all. Frequent comments I hear are that they were not told that Lasik took months to heal and is not the "15 minute miracle" they were led to believe. Fortuanately, it seems that most of the people who have complaints soon after surgery begin to do well later.

Anyway, after three months, I finally made an appointment to see Dr. Markle again. I really like him and was hoping that he still might be able to come up with some answers, or at least act on my behalf and tell the surgeon about my strange case.

Well, I re-explained my problem and after checking my refraction, he told me that I probably needed an enhancement in my left eye. Huh?! Yes, he said I was showing nearly a diopter of astigmatism and that he had previously talked to the new surgeon (Dr. Tanchel left to go to another laser center in Virginia) about similar cases of people having problems with relative low amounts of astigmatism, with the consensus being to enhance those people.

I was very surprised, as my previous refractions did not show such a great deal of astigmatism. Also, as I have reported above, it did not seem that any cylinder/axis improved my vision that much. Certainly, when I go back, I will ask the surgeon to comment on my case and make sure that any enhancement will indeed help and not hurt. I would want to see an Orbscan that clearly shows the astigmatism, too.

To be continued ......