Lasik Problem During Sleep

I was doing great with Lasik - 5.5 days and 5 nights without an issue.
I woke up after night 6 with my right eye in pain and right eye vision
noticeably blurry. I had been sleeping on my right side - don't know if
that caused it or not - but I used drops every 10-15 minutes all day
hoping it would clear up, sometimes dumping a whole vial in. Still in
pain and blurry, I saw my regular eye doc for post op appointment I
already had scheduled that day. She said everything looked normal and
she had no idea why I was in pain or why my 20/20 vision had dropped to
-.75 in my right eye overnight. Any idea what could have happened and
anything I can do to prevent the -.75 from being permamenent when I had
20/20 for 5.5 days straight before this happened? The Lasik center is
closed this week, of course.

Thanks,

-Mike

You have possibly had an epithelial erosion. It will cause pain and a
little swelling, and the cells generally resolve by the time you get to
the doctor. Use plenty of lubrication, especially before bed.

dr grant

I'm into the next day now and the pain is gone though something still
feels "off" or "out of place" in the right eye. The vision has not
improved.

Sounded like a classic flap dislocation to me, until I read your next
post. Maybe it was and you successfully refloated it yourself. 20/20
dropping to -.75 does not compute. 20/20 drops to something like 20/25
or 20/30; 0.00 or -.25 or something like that drops to -.75. It's like
saying your waistline went from thin to 21 inches. I'm a bit concerned
that the doc didn't see something, anything, after such an episode. I'm
thinking it might be a good time to give your surgeon a call and see
what he/she thinks.

w.stacy, o.d.

Mike wrote:

>I was doing great with Lasik - 5.5 days and 5 nights without an issue.
>I woke up after night 6 with my right eye in pain and right eye vision
>noticeably blurry. I had been sleeping on my right side - don't know if
>that caused it or not - but I used drops every 10-15 minutes all day
>hoping it would clear up, sometimes dumping a whole vial in. Still in
>pain and blurry, I saw my regular eye doc for post op appointment I
>already had scheduled that day. She said everything looked normal and
>she had no idea why I was in pain or why my 20/20 vision had dropped to
>-.75 in my right eye overnight. Any idea what could have happened and
>anything I can do to prevent the -.75 from being permamenent when I had
>20/20 for 5.5 days straight before this happened? The Lasik center is
>closed this week, of course.
>
>Thanks,
>
>-Mike
>
>
>

I went to the doc again on day 2. Different doc due to the holidays.
The pain was down but still stinging a bit. The drop unfortunately is
holding steady at -.75. The second doc did some additional tests - dye
to look for abrasions (none), pressure (normal). She says my eye looks
great, yet I am now in day three of stinging in the right eye. I should
mention I have been very good with the drops in the eyes from day 1,
always more often than the minimum once per hour - about twice as
often.

By the way, by "day 2" I meant of the pain in the right eye, not of the
whole lasik procedure. Right eye pain has occured days 7 through 9 of
the procedure. I am told by others that sleeping on the side is ok that
late in the procedure and that most docs only require the gogles be
worn the first 1 to 4 days (mine says one week). The goggles had fallen
off while sleeping on night 6 (as they did two other nights as well). I
am still wearing the goggles for now until the pain goes away. I am
using better fitting goggles now that don't fall off as easily.

Here's a recap and update:

1st 6 days went great - right eye fantastic and slightly better than
the left eye.
Days 7-9 pain in the right eye with significant blur (-.75) overnight
on day 7.
Day 10 pain finally gone but right eye blur remains.

Mike wrote:
> Here's a recap and update:
>
> 1st 6 days went great - right eye fantastic and slightly better than
> the left eye.
> Days 7-9 pain in the right eye with significant blur (-.75) overnight
> on day 7.
> Day 10 pain finally gone but right eye blur remains.
>

Are you only blurred at far, or is it also at near? Have you been
refracted recently, or is the .75 your own estimate?

w.stacy, o.d.

Painful overnight eye episodes are more common following LASIK.
Recurrent corneal erosion, or RCE, is another perhaps less accurate
term. It is possible that you have something called epithelial
basement membrane dystrophy causing a weak adherence of the epithelium.
This would have been aggravated by the LASIK. The cycle goes
something like this: (a) night one -- breakdown of epithelium causing
pain and swelling. (b) days 2 through 4 -- healing of epithelium
occurs, pain goes away, but swelling remains and vision is still
blurry. (c) day 5 -- swelling subsides, and vision clears somewhat,
but not completely. (d) cycle repeats.

DrG
www.leukoma.com