Category Archives: Halos

A LASIK Enhancement may NOT be the best option

LASIK is a laser eye surgery performed to fix the refractive errors of the eye. Lasik is used to correct:

  • Myopia (nearsightedness)
  • Hyperopia (farsightedness)
  • Astigmatism

People undergoing the Lasik procedure expect not to use contact lenses or eyeglasses again in their lives. Although there is good success rate of Lasik and other refractive eye surgeries (PRK), there are some cases where the results may not be the ones expected.

post lasik

Lasik failures and complications do occur frequently but are commonly minor to mild side effects. However when severe Lasik side effects occur they may include partial or complete loss of vision ,along with refractive errors and visual disturbances.

A Lasik enhancement may NOT be the best option

Most patients experiencing post Lasik complications may not be candidates for Lasik enhancements altogether. While those who do opt for enhancement surgery might not be choosing the best option available. Repeated Lasik procedure can result in more damage to the cornea.

Important considerations for Lasik enhancements

Lasik enhancement procedure depends on three basic factors:

  • Timing: Lasik enhancement can only be done after the vision stabilizes after the Lasik procedure, that means around 2-3 months
  • Repeat pre-Lasik evaluation: If someone had Lasik before doesn’t mean that the eyes are still good candidate for repeat Lasik. A detailed pre-Lasik evaluation has to be done again including carefully checking the thickness of cornea.
  • Type of procedures: the type of first surgery and the remaining thickness of cornea below the flap help in deciding the type of procedure to be performed.

When Lasik enhancement isn’t possible?

There are several situations in which Lasik enhancement isn’t recommended including:

  • When remaining cornea is very thin
  • Post Lasik ectesia
  • Keratoconus

Options for post Lasik complications

The best option for post Lasik complication can vary from case to case therefore always consult a specialist to discuss and figure out the best option in your case.

In cases where the repeat Lasik procedure for enhancement isn’t suitable option, the best option is usually using contact lenses or eyeglasses, again based on what’s best in your individual case.

Contact lenses for post Lasik complications include:

Gas permeable contact lenses

Gas permeable contact lenses are rigid and maintain their shape on the eye, without resting on cornea and adjusting according to its shape like soft lenses do.

The space between the lens and the cornea is filled with tears that cover the irregular corneal surface. This helps in avoiding any blurring of vision due to corneal irregularity or other visual distortions.

Modified gas permeable contact lenses

Modified GP contact lenses with larger diameter, flat center or aspheric optics can be specially designed for the post Lasik complication patients as per their individual needs.

Scleral contact lenses

Scleral contact lenses cover the entire cornea and rest on the sclera of the eye. They are especially helpful in patients with post Lasik corneal aberrations and those having irregular astigmatism.

Scleral contact lenses also help in relieving dry eyes.

Hybrid contact lenses

Hybrid contact lenses help in aberration correction while being very comfortable. They’re equally effective as gas permeable contact lenses while being easier to adapt!

High-definition eyeglass lenses

Special eyewear, also called “free-form” lenses, can be used to correct minor errors of refraction effectively for patients who don’t want to wear contact lenses. They are especially helpful in patients without any significant corneal aberrations.

Global Complex Eye Care is specifically designed, equipped, and staffed to provide patients with nothing but the finest in professional eye care. As Post LASIK specialists, we have successfully treated patients with Keratoconus, RK, PRK, and LASIK failures and complications, cornea ectasia, Pellucid Marginal Degeneration, Stevens-Johnson Syndrome, and other irregular corneas. Optometrists and Ophthalmologists from all over Maryland and surrounding states refer patients to Dr. Irwin Azman.
For more information please visit www.LasikFailures.com 

Dr. Oz Show Discusses Long-term Side Effects of LASIK

An episode of the Dr. Oz Show, which aired on October 3rd, 2013, featured an investigative report about the potential life-long side effects of LASIK eye surgery.

As a popular elective surgery, nearly 800,000 people get Lasik every year. FDA clinical data trial shows that every modern laser left 1 out of 5 patients seeing worse after LASIK. Side effects include seeing double, seeing halos or starbursts (especially at night), and dry eye pain.

Investigative reporter Elisabeth Leamy has been investigating the harmful side effects of LASIK for over two years. During her undercover consultations with doctors, she discovered that the side effects were minimalized and the procedure was treated like an easy, no-risk procedure.

Morris Waxler, the former FDA official responsible for getting LASIK surgery approved, is now working to get it banned. He says that the side effects of LASIK are actually injuries and that LASIK harms 20% of patients.

lasik problems

LASIK eye surgery works by cutting a flap of the top layer of the cornea and then using a laser to reshape the exposed cornea. Complications can occur when the flap of the cornea is cut too thick, too thin or too far into the cornea. However, even if this cut is perfect, when the flap is put back down it doesn’t necessarily heal perfectly. Years later it can become dislodged and trigger negative side effects. In addition, if there were underlying issues prior to the LASIK surgery that were not treated, LASIK surgery (and enhancement touch-ups) will most likely exacerbate the issues. Unfortunately many post LASIK patients now have life long side effects, ranging from the smallest amount to the most severe.

Dr. Irwin Azman provides treatment for people who underwent LASIK, PRK, and RK sugery but are now experiencing post-surgical side effects and complications.

According to Dr. Azman:

“While LASIK surgery can be successful under optimum eye conditions, unfortunately many patients do experience side effects due to pre-existing conditions. However, there is hope. Utilizing our vast experience and expertise, as well as an array of new technologies, we are able to treat these side effects with non-surgical techniques.”

For more information about treatments for Post LASIK side effects and complications visit www.lasikfailures.com or call (240) 782-2020.

Glasses After RK surgery

Radial Keratotomy (RK) is a procedure to correct nearsightedness. The procedure included manually flattening the corneal surface to reduce the refraction of light rays passing through cornea in myopic eyes.

However, the problems with the procedure are more than its benefits in many patients. The procedure was widely used before the advent of more technical options that are available today. The patients who went through the RK surgery usually experience visual disturbances and need management of the complications caused by RK surgery. The correction of side effects caused by RK requires the patients to use glasses, lenses with eye drops, and medication too depending upon their individual case.

rk-surgery

Glasses for post RK complications

Patients undergoing RK procedure frequently complain of pain, glare, visual disturbances etc. They might be temporary in some cases, but are reported to be long standing in many cases.

Glasses for under correction after RK

In under corrected cases, the myopia persists and the glasses for fixing nearsightedness are required. Although they’ll be less diverging than the one used prior to the procedure as the nearsightedness will be partially fixed by the RK procedure.

Glasses for over correction after RK

Over-correction means that the condition which was once nearsightedness is now on the side of farsightedness. These patients need converging lens glasses to have a clear vision of far objects.

Glasses for astigmatism after RK

As the RK procedure is a manual, chances of error and irregularities on cornea caused during the surgery are high. These irregularities can result in astigmatism.

The astigmatism correction needs glasses with cylindrical lens to correct the astigmatism along with spherical lens for nearsightedness or farsightedness in the patient’s eye.

Different pair of glasses for different times of day

The RK incisions can swell at a given time in day or can be flat. Depending upon the condition of cornea, the refraction may differ and thus the vision too. Although this might be temporary in most patients during the healing phase only, they still need assistance through eyeglasses in that phase.

Different pair of glasses for each time of day is ideal for such patients so that they can carry on normal routines during all times of the day.

If you had RK surgery and are now suffering from post RK complications, consult with Dr. Irwin Azman, Post RK Specialist, for a complimentary telephone consultation.

Dr. Irwin Azman is one of the pioneers of the Post RK | LASIK | PRK patient. With over 25 years of experience in the management and treatment of the Post RK patient. Together with his knowledge and experience Dr. Azman is able to prescribe each patient with the proper solution in resolving their Post RK complications, including starburst, glare, dry eye, and other RK complications.

Serving the following areas since 1975:

MARYLAND: Annapolis, Baltimore, Bel Air, Bowie, Carney, Cockeysville, Crofton, Elkton, Essex, Fallston, Fredrick, Glenwood, Hampstead, Havre De Grace, Jarrettsville, Kingsville, Laurel, Lutherville, Manchester, Monkton, Parkton, Parkville, Phoenix, Pikesville, Randallstown, Reisterstown, Severn, Severna Park, Silver Spring, Sparks-Glencoe, Sparrows Point, Towson, Westminster, and Perry Hall
PENNSYLVANIA: Harrisburg, Hershey, Middleton,  Shrewsbury,  and York.
VIRGINIA:  Alexandria, Fairfax, Tysons Corner, and Vienna WASHINGTION DC.

LASIK Complications, What to do?

Not Happy After LASIK, What To Do?

The LASIK procedure is said to have a fair success rate and most patients are said to be satisfied with the outcomes. However there are many patients who aren’t just satisfied, but in fact develop one or more post LASIK complications.

What to do if you’re not happy with LASIK results?

Well this is a debatable topic and exact plan of actions depends from case to case and the reason of not being satisfied and / or complications developed due to LASIK.

First step:

The first step to do once you find yourself unhappy with LASIK results is NOT to panic. Relax, panicking isn’t going to solve anything and might drain your valuable energy that you should be focusing on finding the right solution. You’re not alone and luckily most of the post LASIK complications can be managed effectively.

Consult the Doctor

The ideal way to get an explanation to unexpected results or complications is to consult, question and discuss in detail with the doctor who performed the surgery. If he’s not able to satisfy you and even if he does, consult another eye specialist, or a Post LASIK expert and discuss your case with them. Ideally consult three doctors, which you should have done prior to surgery too in fact.

Revision or enhancement procedures

Depending upon the complication and patient’s specific case, some patients might benefit from revision or enhancement procedure following LASIK. Details of which procedure would be best should be discussed with the specialist. However, a LASIK enhancement is not always the best solution. Further surgery may exacerbate the complications.

Manage Lasik Complications

The complications and side effects caused by LASIK surgery are not only disabling but also irritating. You are not only unable to see properly at night, but also what you see is irritating, glare, blurred and so on. Most of the complications following LASIK surgery are manageable therefore you should consult a specialist to get opinion regarding your case and situation.

Certain management options include:

  • Management of dry eyes, this might be the leading issue precipitating other complications too.
  • Using glasses or lenses for glare and blurred vision.

Most patients experience complications following the LASIK procedure are temporary and improve over time. They can benefit from supportive management during this recovery phase too. However if the symptoms persist for a longer period of time, and you’re not happy after Lasik, instead of giving up, contact Dr. Irwin Azman, Post LASIK Specialist and get expert opinion specific to your condition.

Dr. Irwin Azman is one of the pioneers of the Post LASIK | PRK | RK patient. With over 25 years of experience in the management and treatment of the Post LASIK patient. Together with his knowledge and experience Dr. Azman is able to prescribe each patient with the proper solution in resolving their Post LASIK complications, including starburst, glare, dry eye, and other LASIK complications.

Serving the following areas since 1975:

MARYLAND: Annapolis, Baltimore, Bel Air, Bowie, Carney, Cockeysville, Crofton, Elkton, Essex, Fallston, Fredrick, Glenwood, Hampstead, Havre De Grace, Jarrettsville, Kingsville, Laurel, Lutherville, Manchester, Monkton, Parkton, Parkville, Phoenix, Pikesville, Randallstown, Reisterstown, Severn, Severna Park, Silver Spring, Sparks-Glencoe, Sparrows Point, Towson, Westminster, and Perry Hall
PENNSYLVANIA: Harrisburg, Hershey, Middleton,  Shrewsbury,  and York.
VIRGINIA:  Alexandria, Fairfax, Tysons Corner, and Vienna WASHINGTION DC.

 

High Order Aberrations (HOA) Related To Refractive Surgery/LASIK

High order aberrations (HOA) refer to complex imperfections of the optical system and are normally present in all eyes in minor unnoticeable amounts. However as a result of optical refractive surgeries such as LASIK, unnatural and irregular shape of the cornea can result in increase in HOA and thus result in halos, double vision, smears and other visual disturbances.

Measuring and Diagnosing High Order Aberrations

High order aberrations are measured using a wavefront aberrometer. The wavefront aberrometer measures the distortions of light as they pass through the patient’s cornea.

Wavefront aberrometry helps in diagnosing both lower order and higher order vision errors based on how the light passing through eye focuses or refracts.

High order vs. Low order aberrations

Lower order aberrations are common vision errors like nearsightedness, farsightedness and astigmatism.

Higher order aberrations are coma, spherical aberration and trefoil. These aberrations result in visual disturbances like glare, halos, starbursts, blurring, double vision, etc.

HOA after refractive surgeries like LASIK

As discussed above, HOA are present in normal un-operated eyes too, however usually they’re too low to be noticed or to cause any visual disturbances to the normal eye.

As a result of manipulation of the cornea or structures of eye involved in refraction of light entering the eye, the HOA are increased.

HOA in LASIK

In conventional LASIK surgeries, the HOA usually increase to an extent that they’re noticeable and cause visual disturbances especially at night when the pupils are dilated. This is due to the change and irregularity of corneal surface induced during the LASIK procedure.

HOA in wavefront-guided LASIK

Although wavefront-guided LASIK was introduced to reduce the total aberrations of the eye (both higher order and lower order) during the procedure, they still tend to result in increased HOA after the surgery, but reportedly less than conventional method.

The increase in HOA as a result of corneal manipulation in procedures like LASIK is one of the main reasons for visual disturbances like halos, glare, starbursts, double vision, blurring of vision, disturbed night vision, etc.

Treatment of increased HOA

HOA POST LASIK High Order Aberrations (HOA)

Before and After Treatment of POST LASIK High Order Aberrations (HOA)

 

 

If the corneal surface is manipulated and significant increase in HOA has occurred to cause visual disturbances, contact Dr. Irwin Azman to discuss the condition in detail, to understand your issue and best options for your specific case. Options to solve the visual complications due to irregular corneal surface or other related option may include the following: rigid gas lenses (RGP), scleral contact lenses, soft contact lenses, hybrid lenses, and other options.

If you’re experiencing HOA disturbances (halos, glare, starbursts, double vision, blurring of vision, disturbed night vision, etc.) consult with Dr. Irwin Azman, Post LASIK HOA Specialist, for a complimentary telephone consultation.

Dr. Irwin Azman is one of the pioneers of the Post LASIK | PRK | RK patient. With over 25 years of experience in the management and treatment of the Post LASIK patient. Together with his knowledge and experience Dr. Azman is able to prescribe each patient with the proper solution in resolving their Post LASIK complications, including starburst, glare, dry eye, and other LASIK complications.

Serving the following areas since 1975:
MARYLAND: Annapolis, Baltimore, Bel Air, Bowie, Carney, Cockeysville, Crofton, Elkton, Essex, Fallston, Fredrick, Glenwood, Hampstead, Havre De Grace, Jarrettsville, Kingsville, Laurel, Lutherville, Manchester, Monkton, Parkton, Parkville, Phoenix, Pikesville, Randallstown, Reisterstown, Severn, Severna Park, Silver Spring, Sparks-Glencoe, Sparrows Point, Towson, Westminster, and Perry Hall
PENNSYLVANIA: Harrisburg, Hershey, Middleton,  Shrewsbury,  and York.
VIRGINIA:  Alexandria, Fairfax, Tysons Corner, and Vienna WASHINGTION DC.

 

Scleral Contact Lenses For Post LASIK

The concept of scleral contact lenses is as old as 100 years, but their use was limited due to various issues such as permeability and material of lens. However with technological advancement, the use of scleral lenses have become wide spread in past few decades for various ocular conditions, including post-LASIK complications like residual refractive error.

Scleral contact lenses for post LASIK complications

In post LASIK cases, the modified cornea may no longer be able to fit well to conventional lenses like toric soft lenses and may add to patient’s irritation and frustration. Scleral contact lenses are advised to those patients to overcome the post LASIK complications such as visual disturbances and dry eyes.

What is a scleral contact lens?

Scleral contact lenses are a type of rigid gas permeable lenses. They are often considered to be the last resort for patients for whom other lenses have failed.

Scleral contact lenses are wider than usual lenses and thus are supported entirely by the sclera, without irritating or getting support from cornea. Therefore they are helpful in preventing corneal irritation and to overcome corneal surface abnormalities easily.

How scleral contact lenses help post LASIK patients

During the LASIK procedure, the cornea is modified and manipulated. Although the procedure is performed to get rid of lenses and glasses, in some cases of LASIK complications, scleral lenses might be the last resort in solving the post LASIK side effects. However, due to corneal changes during the LASIK procedure, conventional lenses are hard to fit on its surface and thus result in more irritation and issues. In those patients, scleral contact lenses are advised to fix post LASIK complications.

The scleral contact lenses provide vision correction without touching the cornea, therefore any irregularity on the surface of cornea has no affect in de-shaping the scleral contact lens surface.

Furthermore, the permeable material used in scleral contact lenses allows easy gas exchange preventing corneal hypoxia.

The scleral contact lenses are helpful in patients with dry eyes and various other visual issues following LASIK surgery.

If you’re not happy after LASIK surgery and are having any post LASIK complications, consult Dr. Irwin Azman, Post LASIK Specialist, for a complimentary telephone consultation. Discuss the possibility and effectiveness of scleral contact lenses and all your options in your case.

Dr. Irwin Azman is one of the pioneers of the Post LASIK | PRK | RK patient. With over 25 years of experience in the management and treatment of the Post LASIK patient. Together with his knowledge and experience Dr. Azman is able to prescribe each patient with the proper solution in resolving their Post LASIK complications, including starburst, glare, dry eye, and other LASIK complications.

Serving the following areas since 1975:
MARYLAND: Annapolis, Baltimore, Bel Air, Bowie, Carney, Cockeysville, Crofton, Elkton, Essex, Fallston, Fredrick, Glenwood, Hampstead, Havre De Grace, Jarrettsville, Kingsville, Laurel, Lutherville, Manchester, Monkton, Parkton, Parkville, Phoenix, Pikesville, Randallstown, Reisterstown, Severn, Severna Park, Silver Spring, Sparks-Glencoe, Sparrows Point, Towson, Westminster, and Perry Hall PENNSYLVANIA: Harrisburg, Hershey, Middleton,  Shrewsbury,  and York. VIRGINIA:  Alexandria, Fairfax, Tysons Corner, and Vienna WASHINGTION DC.

LASIK Starbursts

LASIK Starbursts| Night Vision Treatment and Correction

LASIK surgery is a generally safe procedure with a high success rate. While most of the patients are satisfied with the outcome, some have complications. Patients may experience blurring of vision and starbursts causing difficulty, particularly with night vision. Although these symptoms might resolve themselves gradually after surgery, some patients experience persistent starbursts and disturbed night vision after many months post LASIK surgery.

What Are Starbursts After LASIK Surgery?

Starbursts are the extreme glare around the sources of light and lighted objects, mainly at night. It occurs usually as a result of pupils dilating more than the diameter of treated zone or improper post-surgical adherence of corneal flap. This symptom can also point towards under correction of nearsightedness during the procedure.

Post LASIK Starbursts Treatment

Let it heal

Before jumping to conclusions it’s recommended that you consult your doctor to understand the exact cause of starbursts and possible prognosis of the condition. Usually the night vision correction takes few weeks or months, and no further treatment or management is required in those cases, except for necessary assistance during the recovery phase.

Wave-Front LASIK Procedure

If applicable in your case, the enhancement procedure following the standard LASIK procedure might be advised by your surgeon to fix the starbursts resulting from standard procedure. However, beware that often touch-ups and enhancement can exacerbate the starbursts and glare issues. A second opinion is always beneficial.

Eye drops

As the starbursts are mainly due to the larger dilation of pupils than the treated zone, pupils constricting eye drops can be helpful in selected cases. Remember to consult your doctor before using them on your own.

Glasses or Contact Lenses For Errors Of Refraction – High Order Aberrations

If the condition persists and if the starbursts are due to the errors of refraction, High Order Aberrations (HOA), prescription glasses or contact lenses may be suggested by your eye care specialist.

  • Specialty Contact Lenses
  • Scleral Contact Lenses
  • Rigid Gas Permeable (RGP) Contact Lenses
  • Hybrid Contact Lenses
  • Soft Contact Lenses
  • High Definition Glasses

Anti-reflective lenses

Anti-glare and anti-reflective lenses may help getting rid of starbursts at night and sunburst in daytime. Specialized lenses can be used to reduce the starbursts glare at night too.

Treating Dry eyes

Dry eyes are a common complication of the LASIK procedure and are a precipitating factor for many other side effects. If you’re suffering from dry eyes get advice from a doctor who specializes in post LASIK Dry Eye. Proper treatment and management of dry eye can reduce or eliminate the starbursts and glare issues.

Always consult a post LASIK specialist and to get the proper advice on your condition before starting any self-management of starbursts or other complications of LASIK surgery.

Dr. Irwin Azman is one of the pioneers of the Post LASIK | PRK | RK patient. With over 25 years of experience in the management and treatment of the Post LASIK patient. Together with his knowledge and experience Dr. Azman is able to prescribe each patient with the proper solution in resolving their Post LASIK complications, including starburst, glare, dry eye, and other LASIK complications.

Serving the following areas since 1975:  MARYLAND: Annapolis, Baltimore, Bel Air, Bowie, Carney, Cockeysville, Crofton, Elkton, Essex, Fallston, Fredrick, Glenwood, Hampstead, Havre De Grace, Jarrettsville, Kingsville, Laurel, Lutherville, Manchester, Monkton, Parkton, Parkville, Phoenix, Pikesville, Randallstown, Reisterstown, Severn, Severna Park, Silver Spring, Sparks-Glencoe, Sparrows Point, Towson, Westminster, and Perry Hall PENNSYLVANIA: Harrisburg, Hershey, Middleton,  Shrewsberry,  and York. VIRGINIA:  Alexandria, Fairfax, Tysons Corner, and Vienna WASHINGTION DC.