Category Archives: Starbursts

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.