- Joined
- Jun 30, 1997
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- Real Name
- Sean
On a somewhat related note:
I have had some visual "aberrations" with primarily bright objects in darker lighted environments. Kind of like a streaking/smearing/ghosting halo-ish effect. I believe I've had it for a couple of years, but it hasn't been very noticeable. It has been much more noticeable this year.
I got glasses for mild nearsightedness this May, and once the rest of my vision became clearer, I realized that these aberrations were much more obvious. They seemed to get worse throughout the summer.
Searching online for possible causes of what I was experiencing, I'd always come across descriptions of the visual aberrations some people have after LASIK surgery. But I never had any type of eye surgery. Still, the similarities in the description of the problems were hard to ignore.
It seems that traditional optical corrections are for nearsightedness, farsightedness, and astigmatism. These are considered First and Second order aberrations. But everyone also has a certain degree of what is called higher order aberrations. Like third and Forth order aberrations, I believe. These include coma, trefoil, spherical aberration, quadrefoil, distortion, and increasing levels of astigmatism. As a result, even people with "20/20" vision can still complain of problems with clarity or crispness of their vision and may experience double images, shadows, halos, or poor contrast. These folks may have difficulty driving at night because of these aberrations.
My online research into high order aberrations and LASIK informed me that the LASIK procedure (and I think other similar procedures) can induce high order aberrations or exacerbate existing high order aberrations. Some people may be more susceptable to this than others.
It seems that currently, the best way to have LASIK is for them to do a wavefront anlysis with an aberometer that measures your high order aberrations. With this information, a custom ablation pattern is computed that should potentially prevent the introduction of significant new high order aberrations and cancel existing ones (to a certain degree??). My understanding is that the custom ablation using the wavefront measurement of high order aberrations has only very recently become available, but it is becoming the standard for how all LASIK procedures are done. Not absolutely certain about this. I do know for certain that today not all LASIK centers use a custom ablation accounting for high order aberrations. So I think that anyone considering having LASIK should look into this on their own and then ask the doctor about it before they consider surgery anywhere.
I've learned that for folks who have had significant aberrations following LASIK that had not diminished over time (for healing) it may be an option to have follow-up custom ablation to help cancel out these aberrations.
I've also come across a company called OPHTHONIX who is taking this technology and incorperating it into custom spectacles and contact lenses. Apparently, the idea is to do wavefront analysis which measures your high order aberrations along with your traditional perscription (no verbal input from patient "better or worse") is necessary. The availability of the technology and the spectacles was supposed to be late 2004. I believe they said that contacts should be available sometime in 2005.
I think anyone who has issue with night vision problems (post-LASIK or not) should educate themselves on high order aberrations and at least be aware of the newer technology that is becoming available. A Google search using "wavefront spectacles" "high order aberrations" and "LASIK" may be interesting for some in this thread.
It is also important to remember that night vision problems can be a sign of other eye disease, as was unfortunately my case.
It seems I have a condition called Keratoconus. It is a thinning of the cornea that results in a "cone" shape instead of the normal round shape it should have. It is progressive, and it can lead to significant visual impairment.
If loss of visual acuity cannot be corrected with normal lenses, rigid contacts can be worn. If it progresses to the point where the rigid contacts cannot correct vision, a corneal transplant can be performed.
When I complained of these symptoms this summer in Long Island, the doc first thought it may be a tear film problem. Told me to use eye drops and come back in a month. A month later (with no change) he suggested to contunue the drops and put me on antibiotics. There was no change, and I didn't expect one really. I was able to see that the aberration I was seeing was directly linked to how much my pupils were dilated. For example, In a dark room a small red display light would have what looked like two smears/streaks (whatever) coming down from it almost making a circle underneath it. When I turned the light on, the aberration was gone. The important part was that when I turned the light OFF again, the light looked perfect for about a half second or so, then I would actually see this streak/smear form down from the light. So it was clearly changing with the size of my pupil (as it dilated). I confirmed this was the case with numerous other observations in a variety of situations. I could also make the aberration mostly disappear by simply covering the bottom half of my eye with my finger. Hard to see how it could be tear film related in any way, it ad to be a refractive problem.
So now after over two months, the doctor said that he thinks it is some type of high order aberration, but he never mentioned keratoconus. I was concerned about keratoconus from research I did on my own, but since he never mentioned it I figured "good he must have ruled that out based on something a doctor wouold know but I of course wouldn't". I believe he did do corneal topography, but never mentioned anything about a concern. AT that point I was moving back to North Eastern PA, so I figured I'd follow up with new docs here.
I saw a great doctor at the North East Eye Institue. I was really happy with him and he spent a great deal of time with me really letting me describe all the observations of my symptoms I have made over the months.
He suspected keratoconus. The corneal topography showed some mild steepness. And the wavefront analysis and "orb scan" were consistent with keratoconus. My visual aberration is clearly the coma high order aberration (primarily) caused by the keratoconus.
I then saw a doc who specialized in keratoconus and his feeling is that, at present, I have the mildest case he's ever seen. My uncorrected vision is still good (mild near sightedness) and with my normal glasses my vision is better than 20/20. So he doesn't recommend hard contacts at this time. If it progress to the point where my visual acuity becomes diminished, then hard contacts may have to be considered. I did try a pair of hard contacts in the office just to see what they were like (can never have too much information when making decisions about stuff like this). They weren't bad, but I was constantly aware that they were in my eye. I'd prefer not to use them if possible. Theoretically, they should reduce (maybe eliminate my visual aberration) because they help flatten out the cornea, but I didn't have them in long enough to experiment, and just having them in my eyes caused some visual effects (from tearing, etc..).
So he didn't recommend them and I didn't feel like dealing with them now either. He told me that the FDA is evaluating a new type of hybrid contact lens that is both hard and soft. I believe hard in the center and soft on the outer portion. They are supposed to have the feel of a soft lens with the rigidity/support of a hard lens, or something to that effect. So if I do require a hard lens in the future, this may be a good option for me (and for others who require hard contacts for other reasons).
The doc says there is a good chance that my diseae may have progressed as far is is going to go and may not get much worse. Of course, it could get alot worse over the years. I just have to see what happens over time. He said the chance I'd wind up needing a transplant is very low.
So for the immediate future, there is nothing that can be done to reverse this or prevent it from progressing (hopefully it won't progress too much more). So then my concern in now back to the original issue. This crappy visual aberration I have that is actually bad enough to be seen when watching movies (theatrical and home theater). With the right lighting conditions, it's not bad at all for home theater (but I prefer to watch with NO light, so that stinks). Interestingly, I can use these eye drops called Alphagan which were given to me (as just an experiment really) but the doc in Long Island. They are for people with glaucoma. They help reduce intra-ocular pressure but also keep the pupil more constricted (less dilated). And this definitely helps alot. It is obviously not the intended use, and I'm not wild about using them. But I can use them when I go to the movie theater or before I watch a special DVD when I just have to have the lights off.
The Eye center I was at told me about these new "wavefront spectacles and lenses". They said they are holding off on adopting it and offering it to patients because it is just so new that they prefer to wait a bit to make sure it is a technology that will stay with them and not become a "boat anchor" after six months.
So I did just a little research today and found Ophthonix's website which is where I learned that the spectacles are available now and the contacts should be out later this year. This is something I'm just going to follow for a bit, and see what happens with it. But I am certainly very interested in it given my condition. I figured some LASIK folks who suffer from distracting high order aberrations may also find this interesting, so this was my long winded way of passing on the info.
I have had some visual "aberrations" with primarily bright objects in darker lighted environments. Kind of like a streaking/smearing/ghosting halo-ish effect. I believe I've had it for a couple of years, but it hasn't been very noticeable. It has been much more noticeable this year.
I got glasses for mild nearsightedness this May, and once the rest of my vision became clearer, I realized that these aberrations were much more obvious. They seemed to get worse throughout the summer.
Searching online for possible causes of what I was experiencing, I'd always come across descriptions of the visual aberrations some people have after LASIK surgery. But I never had any type of eye surgery. Still, the similarities in the description of the problems were hard to ignore.
It seems that traditional optical corrections are for nearsightedness, farsightedness, and astigmatism. These are considered First and Second order aberrations. But everyone also has a certain degree of what is called higher order aberrations. Like third and Forth order aberrations, I believe. These include coma, trefoil, spherical aberration, quadrefoil, distortion, and increasing levels of astigmatism. As a result, even people with "20/20" vision can still complain of problems with clarity or crispness of their vision and may experience double images, shadows, halos, or poor contrast. These folks may have difficulty driving at night because of these aberrations.
My online research into high order aberrations and LASIK informed me that the LASIK procedure (and I think other similar procedures) can induce high order aberrations or exacerbate existing high order aberrations. Some people may be more susceptable to this than others.
It seems that currently, the best way to have LASIK is for them to do a wavefront anlysis with an aberometer that measures your high order aberrations. With this information, a custom ablation pattern is computed that should potentially prevent the introduction of significant new high order aberrations and cancel existing ones (to a certain degree??). My understanding is that the custom ablation using the wavefront measurement of high order aberrations has only very recently become available, but it is becoming the standard for how all LASIK procedures are done. Not absolutely certain about this. I do know for certain that today not all LASIK centers use a custom ablation accounting for high order aberrations. So I think that anyone considering having LASIK should look into this on their own and then ask the doctor about it before they consider surgery anywhere.
I've learned that for folks who have had significant aberrations following LASIK that had not diminished over time (for healing) it may be an option to have follow-up custom ablation to help cancel out these aberrations.
I've also come across a company called OPHTHONIX who is taking this technology and incorperating it into custom spectacles and contact lenses. Apparently, the idea is to do wavefront analysis which measures your high order aberrations along with your traditional perscription (no verbal input from patient "better or worse") is necessary. The availability of the technology and the spectacles was supposed to be late 2004. I believe they said that contacts should be available sometime in 2005.
I think anyone who has issue with night vision problems (post-LASIK or not) should educate themselves on high order aberrations and at least be aware of the newer technology that is becoming available. A Google search using "wavefront spectacles" "high order aberrations" and "LASIK" may be interesting for some in this thread.
It is also important to remember that night vision problems can be a sign of other eye disease, as was unfortunately my case.
It seems I have a condition called Keratoconus. It is a thinning of the cornea that results in a "cone" shape instead of the normal round shape it should have. It is progressive, and it can lead to significant visual impairment.
If loss of visual acuity cannot be corrected with normal lenses, rigid contacts can be worn. If it progresses to the point where the rigid contacts cannot correct vision, a corneal transplant can be performed.
When I complained of these symptoms this summer in Long Island, the doc first thought it may be a tear film problem. Told me to use eye drops and come back in a month. A month later (with no change) he suggested to contunue the drops and put me on antibiotics. There was no change, and I didn't expect one really. I was able to see that the aberration I was seeing was directly linked to how much my pupils were dilated. For example, In a dark room a small red display light would have what looked like two smears/streaks (whatever) coming down from it almost making a circle underneath it. When I turned the light on, the aberration was gone. The important part was that when I turned the light OFF again, the light looked perfect for about a half second or so, then I would actually see this streak/smear form down from the light. So it was clearly changing with the size of my pupil (as it dilated). I confirmed this was the case with numerous other observations in a variety of situations. I could also make the aberration mostly disappear by simply covering the bottom half of my eye with my finger. Hard to see how it could be tear film related in any way, it ad to be a refractive problem.
So now after over two months, the doctor said that he thinks it is some type of high order aberration, but he never mentioned keratoconus. I was concerned about keratoconus from research I did on my own, but since he never mentioned it I figured "good he must have ruled that out based on something a doctor wouold know but I of course wouldn't". I believe he did do corneal topography, but never mentioned anything about a concern. AT that point I was moving back to North Eastern PA, so I figured I'd follow up with new docs here.
I saw a great doctor at the North East Eye Institue. I was really happy with him and he spent a great deal of time with me really letting me describe all the observations of my symptoms I have made over the months.
He suspected keratoconus. The corneal topography showed some mild steepness. And the wavefront analysis and "orb scan" were consistent with keratoconus. My visual aberration is clearly the coma high order aberration (primarily) caused by the keratoconus.
I then saw a doc who specialized in keratoconus and his feeling is that, at present, I have the mildest case he's ever seen. My uncorrected vision is still good (mild near sightedness) and with my normal glasses my vision is better than 20/20. So he doesn't recommend hard contacts at this time. If it progress to the point where my visual acuity becomes diminished, then hard contacts may have to be considered. I did try a pair of hard contacts in the office just to see what they were like (can never have too much information when making decisions about stuff like this). They weren't bad, but I was constantly aware that they were in my eye. I'd prefer not to use them if possible. Theoretically, they should reduce (maybe eliminate my visual aberration) because they help flatten out the cornea, but I didn't have them in long enough to experiment, and just having them in my eyes caused some visual effects (from tearing, etc..).
So he didn't recommend them and I didn't feel like dealing with them now either. He told me that the FDA is evaluating a new type of hybrid contact lens that is both hard and soft. I believe hard in the center and soft on the outer portion. They are supposed to have the feel of a soft lens with the rigidity/support of a hard lens, or something to that effect. So if I do require a hard lens in the future, this may be a good option for me (and for others who require hard contacts for other reasons).
The doc says there is a good chance that my diseae may have progressed as far is is going to go and may not get much worse. Of course, it could get alot worse over the years. I just have to see what happens over time. He said the chance I'd wind up needing a transplant is very low.
So for the immediate future, there is nothing that can be done to reverse this or prevent it from progressing (hopefully it won't progress too much more). So then my concern in now back to the original issue. This crappy visual aberration I have that is actually bad enough to be seen when watching movies (theatrical and home theater). With the right lighting conditions, it's not bad at all for home theater (but I prefer to watch with NO light, so that stinks). Interestingly, I can use these eye drops called Alphagan which were given to me (as just an experiment really) but the doc in Long Island. They are for people with glaucoma. They help reduce intra-ocular pressure but also keep the pupil more constricted (less dilated). And this definitely helps alot. It is obviously not the intended use, and I'm not wild about using them. But I can use them when I go to the movie theater or before I watch a special DVD when I just have to have the lights off.
The Eye center I was at told me about these new "wavefront spectacles and lenses". They said they are holding off on adopting it and offering it to patients because it is just so new that they prefer to wait a bit to make sure it is a technology that will stay with them and not become a "boat anchor" after six months.
So I did just a little research today and found Ophthonix's website which is where I learned that the spectacles are available now and the contacts should be out later this year. This is something I'm just going to follow for a bit, and see what happens with it. But I am certainly very interested in it given my condition. I figured some LASIK folks who suffer from distracting high order aberrations may also find this interesting, so this was my long winded way of passing on the info.
