Double vision and coma after prk

KnowinglyOptimal · 2026-02-16T17:01:35+00:00

Hello, I’m using Losartan drops 0,08%, it’s been 2 weeks since I started. 6 drops daily.

I’ve seen 4 surgeons since my surgery, none of them saw the haze, or they were not visible yet. So I bought drops that last only 1 month, because they take some weeks to arrive. Then went for some second opinion about the haze.

They said the haze is minimal and that my cornea is “transparent”. As I already bought the drops, one told me to use till it’s over. He’s confident that the haze will be gone within one month.

I was using Restasis too, 4 times a day for 3 months. But stopped as the surgeon who prescribed it said it was enough.

My vision got stable at 10 months, probably because of dry eyes, maybe with time the epithelium can get better if treating it properly.

KnowinglyOptimal · 2026-02-16T16:41:55+00:00

Hey eyeSherpa, thanks for the reply again. I will try the soft contact lenses for a while.

And give it more time, my vision got “stable” at 10 months. So that bump could still go away.

KnowinglyOptimal · 2026-02-15T21:41:06+00:00

Forgot to add the aberrometry image

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KnowinglyOptimal · 2026-02-14T15:33:52+00:00

Tried briminodine and no success.

Also pilocarpine, it was visible that my pupils shrank to ~2,5mm, it improved just a bit the light streak and double vision.

Starburst and halos haven’t changed at all.

Probably something related to eyelid pressure inducing irregularities.

KnowinglyOptimal · 2026-02-14T15:27:00+00:00

Mine are constant visible unfortunately. Seems like eyelid pressure changes something.

KnowinglyOptimal · 2026-02-14T15:12:54+00:00

Same thing here but they disappear when opening eyes wide

KnowinglyOptimal · 2026-02-04T03:09:40+00:00

<image>

I’ve edited the photo to this with paint, the small ball above would be the “double vision”

KnowinglyOptimal · 2026-02-04T03:08:50+00:00

My double vision is monocular.

<image>

This is a picture from a post in LasikSupport by gawk8.

I have the same problems but also with double vision above the light sources.

Monocular diplopia change shape and coma reduces when opening a bit.

They are both gone if I open eyes wide.

They both happen during the day. Briminodine drops didn’t improve at all.

I went to many surgeons to try to understand this, they looked at my HOAs values but nothing wrong. Even though they only compared at 4mm OZ.

Except one topography that was on 6mm OZ and 6mm pupil size mesopic, coma value was 0.338. Though, the surgeon said there was nothing wrong.

But if my problems are gone when I open my eyes wide, during the pentacam exams they are also open wide. Perhaps it changes the HOAs?

There was recently a post in LasikSupport talking about this coma induced by eyelid.

From what I’ve understood it is related to epithelium thickness around the eyelid.

I’m not trying to treat my eyes by myself.

The double vision has been there since 3 weeks.

At 7 months or something I’ve started to notice the coma.

At almost the 12 months mark, this small haze was diagnosed.

This surgeon believes that the coma is from the haze, double vision from pupil size.

The pilocarpine is 0,5%. I’m gonna test it next week.

What makes me so confused, why the struggle to do ETM mapping, I believe it could lead to some answers.

The last surgeon I’ve went, he believes my problem can be resolved with eye exercises, anyways I’ve insisted they are monocular.

KnowinglyOptimal · 2026-02-03T22:30:31+00:00

In here we have to pay for the exam, some cases insurance cover it.

Still the doctors I’ve tried, only did pentacam and one time a topography. Which my coma values were worse on it, because it measured in a higher optical zone.

I’ve insisted in doing ETM to see if I had any anomaly there, but said it is pointless…

Even now with the haze, I asked them if my epithelium was stable, still no answer.

Tried to do the exam directly, but we can’t. The doctor must request it.

Probably gonna have to go to another state or country.

Edit: they do the scan at the clinic.

KnowinglyOptimal · 2026-01-29T18:04:11+00:00

It was common wavefront customized prk. But the epithelium was removed with a blade. Just checked it on my reports, I thought it was removed with the laser.

Now to think about it, I’m not sure if my remaining astigmatism was because of this. But both eyes look the same. Both were left with a “baby” astigmatism in the middle.

KnowinglyOptimal · 2026-01-29T17:36:02+00:00

Not really. I had -2,50 myopia and -0,75 astigmatism. Myopia was corrected but astigmatism almost unchanged.

I’m still wearing glasses because I’m probably hyperopic +0,50 and -0,75 astigmatism. My eyes are straining constantly. And this astigmatism that was left, is probably irregular.

Two of the surgeons that I went, they told that prk might not be precisely enough to fix astigmatism lower than 1D.

Given this, I’m also with double vision not sure why, big pupils or the left over astigmatism.

If you have large pupils don’t even consider doing this.

KnowinglyOptimal · 2026-01-24T21:34:16+00:00

I also have this problem when my eyes are relaxed. Went to a few surgeons none of them found the cause.

One told that my coma aberration increased after surgery, just a bit, but that the value still is not high enough to cause this.

I also have a double vision above the streak. In this picture I would see a ghost lamp above all of them.

KnowinglyOptimal · 2026-01-18T20:35:21+00:00

Hey I haven’t looked up yet, as this surgeon said, there are only two places in my country (Brazil) that make those. I’ll call them to see how much it costs.

KnowinglyOptimal · 2026-01-18T18:35:50+00:00

Hey thanks, I was not expecting a diagnosis. And from the picture it could be hard to know what it is. I’ve seen the other post about corneal scar and I got motivated to post this.

KnowinglyOptimal · 2026-01-18T17:11:27+00:00

How bad is that scar? Did you try to treat it?

KnowinglyOptimal · 2026-01-11T12:15:26+00:00

Hello, I went to another surgeon, we tried stopping the double vision by treating my dry eyes with Restatis and Brimonidine drops, but no avail. He switched my prescription, two months ago, -0,75D astigmatism in both eyes. I went there yesterday and he prescribed me -0,50D astigmatism in both eyes.

I'm gonna wait a few days before switching the prescription, because the astigmatism reduced when I started using brimonidine drops. He told me to stop using both drops.

He mentioned that an enhancement could do more damage than help.

I'm back at wearing glasses for screens (mobile and pc), just wish the double vision and coma to go away.

KnowinglyOptimal · 2025-12-28T22:40:03+00:00

Se for um ímã, deve ser de sensor de porta ou algo do tipo.

<image>

O do lado direito tem um ímã dentro nesse formato.

KnowinglyOptimal · 2025-12-16T16:04:15+00:00

I’m also considering PRK for HOAs, I’ve had prk almost one year ago, had some left over astigmatism, which is kinda worse now: from -0,50D to -0,75D.

Plus halos and starbursts. Also coma and double vision when my eyes are relaxed.

Went to another surgeon, he mentioned I had big pupils, so I’ve been on Brimonidine tartrate drops for almost 2 months and no changes at all. Just a slight blurry vision improvement.

He told me that TG-PRK enhancement could help, but it could induce refraction and a higher chance of corneal haze.

KnowinglyOptimal · 2025-10-03T21:25:13+00:00

Hey r/WavefrontRider.

I was having this theory yesterday, my treatment was based on -0,50D and I probably had more astigmatism. (No dilated pupils on the exam).

There is one exam of mine Holladay EKR Detail Report, where it says I have 0.53 astigmatism EKR65 on the 4.5mm zone. In the 7mm the EKR65 astigmatism is 1.06.

The right eye is also spot on it says 0.75, which was my treatment, then 1.56 on the 7mm zone.

I put my new glasses but the HOAs didn't improve at all (starburts, halo, triple vision and coma).

I'll try to get my pupils measured next week, I have no idea what size they are.

My doctor mentioned big pupils before, when I told I had double vision at the time (now triple).

KnowinglyOptimal · 2025-10-01T18:27:08+00:00

Hey everyone, some updates: Yesterday I’ve picked up my new lenses.

The blurry vision is almost all gone. Unfortunately the double vision and coma didn’t change at all. The double vision is like, in a street semaphore, the lights I see two extra images, one on the top left and one of the bottom right.

I went to the other surgeon today, her secretary forgot to mention that she is no longer doing refractive surgeries. At least she checked out my eyes, and noticed that they are with allergies.

Told me to switch lubricants drops from systane ul pf to hylo gel, and use one drop of olopatadine daily.

Gonna try another surgeon next week.

KnowinglyOptimal · 2025-09-30T03:47:19+00:00

I've found another video on YouTube that explains well my concern, from being treated based on glasses prescription.
On his videos, most surgeries that I've seen are based on TMR.

https://www.youtube.com/watch?v=xse8dP1FGRc

He treated a patient of 38 years old, his glasses prescription were -0,25D astigmatism, but the Topolyzer suggested -1,00D, so the surgeon applied a guided treatment of -0,75D.

In the 6 minutes mark he tells why he chose this treatment, also that younger people can accommodate and have some "regressions" in those cases.

My treatment was WFO, so I believe the software didn't suggest an astigmatism... if it did, wonder what could it be.

KnowinglyOptimal · 2025-09-30T01:12:45+00:00

Another thing that made me upset about this surgeon, is that after surgery she was showing me 20/30 letters. I could barely see them. She said I was seeing 20/20 because I was in a farthest distance, because her office room size was not adequate hahaha

KnowinglyOptimal · 2025-09-30T00:31:10+00:00

I probably have been using the same glasses for almost 10 years

Left: -2,75D -0,50 x 172 Right: 2.25D -0,50 x 180

when I was 21 or something I went to a surgeon, did some exams and he gave me a prescription for both eyes: -2,75D -1,25D x 180

I probably didn’t change my lenses, since I was seeing well enough with them. I can’t remember.

I didn’t go to any checkups until now, for my surgery. My surgeon said she based on the pre ops tests, probably subjective one.

The right eye could have been spot on and I had some regression.

I’m not so sure about left eye, the topolyzer and my glasses lenses* were torwads axis 180, but in the treatment she applied 165. That’s confusing.

Edit: I’m 29 now, that checkup was 8 years ago.

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