Richard Adler, MD

Thanks for your question.  The answer depends on a number of factors.  Presumably, you are in the age range where people start to require readers (age 40 and up).  If that's the case, you are correct that most folks corrected for distance see clearly at distance but not at near.  However, the answer also depends in part on you pre-LASIK numbers.  For example, whether you were far sighted or near sighted before your surgery can impact which type of vision, distance or near, comes into focus first.  Regardless, your vision should stabilize one way or another by 1 month.  Persistent clear near vision but blurred distance vision can sometimes imply some residual near-sightedness.  Not sure how far out you are, but if you are under a month, be patient!  Be sure to check with your LASIK surgeon for all concerns!

Thanks for your question.  If I am understanding you correctly, your vision in the right eye is 20/20 and the vision in your left eye is 20/15.  Generally speaking, based solely on those numbers, that is still a fine result for 1 month out.  It is certainly still possible that the 2 eyes will continue to even out, however.  Because you see better than "perfect" in your left, it is making the 20/20 vision in your right seem inadequate perhaps.  Hopefully, at your post op visit your doctor will refract your eyes and tell you what, if any, residual refractive error exists in your right.  This will give you additional information about whether there is a need to consider any additional treatment.  Dry eye in one eye can also result in some asymmetry and is worth inquiring into as well.  Most importantly,  I am glad you are keeping up with your complete post operative care as additional causes of asymmetric vision can only be determined with a careful slip lamp exam of your Lasik flap. 

Thanks for your question.  There can be several explanations for nighttime vision issues that occur even years after Lasik.  3 common explanation include: residual refractive error, dry eye disease, and higher order aberrations that impact vision when the pupil dilates in the dark.  A full visit to your ophthalmologist is necessary to determine which, if any, of these 3 explanations may be affecting you.  Simple solutions that have helped others include:  glasses to be worn during night driving, management of dry eye (which creates dry spots on the surface of the eye, worsening glare/halos), and the use of mild pupil-constricting eye drops 20 minutes before driving at night. Please follow up with your ophthalmologist to determine the right treatment for you.

It would be very difficulty to explain bloodshot eyes resulting from Botox injections of the forehead.  More likely than not, the timing of your eye redness was coincidental with your Botox injections.  One of the more common explanations for redness at the end of the day is Dry Eye Disease.  If you continue to notice a pattern of redness at the end of the day, a full eye exam with an ophthalmologist is advised.  There are many effective treatments available for Dry Eye Disease.  I would not, however, be concerned about this reaction at your next Botox injection. 

It is not unusual to experience a sense of heaviness, achiness, or fatigue months after refractive surgery.  One of the most common explanations for these sensations is dry eye, which itself is not uncommon following refractive surgery.  Many people are surprised to learn that dry eyes don't always feel "dry" or sandy but, in fact, can present with heaviness.  It is essential to be seen by your ophthalmologist for a slit lamp exam to determine the exact cause of your discomfort.   If, in fact, it is dry eye, there are many effective over the counter and prescription drop options for you.  Most of the time, dry eye following Lasik improves; but occasionally it persists.  The good news is there are effective treatments.  Please follow up with your ophthalmologist for a full evaluation!