Hazy, Unclear Post-op Lasik Vision

I had Lasik six days ago. Since the surgery, I have not had any periods of sharp, clear vision. I cannot read signs while I am driving, I have to get closer to things to read, and I feel like I am in a fog most of the time. I really did not expect it to be this way. Was I just not informed properly? I am a surgical resident, and I am very concerned because I will be returning back to performing surgeries in a few days. Is there anything that can be done to help me? Is the post-op course longer, and harder for people with higher prescriptions? I am trying to be patient, but I am getting really frustrated.

Doctor Answers 5

Redness and blurry vision are not uncommon at 2 weeks post LASIK.

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Vision may be more blurry longer post-operatively in patients with stronger corrections. There is also an increased incidence in under corrections with stronger treatments. These can usually be corrected with an enhancement 3 to 4 months after the initial procedure.

If blurriness remains, temporary glasses may be prescribed during the time until enhancement. It is important to discuss your concerns with your surgeon.

West Orange Ophthalmologist

Worried about visual recovery

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The analogy I love to use is this: "when you sit up from the Lasik procedure it is like you just got out of the shower and your bathroom window fogged up. As each hour and day go on the fog gets clearer and clearer." So, this is a good expectation post Lasik. There is some variability in the speed of the fog lifting, so predictions are not exact. However, typically, 90% of the fogginess should be resolved in the first 24 hours. There can be a little more fogginess (or blurriness) if your prescription is higher than average. By and large, any swelling induced by the procedure should be far gone after two weeks. Most patients (including myself) can drive during the day on the first day after surgery and at night on the second night. Using this as a guide, you can decide if things are going according to plan. You should always have your eyes checked the day after your procedure. Most patients are 20/20 or very close to it, although the quality of the 20/20 may not be perfect quite yet.

It sounds like you need to see your surgeon and make sure everything is ok. After some reassurance that all is healing well, then some "tincture of time" should do the trick.

Anthony J. Kameen, MD
Baltimore Ophthalmologist

Unclear vision six days after LASIK

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Your blurring may go away if you are only six days postop. That's extremely early in the grand scheme of things. Predicting your final result is like predicting the results of a football game after the first five minutes of play.

A common cause of post-LASIK blurring is residual refractive error (ie, astigmatism, nearsightedness or farsightedness which still remains). Glasses would correct this--if the blur is severe, have your surgeon write you a prescription for a pair of glasses to get you by while you wait for visual stabilization.

If glasses don't help with the blur, it may be from dryness, in which case artificial tear lubricants will help. It may also be due to corneal swelling, which is relatively common one week postop. In this case, hypertonic saline drops (Muro 128) might be helpful to improve the vision. Occasionally, there can be inflammation in the cornea which would respond to a longer than usual course of anti-inflammatory drops.

Higher starting prescriptions are associated with both a longer stabilization period, and larger swings in the vision during this period, as well as a higher chance of needing a touchup or enhancement procedure.

At this relatively early stage of healing, be patient, and follow your surgeon's instructions. It can take up to three months for the vision to fully stabilize. I always tell patients it's not at all important what your vision is on day one or week one... far more important what it is at the three month mark, when things are fully stable.

Gary Kawesch, MD (retired)
San Jose Ophthalmologist

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Hazy, Unclear Vision After LASIK

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High prescriptions DO take longer to clear up, as do far-sighted treatments. Six days after surgery is far too soon to start worrying. Most likely your vision will continue to improve.  See your surgeon if you have not already to make certain that there is nothing wrong, but please know that what you are experiencing is entirely consistent with normal healing.

Michael K. Tracy, MD
San Diego Ophthalmologist

Blurry vision at six days after LASIK not common, but not necessarily abnormal

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Most patients regardless of their prescription have fairly clear vision within a few days, but it is not unusual to have slightly blurry vision for several weeks, sometimes for unexplained reasons. The most important question is what is your vision best correctable to and if at least 20/30 then you may just be healing a little slower than average. If it is worse than this I would ask your doctor for an explanation as to specifically what is the problem. On the other hand if it is correctable and it is just that there is some residual correction, this may clear in a few weeks, or you may need to have an enhancement at some point.

Since you are a medical resident, you should pursue a technical explanation, and your doctor should be able to give you a plausable explanation. If not you may wish to seek another opinion as to your progress if your vision does not improve in another week.

Jon Dishler, MD, FACS
Greenwood Village Ophthalmologist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.