How Does LASIK Cause Problems With Night Vision?

Tip! People with vision problems usually do not realize that they have them; they have no reason to think that their view of the world is different from everyone else’s.

It is not uncommon to notice unusual visual symptoms at night after LASIK. Patients often report symptoms of haloes, glare, or a general feeling of poor night vision. Fortunately, these symptoms almost always resolve with time.

There has been a large amount of debate as to the cause of night vision symptoms after LASIK. What is known is that it is much less common than it was with the older generation laser treatments. There are some patients who had LASIK surgery many years ago who will require frequent eye drops to minimize the symptoms.

The major debate has surrounded whethere the size of a persons pupil at night plays into night vision symptoms. In the dark,a person’s pupil will enlarge in size. Some people believe that it is this enlargement of pupil size that causes the night vision complaints. More specifically, the pupil size has enlarged to allow light in that is outside the optical zone created by the laser. Therefore, this light is reflected in a different manner than light inside the optical zone; this leading to night vision complaints. A study published in a peer-reviewed journal has suggested this is wrong. At this point, it is unclear as to the true answer. However, pupil measurement is a standard part of the preoperative workup.

Tip! It’s very difficult, if not impossible, to relax your eyes and mind and maintain clear vision if your body is overly tense. Postural imbalances and physical tension have long been associated with vision problems.

A major development in laser vision correction has been the measurement of higher order abberations. It is felt that these abberations, such as spherical abberation and coma cause a lot of the post-operative visual symptoms that may cause a patient to have a less than satisfactory post-surgical outcome. The development of wavefront abberation treatment or custom cornea treatment is designed to address the treatment of these pre-existing abberations and to minimize the induction of these abberations.

It is felt that by treating these abberations symptoms such a night vision haloes and glare can be minimized. Many surgeons will agree that the advancement with this technology in addition to creating smoother optical zone treatments has minimized these symptoms compared to earlier generation lasers.

Tip! I have first-hand experience with vision problems. I will be eternally grateful to Jane Porchey, my younger son’s kindergarten teacher, for identifying his vision problem in October.

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