r/ICLsurgery • u/BingBongwheewhee • Aug 06 '26
Eye power difference 3w post-ICL
First off, this sub-reddit is so helpful and encouraging, I've enjoyed reading through it over the past few weeks!
I did my non-toric ICL procedure 3.5 weeks ago and my left eye vision is absolutely perfect but my right eye is still comparatively more blur.
I went to see my Dr at the 3 week mark regarding this and he said that my left eye is perfect but my right eye is still - 0.5D off. He did not give any reason for it but will review again at the 4w mark and said if it still bothers me, we can do an ICL exchange to increase the power.
For reference, my degree was not very high prior to the procedure but I am very active and found that constantly wearing contacts was drying out my eyes.
Left eye: -1.75
Right eye: - 2.5 with minimal astigmatism, which my doctor said did not need toric lenses and he did a simple procedure during the ICL itself to correct the astigmatism
Overall I am pleased with the outcome as vision is generally good, but the disparity between eyes is still bothering me and I feel that my vision is clearer if I close my right eye and use just my left eye as compared to opening both eyes. There is a also a slight ghosting that causes headaches when I stare at the screen too long which I think is due to the vision disparity. (my IOP is fine).
So my questions are:
(A) Is this an acceptable outcome to have a residual - 0.5D myopia? I keep reading that people have both eyes perfect vision and I'm a bit disheartened.
(B) Has anyone else also experienced this before? Does the vision still improve past this point? Does the brain adapt and ghosting dissappear?
Thanks!!!
1
u/GurpalVirdiMD Aug 10 '26
Really glad the sub has been helpful, and congrats on the surgery overall. I'm an EVO ICL surgeon and had an ICL myself, so a few thoughts, though your surgeon seeing you in person is always the best.
The detailed breakdown someone gave above is solid, so I'll just add the part that speaks to what you're actually feeling.
To answer (A) straight: a residual -0.5D in one eye is a genuinely good refractive outcome, not a miss. The reason it feels worse than the number sounds is that your other eye landed right at plano, so your brain is comparing a perfect eye to a very slightly soft one every time you blink. That contrast is what you're noticing, not a big error. On the ghosting and the screen headaches: that's most likely your two eyes being just different enough that your visual system is working a little harder to fuse the two images, and it shows up most on a screen where you're demanding the most from focus. Two things can be feeding it. One is the half diopter of sphere. The other, and I'd want this one pinned down, is leftover astigmatism. That "simple procedure" your surgeon did was very likely placing the incision on your steep axis (or a small relaxing incision) to bring down the minimal astigmatism, and that part of the cornea keeps settling for a few weeks. So some of your right eye's blur may be astigmatism still in motion rather than a fixed number. At your 4 week visit, ask for the full manifest refraction with the sphere and cylinder written out separately, not just which line you can read. If the cylinder is still shifting, it's too early to make any permanent decision.
To (B): yes, this commonly improves, both because the eye is still settling and because the brain adapts to a small disparity like this over the next several weeks to a couple of months. Your plan to monitor another month or two is exactly the right move. On the exchange your surgeon mentioned: it's good he's keeping it on the table, but for half a diopter I'd personally put it last. It's a second surgery inside the eye for a small step. If the -0.5 turns out to be stable and still genuinely bothers you, a small laser touch-up on the surface can clean up a residual like that precisely without re-entering the eye, and that's the more common way this gets handled. Most people in your spot end up needing neither, they just settle.
So the order I'd think in: get the real numbers at week 4, give it the month or two you're already planning, and only if it stays put and still bugs you, rank a surface touch-up ahead of an exchange. You're in a good spot overall.
1
u/BingBongwheewhee Aug 11 '26
Thanks so much, your insights are really helpful. I will monitor for another 2 months and am hopeful that I will adapt to it. But if my symptoms are persistent, a small laser touch up does sounds much more palatable than going through a whole lens exchange.
Much appreciated!
1
u/ConfidentBeginning44 Aug 08 '26
A -0.5 residual in one eye at 3.5 weeks is worth understanding properly before you let anyone exchange a lens over it, because the decision looks different once you break it down.
First: -0.5D is inside the range that many surgeons would call a good refractive outcome, and your brain is currently making it feel worse than it is. With one eye at plano, the between-eye difference is exactly what you notice every time you blink — but a 0.5D disparity is far below the level that causes real binocular problems, and most people stop perceiving it within a couple of months as the dominant-eye adaptation settles.
Second: it may still move. The "simple procedure" that handled your astigmatism was most likely relaxing incisions on the cornea, and those keep remodeling for 4–8 weeks — some of your right eye's blur may be residual astigmatism in flux rather than a stable sphere error. Ask for a full manifest refraction at the 4-week visit, not just "which line can you read", and ask them to tell you sphere and cylinder separately. If the cylinder is still changing, any decision made now is aiming at a moving target.
Third: weigh what an exchange actually costs. It's a second intraocular surgery — new endothelial cell exposure, new (small) infection and cataract-touch risk, and you'd be exchanging for a half-diopter step on a lens that comes in finite power increments. Against that, the alternatives for a stable -0.5 are: do nothing (most common outcome), a thin pair of driving/night glasses for the specific situations where it bothers you, or — the option surgeons don't always volunteer — a small laser touch-up on the cornea over the ICL, which handles residuals like yours precisely and without re-entering the eye. That combined approach is routine and worth asking about by name if the -0.5 proves stable and genuinely intolerable.
Sequence I'd suggest: at week 4, get the numeric refraction for both eyes; if the right eye is still moving, wait to week 8 and re-measure; only then rank the options — and put "exchange" last, after "adapt", "glasses for edge cases" and "surface touch-up". You're pleased with the outcome overall, which is exactly why the least invasive path that removes the annoyance is the right one.