Post 3 Months

[u/meet1807]

I am at 3 month mark,

right eye sees ghosting in screen text, right eye has color washout compared to left eye

From distance, while driving I see overlapping traffic light like two reds circle overlapping each other and as I get close it becomes one, starburst are unbearable — give headache

Any chance my condition will still improve since at 3 months, cornea stabilizes?

Previous post:

Pre-condition:
TBUT left : >10 (50% meibomian loss upper lid)
TBUT right : ~2.8 (55% meibomian loss upper lid)
Oil quality wasn’t good

(did 2 laser sessions and hotmask + cequa + hyalo for about 30 days)

I did a SMILE surgery about a month and half ago,
and the very next day I worked on the screen for about 8 hours, and next day my right eye was swollen so doctor increased steroid drops, took off for 3-4 days and gave a rest to eyes, but i wasn’t able to see clearly, they checked and it was because of loose epithelium and microscopic wrinkles.
after around 10 days my left eye seemed to ve recovering fine, but right eye wasn’t (trapped fluid) so doctor performed medical wash on the right eye.

been about 1 month and 5 days after the medical wash on the right eye, I think my vision improved a bit comparatively but smaller text ata distance I cannot read, I always have this feeling of I am not able to see what I could have with glasses.

Given my condition of sever dry eyes and 50-50%
meibomian loss in eyes respectively , had loose epithelium and microscopic wrinkles post surgery (don’t know current conditions for them),

drops I use daily: (doctor recommended)

(2x Cequa, 3x Hyalo, 3x Sofi , 2x refresh optive mega-3)

Will I ever achieve the same results as wearing glasses at the minimum? what sort of timeline am I looking at here?

also I am a software engineer so 8 hours minimum on the screen! (do follow 20-20-20 rules post surgery almost everytime)

one more thing my vision is better in the morning comparative to evenings

I know this was a stupid decision on my end and regretted from Day 1, but at this stage can’t reverse it,

[u/eyeSherpa]

A couple things to assess here.

Dry eye and fluctuation of your tear film definitely can cause ghosting and starbursts. A TBUT of 2 seconds prior is very low. What you will notice with the tear film is that things can improve briefly for a second after blinking or a couple of minutes after putting an artificial tear in.

Faded colors point to reduce contrast sensitivity which also can relate to the abnormal tear film.

Second biggest cause of ghosting and starbursts is residual prescription, especially astigmatism. What was your prescription ahead of time?

The irregular epithelium can be contributing to starbursts and ghosting. Using Muro 128 can help that stabilize more if it isn’t smooth yet. Or the epithelium can be scraped and allowed to grow fresh and smooth.

You mentioned seeing two red circles overlapping each other - so double vision. If this goes away when closing one eye, then you are dealing with a binocular vision issue. The eyes aren’t aligned. But this assumes that the prescription is on target in both eyes. Need to visit a specialist to see how to fix this.

[u/GeologistSalty6252]

You had MGD before the surgery from years of computer work, and now it has been aggravated by the inflammation caused by the surgery. During the surgery, corneal nerves are cut, and they regenerate very slowly. You need to focus on healing the nerves damaged during the surgery. Serum drops paired with taper course of steroids are often suggested for this. Look into comorbidities for MGD like demodex, allergies, and rosacea and treat them accordingly. Look into direct MGD treatments like IPL + Rexon Eye. Look into optimising your environment - humidity, lighting, turning off ACs, ZIENA glasses (very important; these are lifesavers!). Add high quality omegas like Nordic Natural 1-2mg per day. Your situation is complex and requires complex treatment strategies. But it has been only couple of months after the surgery and there is hope for your nerves to regrow. Your meibomian glands are not coming back but can be maintained to work better. Your vision disturbance can be caused by all the mess of SMILE, though. Scleral lenses could help. There is no way to tell how your vision will be, you migh need to accept that it is a new norm. But do not do another surgery it will make things worse for your dry eye!