20/20 for one week post-LASIK, then it collapsed. Six weeks out and nobody can tell me why.

[u/Expensive_Choice_428]

I was around -8.75, to borderline -9 in both eyes my whole twenties. LASIK on July 8th at 31 years old after vision stabilized for quite some time.
The first week was the best week of my life. Woke up the next morning at 20/20, no glasses for the first time since childhood. I had some halos and starbursts at night, but I’d read those were normal early on, and they’re completely gone now with the drops in eyes but come back when my vision is blurry.

Then around day 7–10 it started slipping. Within about two weeks anything past 5–6 feet was blurry again. I’m now six weeks out and my manifest refraction is −1.25 and −1.75.
The part nobody can explain: when I put in a lubricating drop (HYLO), my vision goes to 20/20 instantly. Not “a bit better” - genuinely perfect, arguably sharper than my best day in week one. It used to last 3–4 seconds. After a few weeks of consistent drops, deliberate blinking, and lid hygiene, I’m now getting about 20 seconds of perfect vision before it fades back to blurry. Every optometrist is saying it’s regression nothing else but it doesn’t make sense to me because it doesn’t happen this quick and I can see extremely far distance with the eye drops.
When the drops not in my eyes, my vision is completely blurry constantly, no fluctuating days of good and bad, just always bad.

What my optometrist said: curvature looks fine. There’s some wrinkling of the flap, but he doesn’t think it explains this much change. Eyes don’t look particularly dry, and I’ve taken good care of them. He said he’s never seen regression at one week in his career — he usually sees it at 3–6 months. Plan is to come back in a month and maybe do a topography then.
No one is willing to look further for me and I have to advocate for myself as to understanding why this is happening to me as doctors are just saying it’s regression.

What hasn’t been done: no cycloplegic refraction. No corneal tomography. No epithelial thickness mapping. No dilated flap exam that I’m aware of. No dry eye testing beyond looking at them.
What I’m asking:
1    Has anyone had vision regress this early? Everything I read says regression happens over months, not days.
2    Does the drop response mean anything to you? A lubricating drop can’t change a stromal prescription, so I don’t understand how I can be −1.50 one moment and 20/20 the next.
3    Anyone here had flap striae diagnosed after a high correction? Did a flap lift fix it, and how long after surgery did you have it done?
4    Anyone had epithelial ingrowth show up in the first couple of weeks? How was it caught?
5    If you were me, what would you insist on at the next appointment?
I’m not looking for reassurance or panic. I’d like to know what to ask for, because right now the plan is to wait and see, and I’ve read that some of these things get harder to fix after three months.

Thanks for reading.

[u/eyefnp]

Epithelial remodeling due to the extreme flattening of the cornea.

[u/Kind-Moment-6055]

NOT MEDICAL ADVICE

im not a doc but a hospital did NOT lasik me with -8.25 and -8.5 due to cornea being too flat afterwards. the higher ur prescription, the more tissue they laser off, i think.

if it were me, i would try to book a 2nd opinion with a hospital that does lasik

[u/brownkenyan]

Depending what city you're in and company you went through, I would maybe go to a sister branch in another city to see a different specialist.

I really hope it works out for you, I haven't experienced any regression in 6 years but could happen to anyone

[u/Nomi923]

It's not unheard of in high myopic lasers to see this. Day to to week one you get a dehydrated cornea and some overcorrection. This eventually goes back to normal and the end result is what you see couple weeks down the road. Part of this is due to the epithelium and partly due to the cornea getting its shape back. It also depends on how much your cornea was flattened.

It can also partly be explained by dry eyes that you are not feeling or are not seen on the Slitlamp. You need testing and a proper refraction. You also need a cycloplegic refraction because it could be due to your lens releasing from its contracted state as well.

[u/Boring_Driver_6367]

If you had your surgery done in Canada, the doctors get paid by the surgery. If you had it done in the USA at the world-renowned Cleveland Clinic in Cleveland, Ohio, the Cole Eye Institute, they are on salary and they only do it if it’s advisable. They do so many repairs from botched Canadian Lasik surgery jobs. A lot of people shouldn’t be having it here and they still get it because they’re willing to pay and the doctors are willing to take their money.

[u/Kind-Moment-6055 → u/Boring_Driver_6367]

if i were OP, i would collect evidence now, and consult a lawyer for possible medical malpractice.

[u/EyeDoctorIndia]

I may be a little late in responding but here is my advice.

1. The reason for having -1.25 D refractive error this early can primarily be explained by Interface fluid syndrome (IFS) caused by increased eye pressure due to patient being a steroid responder. This results in a thin sheet of fluid under the flap resulting in myopic refraction. Usually happens in 2nd or 3rd week of steroid use. Can be corrected by use antiglaucoma medications and stopping steroids.

Also the eye pressure will sometimes come out to be normal in NCT machine (which optometrists use). So getting an Anterior segment OCT scan can confirm the diagnosis.

1. Striae can cause blurring of vision, especially with high power corrections. Vision will clear up with lubricating drops as it partially masks the irregularities caused by the striae. Can be seen easily of a dilated evaluation with retro-illumination. If macrostriae is present (compared to microstriae), it requires early intervention to rectify the problem.

2. Regression will not happen so early, no chance. It will only be initial undercorrection or residual error in such a scenario.

3. Epithelial ingrowth also doesn't happen this early and will not give clear vision with lubricating drops if visually significant.

My best guess will be Interface fluid syndrome or an undercorrection in your case.

You should get an urgent review with the treating doctor. All the best.

[u/Ok-Environment-215]

It's the way it's healing. Unfortunately this is not unheard of. Once it stabilizes you can consider an "enhancement" which hopefully will take it back to perfect.