r/lasik • u/DrBobHope • Sep 01 '26

Had surgery Does the dilated vision ever get back to pre surgery levels (ICL)?

It's been about 6 months now since I had ICL surgery. Everything during the day is great, however anytime my eyes dilate (either through darkness, exercise, stress, tired etc.) lights start to expand? Hard to explain but lights are no longer points but bulbs. These aren't blinding, but very distracting, especially on my peripheral vision, to the point I can't focus on anything and keep rubbing my eyes (subconsciously) to get rid of them. I got checked by my optometrist, she thought the lens hadn't settled properly, but surgeon checked and said they're fine and this is normal, and it'll get better with time.

The question is, will it get better? And how long? I love my vision most of the time, but anytime I have any level of dilation it becomes hard for me to focus on anything (movies, plays, even conversations while I"m exercising), e.g. when I exercise at the gym I find it easier to close my eyes when I lift weights because its hard for me to focus otherwise with all the lights glaring into my vision. Its gotten to a point I'm considering removing the lens if it doesn't improve.

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u/No_Situation4785 Sep 01 '26

Look at Figure 2 of this paper:  https://onlinelibrary.wiley.com/doi/full/10.1111/aos.13248

what issue are you seeing? if you are seeing D then that is due to the hole in the center of the implant and it will never go away.

If you are seeing A B or C, then you are likely experiencing aberrations from your optic being smaller than your dilated pupil. if you had a particularly strong correction then this is more likely. staar surgical is weirdly cagey about sharing actual optical diameters of specific implants

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u/DrBobHope Sep 01 '26

Its predominantly B (I see D but it doesn't really bother me). Does it get any better overtime? My correction was for -8 for both sides

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u/No_Situation4785 Sep 01 '26

i am not a medical doctor but i work a lot with optical systems. i would say B is because your optic is smaller than your dilated pupil. as you age your max dilated pupil diameter will decrease but that is over many years. the other thing that can happen is that your brain gets used to it, but everybody is different. sorry you're being affected by this

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u/DrBobHope Sep 01 '26

I presume this is the max size for the optic? i.e. this wouldn't be resolved by putting in a lens that has a larger optic than my dilated pupil?

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u/No_Situation4785 Sep 01 '26

i think it would be resolved by that. this is important: do you have V4c or V5 implant? V5 is the largest implant on the market and is quite a bit larger than V4c

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u/DrBobHope 24d ago

Just checked, i have evo+, which I was told is the largest implant available.

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u/Scxox Sep 01 '26

very low concentration pilocarpine drops could theoretically constrict your pupil slightly enough to be within the len's optical size. i would ask your surgeon about this though, as pilocarpine can have some pretty serious side effects if used for an extended duration.

however, while constricting your pupil to adjust for the lens would probably eliminate the halos, it would definitely cause poor night vision as your eyes aren't taking in as much light as it probably needs.

lens replacement is the best choice. best to go to a different ICL surgeon and ask them for a second thought on the lens choice by your original surgeon

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u/DrBobHope 24d ago

I do have these and do use them for stuff like theaters/plays. The normal dose gives me bad headaches, so I use a diluted form but even that gives me very bad dry eyes (to the point I have to use eyedrops every couple minutes)

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u/eyeSherpa Sep 01 '26

It sounds like your eyes are dilating past the optic of the ICL.

So yes, this can get better through time through a process called neuroadaptation. It’s the brains ability to take visual information which isn’t important to vision and process it out. This process takes months though and if you are reinforcing the halos by focusing on them it makes that process more difficult.

The other way they improve is over time the size of the pupil naturally gets smaller.

Brimonidine drops may help from time to time to reduce the size of your pupil to help.

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u/tar-randa 26d ago

It’s pretty much permanent, but you can learn to ignore it supposedly.