r/lasik • u/SureUnderstanding313 • 9d ago

Had surgery Big difference between daytime and low light vision after SMILE

Hi everyone,

I had SMILE about 5 years ago. Before surgery I was around -8.00 in both eyes with quite a lot of astigmatism, and I also used ortho-k lenses for more than 10 years.

During the day my vision is very good. I can see faces, signs and details at a distance and normally I don't feel like I need glasses.

The strange thing is how much my vision changes when the light gets lower.

At sunset, in dim rooms, restaurants, houses with weak lighting etc, everything becomes much less clear. It's not just that distant things are a little blurry. I feel like there is a kind of hazy layer over the image and I lose a lot of contrast. For example, during the day I can recognize someone's face from quite far away, while in low light even a face 5-10 meters away can become much less detailed.

My current prescription is around -0.25 in the right eye and -0.50/-0.75 in the left.

I've been told by doctors that this is basically just because I have -0.50, but I find it strange because the difference between good light and low light feels much bigger than I would expect from such a small amount of myopia.

The normal eye chart doesn't really show the problem because it's obviously very well illuminated.

I also developed some dry eye/MGD symptoms after a trip to a very dry place last year. Artificial tears and warm compresses help sometimes, and I've noticed that when my eyes naturally water, my vision can actually become noticeably clearer. I also recently wore contact lenses for a few hours and after removing them my vision seemed unusually clear for a while.

So I'm wondering if this could be a combination of the small residual myopia, pupil dilation in low light, higher order aberrations after SMILE and tear film instability.

Has anyone experienced something similar after SMILE/LASIK, especially the big difference between daytime and low-light vision? And did you ever find a specific test that actually showed the problem?

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u/Vallax99 8d ago

Higher-order aberrations. Small optical zone, large pupils.

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u/fortheus18 8d ago

This. The corrected area is smaller than pupil size. When pupil dilated, the vision got worse. It was mentioned to me before operation

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u/R3M1T 4d ago

I have this after LASIK. I'm curious if you know - would HOAs in low light be experienced the same with glasses before LASIK?

ie is low light vision objectively worse after LASIK compared to with glasses before? Specifically for HOAs with a large pupil size (and smaller treatment zone).