Post-Surgery Vision Issues: Nearsightedness and Farsightedness After SMILE - Ophthalmology

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After undergoing SMILE (Small Incision Lenticule Extraction) surgery for myopia correction, it is not uncommon for patients to experience a range of visual disturbances, including issues related to nearsightedness and farsightedness. Your experience of having residual hyperopia (farsightedness) of 75-125 degrees, along with symptoms of blurriness and double vision, particularly when using a computer, is concerning and warrants further discussion.

Firstly, it is important to understand that the surgical process can lead to temporary changes in the cornea's shape and refractive properties. While the goal of SMILE is to achieve clear vision without glasses, some patients may experience residual refractive errors post-surgery. This can manifest as either nearsightedness (myopia) or farsightedness (hyperopia), depending on how the cornea heals and adapts after the procedure. The presence of hyperopia, especially in the range you mentioned, can indeed lead to visual discomfort, particularly when focusing on near objects, such as a computer screen.

The symptoms you describe—blurriness, double vision, and headaches—are often associated with uncorrected refractive errors. When the eyes are unable to focus properly, it can lead to eye strain, which is exacerbated by prolonged screen time. In your case, the hyperopic shift could be contributing to these symptoms, as your eyes may be working harder to focus on close objects, leading to fatigue and discomfort.

Regarding your question about whether individuals with a hyperopic prescription of 75-125 degrees typically experience such symptoms, the answer is yes. Many people with even mild hyperopia can experience visual discomfort, especially when engaging in tasks that require sustained near vision. It is not uncommon for individuals to require corrective lenses to alleviate these symptoms, even if their distance vision appears to be adequate (as indicated by your ability to achieve 1.0 vision on the eye chart).

In terms of addressing your concerns with the surgical team, it may be helpful to articulate that while your distance vision is acceptable, the quality of your near vision and overall visual comfort is significantly impaired. You can express that the symptoms you are experiencing are affecting your daily activities, particularly your work involving computer use. It may also be beneficial to request a comprehensive evaluation of your refractive status, including a discussion about the potential need for corrective lenses for near tasks.

Additionally, if your symptoms persist, you might want to consider seeking a second opinion from another ophthalmologist or optometrist who specializes in post-refractive surgery care. They can provide a fresh perspective and may offer solutions such as glasses for near vision, which could significantly improve your comfort and quality of life.

In summary, your experience of visual disturbances after SMILE surgery is not uncommon, and the residual hyperopia could indeed be the culprit behind your symptoms. Open communication with your surgical team about your specific concerns and the impact on your daily life is crucial. If necessary, exploring corrective options or seeking a second opinion may help you find relief and improve your visual experience.