Post-LASIK Vision Issues: Seeking Expert Help for Double Vision - Ophthalmology

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Post-LASIK vision issues, particularly double vision, can be quite distressing and complex. Your experience of having undergone LASIK surgery six years ago, followed by significant changes in your vision, including the development of double vision and discomfort, is not uncommon. It’s essential to understand the underlying mechanisms and potential solutions for your situation.

First, let’s address the concept of double vision (diplopia). This condition can arise from various factors, including misalignment of the eyes (strabismus), issues with the eye muscles, or problems with the brain's ability to process visual information from both eyes. In your case, the fact that you can see clearly with one eye but experience diplopia with both eyes suggests a possible issue with binocular vision, which is the ability of both eyes to work together effectively.

Your description of needing additional plus power for near vision and experiencing symptoms like headaches, nausea, and dizziness indicates that your visual system is under significant strain. The need for ADD +2.00D for near tasks suggests that your eyes are struggling to accommodate, which is the ability of the eye to change its focus from distant to near objects. This can be exacerbated by the fact that you are relatively young and may not typically require such additional power for near vision.

The concern about undergoing another LASIK procedure to achieve emmetropia (zero refractive error) is valid. While it may seem like a solution to reduce the need for accommodation, it could potentially worsen your binocular vision issues. If your eyes are not able to converge properly (the inward movement of both eyes toward each other when focusing on a near object), then reducing the refractive error could lead to increased difficulty in merging images from both eyes, thus exacerbating the diplopia.

In terms of managing your current symptoms, it is crucial to work closely with an eye care professional who specializes in binocular vision and post-operative LASIK care. Here are some recommendations:
1. Comprehensive Eye Examination: Seek a thorough evaluation from an ophthalmologist or optometrist who specializes in binocular vision disorders. They can assess your eye alignment, accommodation, and convergence capabilities.

2. Vision Therapy: If your eye care provider determines that your binocular vision is impaired, they may recommend vision therapy. This is a structured program of eye exercises designed to improve coordination and visual processing.

3. Prism Glasses: You mentioned trying prism glasses, which can help align the images seen by each eye. It may take some time to find the right prescription that alleviates your symptoms without causing discomfort.

4. Regular Follow-ups: Since your symptoms are complex and multifaceted, regular follow-ups with your eye care provider are essential to monitor your condition and adjust your treatment plan as needed.

5. Consider a Second Opinion: If you feel that your current eye care providers are not addressing your concerns adequately, seeking a second opinion from a specialist in LASIK and binocular vision could provide new insights or treatment options.

As for recommendations for specialists in Taiwan, I cannot provide specific names, but I suggest looking for eye clinics or hospitals that have a strong reputation in refractive surgery and binocular vision. Institutions affiliated with universities often have specialists who are up-to-date with the latest research and techniques.

In conclusion, while your situation is challenging, there are pathways to explore that may help alleviate your symptoms. Collaborating closely with a knowledgeable eye care professional will be key to finding a solution that works for you.