Can Long-Term Insomnia Cause Vision Changes After Laser Surgery?

Q: Can Long-Term Insomnia Cause Vision Changes After Laser Surgery?

Hello： Laser surgery will not cause complications due to excessive insomnia. <br>Regarding night blindness, please visit a larger hospital to have an electroretinogram to determine if there are any retinal disorders. <br>Lack of sleep can lead to eye fatigue, which may exacerbate

Can long-term insomnia lead to vision complications after laser surgery?

Dear Dr.
Gao,
I underwent femtosecond laser surgery for my myopia (both eyes at -6.85 diopters) on December 9, 2011.
Prior to the surgery, I had mild presbyopia (+1.00 diopter).
I did not follow the doctor's advice to retain some corrective power, and for over a year post-surgery, I did not experience any significant presbyopia symptoms.
I frequently engaged in cycling without any issues, and my uncorrected vision in both eyes reached 1.2.
However, starting around February 20, 2013, I experienced severe emotional distress leading to chronic insomnia.
During the day, I noticed a deterioration in my overall visual field, which appeared dimmer.
By mid-March, I also noticed a decline in vision in my right eye, and after visiting the original ophthalmology clinic, the examination results showed 0.9 vision with significant floaters.
My left eye maintained good vision, and the attending physician indicated there was no major concern (no retinal tears).
However, as my insomnia persisted, I began experiencing alarming night blindness around late April.
My family does not have a history of this condition.
In low-light conditions, I found it nearly impossible to recognize objects, which caused me anxiety and made it even harder to sleep.
Recently, my left eye has also shown unexplained changes: I now experience astigmatism both during the day and at night, and the worsening presbyopia and uneven vision severely impact my work and daily life.
When I returned to the doctor to discuss my concerns, the only advice I received was to rest more and ensure adequate sleep for potential improvement.
I would like to ask you, Dr.
Gao, could this be a complication arising from the laser surgery due to excessive insomnia? Is there any treatment for the night blindness? What should I do? Thank you!

Feng Cheng Fei Fei, 40~49 year old female. Ask Date: 2013/05/26

Dr. Gao Pilin reply Ophthalmology

Hello: Laser surgery will not cause complications due to excessive insomnia.
Regarding night blindness, please visit a larger hospital to have an electroretinogram to determine if there are any retinal disorders.
Lack of sleep can lead to eye fatigue, which may exacerbate issues with accommodation, thus worsening presbyopia.
Only with adequate rest and sufficient sleep can improvement be expected.
Therefore, I recommend consulting a psychiatrist to address the insomnia issue as a priority! Thank you for your message.

Reply Date: 2013/05/26

More Info

Long-term insomnia can indeed have various effects on overall health, including vision, but it is essential to clarify the relationship between insomnia and any specific changes in vision after laser surgery, such as LASIK or femtosecond laser surgery.
Firstly, it is important to understand that laser eye surgery is designed to correct refractive errors, such as myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. The procedure reshapes the cornea to allow light to focus correctly on the retina, improving visual acuity. In your case, you underwent surgery for myopia and had a pre-existing mild presbyopia (difficulty focusing on close objects due to aging). Post-surgery, you reported good visual acuity without significant issues for over a year.

However, the onset of insomnia and subsequent visual changes you experienced, such as a perceived reduction in visual field, darkening, and the development of floaters, may not be directly caused by the laser surgery itself. Instead, insomnia can lead to increased eye strain and fatigue, which can exacerbate existing vision problems or create new ones. Sleep deprivation can affect the body's ability to recover and heal, potentially leading to issues such as dry eyes, blurred vision, and difficulty focusing.
The symptoms you describe, including night blindness and increased astigmatism, could be influenced by several factors. Night blindness, or nyctalopia, can occur due to a variety of reasons, including vitamin A deficiency, retinal issues, or even stress and anxiety, which can be exacerbated by lack of sleep. The fact that you are experiencing these symptoms alongside significant emotional distress suggests that your overall mental health may be impacting your vision.

Regarding the floaters and changes in vision, it is crucial to have regular follow-ups with your ophthalmologist. While the initial examination showed no retinal tears, ongoing symptoms warrant further investigation. Floaters can be a common occurrence, especially after laser surgery, but if they are accompanied by flashes of light or a sudden increase in number, it is essential to seek immediate medical attention.

As for the recommendation to rest and improve your sleep, it is vital to address the underlying causes of your insomnia. Chronic sleep deprivation can lead to a cycle of anxiety and stress, which further exacerbates sleep issues and can impact physical health, including vision. Consider consulting a mental health professional or a sleep specialist who can provide strategies to improve your sleep hygiene and manage anxiety.

In summary, while long-term insomnia may not directly cause vision changes post-laser surgery, it can contribute to eye strain and exacerbate existing conditions. Addressing your sleep issues and managing stress is crucial for your overall well-being and may help alleviate some of the visual disturbances you are experiencing. Regular follow-ups with your eye care provider are essential to monitor your vision and ensure that any potential complications are addressed promptly.

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