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People Who Have Had Refractive Surgery

Vision changing years after refractive surgery is common and has several possible causes: normal prescription drift, developing cataract, presbyopia, or corneal irregularity. Each needs a different answer.

“My vision was great after LASIK and now it is not.”

Vision drifting years after surgery, or persistent dry eye that never resolved.

Refractive surgery corrects your prescription at a point in time. It does not stop eyes changing afterwards, and a surprising number of post surgical patients assume it does and then worry when vision drifts.

The most common explanation over forty is presbyopia, which has nothing to do with the surgery. After sixty it is often early cataract. In between it can simply be normal refractive drift.

Less commonly, the corneal surface is irregular in a way that glasses cannot correct well. Post surgical irregularity responds very well to scleral and rigid lens fitting, which restores a smooth optical surface over the treated cornea.

Dry eye that never resolved is the other frequent issue, and it is treatable rather than something to live with.

What matters most for this group

Vision drifting: Presbyopia, cataract or normal drift are the usual causes. Each is assessable and each has a different answer.
Persistent dry eye: Surgery interrupts corneal nerve signalling, and for some people tear production does not fully recover. It is treatable.
Night vision effects: Halos and starbursts can persist. Corneal mapping shows whether the surface is contributing, and specialty lenses sometimes help.

Where to start