Appreciate you doing this thread. I have a couple questions.
Almost 50 and had Lasik 25+ years ago and now back in glasses. Pre-op refraction was:
OD -7.50 -1.75 x 165
OS -6.00 -2.50 x 2
Latest prescription that I haven't updated to yet:
OD -4.00 -1.00 x 150
OS -2.50 -0.75 x 165
I was considering contacts, since my glasses are getting heavier on my face but my optometrist said I can only use scleral lenses because of the topography of my cornea from Lasik? Unfortunately, that is way out of my budget! I have read on other forums where people have been successfully fitted with just soft contacts after Lasik so wondering why I cannot try soft or other less costly rigid lenses. Any recommendations?
Without seeing the topography I can’t judge. The problem is your high prescription pre lasik meant they took a lot of tissue during the procedure. Soft lenses likely won’t fit very well (if at all) and it’s doubtful you get the vision or comfort you would like from them. Scleral lenses will provide both of those to you.
My optometrist says I have genetic myopia to explain the extreme regression since Lasik. Does that mean there is nothing I can do to stop my eyesight deteriorating? I also have a very steep posterior pole and beginning signs of AMD. I had a sudden PVD in my right eye a couple years ago with some macular bleeding and now have permanent floaters. Are these all considered serious issues?
Some eyes just like going nearsighted. Especially if you sped a lot of time with near work. Best bet is reduce near work as much as possible (but isn’t alwyss practical). Those issues can be serious or can be minor. Thought to judge without seeing it.
For the AMD, they recommended Vitalux pills - do these actually work? Each time I start supplements (calcium, fish oil, etc), I get GI issues. The Vitalux bottle says it contains 40mg zinc/pill. Is there anything besides supplements to try? I've been referred back to the retinal specialist I saw for the PVD and still waiting for them to confirm appointment.
The evidence for Vitalux is pretty solid but the effect isn’t crazy high. It’s about a 6% reduction in degeneration vs the control group. What vitalux has that really helps is Lutein and Zeaxanthin. These carotenoids are found in leafy green veggies.
Here is a good list of them. https://www.verywellfit.com/learn-about-lutein-2505909
On top of that you should be doing the following
Not smoking, controlling Blood pressure, getting exercise, reducing weight and wearing UV protection.
And lastly, do you dilate patient eyes for annual exams in your practice and is it better than just a scan/photo? I haven't been dilated at the optometrist office since they got some fancy machine ~ 5 years ago. I think it's an OCT scanner? What tests should an annual exam actually consist of?
It depends. If you see a retinal specialist then it can be redundant for us to dilate. Even with the high end peripheral retina scans dilation g should be performed every couple years (for high prescriptions it is every couple years. For others every 5-6 year). The retina specialist will dilate your pupils every visit.
As for an eye exam. It should include visual acuity, prescription check, binocular vision assessment, slight lamp external eye exam and a thorough retinal exam at a bare minimum.
Sorry, that's a lot of issues I have when actually typed out! Thanks for any "insight" you may have.