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LASIK changes the shape of the cornea to correct refractive error. Most patients are satisfied with their results, but some develop persistent or new symptoms such as blurred or fluctuating vision, glare, halos, starbursts, ghosting, dry eye, burning, or contact lens intolerance. These concerns do not all have the same cause, so a comprehensive examination is needed before treatment options can be discussed.
Dr. Edward Boshnick evaluates patients whose post-LASIK symptoms may be associated with an irregular corneal surface, ocular surface disease, or corneal ectasia. When glasses or conventional contact lenses do not provide adequate vision or comfort, a custom scleral lens may be considered as part of an individualized management plan.
Possible LASIK Complications and Persistent Symptoms
- Overcorrection or undercorrection: The remaining refractive error may leave a patient nearsighted, farsighted, or astigmatic and still dependent on glasses or contact lenses.
- Irregular astigmatism: An uneven corneal surface can produce smeared, doubled, or distorted vision that may not be fully corrected with glasses.
- Glare, halos, starbursts, or ghosting: These visual symptoms can be more noticeable at night or in low-contrast conditions. Their cause must be identified before an optical correction is selected.
- Dry eye and ocular surface symptoms: LASIK can cause or worsen dryness, burning, light sensitivity, fluctuating vision, or discomfort. Learn more about dry eye evaluation and management.
- Flap or interface problems: Flap irregularity, inflammation, infection, striae, or other interface concerns require diagnosis by an appropriate eye-care professional and may need medical or surgical management.
- Reduced best-corrected vision: In some cases, the sharpest vision obtainable with conventional glasses or soft lenses is reduced after surgery.
- Post-LASIK corneal ectasia: The cornea can progressively thin and steepen, causing increasing refractive error and distorted vision. Read about corneal ectasia.
- Epithelial ingrowth: Surface cells can grow beneath the LASIK flap. Some cases are observed, while symptomatic or progressive cases may require treatment by a corneal surgeon.
Dr. Boshnick’s evaluation focuses on determining whether a specialty lens can address the optical or ocular surface component of a patient’s symptoms. Depending on the case, testing may include corneal topography, tomography, tear-film and ocular surface assessment, and an on-eye diagnostic lens evaluation.
For a lens-focused explanation of candidacy, diagnostic measurements, fitting, and realistic expectations, read Scleral Lenses After LASIK and RK.
A scleral lens is a large-diameter gas-permeable lens that vaults the cornea and rests on the tissue over the sclera. Before application, the bowl is filled with sterile, preservative-free saline. For selected patients, the lens can create a smoother optical surface over an irregular cornea and maintain a fluid reservoir over the ocular surface. It does not reverse LASIK, stop every disease process, or address every cause of post-LASIK symptoms.
How Scleral Lenses May Help After LASIK
- Optical correction: A well-fitted scleral lens may create a more regular refractive surface over an irregular cornea, improving visual clarity or stability for selected patients.
- Ocular surface support: The fluid reservoir may help protect and hydrate the cornea during lens wear for appropriately selected patients with post-LASIK dryness or ocular surface disease.
- Individualized design and follow-up: Lens clearance, landing, stability, oxygen transmission, comfort, and vision are evaluated together and may require refinement over several visits.
When glare, halos, ghosting, or reduced contrast are related to measurable optical irregularities, Dr. Boshnick may also evaluate whether wavefront-guided scleral lenses are appropriate. Not every patient needs wavefront correction, and no specific result can be guaranteed.
A peer-reviewed review describes scleral lenses as a management option for selected patients with complications after corneal refractive surgery, including irregular corneas, ectasia, and dry eye. An examination is still necessary to determine the source of symptoms and whether a specialty lens, medical therapy, surgical care, or another approach is most appropriate.
What to Do When Vision or Comfort Changes After LASIK
- Do not assume every symptom has the same cause. Dry eye, residual prescription, an irregular corneal surface, flap or interface problems, ectasia, and other eye conditions can produce overlapping symptoms.
- Seek prompt care for warning symptoms. Severe pain, sudden or worsening vision loss, marked redness, discharge, or increasing light sensitivity requires urgent professional evaluation.
- Bring prior records when possible. Operative reports, pre-LASIK measurements, prescriptions, and previous imaging may help the examining clinician understand how the cornea and vision changed.
- Evaluate the cornea and ocular surface. Refraction, corneal mapping, tear-film assessment, and other testing can help distinguish an optical irregularity from ocular surface disease or another cause.
- Consider a diagnostic lens assessment when appropriate. An on-eye lens trial can help determine whether a custom scleral lens is likely to improve the optical or ocular-surface component of the symptoms.
Depending on the findings, care may involve medical treatment, specialty lenses, monitoring, referral to a corneal surgeon, or a combination of approaches. A scleral lens is one possible management tool, not a replacement for diagnosis.
Request an evaluation with Eye Freedom.
Medical Sources
- FDA: LASIK risks and possible complications
- FDA: What to expect after LASIK and when to contact a doctor
- Peer-reviewed review: Advances in scleral lenses for refractive surgery complications
This page is educational and does not provide a diagnosis or individualized treatment plan. Contact an eye doctor promptly for new or worsening symptoms; severe pain or worsening vision requires urgent evaluation.
Frequently Asked Questions
Possible concerns include dry eye, glare, halos, starbursts, ghosting, fluctuating or distorted vision, residual refractive error, irregular astigmatism, flap or interface problems, epithelial ingrowth, reduced best-corrected vision, and corneal ectasia. An examination is needed because similar symptoms can have different causes.
They may be evaluated when post-LASIK symptoms are associated with corneal irregularity, ectasia, severe dry eye, or ocular surface disease and conventional correction is inadequate. Candidacy depends on eye health, measurements, the cause of the symptoms, and an on-eye lens assessment.
A scleral lens may improve vision by creating a smoother optical surface over an ectatic cornea, but it does not stop ectasia from progressing. Medical or surgical management of progression must be discussed with an appropriate corneal specialist.
For selected patients, the fluid reservoir beneath a scleral lens may support corneal protection, hydration, and comfort during wear. Scleral lenses do not cure every form of dry eye, and eyelid, tear-film, inflammatory, and nerve-related factors may require additional management.
They may help when glare, halos, ghosting, or reduced visual quality are caused by an irregular corneal surface. They may not help when symptoms have another cause. Diagnostic measurements and a lens trial help clarify the likely benefit.
Scleral lenses should not be described as reversing LASIK or guaranteeing corneal healing. Their fluid reservoir may support the ocular surface during wear, and their optical surface may improve vision for selected irregular corneas. The underlying condition still requires diagnosis and monitoring.
Contact an eye doctor promptly for new or worsening symptoms. Severe pain, a sudden or worsening loss of vision, marked redness, discharge, or increasing light sensitivity requires urgent professional evaluation rather than waiting for a specialty lens appointment.
Schedule Your Consultation with
Dr. Boshnick
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7800 Sw 87 Ave Suite B-270
Miami, Florida 33173
