Medically reviewed by Dr. Brandon Cohenmehr, OD Last reviewed
Post-LASIK Ectasia: Symptoms, Causes & Treatment
When vision drifts years after surgery.
A small number of LASIK patients develop ectasia: the treated cornea weakens and begins to bulge, like keratoconus arriving after surgery. Glasses stop feeling crisp, night vision fills with halos, and prescriptions keep changing. Imaging confirms it; real options follow.
- What it is
- Progressive corneal weakening
- Signs
- Ghosting, halos, shifting Rx
- Confirmed by
- Topography and tomography
- Managed with
- CXL + scleral lenses
Worth imaging if, after LASIK, you notice
- Vision that keeps worsening despite new glasses
- Ghost images or doubling in one eye
- Halos and starbursts growing at night
- One eye clearly weaker than the other
- Astigmatism increasing at each exam
Two-part answer
Cross-linking (co-managed with corneal surgeons) can stabilize a progressing cornea; scleral lenses then restore the sharp vision glasses can’t. Protection first, optics second.
The pathway
Confirm, stabilize, see.
- Corneal topography and tomography to confirm ectasia and set a baseline
- Monitoring for progression — the decision driver
- Referral for corneal cross-linking when the maps show change, with follow-up back here
- Scleral lens fitting for vision: a smooth optical surface over the irregular cornea, designed from profilometry
Not your fault
Ectasia is rare, and it is manageable.
- Modern screening has made it rarer; it still occasionally appears years later
- Vision changing after LASIK deserves corneal imaging, not just stronger glasses
- Most patients regain sharp functional vision with scleral lenses
Articles
By Dr. Brandon Cohenmehr, OD
Also consider
Next step
Changing vision after LASIK? Map it.
Book a corneal evaluation with topography and get a definitive answer from our optometrists in Los Angeles.