Double/Alternating Hyperphoria

[MWatson1982]

I am a glasses wearer and have been off and on for the last 10 years.  While glasses are fine, I have always wanted contacts since I am a performer and do other hobbies where glasses are not physically practical.  I have also been interested in Lasik.  Im an uninsured person so it will be a while til I could save up for it and that is why Im asking now...

Will double/alternating hyperphoria conflict with the Lasik procedure?  There seems to be a shortage of info on double/alternating hyperphoria, and both older and younger eyed doctors have not had much info to give me.  Since this condition seems to be a neurological one rather than directly involving the eyes, what could happen when Lasik is applied to it?

[MWatson1982]

Would "trial contacts" properly deal with stigmatism of one eye and weakness in the other eye?

[Sandy Feldman, MD, MS]

As long as wearing a trial contact lens was successful, it is unlikely [but possible] that LASIK or surgery would cause worsening.  There are many reasons for difficulties with prolonged computer use.  I would avoid covering one eye if this worsens your symptoms.

[MWatson1982]

The eye doctor said that my problem was not with the eyes ( it cannot be corrected with glasses...and of course that means it cannot be corrected with LASIK as you said) but something to do with the brain and how things got set up when my brain was developing.  

So how exactly does the fusion get disrupted?  The few things I have noticed that "aggravate" my double hyperphoria is the "cover one eye than cover the other one -- back and forth" test at the eye doctors (which is how they found my conditino in the first place), extreme fatigue, exposure to strobe lights, and (as Im finding out just recently) working on the computer using 2 monitors (Im a graphics/web designer).  

I have no medical coverage so I would be paying for LASIK out of my pocket (as well as contact lenses) anyway.  I am not too concerned with LASIK not being able to fix my Alternating Hyperphoria, but I am concerned with it possibly making it worse.  Since I only get one set of eyes, I would be in quite a bad situation if something went wrong with my DDH.

[MWatson1982]

Is "Double Dissocated Hypertropia" yet a third term for "Alternating Hyperphoria" and "Double Hyperphoria"? If so,  Do I need to search for that on google as well.  It seems that not much has changed since I was 12, in the respect of there being very little information on this condition.  

[Sandy Feldman, MD, MS]

Dear MWatson1982,

You have a movement disorder of the eyes which occurs when fusion is disrupted.  If you can tolerate a contact lens and have no double vision, then a surgical procedure such as LASIK can be performed.  I would recommend that you first try wearing a contact lens, even if purely as a trial, before surgery to make sure that you will not have double vision.  Of course, the success of the contact lens trial may depend upon your prescription and its ability to be corrected fully with a contact lens.  Contact lenses as well as LASIK can give you the visual freedom that you seek.

Dr. Feldman

Sandy T. Feldman, M.D., M.S.
ClearView Eye and Laser Medical Center
San Diego, California

[John C Hagan III, MD, FACS, FAAO]

Lasik will not interfer with "Double dissocated hypertropia" however DDH is a disease of eye alignment so lasik will not help it either.  Even if you had insurance it would not pay for lasik.

JCH MD