Why does my myopia keep progressing even after the age of 40 and after LASIK surgery?

It shouldn't keep progressing really.

There are a number of things that your ophthalmologist would want to know to determine the cause. One (which LASIK patients seldom remember) is: How much myopia was treated at the time of your surgery in diopters (your glasses prescription)? This is important because a common cause of the situation you describe is corneal ectasia. The most common cause of this in a LASIK patient is when the ophthalmologist treated over about -8 diopters. Since there is a direct relationship between how much myopia is being corrected in LASIK and how much corneal tissue is being removed, very high corrections can compromise the structural integrity of the cornea.

The second cause is having had any signs (at the time of LASIK evaluation) of any corneal irregularities. Corneal ectasia is the slow, progressive steepening and protrusion of the central cornea in response to over-thinning by LASIK or from a compromised corneal condition. This makes you more myopic, but the worst thing you could do is have more LASIK to correct it. If you had your LASIK in the early days, there was not the advanced diagnostic equipment we have now to identify this and rule out the patient as safe.

You should go to a corneal specialist after assembling as much of your eye history as possible.

Written by J. Trevor Woodhams, M.D. - Chief of Surgery, Woodhams Eye Clinic