- Are you a Candidate for LASIK? 5 Guidelines You Should Know
- Prescriptions within FDA-approved treatment parameters
- Ocular maturity, prescription stability and eye health
- General health
- Corneal shape and thickness
- Realistic expectations
- LASIK Eye Surgery
- Is LASIK eye surgery right for you?
- LASIK 101
- Clearer vision with LASIK
- 1. Age
- 2. Prescription Severity & Stability
- 3. General (Eye) Health
- 4. Balanced Expectations
- 5. Financial Commitment
- 6. Qualified Team
- Step 1: Learn more about the process
- Step 2: Schedule a consultation
- Interested in scheduling a LASIK consultation with Oregon Eye Specialists?
- 8 Reasons Lasik Eye Surgery Might Not Be Right for You
- Pros and Cons of Laser Eye Surgery: Is It Worth It?
- What Is Laser Eye Surgery?
- Is Laser Eye Surgery for Everyone?
- Positive Results From Laser Eye Surgery
- Poor Care and Double Vision
- Weighing the Pros and Cons
- Astigmatism and Subconjunctival Hemorrhages
- Is Laser Eye Surgery Worth It?
- Is laser eye surgery right for you?
- 1. You have a stable prescription and healthy eyes
- 2. You’ve got the right motivation
- 3. Your overall health is good
- 4. You have the right kind of prescription
- 5. You’ve explored the options
- 6. You know the risks
Are you a Candidate for LASIK? 5 Guidelines You Should Know
If you need glasses or contacts to see well, it is ly you have imagined what life would be to be able to see without them. You have probably thought about LASIK and wondered if you could be a good candidate for the laser vision correction procedure. It is an important question, because LASIK is an elective procedure, not a medical necessity.
Patients have the option of glasses or contact lenses, which have their own associated risks. The individual patient has to weigh the inherent risks and benefits to decide how to handle their vision correction needs and if a laser vision correction procedure is right for them.
An important deciding factor in choosing laser vision correction is the surgeon’s recommendation, which is whether or not a patient is a good candidate, because not everyone who wants a procedure should have it. In fact, on average between 15 and 20 percent of patients are considered ineligible for a procedure LASIK.
While every patient is unique, the following are general guidelines surgeons use in determining if a patient is a candidate for LASIK eye surgery:
Prescriptions within FDA-approved treatment parameters
- up to +6.00 diopters of hyperopia,
- up to 6 diopters of cylinder/astigmatism
- up to -12.00 diopters of nearsightedness
Ocular maturity, prescription stability and eye health
- LASIK is FDA-approved for people aged 18 and older who have achieved ocular maturity.
- A stable prescription, meaning your prescription hasn’t changed for at least two consecutive years.
- It is important for eyes to be generally healthy, free of diseases, injuries and infections.
Certain health issues and medications may interfere with the healing process, making laser vision correction a poor choice.
It is important patients share their complete health history with their surgeon to ensure a recommendation for candidacy based upon all available facts.
To determine if you are a candidate requires a complete eye examination with sophisticated testing to screen patents for these problems that may make you a non-candidate.
There are several absolute contraindications to LASIK. Many patients are not good candidates for laser vision correction because of systemic or ocular disease.
Conditions, such as cataracts, diabetes or autoimmune diseases lupus or rheumatoid arthritis, may make LASIK and other laser vision correction options not a good choice for some patients.
Also, certain medications, such as corticosteroids, acne medications, and pregnancy can affect the healing process.
Corneal shape and thickness
LASIK improves your vision by reshaping your cornea – the surface of the eye that helps focus light to create an image on the retina.
If your cornea is too thin or misshapen, or if you have eye diseases significant glaucoma or corneal scarring you are ly not a candidate for LASIK.
During your initial consultation, your ophthalmologist will measure the thickness of the cornea to make sure there is enough tissue for the reshaping required to achieve the desired amount of correction.
Understanding the limitations of laser vision correction is important to a satisfactory outcome. Patients with unrealistic or uninformed expectations for the procedure, recovery and results may not achieve their goals with an elective laser vision correction procedure LASIK.
Knowing if you are a candidate for laser vision correction is necessary for even considering a procedure.
The best way to determine if you are a candidate for LASIK is to work with a highly qualified surgeon and have a complete evaluation of your eyes and vision.
Then both you and your surgeon will have the information needed to make the best recommendation for you. To learn more about what to expect from a LASIK consultation, read here.
LASIK Eye Surgery
LASIK, which stands for laser in-situ keratomileusis, is a popular surgery that can correct vision in people who are nearsighted or farsighted, or who have astigmatism.
It’s one of many vision correction surgeries that work by reshaping your cornea, the clear front part of your eye, so that light focuses on the retina in the back of your eye.
When light doesn’t focus on your retina the way it should, your vision is blurry. Doctors call this a refractive error. The basic types include:
- Nearsightedness (myopia). You see things clearly when they’re close to you, but things farther away are blurry.
- Farsightedness (hyperopia). You see faraway things more clearly, but closer things are blurry.
- Astigmatism. This can make everything blurry because of how your eye is shaped.
Talk to your doctor about whether LASIK is right for you. You shouldn’t have the surgery if you:
The benefits of LASIK include:
- It’s been around for over 25 years. About 96% of patients reach their vision goals afterward. An enhancement can raise this number even more.
- There’s very little, if any, pain involved.
- There aren’t any bandages or stitches.
- If your vision changes as you age, your doctor can adjust it.
- You probably won’t need to use glasses or contacts as much, or at all, after LASIK.
As with any surgery, LASIK carries some risks, including:
- It’s a complex procedure. It’s rare, but there may be problems that permanently affect your vision. This is one reason to choose a surgeon who has a lot of experience with these surgeries.
- Rarely, you may lose your “best” correctable vision, the highest degree of vision that you had while wearing contacts or eyeglasses, after LASIK.
- Most insurance doesn’t cover LASIK.
Some patients have discomfort in the first day or two after LASIK eye surgery. Other side effects are rare and usually go away over time. They include:
Before LASIK, you’ll meet with a coordinator or eye surgeon who will talk about what to expect during and after the procedure. They’ll ask about your medical history and do a full eye exam.
This may include tests to measure the thickness of your cornea, refraction, and eye pressure. They may map your corneas and dilate your pupils. The surgeon will answer any questions you may have.
Then, you can schedule an appointment for the surgery.
If you use rigid gas-permeable contact lenses, don’t wear them for at least 3 weeks before your evaluation. Don’t wear other types of contact lenses for at least 3 days prior to the evaluation. Be sure to bring your eyeglasses so the surgeon can review your prescription.
On the day of your surgery, eat a light meal before going in, and take all of your prescribed medications. Don’t wear eye makeup or bulky accessories in your hair that might interfere with your head position. If you’re not feeling well that morning, call the doctor's office to ask what you should do.
Your doctor will give you drops to numb your eyes. You can also ask for a mild sedative.
They’ll use an instrument called a microkeratome or a femtosecond laser to make a thin flap in your cornea. They’ll peel it back and use another laser to reshape the tissue underneath. Then, they’ll put the flap back in place, and the surgery is done.
The LASIK procedure itself usually takes about 20 minutes. Plan to have someone drive you home after surgery.
Your eyes will be dry, even though they may not feel that way. Your doctor will give you prescription eyedrops to prevent infection and inflammation, as well as drops to keep your eyes moist. You might have a brief, slight burning feeling or blurry vision when you use them. Do not use any eyedrops without asking your doctor about them.
Your eyes will probably heal very quickly. Most patients notice better vision within a few days. Call your doctor if you have any problems or unusual side effects.
Don’t swim or use a hot tub for 2 weeks after surgery. You might get a plastic shield to protect your eyes while you’re sleeping for a few days.
Your doctor will tell you when to come back for follow-up visits. The first one will probably be a day or so after the procedure.
Your vision can still change after LASIK. You might have to use reading glasses as you get older. More than 10% of people need a second LASIK procedure some time later to restore the effects. But overall, 90% of patients have vision that’s between 20/20 and 20/40 after LASIK surgery.
Federal Trade Commission Consumer Information: “The Basics of LASIK Eye Surgery.”
American Refractive Surgery Council: “How Does LASIK Work? Everything You Need to Know About LASIK Eye Surgery.”
American Academy of Ophthalmology: “LASIK — Laser Eye Surgery.”
© 2020 WebMD, LLC. All rights reserved.
Is LASIK eye surgery right for you?
If you’re tired of relying on glasses or contact lenses to see clearly, you may be wondering whether LASIK surgery is right for you.
At Oregon Eye Specialists, we work with many patients who are qualified for LASIK – but not everyone understands whether they are a good candidate for this transformative procedure.
In this blog post, expert LASIK surgeons Dr. Jacqueline Ng and Dr. Martin Balish discuss the key characteristics of a LASIK candidate, and what you can do to empower yourself in this decision!
LASIK (laser-assisted in-situ keratomileusis) is a popular surgical procedure that corrects common vision problems ( nearsightedness, farsightedness, or astigmatism) to reduce your dependence on prescription eyeglasses and contact lenses.
With modern advancements in technology and relative price stability, LASIK has experienced rapid adoption since it was launched in the 1990s. Millions of people around the world have undergone LASIK with successful outcomes, and the more than 700,000 Americans per year who choose to correct their vision through LASIK have granted it the highest satisfaction rate of any elective surgery.
But how do you know if it’s right for you?
Clearer vision with LASIK
Your first step in determining whether to pursue LASIK corrective surgery is to go through a professional evaluation and consultation with your certified ophthalmologist.
Dr. Jacqueline Ng and Dr. Martin Balish of Oregon Eye Specialists are LASIK surgeons. Dr. Balish was one of the first in the region trained in refractive surgery techniques. We have asked for Dr. Balish’s insight into the key characteristics that qualify a patient for LASIK.
“Age can affect the general health of your eye, your ability to recover swiftly and easily from surgery, as well as the stability of your prescription needs,” says LASIK surgeon Dr. Martin Balish.
“Younger patients (early twenties and lower) often continue to experience changes in their vision – at which point LASIK is not a long-term solution.
Older patients (60 years and above) are more ly to have conditions such as cataracts, which means there may be alternative treatment options that will improve vision better than LASIK.”
General rule of thumb? LASIK candidates must be at least 18 years of age, and patients beyond the age of 60 should be checked for additional vision concerns ( cataracts) before considering themselves a strong candidate for LASIK.
2. Prescription Severity & Stability
“The benefits of LASIK are most significant for patients who rely on glasses or contacts for daily life – as the change in vision will not be as significant for patients who can get by without glasses and contacts,” says Dr. Martin Balish.
“Additionally, it’s important that your prescription has been stable for at least 1-2 years.
If your vision is undergoing change when you have LASIK, success can be short-lived and you may experience the need to resort back to prescription glasses or contact lenses.”
3. General (Eye) Health
LASIK eye surgery is a great option to treat common vision problems nearsightedness, farsightedness, and astigmatism. But if you suffer from a health condition that can affect how your body or eyes respond to surgery (or heal afterwards), you should plan to wait until that condition is resolved.
“Certain conditions autoimmune diseases, immunodeficiency states, diabetes, and some medications may prevent proper healing after a refractive procedure,” says Dr. Balish. “But there are eye-specific disorders that can also keep you from being a qualified candidate.”
“If you suffer from an eye disease keratoconus, glaucoma, cataracts, corneal disease, or other retinal and optic nerve diseases, you are ly not a great candidate for LASIK,” says Dr. Balish. “Additionally, LASIK surgery may aggravate certain eye conditions persistent dry eyes or past injuries.”
4. Balanced Expectations
Statistically speaking, LASIK is a low-risk surgery. 93% of LASIK patients who undergo a professionally-administered surgery have their vision restored back to 20/20.
However, as with any surgery, patients should be aware of and consider the risk of side effects and complications before making a decision.
“It’s incredibly important that patients have a full understanding that laser eye surgery, as with all surgical procedures, involves some risk,” says Dr. Balish. “In addition, both the final outcome of surgery and the rate of healing may vary from person to person and even from eye to eye in each individual.”
Patients should know that:
- While LASIK improves vision and reduces the need for corrective eyewear for a vast majority of patients, it cannot provide perfect vision every time for all activities and eyesight range for every patient. Occasionally, re-treatments may be required.
- Some patients experience residual side effects. Usually, these are not significant and resolve within several months of surgery – occasionally, they are severe enough to interfere with normal activities.
- LASIK surgery, as with all surgical procedures, carries a risk of complications. Fortunately, less than 1% of the millions of LASIK patients have experienced serious, vision threatening problems. Most complications represent delays in full recovery and resolve within months of surgery.
The best way to ensure your expectations are realistic is to undergo a full evaluation and consultation with a highly specialized LASIK team.
5. Financial Commitment
Most vision insurance plans do not cover refractive surgery LASIK because they consider it medically unnecessary – or “elective.” Because LASIK is considered an elective surgery, most patients must be willing and able to pay for the surgery out-of-pocket.
“While the cost of LASIK will vary from one provider to another, advancements in technology and rapid adoption of the procedure have kept the cost relatively stable since its introduction in the 1990s,” says Dr. Balish. “Patients today should expect to pay between $2,000 and $2,500 per procedure per eye.”
There are alternative options for to financing a LASIK procedure – Flexible Spending Accounts (FSAs) and financing companies that specialize in elective procedures.
6. Qualified Team
It may be tempting to choose a surgeon ly on cost, but there are many other factors that should go into selecting the right ophthalmic surgeon for your LASIK eye surgery. Dr.
Balish spells out some of these considerations:“In addition to cost, patients should weigh the experience and track record of their LASIK surgeon, the LASIK technology offered by that surgeon, the total cost to achieve desired results (pre- and post-operative care, prescription drops, etc.), and the overall patient experience.”
A qualified team to support your eye health needs is always recommended, especially when it comes to laser eye surgery!
Step 1: Learn more about the process
There are many pre- and post-operative activities that contribute to your experience with LASIK surgery. Learn more about the full LASIK patient experience, and understand what the right treatment plan sounds for you.
Step 2: Schedule a consultation
This is the easy part. If you are not already working with a LASIK-certified ophthalmic surgeon, there are hundreds to choose from in the state of Oregon. Start by asking your optometrist for a referral, and do some of your own research.
We recommend you choose a provider who has significant LASIK eye surgery experience, a track record of happy patients, and who provides you with readily-available information to make your LASIK decision.
Interested in scheduling a LASIK consultation with Oregon Eye Specialists?
Call today to schedule your evaluation: 503-935-5580
8 Reasons Lasik Eye Surgery Might Not Be Right for You
Not everyone is a good candidate for Lasik eye surgery. Several conditions may disqualify you from undergoing the Lasik procedure. Following are the top eight reasons Lasik eye surgery may not be right for you.
Sean Locke/Photographer's Choice/Getty Images
Lasik results are permanent. However, a person's eye can change throughout life. Little is known about how vision changes in a child's eyes and what influences those changes. Vision can change dramatically during the adolescent years. For this reason, results of Lasik may be temporary or unpredictable. Lasik is not recommended for anyone under the age of 18.
Having Lasik just before or after pregnancy is not recommended. Hormone fluctuations and perhaps fluid retention can cause changes to a woman's vision corrective prescription during pregnancy. She may become more nearsighted or develop a bit of astigmatism during pregnancy.
Hormone changes can lead to dry eyes during pregnancy and during breastfeeding. Dry eyes may make her eyes uncomfortable and could delay healing. In addition, to undergo Lasik, the eyes must be dilated.
The medications administered for dilation and after Lasik surgery could be absorbed through mucous membranes, which could be harmful the fetus.
Certain prescription drugs can interfere with Lasik results. For example, some steroids may delay healing and decrease best-corrected vision. Acne medications can cause significant dry eye. Having dry eyes can increase the chance of cornea scarring after Lasik. Your doctor will know if the prescription drugs you are currently taking are acceptable.
You are not a good Lasik candidate if your contact lens or glasses prescription is fluctuating. Most doctors prefer your prescription to be stable for longer than one year. However, one year is a minimum.
Prescriptions can fluctuate for a variety of reasons. Contact lens wear, diabetic blood sugar changes, and normal aging changes can cause your prescription to change over time. Lasik is a permanent procedure.
It makes sense to make sure your prescription is stable before having Lasik eye surgery.
Certain medical conditions can affect the way your body heals after surgery. Patients with autoimmune diseases are not good Lasik candidates. Many autoimmune conditions cause dry eye syndrome. A dry eye may not heal well and has a higher risk of post-Lasik infection.
Other conditions such as diabetes, rheumatoid arthritis, lupus, glaucoma, or cataracts often affect Lasik results. You should have had no eye infections or injuries within the past year prior to undergoing Lasik.
Infection and injury can leave behind corneal scarring that may have detrimental effects.
Having dry eye syndrome is usually a disqualifier for Lasik. A person with dry eyes has an increased risk for significant post-Lasik discomfort and a possible worsening of dry eye symptoms. Having dry eyes can also delay proper healing. This is not to say that a person with dry eyes cannot have Lasik.
Your eye doctor will examine you to determine the severity of your dry eye condition. Sometimes patients are placed on special dry eye medications before Lasik eye surgery. Certain procedures, such as punctal occlusion, may be performed to help the dry eye condition and minimize unwanted symptoms.
You should not expect perfect vision following Lasik. Many Lasik advertisements are misleading to people considering laser vision correction, often promising an end to wearing glasses or contact lenses.
While most patients who undergo Lasik have excellent outcomes, you should not expect perfect vision. Every patient heals differently after surgery.
After undergoing Lasik, there is always a possibility that you may need to wear reading glasses or corrective lenses for at least some activities, especially at night. If you expect perfection, you should reconsider having Lasik.
During Lasik, the area of the eye that will be lasered should only be 6 mm in diameter. This is true with most lasers used during Lasik. If your pupil normally dilates to 7 or 8 mm in the dark, you will probably have unwanted glare, halos or starbursts around lights at nighttime.
This is becoming less and less of a side effect, however, because newer lasers have treatment zones larger than 7 mm. Ask your Lasik surgeon which type of laser he uses and how large of a zone he or she can treat.
Special pupillary testing is usually done as a part of the pre-Lasik measurements.
It should be noted that patients with extreme levels of myopia and corneal thinning, or keratoconus, may not be LASIK candidates. You should be thoroughly evaluated by an ophthalmologist to rule out these conditions prior to proceeding with corneal surgery.
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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
U.S. Food and Drug Administration. When is LASIK not for me? Content current as of July 11, 2018.
Naderan M. Ocular changes during pregnancy. J Curr Ophthalmol. 2018;30(3):202-210. doi:10.1016/j.joco.2017.11.012
Steinert RF, McColgin AZ. Surface Ablation: Photorefractive Keratectomy, LASEK, Epi-LASIK, and Epi-LASEK. Published December 6, 2013.
Pros and Cons of Laser Eye Surgery: Is It Worth It?
Laser eye surgery is a complex and delicate medical procedure, where an eye surgeon cuts a circular flap on the surface of the cornea to remove the excess tissue that contributes to deteriorated vision. (Learn More) Hundreds of thousands of people get laser eye surgery every year, but it is not for everyone.
Some people have negative reactions to the operation because of pre-existing medical or lifestyle conditions. In rare cases, patients experience a decline in their quality of life after they receive the surgery. (Learn More)
In deciding whether the pros and cons of laser eye surgery make it worthwhile, patients should research how much of a benefit the procedure will be to them, how much it will cost (and what their payment options are), who the best doctor is to perform the surgery, and what short-term and long-term changes they can realistically expect. (Learn More)
What Is Laser Eye Surgery?
The American Refractive Surgery Council explains that the procedure is intended to correct long-term vision problems in people who are eligible to receive it.
It starts by a surgeon making a microscopic, circular incision into the cornea, the surface of the eye, with a femtosecond laser (an infrared laser that pulses at one quadrillionth of a second, creating infinitesimally small tissue disruptions in the cornea). This process takes only a few seconds.
When the cut is made, the surgeon carefully lips the newly formed flap to reveal the precise location of where the vision correction treatment will happen: right under the surface of the eye.
After that, a laser guided by a computer permanently cuts away the tiny pieces of tissue that are responsible for the vision problems. The flap is then put back into place, serving as a natural bandage to protect the treated part of the cornea as it heals from the operation.
Because of the precision afforded by lasers, only the cornea is impacted during surgery. No other part of the eye is touched or involved in the procedure, and the tissues around the cornea remain completely safe.
Before the surgery begins, the doctor administers numbing drops to anesthetize the eye. This renders the process relatively painless, although patients will ly experience pressure from the device that holds their eyelids open, preventing involuntary blinking. It is normal for some patients to continue to experience some discomfort for a few hours after the operation.
This does mean that patients are awake while the surgery is performed on their cornea, but the numbing agents (usually tetracaine or proparacaine) are very effective in blocking the nerve endings in the eye from feeling any pain.
Additionally, the laser is so perfectly calibrated that if your eye were to move, the computer-assisted tracking mechanism in the laser would follow your cornea.
Even if you were to sneeze, or to do something that makes your body suddenly move, the laser will automatically deactivate to avoid damaging any tissue in your eye.
Is Laser Eye Surgery for Everyone?
Laser eye surgery is an incredibly common and popular form of elective surgery. Ever since the procedure was approved by the Food and Drug Administration, around 10 million Americans have decided to use it, with 700,000 people getting their eyes operated on every year.
Having said that, it is not for everyone. Certain people have medical conditions, family histories, or environmental and lifestyle factors that might render them ineligible for the operation.
For example, a patient who has an autoimmune disorder, lupus or HIV, might be at risk if they don’t disclose this to their doctor. Conditions that involve the body’s inability to heal itself, or that render it more prone to infections, might mean that the cornea’s recovery is stunted.
An autoimmune disorder would most ly make a person ineligible to receive laser eye surgery for this reason.
Similarly, complications from diabetes can affect the eyes, and laser eye surgery cannot help with that.
Diabetes can also slow down recovery, so a diabetic patient who receives refractive surgery will ly experience a longer recovery time.
Patients who experience fluctuating blood sugar levels because of their diabetes will have to change their prescription medications on a regular basis, and this will complicate the cornea’s healing process.
Lastly, any conditions that cause dry eyes, such as high blood pressure and hormonal imbalances, can result in patients experiencing postoperative pain and delayed healing times.
In addition, a small part of the population experience persistent side effects and aftereffects of the surgery that negatively impact their recovery and quality of life. This can mean that, uncommon as though they may be, there are downsides to receiving laser eye surgery.
Positive Results From Laser Eye Surgery
To demonstrate this, Everyday Health profiled three people who underwent laser eye surgery, all of whom came away with very different experiences.
Michelle started losing her vision when she was only 27. She disd wearing glasses, and could never get used to contact lenses.
She was forced to squint to see signs and read menus, which led her to develop wrinkles in her forehead in addition to the progressive loss of vision. Her experience with laser eye surgery surprised her.
She was not expecting how quick and easy it would be, going to her appointment after her workday ended and leaving just two hours later.
The staff at the surgery center answered all of Michelle’s questions and “really put [her] at ease,” which complemented the research she had done to find the treatment facility that would be a good fit for her.
Laser eye surgery was very much worth it for Michelle. Her vision is significantly better than it was before the operation, and she only occasionally has to use eye drops. She described her experience as “wonderful.”
Poor Care and Double Vision
Not everyone has such a positive experience with laser eye surgery as Michelle did. Carole, aged 61, had to look at a computer screen for her job for up to 10 hours a day. She suddenly developed pain from her use of contact lenses and decided to get refractive surgery to take care of all her vision problems in one swoop.
However, even after her eyes recovered from the procedure, Carole noticed that she still had trouble making out images on screens. She had paid for follow-up care as part of the operation, but the service she received at her surgeon’s office left her frustrated.
Lastly, Elizabeth (aged 31) was told she was a good candidate for laser eye surgery. She struggled with dry and itchy eyes as a result of her contact lenses and made good on her interest to get her eyes surgically improved.
But immediately after her surgery, she started noticing the side effects: halos and seeing double when she tried to read. As a teacher, this represented a significant impairment to her livelihood and in her personal life as well. On more than a couple of occasions, her vision was so bad that she was unable to drive.
Just two months after her laser eye surgery, Elizabeth had to go back to wearing glasses fulltime. She had another procedure done on her eyes, but that was not enough to solve the problem of the halos she was seeing.
Weighing the Pros and Cons
It should be noted that most people come away very satisfied with their laser eye surgery. As the cornea is allowed to heal, there are immediate and dramatic improvements in their vision.
In as little as 18 to 36 hours, a majority of patients enjoy uncorrected vision that was as good as (if not even better than) their vision when they used glasses or contact lenses before receiving the procedure.
As recently as 2012, many children who have to wear glasses reported being bullied for that fact. For people who have issues of self-esteem because they have to wear glasses, or who are so averse to putting their fingers near their eyes that they struggle to wear contact lenses, laser eye surgery has the potential to assuage all their fears.
There are other reasons for not wanting to wear contact lenses. They can reduce the supply of oxygen to the cornea and impair the ability of the eyelids to naturally clean any toxins and allergens from the surface of the eye.
But as with any kind of surgical procedure, especially a procedure that has a significant impact on an organ as delicate as the eye, there are risks, and you should be fully aware of them before you make a decision. For example, the surgery might undercorrect or overcorrect.
In an undercorrection, the laser does not remove enough tissue from the cornea, so the patient still has vision problems even after the operation. In an overcorrection, the laser removes too much tissue, making the patient painfully sensitive to bright lights.
An undercorrection can be addressed by a second surgical appointment with a year, but an overcorrection is harder to remedy.
Astigmatism and Subconjunctival Hemorrhages
Astigmatism (a common imperfection in the curvature of the eye) is one of the conditions that can be addressed with laser eye surgery, but laser eye surgery that does not cleanly remove all tissue from the cornea can cause astigmatism in people who don’t have it or exacerbate the condition in those who do. This may require more surgery or continued use of corrective lenses.
Other issues include the development of subconjunctival hemorrhages, red spots forming on the sclera (the white part of the eye).
Subconjunctival hemorrhages tend to occur immediately after laser eye surgery, and they are caused by the suction ring that was used to hold the eye in place while the laser made the flap in the cornea.
They are effectively bruises on the surface of the eye. They can last from a week to a month, and they can be imperceptibly small or visibly cover most of the sclera.
Subconjunctival hemorrhages look distressing, but they are only cosmetic injuries, and they do not cause pain.
They will naturally clear within a few weeks of the surgery; however, some patients may have medical conditions that complicate what is an otherwise benign condition.
An eye surgeon conducting a preoperative evaluation will ly detect any red flags that suggest the patient might develop subconjunctival hemorrhages or whether they could go on to become a larger problem. In most cases, they will resolve themselves.
Is Laser Eye Surgery Worth It?
Despite the significant improvement to vision that laser eye surgery can bring, it is not a “miracle” cure. A number of patients might still need prescription glasses to see in low-light conditions or to read small print.
An important factor in the decision to get laser surgery is whether the realistic expectations are worth the cost and temporary inconvenience, such as taking a couple days off work after the surgery to allow your eyes to heal.
Ultimately, the question of whether laser eye surgery is worth the pros and cons depends on the investment (financial and otherwise) the patient is ready to make. It is a complex medical procedure with the possibility of rare problems occurring. In extremely uncommon cases, these problems might permanently affect the patient’s vision and their quality of life.
Doing due diligence research, and being completely honest with a doctor about any potential risk factors (no matter how innocuous), can help you and your doctor decide if laser eye surgery is right for you.
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How Does LASIK Work? Everything You Need to Know About LASIK Eye Surgery. (June 1, 2017). American Refractive Surgery Council.
LASIK Eye Surgery and Other Refractive Surgeries. (February 3, 2018). Web MD.
Eye Numbing Drops: Why Are They Used and Are They Safe? (September 14, 2018). Healthline.
LASIK: Know the Rewards and the Risks. (July 27, 2018). WebMD.
Diabetic Retinopathy. (May 30, 2018). Mayo Clinic.
6 Conditions That Cause Dry Eyes. (March 30, 2018). Verywell Health.
The Pros and Cons of LASIK Surgery. (May 5, 2010). Everyday Health.
Kids Who Wear Glasses Feel Worse About Themselves, Studies Find. (May 9, 2018). The Globe and Mail.
Adverse Effects of Contact Lenses. (1999). Contact Lens Use Under Adverse Conditions: Applications in Military Aviation.
Subconjunctival Hemorrhage (Bleeding in Eye). (January 10, 2018). WebMD.
Subconjunctival Hemorrhage: Risk Factors and Potential Indicators. (2013). Clinical Ophthalmology.
What Are the Disadvantages of LASIK Eye Surgery? (April 19, 2018). WebMD.
Is laser eye surgery right for you?
Source: Web exclusive, October 2010
If you begin every morning by fumbling for your glasses, then you may have already fantasized about having your vision corrected with laser eye surgery. The procedure involves re-shaping the cornea, which plays an important role in allowing your eye to focus correctly.
Laser eye surgery has proven highly effective in most people with vision problems’in fact, as many as 70 percent of patients will experience better than 20/20 vision once they’ve had the procedure. However, despite the fact that approximately 75,000 laser eye surgeries were performed in Canada last year, not everyone is an ideal candidate.
Here are a few factors that can help you determine if laser eye surgery is right for you.
1. You have a stable prescription and healthy eyes
If your prescription fluctuates every couple of years, then laser eye surgery probably isn’t for you. It’s also important that you have healthy eyes. ‘The corneal shape needs to be normal,’ explains Dr.
Guillermo Rocha, an ophthalmologist and Medical Director of GRMC Vision Centre in Brandon, Manitoba. He says there should be no evidence of a condition called ‘keratoconus,’ which is a degenerative disorder that causes the cornea to be thin and more conically shaped.
The laser essentially reshapes and thins the cornea, so if it’s not thick enough to begin with, then it won’t hold the new shape.
Also, if dry eyes are a problem for you, laser surgery is not your best bet, because you need a good ‘tear film.’ The process is also not suitable if you suffer from cataracts.
2. You’ve got the right motivation
Because it’s an elective surgery (in other words, it’s seen as non-essential, or cosmetic) having the right motivation is key. ‘You have to really want to do the procedure,’ says Dr. Daryan Angle, an optometrist with IRIS, the Visual Group in Waterloo, Ont.
If you have a high prescription and you don’t the restriction of glasses, if you don’t want the trouble of contact lenses, if you’re a sports enthusiast, or if you just prefer the way you look without glasses, laser eye surgery may be for you. But if your glasses are only a minor inconvenience, you may not be sufficiently motivated.
After all, while laser eye surgery is considered low risk, it is still surgery and should not be taken lightly.
3. Your overall health is good
If you suffer from collagen vascular disease, rheumatoid arthritis or lupus, Rocha recommends avoiding laser eye surgery. That’s because, he says, people with diseases that affect the immune system may have complications when it comes to healing.
4. You have the right kind of prescription
Laser eye surgery tends to work best for people who have myopia, or near-sightedness‘meaning they can see things up close, but everything else is blurry. It can also be used to correct hyperopia (far-sightedness) and astigmatism.
But if you’re over 45 and are finding yourself squinting when you read’a condition called presbyopia, which becomes more common as we age’laser eye surgery may not be the best solution. ‘It can be corrected in certain circumstances,’ says Rocha, ‘but it’s not as well established.
’ In some cases, you may still need reading glasses, even if you’re had your distance-vision corrected.
5. You’ve explored the options
The two most common types of laser eye surgery in Canada are LASIK (laser-assisted in situ keratomileusis) and PRK (photo-refractive keractectomy).
Though both procedures have been in use for at least 20 years (PRK since 1986 and LASIK since 1990), LASIK has become the most popular in North America. While both surgeries use the same kind of laser, the difference is in how the surgeon goes about preparing the eye.
With PRK, the surgeon removes the outer layer of the cornea with a blade, then uses the laser beam to vaporize the tissue just under the surface of the cornea. With LASIK, the surgeon cuts a flap in the cornea, then lifts that flap to let the laser in.
Though LASIK surgery may be viewed as more complicated for the surgeon, the eye recovers more quickly and doesn’t take as long to heal. In fact, Rocha says you can be ‘back in business’ by the next day.
6. You know the risks
Though complications from laser eye surgery are rare (current statistics indicate less than one percent of surgeries), they can happen.
‘Basically, when you remove that flap [in LASIK], and send the laser into that middle tissue [of the cornea], it can become inflamed,’ says Angle. ‘But it’s not serious as long as it’s treated appropriately with steroid drops and careful monitoring.
’ Rocha says that with PRK, there can be a small risk of scarring, but that overall, it is very rare to completely lose vision with any kind of laser surgery.
Once you’ve had eye surgery, you’ll still need to have your eyes examined regularly to make sure they’re still in good shape. And no matter what kind of laser eye surgery you’re considering, you should start by consulting a qualified optometrist who can advise you on what’s best for your eyes.
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