You have gone on long enough wanting crystal clear and crisp vision without the bother of annoying or contacts. There hasn’t been a better time to have LASIK eye surgery done, this advanced technology is unbelievably safe and precise. Call us and schedule a free consultation.
People everywhere agree that there is no replacement for skill and knowledge, especially when we are talking about something as important as your eyes. If you are considering LASIK surgery then you probably want the most experienced LASIK eye surgeon you can find. An surgeon who’s hard work and commitment to his craft has earned him the esteem of not only his patients, but also his colleagues. Let’s face it, you deserve a surgeon like this.
You may be wondering if you are a good candidate for LASIK eye surgery. Maybe all of your questions haven’t been answered about the procedure. If you are wondering “Is LASIK right for me?” or have any other questions or concerns the we implore you to take us up on our free LASIK consultation. No pressure, no strings attached. We also want to make sure you are a great candidate.
It sounds like something straight out of Star Trek, but one of the parts of the eye which determines how clearly we can see is called the, “crystalline lens.” A quick look at this structure helps make a mental picture of one way that things get out of focus. The crystalline lens differs from a contact lens but, if you picture a contact lens on the eye, held in place by fibers that attach to a muscle, you can picture how the crystalline lens would change shape slightly as the muscles relax or contract. This change in shape is called accommodation and, as we age, the lens begins to lose this flexibility. This is eventually true for everyone whether they ever have eye surgery or not.
Light first enters the eye through your cornea and, together with the crystalline lens, the light waves are brought into focus at the back of the eye, on the retina. The reason that we say, “focus like a laser beam,” is because a laser has the ability to create waves of light that all point the same way, have the same wavelength and are very controlled.
For the eye to have a clear focus, the lens, cornea and shape of the eye all have to work together to make incoming light focus at exactly the right place on the retina. If the waves come together and make a focal point that is shorter (you are near-sighted) or farther away (you are far-sighted) than the distance to the retina, then the view is out of focus and fuzzy or blurry. Adding another lens, as you do when you wear glasses or contacts, helps adjust the incoming light so it will focus on just the right spot.
Another way to make this adjustment is to use a laser to change the shape of the cornea and this is the adjustment that is made with Lasik eye surgery. Those with astigmatism have irregularities in the cornea, so Lasik eye surgery can be used to correct these flaws as well.
As technology advances, it may seem harder and harder to answer this question because each depends on the other for good results. But make no mistake, the knowledge, skill and experience of the doctor are far more important than the machine itself. Nevertheless, continual advances in the technology make extremes of accuracy and precision ever more available to the average patient. These advantages also make the surgery amazingly quick with very minimal discomfort, if any.
The machinery can make many sophisticated measurements and it can track your eye movements so rapidly that you don’t need to worry about your eyes moving during surgery. A speculum is applied, which does not hurt, and is used to keep your eye open. Anesthetic drops in the eye also reduce irritation, so you don’t need to be concerned that your movement or responses during laser eye surgery will result in damage to your eyes.
However, only a doctor can determine the suitability of a particular procedure for your particular vision deficit(s). Some factors which can help predict your benefits and risks from laser eye surgery are your age, medical history, lifestyle and goals. The doctor must also consider the likelihood of some regression, which is a mild tendency for the eyes to return toward their previous state before the surgery.
The doctor may decide to make a slight under or over correction if it is felt that this will give the best lasting results. Newer equipment often translates to better results for patients as improvements are made constantly, but no amount of machinery can take the place of a competent, caring physician who places the well-being of patients before all other considerations.
Here are some terms you might find useful when discussing your surgery options. These are simple explanations, but will assist with basic understanding and help you feel more comfortable with some of the words you will hear.
Laser – Light Amplification by Stimulated Emission of Radiation. The light is “amplified” because all of the light waves are synchronized or all doing the same thing at the same time. Normal light emits a variety of wavelengths going in many different directions. The stimulated emission of radiation means that very specific atoms are controlled as to how they eject light particles and the exact wavelength of those particles. Then, special lenses focus them all very precisely which means that the doctor can use the laser to direct a very specific amount of light precisely where it needs to go and nowhere else. Very cool. Lasers can do lots of different jobs, but those used in Lasik are designed to do very specialized jobs. All light is a form of radiation, but the radiation used in vision surgery lasers is not related to radioactivity and does not cause cancer.
Lasik – Laser-Assisted in Situ Keratomileusis. This means that a special laser (excimer laser) is used to reshape the cornea of the eye using a corneal flap technique.
A few other procedures are mentioned here as they are alternatives to Lasik which your doctor may discuss with you if you are a poor candidate for standard Lasik or have several choices available to you.
Wavefront Lasik (Custom Lasik) – This is also sometimes called wavefront-guided Lasik and uses special mapping techniques to treat both basic refractive errors, like nearsightedness and farsightedness, but also higher order aberrations such as difficulty with night vision and poor contrast sensitivity. A manufacturer of contact lenses now claims to use corneal mapping technology to produce contacts which offer some of the same benefits. Clearly, correcting higher order aberrations results in improved vision for many people, though the costs may outweigh the benefits for your situation.
PRK – Photorefractive Keratectomy. This is similar to Lasik in that it also uses an excimer laser, but no corneal flap is made. This makes it a possible alternative to Lasik if you have thin corneas, are extremely nearsighted or are at known risk for ectasia. It can minimize other risks like epithelial in-growth, but has a longer recovery period which may be more painful and usually requires the use of steroid eye drop for several months.
There are a number of eye surgery techniques for vision improvement that do not use lasers or use other variations on laser techniques. They are usually used to offer further choices to those who cannot have, or may not benefit from, laser eye surgery alone. If you speak with several different eye doctors, you may get somewhat differing opinions as to which types of surgery are better, which laser is better, which option is best for you.
Other considerations that may affect your decisions as to whether to have Lasik are best corrected vision and higher order aberrations. The average person may not be too concerned about either one, but those in certain occupations or who have certain interests may care a great deal. Your doctor is best suited to help you decide how important any of these things are to your vision and your goals, but it helps to know which questions to ask.
Lower order aberrations are the standard ones treated by Lasik such as near-sightedness, far-sightedness and astigmatism. Lower order doesn’t mean less important as these are the things most people care about the most. Higher order aberrations are those that affect more subtle aspects of your vision such as how well you see at night and the amounts of glare or shadow you detect. When it gets harder to read in dimmer light, this means that your contrast sensitivity has decreased.
Your best corrected vision is the best vision you can get with glasses or contact lenses. For some people this is 20/20 and for those who are legally blind it is 20/200 or worse, so there is a wide range even with correction. The advantages and risks of custom wavefront-guided Lasik are still being debated. It is more expensive, but also has the potential to correct higher order aberrations and some surgeons use it to treat patients who have these as a result of previous standard Lasik surgery, so you can see that there is still some gray area in this. All Lasik patients should be aware that there are changes to best corrected vision as a result, especially if they may still need to use glasses or contacts for some reason.
The vision needs of a landscape artist are different than the needs of someone who typically draws insects just as the visual needs of a sailor differ from a seamstress. So, while you want to see as well as possible, you also have to consider your general lifestyle choices, possible side-effects or unintended consequences as well as costs. But it is definitely worthwhile to learn about available treatments and be able to discuss the potential pluses and minuses with a doctor who understands your particular needs.
Laser eye surgery is rarely considered medically necessary, which is why insurance usually won’t cover it, but this fact is also a reminder that you are taking risks for something you don’t technically need. The likelihood of serious, irreversible damage to the eye is extremely small and the overall satisfaction rate with Lasik eye surgery is very high, but this doesn’t mean that everyone gets exactly the results that they were hoping for or that bad things never happen.
Most post surgery problems are minor and resolve within weeks or a few months. Some patients may need to use antibiotic, steroid or moisturizing eye drops for a period of time and it’s very important that you do this exactly as directed if your doctor recommends it. These are prescribed for healing and eye health as well as comfort and can help prevent complications.
Your doctor will do a number of tests and ask a series of questions which will help determine which procedure and how much correction should be done on each eye. This will also help determine the safety and suitability for your unique situation. Many problems are predictable in advance, but some are not. A very real risk for Lasik surgery is a condition called ectasia, where the cornea develops a bulge and this causes vision loss. You may be at risk for developing it even though your tests do not yet show this. Those with thin corneas or severe near-sightedness are at greater risk for developing ectasia if they have Lasik eye surgery.
This is one reason why it is so important to have a board certified surgeon with an excellent reputation and a lot of experience. Some doctors will perform surgery on anyone who meets certain minimum standards, while others are much more cautious. Patients with any known risk factor for ectasia can often have other vision correction surgery safely, but not Lasik. If your doctor recommends that you either avoid Lasik or any other procedure, this may be a huge favor to you even if it isn’t what you wanted to hear. It may also be possible that a conservative procedure could give you much improved vision without attempting to give you perfect vision. For some, this would still be a huge plus, while others would not want to take the risk for only modest improvement.
Other possible complications include permanent problems with night vision, starbursts, halos or chronic dry eye. You might have these issues already and not know it, assume they will all go away if you have surgery or develop them after surgery. Some can be caused by surgery or may occur anyway as your eyes age whether you have surgery or not.
Epithelial in-growth and loss of best corrected vision, as well as infection, are also small but real risks. A doctor with experience and high ethical standards are your best protections against risks, both those which can be reasonably anticipated and those that are rare, but unpredictable occurrences.
Real regression to any noticeable degree is fairly rare, provided the patient was a good candidate for Lasik to begin with, though it can happen and an enhancement may correct this. However, some people who can be helped by eye surgery should not undergo Lasik because the flap technique is more likely to result in problems for them.
Those who are extremely near-sighted, already have dry eyes or have thin corneas are at greater risk for regression and other complications and may be advised to have a procedure other than Lasik eye surgery. You may still be an excellent candidate for PRK, for example, which is like Lasik without the flap. This procedure generally requires a somewhat longer healing and adjustment time, but may be a better choice in the long run for certain patients.
The more severe your vision problems are, the more you may wish that something could be done to improve your vision. If your primary goal is to have less dependence on appliances such as glasses and contacts, a certain amount of regression may seem minor to you compared to being unable to see much of anything well without assistance.
Approximately 10% of patients wish to have enhancements after the initial surgery and some of the reasons for this are regression and problems with night vision, halos or glare under certain conditions. Usually the latter problems resolve by themselves in the months following the surgery, but not always. There are a variety of treatments for dry eyes, both before and after surgery, but it is important to carefully consider your position on the possibility of trading one problem for another. A serious complication is very rare, but only you can determine your willingness to accept a certain amount of risk in exchange for the likely rewards.
It may be several months until your eyes normalize completely, though for most people the positive benefits are almost immediate. Inevitably your eyes will begin to change as you age and this does not mean that the benefits of your previous surgery have been lost. Some people think they are becoming nearsighted again when the actual problem is normal presbyopia that occurs with age.
Even with newer lasers, regression remains a genuine issue and the surgeon should be able to discuss with you the likelihood of this in your particular situation, as some patients are more at risk of it than others. You may want to consider other alternatives and avoid taking any surgical risk if you are someone who would regret having had the surgery should any regression occur. Patients who will be happy only with perfect 20/20 vision should not undergo surgery for vision correction because it is impossible to guarantee this at the present time.
Whenever you encounter medical information that is new, there is a learning curve. You may come across things that begin to make topics more clear and then, as you learn more, it all begins to seem more confusing. As you do some research to help make decisions about your eye health and vision possibilities, it should help you to make your own list of questions for the doctor and alert you to some problems you might encounter so you can avoid them.
At some point, you have to rely on doctors and their staff to answer your questions and give you truthful information. They are the people who will do your tests, interpret the results, determine what those mean to you specifically, make recommendations, perform the surgery and provide any after-care you need. This is who you will call first with a problem should you have one.
Your screening should determine both your physical and mental readiness for the procedure. Has the doctor made an effort to be certain that your expectations are realistic or have you simply been assured that you either get 20/20 vision or it’s free? There is a huge difference. In one case, someone is listening to you and making sure you understand all the important aspects of your treatment. In the other case, someone is talking to you about money and statistical risk rather than your personal care or likelihood of achieving your desired goal.
The statistics are hard to come by as the FDA hasn’t published much, but each surgeon should be able to give their own statistics on some of the following: Number of procedures done by that surgeon, number of patients who achieved 20/20, number who achieved at least 20/40, number who had serious complications, number who had minor complications, and perhaps patient evaluation numbers on satisfaction questionnaires completed after surgery. Assuming the information is accurate and true, it can help give you an excellent idea of the success rates of that doctor. A reputable surgeon should be able to provide these figures and willing to do so. This will help provide concrete information that can be used to compare one surgeon to another. Also, the surgeon’s numbers may differ from one machine to another and one procedure to another.
There are a number of important factors to consider when thinking about having Lasik Eye Surgery, but two of the most important and basic considerations don’t involve any fancy numbers or complicated explanations. The reason for this is that Lasik surgery has a very low risk of the serious complications which people fear most – death or blindness. The safety data worldwide indicates a high level of overall safety and patient satisfaction with the results, but the likelihood of ending up in the category of those very happy with their outcome is much higher for those who have realistic expectations prior to surgery and those who know exactly why they want to have the procedure done.
Some of the most common reasons why people choose surgery are that glasses or contact lenses are a major nuisance due to discomfort from physical irritation, extreme dependence on them or fear of losing them and frequent activities that require the glasses to be taken on and off or contacts in and out. Anyone who has been suddenly awakened from a sound sleep only to face further panic because they cannot see without glasses or contacts knows that gut-wrenching feeling. The same thing happens if you are unable to read the buttons on a phone in an emergency or if you would be unable to drive should you misplace your glasses. Many people also suffer from serious irritations while wearing glasses or contacts because they are uncomfortable after hours of wear or under certain physical conditions that may occur on a regular basis. Your current level of unhappiness with the vision solutions provided by glasses or contacts is a good indicator of your readiness to benefit from laser eye surgery.
The other major consideration is whether you will be happy with only a 100% perfect outcome, meaning you that you want to consider your vision perfect under all normal conditions without any aids at all or whether you have a major goal or two and will be overjoyed with anything beyond that. This is critical because the patients whose primary goals are achieved are the happiest with the results. There are a wide variety of choices to make when it comes to the details and potential outcome of your surgery. Some people can’t imagine a vacation without a tote full of paperbacks while others want the freedom of the wind in their face as they gaze out on the glories of nature. Does your work involve a lot of small details or a lot of driving? The things you love and do the most, the ways in which you must live or love to live, are every bit as important as the limitations of your current or future eyesight when it comes to decisions about eye surgery. Give them a lot of thought.
That is perfectly understandable and, for many, it is now possible. It does help to know just what that really means because it will make discussing your vision with a doctor a lot easier. Where did the number “20” come from anyway and why does it mean “perfect” vision? Well, it doesn’t mean perfect vision even though many people think it does. It was chosen to indicate the smallest size of letters on a chart that most people, with vision considered to be perfect, can read from a distance of 20 feet, though being able to read the same line on the chart does not mean that you have perfect vision too. On that chart with the big letter E at the top center which we all recognize, there are other rows of letters and each of those sizes corresponds to a number which indicates what you can read while standing 20 feet away.
When a doctor or someone at the DMV tells you to read the lowest line that you can see and read, they can determine one aspect of your “visual acuity.” There are other measurements for this as well, but this test measures what you need to be able to see in order to drive safely, which is usually 20/40. While 20/20 tells about your distance vision, this visual acuity measurement also only tells about your sharpness and clarity of vision at a distance. So, 20/20 is definitely a good thing, but it’s not the only important thing when it comes to good vision, nor does having 20/30 vision, for example, mean that you have a serious problem with distance vision. However, a pilot must have better vision than that, at least when flying.
If you tell a doctor you want 20/20 vision, you haven’t told the doctor whether or not you would like to read a book without glasses because those numbers don’t apply to near vision. However, if the doctor knows that you have a career as a pilot or in law enforcement or the military, then the doctor will know that your distance vision is extremely important to you. This is just a small illustration of the value of understanding some of the basic terms when you have a discussion with your doctor.
The more I learn about laser eye surgery, the more convinced I become that those with realistic expectations are those most likely to be supremely happy about their decision to either have it or not. Not everyone can safely have Lasik surgery and not everyone can reasonably expect to have 20/20 vision afterwards. However, once you have the tests done and determine how a competent doctor assesses your risks and likely rewards, you can make an informed decision.
If happiness for you only means never wearing glasses or contacts again no matter how long you live or what you want to do, then you don’t understand what can and cannot be done. At some point, most people in their 40s and everyone over 50 will begin to notice the effects of presbyopia so even if you get perfect vision at a younger age with surgery, you will still be affected as you get older.
Someone who is 25 may not be that concerned with what happens in 15 years, though that may be a bit short-sighted, pardon the expression. On the other hand, if you are 30 and everyone in your family was wearing reading glasses by 40, you might view things differently. That was terrible. Either way, your doctor cannot decide for you what is most important to you. Listen carefully to the risks and imagine what your attitude would be if you were one of the unlucky few who had a problem in spite of great care or because you didn’t choose a doctor wisely.
It isn’t necessary to spend time worrying about pain. The vast majority of patients experience no pain during surgery and relatively little discomfort afterward. The only surgical anesthesia needed is some drops in the eyes so the needle-phobic have no worries there. Your eyes may be a bit sensitive for a few days although most people can return to work within a day or two of having Lasik. The use of the corneal flap generally makes recovery quicker which is part of its popularity and a successful eye surgery is truly an amazing and wonderful thing.
