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Impaired vision can be caused by age-related eye diseases, refractive error, or head injuries. Patients who suffer from eye diseases may have difficulty performing everyday tasks such as reading, writing, shopping, and cooking. Most eye diseases can be detected with yearly eye exams that include a visual acuity test, pupil dilation, measurement of intraocular pressure (IOP), and evaluation of the visual field (peripheral vision). If you think you may be suffering from an eye disease, it is important to visit an ophthalmology center for an eye exam. An experienced ophthalmologist can diagnose your condition and recommend the proper course of treatment.
A cataract is defined as a clouding of the lens of the eye, resulting in blurry vision. A cataract forms when protein in the lens begins to clump together and cloud a small area of the eye. Over time, this cloud will continue to grow and interfere with vision. Cataract treatment involves surgery to remove the natural, clouded lens of the eye and replace it with a clear, artificial one. There are several variations in both the removal and the replacement portions of the surgery. The technique used depends on both the patient and the ophthalmologist.
One of the leading causes of blindness, glaucoma is an eye disease that causes damage to the optic nerve. This damage results from an elevation in intraocular pressure (IOP). Elevated IOP occurs when the clear fluid that nourishes the tissues of the eye does not drain properly, causing fluid buildup and subsequent pressure. Over time, elevated IOP will damage the optic nerve and cause vision loss. There are also rare instances when glaucoma can occur without elevated IOP. Glaucoma cannot be cured, but it can be treated in one of two ways: medication or surgery. Both of these glaucoma treatments are aimed at lowering intraocular pressure. In the United States ophthalmology field, glaucoma medications are considered to be the first-line treatment for the disease. If this fails, your ophthalmologist will then consider performing glaucoma surgery to reduce intraocular pressure.
Macular degeneration, or age-related macular degeneration, is an eye disease that slowly destroys central vision and, if left untreated, can lead to blindness. Vision loss from macular degeneration occurs when the macula - a tiny area of the retina - becomes damaged. Although there is no known cure for dry macular degeneration, there is a treatment for the wet form of the disease. If diagnosed early, wet AMD can be treated by an ophthalmologist with laser therapy or photodynamic therapy (PDT). PDT cannot reverse damage already done, but it can stop blood vessel growth.
Diabetic retinopathy is a degenerative eye disease that occurs in people with diabetes. Diabetic retinopathy manifests itself gradually and occurs as a result of damage to the retina. If left untreated, this eye disease can lead to severe vision loss and/or blindness. Diabetic retinopathy does not always require treatment, but when it does, treatment is aimed at preventing further vision loss and improving impaired vision. There are two types of treatment utilized at ophthalmology centers for diabetic retinopathy: laser photocoagulation and vitrectomy.
Correction of Refraction Errors
Used to correct refractive errors, LASIK eye surgery is a treatment that reshapes the cornea in order to produce clear vision. The LASIK refractive eye surgery procedure can treat myopia (nearsightedness), hyperopia (farsightedness), and astigmatism, and reduce patients’ dependency on contact lenses and glasses. Because refractive errors impede the focusing ability of the eye, patients who suffer from these conditions experience blurred vision. LASIK eye surgery provides these individuals with an effective treatment option, where a predetermined amount of corneal tissue is removed. This reshaping of the cornea improves the eye’s focusing power and enhances patients’ visual acuity.
FIG: This is a photo of the excimer laser treatment being performed on the bed of the corneal flap. The laser is reshaping the cornea to correct the vision. The part of the procedure only lasts 10-90 seconds, that is good news, back to its original position and the procedure is complete
A good candidate for LASIK eye surgery must meet several general requisites. LASIK patients should be at least 18 years old, demonstrate no change in refraction for at least one year, and have realistic expectations regarding the results of LASIK eye surgery. Patients who have experienced an eye infection or injury in the past year should not undergo LASIK. If you are interested in LASIK, an eye surgeon or ophthalmologist can determine if you are a candidate for the procedure. During a comprehensive eye exam, your ophthalmologist will check your eyes and medical history.
To determine whether or not a patient is a good candidate for LASIK eye surgery, the ophthalmologist will conduct a pre- LASIK eye examination. Once completed, patients should follow certain guidelines in the days and weeks preceding LASIK vision correction.
The traditional LASIK vision correction procedure begins with the creation of a hinged corneal flap. After the eye is anesthetized with topical eye drops, the LASIK eye surgeon creates the flap on the outer surface of the eye to expose the underlying cornea. The flap can be created with a microkeratome (a hand-held device) or with the IntraLase® laser, which allows the surgeon to create the flap using a computer-guided laser. The cornea is then reshaped using an excimer laser and the flap is replaced.
After LASIK eye surgery many patients experience immediate improved vision, although it can take up to six months for vision to stabilize. Patients can expect a short LASIK surgery recovery period but there is usually little to no discomfort following the procedure. Follow-up exams ensure proper healing.
Most patients are extremely pleased with their LASIK results. LASIK eye surgery benefits include improved visual activity, freedom from corrective eyewear, and possibly new career opportunities. Patients who achieve a successful LASIK outcome can eliminate their need for glasses or contact lenses, and enjoy the freedom of clear vision at all times. Patients can play sports, swim, spend a day at the beach, and participate in various activities without the restrictions that glasses and contacts bring. LASIK eye surgery is a safe and effective treatment that has continued to gain popularity among patients.
A small number of patients – one to five percent – experience LASIK eye surgery complications. LASIK risks include sensitivity to light, haloed or glared vision, irregular astigmatism, dry eyes, loss of visual clarity, and sensitivity. Fortunately, advances in LASIK technology have dramatically reduced complications and many problems can be easily corrected with additional treatment
LASIK eye surgery has become the most popular vision surgery in the country. More than one million Americans undergo LASIK each year. LASIK surgery statistics and information from the FDA indicate that complications occur in just 1 to 5 percent of patients. In most cases, LASIK treatment provides patients with exceptional results, with many patients experiencing 20/20 vision or better following LASIK eye surgery.
If you are interested in LASIK vision correction but are nervous about undergoing a surgical treatment, read about the latest developments in LASIK technology. Advances in LASIK eye surgery now provide patients with the safest and most accurate form of treatment ever available. The development of the excimer laser made LASIK eye surgery possible. Excimer lasers are incredibly precise, only penetrating a microscopic amount of tissue at a time for remarkable accuracy. New-generation microkeratomes provide increased accuracy and safety for LASIK eye surgeons during the creation of the corneal flap. A microkeratome, or hand-held blade, allows the surgeon access to the cornea so irregularities can be corrected.
There are several things that will happen prior to LASIK vision correction surgery. Your doctor will perform a full eye exam and ask for your eye history to make sure your prescription has been stable for at least one year. During this examination, the doctor will determine whether you are a good LASIK candidate. In the days and weeks leading up to the procedure, LASIK vision correction patients will need to follow certain pre-LASIK guidelines.
Prior to LASIK vision correction surgery, your LASIK surgeon will perform a comprehensive eye exam to ensure that you are a good candidate for treatment. During this exam, a map of your eye will be created. This map will be used during the LASIK procedure so a precise amount of corneal tissue is removed, providing you with the clearest visual results possible. The pre-LASIK vision correction evaluation should include:
- Dilated exam to check for ocular irregularities
- Refractive error measurement
- Pupil and corneal thickness measurements
- Corneal topography map
- Tear function analysis
- Discussion of medical history, lifestyle, and expectations
This evaluation determines if the patient’s eye curvature is suitable for the LASIK procedure. If not, the surgery could result in tear problems or unstable vision. Additionally, the evaluation measures tear production. The eyes naturally produce fewer tears as we age and LASIK always causes temporary dryness. If a prospective patient has naturally dry eyes, LASIK vision correction may not a suitable option.
Contact lenses should not be worn in the weeks prior to LASIK vision correction surgery. This is because the success of LASIK is dependent on accurately measuring the shape and curvature of your cornea, which can be affected by lenses. A period of time without contacts restores your cornea to its natural shape. The Food and Drug Administration (FDA) recommends that LASIK patients adhere to the following guidelines:
Soft contact lenses should not be worn for at least two weeks prior to LASIK vision correction surgery.
Gas permeable contact lenses should not be worn for at least three weeks prior to LASIK vision correction surgery.
Hard contact lenses should not be worn for at least four weeks prior to LASIK vision correction surgery.
Following these standards will ensure that your refractive error is measured properly, resulting in an optimal LASIK surgery recovery period and superior vision correction.
On the day before LASIK vision correction surgery, patients should stop using any makeup, lotions, perfumes, or creams that may cause debris to get into the eye. Patients should also arrange transportation for after the surgery as it may take several days to adjust to the change in their vision. LASIK eye surgeons may request patients thoroughly wash their eyes to prevent any chance of infection.
On the day of your LASIK vision correction surgery, eat a light meal before going to the eye surgeon and take any doctor-prescribed medications as normal. Do not wear any makeup or lotion, as they may increase the likelihood of infection. Also, do not wear any bulky accessories in your hair that may interfere with positioning your head under the laser. Patients’ eyes will be measured again before surgery and the LASIK surgeon will once again go through the procedure, making sure you have no additional questions or concerns. An anesthetic and any needed anti-anxiety medication will then be administered. If you are not feeling well the morning of your surgery, call the doctor’s office to determine if the procedure needs to be postponed.
Most patients are extremely pleased with their LASIK results. The benefits of LASIK eye surgery are many, and include immediate vision improvement, the ability to discontinue using costly and frustrating corrective eyewear and contact lenses, and broadened social, recreational, and career opportunities.
One of the truly remarkable benefits of LASIK eye surgery is that most LASIK patients experience dramatically improved vision within mere moments of the procedure. While ideal visual acuity may take up to six months to achieve, it is very common for patients to demonstrate near-perfect vision during their follow-up examinations the very day after LASIK surgery, and to immediately discontinue the use of glasses or contact lenses.
After successfully undergoing LASIK eye surgery, one of the benefits patients are most excited about is their new-found freedom from corrective eyeglasses and contact lenses. In the vast majority of cases, patients enjoy visual acuity that is better than what they formerly experienced with the use of corrective lenses, and are no longer dependent on glasses and contacts. For many LASIK patients, gone are the days of worrying over broken glasses or lost contacts, packing cumbersome cleaning and storing solutions for a vacation, or paying for costly replacements each time refractive needs change. With LASIK eye surgery, patients not only enjoy incredibly clear vision, but also enjoy a life free from the daily hassles and expenses of glasses and contact lenses.
Patients who have undergone successful LASIK eye surgery find that travel becomes much more enjoyable and convenient because they no longer have to worry about packing a back-up pair of glasses or all the accessories necessary for contact wearers. Furthermore, such activities as swimming, cycling, sky-diving, and even spending a day at the beach become more pleasurable without the worries and hassles associated with corrective eyewear.
Perhaps the most life-changing of the many LASIK benefits is the heightened self-confidence many patients attain. After LASIK surgery, patients no longer feel as though their faces are hidden by glasses. Furthermore, many patients find that the ability to see more clearly than ever before helps them to be more outgoing socially. For instance, patients who were formerly disoriented while trying to navigate in a darkened environment with poor vision now feel more at ease in dimly-lit clubs and restaurants. Increased self-confidence not only enhances the social lives of LASIK eye surgery patients, but can also lead to a more satisfying love life and a dramatically enhanced professional life.
Laser Vision Correction Surgery FAQs
Is LASIK Safe?
LASIK is usually safe, provided you are a good candidate. The success rate for LASIK averages above 95 percent for most experienced LASIK surgeons. Do your researches to see if you are a good LASIK candidate prior to receiving laser vision correction surgery?.
What Are The Risks Associated With LASIK?
As with any refractive surgery, there are risks of LASIK complications. Common side effects of this laser vision correction surgery include:
- Starbursts
- Difficulty with glare and night vision
- Foreign body sensation
- Most of these side effects are temporary and should pass within a few days or weeks of the surgery.
- Approximately 1 to 2 percent of patients will have permanent side effects. Talk to one or more LASIK surgeons to find out if you could be prone to LASIK complications, or to learn about safer methods, including IntraLASIK and custom LASIK.
Is LASIK Painful?
Because of the minimal amount of tissue affected, the LASIK procedure is typically near-painless. Most patients complain of mild discomfort, but this usually can be controlled with medication.
What Results Should I Expect?
It is very common to see doctors advertising claims of 20/20 vision in all of their LASIK patients. However, LASIK statistics show that 20/20 vision does not occur with every surgery. You should expect to have improved vision and reduced dependency on your glasses and contacts.
What to Expect after LASIK Surgery
LASIK surgery takes less than 15 minutes to perform. Most patients experience improved vision immediately, although complete LASIK surgery recovery can take up to six months as vision takes some time to stabilize following surgery.
LASIK Surgery Recovery
Following LASIK surgery, patients can expect a short recovery period. You may be required to wear a protective shield over your eyes for the first night or two following the procedure. Your doctor may also instruct you to take antibiotic, anti-inflammatory, or moistening eye drops, and to wear dark eyeglasses if you experience sensitivity to bright lights.
Although LASIK complications can occur, most vision correction patients are able to return to work and other daily activities the day after the procedure. There is usually little to no postoperative discomfort after LASIK surgery and follow-up exams during recovery are required to ensure that your eyes heal properly. It is recommended that you go to sleep right after LASIK surgery to reduce post-operative pain. When you wake up, you should already notice improved vision.
LASIK Results
Nearsighted patients who undergo LASIK surgery typically return to functional vision the day after the procedure. Although some patients experience difficulty reading the first few days, this is normal, as it may take one to three months for final vision to stabilize.
Farsighted LASIK surgery patients usually experience dramatic results the day after LASIK. Although distance optics may appear blurry, this is also temporary.
Generally, it is considered more difficult to correct astigmatism than farsightedness or nearsightedness. Nevertheless, LASIK surgery statistics show that many astigmatism patients are still LASIK candidates and can achieve great results and dramatically improved vision.
LASIK Post-Operative Care
After LASIK surgery, you should lie down, relax, and close your eyes. Watching television, reading, or operating a computer should be avoided for the first 24 hours. The LASIK surgery recovery process requires your eyes to remain relaxed.
Do not rub your eyes. Protective eye shields should be worn for the first seven nights. Some patients report a mild burning sensation two to four hours into LASIK surgery recovery as the anesthetic wears off. The sensation resembles wearing an itchy or dirty contact lens.
Wear sunglasses after surgery – rain or shine. Take baths instead of showers for the first 24 hours after surgery and be careful not to allow the shower to spray directly into your face for the first week. Use a face cloth and be careful not to rub your eyes. Avoid eye makeup and smoky or dusty environments for a week. Avoid alcohol consumption for 48 hours after LASIK surgery.
Your surgeon or ophthalmologist will schedule follow-up appointments to monitor your LASIK results and potential problems such as epithelial growth. Contact your physician immediately if you experience any complications.
LASIK Risks
Most prospective surgical patients are aware that any surgery has inherent risks. LASIK eye surgery carries risks, as well. Though rare (occurring in about 1 to 5 percent of cases), some patients do experience laser eye surgery complications. To learn more about the potential complications of LASIK surgery, please read the page below.
Over/Under Correction
With LASIK eye surgery, overcorrection and under correction are both possible. These and other potential laser eye surgery complications can usually be attributed to the fact that corneas can vary greatly from patient to patient, in terms of water content, healing ability, and other variables that are beyond the control of the surgeon. While extreme cases of over- or under correction may necessitate further treatment, mild cases can be effectively addressed by wearing glasses when necessary.
Infection
As with any surgery, a risk of infection is possible with LASIK. If left untreated, eye infections can result in scarring on the cornea or significant and permanent loss of vision. However, eye infections from LASIK surgery are very rare. Antibiotic eye drops are normally prescribed after surgery to prevent infections, and patients should schedule regular post-operative visits to make sure eyes heal properly. If an eye infection does develop after your LASIK treatment, your surgeon will discuss treatment options with you.
Flap Wrinkles
Small folds in the corneal flap are among the most common complications of LASIK surgery, but the surgeon can easily identify and remove them. Also, within the first few hours following surgery, wrinkles can form in the corneal flap if the patient tightly shuts the eye. The surgeon can fix this by re-laying the corneal flap to smooth out any wrinkles. However, flap wrinkles are a rare laser eye surgery complication and occur in less than 1 percent of cases.
Central Corneal Islands
Central corneal islands are small areas of raised tissue that show up on the cornea when the laser used during surgery does not remove tissue uniformly. This type of complication occurs in less than 1 percent of LASIK cases, and can usually resolve itself after a few months. If central islands persist, the surgeon may prescribe contact lenses to smooth out the cornea surface or a laser touchup if necessary.
Epithelial Ingrowths
Another LASIK risk occurs when cells from the corneal epithelium start growing under the corneal flap. In some cases, these epithelial ingrowths will stop growing, die, and be absorbed into the cornea. But if the epithelial cells continue to grow, they can significantly affect vision. To treat this, the surgeon must lift the LASIK flap and remove the ingrown cells. However, this eye complication happens in less than 1 percent of LASIK cases.
Corneal Ecstasia
Corneal Ecstasia refers to a weakened cornea that may bulge out months after LASIK surgery. This occurs when the surgeon makes too deep an incision during the flap creation process or removes too much corneal tissue during surgery. Ecstasia can only be treated with a corneal transplant. If left untreated, the patient may have a recurrence of nearsightedness or astigmatism. This LASIK complication is rare and can be prevented if the thickness of a patient’s cornea is measured prior to surgery.
Diffuse Lamellar Keratitis (DLK)
Diffuse lamellar keratitis (DLK) is a post-operative LASIK risk that occurs when foreign bodies become trapped behind the corneal flap. Patients with DLK may experience pain, sensitivity to light, blurred vision, or the sensation that there is something trapped in their eye. Some patients experience no symptoms at all, but DLK can be detected during follow-up examinations after surgery. Symptoms typically present themselves within a week of LASIK surgery, but DLK complications have been known to occur even years after surgery if patients experience corneal trauma. Patients who experience any sort of eye trauma should be evaluated by an eye care professional. Though DLK is one of the more dangerous post- LASIK risks, it is easily treatable with topical and oral medication when caught in its earlier stages.
Astigmatism
In rare instances of laser eye surgery complications, a patient’s cornea can permanently warp as a result of scarring. This may lead to astigmatism and an inability to use traditional contact lenses. Astigmatism after LASIK surgery, known as induced astigmatism, may cause blurred or distorted vision. Patients who encounter astigmatism as a result of LASIK usually must continue to use corrective eyeglasses.
Presbyopia and LASIK Surgery
Prospective LASIK candidates should be aware that LASIK surgery does not prevent presbyopia – the decline of near vision as an individual enters middle age. Generally thought to be caused by a gradual loss of flexibility in the eye’s natural crystalline lens, presbyopia affects virtually everyone and generally requires the use of reading glasses. Learn more about presbyopia and other presbyopia treatments, such as IOLs, by visiting the appropriate DocShop pages.
Reducing Your Risk of Complications after LASIK
Advances in LASIK technology provide patients with choices that can reduce the risk of post- laser eye surgery complications and provide more precise results. With IntraLASIK, the surgeon uses a laser instead of a blade, or microkeratome, when creating the corneal flap, ensuring fewer flap-related complications. During custom LASIK surgery, a three-dimensional map of the eye is used to guide the excimer laser, providing superior visual results and less risk of corneal irregularity and over- or undercorrection. While these methods are considered safer, LASIK – like any surgery – does pose some risks, and some LASIK patients do experience complications.
LASIK Side Effects
Patients who are considering undergoing LASIK eye surgery should be aware of possible side effects that can occur. The most common side effects associated with LASIK include glare, halos with night vision, and dry eyes. In many cases, LASIK eye surgery side effects disappear within a few days to a few months following the procedure. However, it LASIK side effects last more than six months it is important to undergo an eye exam with your surgeon.
Sensitivity to Light
Sensitivity to light is one of the most commonly experienced LASIK side effects. While it will be tempting for patients to rub or touch their eyes when they experience this sensation, this could impede the healing process or damage the eyes during LASIK recovery. Light sensitivity generally subsides within the first few days after a LASIK procedure.
Halos, Starbursts, and Glare
Halos, starbursts, glare, and other general vision problems can occur when the corneal flap does not adhere correctly to the eye after it is replaced, or when the pupil dilates to a size that is larger than the treatment zone. These complications of LASIK surgery most commonly disappear within the first month after a LASIK procedure, but if symptoms persist, the use of glasses or additional treatment can usually remedy this problem.
Visual Regression
Loss of visual clarity or regression, one of the more uncommon LASIK side effects, is usually only temporary and occurs during the first few months of healing. Visual regression after LASIK surgery is usually caused by wrinkles or folds in the corneal flap or hazing of the cornea, and is typically resolved as healing progresses. Women on hormone therapy may be at particular risk of regression, and should discuss all medications they are taking with their doctor to avoid unnecessary laser eye surgery complications. If you are unsure if you are a suitable candidate for LASIK, please visit our page on LASIK Candidacy.
Dry Eye
One of the most common complications of LASIK surgery is dryness of the eyes, which can manifest itself in the form of redness, itchiness, blurred vision, crusting, or the sensation that there is a foreign body in the eye. Fortunately, post LASIK dry eye complications usually subside within the first three months after surgery, and are easily relieved by the use of preservative-free lubricating drops. If you are experiencing dry eyes after your LASIK procedure, contact your doctor to learn what kind of eye drops will most effectively relieve your symptoms.
Loss of Contrast Sensitivity
Loss of contrast sensitivity after LASIK surgery can impair the patient’s ability to clearly discern objects. This is particularly noticeable in low light conditions and may affect night driving ability. Patients usually find that contrast sensitivity returns to normal within six months.
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