FitSugar

Speak Up: How Do You Feel About Lasik Eye Surgery?

FitSugar — Thu, 25 Sep 2008 13:00:00 -0700

I started wearing glasses when I was in fourth grade and later switched to contacts. I can't see without either, especially the alarm clock in the early hours of the day. Every morning, the site of the fuzzy alarm clock sends thoughts of Lasik Eye Surgery running through my mind. It sounds so simple; you walk into the doctor's office, everything's blurry, and after the surgery everything's clear. While it sounds amazing, I do have a friend who had the surgery, but still needs to wear glasses. I guess for some folks, the success rate isn't that great.

Lasik is also super pricey, and I'm not sure I could go through with an operation like this knowing there's a possibility that it wouldn't work. Also, the actual procedure freaks me out a little. A laser in my eye? I don't think I'd ever be ready for that.

What do you think? Have you ever thought about having Lasik Eye Surgery? Have you already gone through this procedure? If so, would you recommend it to others? Do you know anyone who's had a bad experience? I'd love to hear your thoughts so share in the comments section them below.

LASIK eye surgery

admin — Thu, 04 Sep 2008 19:18:59 -0700

Illustrations

Lasik eye surgery - series

HEALTH GUIDE REFERENCE FROM A.D.A.M

Definition

LASIK is a surgical procedure that can reduce a person's dependency on glasses or contact lenses. The procedure permanently changes the shape of the cornea (the delicate clear covering on the front of the eye). For clear vision, the eye's cornea and lens must bend (refract) light rays properly, so that images are focused on the retina. If the light rays aren't clearly focused on the retina, the images you see are blurry.

This blurriness is referred to as a "refractive error." It is caused by an imperfectly shaped eyeball, cornea, or lens. LASIK uses an Excimer Laser (an ultraviolet laser) to precisely remove corneal tissue to correct the shape for better focusing.

LASIK eye surgery is performed most often on people who have nearsightedness (myopia), which means that they only clearly see nearby objects; anything far away is blurry.

Alternative Names

Laser-Assisted In Situ Keratomileusis; Laser vision correction

Description

A complete eye examination will be done before surgery to make sure your eyes are healthy. Once this is determined, the doctor will measure the curve of the cornea and the size and position of the pupils, the shape of the eyes (making sure there are no irregularities that would prevent LASIK as an option), and the thickness of the cornea (making sure there will be enough tissue left, once the cornea is cut and reshaped).

A signed informed consent form is needed before the procedure, confirming knowledge of the risks, benefits, alternative options, and possible complications.

LASIK is an outpatient surgical procedure and will take 10 to 15 minutes for each eye.

The only anesthetic used is an eye drop that numbs the surface of the eye. The procedure is done with the person awake. LASIK may be done on one or both eyes during the same session.

During LASIK, a special knife (a microkeratome) is used to cut a hinged flap of corneal tissue off the outer layer of the eyeball. The flap is lifted out of the way and a special laser is used to reshape the underlying corneal tissue.

The calculation for how much tissue is removed by the laser is done ahead of time. Once the reshaping is done, the surgeon replaces and secures the flap. No stitches are needed. An eye shield or patch will be placed over the eye to protect the flap and to help prevent rubbing or pressure on the eye until it has had enough time to heal.

Indications

LASIK is done most often on people who use glasses or contact lenses because of myopia (nearsightedness). It is occasionally used to correct farsightedness. It may also correct astigmatism.

The FDA has approved the Excimer Laser to correct nearsightedness up to -12.00D with -4.00D of astigmatism, and farsightedness from +1.00 to +6.00 with 1.00D of astigmatism. (Diopter, symbol D, is the measurement of the refractive error. A negative D value indicates nearsightedness and a positive D value indicates farsightedness.)

The FDA, in cooperation with the American Academy of Ophthalmology, has developed the following guidelines and recommendations for good candidates for LASIK:

You should be at least 18 years old (21 for some lasers), since the vision of people younger than 18 usually continues to change. An exception is the small child with one very nearsighted and one normal eye. The use of LASIK to correct the very nearsighted eye may prevent amblyopia (lazy eye).
You should not be pregnant or nursing because these conditions might change the measured refraction of the eye.
You should not be taking certain prescription drugs, such as Accutane or oral prednisone.
Your eyes must be healthy and your prescription stable. If you're myopic, you should postpone LASIK until your refraction has stabilized, because myopia may continue to increase in some patients until their mid to late 20s.
You should be in good general health. LASIK may not be recommended for patients with diabetes, rheumatoid arthritis, lupus, glaucoma, herpes infections of the eye, or cataracts. You should discuss this with your surgeon.
Weigh the risks and rewards. If you're happy wearing contacts or glasses, you may want to forego the surgery.
Understand your expectations from the surgery. Are they realistic?
For patients with presbyopia, LASIK cannot correct so that one eye can see at BOTH distance and near. However, LASIK can be used to correct one eye for distance and the other for near. If you can adjust to this correction, it may eliminate or reduce your need for reading glasses. In some instances, surgery on only one eye is required. If your doctor thinks you're a candidate, ask about the pros and cons.

Risks

Over- or under-treatment of the condition may occur, requiring additional surgery, contact lens, or glasses.
Reading glasses may still be needed after surgery.
Some patients, although they may see much better than before LASIK without glasses, will still need glasses for their best vision.
Problems with night driving or visual symptoms, such as glare and haloes.
Problems with a decrease in contrast sensitivity, and even with 20/20 vision, objects may appear fuzzy or gray.
Corneal infection.
Corneal scarring, permanent warping of the cornea and an inability to wear contact lenses.
A loss of vision -- not seeing as well after surgery, even with glasses or contacts as before the surgery.
Permanent vision loss.
Flap complications.
Light sensitivity.
Dryness.
Scratchiness.
Patches of red or pink in the white of the eye.
Decreased distance vision at high altitudes.

Expectations after surgery

Immediately following the surgery, there may be a sense of burning, itching, or a feeling that something is in the eye. There may be mild discomfort for which the doctor may prescribe a mild pain reliever medication. It is very important NOT to rub the eye after LASIK, so that the flap does not dislodge or move.

The day of surgery, vision generally is blurry or hazy but by the next day the blurriness improves. The doctor should be called immediately if there is severe pain or any of the symptoms worsen BEFORE your scheduled follow-up appointment (24-48 hours after surgery).

At the first doctor visit after the surgery, the eye shield will be removed and the doctor will examine your eye and test your vision. You may receive eye drops to help prevent infection. Do not drive until your vision has improved enough to safely do so.

Other things to avoid include swimming, hot tubs, whirlpools, contact sports, lotions, cremes, and eye make-up for between 2-4 weeks after surgery. The doctor will give you specific instructions.

Convalescence

It may take up to 3-6 months for vision to stabilize after surgery.
The most common complaints after LASIK are glare, haloes, and difficulty with night driving. Often, these problems will go away after 6 months, but a small percentage of people continue to complain about glare.
Sometimes additional surgery may be needed in order to get the best possible vision. These re-operations may be called "enhancement surgery." Generally, while the distance vision may improve with enhancement surgery, other visual symptoms such as glare or haloes may not.
The Academy of Ophthalmology (AAO) reports that of approximately 500,000 Americans who had LASIK surgery in 1999, 70% had 20/20 vision after surgery.
If your distance vision has been corrected with LASIK, it is likely that you may still need reading glasses around age 45.
The long-term effects of LASIK past 5 years after the surgery are yet to be determined.

References

Yanoff M, Duker JS, Augsburger JJ, et al. eds. Ophthalmology. 2nd ed. St. Louis, Mo: Mosby; 2004:188-195.

Duffey RJ, Leaming D. US trends in refractive surgery: 2003 ISRS/AAO survey. J Refract Surg. 2005 Jan-Feb;21(1):87-91.

Cobp-Soriano R, Calvo MA, Beltran J, Llovet FL, Baviera J. J Cataract Refract Surg. 2005 Jul;31(7):1357-65.IG.Thin flap laser in situ keratomileusis: analysis of contrast sensitivity, visual, and refractive outcomes.

Balazsi G, Mullie M, Lasswell L, Lee PA, Duh YJ. Laser in situ keratomileusis with a scanning excimer laser for the correction of low to moderate myopia with and without astigmatism. J Cataract Refract Surg 2001 Dec;27(12):1942-51.

Miller AE, McCulley JP, Bowman RW, Cavanaugh HD, Wang XH. Patient satisfaction after LASIK for myopia. CLAO J 2001 Apr;27(2):84-8.

McGhee CN, Craig JP, Sachdev N, Weed KH, Brown AD. Functional, psychological and satisfaction outcomes of laser in situ keratomileusis for high myopia. J Cataract Refract Surg 2000 Apr;26(4):497-509.

Review Date: 8/17/2007

Reviewed By: Manju Subramanian, MD, Assistant Professor in Ophthalmology, Vitreoretinal Disease and Surgery, Boston University Eye Associates, Boston, MA. Review provided by VeriMed Healthcare Network.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

A.D.A.M. Copyright

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997-2009 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

adam.com

Source Doc: 1_007018

Lasik eye surgery - series

admin — Thu, 04 Sep 2008 19:44:52 -0700

Back

Overview

Normal anatomy
Procedure, part 1
Procedure, part 2
Procedure, part 3
Aftercare

HEALTH GUIDE REFERENCE FROM A.D.A.M

Normal anatomy

The cornea is the transparent part of the eye that covers the iris. It is also the main light bending part of the eye.

Procedure, part 1

Anesthetic eye drops are given to numb the eye and the surgeon marks the cornea with water-soluble ink to guide replacement of the corneal flap.

Procedure, part 2

The surgeon performs a keratectomy which creates a corneal flap. A keratectomy is a procedure that uses a small instrument that makes a cut in the cornea as it moves across it. The flap is lifted and reflected exposing the cornea beneath.

Procedure, part 3

A computer-controlled laser reshapes the cornea to the prescribed shape for clear vision.

Aftercare

The corneal flap is repositioned and bonds to the cut edge of the cornea quickly.

A.D.A.M. Copyright

adam.com

Source Doc: 3_100206

Corneal surgery

admin — Thu, 04 Sep 2008 19:02:39 -0700

Overview

Definition
Alternative Names
Description
Indications
Risks
Expectations after surgery
Convalescence
References

Illustrations

Radial keratotomy for myopia - series

Lasik eye surgery - series

HEALTH GUIDE REFERENCE FROM A.D.A.M

Definition

Corneal surgery corrects mild to moderate nearsightedness so you no longer need to wear glasses or contacts.

Alternative Names

Nearsightedness surgery; Radial keratotomy; Refractive surgery; LASIK

Description

The health care provider will place numbing drops into your eye so you do not feel pain during surgery.

The exact type of surgery done varies with each person. In many cases, the surgeon will use an instrument called a keratome to lift a piece of tissue from the surface of the cornea. A laser re-shapes the surface of the cornea and the tissue is put back into place.

This method of refractive surgery offers fewer side effects compared to radial keratotomy, which was common in the 1980's. Usually both eyes are done in the same session.

Indications

Refractive surgery is used to treat nearsightedness so you no longer need to wear glasses or contact lenses. Procedures are also available to treat farsightedness and astigmatism.

Risks

The vision may not be completely restored after surgery. This is called under-correction. In some cases, vision may be over-corrected.

After surgery some patients may have:

Spots (halos) in the eyes
Difficulty seeing at night due to glare (light sensitivity)
Dislodgement of the flap, even long after surgery
Infections of the cornea that may lead to permanent vision loss (unusual)
Scarring that may lead to permanent vision loss (unusual)
Dry eye

Expectations after surgery

The procedure is usually painless. You should have an immediate improvement in vision.

Long-term studies show that most people who have this procedure will see close to 20/20 without glasses. A few people (about 10%) will continue to need glasses or contact lenses. Rarely, there are serious complications that permanently decrease vision.

Older patients who needed bifocals before surgery will still need reading glasses after the procedure.

Convalescence

Protective glasses may be worn for several days, although full recovery can take several months.

You can quickly return to most activities. However, avoid bumping the eye or placing it under in water (swimming, for example) for at least 4 weeks.

References

Yanoff M, Duker JS, Augsburger JJ, et al. Ophthalmology. 2nd ed. St. Louis, Mo: Mosby; 2004:127-132.

Schallhorn SC. Avoidance, recognition, and management of LASIK complications. Am J Ophthalmol. Apr 2006; 141(4): 733-9.

Review Date: 2/22/2007

Reviewed By: Manju Subramanian, MD, Assistant Professor in Ophthalmology, Vitreoretinal Disease and Surgery, Boston University Eye Associates, Boston, MA. Review provided by VeriMed Healthcare Network.

A.D.A.M. Copyright

adam.com

Source Doc: 1_002959

Laser surgery

admin — Thu, 04 Sep 2008 19:02:38 -0700

Overview

Definition
Alternative Names
Description
Indications
Risks
Expectations after surgery
Convalescence

Illustrations

Laser therapy

Lasik eye surgery - series

HEALTH GUIDE REFERENCE FROM A.D.A.M

Definition

Laser surgery uses a laser light source to remove diseased tissues or treat bleeding blood vessels. The laser may also be used for cosmetic purposes, including removal of wrinkles, tattoos, or birthmarks.

Alternative Names

Surgery using laser

Description

A laser is a light beam that can be precisely focused. It is used to treat tissues by heating the targeted cells until they "burst."

There are several types of lasers, including the carbon dioxide (CO2) laser, the YAG (yttrium aluminum garnet) laser, and the pulsed dye laser. Each laser has specific uses. The color of the light beam used is directly related to the type of surgery being performed and the color of the tissue being treated.

Indications

Laser surgery can be used to:

Remove tumors (brain, liver)
- With minimal damage to surrounding healthy tissue
- With minimal scarring
Seal small blood vessels to reduce blood loss
Seal lymph vessels to reduce swelling and decrease the spread of tumor cells
Seal nerve endings to reduce postoperative pain
Remove warts, moles, and tattoos
Reduce the appearance of skin wrinkles, scars, and other skin blemishes
Remove hair

Risks

As with any type of surgery, laser surgery is not without risks. Possible problems include incomplete treatment of the problem, pain, infection, bleeding, scarring, and skin color changes.

Some laser surgery is performed under general anesthesia. Be sure to discuss the risks of general anesthesia with your anesthesiologist.

Expectations after surgery

Your outcome and recovery period will vary significantly, depending on the condition being treated. Always consult your health care provider about your prognosis and recovery period before surgery.

Convalescence

The amount of time it takes to recover from surgery depends on the surgery and on the individual. Based on an evaluation of your health status prior to surgery, your health care provider can give you a good estimate of the recovery time.

Review Date: 10/16/2006

Reviewed By: Kevin Berman, MD, PhD, Associate, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network.

A.D.A.M. Copyright

adam.com

Source Doc: 1_002958

Nearsightedness

admin — Wed, 03 Sep 2008 17:53:52 -0700

Overview

Definition
Alternative Names
Causes, incidence, and risk factors
Symptoms
Signs and tests
Treatment
Expectations (prognosis)
Complications
Calling your health care provider
Prevention

Illustrations

Visual acuity test

Normal, near, and farsightedness

Lasik eye surgery - series

HEALTH GUIDE REFERENCE FROM A.D.A.M

Definition

Nearsightedness is when the eyes focus incorrectly, making distant objects appear blurred.

Alternative Names

Myopia; Shortsightedness

Causes, incidence, and risk factors

A nearsighted person sees near objects clearly, while objects in the distance are blurred. As a result, someone with myopia tends to squint when viewing far away objects. This characteristic is the basis of the word "myopia," which comes from two Greek words: myein, meaning shut, and ops, meaning eye.

A nearsighted person can easily read the Jaeger eye chart (the chart for near reading), but finds the Snellen eye chart (the chart for distance) difficult to read. This blurred vision results when the visual image is focused in front of the retina, rather than directly on it.

Nearsightedness occurs when the physical length of the eye is greater than the optical length. For this reason, it often develops in the rapidly growing school-aged child or teenager, and progresses during the growth years, requiring frequent changes in glasses or contact lenses. It usually stops progressing as a person finishes growing in his or her early twenties.

Nearsightedness affects males and females equally. Those with a family history of nearsightedness are more likely to develop it. Most eyes with nearsightedness are entirely healthy, but a small number of people with myopia develop a form of retinal degeneration.

Symptoms

Blurred vision or squinting when trying to see distant objects (children often cannot read the blackboard, but can easily read a book)
Eyestrain
Headaches (uncommon)

Signs and tests

A general eye examination, or standard ophthalmic exam may include:

Measurement of the pressure of fluid in the eyes
Refraction test, to determine the correct prescription for glasses
Retinal examination
Slit-lamp exam of the structures at the front of the eyes
Test of color vision, to look for possible color blindness
Tests of the muscles that move the eyes
Visual acuity, both at a distance (Snellen), and close up (Jaeger)

Treatment

You can compensate for nearsightedness by wearing eyeglasses or contact lenses, which shift the focus point to the retina. There are several surgical procedures that reshape the cornea, shifting the focus point from in front of the retina to the retina.

Radial keratotomy is a surgical procedure that was popular in the recent past. Now it has been almost completely replaced by LASIK, in which an excimer laser is used to reshape the cornea.

Expectations (prognosis)

Early diagnosis of nearsightedness is important, because a child can suffer socially and educationally by not being able to see well at a distance.

Complications

Complications can occur in people who use contact lenses (corneal ulcers and infections)
Complications of laser vision correction are uncommon, but can be serious
People with myopia can, in rare cases, develop retinal detachments or retinal degeneration

Calling your health care provider

Call for an appointment with your ophthalmologist if your child shows these signs, which may indicate a vision problem:

Having difficulty reading the blackboard in school or signs on a wall
Holding books very close when reading
Sitting close to the television

Call for an appointment with your ophthalmologist if your child is having difficulties at school that may be caused by a vision problem.

Call for an appointment with your ophthalmologist if you or your child is nearsighted and experiences:

Flashing lights
Floating spots
Sudden loss of any part of the field of vision

Prevention

There is no way to prevent nearsightedness. Reading and watching television do not cause nearsightedness. In the past, dilating eye drops were proposed as a treatment to slow the development of nearsightedness in children, but they have never been proved effective.

The use of glasses or contact lenses does not affect the normal progression of myopia -- they simply focus the light so the nearsighted person can see distant objects clearly.

Review Date: 11/13/2007

Reviewed By: Manju Subramanian, M.D., Assistant Professor in Ophthalmology, Vitreoretinal Disease and Surgery, Boston University Eye Associates, Boston, MA. Review provided by VeriMed Healthcare Network.

A.D.A.M. Copyright

adam.com

Source Doc: 1_001023

Farsightedness

admin — Wed, 03 Sep 2008 17:53:50 -0700

Overview

Definition
Alternative Names
Causes, incidence, and risk factors
Symptoms
Signs and tests
Treatment
Expectations (prognosis)
Complications
Calling your health care provider

Illustrations

Visual acuity test

Normal, near, and farsightedness

Normal vision

Lasik eye surgery - series

HEALTH GUIDE REFERENCE FROM A.D.A.M

Definition

Farsightedness is difficulty seeing objects that are nearby.

Alternative Names

Hyperopia

Causes, incidence, and risk factors

Farsightedness is the result of the visual image being focused behind the retina rather than directly on it. It may be caused by the eyeball being too small or the focusing power being too weak.

Farsightedness is often present from birth, but children have a very flexible eye lens, which helps make up for the problem. Most children outgrow the condition. As aging occurs, glasses or contact lenses may be required to correct the vision. If you have family members who are farsighted, you are also more likely to become farsighted.

Symptoms

Blurred vision of close objects
Eye strain
Aching eyes
Headache while reading
Crossed eyes (strabismus) in children

Signs and tests

A general eye examination to evaluate hyperopia may include:

Visual acuity
Refraction
Glaucoma testing
Eye movements
Slit-lamp
Retinal examination

Treatment

Farsightedness is easily corrected with glasses or contact lenses. Surgical techniques are available for correcting farsightedness and can be used for those who do not wish to wear glasses or contacts.

Expectations (prognosis)

The outcome is expected to be good.

Complications

Farsightedness can be a risk factor for glaucoma and lazy eye.

Calling your health care provider

Call for an appointment with your health care provider or ophthalmologist if symptoms of farsightedness develop and you have not had an eye examination recently.

Also, call if vision begins to get worse after you have been diagnosed with farsightedness.

Review Date: 10/20/2006

Reviewed By: Manju Subramanian, MD, Assistant Professor in Ophthalmology, Vitreoretinal Disease and Surgery, Boston University Eye Associates, Boston, MA. Review provided by VeriMed Healthcare Network.

A.D.A.M. Copyright

adam.com

Source Doc: 1_001020