At the La Jolla LASIK Institute, I answer questions about LASIK every day. In this post, we cover the Top 5 LASIK questions I receive from my patients. Continue reading “The Top 5 LASIK Questions, Answered”
The Top 5 LASIK Questions, Answered
Questions to Ask at Your LASIK Consultation
The first step toward achieving your best vision without glasses or contacts is to consult a qualified LASIK surgeon. I personally meet with each and every patient that contacts my practice for a consultation to learn about their needs and recommend the best treatment approach for their goals.
To help you get the information you need to make educated decisions about laser vision correction, I recommend you ask your LASIK surgeon the following questions during your consultation: Continue reading “Questions to Ask at Your LASIK Consultation”
What You Should Know About Laser Surgery and Contact Lenses
What You Should Know About Laser Surgery and Contact Lenses
Recent studies suggest that laser surgery may have less risk than the continued
use of contact lenses. Researchers at Oregon Health and Science University
suggest that contact lenses poses a greater risk than laser surgery when it
comes to vision loss and other eye problems. The highest risk of vision loss
occurred in patients who slept in their contact lenses. They also concluded
there was less risk of vision loss when refractory surgery was performed.
Risk involved with contacts and laser eye surgery
While the research offered suggests some risk for both contact lens wearers as
well as laser surgery, it also claims that both are relatively safe. Every
option poses some risk, but the continued use of contact lens illustrates the
public’s willingness to accept it if it improves their vision. The research
merely suggests that the use of laser surgery may be safer in the long run than
wearing contact lenses for several years.
When it comes to laser eye surgery, it has been determined that advances in
technology improves the accuracy of the procedure and speeds healing. Faster
lasers and surgeries performed without blades offer better results with fewer
complications.
Contact lenses continue to pose a risk simply because they are touched by the
fingers. They are foreign objects placed on the eye and can easily introduce
bacteria that may lead to infection. This normally does not occur when glasses
are used.
Alleviating risks associated with contact lenses
To reduce the risk of infection associated with contact lenses you should follow
these precautions:
- Never reuse solutions
- Wear lenses according to doctor’s instructions
- Only use contact lens solution to clean contacts (do not use tap or
distilled water) - Rinse contacts according to instructions
- Replace the case for your contacts regularly
- Do not wear your contacts when you sleep
You can reduce the risks associated with laser eye surgery by:
- Choose a highly trained surgeon
- Choose a surgeon who uses the most recent technology
- Cost should not be a factor
- Be completely honest about your medical history
- Follow all instructions, especially when it comes to after care
Contact us today to find out how the cost of a one time laser eye surgery San Diego offers can
compare to the continued cost of contact lenses over your lifetime.
What Happens at a Laser Surgery Consultation
What Happens at a Laser Surgery Consultation
The first step when considering San Diego laser eye surgery is a consultation. A trained
doctor will evaluate your condition and determine your eligibility for the
procedure. A non-invasive eye exam will be performed and the doctor will discuss
your surgery options with you. He will tell you which procedures would work best
for your particular situation and offer the best results.
Before your LASIK consultation
You will be advised by your doctor or someone in his office to discontinue the
use of your contact lenses for a few weeks prior to your evaluation. The use of
contact lenses can change the surface of the cornea. Discontinuing the use of
your contact lenses allow the cornea to return to its original shape in time for
you scheduled consultation.
What happens at a consultation
Your doctor will discuss your vision problems and how you use your contacts and
glasses. He will also inquire as to why you are interested in the LASIK
procedures. The doctor will also ask what you expect to gain from the procedure.
Many patients have unrealistic expectations and believe they will no longer
needed glasses or contacts of any kind. Over the time, the use of reading
glasses may be required as an example.
To be a good candidate for any type of laser eye surgery, you must have
realistic goals. Positive reasons for having laser procedures include, becoming
more active and having to rely less on contact lenses and eyeglasses.
Your general health history will also have a direct impact on your candidacy for
laser eye surgery. There are several conditions that affect the eyes, including
diabetes and other autoimmune disorders. Conditions that affect the eyes can
also affect your candidacy for the surgery. These conditions will also affect
how you recover after the surgery is performed.
Certain medications and lifestyle factors can also impact how a person will heal
after surgery. Medicines designed to treat migraines can impact the healing
process. Drug and alcohol use, as well as playing contact sports will directly
influence whether or not you are a good candidate for laser eye surgery. Your
doctor will need to have the answers to these questions in order to make an
informed decision.
Comprehensive exam for laser eye surgery
Comprehensive eye exams are included in the consultation. Each exam includes
tests for pupil dilation and measurements used for prescriptions. There are also
tests that are exclusive to laser procedures. Your cornea will be measured in
great detail. This includes its curvature, thickness and the topography of the
eye. A test will also be performed to determine if you have dry eyes. The tests
are painless and will be explained before they are performed.
What a LASIK consultation will tell you
At the end of the consultation, the doctor will talk to you about your candidacy
for eye laser surgery. The results of the tests will be discussed and your
questions will be answered. If you are eligible for the surgery, the doctor will
explain the process and what you will need to do prior to your scheduled surgery
date. Procedures will also be discussed and you will be informed which surgery
is right for you.
What Is Laser Eye Surgery?
What Is Laser Eye Surgery?
The term laser surgery is used to describe several different procedures that are
used to improve how your eyes focus light. Refractive errors reduce the accuracy
within which the eyes transmit information to the brain. PRK, LASEK, LASIK and
EpiLASIK are a few of the most common eye surgeries included in this specific
category.
The following four surgical procedures use what is known as an “excimer” laser.
The laser is used to reshape the cornea and correct any vision problems a person
may be experiencing. Each type of procedure varies in recovery time, the type of
instruments used during the procedure and which surgery will work best for your
particular condition and needs.
Some patients may do well with LASIK in San Diego, while another person would be a better candidate for PRK. An ophthalmologist will be able to evaluate your
eyes by performing a comprehensive, surgery specific exam. Once the results of the exam are known, the doctor will be able to advise you on what type of surgery is best for your particular condition and which one offers you the best results.In most cases, a person’s vision is returned to 20/20 or better after
the completion of the surgery.
PRK (Photorefractive Keratectomy)
The PRK procedure is one of the more popular eye procedures. During the surgery,
the doctor removes a small section of the cornea’s surface, also known as the
epithelial tissue. The tissue that is removed will eventually grow back, so
there isn’t a need for the creation of a flap. After the removal of the
epithelium, the laser reshapes the cornea to correct discrepancies in the
person’s vision. A PRK procedure has a longer recovery time than that of a LASIK
procedure.
LASEK (Laser Epithelial Keratomileusis)
Similar to both PKR and LASIK, LASEK also begins with the doctor applying
alcohol to epithelium of the cornea. Alcohol loosens the surface cells. The
surgeon can slide them away without having to cut them away completely. Using
the excimer laser, the cornea is reshaped and the cells replaced. A contact lens
is put in place to aid in the healing process. For patients with thin corneas,
LASEK is an excellent option.
LASIK (Laser in Situ Keratomileusis)
The most common of all laser eye procedures, San Diego LASIK involves using a laser or blade to create a thin flap in the front of the cornea. Many doctors prefer to
use a laser due to the precision of its precision. Laser surgeries also have
fewer complications. LASIK procedures that involve exclusive use of a laser are
more expensive than other procedures. The excimer laser is used to create the
flap and reshape the cornea. This will correct any refractive error and return a
person’s vision to normal.
EpiLASIK (Epithelial Laser in Situ Keratomileusis)
EpiLASIK involves the creation of a flap that is much thinner and only involves
the epithelial tissue of the cornea. The flap is moved aside once it has been
created. It is moved slightly to the side to give the surgeon enough room to
reshape the stroma with the laser. The epithelium flap is replaced and a contact
lens put in place to allow the incision to heal. Surgeons sometimes prefer the
EpiLASIK procedure because only the epithelial cells are affected. No alcohol is
used in the procedure.
The History of Laser Eye Surgery
In the 1980’s, IBM was using an excimer laser at one of its research facilities
when one of the researchers discovered the laser could be used on animal tissue
without causing a scar. The laser was then used on human tissue to see if the
same results could be achieved. Once it was approved, ophthalmologists, or eye
surgeons, began to inquire how the new laser procedure could be used to treat
problems with vision.
It took almost ten years of clinical trials, technical advancements and
improvements before eye surgeries using the excimer laser were approved for use
on humans. After a few short years, LASIK and other laser eye surgeries became
the most popular elective procedures the world over.
Who is a good candidate for laser eye procedures?
Any type of surgery involving the eye should be performed after a person reaches
the age of 18. Prior to that time, changes may still be occurring. Eyes may
continue to change after the age of 18, but at that point, they are minimal. In
order for laser surgery to be effective, a person’s vision must have remain
unchanged for at least one year before scheduling the procedure. Certain
providers require two years of stability. Depending on the type of surgery and
who is performing it, additional requirements may have to be met. A person’s
eligibility for any laser procedure must be determined by a professional. They
will be able to review your case and recommend which procedure would offer you
the most benefit.
Glare and Halos Worse with Glasses and Contacts than LASIK
A recent large (3,800 patient) multicenter survey, the Needs, Symptoms, Incidence, Global Eye Health Trends (NSIGHT) study, found that about 50% of glasses- and contact lens-wearers experience glare and halos more than three times a week.
About 40% of glasses and contact lens-wearers found the glare and halos unsatisfactory and had not been able to find a solution. Add on top of that the dissatisfaction with frames, contact lens solutions, infections, and the dissatisfaction rate becomes, well, way too high.
In contrast, 97% of LASIK and PRK patients are satisfied and would recommend the procedure to a friend. In large studies, 3% of LASIK and PRK patients are unsatisfied for any reason — and the reasons provided are only sometimes things like glare and halos after LASIK; some of the time, the complaints are minor quibbles such as a doctor’s office without wifi reception, bad coffee, or no beverages at all.
Link to Bausch & Lomb press release: https://www.bausch.com/our-company/newsroom/2011-archive/glare-and-halos-are-significant-problems-for-people-wearing-glasses-or-contact-lenses#.VCJLe_ldUpk
How Soon Can I Exercise After LASIK in San Diego?
When it is safe to exercise after having LASIK?
Generally, 3 days after the procedure but consider your sport and how you play the game:
- Don’t squint or scrunch your eyes for 24 hours
- Return to most exercise in 1-3 days
- Back to swimming pools, hot tubs, oceans, rivers, and lakes after 14 days
- Don’t rub your eyes for 30 days
- Choose PRK over LASIK if the sport involves getting hit in the face
If your sport is boxing, martial arts, wrestling, or another sport with a big chance of getting hit in the eye, let me know, and we’ll consider PRK for your San Diego refractive procedure.
Hold off for two weeks from spending time in Jacuzzis, playing water polo, or swimming just about anywhere.
Remember if you sweat profusely not to rub your eyes for a month after your procedure. Just blot your face, not your eyes. I was a big eye-rubber (and have the wrinkles to prove it!) but I did it. If I can refrain from rubbing my eyes for a month, so can you!
When you’re working out at the gym after LASIK, consider all the equipment to be covered in toxic waste, so don’t touch your face until you’ve washed your hands.
Sure, you can walk or do yoga for exercise after LASIK, but after day 3, as long as you don’t get hit in the eye or rub your eyes, you don’t need to limit yourself to these!
Confused? Come on in with your specific question and I’ll help you find clarity, and peace of mind, and your best LASIK San Diego or PRK San Diego procedure.
FLEX Dollars Qualify for LASIK
Just a quick reminder that LASIK qualifies as a medical expense for tax purposes.
This means you can use your Flexible Spending Account (FSA or FLEX), Health Savings Account (HSA) or Medical Savings Account (HSA) to pay for LASIK. So use your 2010 FLEX dollars for LASIK today. Or plan for January 2011 now and enjoy a new year of great vision after your LASIK San Diego procedure.
Can Pilots Have LASIK?
Current and prospective aviators concerned about whether or not LASIK, PRK, and other refractive surgeries disqualify them from flying can rest at ease because these vision enhancing procedures do not jeopardize their dreams. The Federal Aviation Administration (FAA), the Naval Bureau of Medicine and Surgery (BMED), the United States Air Force (USAF), and even the National Aeronautics and Space Administration (NASA) all find these forms of refractive surgeries acceptable procedures for their aviators. So, whether you fly a A380 to transport hundreds of people safely to their destinations, a F-22 to protect and serve your country, or the Endeavor to explore the entirety of space, you may be eligible for LASIK and PRK and still have your dreams of flying within clear sight! Always check with your current and prospective employer to verify their procedures and requirements.
Short Arm Syndrome, or Why Can’t I See Anymore?
What is Presbyopia?
Presbyopia is a condition of the eye where a progressive loss of magnification ability results in the inability to see near objects.
What causes it?
Presbyopia is caused by the hardening of the crystalline lens of your eye and occurs in a predictable fashion as a result of the natural process of aging. The first symptoms of presbyopia normally occur between ages of 40-50 and the ability to focus on near objects continues to decrease. In fact, if your eyes have a distance prescription of zero (“plano” in ophthalmology terms), you will first need reading glasses very predictably at 42 or 43 years old.
What happens if I have…
Myopia (nearsightedness) and Presbyopia?
If you’re myopic, as you age, you lose the magnification power of your lens just like any other person.
If you’re over 42 and wearing single vision distance contact lenses, you’ll notice that you have to hold things farther away when you’re wearing contact lenses for distance and trying to read, or that you need reading glasses on top of your contact lenses to see well up close. You’ll also notice your presbyopia symptoms when you’re wearing glasses and have an irresistible urge to take them off to read.
Hyperopia (farsightedness) and Presbyopia?
If you’re a latent hyperope (person with farsightedness who doesn’t need glasses for distance until they get older), at a young age you probably had the best distance vision out of all of your friends. However, as you get older, you need reading glasses far earlier than most people in your age group (even by your late 30s).
Here’s how it works: hyperopes who don’t wear glasses in the distance are using their magnification power just to see far. As you age, the lens in your eye becomes less flexible, decreasing its ability to magnify. So, you’re a latent hyperope in your late 30’s sitting in a chair, looking at the beautiful view, using most of your magnification power just to see far. Now, you pick up something to read, and whammo! It’s blurry. This scenario happens earlier to untreated hyperopes than myopes (nearsighted people) or emmetropes (people who have no need for prescription in the distance) because their accomodation (ability to magnify) is already used up from looking far, and there’s not as much left to magnify to read. Eventually, when the hyperopia is high enough or you get old enough, combining hyperopia and presbyopia blurs both your near vision and your distance vision.
What are the possible treatments for my eyes?
Bifocal spectacles – The most common type of bifocal spectacle is the Flat Top Bifocal and is comprised of two segments: one for far vision and one for near. The segments are available in different sizes according to the field of vision you need to see. The other bifocal “with line” spectacle style is the Executive Bifocal. The lenses are also split into two segments, with a dividing line across the width of the lens. They do not allow for a continuous range of vision and sometimes cause blurriness. A third type of bifocal is the progressive or “no line” bifocal. This is the type people are wearing when you see them bobbing their heads and looking for the sweet spot in their spectacles for focusing at that exact distance.
Monovision contact lenses – With monovision contact lenses for presbyopia, each eye is treated differently. One eye (most commonly the dominant eye) is corrected for distance vision and the other eye is corrected for near vision. Ideally, your brain will choose the magnified image and provide your eyes with what appears to be continuous, smooth vision. However, Monovision contacts can sometimes cause a loss of depth perception which patients find difficult to adapt to.
Monovision LASIK or PRK – LASIK or PRK surgery is used to permanently correct one eye for near vision and the other eye for distance vision. Monovision after LASIK or PRK tends to be better accepted by patients than contact lens monovision because the patient’s visual experience is the same all the time. During LASIK surgery, a flap is created on the surface of the cornea (the front layer of the eye). A laser is then used to re-shape the cornea back into a natural shape so that it focuses light more efficiently, and then the corneal flap is put back in place.
During PRK surgery, the surgeon removes the epithelium of the cornea altogether, and after the procedure, bandage contact lenses are worn to help in healing the epithelium.
About 10% of presbyopic patients prefer single vision distance correction over monovision. I spend a great deal of time and care getting your prescription right (this includes whether to go with Monovision or not) and if so, the right amount. I spend a significant amount of time learning about your daily activities and do my best to simulate your results so that you will be thrilled with the end product.
Most people find that they can adjust to Monovision LASIK or PRK far easier than contacts because the correction is 24/7, without the hassle of taking out and putting in contact lenses. For the remaining 10%, single distance vision after LASIK or PRK with “drugstore readers” is an excellent choice.
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Sources:
https://www.seewithlasik.com/docs/presbyopia/presbyopia.html
https://www.pendletoneye.com/errors.htm
https://www.webmd.com/eye-health/tc/farsightedness-hyperopia-what-happens
https://www.docshop.com/education/vision/refractive/monovision/
