Laser Vision Surgery for Developers?

cyclops asks: "I have been contemplating about going for LASIK surgery for a couple of years. I want to get rid of my dependency on glasses or lenses because I really find them cumbersome. The main thing that is stopping me now is that like you, programming is my livelihood and thus I spent a major part of my day staring into the monitor. I have readthat there is always a certain percentage of patients not regaining 20/20 vision but it's OK for them since most of them don't need that sharp vision during work. I am about to consult with a LASIK surgeon but I would love to hear anecdotal evidence about your experiences, to hear if it works out for you eventually. (I have stable myopia of -5.50 and astimagtism of -1.00 for 3 years already)." Ask Slashdot has handled this issue in the past in two previous articles: this one from 1999, and a related article from 2000. With at least 2 years since the last time this question was posed, how has medical technology improved in this aspect? For those unwilling or unable to take advantage of Laser Surgery, have other viable alternatives arisen in the past two years?

Comments

Night vision

[JohnTheFisherman]

Lasik can harm your night vision, among other things. For such a distance-specific task as programming, you're probably much better off with glasses (and much safer).

I don't know much about this site, but I'd just heard about it: http://www.lasiktruth.com/. Look around, I've heard a lot of bad stuff second hand about it.

Re:Night vision

[Xerithane]

I went in to consult with my regular eye doctor (well, was) who was also a Lasik surgeon. He had great things to say about it if your career/hobbies don't strain your eyes.

I have a pretty rare eye condition that pretty much eliminates me as a candidate for Lasik, but some people still have similar symptoms and have had less than desirable results. If you have sensitive eyes to light for whatever reason, make sure to really talk it over with your eye doctor and get more than one opinion. My problem doesn't permit my eyes to contract normally, and apparently this produces some pretty serious havok amongst Lasik patients. If you get your eyes dialated, or sensitive to light, I've heard don't do it from a few sources. Halos around lights are a common tale, but I've also heard of glare that reflects around your eyes and things along those lines.

Best advice I can give: Talk to more than one doctor/surgeon about it before even considering it. Their informational videos are meant to get you to want to do it, so don't take their advice. Talk to people who have had it done that have similar prescriptions/eye conditions. Those are the people you really care about.

Aberrations

[Anonymous Coward]

At present, opticians measure and correct defocus and astigmatism. The eye has many higher orders of aberration (spherical aberration, coma, trefoil etc), which are not measured and are not corrected. The problem is that, for laser surgery, the astigmatism and defocus are corrected over a small area of the pupil, smaller than the area of the dilated pupil. Outside this area, aberrations are exacerbated, and not currently measurable (although there is a lot of work in this area). Hence, if you have laser eye surgery, your corrected vision will (barring complications), be fine during the day or when in a brightly lit area, but vision may be worse than pre-correction at night. Doesn't sound too bad, unless you drive at night...

BIG FONTS ARE YOUR FRIENDS :-)

[Bruce Perens]

I have used a 21-inch monitor, way far back on my desk... actually behind the desk on a shelf, with huge fonts, for years. At Pixar, they called it "the world's most expensive TTY", as I usually work in one screen-sized terminal window. I have improved my eyesight substantially and went from needing glasses to needing none. With my 45th birthday rapidly approaching, I'm noticing some slight degradation in my sight due to aging, but avoiding strain helps a lot.

Bruce

I did it

[mclem]

Had the procedure done -- both eyes on the same day! -- and it was fantastic. My night vision was never very good, so I don't mourn the loss, and in fact, my depth perception has improved since getting rid of my glasses. After a year, I'm 20/20 in one eye, 20/15 in the other -- a vast improvement over my pre-surgery vision. (And my good eye now was my good eye then, too.)

I notice my eyes getting a little tired near the end of the day, which is normal for folks with naturally good vision. And I know that I'll need reading glasses eventually. Big deal. I can see my wife in the morning, swim with my kids, fall asleep while reading, wear decent sunglasses, etc... All trivial things when you've got normal vision, but oh-so-worth it when you've needed glasses for 20+ years just to find your frelling shoes.

Oh yeah, it's worth it. Find a decent surgeon -- research! ask questions!

Re:I did it

[jht]

Similar experience for me - I had my eyes zapped at the beginning of 1999, and I have no regrets at all. I can work in front of a screen all day comfortably, and I've noticed no significant change to my night vision. According to my wife, I have better night vision now than she does, and she has natural 20/20 vision.

The actual surgery was performed by the New England Eye Center (affiliated with Tufts), at their Boston facility. The eyes were done 2 weeks apart - my left (weaker) eye first and then my dominant eye. My right eye is corrected from close to 20/200 myopia to around 20/15 - my left eye was corrected to 20/20. I do have a insignificant amount of astigmatism in my left eye, which I was given the option to further correct if necessary but so far I haven't noticed it except on the eye tests themselves.

All in all, it was a very worthwhile experience. One thing to check - see if your emloyer has a flex spending plan for medical expenses. If they do, you can potentially contribute to the fund pre-tax, and then use the money to pay for the surgery. Depending on your bracket, you can potentially save as much as $1000 doing it that way (I did).

And reading glasses are pretty much a certainty by the time I'm in my mid-to-late forties (I'm 36 now). But I consider that to be no biggie, as I'd have probably needed bifocals eventually without the surgery.

I agree on finding a good surgeon. Preferably one affiliated with a real hospital rather than a free-standing opthamalogy center. And I'd say discount sushi and discount LASIK are two things to potentially avoid.

Great Experience: Strongly Recommend

[jrichau]

My story is anectdotal at best, but I can't recommend the surgery strongly enough. I spend most days staring at the computer screen (I remember talking to my eye doctor suggesting that I spend 14-16 hours looking at the computer, he replied "in a week?", "No, a day..."). Both of my parents also had the surgery with success which gave me more confidence to have it.

I had laser surgery (LASIK) last spring. It was a fantastic experience. I basically have had contacts forever (-4.5 in one eye, -4.25 in the other, slight astigmatism in one but I don't know the number value for it). I went in for a consult and they deemed me an ideal candidate after checking my vision and doing some measurement of the size of my cornea (mine is thicker than average which is good for them because they effectively reshape your eye by getting rid of some of the cornea).

I went in for the surgery on an afternoon. I had both eyes done on that day. I basically sat in this chair and focused on a little red light. They put some numbing drops in my eyes and then lowered this eyeball sized tubish thing over my eye. It basically sucked onto and grabbed hold of my eye, then a blade comes out of that to slice a thin layer of the cornea. The surgeon then lifts up that layer and the world goes super foggy. I focused as best I could on the red light (with the sucker thing on my eye, I couldn't have moved it anyway). And they basically fired a laser at my eye for 50 seconds or so. Then they flipped the cornea layer back over my eye and the world became clear. They then did the same process for the other eye. It did not hurt in any way during the process.

When it was done, I could immediately see better but it did hurt to look at bright light so I basically got patches over my eyes and was driven home. I took some Tylenol PM and went to sleep with these plastic things covering my eyes to protect from rubbing during the night.

The next morning I drove back to the eye center without my glasses. At that point my eyes were about 20/40 or 20/30. I went to work that day as well so I basically missed an afternoon of work. I had to wear the eye covers at night for the next few nights. Over the next week or so as my eyes completely healed, my vision became 20/15 in both eyes. It has been that way ever since. I do notice slightly more haloing (halos around point light sources) at night but nothing that might not have been there before and I just didn't notice.

I can't recommend it strongly enough. Not having contacts has been a pleasure and the whole surgery experience was a breeze. The worst part of it was the anxiety as they did the surgery but it only lasts about 15 minutes and was well worth it.

Re:Don't Do It!

[MoxCamel]

Any laser surgury will ruin your night vision...

Hogwash. There is a chance, but night vision problems (like haloing) typically go away over time.

I had Lasik a couple years ago. I never had nightvision problems, even temporarily. My wife had hers done a week before mine. She had haloing for about 6 months, but it eventually went away.

It's different for everyone. General statements like that are just FUD. We /.ers don't like FUD.

Mox

Horror stories

[Anonymous Coward]

http://surgicaleyes.com

Wish I'd found that site before I had my eyes fubared.

Short version...its been a year+..I'm spending over $50 a week on eye drops due to major dry eye issues....reading which used to be a pleasure in my life is now a nightmare....most importantly, due to the dryness and constant tiredness of my eyes, long term comp work is flat out. Also, caffine is majorly restricted due to how my eyes react to it... Nightvisions pure hell.

So..if contemplating it....do ALOT! of research...any doubts, dont do it.

See also : http://www.martialtalk.com/showthread.php?&threadi d=1618&highlight=lasik for more info on what I went thru.

Good luck

My case is pretty typical, I think

[Reality Master 101]

I was like -4.00 and -3.75. I had Lasik a few years ago. Now I see about 20/25 and 20/20. I have the halos at night.

I have to admit, initially I was somewhat disappointed because my vision definitely wasn't as sharp as it was when it was fine-tuned with my contact lenses. But to tell you the truth, now I don't even think about it. My vision is definitely "good enough" and I'm glad I did it. Being free of any vision correction is really, really nice. The halos at night used to be somewhat annoying, but I've pretty much gotten used to them and they don't bother me.

One big advantage is that my eyes don't get as fatigued from wearing contact lenses at the end of the day, and I find that to be an advantage in late night programming sessions.

For me, the positives outweighed the negatives, but unfortunately there's no way to really know for yourself without doing it.

Thrilled with Mine

[stoolpigeon]

I'm a programmer. I had my eyes done about 4 years ago. I've had no problmes. I did get a 'starburst' on bright lights at night but it is actually milder than the same effect when I wore glasses.

I had the procedure mainly because glasses interfered w/hunting and other outdoor sports.

From what I understand- the greater the correction needed, the greater the risks. My vision was not too bad prior to the procedure and better than 20/20 in both eyes after it was done.

I would do it again in a heart beat.

.

i had lasik done..

[jspectre]

18 months ago and have had better than 20/20 vision since.

my advice is to very carefully research your doctor and the equipment he uses. you get what you pay for, cheap prices usually means cheap service. much of the equipment they use can be looked up on the web (my doctor used a system developed by B&L, i could look up the stats and success & failure rate on B&L's web site as well as the FDA).

i'm very happy with having it done.

oh. i had it done at lasik plus.

Not like buying toothpaste

[gclef]

I had it done about 2 1/2 years ago. No regrets at all. For the record, I had about -6.5 with about -3 astigmatism.

However, if you take one quote away from this post, it should be this: This isn't like buying toothpaste. This is surgery. You will get what you pay for.

In other words, do your homework before even talking to doctors. Be aware that this is surgery, even if it is outpatient surgery. I ended up paying much more than the "average" rate because the doctor I chose had done over 10,000 procedures (successfully), and was an instructor of the procedure. If you can afford it, the extra money for someone really experienced in the procedure is worth it.

Not for the Squeamish

[Tablizer]

I basically sat in this chair and focused on a little red light. They put some numbing drops in my eyes and then lowered this eyeball sized tubish thing over my eye. It basically sucked onto and grabbed hold of my eye, then a blade comes out of that to slice a thin layer of the cornea. The surgeon then lifts up that layer and the world goes super foggy....

My brother had it done. He does not regret it, but he did say that the experience can be phychologically very uncomfortable. If you are the least bit squeamish about people playing with your eyeballs with scary tools and having your head and eyes locked into one position for a duration, then forget it.

They can't put you under anesthesa (sleeping gas) because you must keep your head and eyes still, and sleeping people tend to move both. Bummer.

Re:Not for the Squeamish

[sessamoid]

They can't put you under anesthesa (sleeping gas) because you must keep your head and eyes still, and sleeping people tend to move both. Bummer.

Actually, one could use general anesthesia for vision correction surgery, but it isn't done for a number of good reasons.

1. complexity - general anesthesia requires a fully equipped operating suite and lots of extra equipment.

2. cost - cost of above mentioned equipment, plus the services of an anesthesiologist to take care of the medications, intubation, artificial ventilation, etc.

3. risk/benefit ratio - with general anesthesia, the risks suddenly become much, much higher--too high for an outpatient elective procedure when a safer alternative exists.

The bit about not being able to keep sleeping peoples' eyes still is not a problem. It's a simple matter of medication to completely paralyze a patient during general anesthesia.

Make sure to check fda.gov first

[GuyMannDude]

I'm not sure if you've already looked at the FDA's When is LASIK not for me? site but you'd better have a look at their suggested restrictions. Among them: your vision has not stabilzed yet and history of autoimmune diseases.

GMD

Re:Dangerous

[SandSpider]

You don't need the surgery in order to live. You would get Lasik in order to be able to not have glasses. The two reasons for not having glasses are the convenience of not having to deal with glasses (including long-term cost reduction with respect to new prescriptions and such) and not looking like someone who wears glasses.

However, except in extreme circumstances, you can live a perfectly good life for just as long with glasses as with lasik. If you prefer, you could consider it 'unnecessary' surgery. There's probably a fancy word for that in the medical world.

=Brian

Re:Don't Do It!

[Dahan]

Lasik reshapes the lens itself. The thickness and shape of the lens.

No it doesn't. LASIK uses a laser to vaporize parts of the cornea, which causes the cornea to change shape before healing, just like with RK (I wouldn't say that either method "causes the eyeball to collapse in on itself" though). Read up for some more info on LASIK, as well as comparisons to RK and PRK.

There are no procedures to reshape the lens itself. You can, however, get your old lens removed and an artificial lens implanted. This is usually done to people with cataracts--my mom just had it done a few weeks ago, and she no longer needs glasses. Some people do get their lens replaced even when they don't have cataracts, but that seems a bit too extreme to me.

get computer glasses

[g4dget]

If you don't want to focus nearby when looking at a monitor, just ask your optometrist about "computer glasses". They are glasses that allow you to perform close work while being focussed further away and they do help with eye strain.

Beyond that, if you are nearsighted and don't suffer from stress-related vision problems, there is no way to "improve" your eyesight through eye exercises; eyes just aren't built that way. Most likely, the "improvements" you are seeing are the onset of presbyopia. Moving monitors further and further away is a common way of dealing with it. Most people get reading glasses when they reach the limits of their desk--it's more convenient. And, no, there is nothing to be done about presbyopia--everybody gets it sooner or later. Some people are just more willing to tolerate inconveniences for vanity--that's the only reason you don't see everybody over 50 running around with reading glasses.

Ortho-keratology

[Tack]

I looked into LASIK, but it is both expensive and risky. I took an alternate approach that not very many people seem to know about: ortho-keratology, aka ortho-k.

Essentially, with ortho-k you wear hard contacts while you sleep. These contacts are engineered in such a way that they reshape your cornia to adjust for myopia or astigmatism. I also depend on staring at a monitor both during my job and when I get home (as a hobby). My vision has changed from a -3.5 lens to about +0.25. (The slight far-sightedness is actually a good thing.)

One of the advantages (or perhaps disadvantages depending on your perspective) is that ortho-k is not permanent. As a result, it's less risky. If you stop wearing the contact lenses, your eyes will slowly revert (however probably never as bad as they were when you started).

I've been using ortho-k for over a year now and I love it. I don't have to worry about dry eyes from contacts (since when I do wear the contacts I am sleeping, so I don't feel them) nor do I have to deal with the inconveniences of glasses. Plus I don't have to undergo the scary LASIK surgery. The risks and the costs are much less with ortho-k. I highly recommend it.

Jason.

Anecdotally speaking

[Jahf]

I had LASIK done in April of 2001 (almost 18 months ago).

I was fairly nearsighted and also mildly astigmatic, both eyes were almost equal.

Anyway ... I was never able to wear contacts because these blue eyes are just too sensitive. My first day after surgery I had to keep fairly sedated because my eyes itched/hurt, so of course my instinct was to try and open or rub them.

After the first day I could open my eyes and see. After the 3rd day I didn't have any measurable irritation. By the 7th day my vision was better than 20/20 except for the normal halo patterns.

However, after about 3-4 months my vision got a little worse. I'm not quite 20/20 in either eye. My right eye is better (but I'm left-eye dominant, so it's frustrating). My left eye is able to pass the Colorado driver's exam, but just barely.

My biggest problem is "ghosting" as I call it. I think it's just the healed version of the halos that I had bad at first. It is only a problem in very bright light or in high-contrast images (like driving at night ... I tend to see 1 strong yellow line and 2 converging "ghosted" yellow lines when looking at the road).

The ghosting is enough to give me a mild eye-strain headache every once in a great while, but usually it just makes me squint a bit. I have no problems working on a computer monitor for 10+ hours a day and I don't have any problems reading in bed (I had gotten so nearsighted that I had to wear my glasses to read at night).

My eyes have been stable since about 6 months after the surgery. My cost was $1500/eye, but it was at a well known clinic and they give as many free tune-ups as required for 3 years after the procedure. I would have gotten a tune-up by now, but I've moved.

I'm waiting for our vacation back to the place where it was done (Dr. Arrowsmith in Nashville, TN) this winter to get my tune-up. That will give me 14 months left on the policy to heal and see how things go. I doubt I will go for more than 1 tune-up though, as I am worried about causing scarring.

The best part is, I went in to get a tuneup in June and the doctor actually told me to wait because they were getting in a new machine (Wave laser) that was much more accurate. Apparently my nearsightedness is gone and the ghosting (which is exacerbated by my having had astigmatism) is a result of a barely uneven surface from the old laser. The new laser handles this much better. I like a doctor who will tell you that instead of just trying to clear their schedule.

Overall I'm very happy I did it. I never liked my glasses and am very happy that I can read at night. Plus, now I can buy ski goggles and motorcycle helmets that are comfortable :) ...

Recommendations:

1) I had both eyes done at the same time. DON'T DO THAT. While I turned out ok, if my eyes had healed any less "ok" than they are I would be upset that I did them both. I would recommend doing 1, waiting 2-3 months, then doing the other if you're satisfied.

2) If you get a free tune-up, especially if it's valid for a couple of years like most reputable clinics are wont to do, wait at least 6 months, maybe 12, before having a tune-up. Not only will your eyes continue to heal the first few months, but more refined technology is continuously being rolled out.