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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?
I know this may seem difficult to believe, but bad vision is usually due to chronic tension in the muscles of the eyes. There are methods available to reduce your chronic muscle tension. There is a book about this; I will see if I can find the title.
A friend of mine is a senior uni researcher in optometry. She's told me that the flap of cornea that they open up in order to do the surgery never heals properly and that even mild trauma is able to re-open the cut. This can result in infection, scarring and permanent damage. She wears glasses and preaches openly against this technology.
I don't know what the odds are that such a thing would happen for a given laser eye surgery. Personally, I think that if there is any chance at all that a cosmetic surgery will prevent me from doing serious computer work, then the cosmetic surgery is not worth it.
=Brian
There is nothing so good that someone, somewhere, will not hate it.
I just went to my eye doctor last week and asked about Lasik. HE wouldn't even recommend because he thought there was not enough case work on long term effects of Lasik. He was concerned about possible long-term corneal degeneration risks, since Lasik cuts away part of your cornea.
OTOH, I had previously thought that the biggest problem would be that some patients experience "halo" effects, especially at night. He said that was mainly due to other techniques based on RK, but not so much with Lasik.
BTW, as an optometrist, he was offered Lasiks for free, for himself, but didn't take it for these reasons.
I'm with Brian Barsky's OPTICAL group at UC Berkeley. (http://www.cs.berkeley.edu/optical/ )
We are currently doing research on how to better describe the damage caused by laser surgery.
You see why laser surgery repairs correctable damage (damage that can be otherwise corrected with lenses)
it also causes uncorrectable damage... more or less a "corner" where the laser stops hitting the eye.
this "corner" gets more profound after the eye begins to heal from the surgery and tissue regenerates.
It eventually causes people to have intense glare from light sources on the side of their faces (i.e. headlights when you drive at night)
I would recommend NOT getting this surgery.
Unfortunately not too terribly much progress has been made in consistently describing this damage (reports cite perhaps 30th order zernike polynomials for approximation of these problems...which is not helpful at all in describing the shape of the corner)
We are hoping to better describe quantitatively the damage caused by this surgery.
Anyhow I suggest you use a reversible method for correcting your vision (eg glasses/contacts)
--Daniel
Vega Strike Lead Developer
http://vegastrike.sourceforge.net/
Ortho-K. They are contacts that reshape your eyes. Eventually you only have to ear them at night or only once a week/month. Can give you better then 20/20, no side effects, reversible if desired, no risks really! I have too much astigmatism for it right now. But I'm waiting!
There is a school of thought that says that vision can be improved by stretching the eye muscles. This is advocated by behavioral optometrists. The idea is that when you spend time focused at a certain distance, as so many of us do, our eye muscles tighten chronically. When this happens, the cornea and lens distort and vision problems arise. The problem is not helped in the long run by corrective lenses.
I believe some other behavioral optometrists have some other theories about "learning to see", etc.
I know this all sounds crazy, but my vision got worse every time I go in for a few months of really intensive coding. A few months ago, I was certain my prescription had gotten worse - I can usually tell because on top of not seeing distances clearly, I have headaches and feel sick a lot.
On a lark I bought a book (really, an ~80 page pamphlet) on eye exercises, and also a bigger one on behavioral optometry. I did the eye exercises they prescribed, and within a week or so I was seeing noticeably better.
Now, I believe behavioral optometrists would prescribe a regimen of steadily weaker corrective lenses, to exercise your eyes. I haven't gone that far yet, but I do have to say I was stunned by the marked improvement in my vision a few weeks of exercises got me. I've dealt with steadily worsening vision for the last 20 years, so I KNOW I am not imagining it.
I've heard a lot of good things about lasik, but one thing that concerns me personally is the fact that, AFAIK there aren't any studies on the long term effects (probably because it hasn't been around long enough).
---
Open Source Shirts
The new method uses computer assisted distorted mirror and lens technology to create a real time map of the retina for the shaping beam (also new).
The benefits? Try 10/20 vision. And unlike LASIK, this new method promises less irritation and actually improves your night vision instead of nearly erasing it.
For my money, near super-human vision is worth the wait... and the estimated 5k per eye price tag.
None of the corrective surgeries available are approved for any class of aviation medical certificate.
This means if you have it done, you can *never* get a pilot's licence. If you currently have a licence, your medical certificate will not be renewed.
This has changed and changes every few months, as they update the software to ablate to areas larger and larger outside of the previous software revs.
So check what version of the software the laser is running and if the surgeon is keeping up with the laser manufacturer on maintenance.
The problem is that the myopia surgery goes only on one part inside of the eye pupil. they make a circle inside the pupil so as part of it sees well, and the other part, that stays outside the perimeter of this circle remains 'blind'. :)
during the day, when the pupil closes, you see very well. but at night, when it opens to gain light, you may have some problems, because part of your eye would see well, and the other part won't.
this things they don't talk about. so as if you have like 5 of myopia, u WILL feel strange. if u had like 2 or 3 of myopia u'd feel less the difference.
sorry 4 my bad english
Like yourself, I'm a developer who's been myopic (-3.0) for about half my life and wanted to do something about it. I was looking at LASIK and PRK, and was very close to doing it, when I found this site: http://www.surgicaleyes.com. I recommend you read some of the stories there and think again, carefully, very carefully, before you go ahead.
What I did was post there and ask if there were any known alternatives, and lo and behold, a person recommended a method called Ortho-K (http://www.ortho-k.net), which I've happily gone with instead. Basically it means that I wear contacts during the night and have perfect vision during the course of the day. And it's fully reversible, and can be adjusted as your eyes change with age (try and do the same with LASIK!). The fact that my optometrist offered either that I'd be fully satisfied with the outcome, or a full refund didn't make things worse, exactly. I'm very happy, and I've been using this for about a month now.
My vision is easily 20/20 these days, but I've learned that that doesn't necessarily mean that I have a good quality vision. I have had days when I have had a fair bit of ghosting, and in poor lighting I experience too significant starbursts. I have just had small modifications made to my lenses to compensate for this, and my optometrist is quite optimistic about improving this considerably.
Now that I've had the chance to "toy around" with my vision and have seen some of the effects that can result from it, there is no way in hell that I'd use something as permanent as LASIK, with little or no way of adjusting after the deed is done. The prospect of coding in braille is not one I'd look favorably upon.
Ok, I had the surgery, and I am in the unique position to do an A/B comparison of a corrected eye and an uncorrected eye. I had one eye done at a time, and after much frustration, decided not to get the second eye done.
I would NOT recommend it.
I was signed up for a the LASIK procedure, but at the last minute, they told me my corneal depth wasn't enough for LASIK. I was offered another newer surgery called LASEK which was supposed to be much better: no cutting of the cornea but the same laser accuracy. They put alcohol on your eye and loosen and fold back the epithelial layer covering the cornea. Then they etch your cornea with the laser and fold it back. It supposedly has a shorter healing time, less trauma from the cutting and doesn't have the "fallen circus tent effect". This happens when the LASIK corneal flap re-covers the cornea and gets little micro-striations from settling down on a flatter surface.
So, I had the left eye done, and continued to wear a soft contact lens in the right eye.
They say I have 20/20 vision in my left eye. My right eye with the contact lens does about 20/15.
My left eye is probably 20/20 in bright bright daylight. However, the darker it gets, the worse my vision becomes.
I believe what has happened is that the brighter the light is, the smaller your pupil closes down. With the pupil closed, only a small portion of your cornea is used to bring light into the eye and irregularities in the surface don't make much difference.
However, when the pupil opens up, you need a much more precise curve in your cornea to properly focus the light on your retina. I think that not only is the curve of my cornea imprecise, when my pupil opens some light comes through the portion of my eye not corrected by the laser. (And I had the "large pupil program")
At night, my left eye shows a confusing view of lights. Headlights from cars have a certain percentage focused at a point, but a large portion comes out in a halo (seems to be more to one side for me). Signs are quite difficult to read until I'm right up on them. If I didn't have my right eye to help, I would not trust myself to drive at night.
Movie theaters are another bother. You go in a theater and as soon as things get dim, the screen washes out for one eye.
My right eye is corrected by a soft Toric contact lens. It does significantly better in almost every case. Although it is nice to get up in the morning with SOME vision from the left eye, I have to put in my contact lens to get really crisp clear vision.
I can't sit at the computer screen in a dark room easily. It helps to have a bright light near the computer screen. This closes down the pupil and I get crisper vision in the left eye.
If I could do it again, I would definitely stick to my contacts.
My doctor seemed bothered that I was upset. He kept on trying to get me to compare the eye with the surgery to the same eye without any vision correction. Yeah, maybe things are better for the 5 minutes I need to put my lenses in in the morning, but really, is that meaningful?
I believe your vision will get worse than corrected vision, especially at night. Oh yeah, I can't wear glasses anymore because they change the size of the image that I see and though the brain can adjust for minor offsets in vision, it can't deal with two differently sized images.
no it's not rubbish.. it's only the tip of the iceberg of the problems and complications you can have.
Here's a clue from a developer who has worked on these systems (me) and not someone who sat like a gerbil under the laser letting his wallet get lighter (like most of the posters here).
The FDA has only approved certain procedures which have had extensive trial data in the US. Unfortunately most of these approved procedures are very limited in scope, and only correct the most generic of corrections. They'll correct astigmatism, but only to a fixed amount of diopters. They also fix the diameter of the laser to a certain width, which is awful, since your eyes dilate at night, and you will get halos. Unless of course you have small eyes like the sample data they used when submitting to the FDA for approval.
also, the more diopters you correct for, the worse the potential side-effects you may suffer. You may be one of the 5% of the people who suffer side effects. You will have little to no recourse against the "doctor" who performs the operation, because it's cosmetic surgery.
My brother rushed to get it done over my objections because it was cheap for family members to get their eyes treated. I will not let him drive a car I am in at night, because quite plainly, I'd like to get home in one piece. He gets halos...
If you're eager to have your eyes corrected, get good old fashioned RK, there's less side effects, a wider range of procedures that can be performed (since it's been done for over 50 years), and the results are just as accurate if not more so. I had a girlfriend that had RK performed, and a friend from high school as well, they were both quite happy with it, and didn't have any of the side effects you'll hear laser treated people have.
Asking the doctor who stands to profit from your operation for advice is about the most foolish thing you can do. He's a salesperson, he's got a very expensive laser ($250,000 to $750,000, unless he shares it with other doctors) plus operating costs (not cheap either), a $250 royalty payment for each procedure, and on top of that staff, rent, etc. Of course he thinks it's safe. He's done hundreds (you hope).
Since the company I work for no longer exists (bought or sold, no idea, I left a couple years ago) I feel safe revealing this much, but trust me, the horror stories I left that place with are minor compared to the ones some of my co-workers had heard/seen.. and no, I'm not revealing any (even in email)..
The comment on the homepage about maybe things have changed in the last year or two is humorous. Most of the major research in this field was complete over a decade ago... all they do now is try and convince the FDA to let the quacks unlock more procedures in this country.. and try to back it up with clincal data..
one of my co-workers did the ole' flap'n'zap last year.. I told him not to.. his vision comes out great after the treatment, and then progressively gets worse every week. Then he goes back to do it all over again every few months.. he keeps an eye chart next to his desk to keep track of how quickly his eyes degrade.. along with a lot of eye drops..
oh, here's another interesting factoid to mull.. after they slice your eye and flip it open to zap it with the laser, it will NEVER HEAL. The only thing keeping that flap on your eye is surface tension essentially. Don't believe me? Ask someone who has had to have a correction after their initial treatment if they re-cut their eye before they flip it up.. If you ever get hit on the back of the head real hard, BLINK! If you think finding a contact is hard to find, imagine what happens if the flap falls off.. Of course, it's never happened, but it's never been proven that it can't happen (and it's not like it'll regrow)..
I'll keep my glasses.. my CEO asked me when I worked there why I didn't have my eyes done.. I kept telling him I never had any time (which was true, they worked me like a dog).. but the reality is, my prescription has been stable for 10+ years, and I don't feel like having to worry about it chaning until I'm in my fifties..
ChuckyG
Three years ago I managed to get into FDA phase 3 trials for Staar Surgical's implantable contact lens (ICL). The lens is already widely used in other countries. The results have been good. I was extraordinarly near-sighted (-17 D), so LASIK as not a good option. I now see 20/30, owing to some residual astigmatism the lens is not designed to correct. I wear some very light, thin glasses when I want things to be crisp, like night driving. There are a number of implantables in trials right now. They have the advantage of being reversible and the optics are more precise because you are not dealing with tissue.
With my left eye, I have very fine "microscope" vision. I can get very close to something, like a monitor, and easily make out very fine details, like individual pixels on a very high resolution display. While I can sort of do this with my right eye, I cannot get as close to things without loosing focus, and while I can still make out 90% of the detail I can make out with my left eye, it's an order of magnitude more difficult. It's also very hard to explain without the unique perspective that I have. The best way I can describe it is to imagine wearing a very low power microscope on one eye -- you can see great detail, but you lose a bit of distance vision in the process.
All that said, I'm thinking seriously of Lasik. My wife had it done on both eyes, and she's never had one complaint about the procedure. I can't wear glasses because of the extreme differences between the prescriptions for each eye, and I have never done well with contacts. I figure my risk is much less than normal, because it's only one eye, and if I have a less than perfect result, my brain is already used to ignoring most of the faulty data from that eye anyway (I see 20/20 using both eyes). While I enjoy my microscope vision, it seriously interferes with my depth perception, and I find myself wanting good depth perception more than I want super-detailed vision.
My advice to those seeking Lasik, is to definately shop around, and get several recommendations. Take the time to find a competent doctor, and don't cheapen out on the cost of the surgery. The doctor who did my wife's surgery owned his own machine (many are simply rented and shared among many doctors), and never reused blades. He'd also been performing Lasik since it was an experimental surgery, and was very honest about the risks, bad experiences, and eligibility. It was quite a bit more expensive than anywhere else in town, and even the preliminary exam wasn't free -- but in retrospect, it was worth every penny.
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