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.

Obligatory Simpsons Reference

[Cyno01]

from BABF13 - Bart to the Future Ralph: Mr. Flanders, your blindedid. Flanders: Yeah, I never shoulda had that trendy laser surgery, it was great at first, but at the 10 year mark your eyes fall out.

do it yourself

[joe_bruin]

i stared into the fiber coming from our t3 drop, and my vision was miraculously cured. well, except for the one dark spot that has a burned in backwards "NORTEL" logo on it.

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...

Don't - just don't

[Anonymous Coward]

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.

Re:Don't - just don't

[sessamoid]

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.

Hmm... conflict of interest? Optometrists are largely in danger of becoming an obsolete species thanks to vision correction surgery. I detect some possible bias here. Mild trauma is NOT going to open up the cut, any more than mild trauma is likely to rebreak a formerly broken bone, any more than mild trauma is likely to open a cut that healed on your skin years ago. LASIK is fairly prevalent now, and I've NEVER heard of a single case of the corneal flap avulsing, let alone see one (and I see lots of bad car accidents every day, none of which complain of vision loss without other severe trauma to the eye, i.e. denucleations, hyphemas, etc.).

Basically, I'd take your friend with a grain of salt. Get more than one side of the story, preferable one whose livelihood isn't endangered by the new technology.

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

Dangerous

[SandSpider]

Cal Simone, who is very famous in the Applescript world, had laser vision surgery done recently. Unfortunately, now he can't look at a computer screen for any period of time without getting a headache. He can't do any coding, and is very limited by how much computer work he can do at any given time.

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

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

Long term risks unknown

[kindofblue]

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.

Then there's the risk

[hatless]

Me, I wear glasses, ones with a pretty thick lens on the left at that. The frames get a little in the way of my peripheral vision. But I don't want Lasik. Why? Because of the failure rate--even if it's somehow down to only 1%, and I'm not sure it is.

Forget worrying about not achieving the 20/20 vision you want and that many people get from it. Worry instead about the real risk of corneal damage that will leave your vision worse than it was before, with permanent starbursts and haloes like you're looking through scratched, scuffed glasses all the time.

Will this happen to you? Probably not. In fact, if you have the sort of vision that Lasik corrects, you have a well over 95% chance of getting the great vision without glasses that you want. It's just that if you draw the short straw, you could find your ability to read a screen pretty thoroughly ruined, with or without glasses.

Weigh the benefits against the risks, and if you decide to do it, note that most surgeons have you sign a boilerplate contract that bars you from suing them if your vision is ruined. Who's the real winner?

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.

You've come to the right place then

[Target Drone]

I would love to hear anecdotal evidence about your experiences

If it's anecdotal evidence, conjecture, speculation, or just good old innuendo your interested in then Ask Slashdot is the place for you.

I'm doing research in this area-- don't do surgery

[Anonymous Coward]

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/

Wrong

[Johnboi Waltune]

I had LASIK 2 years ago and have no night vision problems. For the first couple months, there was a slight 'ghosting' effect around bright lights at night. That has completely disappeared. My night vision before the surgery was excellent and it continues to be so.

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

Behavioral Optometry

[tmark]

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.

Re:Behavioral Optometry

[kbonin]

I'd second this. I stare at a monitor 10-15 hours a day. My eyesight finally degenerated to the point where I got tested, and my vision sucked. Astigmatism in both eyes, I forget the scores, but I got perscribed reasonably thick glasses. Everybody else in my family wears them, I figured it was unavoidable...

I hated them. I did more research, and found out about eye exercises. I adopted new habits, most notably staring out window at horizon for a few seconds every 10 mins.

About a year later I tossed the glasses in a drawer. That was >10 years ago, and I currently test at 20:20 again. The astigmatism is still there, but its managable, brain processing seems to remove wierd smear/blur if I use both eyes, which I tend to do most of the time anyway...

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.

Alternatives

[guttentag]

For those unwilling or unable to take advantage of Laser Surgery, have other viable alternatives arisen in the past two years?

There have been some amazing advances in the Braille terminal industry.

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.

I can see my wife in the morning

[SIGFPE]

I hope she turned out to be as good looking as you hoped. A low pass filter does wonders for a woman's beauty and having it removed like that can be a shock!

Re:I'm probably going to have it done... (OT)

[GeekDork]

I'd be careful about wildly comparing everythings "danger factors" with driving at rush hour. Especially eye surgery. It is morbid, but chances are high that in a car accident you either won't really have to handle the results or get over it rather quickly. In eye surgery however, you're quite unlikely to die if the surgeon hits the "disintegrate" button, but you'll probably be blind as a mole for the rest of your life. Now, I would think that most of us are at an age where it would be very difficult at least to adopt to a completely changed lifestyle, especially if your defect was rather minor beforehand (nothing really requiring glass bricks).

I don't want to say that eye surgery is a bad thing. It has its merit in repairing defects that are otherwise incorrectible. But if it's (ab)used as purely cosmetic surgery, then I think the dangers outweigh the use.

Also note that my sight is rather good (-1.0 on both eyes, with a nasty embryonal core in the left which makes me see double on this eye), and so I might be unqualified to say this. But what I know is that every kind of surgery has very real dangers and that it should be regarded as a last resort.

Cyclops is looking for help with his vision!!!

[Gandalf21]

Does anyone else find it ironic that the guy posing this question has the nick cyclops? If I were him, I would be very careful not to damage my lone good eye .)

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:Same night vision problem with contacts

[Xerithane]

Anyone know if the LASIK halo problem stems from the same reason of the Contact Lens halo problem(over large pupil dialation)?

Yes, this is coming from late 1999 so maybe they have more work. I have abnormally large dialation ranges, and abnormally large contraction ranges as well. My eyes pretty much stay dialated.

I have talked to a few doctors about it, they all said don't do it. Even in normal light, my pupils would expand past the area that Lasik can modify so I would get constant ghosts and halos. If you have a large dialation area, anytime you hit that point you will experience it as well. But, like I said, this may be different now.

I'm waiting for a surgery that corrects my contraction problem, then I can worry about Lasik... sigh

Re:Same night vision problem with contacts

[foolish]

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.

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.

Re:Don't Do It!

[Timmeh]

We /.ers don't like FUD.

Hogwash. General statements like that are just FUD. ;P

Better than contacts but sometimes "normal" is bad

[GlenRaphael]

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.

If you wear contact lenses, there is a small chance you may permanently screw up your eyesight due to a scratched and/or infected cornea. The risks of serious negative outcome associated with LASIK are smaller than the normal risks associated with contact lenses, so people who wear contacts now are probably on net helping their odds of keeping decent eyesight if they get LASIK.

Me? I got LASIK a few years ago. Best $4400 I ever spent. The main caveat I might add is that for a computer geek sometime it sucks to have "normal" vision. Back when I was nearsighted it was possible for me to read ultra-fine print. I could print program listings 8 or 16 pages to one side of a laser-printed page and still read it. I could squint a bit and easily make out individual pixels on my Newton or CRT monitor - often useful when doing graphic work.

Now, my vision is just normal. Meaning I no longer need glasses to read stuff 20 feet away, but the flip side is I can't take them off to read stuff 2 inches away. Sometimes I miss that ability.

Re:I'm probably going to have it done...

[barfomar]

Talk to your eye surgeon about intra-ocular lens (IOL) implants too. These are same clear plastic replacements for the lens that millions of the elderly have had for cataracts. They're now being used for vision correction too. A "multi-focal" lens implant allows a broad range of focusing. Its a 10 minute surgery, done under local anesthetic drops. A tiny incision is made along the border of the lens and a pencil-like phacoemulsifier (ultrasonic) probe liquifies the old lens. A new lens, rolled up like a taco, is inserted and allowed to unfold. Stitches are rarely needed. There's a lot more history behind this technology than the lasik approach. It's true that it's more invasive, but it doesn't purposefully involve scarring the lens.

No...

[Greyfox]

But my brain did supply sound effects. That was disturbing. It went "*SCHLURP*... *POIK*...EEEEZzzztZzztZzttt *ZAPPO* *ZAPPO* *ZAPPO* *SCHLURP* *RRR-RRR0RR*" Really... really disturbing...

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.

I am an interesting case...

[Polo]

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.

Re:Don't Do It!

[chuckgrosvenor]

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..

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.

You may not see this....

[aengblom]

...since I am posting late.. but
(haha, pun originally not intended, but it is now)....

Find someone who will turn you away!

One of the big things about this surgery is that, most (all?) Dr's will tell you the average risk. But they will not tell you your specific risk. For people with certain eye characteristics, the rate for having complications is much higher than others. I'd have serious reservations (if I couldn't see 20/20 already :P) if I couldn't get someone to tell me if I was above or below.

In fact, I'd be willing to pay a fair some of money to a doctor to evaluate me who KNEW he wouldn't be getting me as a patient. Second opinion is one thing. Objective opinion is another.

Re:Better than contacts but sometimes "normal" is

[einTier]

I have 20/200 vision in one eye and 20/15 in the other. By having two such extremes, I can verify this story.

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.

Re:I'm probably going to have it done... (OT)

[n9hmg]

A: This is not OT.
B:I chose to comment at this level because you're talking about my prescription, or close to it - 10.0 and 10.5 nearsighted, with a couple of diopters of astigmatism.... at least, it was. It was a scary decision, but i figured the chances of permanent crippling vision damage was miniscule, and the chance of some degradation was still pretty small. I figured i could wear even worse coke-bottle-bottoms, switch to a larger font, and maybe squint a bit, maybe even use a screen reader, for my job. On a mountainside, glasses can be a real hassle. Fogging in the cold, sliding down your nose in the heat, and, the possibility of them falling off and leaving me hoping for a high-altitude rescue (contacts are even worse when you're that far out on your own) made me take the chance.
I had to go with PRK, as my cornea is only about as thick as the flap they cut for LASIK. During my post-procedure phase, I accidentally took the cortisone drops a few days too long, and ended up making myself slightly farsighted. I'm only 39, so i've still got good focal range, and can focus down to about 8 inches, but I'm going to need reading glasses sooner than I should have. I still don't regret it. I'm a solid 20:15, and can jump out of bed in the middle of the night seeing perfectly.
Note that if you're much past 10, nobody will do you, so it can't get rid of 2-inch-thick lenses. What it comes down to is your own priorities, what losses you can live with, what risks you can stomach. If you're a couch potato, barfly, gamer, or otherwise sedentary, vision correcting surgery is probably a waste of time, stress, money, and karma. For me, not a day passes where I don't think about it and giggle about the fact that I'm no longer a cripple when I sleep.