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The U.S. Navy's Doctrine of Laser Eye Surgery
The New York Times reports that laser eye surgery — now performed on nearly a third of every new class of midshipmen — is transforming Naval careers. Navy doctors are performing these operations with "assembly-line efficiency," allowing older pilots to continue flying, and those who might otherwise have been disqualified to pursue flight school. The number of procedures has reportedly climbed from 50 to 349 over the past five years. The Navy uses a different procedure than that used on civilians — grinding the cornea rather than cutting a flap — out of fears that the flap could come loose in supersonic combat.
I got out quite a few years ago, before this was possible. My cousin however is still in, and he got the surgery done, for free. They offer it to everyone, and encourage you to do it. It makes all aspects of being a soldier - particularly an infantryman, much easier. Now you can wear off the shelf eye protection, no longer are gas masks a pain in the ass to put on, nightvision goggle, scopes, sights in a tank, are all easier to use.
I think it's a great idea, myself.
When I was in, 10 years ago, the actual doctors (officers) were top-notch. A lot of them were reservists that had a private practice and were spending their two weeks helping out as a way to help cut the costs of college. Now...the enlisted people that you have to shuffle through to get to talk to a real doctor were another story. I had bronchitis in a bad way for three weeks before they decided the standard "cold pack" wasn't cutting it and maybe I should get to see a real physician.
"It is a miracle that curiosity survives formal education." -Albert Einstein
Followup to my own post. Here's a copy of my journals regarding my PRK experience:
Exam notes:
It was intresting. I had filled out the eye history sheet before I went
in. They gave me a quick eye exam, but it wasn't like a normal one.
First up was the typical Big E projected on the wall (no glasses!)
"Nope, can't see it."
Next up they took two pictures of each eye. It was a weird device, it
was cone shapped, and I was looking into the big end of it. The inside
was black, with many concentric circles of purple light, with a lens at
the center. It made a topographical map of my corneas.
Next up was a device that measured my perscription. I had to stare at
a little picture while it zoomed in and out of focus. Apparently this
determines my exact perscription, none of that "Is this better, or that"
lens swapping. I wonder why eye doctors don't use this all the time.
Last of the inital measurements was another corenal mapper. Nothing to
see, just a red light.
Then I got a 10 minute vides summerizing LASIK. I knew all that stuff
already from my research.
Then I got to speak with the doctor. She did a few more measurements,
including measuring the thickness of my corenas. Then we got down to
the nitty gritty.
I am NOT a good canidate for LASIK. The corena mappings reveal that
they're buldging on the lower sides, kinda pear shapped. LASIK can be
done, but by pealing back the flap, my corenas loose some of their long
term strength, and I risk having them thin so much I may need a corena
transplant in the years to come.
However....I am an exceptional canidate for PRK, which is basicly LASIK,
but with no flap, they just burn off the extra portions of the cornea.
The recovery time is a bit more involved, and would likely be unable to do
much of anything for a couple of days. I'd have to wear contacts as
bandages while the areas where tissue was removed healed.
Lots of questions with the doctor, but generally very optimistic about
my final result being 20/40 or better. Like 95%+
Then I was off to the office manager for the bottom line. $3700, for
both eyes, all the pre and post care (7 appointments!), and any
additional corrections for life. This about what I expected. And
that's with 15% off from my insurance. I asked, normally they'd give a
cash discount, but I can't combine it with my insurance. Then she gave
me several consent forms and whatnot to review.
4 hours post op:
Well, I did it, and I'm not blind.
It went very smoothly. Arrived, filled out a couple (more) consent forms, one last cornea mapping, and had a last minute chat with the doc. Got a perscription for some vicoden, and got my final post-op instructions. Paid the nice lady, and she gave me some Advil and a valium. Back to the waiting room for 10 minutes.
The proceedure itself I can't really describe, as most of the time I was staring at a bright light 6" from my face. But, they gave me a stylish hair net, and ploped me in a dentist like chair. Leaned me back, and it slid me under the light/laser/camera.
They gave me a half dozen eye drops in each eye and let me sit for a few minutes. I know one of them was an anastetic, hence the wait. They put a plastic shield over my left eye, and taped it in place. Then they tapped my eyelashs/eyelids open on the right eye. They put in the thingy that holds my eye open, which wasn't as uncomfortable as I thought it would be. Few more drops, and then they (according to C) put a little white disk over my cornea. I couldn't see anything, but after they lifted it, I could see the q-tip removing the outer layer of my cornea. Then, he used what looked to be a ice scrapper, I swear. Couple more drops, and then "Don't move, stare at the light" Then they fired up the laser, it made a clicking noise for about 40 seconds. The light went from really blurry to mostly blury, and then they popped in a "bandage" contact, and removed the thingy and left ey
Sure, eye surgery can solve these problems and it's not very likely that the surgery will "backfire". But that just is not a risk I would like to take with my eyesight.
Like lots of things, I think it's a risk/reward question. In my case, I wear glasses and will continue to wear glasses, but my vision isn't that bad so the reward I'd get from eye surgery isn't all that great. The glasses sharpen my vision and make it easier for me to read road signs, but I can actually get along just find without them.
My wife, on the other hand, was blind as a bat without her glasses, to the point that she had to carefully place her glasses in the same place next to the bed each evening, because she had to find them by touch in the morning. She could not see them. She got Lasik about three years ago, and it has significantly improved her life. Before the surgery, for example, she didn't dare participate in any sort of water sports because losing her contacts or glasses would leave her completely blind. Now she SCUBA dives and I expect to get her up on water skis this summer. Even more important is the sense of freedom she has, being able to see without assistance. After the surgery, her sight was 20/20, but has gradually declined to where she is contemplating getting glasses again to sharpen her vision a bit. She could have the surgery re-done (for free, even, since a followup was included in the original price) instead of getting glasses, but it's no longer worth the pain or the risk.
I know others with similar stories, and I can definitely see how someone who'd like to fly military jets would perceive the risk/reward tradeoff as a good deal. Heck, I'd get the surgery if it meant someone would let me fly an F-14.
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There are less side effects and the results are almost always better with PRK. It also is easier to do touch ups as needed. The reason why it isn't as popular in the states is that it requires people to take a few days off so their eyes recover. I could afford a week off in countries where you can get more than 2 weeks of vacation. ;-P
Brought to you by the Vacation for everyone lobby.
My parents are both MDs, so I always go to them with medical questions before paying anyone for advice.
Last time I asked (I'm around -4.5 in both eyes), they were worried about the long terms of removing part of the lens in either eye. Apparently, part of the lens is also removed as a treatment for cataracts, and they had some worry that
a) Laser eye surgery could remove enough of the lens to make cataract treatment later in life difficult or impossible, and, also
b) There weren't any large scale long term (20+ yrs) studies on the rusults of the surgery.
As I said, this is secondhand... perhaps if there's a MD or a Optometrist on these boards they could comfirm/deny/just explain better?
The commonly held belief back then was these docs (and dentists... don't get me going on this one...) were only in the military because they couldn't hack private practice.
More like because they couldn't afford medical school another way.
My experience with military docs is that they're reasonably good physicians, but that the health care system in the military lacks continuity, and that causes problems. Also, because most of the doctors leave the military after they complete their obligation, the active duty doctors all tend to be young and somewhat inexperienced. The best thing to do, if you can, is to get one of the doctors who is a reservist.
My anecdote: The Army doctors at Fort Hood nearly killed my younger sister because she had condition (pyloric stenosis) that is rare in girls, so each doctor wanted to exhaust all other possibilities first, and didn't really trust that the other doctors had done their job. In desperation because my baby sister was dying of dehydration and malnutrition, my parents eventually took her to a nearby civilian hospital, where they operated and corrected the problem within a few hours. To the Army's credit, they admitted their error and the correctness of my parents' actions, and covered the civilian medical bills.
In contrast, my parents now get all of their medical care through the nearby Air Force base hospital, which is generally staffed by a rotating group of reserve physicians who seem to be uniformly excellent doctors. The docs recognize the need for continuity of care and make heavy use of referral to local civilian docs for any condition that requires the sort of continuity they can't provide. They also try to arrange so that each patient sees the same doctor for routine physicals, etc.
Note to ACs: I usually delete AC replies without reading them. If you want to talk to me, log in.
My wife also had a great experience. So good that I decided to get it done myself.
I am now one of many others who have not had such a pleasant experience even after coughing up thousands of dollars and spending many hours finding the best surgeon in the Columbus Ohio area. Luckily, I can still see with glasses after my botched surgery, but it was one of the most frightening experiences of my life. The microkeratome lost it's grip (suction) on my left eye during the actual cutting of my cornea. Now my eyes cannot create tears and I will be using artificial tears every couple of hours for the rest of my life.
Is it worth it? No way!