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You have decided it’s time for LASIK. After researching and talking to your friends, you decide it’s time for LASIK at LasikPlus.  So who are you going to meet on your journey?

On your first phone call to LasikPlus, you will speak with a Call Center Consultant.  This person will schedule your first, free consultation at the most convenient LasikPlus vision center.  The Consultant will ask you some general questions about your vision and provide you with the needed information to get you prepared for your exam, as well as answer your questions.

When you arrive at the LasikPlus vision center for your consultation, you will be greeted by one of our ophthalmic technicians.  He or she will walk you through the completion of a few standard medical information forms. If you were able to complete the forms online in advance of your appointment, you will only need to confirm that the information is correct and sign the forms. While in the waiting area, you will watch a short educational video about LASIK and the other procedures we perform. The video covers frequently asked questions. Also, the technician and optometrist will be happy to answer any additional questions or offer more detailed information during your exam.

The technician will then guide you through a series of tests to evaluate the health of your eyes, measure your needed refractive correction based on your prescription and answer your questions.  The technician will put dilating drops in your eyes, which will allow the optometrist to examine the inside of your eyes.  While the dilating drops are taking effect, the technician will review our pricing and financing information.  He or she will show you our treatment calendar and go over treatment day instructions with you, such as the need to have a driver for your treatment day. Treatment day information will also be provided to you in a take-home packet to be reviewed at your convenience.

Once your eyes are dilated, you will meet the optometrist, a doctor who specializes in eye health.  He or she will examine the refractive correction that you will need, examine your eyes, review the results of the testing that you did with the technician, discuss which procedure will be right for you, and answer any questions that you may have. The doctor will also finalize your treatment date and provide you with prescriptions for drops that you will need to obtain at a pharmacy prior to your treatment date. 

On your treatment day, you will arrive at the center with your driver.  You will be greeted by a member of our staff.  If additional testing is required, you may meet with the optometrist again.  You will go through the check in process with an associate who will take your payment for the procedure.  One of the associates will then review the post-operative instructions with you.  Your driver is welcome to be with you at this time as it may be helpful for them to hear the instructions as well.

The surgeon will then come in to meet with you, explain the consent forms and answer any additional questions that you may have before having you sign these forms. He or she will verify the procedure that you are having, review what will happen during the procedure, and have you sign the final consent forms.  You will then be taken into the laser suite for your procedure.  The surgeon will have one or two technicians with him/her in the laser suite.  It is normal to be nervous and our LasikPlus teams will do everything we can to make the procedure as easy as possible for you.  At the end of the procedure, you may be asked to sit for a few minutes in a quiet room where the surgeon will do one last check before an associate walks you out to meet up with your driver. 

On the day following your procedure, you will return to the center for a follow up exam.  At the one day exam and at your subsequent follow up exams you will meet with the ophthalmic technicians and the optometrist.  If you should require an exam with the surgeon or a meeting with the Center Director, these visits can be arranged. 

All the members of the LasikPlus team hope that you have a fantastic experience and are available to help you any way that we can on your journey from “I want LASIK,” to “I GOT LASIK!” 

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Myopia is the medical term for “nearsightedness”.  Being nearsighted means you can see near objects well without the use of glasses or contact lenses, but your distance vision is blurry.  Myopia affects about one out of every 3 or 4 people.  

Myopia often begins in school age children, as early as grade school for some, when the vision problem is detected during a vision screening test at school or when a teacher notices the child cannot see the chalk board.  Other people may not be affected until their high school years or early twenties.  People often first suspect that they are nearsighted when they realize they need to “squint” their eyes to see better at night or in low light conditions.  Partially closing or “squinting” your eyelids reduces the amount of scattering of light by the myopia and usually helps you see a little clearer.  Usually poor night vision is one of the first signs of myopia but day time vision also worsens as myopia progresses.  Myopia may be slowly progressive throughout your life or it may “stabilize” in your 20’s or 30’s. 

My Struggle With Nearsightedness

I first started developing nearsightedness when I was in high school, although I did not realize it.  One of my jobs on the high school football team was returning punts.  We had practices after school when it was daylight and I had no problem seeing the ball.  However, during our Friday night football games, under the stadium lights, I had more difficulty seeing the ball.  I had to “squint” my eyes to see the ball more clearly.  Also the scoreboard numbers were hard to see and the individual lights appeared fuzzy with starbursts around them and looked like Christmas tree lights.  I also noticed it was much harder to read street signs when driving at night.  In retrospect, these were early signs of myopia.  My myopia slowly progressed and I eventually had an eye exam and was prescribed a pair of glasses.  I was amazed how well I could now see the chalk board and see the “leaves on the trees.”  Lights at night looked clear and without glare.  My myopia did progress to the point that I needed to wear glasses or contacts at all times to see clearly.  I was very active and I hated wearing glasses or contacts for sports, swimming, scuba diving or any other activity.  My glasses had nose pads that used to “dig into” the sides of my nose and make my skin red and sore.   Also, I hated wearing sunglasses or goggles on top of my glasses or contacts when snowboarding or skiing. 

My Life After LASIK

In 2002, I had laser vision correction of my myopia at LasikPlus and my vision has been great ever since.  I am able to play sports, swim with my kids, drive at night, read street signs and books all without the need to wear glasses or contact lenses.  My experience with myopia is similar to many of my patients’ experiences.  I have now done more than 78, 000 laser vision correction procedures and the majority of those have been patients with myopia.  It has been quite satisfying for me to dramatically improve the lives of so many thousands of “nearsighted” people.  If you have myopia, you may want to see if you are a candidate for laser vision correction.   

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This article recounts some of the steps LASIK took to become one of the most popular procedures in the U.S. and takes a look at where the road ahead could lead.

Most of us are familiar with the Chinese proverb “A journey of a thousand miles starts with a single step.” This article recounts some of the steps LASIK took to become one of the most popular procedures in the U.S. and takes a look at where the road ahead could lead.

LASIK’s Proven Past

Vision correction technology has come a long way in 35 years — allowing more and more people to be free of glasses and contacts. Some key dates in LASIK history include:

1978: Doctors perform the first radial keratotomy procedure in the “free world” in Detroit, Mich.

Early 1980s: Doctors at Colombia University start using an argon fluoride excimer laser instead of a knife blade to flatten the cornea and correct vision. However, doctors still need to use a blade to create the corneal flap necessary for LASIK.

2000: Clinical trials began to make the corneal flap with a femtosecond laser, completely removing steel blades from the LASIK treatment.

LASIK’s Bright Future

So what does the future hold for vision correction? Researchers are hoping someday to use eye drops to change refractive errors, completely eliminating lasers from the procedure. Then, different eye drops will be used to halt the progress and maintain vision at the desired result. While this sounds exciting, it could take years or decades before this technology is publically available, if it is successfully developed at all. Other technology currently in development includes corneal inlays to help correct presbyopia.

Methods of vision correction will surely evolve, just as cars will run more efficiently, air travel will be faster and medical technology will advance. The question is: How long do you want to wait to be able to see without prosthetic devices such as glasses and contact lenses? The timeline on these future advances is not defined. Perhaps now is the time to change your life and enjoy better vision. The safety and accuracy of the current LASIK procedure have never been better.

Another Chinese proverb says, “To know the road ahead, ask someone coming back.” Ask friends what their LASIK experience was like. Ask three questions: “Are you glad you did it?” “Is your vision better than it was before the procedure?” “Would you do it again?” Then make your own decision.

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LASIK doesn't only result in noticeably improved vision. There are also unexpected benefits to having the procedure.

For many patients, LASIK results in noticeably improved vision. As noted in previous post, there are also unexpected benefits to having the procedure. Here are four more advantages my patients frequently mention.

Improved peripheral vision.

In addition to improved straight-ahead vision, many of my patients remark how much better their peripheral vision has become since they no longer wear glasses. Glasses do not “wrap around” the eyes, so peripheral vision is blurry unless the patient turns his/her head. Once the glasses are gone, peripheral vision is clear as well.

Reduced allergy symptoms.

Some patients say their allergy symptoms improve after treatment. They claim fewer headaches and less sinus pain without glasses sitting on their nose. Contact wearers claim less eye irritation and redness because they don't have to put contacts in their eyes.

Better nighttime vision.

Although a small number of patients experience mild glare/haloes after their LASIK procedure, many people say that their nighttime vision improves after the procedure. I believe it might have to do with the fact that they are no longer dealing with the light reflecting off the lenses in their glasses. For people who wear contact lenses, end-of-day dryness may also cause fuzzy nighttime vision. Without having reflections and a poor refractive surface because of dryness, many post-LASIK patients actually see better at night.

Additional lines of sight.

Some patients with high levels of myopia or astigmatism gain additional lines of vision after LASIK. These types of refractive errors are best corrected on the corneal surface and often increase a patient’s clarity after surgery — as opposed to only partially correcting them with glasses or contacts that move with each blink.

Each person’s eyes are different, and the benefits of LASIK vary from patient to patient. Consult with a qualified LASIK doctor to determine if the procedure is right for you.

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More than 11 million Americans have vision problems due to refractive errors. Fortunately, the majority of these issues can be addressed with prescription eyewear or laser vision correction.

Types of Refractive Errors & When They Occur

The most common refractive errors are nearsightedness, farsightedness and astigmatism. All of these are caused by light not bending — or refracting — correctly as it hits the eye. Nearsighted individuals have difficulty seeing objects far away. Farsighted individuals have difficulty seeing objects up close. Those with astigmatism have football-shaped eyes, which causes objects to appear blurry.

Most children have clear distance and up-close vision. Starting in adolescence, some develop a refractive error and need corrective lenses. The prescription for these lenses may change often from adolescence into early adulthood. In adulthood the prescription stabilizes and varies little thereafter.

As many people enter middle age, they develop a condition called presbyopia. This is caused by the natural lens of the eye becoming inflexible, which affects the ability to see up close.

Types of Vision Correction

Glasses are the oldest method of refractive vision correction and have been around for hundreds of years. Contact lenses have been available since the 1950s. Both glasses and contacts change how light focuses on the retina, which corrects the refractive error and improves vision. Reading glasses help those with presbyopia see up close.

Since the 1990s, a laser vision correction method called LASIK (laser assisted in situ keratomileusis) has been available as a third option to correct refractive vision problems. LASIK reduces or eliminates refractive errors by changing the structure of the cornea, which is located on the front surface of the eye. This restores visual function.

LASIK is a two-step process. First, the doctor uses a laser to create a flap in the eye’s cornea to preserve the skin of the eye called the epithelium. In the second step, the doctor uses another laser to etch an individual’s own corrective lens prescription on the cornea below the flap. The flap is then put back in place.

No stitches are used in LASIK, and healing is fast for the majority of patients. In fact, many are able to return to work the next day. Numbing drops are used, so patients experience very little discomfort. While side effects and complications may occur, they are rare and usually temporary.

Patients with presbyopia may benefit from monovision LASIK. Monovision corrects one eye’s distance refractive error, while the other eye is left mildly nearsighted for near vision.

Symptoms Versus Cause

Glasses and contact lenses only improve the symptoms of refractive errors. LASIK reshapes the surface of the eye, therefore addressing the structural cause of blurry vision due to refractive errors. This allows the eye to focus without the use of glasses or contacts. LASIK addresses the cause of refractive errors, not just the symptoms.

Each person’s eyes are different. Always consult with a trusted, experienced ophthalmologist to determine which vision correction solution is best for you.

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LASIK (laser assisted in situ keratomileusis) is a type of refractive procedure that can correct myopia, hyperopia and astigmatism. The goal of LASIK is to provide a reduced dependence on glasses or contact lenses. So how long does LASIK last?

Long-Lasting Results

Prospective patients often ask me, “after successful LASIK, how long will the results last?” The answer for most people is years or even decades. However, there are some exceptions to the rule. Approximately 5 percent of patients develop small changes in their eyes that require a second procedure. This can happen three months after the initial procedure or 20 years later.

Presbyopia in Middle-Aged Patients

Another issue to consider is presbyopia, a progressively-diminished ability to focus on nearby objects. This is why many people start wearing reading glasses or bifocals as they reach middle age. Patients who have LASIK before they become presbyopic will need reading glasses to see up-close. An alternative to reading glasses is a laser vision correction procedure called monovision.

Cataracts in Elderly Patients

Elderly patients often get cataracts, cloudiness to the lens inside the eye, that lead to a decrease in vision. Usually this occurs when patients reach their 70s or 80s, but it can happen at any time. Successful cataract surgery removes the cloudy lens; replaces it with a new, flexible, artificial lens; and restores pre-cataract visual acuity.

LASIK changes the shape of the cornea to focus light crisply on the retina. While results vary from patient to patient, the procedure allows many to enjoy years of clearer vision.

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Many LASIK patients previously visited an eye doctor (optometrist or ophthalmologist) only when they required an update for their eyewear prescription. Do patients require regular eye care now that they are less reliant on glasses and contacts? The answer is absolutely yes — for several reasons.

Treat Occasional Complications

Complications related to laser vision correction procedures are uncommon, especially after the initial postoperative period. Very rarely, a trauma, such as a pet scratching the patient’s cornea, may cause the LASIK flap to be moved and require repositioning. A corneal abrasion may require treatment and a course of topical steroids to prevent inflammation.

Chronic conditions, such as dry eye, may cause foreign body sensation, tearing, fluctuating vision and haloes at night. Most often, proper treatment with doctor-provided eye drops will help restore optimal vision. LASIK does cause a temporary reduction in tear production, a side effect that is usually bothersome for two to four weeks at most. Normal tear production levels return by six months after the procedure. LASIK patients with preoperative dry eye will, of course, continue to have the condition and require appropriate care.

Assure Proper Response to Treatment

While side effects are an issue, most patients are more concerned about the long-term stability of their improved vision. Will LASIK or PRK (photorefractive keratectomy) last? Will they have to keep coming back for retreatment? Laser retreatment (or enhancement) is uncommon after patients pass their one-year treatment anniversary. In most cases, retreatment is required because of an over-response or under-response to treatment. These issues are usually recognized and treated three to six months after the original procedure. If retreatment is required, LASIK flaps are lifted and several seconds of laser treatment are applied to correct the small remaining refractive error. If more than two years have passed since the procedure, the doctor may opt to perform a PRK procedure. This reduces the risk of surface cells growing under the flap. While some patients require retreatment, most remain stable or have insignificant changes in refractive error and vision long-term.

Monitor for Eye Diseases

A major reason to seek regular eye care is to prevent and detect eye diseases — for example, cataracts and glaucoma. Cataracts, or clouding of the eye’s natural lens, can cause changes in vision. While more common in the elderly, cataracts can occur at any age. Vision changes due to a cataract are treated by removing the cataract — not laser retreatment.

While cataracts will eventually result in visual symptoms, many eye diseases will not show symptoms until damage is severe. Glaucoma is actually a group of diseases that damage the optic nerve, resulting in blind areas. Untreated, it can result in complete blindness. Perhaps a third of glaucoma-related conditions will occur with no recorded elevated eye pressure. Only a detailed optic nerve examination or special diagnostic testing can diagnose the problem prior to damage. Glaucoma can occur at any age and is without symptoms in the early stages. After LASIK or PRK, a patient’s cornea will be thinner and traditional pressure testing devices may record an artificially low reading. Therefore, a complete eye exam is even more important to insure eye health.

Retinal tears or detachments can be asymptomatic (displaying no symptoms) in the initial stages. Of course, if patients see flashing lights or new-onset floaters, plus experience a decrease in vision, immediate evaluation is required. Routine care can often detect asymptomatic retinal pathology that increases the risk of detachment.

For all diabetics, annual retinal exams are critical. If bleeding or swelling are detected, early treatment may preserve a patient’s vision.

Regular check-ups with your eye doctor are critical — whether a patient has had laser vision correction or currently wears prescription eyewear. A qualified eye doctor can make sure that the eyes are healthy and functioning properly.

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This article offers general guidelines on what to expect after LASIK, but each patient’s experience will be different. The best way to increase positive outcomes and decrease negative outcomes is to find an experienced, trusted LASIK provider.

As with any medical procedure, LASIK can have positive and negative effects. Below are some of the more common benefits and drawbacks.

Pro: Better visual acuity

Many patients notice an immediate improvement in their vision after receiving LASIK. As the cornea heals, this effect becomes more noticeable. For the majority of patients, their uncorrected vision 12 to 18 hours after the procedure is as good as their vision was prior to the procedure with their glasses or contact lenses.

Con: Night vision issues

Many people will notice nighttime glare, halos and sensitivity to bright light after their LASIK procedure. These issues usually resolve within three months. Rarely, some people will have persistent night vision issues that last longer than one year. While these side effects rarely persist for such a long period, they are some of the risks of the procedure. Most people who have LASIK do not experience these types of effects long-term.

Pro: No more “four-eyes”

Glasses can negatively affect people’s self image, and unfortunately for some people, contact lenses may not be an option. Freedom from glasses can improve patients’ self-esteem, as well as broaden their fashion and cosmetic options.

Con: Subconjunctival hemorrhages

Subconjunctival hemorrhages — red spots on the white of the eye — are very common immediately following LASIK. These spots are bruises caused by the suction ring that was used to hold the eye still while the corneal flap was created. These bruises are bright red because the skin overlying them, the conjunctiva, is clear. The red spots can last from one week to one month and can be small or cover the majority of the white part of the eye. Although they may look alarming, they are cosmetic and do not hurt or affect the vision. They are temporary, and your body will naturally clear the spots within a few weeks.

Pro: No more irritating contact lenses

Contact lenses decrease oxygen delivery to the cornea, the front surface of the eye. They also decrease the ability of the tear film to naturally remove toxins, allergens and bacteria from the eye. Contact lenses can cause dry eyes, allergic reactions and infections. LASIK decreases most patients’ reliance on contact lenses, which means their eyes are more comfortable.

Con: Dry eyes

LASIK causes an acute dry eye condition in most people that can last from one week to three months. For most people, topical artificial tears, topical dry eye medications and use of oral omega-3 fatty acids can alleviate most of the symptoms and signs of LASIK-induced dry eyes. In rare individuals, the dry eye can persist for up to a year or more.

While the above information offers general guidelines on what to expect after LASIK, each patient’s experience will be different. The best way to increase positive outcomes and decrease negative outcomes is to find an experienced, trusted LASIK provider.

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Many potential LASIK patients ask me if they will need more than one procedure to correct their vision. They are under the impression that LASIK doesn't last, and they will need to have the process repeated at some point in the future. I am not sure where this idea originated, but in the majority of cases, it is just not true.

A Permanent Procedure

The first step for any patient considering LASIK is a comprehensive eye exam and consultation with the doctor who would perform the procedure. The doctor examines every aspect of the patient’s eye health and carefully measures and scans the patient’s corneas. This initial appointment could take up to 90 minutes.

Why do patients undergo such a thorough exam? First, it helps determine whether the patient is a good candidate for LASIK. If she is a candidate and opts to have the procedure, the measurements and scans guide the doctor, who uses a laser to permanently remove tissue and precisely reshape the corneas. The matter that is removed from the cornea does not grow back.

A High Degree of Success

In a recent study, 97 percent of responding LASIK patients said they would recommend the procedure to a friend or relative. During my 14 years of practice as a LASIK doctor, less than 2 percent of my patients have needed a second procedure. These were usually patients who had a high degree of nearsightedness or farsightedness before their LASIK. In fact, I underwent LASIK myself in 1999, and I haven’t needed a follow-up procedure.

In the rare case that a patient requires a second LASIK procedure, it is mostly likely due to natural changes to his vision. His eyes would have changed even if LASIK had not been done. For most of these cases, a retreatment — or enhancement — can address any changes that have occurred. Some LASIK providers offer packages that cover these enhancement procedures. Talk to your LASIK provider and see if this would be a good option for you.

As with all medical procedures, there are some side effects and risks associated with LASIK. The best way to minimize these is to choose a competent, experienced provider who will get to know you and your eyes and determine the best treatment for your vision correction needs.

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A patient’s age can affect the type of LASIK he receives and the outcome of that treatment. While each person is unique, I’ve used the following guidelines over the course of performing more than 75,000 laser vision correction procedures.

LASIK for Patients Aged 18 to 38

Since LASIK is an elective procedure, there is no rush to treat anyone. During the teen years and early 20s, a patient’s eyes may change dramatically. To be considered a candidate for LASIK, a patient must be at least 18 years old and have a stable eyewear prescription.

Age and prescription stability are only two of the factors doctors consider when assessing LASIK candidacy. They also look at the patient’s goals for the procedure, eye health, overall physical health, occupational needs, corneal shape and thickness, myopia versus hyperopia and other factors. All these help the doctor determine the safety and efficacy of the proposed procedure.

LASIK for Patients Aged 39 to 59

As patients near their 40s, presbyopia becomes a factor in their vision correction needs. Presbyopia refers to age-related changes to the lenses inside the eyes, which makes it more difficult to focus on nearby objects. Monovision LASIK is one possible option for patients with this condition. During the procedure, the doctor corrects one eye for distance vision and the other eye for up-close vision.

Admittedly, monovision does sound strange. And although it does take time for patients to adapt, most of them are happy with the results. If a patient is considering monovision LASIK, the doctor may do a “trial” with glasses or contact lenses to test if this new way of seeing works prior to treatment.

LASIK for Patients Aged 60+

Patients in their 60s and beyond often begin to develop cataracts. If their cataracts are slow growing, and the patient’s refractive error is relatively mild, laser vision correction may be great for them. Their doctor would determine whether the LASIK would be performed before or after cataract surgery.

I do not consider there to be an upper age limit for laser vision correction. I have treated patients in their 70s and 80s with the goal of reducing their dependency on glasses or contacts. One of my happiest patients is a man in his 80s who no longer needs glasses after wearing them for 68 years.

While important, a person’s age is only one factor affecting her vision correction needs. Only a thorough eye exam and consultation with a qualified eye doctor can fully determine if LASIK is the best choice.

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To the average observer, it seems as if LASIK exploded onto the scene as an accepted and routine procedure. In many respects, it did. But if we look back at its development, we will see that it is more like an explosion that happened in slow motion.

1940s: Pioneering Refractive Surgery

One of the early pioneers in refractive surgery was Jose Barraquer, M.D. In his clinic in Bogota, Columbia, in the late 1940s, he worked on his idea to reshape the cornea. His work on the concept of cornea-based surgery to decrease a patient’s reliance on glasses led to the development of the microkeratome, a tool instrumental in the LASIK procedure. Moving from a manual dissection of the cornea to a mechanized technique, he first used a prototype microkeratome in 1958 to remove a disc of corneal tissue. Next, he coupled the use of the microkeratome with a cryolathe. The cryolathe was an instrument used to carve the corneal disc removed by the microkeratome. Once the disc was reshaped to compensate for the patient’s refractive error, it was reattached to the patient’s cornea. Interestingly, the cryolathe was based on the same technique used to generate contact lenses.

Because the use of the cryolathe had certain drawbacks, Barraquer and others in the 1980s introduced a non-freeze technique that gained popularity among ophthalmologists. It involved using a microkeratome to make two separate cuts on the cornea and removing the tissue from the second cut to effect a change in the corneal shape. Automated lamellar keratoplasty (ALK) was a big advancement in corneal-based surgery, but its accuracy was not good as many had hoped.

1980s: Introducing Lasers

At approximately the same time, Stephen Trokel, M.D., began to explore the possibility of using the newly-invented excimer laser to perform surgical removal of corneal tissue. This laser removal of tissue was shown to be effective in flattening the central cornea, first in animal models and then later in humans. The first patients treated were blind, and when their recovery showed no damage to the clarity and structure of the human cornea, the first sighted patients were treated in the mid 1980s. This procedure was named photorefractive keratectomy (PRK). Because PRK removed tissue from the front part of the cornea after the creation of a well-controlled corneal abrasion, recovery was measured in weeks.

Late 1980s: Inventing Modern LASIK

In 1989, Lucio Buratto, M.D., of Italy introduced a procedure combining the microkeratome and the excimer laser. A corneal cap was created using the microkeratome, followed by tissue removal from the surface under the cap, or the exposed cornea under the cap, using the excimer laser, a technique called excimer laser intrastromal keratomileusis (ELISK). Further refinement led to a procedure where the corneal cap was not completely removed from the cornea, but rather left partially attached. This made for easier repositioning of the cap, and thus began the era of laser assisted in situ keratomileusis (LASIK).

Today: Continuing to Evolve

While the technology has improved drastically over the last two decades, the basic concept of LASIK is still the same. The efficacy of LASIK has improved dramatically. The understanding of who makes for a good candidate has expanded. The accuracy of visual outcomes has increased. And the future of this simple, yet life-changing, procedure is even brighter now than it was for the ground-breaking innovators of the past 65 years.

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If you are near or over age 40 and considering LASIK, consult your eye doctor to determine if monovision LASIK is right for you.

In my 15-year career as a LASIK doctor, I have corrected over 50,000 eyes. The most common question I get from my patients over age 40 is about how to correct for both distance and reading vision. This can be a source of confusion for some individuals and requires careful consideration prior to having the procedure.

Age-Related Vision Changes

As we mature into our 40s and beyond, the lens in the eye begins to change. It loses its elasticity and hardens into more of a plate shape. This process is called presbyopia. When patients with this condition have their vision corrected for distance, nearby objects become fuzzy. For this reason, many individuals wind up wearing reading glasses or bifocals. Presbyopia affects nearly all of us as we enter middle age, and by the time most of us reach age 45, it has progressed to the degree that it is visually noticeable and requires some form of correction.

Monovision Laser Vision Correction

One potential treatment for patients with presbyopia is a laser vision correction procedure called monovision or blended vision. We all have a dominant eye just like we have a dominant hand (although ocular dominance and hand dominance don’t correspond). With monovision, the dominant eye is usually corrected for full-distance, and the non-dominant eye is left nearsighted to enable it to see up close. The brain then has to adjust to this new way of seeing, which can take a few weeks. Over time, most patients become comfortable with monovision and don’t even realize the difference. Monovision correction works well for those who want complete freedom from glasses or contacts, but it does have some limitations. For someone who spends most of his time reading or looking up close, such as a tax attorney, monovision can lead to eye strain. Monovision can also adversely affect depth perception and night vision. Because the need for reading correction increases over time, someone who can initially see well up close with monovision will probably need reading glasses eventually, but she will be less dependent on them.

Personal Experience

I am very happy with the results of my monovision procedure, but I realize that it is a compromise. Although my distance vision is good, it’s not quite as sharp as it was when I used both eyes together — plus glasses or contacts — for distance. For certain activities, such as tennis, I may use a contact lens to correct the eye that was uncorrected for distance, so that I can use both eyes together.

If you are near or over age 40 and considering LASIK, consult your eye doctor to determine if monovision is right for you. It is usually best suited to someone in his early 40s, because at that age the brain is more flexible. It works especially well in patients who have been doing monovision with their contact lenses, because they have already adjusted to that way of seeing. It can also work well for those who have never needed glasses for distance vision but have noticed a loss of reading vision. Individuals over 50 who have never tried monovision may not be able to adapt to it as easily. Also, there are some types of correction that do not work well with monovision. Your doctor will go over all the options with you, so you can choose what works best.

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New technologies, including custom LASIK, have improved outcomes for a number of LASIK patients.

Laser assisted in situ keratomileusis (LASIK) is a vision correction procedure that can correct refractive errors such as myopia (nearsightedness), hyperopia (farsightedness) and astigmatism. New technologies, including custom LASIK, have improved outcomes for a number of LASIK patients.

Custom LASIK allows the doctor to not only treat the refractive error but also the patient’s higher order aberrations. Higher order aberrations are eye issues that require special tests to diagnose and cannot be corrected with standard corrective lenses. Examples include poor night vision, glare, halos, starbursts and poor vision in low-contrast situations. Custom LASIK technology accurately measures each patient’s higher order aberrations. This is just like taking a “fingerprint” of each patient’s cornea. Doctors then use these “fingerprint” measurements to perform a custom LASIK procedure on the patient.

LASIK doctors have been encouraged by the results of most custom LASIK procedures. Because the procedure is tailored specifically to each patient, custom LASIK may lower the risk of side effects. In fact, the U.S. Air Force and the U.S. Navy Surgeons General approved custom LASIK for their fighter pilots. As the former Program Manager of the U.S. Air Force Warfighter Refractive Surgery Program and U.S. Air Force Surgeon General Refractive Surgery Consultant, I was excited to see the Air Force adapt the custom LASIK technology. Aviator studies after custom LASIK showed better postoperative night vision during aviation tasks such as landing on aircraft carriers in dark conditions.

Each person’s eyes are unique, and each patient will experience a different outcome from her laser vision correction procedure. To find out if LASIK is right for you, visit a qualified, experienced LASIK doctor.

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Age does not automatically disqualify you from receiving LASIK, but many factors affect your candidacy for the procedure. Only an evaluation by a qualified LASIK professional will tell you whether laser vision correction is right for you and which technique is recommended for your treatment.

Is LASIK just for the young? Not necessarily. Each prospective patient has a unique set of circumstances that must be evaluated before determining whether laser vision correction is a viable option.

Laser vision correction is capable of treating nearsightedness, farsightedness and astigmatism at any age. However, you must have a comprehensive preoperative evaluation to determine if you are a candidate. This includes a complete eye exam and several advanced diagnostic tests. The doctor evaluates your eye health, as well as corneal regularity and thickness. This article covers some eye health issues and diseases that may affect your candidacy for LASIK.

Eye Diseases and LASIK Candidacy

As you age, vision loss from eye disease becomes more likely. Common diseases that may decrease your vision include cataracts, glaucoma and macular degeneration. If your vision is significantly reduced because of eye disease — to the point where you can’t even see well with glasses — LASIK is not an option.

Cataracts and LASIK Candidacy

Cataracts eventually cause blurred, cloudy vision. However in early stages, cataract progression may be revealed by frequent eyewear prescription changes to maintain good vision. You must have a stable prescription for at least one year in order to qualify for LASIK. Therefore, an early cataract may disqualify you for LASIK, but it may not be severe enough to require removal.

Cataract surgery removes the cloudy natural lens and replaces it with an intraocular lens implant. Despite sophisticated calculations, most patients still have a small amount of refractive error after surgery. This error is usually so small that most patients function well without prescription eyewear. However, patients who desire more precise vision correction should consider laser eye surgery after their cataract surgery. Both LASIK and PRK are excellent laser vision techniques that further improve your vision. Your surgeon will recommend the best technique for you.

Presbyopia and LASIK Candidacy

If you’re over 40, you likely experience presbyopia, or difficulty focusing on nearby objects, and you treat the condition with reading glasses. However, monovision LASIK may offer a more permanent solution. During the monovision procedure, your dominant eye is corrected to be used as your distance-vision eye, and your non-dominant eye is then corrected for near-vision. For those who were nearsighted before the procedure, the non-dominant eye is left slightly under-corrected. If you were not nearsighted prior to the procedure, your non-dominant eye will be corrected to be slightly nearsighted.  This non-dominant eye allows for better reading and other close-up work, but it will see less well in the distance. At first, you may not feel comfortable with one eye for distance vision and the other for near vision. However, as each day goes by, your brain will adapt to processing the images. One month after monovision treatment, close to 90 percent of patients are comfortable with their vision. They are able to function at distance and near without glasses. Many doctors offer a preoperative monovision trial with contact lenses to make sure that the adaptation will be successful.

Age does not automatically disqualify you from receiving LASIK, but many factors affect your candidacy for the procedure. Only an evaluation by a qualified LASIK professional will tell you whether laser vision correction is right for you and which technique is recommended for your treatment.

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Yes, even doctors who perform LASIK sometimes choose to get laser vision correction themselves. This is my experience of life before and after I underwent the surgery.

People with myopia have difficulty seeing objects at a distance. Prior to having LASIK, that is how I saw the world around me. My nearsightedness limited almost everything I did.

Yes, even doctors who perform LASIK sometimes choose to get laser vision correction themselves. This is my experience of life before and after I underwent the surgery.

Life Before LASIK

My vision wasn’t horrible, but it was bad enough that I needed to wear glasses to see anything that was more than a few feet away from me. My dry eyes wouldn’t allow me to wear contacts, plus I didn’t like the idea of poking a piece of plastic on my eyes.

I lead a very active lifestyle, and I hate wearing glasses, so many times I just wouldn’t put them on.  And I never cared for the limited selection of prescription sunglasses. This meant that when I was playing tennis or sand volleyball, I couldn’t see the ball clearly and had to guess where to hit it. If I was playing at dusk, I would need to switch from prescription sunglasses to glasses to continue playing.

When traveling on vacation, my nearsightedness limited the fun activities I wanted to try. If I went swimming in the ocean, I was afraid that saltwater would splash in my eyes and cause an infection. I didn’t want to scuba dive, because I couldn’t see any of the colorful fish clearly. I was afraid to snow ski, because I didn’t see the moguls very well. I even tried to wear glasses under my goggles, but that didn’t work. And when I tried contacts under the ski goggles, they would dry out.

Movies and television were always fuzzy, and I couldn’t recognize a face across the room. When I put on my glasses, they would leave marks on my nose and make my male-pattern baldness look worse. Maybe I just saw my forehead more clearly.

Life After LASIK

With the help of LASIK, I’ve shed my myopic view of the world, and it’s wonderful. I had monovision LASIK, so I can see distance and near objects clearly. I think my improved vision has made my personality more outgoing, and I’m no longer jealous of my friends who don’t need glasses.

On a recent trip to Hawaii, I took a helicopter ride over a volcano and marveled at how well I could see everything. Then I went boogie boarding in the ocean with my cool new sunglasses and didn’t have to worry about getting sand or saltwater in my eyes.

This is my personal LASIK story. It’s important to remember that each person’s eyes are different, and LASIK results may vary. Consult a qualified ophthalmologist to see if laser vision correction can help improve your vision.

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