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Preparing for LASIK

 

Refractive surgery is a general term for surgical procedures designed to improve or correct the focusing ability of the eye. It is estimated that nearsightedness and astigmatism affect over 60 million people in the United States. A person's inability to see clearly can be caused by nearsightedness (myopia), farsightedness (hyperopia), and/or astigmatism. In most cases, these three types of refractive errors can be corrected through refractive surgery. There are a variety of procedures available to correct each of these refractive errors and determining which is best for you is not always simple. There are many considerations to make before choosing a procedure that appropriately suits your lifestyle. It is also important to know that refractive surgery is not a choice for everyone. In some instances, we strongly encourage people who are not suitable candidates, to continue wearing their glasses or contact lenses.

If you are an active person, you may appreciate being less dependent upon glasses or contact lenses for water skiing, swimming, scuba diving, snow skiing or other activities that are an important part of your lifestyle. For some professionals, like firefighters and police officers, many have found that being able to function without glasses or contact lenses on the job is an added safety benefit. It is important that in addition to knowing how the eye works, you should have some information about the phenomenon of vision prior to considering any Refractive Surgery.

Vision is a complex experience involving sharp acuity for near and distance, color vision and perception, motion detection, flicker fusion, contrast awareness, depth perception, peripheral vision and many other phenomena. The system requires a well functioning eye, a connection with the visual cortex of the brain and the training and experience to understand what you a connection with the visual cortex of the brain and the training and experience to understand what you have seen. It also requires a feedback nerve loop that continuously tracks any objects that you are interested in. Following are a few examples:

Snellen Visual Acuity - "20/20" vision refers to the size of a letter projected onto a chart that a person with "average" or "normal" vision can see at 20 feet. Someone with 20/40 vision needs to go to 20 feet to see what the "normal" person can see at 40 feet and the person with 20/200 vision needs to go to 20 feet to see what the "normal" person can see at 200 feet. The same information is often documented in meters (6/6 =20/20 ) or even numerically as 1.0 . Most states require 20/40 vision or better in at least one eye to get a driver's license without a restriction for glasses or contact lenses.

Monocular Vision - When you get to be 40 + you often lose your ability to read (presbyopia) up close. At Natural Vision (tm) we can use this to your advantage by correcting one eye for near and the other for distance. One of the best ways to define monovision, in the context of contemplating refractive surgery, is that you can aim to have each eye corrected to a natural focus at any distance you choose. As a rule, we don't suggest monovision if you are under the age of 35 for two reasons. The first being that it will be a number of years before there will be any benefit from it and second being that it is very possible that there will be a better (or at least as good) surgical way to help correct the effects of presbyopia by the time it is a problem for you. We also would most likely recommend against it at any age for people who may need to see better than average for certain tasks. Some examples of this type of person might include airline pilots, race car drivers, someone who drives for a living (especially at night), and avid tennis or baseball players (especially for playing at night). In our experience, most people over the age of 40 to 45 who try monovision and take a few months to become accustomed to it, like it and find it very useful.

Those who have monovision will be able to generally see well enough both at distance and near to do most things at any age without corrective lenses. Depending on the exact result obtained (as is true for everyone having refractive surgery) there might still be some situations when the very best vision or the maximum visual comfort might require wearing glasses (or possibly contacts). Night driving and prolonged reading are two examples that are mentioned frequently, but it could be anything for which you feel the need or the desire to see the very best possible. We suggest that if significant you aim to have your vision corrected for good general vision and plan to use reading glasses when necessary. 

Amblyopia - The term amblyopia, sometimes called 'lazy eye' (which usually occurs in one eye, but occasionally both), is generally used to mean that your vision is less than 20/25 even with glasses, but with no obvious disease or injury to account for it. Amblyopia is usually a developmental outcome often as a result of improper development of the visual system in very young children prior to the age of about 8. If it is not discovered and treated prior to this age, it will be permanent. It is important in relation to refractive surgery because regardless of any treatment or surgery, including refractive surgery, the best the vision can be with or without correction is what it was with best correction prior to surgery. We can help you as much as possible with your understanding of this condition and what to expect if you choose to correct your eyes. Be sure you understand the risks, benefits, and alternatives before proceeding with "any type" of surgery. 

Corneal Topography - This is an essential test performed prior to any refractive surgery. A pattern of circular lights are placed in front of your cornea and then photographed and analyzed. Recently, laser light systems are being used to create optical wave fronts to measure the entire refractive power of the eye. These computers are being linked to the actual Excimer Laser, such that real time custom ablation patterns are under investigation. There is debate as to whether 'Wave Front Analysis' versus 'surface topography'is the better solution.


   

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