The Basics Of Vision Correction

By Tom Roseberry, DoctorMatch Medical Staff Writer

Considering surgery to correct your vision problem? Learn your options, and read tips on how to find a surgeon.

Getting Ready For Refractive Surgery

Vision problems come in many different forms, including myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. Don't have vision problems yet? You will; everyone develops presbyopia in middle age, usually by the age of fifty, requiring the use of reading glasses. Of course, there are other age-related vision problems including cataracts and macular degeneration. With so many different vision problems, surgery to correct these problems continues to grow and add new procedures in order to offer the refractive surgery option to as many people as possible.

Questions To Ask Your Doctor

About 90% of Americans who undergo vision correction surgery, do so through the use of LASIK. For most people, this procedure that employs the use of a laser to reshape the cornea is a familiar term and often synonymous with eye surgery, but refractive surgery is no longer just LASIK. To help qualify your options, remember to ask your doctor:

• Am I a candidate for refractive surgery (minimum requirements include having no change in prescription for one year and being of age 18 or older)?
• What results can I expect from surgery?
• What types of procedures are available to correct my specific vision problem?
• What are the advantages and disadvantages of each?
• What is the recovery process like?
• What serious complications are associated with surgery?
• What eye care and safety precautions must I take after surgery?
• What is the likelihood of needing additional surgery for vision correction?
• What complications have your patients experienced and how have they been remedied?
• Do you offer financing?

Things To Remember

Before refractive surgery is performed you will be required to discontinue use of your contact lenses for a few days to several weeks so that your cornea will have time to return to its original shape. Refractive eye surgeries are done as outpatient procedures. You will not require hospital or overnight stay, and most procedures are completed in less than an hour. You will need someone to take you home after the surgery, and will probably feel drowsy and require rest.

Expectations

Results following eye surgery cannot be guaranteed, but with most procedures about 95% of patients enjoy 20/40 or better post operative vision. After surgery your doctor will schedule you for a follow up exam within one or two days in order to gauge recovery, and he or she may also wish to see you at periodic intervals throughout the next six months. Soreness, a burning or itching sensation, and the feeling that something is in your eye are all typical for the first several hours to few days following surgery. Vision is usually hazy or blurry for the same period of time, and tearing or watering is not uncommon.

It is important to remember to not rub your eyes as this might interfere with the healing process. Strenuous activity, contact sports, and swimming should be discontinued for the first one or two months following surgery, although you may feel comfortable enough to return to work as early as three days after surgery. Your doctor may place additional restrictions on your activity and return to work based on your individual case. If pain becomes intolerable you should see your doctor immediately.

Choosing Your Surgeon

Not all ophthalmologists are trained for all refractive procedures. It is important to find a surgeon that is experienced in the particular surgery that you are having performed. You should then research that doctor's medical background including membership in professional organizations and testimonials from former patients if available.

Choose The Clinic

Because refractive surgery is performed as an outpatient procedure in an office or surgical suite, the most significant differences between one clinic and another involve comfort.

Consultation

The consultation is your opportunity to ask your doctor all of the questions you may have regarding surgery. Making a list of questions to bring with you is a good idea. It may also be helpful to bring the friend or family member that will be taking you home the day of surgery.

Your consultation is also the opportunity for the doctor to help you decide whether or not surgery is right for you, and what procedure best fits your needs. You will also be given pre-operative instructions including when you should stop wearing contacts.

Communicate

Communication with your doctor should be ongoing, from the first consultation to post-op follow-ups. Most importantly, you should make your doctor aware of any medical conditions you have had in the past, medication you are taking, and any specific eye pain or vision maladies. If you are unable to focus on a fixed point for at least one minute you should tell your doctor, as this may effect the success of surgery.

Know The Risks

Although some procedures have a higher occurrence of complications than others, serious risks associated with refractive surgeries including retinal detachment and loss of vision are very rare. Some patients experience haloed images, blurred vision, and severely dry eyes. These effects typically disappear in less than a year. During LASIK surgery, some patients experience complications due to scarring or improper healing of the flap that is cut on the cornea during surgery. Refractive patients may also develop a post-operative astigmatism or under/over correction.

During cataract surgery, patients can suffer infection, bleeding, loss of vision, double vision, change in eye pressure, or inflammation, which usually can be successfully treated if medical attention is sought immediately. Additionally, cataract surgery slightly increases the risk of retinal detachment. Retinal detachment does not cause pain, but can be identified by a sudden increase in flashes or floating specs in the field of vision. Secondary cataracts can also develop as a result of surgery.

Surgery Costs

Most refractive surgeries, including LASIK, LASEK, CK and PRK, cost about the same, averaging between $1,700 and $1,800. IOLs (intraocular lenses), sometimes called implantable contact lenses, can cost $3,000 or more when used for refractive surgery, but can correct a higher amount of refractive error than other surgeries. When used during cataract surgery to replace the eye's lens, IOLs, which vary from the type used for refractive surgery, cost around $1,000.

All refractive surgeries are considered elective, and not covered by insurance. The costs of cataract surgery and medication and other necessities for glaucoma and macular degeneration treatment are covered by healthcare providers.

Quality Over Cost

There has been a lot of hype and attention about the cost of surgery. Some firms claim that they can perform the surgery at a starting cost of $299 per eye. Of course, no one actually gets the surgery at that cost, and patients should beware of such advertisements; you get what you pay for. There are some vision correction centers that experience more complications and poorer vision correction than others. Ask for the results of former patients before selecting a doctor or clinic.

Take Your Time

Because the amount of correction experienced after refractive surgery has many variables associated with it, you should consider your options carefully, and do some research before choosing a surgeon.

Anesthetics

Before surgery a local anesthetic is administered in the form of eye drops. In some cases a mild sedative or relaxant is given orally.

More Risks To Consider

If you are very active or engage in activities that may cause your eyes to come in contact with another person or object, surgery could increase the possibility of injury to your eye or damage to your vision. In addition, your job may have requirements about vision correction surgery. Some airlines place requirements on their pilots about when they are allowed to return to work following surgery, and military professions have guidelines for who are eligible for surgery and what type is allowed.

Afterwards

Following surgery you will need a friend or family member to help you home, and most people require rest to recover. Optimal vision can be reached within a few days, but may take as long as a few months to be realized. You may have to wear a protective eye patch or lens for the first few days, and will have to avoid contact sports and swimming for a while, based on the type of surgery you have and your doctor's recommendation. You will have a post-op checkup shortly after surgery, and may have periodic evaluations for up to six months afterward.

Recovery

Patients recover differently, and some procedures offer a faster recovery time than others. Return to work can be as quick as a day or two or as long as a week or more. Full recovery can happen within a few short days or weeks, and can sometimes take up to several months.

Tom Roseberry is a medical writer in Orlando, Fl. Source: DoctorMatch.net Medical Staff Writer