So you wanna slash your specs? You have our sympathies. There's a negative aura glinting from glasses. No matter how trendily framed, they are nuisance to tote around especially if you need several pairs for various purposes - reading, computer work, vision correction. What's more, they can break, cloud up, get misplaced, come in the way of things, restrict activities,

And then we have contact lenses in many avatars, which can be itchy, difficult to maintain or stay on, tend to fall out, slip or disappear. Your next thought for convenience and cosmetic reasons is refractive eye surgery. Ads promoting the procedure promise better vision as swiftly and efficiently as specs and soft contact lenses. But as with any other medical procedure, before you put eyes and laser together, do consider your own needs and expectations along with the risks and benefits.


LASIK is a simple acronym for Laser in Situ Keratomileusis, which was created in Columbia, South America, some 40 years ago by Dr.Barraquor. Your eyes are first numbed with anaesthetic drops and then a lid speculum is placed to keep your eyelids open. No injections are given and you will not feel any pain.

A ring will be placed on your eye and pressure will be applied to create suction, which may cause a vague discomfort. A micro-keratome blade cuts a flap in your cornea, which will be lifted and folded, after which the exposed tissue will be dried. An excimer laser beam will then be focussed over your eye, while you stare at a red light for about a minute. A computer controls the amount of laser energy delivered to your eye, to reshape the corneal tissue. The flap is then put back into place. You will get 90% of full vision potential within a few days and full potential in 3 months.


The media is misleading. The aim is not to eliminate your glasses but to reduce your dependency on them.The key words are full vision potential. Most people's distant vision gets much better so that they can do most things well, such as playing a game, watching a movie, drive without glasses, although not everyone has 20/20 vision. You may still need glasses for middle vision, say for computers and playing snooker. If you have a low prescription number before refractive surgery, your eyesight will be 20/20 later. A lot depends on how the healing process takes place after the procedure. Sometimes the post-op healing can induce a small number, but you may not need to use glasses all the time. A refractive error can be corrected by an enhancement procedure in selected cases.


The cornea is a part of the eye that helps focus light to create an image on the retina. It works in much the same way that the lens of a camera focuses light to create an image on film. The bending and focussing of light is known as refraction. When the light rays come to a perfect focus on the retina, you do not need glasses. Refractive errors happen when the rays of light do not come to a focus on the retina. There are three main types

Myopia: If you have short or near sight, you can see objects that are close by better than those that are far away, because the rays of light come to a focus in front of the retina. You get a minus number.

Hyperopia: If you have farsightedness, you see distant objects better than those that are near, because the rays of light come to a focus behind the retina. When the condition occurs after 40 it is called presbyopia, caused by the loss of elasticity of the lens, as part of the aging process. You get a plus number.

Astigmatism: The image on the retina is distorted because of irregularities in the cornea or lens of the eye. Combinations of myopia and astigmatism or hypermetropia and astigmatism are common. You are given a compound number.


With the march of time your eye will inexorably age, and you will need reading glasses just like anybody else. If you are hovering at 40 and were using reading glasses before LASIK you will probably still need them. Exiting presbyopia cannot be corrected by LASIK. One option for presbyopia is conductive keratoplasty (CK). In CK the surgeon uses radiofrequency waves emitted from a probe to shrink and tighten collagen tissue around the edges of the cornea to steepen/reshape it. CK like LASIK produce similar results and side effects.

Monovision is a technique to take care of myopia and presbyopia that is correcting one eye for distance and the other for near wear. This can also be done after a cataract operation. Although monovision takes some getting used to, you don't need to make conscious adjustments in how to see. Your brain integrates the visual information typically needs a few weeks to adjust to the change in vision.

However nighttime driving in unfamiliar areas may still prove a challenge, requiring glasses. And you may need additional vision correction at some point as your eyes continue to age. A third procedure for presbyopia replicates the treatment used in patients with cataract. That is the natural crystalline lens is replaced with implantable, variable-focus lenses that correct for near, distance and/ or intermediate vision.

This procedure is becoming more popular as newer specialty lenses are developed, appropriate for people with larger degrees of near sightedness or who can't have LASIK because of thin corneas. However since it's a relatively new technology and long term effects are still unknown. Infection, retinal detachment, inflammation, cataract, increased intraocular pressure and loss of endothelial corneal cells are possible risk.


Yes, it's like driving a car - you need both hands and both legs. Remember, in the hands of a bad driver even a Mercedes is a meaningless piece of machinery.


Word of mouth is important. Check your doctor's track record, which should be over 5 years.

Check out the machine. The newest types offer more accuracy.

Who is a suitable candidate for LASIK?

You are if

...You can't tolerate contact lenses and find activities such as swimming and skiing difficult with glasses and contact lenses. ... You are an over 18 (girl) or 20-year-old (boy). ... Your eyes are healthy

... You have a stable spectacle prescription for at least 2 years. ... Your vision is within a correctable limit... You have realistic expectations of the outcome of the operation.


• Your hormonal levels fluctuate because of diabetes, pregnancy.

• You have viral infections such as herpes simplex or herpes zoster of the eye area; eye diseases such as advanced glaucoma, uveitis or iritis; eye injuries.

• You have severe dry eyes.

• You have very thin corneas, cornea surface skin, large corneas.


An older procedure called Photo Refractive Keratectomy (PRK), where an excimer laser makes cuts to reshape the cornea, can be used. The drawbacks are post operative pain, longer healing time and a risk of corneal hazing or scarring.


Implantable collamer lenses can help those with very high myopia (more than -10 diopters) while those with extreme hypermetropia (worse than +6 diopters) should wait until they need cataract surgery


You need to stop wearing soft contact lenses at least 48 to 72 hours and rigid gas permeable lenses for 15 days prior to your evaluation. In a two- to three-hour testing period the ophthalmologist will examine your corneas and map their shape with a special exam called corneal topography, pachymetry to reassure the thickness of the cornea, check the pupil size in light and dark and such. You need to tell your doctor about past and present medical and eye I conditions, every medication that you are taking, I medications you may be allergic to.


Expect some burning, redness, heaviness, itching, grittiness, blurring for 3 to 4 days. Don't give in to the temptation to rub your eyes, which could dislodge the flap and need another procedure. Dry eyes are a common side effect specially in I contact lens users; computer workers and perimenopausal women, which usually reverts to normal within 2 to 3 months.


It's best and more convenient. However, if you are very nervous, one eye can be done at a time.


Just 10 minutes per eye, but you may have to stay in the clinic for half an hour to an hour.


Reasonably so. Complications include over correction and under correction, excessive inflammation, infection, double vision, sensitivity to light; wrinkling of the cornea, deposition of cells or other material in the cornea, cornea flap irregularities which may trigger astigmatism. Rarely, even with spectacles a person may land up with worse vision after surgery, because ophthalmologists prefer to under correct rather than over correct, in which case another procedure can be done.

Your eyes are more vulnerable to injury so you need to use protective eye wear for contact and racquet sports. However nobody has ever become blind after LASIK surgery. What's more your eyes cannot revert to their former state. The effect on your vision is forever.


No. You may experience a diminished ability to see in dim light. Star bursts, glare, haloes around light, especially in the dark can trouble you post-LASIK. You may have difficulty with seeing and driving at night. This may take 3 to 4 months to settle. People with smaller pupils fare better after LASIK than individuals with large pupils.

Can you lose depth vision?

No.

Why don't ophthalmologists undergo LASIK themselves?!

Because sometimes there is a loss of colour contrast, so important for their work.

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