LASIK - Laser eye surgery

Since the age of 9 when my eyes were first tested in primary school, I have had to wear glasses, with my prescription rapidly declining to -7.75 diopters, 1.25 astigmatism, considered severe in the following description ( I couldn't see my own feet!).

The degree of refractive disorder, or how much correction is needed, due to any of these conditions, is measured in something-called "diopters". The greater the degree of correction needed the higher the number of diopters. A negative diopter number indicates nearsightedness. A positive diopter number indicates farsightedness. Diopters are also used as a measure of astigmatism and presbyopia.

For nearsightedness the scale of diopters is given in increments of three and ranges from mild (less than -3.00 diopters) to moderate (-3.00 to -6.00 diopters) to severe (-6.00 to -9.00 diopters) to extreme (more than -9.00 diopters). Astigmatism is also measured from mild to extreme in increments of one. Mild astigmatism is considered to be less than 1.00 diopter while extreme astigmatism is anything greater than 3.00 diopters.

I hated glasses ever since I first learnt I needed them and refused to wear them. I actually went without watching tv for a year as punishment for not wearing them (pretty hard for a 10 year old but I am very stubborn!)

I started wearing contact lenses at age 12 when it became impossible to keep up with my school work without correction and my parents finally gave in. I wore contacts continuously throughout highschool, but by the time I started university my script had gotten much worse and I needed to change to hard contacts.  I never got used to them as they are very uncomfortable to wear and dry out quickly, especially in a windy place like Melbourne.  I kept trying new types and went through many of kinds of permanent and disposables, but had limited success and could only wear them for a few hours at a time. As a result I gave up martial arts and dance classes, and added most sports to the list of things I couldn't do, in particular water sports.

I had limited success with prescription goggles bought cheaply in Japan, but lost them in the surf which resulted in the dangerous situation of not being able to tell where the waves were coming from and being continually swamped.

I first heard about laser eye surgery while in highschool in 1991 and have followed the technology ever since. At the time, PRK was the most common, similar to LASIK but without the flap and considerably longer healing time.
See for a comparison.
I underwent testing every few years and was found suitable but didn't think at the time the risks were worth the gains. In 1997 I first had testing for what was then a relatively new procedure, LASIK, but was given the surgical outcome of being able to drive without needing glasses the best I could expect. I decided I would wait until the outcome was perfect vision, the same if not better than with my glasses.

I had LASIK on April 12, 2004 through the Dartmouth Medical Center in New Hampshire, USA.

As I already knew a lot about the process, I underwent a rather quick time frame from testing to surgery, having the tests two days before the procedure.  I was surprised to hear that the technology has advanced even beyond what was needed to treat me.
On the day of the procedure I was given Valium to calm my nerves, which apparently is very commonly dished out in the US. I took both tablets as my legs were twitching in the waiting room and I didn't want to be shaking while under the laser!
Having never had Valium before I wasn't sure how to use it and didn't get a very good answer from the pharmacist and ended up taking it a bit too late. The full effect hit me about an hour after the operation and I felt very groggy.

The assistant started the procedure by putting a series of antibiotic drops in my eyes while going through the post-op care package. I then went into the surgery room, lay on the table and was given a toy moose to hold (strangle!).  Starting with my right eye, the surgeon taped my eyelashes back as these are apparently a terrible source of germs, then put a brace in to hold my eye lid open. The impulse to blink was quite strong throughout the procedure so although I felt like the character in A Clockwork Orange, (see pic) I was glad it was there.

He next put anaesthetic drops in my eye (having numb eyes is really weird!) and put on the suction thing (?) to hold the eye in place. My head was in a hollow to keep upright and I was told to just keep looking at the red light.  A cutting instrument (microkerotome) was then used to make a flap at the front of my eye. As the machine cut I could hear the whirring and my vision went black. I was warned this would happen but it was still very strange. This part was the most uncomfortable as the suction thing was quite tight and I could feel the cutting tool stinging a little, but it was over very quickly.

The surgeon lifted the flap and began the laser. I counted about six bursts of about 8-10 seconds each, with the laser stopping and shifting between. The most unpleasant part was the smell! This part was quite mentally challenging, lying very still and staring at the light and trying not to imagine what was happening. I think the moose toy suffocated at this stage!

The flap was placed back and some more drops put in, then onto the left eye.

It was all over in about 10 minutes, and I sat up and my first thought was 'it didn't work' but then I blinked and I could see, albeit with haze.  I sat with the surgeon in recovery for a few minutes while he shone a light in my eyes to check the flap, then it was off home. By now the Valium was starting to take hold making me a bit groggy, and whilst I was aware of everything, couldn't seem to retain anything and kept asking the same questions.

I spent the next two hours with my eyes mostly closed, wearing sunglasses, as I was driven home. We stopped a couple of times to put artificial tears in. I only used the pain killer drops once, about an hour after the op and should have used them as soon as my eyes started to scratch - do this!
As we got home mid afternoon, I wasn't ready to sleep and lay on the couch listening to old episodes of Melrose Place.

The next morning l could see quite well and drove myself to my post op appointment. It was amazing to drive with peripheral vision, after hating driving for so long as I was never sure there was no one in my blind spots changing lanes. My vision was 20/20 in both eyes.

Week one-
I used drops for anti-inflamation and antibiotics on a four-hourly schedule, plus artificial tears every half hour. My distance vision is fantastic and my night vision has improved dramatically. I am now able to read signs at night and halos are greatly reduced.  My near vision has taken longer to adjust to, I found I could no longer focus at less than about 10 cm in front of my face and I felt I needed to hold things further away when reading. When I mentioned this to other people, some laughed and said 'that's how normal people see!'  The muscles in my eyes are still adjusting to their new focal length and I am glad I didn't have to work for a week after the surgery which gave me time to recover. If I'd had to stare at a computer I would have had trouble due to my focal length wavering and the need for constant lubricating drops.  During the first week I had the most trouble with close work such as computers, embroidery and reading. This was very frustrating as patience is not one of my virtues!
For the first two days it felt like my glasses were still pressing on my nose.  Most mornings I look for my glasses, and I find myself lifting my glasses to wipe my eyes.  While exercising, I have an urge to push them up.

Week two - I started a new job and my vision became increasingly stable and I had no trouble using the computer or doing close work for hours on end.  I'm still using the artificial tears at least every hour because I have drier than average eyes.  Sometimes it felt like wearing contact lenses - I wanted to take them out then remembered that I'm not wearing them!

3 Months - At my checkup it was recorded that I have better vision than with glasses. I absolutely love having peripheral vision and I have found my hand-eye coordination has greatly improved. I danced down the hallway at work when I realised I could throw things in the bin from across the room without lining it up and concentrating very hard. I have been in caving and out at night and my sight in dull light and night vision is so much better. After reading extensively on the web and talking to other patients, this seems to be a problem for many people and I feel very fortunate I had such a good result. One odd thing I noticed is reading signs from the car at a distance, before they were too blury till I got right up to them. Now I can read the letters but sometimes not the word. Most people when reading their native language read by recognition, not sounding out the word and I realised I am not used to seeing words in the distance and have not associated them yet.

I still think like a glassered person and am only just starting to realise how many activities have opened up for me. I have tried aerobics and soccer and can't wait to go swimming (it's not hot enough here!). I was getting worried that I had freed myself from glasses, only to become dependent on eye drops so at the three month mark I cut down and realised that I didn't have the scratchy feeling anymore, I was actually addicted to the lubricated feeling. As soon as I cut back, my own natural tears started up and now I only use the drops when I wake up and maybe late at night if neccessary. The urge to constantly push up my glasses has wained a bit but is still there. I also still have dents on the sides of my skull from where the glasses pushed for years.

All in all, the operation outcome was fantastic and I thoroughly recommend it. I now look at people with glasses feel a bit sorry for them and hope that someday they might know how great it is too.   Some people tell me that they are too scared or that the procedure is too expensive, I hope that my experience can give perspective on the pros and cons.  I found the procedure unnerving, but quick and effective.  It's essential to have someone looking after you for the first six hours - driving you home, bringing you drinks and being generally reassuring.  The freedom the surgery has given me is amazing - a huge change after 20 years of restrictions and I am still discovering new and wonderful things I can do.

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