A refractive error is the second major cause of visual impairment. Despite that it can be corrected simply by a pair of spectacles, millions remain blind or visually impaired due to uncorrected refractive error.
Uncorrected refractive error remains largely unaddressed – this is contributed to by a complicated web of barriers.
The cornea and lens of your eye helps you focus. Refractive errors are vision problems that happen when the shape of the eye keeps you from focusing well. The cause could be the length of the eyeball (longer or shorter), changes in the shape of the cornea, or aging of the lens.
Four common refractive errors are
- Myopia, or nearsightedness – clear vision close up but blurry in the distance
- Hyperopia, or farsightedness – clear vision in the distance but blurry close up
- Presbyopia – inability to focus close up as a result of aging
- Astigmatism – focus problems caused by the cornea
The most common symptom is blurred vision. Other symptoms may include double vision, haziness, glare or halos around bright lights, squinting, headaches, or eye strain.
Glasses or contact lenses can usually correct refractive errors. Laser eye surgery may also be a possibility. Refractiv surgery includes phakic intraocular lenses (implantable contact lenses), LASIK (laser-assisted in situ keratomileusis). Other options in refractive surgery include LASEK (laser epithelial keratomileusis), PRK(photorefractive keratectomy) & PTK (phototherapeutic Keratectomy).
LASIK
What is LASIK?
LASIK is an acronym for Laser in-situ Keratomileusis and is the most commonly performed laser eye surgery today. It is a wonderful option for individuals who desire a reduction in dependence on eyeglasses or contact lenses. For both personal and professional reasons, active and social patients choose LASIK as it allows them to more freely pursue their hobbies, sports activities or career options. LASIK is generally safe and is a very successful procedure when patients take the time to educate themselves and diligently search for a skilled and qualified surgeon.
LASIK was approved in 1995 by the U.S Food and Drug Administration. Since its approval, advancements in technology have continued to increase its effectiveness and safety profile.The LASIK procedure is performed in several steps. In preparation for the procedure, the surgeon applies anesthetic eye drops to numb the eye. The cornea is then marked with water-soluble ink which assists with alignment of the corneal flap during latter stages of the surgery.
The first step is to create a flap in the corneal tissue. A suction ring is gently applied to the eye to keep it immobile. The corneal flap, which is a separation of layers of tissue, has traditionally been created using an instrument called a microkeratome. During this step, the patient’s vision will “gray” out and he/she will feel pressure on the eye. This step takes less than 30 seconds per eye. Once the flap is created and the suction ring removed, the pressure subsides and the vision returns.Step two in the LASIK procedure is where the change in the patient’s prescription occurs. The surgeon will lift the corneal flap (which resembles a soft contact lens) to apply the laser beam to the interior surface of the cornea to reshape the tissue. The excimer laser is computer-controlled to remove minute amounts of tissue to precisely resculpt the cornea. The excimer laser is a “cool” laser and generates its power from light in the ultraviolet range. Because it does not generate any heat, there is no damage to the surrounding tissue. This allows the surgeon to remove microscopic layers of tissue, approximately 1/10th the width of a human hair, to achieve the desired result.
Once the laser treatment is completed, the corneal flap is then replaced over the treated area. This flap serves as a natural bandage, which helps to lessen the discomfort after surgery. It also helps to expedite the healing process. Because of the extraordinary bonding properties of the corneal tissue, stitches are not needed.
Upon completion of the procedure, the patient is encouraged to go home and rest through the evening. Although some patients notice better vision immediately, most will have the most dramatic improvement occur overnight.
LASIK was approved in 1995 by the U.S Food and Drug Administration. Since its approval, advancements in technology have continued to increase its effectiveness and safety profile.The LASIK procedure is performed in several steps. In preparation for the procedure, the surgeon applies anesthetic eye drops to numb the eye. The cornea is then marked with water-soluble ink which assists with alignment of the corneal flap during latter stages of the surgery.
The first step is to create a flap in the corneal tissue. A suction ring is gently applied to the eye to keep it immobile. The corneal flap, which is a separation of layers of tissue, has traditionally been created using an instrument called a microkeratome. During this step, the patient’s vision will “gray” out and he/she will feel pressure on the eye. This step takes less than 30 seconds per eye. Once the flap is created and the suction ring removed, the pressure subsides and the vision returns.Step two in the LASIK procedure is where the change in the patient’s prescription occurs. The surgeon will lift the corneal flap (which resembles a soft contact lens) to apply the laser beam to the interior surface of the cornea to reshape the tissue. The excimer laser is computer-controlled to remove minute amounts of tissue to precisely resculpt the cornea. The excimer laser is a “cool” laser and generates its power from light in the ultraviolet range. Because it does not generate any heat, there is no damage to the surrounding tissue. This allows the surgeon to remove microscopic layers of tissue, approximately 1/10th the width of a human hair, to achieve the desired result.
Once the laser treatment is completed, the corneal flap is then replaced over the treated area. This flap serves as a natural bandage, which helps to lessen the discomfort after surgery. It also helps to expedite the healing process. Because of the extraordinary bonding properties of the corneal tissue, stitches are not needed.
Upon completion of the procedure, the patient is encouraged to go home and rest through the evening. Although some patients notice better vision immediately, most will have the most dramatic improvement occur overnight.
What are the risks of LASIK surgery?
Although LASIK is performed commonly, it is still a surgical procedure and therefore has risks. It is important that you are well educated. During your pre-operative evaluation, be sure that you discuss those risks with your surgeon. Every patient’s eye is different and different treatment options are available to give you the best possible results. The only way to determine if LASIK (or an alternative procedure) is right for you is to have a thorough consultation and examination with an experienced eye surgeon.
Fund out what the difference between LASIK and PRK is?
Refractive Surgery Step by Step
You may find it helpful to know more about the “typical” routine our patients experience when they have refractive surgery. Of course, you will see some variation depending on the type of surgery, but these guidelines should give you a good picture of the process and what to expect.
Preparing for surgery
Do not wear soft contacts for one week before surgery and hard or rigid gas permeable lenses for three weeks before surgery.
Do not wear make-up, including mascara, for one week prior to surgery.
Prescriptions for eye drops will be sent to your pharmacy a week prior to your surgery. Please bring these eye drops with you on the day of surgery.
Plan to spend approximately one hour at the Refractive Surgery Clinic.
Bring someone with you to drive you home.
Wash your face with soap and water before you arrive.
You may eat a light snack prior to surgery.
Avoid alcohol and medications that produce drowsiness.
Do not wear make-up, including mascara, for one week prior to surgery.
Prescriptions for eye drops will be sent to your pharmacy a week prior to your surgery. Please bring these eye drops with you on the day of surgery.
Plan to spend approximately one hour at the Refractive Surgery Clinic.
Bring someone with you to drive you home.
Wash your face with soap and water before you arrive.
You may eat a light snack prior to surgery.
Avoid alcohol and medications that produce drowsiness.
Day of surgery
First you will meet with your surgeon, who will review everything that is going to happen during your surgery. You will be fully awake during the procedure, but you will be given a mild sedative to help you relax. Next the surgeon or assistant will administer antibiotic eye drops as well as anesthetic drops to numb your eyes. When you are ready, the procedure will begin. Typically, refractive surgery takes 10 to 15 minutes per eye. Most people say they feel a slight amount of pressure during the procedure, but no pain. When your surgeon feels that the flaps (if any) are adhering properly, you will leave the treatment room and walk back to the clinic for a brief examination. Your surgeon will place an eye shield over each eye.
Evening after surgery
Many patients feel as if there is something in their eye, although most do not feel much discomfort. If your ophthalmologist anticipates that you will be in pain, s/he will have prescribed pain medication. We recommend that patients spend a quiet evening at home.
Day after surgery
You will have an appointment with your surgeon to check your vision and the healing process. When your eye shields come off you will be able to see how your vision is beginning to improve. Most patients notice an immediate and significant difference. Typically, people return to their normal activities within days of surgery.
Follow-up care
You will see your doctor one week after surgery, and again in one month, three months, six months, and one year.