Things in my eyes!

  • Article

Another quick non-technical post today.

I was reading KC Lemson's blog and she mentioned that she's considering laser in-situ keratomileusis, also known as LASIK. I started to email her my experience, but then realized that I might as well just put it up here, and see if anyone else has experiences they'd like to share.

Best money I ever spent. Seriously.

I was -6.25S/-5.75D, slightly astigmatic, and wore glasses for over twenty years. I briefly tried contacts when I was in high school, but, like KC, could not tolerate them. Actually, it was quite amusing -- well, it wasn't amusing at the time, but it is now. As my optometrist put the lenses in my thought process went like this.

"Wow! I can see perfectly but I'm not wearing any glasses! Cool! I'm going to stand up and walk around a bit. I can see perfectly because there are things in my eyes. Things. In. My. Eyes. THERE ARE THINGS IN MY EYES!"

Then I fainted. My mother, who was in the next room, said that she thought that Dr. Lutzi had dropped a whole armful of textbooks or something, I hit the floor so hard. Fortunately I didn't break anything. That's quite literally "the hard way" to discover that you have a phobia about things touching your eyes. (Apparently it is not uncommon for people -- mostly men -- to faint upon first getting contact lenses.)

I never fainted again -- I toughed it out for about a year but I just could not stand it. I couldn't stand touching my eyes, I hated having to clean them -- had there been cheap disposable lenses back then I might have lasted a little longer, but I'm sure that the sheer displeasure of touching my eyes every day would have driven me nuts. (Aargh!) But wearing glasses was the lesser of two evils, that's for sure. I hated dealing with smudges and scratches and worrying about losing them over the side of the boat and having to buy expensive prescription sunglasses and all that.

Now, as you can imagine, someone who is phobic about things in their eyes is maybe not so keen on the keratomileusis, aka, “slice open your eye” part. For those of you who don't know the procedure, here's how it goes. You are fully conscious throughout the procedure. You have a device inserted under the eye lids to keep them open and they cut a slice out of the top portion of the cornea, but not all the way across -- they make a flap basically. Fold the cornea back, burn the underlying tissue away with an eximer laser until it is the right shape, put the flap back, and do the other eye.

Let me tell you, burning eye tissue does not smell good. And though you cannot feel pain from the blade, you definately know that something is in there.

I'm getting the shakes just thinking about it. It was quite literally the most terrifying ten minutes of my life. But I managed for three reasons. First, I went over and over the literature so that I understood exactly what they were going to do, what the risks were, all that stuff. I mentally rehearsed it, which helped a lot. Second, they gave me a delicious Demerol-Percocet-Valium cocktail that took the edge right off. Third, there was a nurse whose sole job, as far as I could tell, was to hold my hand and tell me everything was going to be juuuust fiiiiine.

I could see better than without my glasses immediately, though about three hours later, my eyes hurt like hell. It was like having sand under a contact lens. Fortunately the local anesthetic helped out there. By the next morning, I was 20/40 and went and got the "needs glasses" taken off my driver's license. By the day after that, my eyes felt like I was wearing week-old contact lenses -- they were dry and irritated, but not painful, and I was 20/20. Within a week my eyes were slightly dry and I was actually 20/15 in my right eye. It is very rare to get better vision with LASIK than with glasses, but it does happen. In the three years since my left eye has become very slightly farsighted -- enough for my optometrist to measure but not enough for me to notice -- and my right eye is 20/20 again.

I love it, this whole "not wearing glasses" thing. It's the little things, like being able to see in the shower, or walking into a warm house and not fogging up, or being able to lose a pair of $8 sunglasses over the side of the boat and still being able to sail home safely. I love having an excuse to use the word "keratomileusis" in conversation.

Now, LASIK is not for everyone. If you're considering it, some advice:

  • I was very lucky to end up with better than average vision. If you expect perfect vision and you're currently satisfied with what you've got, don't risk it.
  • Ask optometrists who have had LASIK who they went to. I asked several local optometrists; they all said the same thing -- Dr. Ford at the Pacific Cataract and Laser Institute. He's the most expensive LASIK surgeon in the Seattle area, and for good reason. Something like 20000 eyes so far with no major complications. The skill of the surgeon is definitely an important factor. And that highly trained hand-holding nurse doesn't come cheap either I'll bet. :-)
  • Don't shop based on price. These are your eyes we're talking about here. And don't shop based on high success rate, shop based on low complication rate. The success rate is the fraction of patients who got better than 20/40 vision after one or two surgeries. (Yes, it might take two times to get it right.) The complication rate is the number of patients who developed serious problems as a result of the surgery. Worry about the latter.
  • I occasionally get haloes around bright objects at night. I'm used to it, doesn't bother me at all. Some people find their night vision seriously compromised, and some people find they're eyes stay dry long after the surgery. If you've got big pupils or thin corneas, it might not be such a good idea.
  • LASIK doesn't stop your eyes from changing. I'll likely go farsighted earlier than I would have otherwise. (But by the time that it happens, we'll just rebuild my eyes with nanorobots, right?)

Isn't technology wonderful?