About 700,000 Americans have LASIK eye surgery each year. The procedure is meant to correct defects in the lens or front surface of the eye (astigmatism), nearsightedness (myopia), and farsightedness (hyperopia).

A surgeon uses lasers to get rid of unwanted material inside your eye. You must be awake during surgery to answer questions that your doctor will pose so that he can ensure a successful treatment.

You may be apprehensive about being conscious during the corrective surgery, thinking that you might move, sneeze or cough and affect the outcome. But doctors have encountered this issues before – and addressed them.

What to Expect with Outpatient LASIK

Once your surgery is set, you should expect the following protocols on the day of your procedure:

  • An eye test to ensure an accurate and updated eye health history.
  • You will lay comfortably on your back on the reclining bed or chair.
  • After positioning you under the laser, the surgeon will clean the areas around the eyes and place numbing eye drops inside your eyes.
  • An eyelid speculum will hold your eyelids in place and prevent movement. A suction pad will fixate your eyes.
  • The surgeon will use a microkeratome blade or laser keratome to create a flap on your cornea and move it to reveal the underlying tissue.
  • At this point, you may feel a bit of pressure and mild discomfort. You may lose vision for a brief moment.
  • The underlying corneal tissue is measured and excess moisture dried. A laser is placed in position over the eye.
  • Even though the doctor will ask you to stare directly at the light, it’s just for focus as it’s not the same laser that will conduct the surgery. It will have different colored lights depending on the laser in use.
  • Once your eye is in a proper position, the surgeon will start the procedure.
  • You will hear a ticking sound and smell an odor that resembles burning hair. The sound is the laser pulses, while the smell is because of the evaporation of fluid during the removal of material from your cornea using the laser beam (laser ablation).
  • Once enough corneal material is ablated, the surgeon will place the flap back in position and place a shield around the eye to protect from rubbing or pressure.
  • If both eyes need LASIK, the surgeon will position the laser machine over the other eye and repeat the procedure.

Surgery typically lasts less than 60 seconds per eye, but the entire process takes about 20 to 30 minutes to complete. Most of the time is spent getting you and laser machines prepped for surgery.

Rear View Of Loving Couple Walking Towards House

Do I Need to Be Awake During LASIK?

Yes, you will be awake during the entire procedure. That’s because the process is too short (less than a minute), and it’s not that uncomfortable for most patients anyway.

The numbing agent and medication should keep you calm.

Can I Be Put to Sleep During LASIK?

No, the surgeon will not put you to sleep because they need you to be alert throughout the process to provide feedback on how your eye is feeling.

Why Local Anesthesia During LASIK is Safer Than General Anesthesia

Firstly, general anesthesia causes hypnosis, sedation and loss of consciousness. This is a problem because the surgeon needs you to be alert and awake during the procedure.

In addition, local anesthesia reduces redness, swelling, and chances of an allergic reaction typically associated with general anesthesia. You will recover quicker with local anesthesia, which also provides pain relief for several hours after the operation.

What if I Accidentally Move While I’m Awake?

One of the tests that determine if you’re a good candidate for LASIK is the ability to stare at a fixed object for a minute uninterrupted. Still, that does not rule out movement during surgery, but the surgeons are way ahead of you.

Firstly, you will be lying in a comfortable position with a head support to reduce movement. Next, the surgeon will place a blinking retainer that holds your eyelids in place to prevent blinking. Moreover, a suction device stops eye movement.

Additionally, laser eye surgeons have advanced equipment that can track eye movement up to 4,000 times a second. The machine will stop the operation if it detects any sudden movements that could cause injury or surgical errors.

In short, you need not worry about movements because there are plenty of fail-safe procedures to ensure a successful LASIK operation.

The topical anesthet...

The topical anesthetic will eliminate any pain or discomfort during the procedure that may cause eye movement, the eyes will be kept hydrated, and the eyelids are held open. Additionally, modern LASIK devices are typically equipped with a safety shutoff. In the event that you do move accidentally during the procedure, which is very unlikely, the device will shut off very quickly, avoiding any accidental changes or nerve damage to the eye. The device is designed to react well before your surgeon can.

What to Expect after Surgery

You will feel little pain under normal circumstances, but you might feel your eyes itch, burn, feel gritty, watery, or have blurry vision.

Even though you should see better immediately after surgery, it will take about 2-3 months for your vision to get to optimal levels. How good your vision gets is dependent on how well you could see before the surgery.

Your ophthalmologist will prescribe eye drops and pain medication that will last you several hours after the surgery. They may require you to wear an eye shield at night to protect your eyes until you heal.

The first follow-up appointment will be two days after the surgery to check for healing and complications, and the next will be within six months.

LASIK Is Safe and Effective With Local Anesthetic?

they are able to sit through the 10 to 30 minutes of prep time and the very short amount of time it takes the laser to shape their cornea. Side effects do not last long, with most people experiencing improved vision within a day or two and being able to return to work (unless it is physically taxing) within a few days or a week. Rates of complications and side effects are very low.

What to Expect after Surgery

You will feel little pain under normal circumstances, but you might feel your eyes itch, burn, feel gritty, watery, or have blurry vision.

Even though you should see better immediately after surgery, it will take about 2-3 months for your vision to get to optimal levels. How good your vision gets is dependent on how well you could see before the surgery.

Your ophthalmologist will prescribe eye drops and pain medication that will last you several hours after the surgery. They may require you to wear an eye shield at night to protect your eyes until you heal.

The first follow-up appointment will be two days after the surgery to check for healing and complications, and the next will be within six months.

Frequently Asked Questions (FAQs)

  • What if I cry during LASIK?

    LASIK surgery doesn’t take long, and it’s usually completed too quickly for there to be a concern about a patient crying. Even it happens, the doctor can wipe away your teas and half the surgery for a few seconds. If it’s a concern, you can ask your doctor to use a drying medication.

  • What if I sneeze?

    Lasers monitor your eye’s micro-movements several times a second and will shut down the lasers the moment they detect the slightest movement caused by sneezing or coughing. Any involuntary movement will not affect the surgery.

  • What if I blink?

    It should be impossible to blink during this procedure. Surgeons secure an eyelid speculum, which stops eyelid movement. Doctors also keep your eyes lubricated to prevent dryness and eliminate the need to blink.

  • Can I smoke after LASIK?

    Your eye doctor will likely advise you not to smoke until the cornea heals. Smoke tends to irritate eyes, cause dry eyes and slows down the natural healing process of any tissues it encounters.

References

LASIK Eye Surgery. (December 30, 2017). Mayo Clinic.

What Should I Expect Before, During, and After Surgery? (July 11, 2017). U.S. Food and Drug Administration (FDA).

Medical Devices: What Is LASIK? (July 11, 2017). U.S. Food and Drug Administration (FDA).

Do I Have to Be Awake During LASIK? (March 2018). All About Vision.

What to Know About LASIK Surgery. (September 21, 2017). U.S. News.

Anesthesia for Adults Having Eye Surgery. (July 2018). American Association for Pediatric Ophthalmology and Strabismus (AAPOS).

Frequently Asked Questions: LASIK & Advanced Vision Correction. University of Rochester Medicine, Flaum Eye Institute.

LASIK Eye Surgery. (August 2020). MedicineNet.

What should I expect before, during, and after surgery? (July 2018). U.S. Food and Drug Administration.

How Does LASIK Eye Surgery Work? Everything You Need to Know. (October 2021). American Refractive Surgery Council.

LASIK eye surgery. (September 2021). Mayo Clinic.

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