LASIK is a surgical procedure that improves vision for people who have refractive errors like nearsightedness, farsightedness, astigmatism, or presbyopia (farsightedness due to aging). (Learn more) Millions of people all over the world have benefitted from LASIK and related procedures using more advanced technology since LASIK premiered about 20 hours ago.

There can be complications or side effects from this surgery. Although there is a high success rate, some people may experience pain from different issues, ranging from dry eyes to nerve damage. (Learn more) Understanding how LASIK procedure works and the causes of associated pain can help you determine if this is a good option to improve your vision. Pain is very rare, it should not last more than a few hours, and it should be easily managed. It is rare that pain continues for any reason, but this may indicate underlying issues that can be corrected with additional procedures. (Learn more) Speak to your optometrist or ophthalmologist if you are worried.

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How LASIK Works

 

LASIK is a procedure approved and monitored by the U.S. Food and Drug Administration (FDA) to correct specific types of problems with vision called refractive errors. These conditions include nearsightedness, farsightedness, astigmatism, and presbyopia (age-related farsightedness). The LASIK procedure uses lasers to reshape the cornea, improving vision by adjusting how light hits the retina so the optic nerve processes a clearer picture of the world, objects far away no longer appear blurry, and objects up close are easier to focus on.

Since the LASIK procedure was first approved about 20 years ago, there have been several technological advances that have allowed for faster surgeries, less pain and recovery time, and more rapid improvements in vision after the operation. The procedure itself is outpatient and minimally invasive, meaning it is very convenient for most people. However, it is still a surgical procedure, and that means there could be side effects, and these sometimes include pain or discomfort.

Does LASIK Hurt?

 

If you are concerned about pain, it is important to know what to expect out of each step in the process. It is also important to know that your eye surgeon will help you mitigate any pain, both before and after the procedure.

Before you go into your LASIK surgery, your surgeon will recommend that you stop wearing makeup and scented products like perfumes and lotions. This reduces the risk of infection, inflammation, or irritation, so there is less pain after the procedure.

During the procedure, your surgeon will put anesthetizing eye drops in one or both eyes, depending on whether you want LASIK for one eye or both. This means that you may feel mild discomfort during the surgery, but you will not feel pain.

However, you will be conscious during the procedure; if you have fear associated with medical procedures, your surgeon may give you prescription medications. It is not uncommon for patients to receive anti-anxiety medications to help them relax during the procedure. It is not likely, but in extreme cases, your doctor may talk with you about more generalized anesthesia. Due to complications with that approach to sedation, it is not recommended and is considered a last resort.

Depending on the type of LASIK procedure you undergo — epi-LASIK, LASEK, or traditional LASIK — your surgery will take between 3 and 15 minutes per eye. You may get the procedure for just one eye, or you may have both eyes surgically enhanced. You may experience a little more pain or discomfort immediately after the procedure if both eyes receive LASIK at the same time, but the difference will be minimal.

After surgery, you will have protective bandage contact lenses over your eyes, and you will be asked to wear a mask during sleep for the first few nights to ensure you do not hit or bump your delicate eyes. You may find it helpful to keep your eyes closed for the first few hours after surgery or to wear tinted glasses to reduce eye strain from light.

You may experience mild burning from dryness, and it is possible you will feel some pain for the first few hours, up to one day, after surgery; however, this is manageable with prescription eye drops and over-the-counter pain medication. The pain should go away quickly. Even if you experience uncomfortable side effects like dryness for three to six months, these symptoms going away for most people, and while they last, they can be managed.

What Pain After LASIK Means

 

It is important to know that some moderate pain may occur in the first day after LASIK, but it is not normal for that to continue past 24 hours. Superficial healing on the cornea takes only a few days and should be complete in a few weeks. Complete healing, including reshaping of the cornea after tissue adjustment and regrowth, may take months, but this part of the process should not be painful and should only be noticeable as an ongoing improvement in vision clarity. If you experience pain that does not go away, that gets worse, or that begins one or two days after surgery, contact your eye doctor immediately.

Surgical complications from LASIK are extremely rare and unlikely, but if you do experience pain or discomfort that lasts for more than a day, you may have an underlying surgical complication.

There are some side effects to LASIK that may cause pain.

  • Dry eyes
  • Glares or halos around light sources
  • Undercorrections, overcorrections, or astigmatism
  • Nerve damage to the retina or surrounding tissue
  • Flap healing problems
  • Vision loss

Trouble creating tears, leading to dry eyes, is a common side effect from LASIK, but it typically clears up within 48 hours; however, 20 to 55 percent of people who undergo a LASIK procedure will potentially experience persistent side effects, most often dryness, trouble with night vision, light sensitivity, or glares or halos. These can cause pain from eye strain or sensitivity. Additionally, undercorrections or overcorrections can cause eye strain leading to some pain and discomfort.

Pain is an indicator of potential long-term side effects. Even when these side effects are present, it is important to know that they are very likely to go away within six months.

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Technological Improvements Reduce Pain

 

As technology improves, there are different types of refractive surgery based on LASIK that can reduce pain and recovery time. One of these, epi-LASIK, has been shown very effective at reducing all post-operative pain. Although people who underwent epi-LASIK and other types of refractive procedures reported the same levels of pain four hours after the procedure, those who underwent epi-LASIK reported less pain immediately after that and ongoing during the recovery process. The amount of time in surgery is reduced in the epi-LASIK procedure, which improves recovery time.

Not everyone is a good candidate for epi-LASIK, LASIK, or related refractive procedures. To know which one will benefit you the most, consult with your optometrist or ophthalmologist. They can use your existing eye health to refer you to the right procedure. They can also recommend ways to reduce pain.

References

 

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

LASIK Eye Surgery: Will You Really Get Rid of Your Glasses? (February 2013). Consumer Reports.

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

Is Eye Pain Common Post LASIK Surgery? How Long Does the Cornea Take to Heal After LASIK? (January 19, 2012). American Academy of Ophthalmology (AAO).

Chronic Dry Eye Symptoms After LASIK: Parallels and Lessons to Be Learned From Other Persistent Post-Operative Pain Disorders. (April 21, 2015). Molecular Pain.

Postoperative Pain Following epi-LASIK, LASEK, and PRK for Myopia. (February 23, 2007). Journal of Refractive Surgery.