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Can LASIK Fix or Cure Nearsightedness?

Antoine K. Fahd, M.D., PhD.

Medically Reviewed by Antoine K. Fahd, M.D., PhD.

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patient undergoing prk surgery

If you are struggling to see distant objects, you may have one simple question on your mind: What will fix it? For some people, LASIK surgery can be helpful, and the procedure can be modified to help you reach your specific vision goals.

Using LASIK to Correct Nearsightedness

Nearsightedness, or Myopia, is often caused by an eyeball that is too long, and this is a condition that begins in childhood and progresses until growth stops in early adulthood. When growth stops, the vision correction required also stops changing. People with a stable prescription like this might be prompted to think about laser-assisted in-situ keratomileusis (LASIK).

During a LASIK procedure, a tiny flap in the cornea is created and folded back, giving a laser access to deeper corneal tissue in the eye. Some of that tissue is removed, making the eye a little thinner and allowing light to focus in an ideal manner on the back of the eye. When the proper amount of tissue is removed, the flap is replaced.

Surgeons can modify this basic surgery in a variety of ways. For example, some surgeons remove tissue from one eye to allow that eye to have sharp distance vision. The other eye is optimized for close work. This monovision allows for visual acuity at almost all distances, and it can be quite effective.

In a study published in the American Journal of Ophthalmology, researchers found that their patients who had monovision were able to see well both near and far without correction, and they had good contrast sensitivity too. Results like this suggest that creating this dual correction within the eyes could be a good choice, especially for people who need to perform close work as well as distance work. Ensuring one eye can always see clearly close up could be quite helpful for them.

In traditional LASIK, both eyes are optimized for distance, allowing people with myopia to see items far from them without the constant use of glasses or contacts. In a study about the efficacy of this surgery, published in the Journal of Refractive Surgery, researchers found that 100 percent of people who had LASIK had 20/25 vision four years later without the use of glasses or contacts. This is a remarkable result, and it suggests that this surgery could be quite helpful for some people with myopia.

The degree of myopia does play a role in surgery success, however. People with very high degrees of myopia may need to have quite a bit of tissue removed from their eyes in order to see clearly, and they may experience a regression in prescription levels over time. Those with lower levels of myopia tend to avoid these problems.

For example, in a study published in the Journal of Cataract and Refractive Surgery, researchers examined outcomes in people with high myopia (prescriptions of about -3.98 diopters) and low to moderate myopia (prescriptions of about -7.64 diopters). In a follow-up 13 years after LASIK, 64.8 percent of the eyes in the low group were within 0.5 diopter of the attempted correction, but only 37.3 percent in the high myopia group had the same benefit.

Studies like this demonstrate the importance of screening before surgery begins. That is something surgeons take very seriously.

What Does LASIK Involve?

The goal of LASIK is to reshape your cornea, which improves the focusing of images onto your retina.

Here’s what you should expect when you’re about to undergo the procedure:

  • The surgeon will have you lie back and get into a comfortable position.
  • You will go through a brief eye test to update your eye health history.
  • The doctor or physician’s assistant will administer a sedative and place numbing eye drops in both eyes.
  • The doctor will use an instrument over your eyelids as well as a suction ring set over your eye to prevent them from moving during the procedure.
  • Using a femtosecond laser, the surgeon will create a thin flap in your cornea and fold it back to reveal the underlying material (stroma).
  • You will have to stare at a light, but it’s a focus light, not the laser.
  • The surgeon will direct the laser beams towards the exposed stroma and reshape it. You will hear rapid clicking sounds as the laser does its job. Every pulse of the laser machine is reshaping your cornea.
  • If you’re nearsighted, the aim is to flatten your cornea. Farsighted people will have their corneas steepened.
  • You will detect a smell resembling burning hair. This is just the laser scrubbing off the corneal tissue.
  • After completing the reshaping, the surgeon will lay back the flap, which usually heals naturally without further intervention.

If your other eye needs LASIK, the surgeon will position the laser machine to the other eye and repeat the operation.

Screening Before Surgery Is Required

LASIK procedures take just a few minutes to complete. During that time, very precise equipment is used to help doctors take off just the right amount of tissue. The combination of doctor skill and machine precision helps to ensure that the surgery runs smoothly. But before the procedure begins, doctors need to ensure that the eyes they will work on can handle the procedure.

During a pre-surgical exam, doctors examine the eyes of their patients and perform tests in order to ensure that these issues are not present. They will take measurements of tear production, pupil size, eye shape, and more. They will ask in-depth questions about the overall health of their patients, to ensure that the surgery will run as smoothly as possible.

It is not uncommon for surgeons to turn patients away even when they have asked for LASIK for myopia. Performing the surgery on people with the conditions listed above can lead to serious complications, including severe dry eye, visual disturbances, and even blindness. Surgeons do their part to ensure that they do not perform the surgery on people who may not benefit.

Am I Eligible?

Since LASIK promises almost instantaneous vision correction, it’s a popular choice for many people. However, not everyone is eligible for the procedure.

You may qualify for LASIK if you have one of these conditions:

  • Astigmatism happens when your cornea flattens or curves unevenly, disrupting your ability to focus on near or distant objects.
  • Nearsightedness (myopia): when you see close-by objects clearly but have difficulty focusing on distant objects, it means your eyeballs are more prolonged than they should or your cornea curves too sharply. That means light rays focus at the front of the retina instead of on it, causing clear vision for nearby objects but blurring objects at a distance.
  • Farsightedness (hyperopia): where you can see objects far away from you clearly, but can’t focus on nearby things. If your cornea is too flat or eyeballs are shorter than average, light rays focus behind the retina, causing clear distant vision but blurry nearby objects.

Recovery Time after LASIK

You will face a recovery phase and a healing period before you regain vision stability. Most people will suffer some vision loss during the surgery, which takes 1 to 2 days to recover.

The healing phase can take close to six months for vision to stabilize completely.

Potential Side Effects

One of the most common side effects of LASIK surgery is dry eye and fluctuating vision clarity throughout the day. It usually happens during the first month, but it should get better with time.

Other uncommon side effects include:

  • Halos at night
  • Light sensitivity
  • Puffy eyelids

Costs, Insurance and Financing LASIK

The average cost of LASIK eye surgery is between $1,000 to $2,000 per eye. Most health insurance will not cover LASIK as it’s an elective surgery, but some might offer a discount.

The most common way to get help paying for such a surgery is to seek financing from a LASIK financing company that your eye doctor approves. Alternatively, the eye surgeon could offer you financing.

Your Health Savings Accounts and Flexible Spending Accounts allow withdrawals for LASIK surgeries. Another viable financing option is a credit card.

That said, it’s not as costly as getting glasses or contact lenses because LASIK surgery can potentially last you a lifetime. On the other hand, you have to keep replacing glass lenses, frames, and contact lenses.

Even though the initial payment for LASIK is steep, the frequent replacement cycles of glasses and contact lenses can rack up, which means LASIK might be the more cost-effective option long run.

New Techniques Are Being Developed

Nearsightedness is common, and many people who struggle to see clearly look to their doctors for solutions. As a result, doctors and researchers continue to look for ways to help their patients, and some of these new solutions could be ideal for you if LASIK is not recommended.

Intraocular lenses are one such solution. As the Cleveland Clinic points out, these lenses were once used exclusively in people with cataracts. When the natural lens clouds and makes clear vision difficult, surgeons break the old lens apart and place an artificial one inside the eye. Lenses for myopia can give you sharp focus both near and far, and some are even made to correct astigmatism. This could be a good option for you if you’d like eye surgery but your eyes are not quite right for LASIK.

Researchers are also experimenting with different types of lasers. For example, some engineers have designed a laser that can correct myopia without the need for a flap or surgery. This type of laser, they say, could even be used in people with dry eyes and thin corneas. More research is required before it’s ready for use in all people, however.

Male hands holding glasses for you to look at two businessmen shaking hands

Old Standbys May Still Help You See

Surgery is not the only way to ensure you can see items far from you. For some people, the traditional tools work quite well, and there is no need for them to even consider the risks and benefits of something more severe.

For example, according to the American Optometric Association, eyeglasses are the primary correction choice for most people with myopia. Often, people get a pair of glasses with a lens that allows for clear vision at all distances. If vision changes with age and it grows more difficult to see things near the face, those glasses can be removed for close work. If vision changes during life, growing either better or worse, the prescription can easily be amended. This can be the simplest and easiest way to deal with the difficulties myopia can cause.

Contact lenses can also be used to amend myopia, and like glasses, the prescription used with the lenses can be changed as vision changes. They are nearly invisible to others, and they are relatively easy to put on and take off. People can wear contacts while playing sports, and the lenses will not cloud in hot or humid conditions. For people who do not like to wear glasses and who cannot have surgery, contacts can be a good choice.

According to the American Academy of Ophthalmology, it’s vital to ensure that contacts fit properly and are replaced often. Old, ill-fitting lenses can scratch the eye or cause an abnormal growth of eye blood vessels. Both can threaten vision. People who wear contacts must be careful to care for those tools properly.

Insurance companies tend to cover the cost of these solutions, which can make them a good option for people on a budget, but the companies may not cover the cost of maintenance of these tools. Contact solution, glasses cleaners, and more can get expensive over decades of use.

Taking Action

Myopia is serious. An inability to see things far from you can make it impossible for you to drive. You may be more likely to slip and fall on items you can’t see. You may not catch nonverbal language from your coworkers and the people you love. You may miss out on the beauty the world has to offer.

Myopia is also a very treatable condition. Glasses and contact lenses can help to sharpen your view while giving you the opportunity to make quick changes as needed. LASIK can help you to see clearly on a permanent basis without the continual use of other lenses. And new surgeries are on the horizon that may do even more for your eyes, your vision, and your health.

Work with a doctor who knows your eyes and your preferences. Work with our doctors. We will perform a comprehensive examination of your eyes and help you understand what solution might be best for you. Should you need surgery, you are in good hands. If surgery is not right, we will find another solution. Contact us for an appointment. Let’s get started.

References

  1. Visual Outcomes of LASIK-Induced Monovision in Myopic Patients With Presbyopia. (September 2010). American Journal of Ophthalmology.
  2. Four-Year Visual, Refractive, and Contrast Sensitivity Outcomes After Wavefront-Guided Myopic LASIK Using an Advanced Excimer Laser Platform. (October 2013). Journal of Refractive Surgery.
  3. Long-Term Refractive Outcomes and Stability After Excimer Laser Surgery for Myopia. (October 2010). Journal of Cataract and Refractive Surgery.
  4. Phakic Intraocular Lens (IOL) for Myopia Correction. (September 2016). Medscape.
  5. LASIK (Laser In-Situ Keratomileusis) for Nearsightedness. Peace Health.
  6. PRK, LASEK, and Epi-LASIK for Nearsightedness. Kaiser Permanente.
  7. Lens Implants: New Fix for Your Nearsightedness, Astigmatism? (July 2017). Cleveland Clinic.
  8. Engineers Invent a Noninvasive Technique to Correct Vision. (May 2018). Phys.org.
  9. Myopia (Nearsightedness). American Optometric Association.
  10. How to Take Care of Contact Lenses. (September 2018). American Academy of Ophthalmology.
  11. What to Expect with LASIK Recovery. (October 2021). American Refractive Surgery Council.
  12. 6 Common Questions About LASIK Eye Surgery. (March 2019). Penn Medicine.
  13. LASIK surgery: Is it right for you? (August 2021). Mayo Clinic.
  14. The 25th Anniversary of Laser Vision Correction in the United States. (March 2021). National Center for Biotechnology Information.

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