If you're 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. (Learn more)

Before you schedule surgery, you will need an examination, and your doctor may determine that surgery is not right for you. (Learn more) You may also need to think about costs before surgery. (Learn more)

If surgery isn't right for you, new techniques are under development that can offer permanent fixes for your vision. (Learn more) Standby solutions, such as glasses and contacts, may also offer relief. (Learn more)

patient undergoing prk surgery

Using LASIK to Correct Nearsightedness

Nearsightedness, also known as myopia, is technically a refraction error. The eyes use refraction, or bending of light, to help images focus sharply on the back of the eye. People with myopia experience refraction errors when looking at objects at a distance. Those objects seem fuzzy or indistinct, as they are focused in the middle (not the back) of the eye.

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's something surgeons take very seriously.

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.

Medscape reports that LASIK may not be the right option for people with:

  • Severe myopia or astigmatism.
  • Thin corneas.
  • Irregularly shaped corneas.
  • Keratoconus (a condition causing bulging of the cornea).
  • Dry eye.
  • Pellucid marginal dystrophy, causing thinning of the cornea.

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 don't perform the surgery on people who may not benefit.

We Promise Our Patients Peace of Mind
Consultation
Consultation

During the consultation, we will ask you about your eye health history and your medications, and perform some tests. You will then be examined by the surgeon who will discuss your treatment options. Your personal Patient Counselor will help you throughout the process.

Your Counselor can review payment options and schedule you for surgery and related appointments, such as pre- and post-operative exams. Prior to your procedure you will have a dilated eye exam, and you should discontinue wearing your contact lenses and begin taking eye drops as instructed.

Procedure
Procedure

Plan to be at the center for two to three hours the day of your procedure. ICL eye surgery is a fairly brief outpatient procedure. Your surgeon dilates your eyes, and gives you a local anesthetic to numb the area. A tiny incision is made, and the clear lens is slipped between your iris and your eye’s natural lens. The day of your procedure should be a day of rest.

Post Procedure
Post-Procedure

Your Patient Counselor will give you detailed post-operative instructions and eye drop regimen for your recovery. After ICL surgery, you’ll need several follow-ups with your eye doctor. Visual recovery is rapid, and you can expect noticeable improvement within a day or two. Most patients are generally able to return to their normal activities within two or three days following their procedure.

What to Think About Before Surgery

Before you schedule surgery, you must think about the risks and benefits involved. If you are overly concerned about developing dry eye, or you grow worried that you will not see as well after surgery as you did before it began, surgery might not be right for you. You may also have cost issues to consider.

As the health insurance provider Peace Health points out, LASIK is a cosmetic procedure, and as such, it is not typically covered by insurance companies. To an insurance company, there is no medical reason to have this surgery, as most people have the procedure in order to stop wearing glasses or contact lenses. Those tools may help them to see clearly, but people simply don’t want to wear them anymore. For an insurance company, that wish is not enough to spark an insurance claim.

Insurance company Kaiser Permanente agrees and also defines the surgery as a cosmetic procedure. That means this provider also expects people to pay for the surgery out of pocket, and Kaiser Permanente reports that it can be expensive.

Some LASIK providers offer financing options that can make paying for the procedure easier. But the costs incurred will still total thousands of dollars. This is something you will need to consider before you schedule your surgery.

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 isn't 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 isn't the only way to ensure you can see items far from you. For some people, the traditional tools work quite well, and there's 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're relatively easy to put on and take off. People can wear contacts while playing sports, and the lenses won't cloud in hot or humid conditions. For people who don't 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're in good hands. If surgery isn't right, we will find another solution. Contact us for an appointment. Let's get started.

	

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References

 

Visual Outcomes of LASIK-Induced Monovision in Myopic Patients With Presbyopia. (September 2010). American Journal of Ophthalmology.

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.

Long-Term Refractive Outcomes and Stability After Excimer Laser Surgery for Myopia. (October 2010). Journal of Cataract and Refractive Surgery.

Phakic Intraocular Lens (IOL) for Myopia Correction. (September 2016). Medscape.

LASIK (Laser In-Situ Keratomileusis) for Nearsightedness. Peace Health.

PRK, LASEK, and Epi-LASIK for Nearsightedness. Kaiser Permanente.

Lens Implants: New Fix for Your Nearsightedness, Astigmatism? (July 2017). Cleveland Clinic.

Engineers Invent a Noninvasive Technique to Correct Vision. (May 2018). Phys.org.

Myopia (Nearsightedness). American Optometric Association.

How to Take Care of Contact Lenses. (September 2018). American Academy of Ophthalmology.