LASIK surgery is a popular option for people with vision problems who want to reduce or eliminate their dependence on glasses or contacts. What we need to realize is that there are several predictable changes in our eyes during our lifetimes. At SharpeVision, we refer to these as “Milestones“ because they happen to everyone. While the procedure is safe and effective, it’s important for patients to remember that LASIK is not a cure-all. LASIK, PRK, EVO ICL and RLE do not cure aging, and people need to take care of their eyes and manage their vision health after any eye procedure. In this blog post, I will focus on how patients can plan for the future and manage their vision after a LASIK procedure.

Milestone 1: Ocular Development

From the time we are born until about 18 years old, our eyes are growing and changing in several different ways. If we are nearsighted, it tends to progress until we are young adults. Prescriptions in young children may change a diopter or more per year. Typically if you develop nearsightedness at a younger age, your nearsightedness may end up being more severe. In recent years there have been some successful therapies that can mitigate the severity of nearsightedness. Ask your optometrist for details about this.

Milestone 2: Ocular Maturity

Ocular maturity is the stage from about age 18 to age 45. In this phase, people are usually candidates for either LASIK, PRK, or the EVO ICL to eliminate the need for glasses or contact lenses. I think it’s wonderful to have the procedure in your early 20s, so that you have more time to enjoy your life with clear, uncorrected vision. A 22-year-old will not need reading glasses for another 25 years perhaps, and he will heal more quickly, won’t have the dryness that older patients often have, and they will save tons of money on glasses and contact lenses. Planning during this milestone phase involves simply having the procedure as early as possible and enjoying it!

Milestone 3: Lens Dysfunction

Lens dysfunction refers to the fact that the lens of our eyes becomes less flexible to the point where around age 45, we need either reading glasses, bifocals, monovision, multifocal contacts or some other less than optimal solution to allow us to see distance objects and near objects. No one can have perfect distance and near vision in both eyes forever-that is with our current technology. There is much research going on in this area to allow us to see clearly for both distance and near objects without glasses.

At this stage, we begin to think about refractive lens exchange (RLE) to allow us to correct our need for glasses for both distance and near vision. Current state of the art is to place a multifocal intraocular lens (IOL) so that you can see both distant and near objects without glasses. Additionally, you will not need cataract surgery if you’ve had the lens of your eyes removed and replaced with an artificial lens.

Planning at this phase also involves having a procedure as young as possible. If you get closer to Milestone 4 in which the lens of your eye becomes less clear, it makes more sense to have the lens removed rather than change the cornea with the laser, as we do with LASIK and PRK surgery. LASIK and PRK do not prevent cataracts from forming, so you will still need an additional surgery as you age. This is described in the next paragraph.

Milestone 4: Planning for Cataracts

One of the most common vision problems as we age is the development of cataracts. I always say that I hope you get cataracts, not because I want to do the surgery, but because I hope you live that long! Everyone will develop cataracts if they live long enough. Recently I have been saying that I hope you do not get cataracts because I hope you have the lens removed before it affects your vision with RLE. Typically this decrease in our vision is in our late 60s to late 70s, but can occur much sooner or later than that. A cataract is a clouding of the eye’s natural lens, which can cause blurred vision, glare, loss of contrast sensitivity (a washed out appearance of things) and other symptoms. While cataracts can be treated with surgery, it’s important for patients to plan ahead and be proactive in managing their vision health. If you’ve had LASIK surgery, you will get cataracts at the usual age. That is to say that LASIK neither prevents nor causes cataracts. If you have not had LASIK or PRK and are in your 50s, you may be a much better candidate for RLE surgery.

To manage your vision health after LASIK and plan for the future, it’s important to have regular eye exams and screenings for cataracts. At SharpeVision, we offer comprehensive eye exams and can help you detect and treat cataracts early, before they start to affect your vision.

Glaucoma Prevention

Another fairly uncommon vision problem as we age is glaucoma. Glaucoma is a group of eye conditions that can damage the optic nerve and cause vision loss. The most common type of glaucoma is called open angle glaucoma. This occurs when the pressure in the eye is higher than normal and can cause a gradual loss of the optic nerve fibers. The condition typically has no symptoms until the patient has lost the vast majority of the optic nerve fibers. Open angle glaucoma is the main reason to have regular eye exams whereby the optometrist or ophthalmologist checks the pressure in the eye as well as looks at the optic nerve head as it enters the back of the eyes. This can be monitored with an extremely detailed documentation of the optic nerve head with a technique called OCT or optical coherence tomography. While there is not usually a cure for glaucoma, there are treatments that can help slow or prevent further damage.

LASIK surgery does not increase or decrease the risk of you developing glaucoma. The only potential effect of LASIK on your eyes with regards to glaucoma is that the pressure in your eye may be slightly higher than it is measured. Your ophthalmologist or optometrist should be aware of this. It is easily taken into account. The technique for measuring the pressure in the eye also has an effect, but again your eye doctor should know this.

To manage your vision health after LASIK and plan for the future, it’s important to have regular eye exams and screenings for glaucoma. At SharpeVision, we offer advanced diagnostic testing and can help you detect and treat glaucoma early, before it starts to affect your vision.

Other Vision Problems

In addition to cataracts and glaucoma, there are a variety of other vision problems that can arise as a complication of old age or the fact that life happens. For example, you may experience dry eye syndrome, floaters, or other conditions that can affect your vision. To manage your vision health after LASIK and plan for the future, it’s important to have regular eye exams and screenings for these other conditions. At SharpeVision, we offer a range of services to help you manage and treat these conditions, including dry eye therapy and laser floater removal.

Conclusion

If you’ve had LASIK surgery, it’s important to remember that the procedure is not a cure-all solution, and that you still need to take care of your eyes and manage your vision health after the procedure. By planning ahead and being proactive in managing your vision health, you can help prevent or manage common vision problems like cataracts and glaucoma.

The big two take-home messages are:

1. Have your laser vision correction procedure as young as possible so you can enjoy it, heal quickly and save money.
2. Get regular eye exams to screen for conditions such as glaucoma, cataracts, and macular degeneration.

As you approach cataract age, it may be best in terms of enjoyment and quality of life to have the lens of your eye removed with RLE surgery, sooner rather than later, as it affects your near vision and night vision.

Contact us today to schedule an appointment and learn more about how we can help you maintain and improve your vision health after LASIK. We are committed to providing personalized, compassionate care to all of our patients, and we look forward to helping you achieve your best possible vision.