Let’s discuss all the many ways that we can take care of our eyeballs after we’ve had LASIK, PRK, ICL or RLE vision correction surgery. Many of my patients have asked me if they can use screens, should they wear blue blocking glasses while using screens, how much screen time is OK, and what they should do if they experience eyestrain. The good news is that the recommendations are the same whether or not you’ve had LASIK, PRK, ICL, or RLE vision correction surgery. I’ll also discuss how to protect your eyes outside of work when engaging in sports and recreational activities. Protecting your eyes is vital. Obviously, we use our eyes every waking minute our entire lives. It’s amazing the amount of work that our eyes do for us and how they help us in life. Clear uncorrected vision is awesome, but unfortunately we often take it for granted until there is an accident to remind us. Let’s look at ways that you can protect that vision and yourself.

Is it OK to Use My Phone and Computer after LASIK?

If I say wait three months before using your smart phone or computer, would you listen? If you listen, would you stop using screens? Not likely! So when you do use your phone, computer, or tablet after LASIK, here are a few things I recommend to make you more comfortable:

• Hydrate your body. Lots of liquids, but not lots of caffeine or alcohol. Both dehydrate you.
• Hydrate your eyeballs. Lots of artificial tears, even if they don’t feel terribly dry. If your eyes are burning, watering, or if your vision is foggy, it’s probably due to the surface of your eyes drying out. You may use artificial tears as much as you want. Often patients ask if they will get addicted to artificial tears. Absolutely not. There is no feedback loop that would get you addicted.
• Lubricating ointment at night time. Just a tiny bit can make a big difference in your comfort and vision the following morning. There are several brands out there, such as Lacri-Lube and Refresh P.M. You can use any brand, as they are all the same ingredients: mineral oil and petrolatum. The same as Vaseline.
• Hold the phone a little farther away. This places less strain on the muscles in your eyes that focus.
• Wear blue blocker glasses. Even if they don’t work in terms of protecting our retinas, they may keep your eyes from drying out. Evaporation is the loss of water off the surface of your eyes. Generally speaking, when you’re on a screen you blink less frequently, causing your eyes to dry out through evaporation. Each blink is like a tiny windshield wiper/cleaner that sprays a little water on the surface and spreads it around your eye. Blink if you need to, and even if you don’t!

How Much Screen Time is Too Much?

The amount of screen time that we all endure is increasing and concerning. Not only does it prevent us from experiencing life directly, inhibits socialization, and makes us increasingly sedentary, but it may have a deleterious effect on our eyeballs. The amount of screen time will be dictated by a number of things, but most likely will be due to whether or not you get your work done. There are limiting factors such as eye dryness, burning, and blurry vision that may happen with prolonged screen time. A useful tool is to think of the 20/20/20 rule  where after every 20 minutes, you take 20 seconds to look at something 20 feet or more away from you. This gives your eyes a rest and allows you to return to work.

Should I be Wearing Blue Light Blocking Glasses when Using My Computer or Smart Phone?

There have been some headlines that huge amounts of screen time may be detrimental to not only our eyes, but our mental health, our socialization, and circadian rhythms (sleep cycles). I can’t comment on numbers two, three, and four above, but can speak to the effect of blue light on our eyes. Some headlines in the past have brought up these issues. I don’t know that there is a huge body of evidence that blue light is dangerous. Amazingly, there is an international commission on non-ionizing radiation protection (for you engineers out there) that studies and reports on the effects on the body (specifically skin and the lens of the eye) of different wavelengths of the electromagnetic spectrum, such as ultraviolet, visible light and infrared light. It makes for some fascinating reading.

The bottom line is that if you feel better wearing blue blocking glasses, then do it. There’s not much evidence either in the scientific journals or from my patients in terms of symptoms of eye strain specifically due to screens. I also wrote a blog post with more details specifically on blue blocking glasses. Go ahead and check it out.

What Kind of Lighting Should I Use at Work?

There are many variables to consider when it comes to your lighting at work. The type of lighting, such as fluorescent bulbs, can increase eye strain due to the wavelength of light emitted from the bulbs. Fluorescent lighting is not natural and limited to a blue spectrum. In places like Costco, they have mostly replaced their old fluorescents with LED lights that have a broader spectrum and are less bothersome to our eyes. The best light is natural, outdoor light that has a full spectrum. But like everything in life, only in moderation. Ultraviolet light is also contained in natural sunlight, and as we know, can cause skin cancer. What most people don’t know is that it can also accelerate the formation of cataracts. People who live in equatorial regions often get cataracts at a very young age due to extreme light exposure. The moral of the story: wear sunglasses outside. But I digress.

The other important factors to consider with your “work” lighting are the direction and intensity of the light you are using. Generally a diffuse, moderate, natural light is best. If you have windows, you can adjust the lighting with blinds. I’ve had patients complain of skylights that were too bright and not adjustable. Hopefully your working situation, especially if you are WFH, allows you to create your own lighting environment. Working in the dark with only the light of your screen will often cause increased eyestrain, so I always recommend having a lamp or room lighting on.

Can I do Sports after LASIK?

After LASIK, I always tell my patients two things: use the drops as directed and don’t get poked in the eye. The LASIK flap adhesion to the underlying tissue will get stronger over the following 3 to 6 months after surgery. After that, it’s not easy to move the flap, but if you got a finger in the eye, the flap may become dislocated which is painful, scary, and results in very blurry vision. There have been a couple of my patients who have moved the flap in a sporting event. The two that I recall are a young man who got poked in the eye during a basketball game, and a young woman who was hit in the eye with a tennis ball. Both of these traumas moved the flap and both were fairly soon after the LASIK procedure. In all cases, I have been able to put the flap back in place with no further vision problems. Of course it could always be worse, and either trauma is always scary and potentially could result in vision loss.

In my opinion, you can participate in sports the very next day after LASIK. Activities such as snowboarding/skiing always require goggles to protect your eyes. If you were to fall skiing, the flap will not move. The same goes for strenuous activities such as weight lifting. Although the strain of lifting will result in increased eye pressure, there is no risk of the flap moving. I also recall a case report of someone going skydiving shortly after LASIK and having the flap dislocate. This could have been from the wind, or from the goggles hitting the person in the eye. As I’ve said many times, “Wear protection!”

The most common reason for a LASIK flap dislocation in my practice has been 18 month old toddlers. Toddlers love to poke mom and dad in the eye. It generally won’t happen with a newborn who cannot move their hands quickly and forcefully. It also won’t likely happen with a five year old or older, but when children are very young and curious, they can quickly throw something or poke mom or dad in the eye and move the flap. So…don’t get poked in the eye, and you’ll be good!

Am I Allowed to Go Swimming after LASIK?

I recommend waiting at least a week to go swimming because goggles could snap you in the eye and move the flap. There is also a small risk of infection in a pool and a much larger risk of infection in a pond or lake. It’s probably never a great idea to open your eyes underwater in a lake, pond, or any other slow moving water. There can be some bad stuff in there! Even worse is wearing contact lenses in the lake or pond because there is a dangerous parasite called acanthamoeba that can cause very severe vision loss.

What Other Precautions Should I Take to Protect My Eyes?

One of the most essential pieces of advice I can give anyone, whether or not they’ve had vision correction surgery, is to wear protective glasses or goggles while doing yard work, chipping, shredding, using any power tools, and certainly any sports such as racquetball or tennis. And always wear goggles while skiing and motorcycling, and almost always while bicycling.

The reason you don’t want to go fast without glasses/goggles is that the air blowing hard in your eyes makes it nearly impossible to keep your eyes open and see where you are going! Sometimes in the movies, I see someone riding a motorcycle with no eye protection. I always chuckle because anyone who’s ever ridden a motorcycle over 10 miles an hour knows that there is no way you could do that. The wind is simply too strong. Even with a windshield there is a lot of wind. Rocks, bugs, etc., fly in your face. So it’s pretty easy to understand why wearing glasses or goggles while doing these activities is essential.

Less obvious is why you would want to wear protective goggles while playing tennis. Very few people do, and it’s somewhat socially awkward. A tennis ball is extremely dangerous to our eyeballs because it is small enough to hit the eyeball itself. A bigger ball, such as a soccer ball, generally will not easily hit the eyeball because it will be stopped by the bones in your forehead if you have a ball kicked directly at your face. Painful yes, but less likely to cause a serious eye injury. When a small ball such as a racquetball or tennis ball hits someone directly in the eyes, it can cause immediate and permanent blindness by something called traumatic optic neuropathy. The energy of the ball can immediately separate the optic nerve from the back of the eye and results in total blackness. A ball can also cause dangerous injuries to the retina causing swelling, tears, and detachment that can result in partial or complete vision loss. There are goggles that are made of clear acrylic that have just a thick frame and are nearly invisible. You can get goggles or protective glasses from Home Depot. Aisle 30 Bin 16. Or from Dick’s sporting goods for racquetball and tennis. Wear goggles or glasses!