What's that smell? Oh, it's my eyeballs crisping.

February 8, 2008 8:47 AM

LASIK: Considering eye surgery, have new questions for those who've had it. I'd like to hear from people who know what they're talking about.

So I'm seriously considering custom LASIK, strongly enough that I plan to apply for the financing and schedule the procedure today for within about a month from now. I'm 33, nearsighted, about -5.25 in one eye and -6 in the other. I currently wear glasses and occasionally, soft contacts. With my glasses on, I see very crisp and clearly. I do not have astigmatism and have already gone through an evaluation with a clinic I trust, and am told I am a good candidate. I have some questions which I have not seen addressed in previous Askme threads and am hoping for additional insight and experiences from those of you who've had the procedure done.

Caveat: I'm aware there are tons of older Askme threads on Lasik, and I've probably read them all, and have weighed the pros and cons offered therein. Please don't point me to these prior posts, as I'm seeking different perspectives from what's already out there. Thanks!! :-) So that said, here's what I'm wondering:

- I know that Lasik does not prevent the potential need for reading glasses in middle age, because presbyopia is due to lense changes which corneal alterations from Lasik would not affect. Also, given that Lasik may not prevent all vision changes and my sight may still decline again later, will having had Lasik prevent me from being able to see well at long & short distances with *regular prescription glasses* in old age? Or will I be stuck with blurry long distance vision (should such a decline happen) and only be able to wear reading glasses for up close?

- If my vision were to decline again as I age, would having had Lasik mean I would never be able to wear contact lenses again? Do contact lenses irritate or damage the laser-altered corneal tissue?

- Those of you who have had eye surgery many years ago; have you noticed any vision decline as you get older? In what way? Can you see well again with glasses, like in the old days?

- Night driving: I'm aware of the possibility of halos and heard that if they occur they may decrease over time as I heal. However, would wearing glasses for driving prevent halos?

- My doc explained the laser touch-up process in the event that the work needs to be enhanced with more lasering within the year after the first surgery. She explained that the same flap is lifted open in later procedures that was cut in the first one, and made it sound like the flap is just kinda always there, "flapping" for lack of a better term. This squicks me out. Does the flap eventually heal fully and seal itself down for good? How long does it take?

- Does having had Lasik mean I won't be able to have surgery or treatment for cataracts later in life, should I develop them? Basically... I'm wondering if Lasik means I could never have any additional surgery done the eyes ever again.

- Hayfever and allergies: in terms of itching, redness, noseblowing, runny eyes, etc. -- Those of you who had Lasik, how do your allergies affect your eyes now? Any differently from before Lasik?

- More on the allergies thing, also regarding headcolds: Sometimes I use pseudoephedrine or other otc meds to dry up my nose. Any contraindications for using these after Lasik? Will they cause too much eye dryness?

- What about smoke? Like campfire smoke or incense (we use incense a lot around the house). Is smoke any worse for lasered eyes than for normal eyes?

- Crying: I'm an emotional softy. Sometimes I cry. Will fountains of tears and the eye pressure/redness resulting from said crying cause damage or problems with lasered eyeballs? Pain? Flap issues?

- Ladies: Eye makeup. Anything bad happen when using mascara or eyeliner? Doc said not to use makeup for the first couple of weeks after surgery but didn't expand on that or mention if it could cause problems later.

- Cat hair and other debris: We have five cats. Sometimes I get a hair in my eye. Or I get dust or eyelashes or whatever in there & have to pick them out. Would this have the potential to cause major corneal damage even after the flap has healed? (I know it would in the first few weeks during the "hands off" period... but what about years later?)

And finally: What does the procedure feel like? I'm a little scared that I'll see the flap-knife & the laserbeam coming at me & I'll be emotionally scarred for life. Does your vision go black before the blade looms? Are the numbing drops effective enough? I heard it doesn't really hurt. Is it pointy feeling? Just wondering what to expect.

That's all I can think of for now. Thanks in advance for insight!

posted by cuddles.mcsnuggy to health & fitness (17 answers total)

I had LASIK four years ago. I have noticed no degradation in vision since then (and never halos at night), although I do know there is a possibility that I will need reading glasses with age.

I cry a lot, I wear makeup, I have sat in front of campfires, I've had many a cold, I have gotten eyelashes in my eyes. All of these things are just the same as before I had the surgery.
posted by pinky at 9:07 AM on February 8, 2008

I had LASIK done 5 years ago, and I've had a little bit a degradation, but I went from Super-Amazing-Awesome to just Super-Awesome over the first year or so, but it's holding steady. I have no night-vision problems, or any other type of problems. With LASIK they pretty much guarantee that your eyes will continue to change as you get older (as they would even without the procedure) so you'll probably need reading glasses late on in life.

No pain, no issues, although they told me not to rub my eyes for about 3 months afterwards. That was interesting/hard.

As for the surgery, I won't lie to you, it was the scariest thing I've ever done in my life. When they cut your eyeball open and flip up the flap, everything goes dark and fuzzy, and you know that if they screw up you'll be blind. That being said, it was fast, painless, and I got over the fear. If they offer you some sort of muscle relaxant, take it, it takes the edge off. Plus it's an interesting sensation when you smell burning hair, and you realize that it's because someone is shooting a laser into your eyeball.

While it was really scary for me, it was one of the best things I've ever done, I love not having glasses, it's a whole different world out there.
posted by blue_beetle at 9:12 AM on February 8, 2008

I did it couple of years ago - changed my life and I recommend it to everyone. Especially if you travel at all.

When they did my eyes, they tuned one to 20/20 and the other a little under that, which is supposed to compensate for loss of close-up vision as you get older.
posted by RandlePatrickMcMurphy at 9:17 AM on February 8, 2008

Thanks for the thoughts so far; I guess what I'm seeking to hear is what it's like living day-to-day with lasered eyes & how anything may differ from unaltered eyes, even the small details that most people don't even think about. I'm excited at the possibility of not needing glasses/contacts when camping, at festivals, being able to swim and not worry about losing contacts under water. Being able to see the clock from bed and my soap in the shower would be nice. Right now I can't see squat. Just colors & vague large shapes.

So blue_beetle since your vision changed, do you ever wear glasses at all any more?

Is there, an icky "pop" or poking feeling when the blade hits the eye? (shudder) Yes, I'm squeamish. I definitely plan to use all the relaxants they offer!

Oh, and more questions: I sit in front of a PC all day reading small text off paper forms & on the screen. Will such eyestrain cause complications with Lasik? Will Lasik help with the eyestrain?

Does it effect vision in the dark? With my glasses on I see quite well in low light and dark rooms. After Lasik will a lack of light make it harder to see than I do now with glasses?
posted by cuddles.mcsnuggy at 9:27 AM on February 8, 2008

My girlfriend is getting PRK surgery (like lasik, but all laser instead of blade + laser), so we've been over a lot a this recently. In general, these questions can be answered by your surgeon far better than random Internet strangers. We discovered in researching my gf's procedure, there's a lot of incorrect information about lasik on the Internet. That being said, I'll answer what I can (and MeFiers are generally canny folks anyway, right?).

#1 - Myopia and hyperopia are caused by the cornea and lens of the eye incorrectly focusing light entering it. Lasik fixes this and the chance of your eyes degrading to the point of needing {my,hyper}opia correcting glasses again is very slim. As you said, you might need reading glasses to correct presbyopia later in life, but for near vision only.

#2 - Ibid. The chances of you ever needing contacts again is tremendously low.

#3 - Laser eye surgery has advanced by leaps and bounds even in the last few years. Anyone who had the surgery a significant period of time ago probably isn't going to be able to offer very accurate information.

#4- The surgeon told my gf that the night halos issue is largely resolved and only noticeable while you're still healing.

#5 - The flap will eventually heal, but or it to be healed completely, it maybe take 6-12 months. Any touch-ups you'd need would occur before then.

#6 - It's unlikely that lasik would permanently impair your candidacy for other eye surgeries, but they might be more complicated if needed in the first year after lasik, while the corneal flap is still healing.

#7 - If you have severe allergies, then you need to consider how this will effect your ability to recover. Once you've had lasik, you absolutely, positively can not rub your eyes. Doing so can shift the corneal flap and prevent it from healing correctly. If you think you may not be able to do this, you may want to schedule your surgery after the worst of allergy season is over.

#8 - Ask your doctor.

#9- Maybe effect the healing (but I doubt it). Ask your doctor.

#10 - Ibid.

#11 - Has more to do with make absolutely sure you aren't touching your eyes while the flap is healing than anything specific to the makeup. Basically, you shouldn't have anything at all near your eyes while they're healing.

#12 - Once the flap is healed, it's a normal eye again. You may have to go out of your way to keep your place as free of pet hair as possible while you're healing.

#13 - If they offer you some Gravol or Ativan, take it.

Extra #1 - While your eyes are recovering, you'll need to take frequent breaks to avoid eye strain. Beyond that, things should be largely as they are with glasses.

Extra #2 - Once your eyes have healed completely you won't notice any difference.
posted by Nelsormensch at 9:37 AM on February 8, 2008

#3 - Laser eye surgery has advanced by leaps and bounds even in the last few years. Anyone who had the surgery a significant period of time ago probably isn't going to be able to offer very accurate information.

Upon rereading this, all I mean is that your procedure will almost certainly be better.
posted by Nelsormensch at 9:40 AM on February 8, 2008

I had it several years ago -- maybe seven? Hard to remember.

My night vision is a bit worse, yes. This has only ever been a big deal when it was almost pitch-black dark, though. A friend had to help guide me through a cornfield once, and I ended up installing some cheap-ass solar lights along my driveway. That's been the total extent of my problems.

I sit in front of the PC pretty much nonstop. No problems. The last time I got my vision checked, admittedly a while ago, it was about 20/40.

I've cut my eye, gotten things in it, shot it full of boiling water. Everything healed fine.

I do not remember an icky pop or poking feeling. However, and here's my caveat...

When I got mine, I was working way too much and very tired. The process (at least the one I went through) starts off with them putting you on a comfy bed-thing in a dark room and feeding you Valium a quarter-pill at a time until you are sufficiently chill.

Well, they put me on something comfy in a dark room and I fell asleep, so they figured I was plenty chilled and wheeled me in.

When I woke up, I was surrounded by people, the surgery was about to start... and I don't even know why (it may have been the Valium, I have a history of reacting weirdly to meds), but I freaked OUT. I don't remember the actual surgery that well, because I was so freaked. They told me that I needed to hold very very still, and I was doing that and having a panic attack, so that's all I remember, really.

The valiums, you should take moar than I did.

All in all, one of the best things i ever did for myself. I was forever losing/breaking glasses, having problems with my contacts, falling asleep in my contacts, lalala. I highly, highly recommend it.
posted by Gianna at 9:45 AM on February 8, 2008 [1 favorite]

1. Glasses. Apart from the unlucky ones whose vision is permanently messed up by lasik, I'm not aware that glasses would be less effective for you down the road, and don't see why that might be the case.

2. Halos. Night-driving glasses will not affect halos, if you get them. The halos can subside over time (they did for my wife).

3. Flap-healing. My understanding is that it never fully heals. This is why they tell you never rub your eyes after you've had lasik, although that's being cautious. Two months is the "really, don't rub your eyes at all" period, and after two years (from what I understand), the flap is mostly healed. When I asked about flap detachment, the guy who did my eyes said that in 30,000 procedures (?) they'd seen one guy with a detached flap, caused by a dog jumping up and sticking a paw in his eye. Agreed, it is squicky to contemplate.

4. I haven't had any unusual eye irritation following lasik. I'm not aware of any contraindications on eyedrops (and I'm sure they would have told me).

5. Sensation: You get numbing drops and valium for the procedure. In my case, they cut the flap with a laser, not a knife, and the only physical sensation I recall was a slight sense of pressure when they affixed the vacuum clamp to my eyeball. Because I was alert through the whole thing, I was aware of exactly what they were doing to me at each step, which was kind of unnnerving, but I kept saying to myself "don't flinch, don't flinch, don't flinch."
posted by adamrice at 9:50 AM on February 8, 2008

i had lasik several months ago, and my healing process mostly stopped being intrusive to my life after the first week, and almost completely stopped after a month, when i could finally rub my eyes again.

i'm still using sterile eye drops several times a day (note that these are the preservative free type that come in individual doses rather than the plain old bottles of saline type), and expect to do so for several months, but other than that, things are fine.

i noticed my close-up vision deteriorated a bit after the surgery, but it may improve with long-term healing. mostly, i have to hold things slightly further away to read them. considering that i'm in my 40's, this is not a surprise and was quite expected. no issues with computer work, although i took the first few days off from dealing with the screens to rest my eyes.
posted by rmd1023 at 9:52 AM on February 8, 2008

I had LASIK last year. My left eye is really bad still, halo, blurry, can't see to drive very well at all. I had the surgery in another state so thus far I've not been able to get back for a correction. My right eye is great so it seems to compensate but still, I cannot see very well to drive at night. I cry a lot, wear make-up sometimes, have allergies, take a lot of OTC meds for said allergies, sleep with dogs who shed, directly into my eyeballs if they can, and have no issues with smoke from campfires. None of these things got worse after the surgery. I can no longer cut onions without crying but I assume that's because I lost my protective contact lens barrier. I only had to "baby" my eyes for a few days post-surgery which is good because I went to Florida right after and swam in the ocean. I had VERY bad vision and very bad astigmatisms as well as sort of thin corneas so while I qualified for the surgery I was by no means an ideal candidate. Just to mix it up, I sort of freaked out during the procedure and MOVED MY EYE. I know, I'm a dork. They have your lids pried open but you can still move your actual eye ball. Like me! The nice Dr. explained that the laser automatically turned off when I did such things and I should stop it immediately. It didn't hurt, I took the optional Ativan and my eyes were itchy for a few days but nothing too bad. You can see as soon as you get out of surgery, it's so odd. You can smell your eye burning during the procedure, I think that's why I moved. Ok that's my rambling experience with LASIK.
posted by yodelingisfun at 9:56 AM on February 8, 2008 [1 favorite]

I had it done in July of '05; my prescription was pretty close to yours, and now I'm 20/10. I can't speak to the degradation over time, but my eyes are just as superman-ish as they were the day I got it done. :) From what I recall, they can correct your eyes to the vision you would've had if your eye hadn't started to change shape, but that's it.

The week or so you spend wearing a shield at night is kind of a pain, but recovery isn't really a big deal. Lots of eye drops, no rubbing your eyes (this one KILLED me; it was my favorite morning-shower routine before I had my eyes repaired), being careful for a little while and going to see a doc regularly to make sure it's healing properly. And we had a small house with three cats and a very furry dog, and I never had a bit of trouble with furrballs getting into my eyes.

For the surgery itself, they tape your eyelid open but you can't see anything out of the eye that's being worked on; when you sit up, you can see again. I was a bit nervous, but it literally took like 3 minutes so I didn't have time to get really scared. I thoroughly enjoyed donating my no-longer-needed glasses as I walked out of the office.

Halos: I didn't have a problem after the first couple of weeks, but I was very careful to keep my eyes well lubricated. IIRC, the doc said that keeping your eyes moist would reduce the occurrence and severity of halos.

As to your concern about there being a permanently open flap of tissue, it will seal almost immediately after surgery (one of the steps is that they make sure it closes properly, obviously), but it takes about a year for the flap to permanently seal. Hence the no-rubbing rule. But after about a year, it heals completely and permanently; if they were to do corrections after that, they'd have to re-create the corneal flap.

Congrats and good luck! I'd do mine over a dozen times to be able to see like this and not worry about contacts and glasses and solutions and all that stuff.
posted by tigerjade at 9:58 AM on February 8, 2008

My brother-in-law had many of the same concerns you do and he is not a risk taker. He had only 1 eye done. He is very happy with the results.

COnsider 1 eye at a time. Wait 6 months. If you like the results do the other. If not, wear a contact in 1 eye.
posted by JohnnyGunn at 11:08 AM on February 8, 2008

Ditto most of the above. Two additions:

My lasik was done in two stages. Not one eye at a time, no, but two surgeries in each eye, sort of macro surgery, then a touch up a few months later. For the first one, there was almost no pain, just a kind of freaky pulling sensation in a place where you aren't supposed to feel that. A little scratchy the second day, then beautiful after that.

Second time around wasn't as painless. They don't re-cut the flap; instead, they more-or-less tear it along the healing seam. With the numbing drops, I didn't feel anything bad, but the next day it felt like there was sand in my eyes. That lasted two or three days, IIRC. I still would have done it if they'd warned me, but I really wish I'd known to expect that. It was scary.

Don't worry too much about the flinching. Yes, you do have to keep your eye still, but my doc explained to me that no one can keep his eye completely still, and the machine compensates for that. If your eye wanders too far away, the machine detects that, and the laser doesn't fire. You do need to keep still for the operation to work, but you won't do any damage if you get all wild-eyed--you'll have wasted your time, sure, but you'll be able to put your glasses back on and walk away.
posted by MrMoonPie at 11:38 AM on February 8, 2008

I had it done a couple of years ago and remain thrilled with the results (no noticeable degradation).

I agree with everyone who has commented how once the eyes have healed, it's just like before re irritation, make up, cat hair whatever. I was out and about the following day.
Few extra things:

The no make-up rule is temporary, I think just a week. If it matters to you, you could always get your eyelashes dyed beforehand (which lasts a few weeks).

I used the eye drops for a week. My bf who's a doctor explained that it's really important to take them carefully, as the thing you really want to avoid is any chance of the eyes getting infected. His view was that the reason why the eye surgeon I went to has such a good success rate was because he's very 'strict' about people keeping to the drops regime.

The only pain I felt was about an hour after the operation. My surgeon had given me a vial of anasthaetic drops to take if that happened. I did, and the pain subsided instantly and did not return.

As for the operation itself, the thing I was most scared about was moving and the laser hitting the wrong place. Based on my experience, there's no need to worry about that, though, as your head is gently but very firmly held in place by the cupping cushion of the bed, your eyelids are held open (that sounds horrible, but it isn't. It doesn't have that horrible feeling like when you want to blink and can't or are trying not to. It feels like the eyelid muscles are allowed their blinking action, but they just don't move), and your eyeball is held in place (the anaesthetic prevents you feeling that).

Yes, the sight of the laser is a bit scary, but with your vision (pretty similar to mine as was) and the drops in your eyes, everything is pretty blurry. The thing I found most freaky was the sound, but the whole thing is over so soon that it's over before you know it. I really liked how my surgeon explained everything as it was happening 'And this is going to last 45 seconds' or whatever, so you could always ask for the same.

I asked to hold someone's hand. The nurse held my hand during the process, which made me feel better, although she theatrically shook it afterwards as if to get the blood flowing again, and stalked off. You could always take something in with you to squish, or a stuffed toy to hold or something. I didn't have the muscle relaxant/laughing gas option or whatever, but if it helps, then why not?

It's good to have someone come with you and take you home and everything, even if it's not really necessary. Made me feel much better!

Overall, completely worth it.
posted by Marzipan at 2:10 PM on February 8, 2008

The cutting open of the flap was easily one of the squickiest moments of my life, but it was over quickly and the result was entirely worth it. Also it makes a great story when everyone is getting together to trade "and my femur was sticking out of my leg!" tales.

Post-LASIK my eyes are just.. my eyes. No special care required -- although I probably take better care of them now in that I actually wear safety glasses in the shop rather than relying on my glasses half the time.
posted by tkolar at 2:33 PM on February 8, 2008

I had LASIK 4 years ago. I love my results. Here's what I can remember.
The surgery itself was extremely fast. The strangest sensation for me was the suction holding my eyeball in place. You don't feel anything in terms of pain because of the numbing drops; you may feel pressure. The laser part just looks like a flashing light. It was over in like 5 minutes. I had both my eyes done at the same time. If you are nervous or anxious about the procedure, ask about a mild sedative pill before surgery.
I remember being uncomfortable in sunlight on my way back home after the procedure. It just hurt my eyes and they started to tear up.
I didn't take the steroid drops and I didn't experience much, if any, post-op swelling. I did take the antibiotic drops.
4 years later, my vision is the same (20/20) and I have had no problems with night driving or weird shapes or anything.
My mom had the surgery when she was 50 to correct her distance vision. She still needs reading glasses, though. That's just a fact of getting older as far as I understand.
I wear eye makeup and everything still stings the same if it gets in my eyes. No changes. Not wearing makeup for a while pre- and post- was annoying, but it was so temporary it didn't really matter to me.
I did not have any recovery problems with my flaps or otherwise. I am very happy with my results and I would repeat it in a heartbeat. My husband also had the surgery a year after me and is totally satisfied as well.
I would make sure your doctor does a ton of these every year and that he/she doesn't just steer you to one laster; there are multiple lasers that can do laser eye surgery. If you want, get a second opinion. I felt very confident about my surgery because it was with a large practice affiliated with a local medical school.
Good luck!
posted by FergieBelle at 6:38 AM on February 9, 2008

LASIK lover here. Female, got it at age 29, am 35, and for five years I've barely even thought about my first 29 years of squinting. It's wonderful.

I don't have any side effects. I wear makeup. It's as if I was born with good vision.

It took a while for my eyes to "heal" ... I'm a big eye-rubber and it seemed like for a few months it would hurt to rub them. But that was temporary. The only recovery issue I really remember was lying on the couch all day the next day with these funny glasses on to protect my eyes. And eye drops for a while. But the recovery process was otherwise so unremarkable that I don't even remember it.
posted by iguanapolitico at 2:51 PM on February 11, 2008