LASIK and being a first year med student...

[Saffron304]

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Hi...don't know if anyone can offer advice, but it would be greatly appreciated. More than you know.
I have been looking into getting LASIK for years now and finally decided to go ahead with it. I have an appointment for Tuesday morning (June 1st).
They are performing Custom @ $1300 per eye.
Now at the last minute, I am getting nervous. I have allergies and get dry eyes...I can use drops maybe even everyday, mainly in morning. I asked my Doc and he said that it probably was not the syndrome, but would worsen momentarily after op., but then will go back to my normal state of somewhat dry.
Also, this is my first year of school, I will be REALLY needing my eyes, most people I have talked to say it should be no problem. So, just a thought.
I really want to do this, but am getting nervous.
Thank you very much.

 

[freddydpt]

Hi...don't know if anyone can offer advice, but it would be greatly appreciated. More than you know.
I have been looking into getting LASIK for years now and finally decided to go ahead with it. I have an appointment for Tuesday morning (June 1st).
They are performing Custom @ $1300 per eye.
Now at the last minute, I am getting nervous. I have allergies and get dry eyes...I can use drops maybe even everyday, mainly in morning. I asked my Doc and he said that it probably was not the syndrome, but would worsen momentarily after op., but then will go back to my normal state of somewhat dry.
Also, this is my first year of school, I will be REALLY needing my eyes, most people I have talked to say it should be no problem. So, just a thought.
I really want to do this, but am getting nervous.
Thank you very much.

Good luck... let me know how it goes cause I'm debating the same thing.

 

[St. James]

just my $.02 -- i'd wait till after med school (or preclinical yrs) at least. there's so much reading and eyestrain involved that a lot of people say thier eyesight has gotten worse.

there was a thread within the last month about lasik (in the lounge, i believe). search for it, you might find some info/someone to PM for their lasik experience

 

[Andrew_Doan]

The thread in the lounge is here: http://forums.studentdoctor.net/showthread.php?t=102143

Dry eye can be a problem after LASIK; thus, if patients have problems with dry eyes before the surgery, then this may be a worse problem after the surgery.

 

[Saffron304]

Thank you...it seems very 'half and half' on the subject.
Some people have had major success, while some have been less than satisfied.
I have such a long road ahead of me, concerning school and my career...I want to make sure that I can perform at my optimum. I'm really trying to weigh out the pros and cons here. I can't believe I'm having second thoughts after wanting this for so long and my appointment for surgery being on Tuesday. Ahhh!

 

[Yogi Bear]

at my school, one of the optho docs mentioned that there was like only 1 ophthalmologist w/in the department that had lasik done. getting lasik is like getting a permanent set of glasses. If ur vision slowly gets worse every year like mine do (often like .25 diopters), then u'll keep needing supplmental surgeries.

 

[Saffron304]

My eyes have been pretty stable in the past 3 years with only very minor change, oddly enough in the direction of improvement...
I have another day to ponder on this I guess. We'll see! I will post on what I decide.

 

[vwhan]

Saffron,

You're nervousness is typical. I had Lasik done about 5 years ago. I worked for the ophthalmologist (as a tech) that performed the procedure. So I got a first hand look at his results. He is one of the leading refractive surgeons in Philadelphia area. My vision is still the same is 1 day PO (20/15 OD, 20/25 OS). He had performed over 1000 by the time I had it done, so I was really confident in his ability. The night of the procedure I became pretty nervous when I signed the consent form that listed all the complications, even knowing that I was in good hands. The recovery time for Lasik is so quick that I would not worry about eye strain. I went to work the next day after the operation.

I had a condition called, "Sands of the Sahara" which is unknown in cause (possibly not completely sterilized microkeratome). I continued using steroid drops (Pred Forte) for a few months, instead of the typical 1 month. I did have dry eyes for about 6 months and used artificial tears about 4 times/day for those 6 months. I did not have dry eyes before the procedure. Most people I run into only need art. tears for about 1 week. My dry eyes went away suddenly and ever since then I have used tears a handful of times.

I have absolutely no regrets, and am very happy with the procedure. A friend of mine just had it done and we just finished our 1st year of med school. He is ecstatic.

I hope this helps.
Hany

 

[Saffron304]

Thanks Hany...so as a former MSI, you had no problems studying?
Sands of Saraha? Ouch! I worry about the dry eye thing too. My doc is over 3000 now. So if I get it done on Tuesday, I only have 2 months and 1 week before school starts for adjustment. 😎 <--Me with possible protective blinders on.

 

[Richard_Hom]

Hi...don't know if anyone can offer advice, but it would be greatly appreciated. More than you know.
I have been looking into getting LASIK for years now and finally decided to go ahead with it. I have an appointment for Tuesday morning (June 1st).
They are performing Custom @ $1300 per eye.
Now at the last minute, I am getting nervous. I have allergies and get dry eyes...I can use drops maybe even everyday, mainly in morning. I asked my Doc and he said that it probably was not the syndrome, but would worsen momentarily after op., but then will go back to my normal state of somewhat dry.
Also, this is my first year of school, I will be REALLY needing my eyes, most people I have talked to say it should be no problem. So, just a thought.
I really want to do this, but am getting nervous.
Thank you very much.

Dear Saffron304,

One solution to "dry eyes" is pretreatment with Restasis 1gtt BID, OU for 1-2 months prior to surgery. This seems to "prep" the eye better for post-op complaints of dry eye. However, up to 80% of patients will complain of the same or higher level of dry eye up to 3 months after the procedure and nearly a third up to a year after the surgery.

In addition, post-operatively, I'd avoid any chance of an airbag explosion because of reports of decpatitated flaps.

Richard_Hom

 

[vwhan]

Thanks Hany...so as a former MSI, you had no problems studying?

I had it done July 1999, then started graduate school in August. No problems in grad school nor med school, except dry eyes which went away on its own 6 months status post lasik. I went to grad school before starting med school.

 

[xmattODx]

Thanks Hany...so as a former MSI, you had no problems studying?

Consider reading specs (power could be determined by an OD) after your surgery while studying to ease strain and possible increase in myopia.

 

[Andrew_Doan]

Consider reading specs (power could be determined by an OD) after your surgery while studying to ease strain and possible increase in myopia.

Unless he has accomodative insufficiency, reading glasses after LASIK should not be necessary in a young patient.

 

[xmattODx]

Unless he has accomodative insufficiency, reading glasses after LASIK should not be necessary in a young patient.

This is an area that Optometry and Ophthalmology will, I guess, disagree. Behaviourly speaking everyone deserves near point lenses, in addition there was a worry of increasing myopia following Lasik surgery. I buy into a model of vision that is not as medical as yours and would indicate that the cause of myopia in many patients is near point stress which would not be solved by Lasik and the patient would, therefore, have a risk of regression especially as a medical student.

 

[Andrew_Doan]

This is an area that Optometry and Ophthalmology will, I guess, disagree. Behaviourly speaking everyone deserves near point lenses, in addition there was a worry of increasing myopia following Lasik surgery. I buy into a model of vision that is not as medical as yours and would indicate that the cause of myopia in many patients is near point stress which would not be solved by Lasik and the patient would, therefore, have a risk of regression especially as a medical student.

Not everyone needs near point lenses. Furthermore, if the patient is a mild myope, then near point vision is fine without correction. Please show me the data and papers that demonstrate that near point stress induces myopia. I don't think there is strong data to support this.

 

[xmattODx]

Dr. Doan,
Thanks for your interest. Unfortunately I'm not at an academic institution and not able to do a literature search for you. I barely have an internet connection.

Check out:

"Optometric Management of Nearpoint Vision Disorders" by Martin H. Birnbaum (Butterworth - Heinemann 1993) for more information. There are a lot of references in his text.

Note I did not say, or if I did - did not mean to say, that myopia develops solely secondary to near point stress - rather I meant to say that it is often a cause. If one is about to embark on a very long and difficult education near point lenses can often reduce the stress of spending long hours in books.

I won't say anymore in this thread as it is no longer addressing the original question. Back to Lasik and a new medical students. OP are you having the surgery? If so good luck, I'm sure you'll be very happy with your new uncorrected visual acuity.

 

[Richard_Hom]

Not everyone needs near point lenses. Furthermore, if the patient is a mild myope, then near point vision is fine without correction. Please show me the data and papers that demonstrate that near point stress induces myopia. I don't think there is strong data to support this.

Dr. Doan,

Unfortunately, most of the "theory" behind this has not been borne out by any large studies. Most practitioners in this area see clinical success. With that in mind, most are not ambitous to start a blind or double blind clinical or meta data analysis.

What is difficult is the improbability of predicting good vs. poor candidates for this kind of treatment.

Richard_Hom

 

[Saffron304]

The surgery is tomorrow morning and I suppose I will be deciding tonight. If I cancel, I want to call early so that they are not put out.
Concerning the suggestion of glasses, would it be appropriate to say if my eyes do end up reacting to studying I should purchase a low prescription drug store brand of reading glasses, in order to 'counterbalance' my visual stress? Also, would this ever cause dependency on reading glasses? I am 27 by the way. Thank you.

 

[Richard_Hom]

The surgery is tomorrow morning and I suppose I will be deciding tonight. If I cancel, I want to call early so that they are not put out.
Concerning the suggestion of glasses, would it be appropriate to say if my eyes do end up reacting to studying I should purchase a low prescription drug store brand of reading glasses, in order to 'counterbalance' my visual stress? Also, would this ever cause dependency on reading glasses? I am 27 by the way. Thank you.

Dear Saffron304,

I'm unclear without sufficient other data to say that a low plus reader might nor might not help. A bit more data might be helpful such as near point retinoscopy, relative convergence and positive and negative relative accommodation.

Richard_Hom

 

[Saffron304]

Thank you, I will look into the topic.
And... thank you all...I do appreciate everyone's advice and suggestions.
I know that no one can tell me what to do in this situation, I will ultimately decide based on all the data I have been exposed to.

 

[Saffron304]

I just got off the phone with my surgeon. I had so many tests being done (for almost 3 hours) during my consultation I didn't realize they had done a dry eye test on me...it was fine. I plan to go ahead and will be having surgery today at 11:00. I have 2 1/2 months to rest my eyes, so hopefully they will adjust and I will have no probs with studying. The Doc also said that since my Rx was on the moderate side and hasn't changed for years, there should be no drastic changes in the future (probable). I will post my experiences if anyone is interested!
Thank you again for all your advice.

 

[St. James]

Glad you got your concerns addressed before surgery. Hope you're doing well-- def keep us posted!

 

[Saffron304]

Hello everyone...it is day three and I am doing quite well. The first couple days I had some stinging, headaches, very slight pain/soreness and intermittant blurriness. Today my vision is pretty stable, I have a slight headache and am still photosensitive. I am on Vigamox and Econopred qid.
All in all I'm doing well and at my post-op visit I checked out for 20/20. The world does look more beautiful...very crisp but still with occasional bout of blurriness! Supposedly, with custom, my night vision should be improved within a couple of weeks. Only time will tell. Any questions about the procedure...I would be happy to comply.
😎 <---Me with my 'blinders' on.

 

[freddydpt]

painful?
were you nervous?
what would happen if you blinked?

 

[Mirror Form]

I'm a medical student who just started my first rotation in ophthalmology. Today I was talking to one the senior ophtho residents (who's about to doa retina fellowship) and he said he had lasix 6 months ago. So it sounds like it's pretty safe is a senior ophtho resident will get it done.

 

[Saffron304]

painful?
were you nervous?
what would happen if you blinked?

-No...it wasn't painful, but a little uncomfortable. The worst part for me was the eyelid speculum. 😱

-I was very nervous at first...then when I got into surgery I became focused on doing what the docs told me to do.

-You can't blink (see above)...even if your eye moved slightly during the laser treatment (which I was really concentrating on not doing!) the laser can follow your eye supposedly. I did however, smell my eye burning after laser treatment.

 

[St. James]

You can't blink (see above)...even if your eye moved slightly during the laser treatment (which I was really concentrating on not doing!) the laser can follow your eye supposedly. I did however, smell my eye burning after laser treatment.

far braver than me.

 

[femdoc]

How long did the surgery take? How are you at this point, OP?

 

[Tony.]

Hello everyone...it is day three and I am doing quite well. The first couple days I had some stinging, headaches, very slight pain/soreness and intermittant blurriness. Today my vision is pretty stable, I have a slight headache and am still photosensitive. I am on Vigamox and Econopred qid.
All in all I'm doing well and at my post-op visit I checked out for 20/20. The world does look more beautiful...very crisp but still with occasional bout of blurriness! Supposedly, with custom, my night vision should be improved within a couple of weeks. Only time will tell. Any questions about the procedure...I would be happy to comply.
😎 <---Me with my 'blinders' on.

just a quick question:
if your prescription DOES change in say, 3 years; will you have to pay again to get another surgery? or does the payment you've made guarantee a lifetime of LASIK maintenance....?

 

[Saffron304]

Hi! I'm doing pretty good. But, recovery time for me at least, has been longer than I expected. I have had headaches and my eyes are very dry almost 24/7. This has been very draining.
Upon, examination, the doctors say the surgery looks wonderful, but is still healing. My right eye is still not yet 20/20. My left eye is perfect...better than, if that.
Oh, to answer the question about surgery time, it was about 15 minutes tops.
And no, if a touch-up is needed in the future, another surgery is not covered. It is $245 per eye, if so.

 

[vwhan]

will you have to pay again to get another surgery? or does the payment you've made guarantee a lifetime of LASIK maintenance....?

This is called an enhancement. It depends on who performs the initial Lasik procedure. The guy I went to had a lifetime garuantee. Therefore, if I needed to have an enhancement at anytime, it was covered under the initial payment. Just as long as my stroma was thick enough.


Saffron,

Hang tough. I had dry eyes for 6 months then went away. The most important thing is you don't need glasses or contacts. Glad to hear the procedure went smoothly.

Hany

 

[Saffron304]

Saffron,

Hang tough. I had dry eyes for 6 months then went away. The most important thing is you don't need glasses or contacts. Glad to hear the procedure went smoothly.

Hany

Was it BAD dry eye or just not as moist at pre-op? Mine seem better today...
What about your vision, did it change (improve, decline) in the few weeks-months after surgery?
My surgeon says my R eye may catch up, but may not.
Thank you!

 

[vwhan]

Was it BAD dry eye or just not as moist at pre-op?

My eyes became a lot drier post surgery. I remember using artificial tears once a day with contacts in, but used 4-6 times/day following the surgery.

What about your vision, did it change (improve, decline) in the few weeks-months after surgery?

My vision has stayed stable since day 1 post-op, 20/15 in right eye and 20/25 left eye.