Lasik, To have or not to have?

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ir0nsoul

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Hello, I was wondering if any of y'all had considered Lasik before medical school or during. any specific reasons to do so or not? Also, what is your degree of myopia? I am only at -1.75, so its not bad at all, but i still need glasses/contacts to be able to see clearly beyond arm length. I'm 22 and my vision has been stable for 3 years, so as far as i can tell from my research online i would be a decent candidate. I looked for other forum posts here and the only other one was from 5 years ago, has the tech for lasik improved much since then? I already see starbursts or halos at night, so i don't think that would be much of an issue if it happened.

One of my relatives works for an ophthalmologist, and he said there was no way that he would recommend Lasik for someone going into medicine with as low of a prescription as mine, because if i do have it done, then i will need reading glasses like everyone else when i'm 40ish. However, he says that if i do not have it done, then my vision will get better and i will go through a period where i do not need glasses, and then can go till i'm 50 before i need reading glasses. He said that it would be much better for doing surgery if i do not have to wear reading glasses. I have two questions about that.

1) how does the getting good vision work? because as i understood it, the reason people needed reading glasses was that the lens became stiffer as people age so it was harder for the eye muscles to reshape it to focus on closer objects. However I don't see how that would affect your far-sight abilities at all. Seems to me that if you are nearsighted, you will just be "no-sighted" your abilities to focus close up goes away (thus needing bifocals). Now, objectively i see if your perscription goes from negative to positive, then you will pass through zero, but i haven't been able to figure out how that works precisely. I suppose if your eye actually reshapes itself then that would make sense, but could someone enlighten me on this one?

2) looking at it from a logical perspective, if i have lasik now, i will have approximately 18 years of good vision before i need reading glasses. If i do not have lasik, then (assuming that my vision starts changing at 40) i will get at most 10 years but probably less of good vision. Not to mention i think i would prefer to have my good vision when i'm younger rather than in my mid 40's. At least i think so.

TLDR: i currently wear contacts every day, and i would rather not if i had the option. Most of the research i've turned up has said that 90+% of patients are satisfied with their surgeries (most figures from >5 years ago though), but one of the eye doc's i know said don't do it. Opinions?
 
Most clinics where you can get lasik/prk/etc offer free consultations. I would take that up pronto for answers to all these questions. There is a lot of misinformation floating around, especially since procedures can be vastly different based on cornea shape, degree of myopia, astigmatism, etc, so go straight to the source. They'll do some measurements on your corneas and probably name you a price as well.

That said, I had lasik done around Christmas of last year and it was a terrific decision - though I was at -4.75 so it was more of an issue for me.
 
I had LASIK in 2007 and have been through med school and my vision is still excellent. LASIK reshapes the cornea and has nothing to do with the lens, which is what causes most people to need reading glasses when they get in their 40s.
 
funny that I saw this because I JUST got back from my optometrist and was talking to him about LASIK. I'm basically 1/2 blind. L eye is -5.00 and R is -4.50 with the astigmatism on the L which makes some number 1.25 (I don't know what that stands for but...yes)
Anyways, what he said is that he def does not recommend Lasik yet for me considering I'm planning on going to med school because all the studying and straining is going to probably result in my 1st Lasik procedure being unsuccessful. Of course, this guy has been my opto for 7 years and knows my "eye hx" really well. I've had horrifically bad eyesight since the 4th grade and it keeps changing (Finally hit the 3rd year mark where its been stable)...
 
Anyways, what he said is that he def does not recommend Lasik yet for me considering I'm planning on going to med school because all the studying and straining is going to probably result in my 1st Lasik procedure being unsuccessful.

I have heard something similar too - that all the reading in med school might change your prescription. but i've always read a lot, so i don't see what would change much there. And if not before med school, then when? before residency? during when actual practicing? should i wait 10 years to have this procedure when i was only maybe going to get 18 years of benefit out of it? I will go see a lasik surgeon i guess. hopefully he will know what to do.
 
n=1, but I've experienced diminished night vision with the related PRK procedure here, perhaps attributable to my blue eyes. Light eyes dilate more, and the laser-contouring of your eye is less precise as it extends outward, or so I'm told. IMO avoid if you have blue eyes, again, n=1.
 
Seems to me that if you are nearsighted, you will just be "no-sighted" your abilities to focus close up goes away (thus needing bifocals). Now, objectively i see if your perscription goes from negative to positive, then you will pass through zero, but i haven't been able to figure out how that works precisely. I suppose if your eye actually reshapes itself then that would make sense, but could someone enlighten me on this one?

Everything you said up to this point above was true. You know a lot about eyes. Now if you have -1.75 diopters of myopia in both eyes with no astigmatism present then without correction you will see clearly at 1/1.75meters = 57.14 centimeters. Now eyes have a depth of field otherwise known as a range they can clearly around their Rx and you can accommodate for distances closer so I'd estimate your clear area of vision is probably around 65cm. out, to close to your nose ~ 5cm. which is basically what you stated about only seeing up to arms length.

So when your lens becomes less malleable at older age if you go uncorrected you would still see clearly at 57cm +/- 5cm or so if you Rx remains stable. So no you wouldn't have "no-vision". You just wouldn't see clearly much closer or further than that.

I have worked with many ophthalmologists and even the cornea fellows have not gotten LASIK themselves and just use contact lenses. Personally, I do not know of one optometrist or ophthalmologist that has gotten surgical refractive vision correction but I could be in the minority. I guess it is too much of a risk for them because their profession depends on their eyesight so heavily.

In any case LASIK/PRK is a great procedure for the right candidates. And the technology has improved a lot over the past few years so halos and nightglows are less common. At the same time complications are underreported so its really your decision. And yes medical school will probably make your eyesight more myopic. And yes LASIK/PRK isn't perfect and doesn't guarantee 20/20 vision. You may still have to wear contacts, but it is unlikely.
 
I think I am going to get this done at the end of third year/into fourth year unless I can make tim for it between step 1 and 3rd year somewhere.

I entered medical school at about -3.0 in both eyes, I am already at about -4.5 in both eyes. All of the reading seems like it is killing my eyesight, I can hardly use the prescription in my glasses from last summer. I had to get contacts in a new prescription this year.

I really, really want Lasiks before residency. I am terrified of doing it and my eyesight getting even worse. 🙁 I guess sometimes in males your prescription won't even out until 25ish? I am 24.... I am sure Shnurek can expound more on this.
 
I think I am going to get this done at the end of third year/into fourth year unless I can make tim for it between step 1 and 3rd year somewhere.

I entered medical school at about -3.0 in both eyes, I am already at about -4.5 in both eyes. All of the reading seems like it is killing my eyesight, I can hardly use the prescription in my glasses from last summer. I had to get contacts in a new prescription this year.

I really, really want Lasiks before residency. I am terrified of doing it and my eyesight getting even worse. 🙁 I guess sometimes in males your prescription won't even out until 25ish? I am 24.... I am sure Shnurek can expound more on this.

-3.0 --> -4.5 is your eye just adapting to the conditions you present it with. Near work is correlated with myopia progression. The eye actually elongates. A lot of scientific research is being done in this discipline. Especially as the stimulus for elongation seems to come from peripheral retina defocus. This is why orthokeratology is scientifically proven to halt myopia progression. Its one of the few forms of vision correction that can actually halt myopia or even reverse it. Glasses, CLs and LASIK won't do this. Ask your OD or OMD about ortho-k.
 
-3.0 --> -4.5 is your eye just adapting to the conditions you present it with. Near work is correlated with myopia progression. The eye actually elongates. A lot of scientific research is being done in this discipline. Especially as the stimulus for elongation seems to come from peripheral retina defocus. This is why orthokeratology is scientifically proven to halt myopia progression. Its one of the few forms of vision correction that can actually halt myopia or even reverse it. Glasses, CLs and LASIK won't do this. Ask your OD or OMD about ortho-k.

If I plan on getting Lasks later does it really matter if I do ortho-k or not?
 
Most clinics where you can get lasik/prk/etc offer free consultations. I would take that up pronto for answers to all these questions. There is a lot of misinformation floating around, especially since procedures can be vastly different based on cornea shape, degree of myopia, astigmatism, etc, so go straight to the source. They'll do some measurements on your corneas and probably name you a price as well.

That said, I had lasik done around Christmas of last year and it was a terrific decision - though I was at -4.75 so it was more of an issue for me.

This. Just have it done by a reputable surgeon. It'll cost you more, and there probably won't be a groupon.

Best decision of my life. It's been almost 2 years now, and I am still better than 20/20 in both eyes with no dryness problems, halos, or any other side effects that I can think of.
 
just make sure you get evaluated by an ophthalmologist with lots of experience, preferably > 10k surgeries. My ophtho had links from his site to the research he had done on his patients (with consent of course) and showed out of 600+ surgeries there were NONE with worse vision than before, 93% > 20/15, 95% were > or = to 20/20, something like 99% > 20/40. He had invented a device I was familiar with from working ER.. If your surgeon can support such solid numbers and has the best technology (wavefront laser, advanced cutter to make the flap, etc.. likely you are making a good decision. No one has ever experienced total loss of vision from Lasik before IIRC.

I had my glasses stolen and was deciding between $500+ for glasses and new contacts or $2k for LASIK.. no-brainer.. got LASIK and now am 20/15 in both eyes. No halos, did have some dry eyes for a few months easily controlled with natural tears OU bid. Currently no dryness.. I have perfect vision and don't wear any sort of lens. The negative is that your cornea never fully regains strength, so technically you are more vulnerable to getting shot in the eye with a bb gun. I almost got shot in the eye a lot as a kid but not so much anymore.. takin my chances..
 
Do you guys have any ideas about getting lasik done twice? I've got it done once before (way too early, in retrospect, but my vision was ~ -5.7) and my vision's gotten a fair bit worse in the recent years. Would there be any harm in getting it done again, let's say, a few years down the road?
 
Do you guys have any ideas about getting lasik done twice? I've got it done once before (way too early, in retrospect, but my vision was ~ -5.7) and my vision's gotten a fair bit worse in the recent years. Would there be any harm in getting it done again, let's say, a few years down the road?

there's a lot of complications in LASIK such as epithelial in growth, DLK, etc.

I had LASIK done last year and one of my eyes had DLK due to an infection. My other eye had regressed a little and I had that one redone (I can see a little regression again). I still need to correct my other eye and if I didn't have a good relationship with my opthamologist, I would be paying so many damn bills. I'm afraid of having more complications but I have to get it corrected or else my eye is useless.
 
It's a gamble. The long term outcomes for some are great, but you can seriously impair your life if you aren't one of those people. Also, if you get the surgery and it doesn't take/keep you may not be able to go back to contact lenses afterwards so you'd be stuck with glasses.
 
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