Poor vision and going into surgery

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blaqmamba

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What do you use during surgery? I'm tempted to use my contacts, but sometimes get the urge to rub my eyes which obviously wouldn't work while scrubbed. So, the default seems to be glasses, but mine fog up almost every time (what does everyone else do??)

How is your choice (glasses or contacts) affected by using loupes?

And what are everyone's thoughts on getting corrective vision surgery such as LASIK or PRK? It wouldn't be a big deal, but a profession necessitating such high visual acuity makes the risks of surgery a little more apparent.
 
What do you use during surgery? I'm tempted to use my contacts, but sometimes get the urge to rub my eyes which obviously wouldn't work while scrubbed. So, the default seems to be glasses, but mine fog up almost every time (what does everyone else do??)

How is your choice (glasses or contacts) affected by using loupes?

And what are everyone's thoughts on getting corrective vision surgery such as LASIK or PRK? It wouldn't be a big deal, but a profession necessitating such high visual acuity makes the risks of surgery a little more apparent.

My vision is total crap and I always was in contacts during surgery (with eye shield for splash, of course). The solution here is to stop touching your eyes, period, whether you're in the OR or not. Like sticking your fingers in your nose and mouth, it's just another way to get infections.
 
I just had lasik after 32 years of wearing contacts. The problem with Lasix if you are nearsighted is that you get the long distance vision corrected but you lose clarity from 8 inches in and have to wear readers for fine print. I don't find any issues with trying to suture, etc because I'm at arms length.
 
Uncorrected vision here but wanted to agree with the above in terms of the best way to avoid fogging the mask.

I too prefer the green masks with the adhesive. Make sure it's loose under your chin and tight across the nose and under the eyes use extra tape if you have to.
 
I got LASIK the summer after M1. I always thought those brochures where people talk about how it changed their lives were overdramatic, but honestly, I noticed the difference right away and 3 years out, I am still so, so happy I went for it. I had pretty crappy vision and currently need no correction, and have no problems with night driving or close-up sight.

When I told some of my classmates why I wasn't wearing glasses anymore, about half thought it was great and half thought I was crazy to take the risk. Heading into surgery this summer, though, I'm just grateful it will be one less thing to worry about. Feel free to PM if you have any questions about what the process was like - I realize it's a scary proposition for a lot of people and even I freaked out a bit the night before the procedure ("I'm letting them do what to my eyes tomorrow?!")
 
The only real issue is if your vision is not correctable. Something crazy like 2/3 the population needs vision correction. I'm better than 20/20 with either my contacts or glasses.

I wear my contacts 99% of the time. Only time I ever wear glasses is at night sometimes if I have to come in from home quickly.

If you have issues with dry eyes that are causing the urge to rub, you should consider switching to daily wears. That's a lay opinion not a medical one.

Agree with the above that you need to stop touching your eyes in general. However, the ritual and routine of sterile technique is such that even if you normally adjust your contacts, you probably won't when you're in the OR doing stuff. I mean we all touch our face like many times an hour, this has been well studied - somehow we manage to suppress that natural habit in the OR.

For glasses, the key to preventing fogging is ensuring a good mask seal and good ventilation out the bottom of the mask. I like the green masks with a built in adhesive on the nose bridge. If those aren't available I will just use tape. Tie the bottom of your mask loosely and make a little space so that when you breathe it preferentially vents out the bottom.

For loupes, you can get them with your prescription if you want. I went with the non-prescription since as I said my preference is for contacts.

For lasik - I asked two ophthos. One said it was NBD and I should go for it if interested. The other said the old tried and true line that you always hear - that most ophthos you see are still wearing glasses. I have good vision with correction and no real issues so I've been hesitant to take the plunge. But people with much higher vision stakes than us (Tiger Woods, Greg Maddux, etc) have gotten lasik...

Hahah those damn green masks! Make the bridge of my nose itch. But I honestly feel that I'm hypersensitive to the touching of the face, I even notice myself have to suppress the urge1-3 times during surgery.

I'm going to try contacts in the next short case and see how it goes. I usually use frames when on the computer/tv or anything stationary (ie, home, lab), but contacts anytime I'm up and about.

I know it's a preference thing, but I've been using the Acuvue Oasys +astigmatism, & they've been working pretty well. Anyone else have a great experience with their contact lenses?

Thanks for the info about LASIK, I'll send you a PM Traumallama...
 
For a couple of years I have struggled with the dilemma surgery or no surgery to correct my vision. A couple of my classmates have done it but all of them are going into a clinical specialty.

Recently I found this article http://www.sciencedirect.com/science/article/pii/S0886335013016295 , there were a couple of surgeons who underwent the procedure.
However, I still have some doubts.

Would be great if you could share your experience here @TraumaLlamaMD
 
For lasik - I asked two ophthos. One said it was NBD and I should go for it if interested. The other said the old tried and true line that you always hear - that most ophthos you see are still wearing glasses. I have good vision with correction and no real issues so I've been hesitant to take the plunge. But people with much higher vision stakes than us (Tiger Woods, Greg Maddux, etc) have gotten lasik...

I forgot to add that the reason I got lasik now is that I was at the point where my vision could not be corrected anymore. I wore "office vision" contacts where I could see close up at work but anything beyond 15 feet was still blurry. I had to wear glasses over my contacts to drive. Then I had a separate pair of glasses when I didn't have contacts in. Just got to be too annoying. Now I don't wear anythings but readers occasionally.
 
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I forgot to add that the reason I got lasik now is that I was at the point where my vision could not be corrected anymore. I work "office vision" contacts where I could see close up at work but anything beyond 15 feet was still blurry. I had to wear glasses over my contacts to drive. Then I had a separate pair of glasses when I didn't have contacts in. Just got to be too annoying. Now I don't wear anythings but readers occasionally.

Huh. I was told by ophtho that I didn't qualify for Lasik because my prescription is too high; my vision is still correctable though. If I knew that it was an option for me, I'd probably consider it.
 
Huh. I was told by ophtho that I didn't qualify for Lasik because my prescription is too high; my vision is still correctable though. If I knew that it was an option for me, I'd probably consider it.
They used to tell me that too. Then I went to a specialist in Vegas who said he could fix it. I got it done. Love it. Cost me $4000
 
I certainly appreciate the wisdom in here. Sounds like that chin ventilation is key. The fog was a huge problem for me in the past, so I'll have to try it out when I'm on surgery. I thought I might have to carry around anti-fog spray!
 
Have contacts, but always wear glasses in the OR.

IMO, both a nasal space and chin space are essential for comfortable breathing and non-fogging. I wear the blue masks with no adhesive but the thin metal strip and make a narrow pinched up portion just under the bridge of my glasses. It's too narrow to allow the lenses fog, but keeps the mask from getting too warm. Loose infra-chin fit is also important for good aeration. Never had a fogging problem...

I'll get lasik after I become an attending and have attending level own-occupation disability insurance should something go wrong...
 
Would be great if you could share your experience here @TraumaLlamaMD

I was in a place where I needed correction all the time during the day, but contacts could never get my vision quite as good as my lenses. Being nearsighted, though, I'd take my glasses off to read and they had a bad habit of getting sat on or left behind (though less so as my vision got bad enough I would notice right away if I tried to walk out of the room without them!). I preferred my lenses, but even with the astigmatism correction brand, they weren't perfectly crisp, and I had more than one dumb moment where I'd want to stay out overnight but hadn't prepared with solution and a case in my purse. In retrospect, trying to be on call overnight in contacts would have been a nightmare, and glasses have their own issues in surgery (mine liked to slip down my nose a bit and it's hard to adjust them once you're sterile).

Once I decided to go for the LASIK, the process was really easy - I think it was a single screening exam (I'd been worked up for it a few years earlier but they had advised I postpone since my vision was still changing at the time) before I scheduled the procedure. They did ask me not to wear my lenses for about a week before the surgery to prevent any scratching. I got there the morning of the procedure and took the benzos they'd prescribed, waited a bit for them to kick in, and then went into the room. It was overall a pretty relaxing experience (as much so as it could be!) - they put my playlist of choice on the stereo, laid me back on the table, and asked me to look straight up at the green light above. I was awake for the experience and remember it to some extent, but never felt anything more than a small bit of pressure on my eyes.

After it was over (I wasn't with it enough to know how long it took, but it was probably 30-45 minutes) they let me sit with a blanket in this lovely leather chair. I looked over at the nearby table and noticed a bowl of candy. My first thought was, "awesome, they left me M&Ms" - my second thought was, "holy crap, I can read those candy labels." I'd read the brochures where past patients claimed they had some "aha!" moment where they suddenly realized they could see, and I was skeptical the difference would be so striking, until it happened. I went home, took a nap, and was able to go out to dinner with my family later that evening with pretty good vision. By the next day at my followup appointment I was seeing 20/20. I had drops to put in my eyes a few times a day for about a week, and that was it. I had follow up the day after, a week after, a month after and 6 months after, and my vision remained consistent.

I had a pretty great experience, but there are a few caveats: my vision pre-surgery was at the point where I couldn't function at all without lenses or glasses. If you can get by without them sometimes, or if your vision is still changing frequently, it may not be worth the money to you right now. I definitely find my current situation more comfortable than either lenses or glasses, but some people don't mind wearing them as much as I did. Finally, while my vision is great now and I don't have the "light halo" effect that some people experience at night, I do find that over the last year or two if I'm driving for multiple hours at a time, one eye or the other will get a little "tired" and my vision won't be quite as crisp until I rest for a bit. I have no idea if that's related to the LASIK or just a function of getting older (!), and it hasn't happened to me with extended near vision like during long surgeries or when reading.

Honestly, it's the small things that I appreciate most - being able to stay up watching TV without worrying about falling asleep in my glasses or with my lenses in, being able to see and read labels in the shower/pool/beach, playing sports without lenses shifting after I rub my eyes, not having to worry about an unexpected lens tear in the middle of the day leaving me half-blind until I can get home and change it out. It was definitely worth it to me, but YMMV for sure.
 
I have a sneaking suspicion your disability policy would not cover you in the event of a problem related to lasik.
Yep.

Pretty sure my policy includes "elective and/or cosmetic procedures" (in addition to skydiving, scuba and other high risk activities) as exclusionary criteria.
 
I have a sneaking suspicion your disability policy would not cover you in the event of a problem related to lasik.

So, uh, my plan to get lasik and then take up sky diving, rock climbing, and shark swimming and thus retire an early millionaire isn't actually feasible? Darn. Thought I had it figured out ;-)
 
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