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Are Your Suitable for Laser Refractive Surgery?

You’ve worn glasses and contact lenses for most of your life. Perhaps you’ve just started to wear glasses to improve your distances and finds spectacles or contact lenses very cumbersome to deal with. You’ve heard from your friends and family who’ve had laser surgery saying it’s the most wonderful thing they’ve ever done and they wished they’ve done it sooner. This has got you thinking; should you perhaps consider laser refractive surgery as a permanent solution to all these issues you hate dealing with that comes from having glasses and contact lenses?

Understanding Why You Need Glasses or Contact Lenses
Simply put, you need glasses or contact lenses to see better. Your prescription determines the power or the strength of lenses of these glasses or the contact lenses. The level of your unaided vision, or, how blurry your vision determines what optical prescription you would need. The optical prescription determines the refractive state of your eye. That is to say, for example, whether you are short-sighted (blurry distance vision) or long-sighted (blurry vision up close). You may have a combination of both long-sightedness and short-sightedness. Whatever lenses you require to fix your vision issues, this is the refraction state of your eye, and we are correcting it with either glasses or contact lenses.

The refractive laser used is to correct the refractive state of your eye, which is guided by your prescription. If your prescription is complex, such as high astigmatism, high myopia or significant hypermetropia, the refractive laser surgery is often more complicated.

So how does laser help to correct your vision?

Understanding the Structure of Your Eye
The structure (or the anatomy) of your eye determines your refractive state.

Your eyes might be larger and longer than average. Which means that the image that usually is in sharp focus on your retina, now is in focus in front of the retina, creating this blurry vision when you look into the distance.

The reverse is similar that if your eyes are smaller than average, the image now focuses behind the retina, making vision blurry when you look at things up close within arms reach such as reading and computer vision.

The structure of your eye that is responsible for the majority of focusing is the cornea. This is the clear window in front of your eye. Your natural crystalline lens, which is located inside your eye is responsible for fine-tuning the refraction to ensure it is sharply focussed on your retina. So any eye disease that affects the cornea (such as dry eyes) have a significant impact on your vision. Eye diseases that affect the lens, such as cataracts also have some level of impact on your vision (depending on the type of cataracts).

So this means that if your eyes have significant cataracts, dry eyes or pre-existing corneal conditions, the therapeutic effects from having laser refractive surgeries can be limiting.

Understanding Laser Refractive Surgery
Your laser refractive surgeon can elaborate on how the procedure is performed. In a nutshell, during the laser refractive surgery, the laser is used to alter the shape of the cornea, hence adjusting its refractive power to reflect your optical prescription.

During your first laser refractive surgery suitability consultation with your surgeon, along with assessing your eye health, there’s a few “lifestyle” questions which play a significant role in determining your suitability.

Is Your Prescription Constantly Changing?
Think of the refractive laser surgery is a permanent solution to your need for glasses and contact lenses. If you needed to change your glasses and contact lenses every year because your prescription has changed, then you might need to think again whether refractive laser surgery is the best option for you. If the changes are minimal or fluctuating, you may be suitable as these changes are often not noticed; we get these fluctuations in measuring your vision depending on how we fit your glasses or contact lenses anyway. However, if your prescription changes significantly every year, for example, like plus or minus 1.00D, then you might want to wait till your prescription stabilises and plateaus. You might think you might’ve said the wrong answer during the “one or two” assessment. This is why during our laser refractive suitability consultation, we use the corneal topographer to measure the refractive power of your cornea and measure any changes between visits. As a general rule of thumb, we don’t want any significant prescription changes within a year. If you have previous optical prescriptions, we can have a look to see if there are any significant changes in your refraction year on year.

Why Now?
If you’ve worn glasses for most of your life, you are probably used to putting on your glasses as soon as you get out of the bed in the morning. You’ve probably have been doing so for decades. It is highly unusual to wake up one morning, and one decides they want laser refractive surgery. If you don’t like the idea of constantly wearing glasses or contact lenses, there are other non-invasive and reversible optical correction options such as orthokeratology.

Orthokeratology uses hard contact lenses to mould the corneal surface, just like laser. Think of it as braces for the eyes. The patient wears these rigid contact lenses braces overnight, and as soon as they take them out in the morning, their vision is corrected.

Orthokeratology would require the patient to wear contact lenses every night, and during the night that they don’t wear these lenses, their vision return to their “pre-treatment” state. Orthokeratology has also been shown to reduce the rate of progression of your prescription. Hence it is widely used as a technique to manage myopia progression.

Your Profession and Your Age
Suppose your profession or perspective career involves you need to have “20/20” vision without the use of glasses or contact lenses. In that case, refractive surgery is possibly the only option that it is available. An example of this is some public service jobs such as joining the police or the defence force or even becoming an astronaut.

Your age also determines the “usefulness” of the refractive laser surgery. As we approach the early 50s and head towards our 60s, the performance of our own natural crystalline lens is impacted, and the need for reading glasses becomes apparent. As discussed previously, the laser refractive surgery only alters the refractive state of the cornea; you’ll still eventually end up requiring reading glasses.

Generally, laser refractive surgery only improves distance vision. Hence refractive laser surgery is more suitable to younger individuals among mid to late 20s which their prescription has stabilised, and would most likely to benefit from the surgery for 20 – 30 years after the procedure.

The Bottom Line
Refractive laser surgery has its benefits and tends to be suitable for those who are young, low to moderate prescriptions for the distance and with healthy eyes. It is also a perfect alternative to meet stringent vision requirements of some professions. As with any surgery, there’s always an apparent risk for complications although these days with vastly improved technology and the procedure itself, they are very low; but still, need to be considered.

The laser refractive surgery doesn’t improve your vision per se. It gives you the same vision with glasses without the need to be wearing glasses. If you need advice on how to proceed with laser refractive surgery, and requiring a more in-depth personalise discussion around your needs, book a comprehensive eye exam appointment with us today.