GoCorral

If I ever found a genie in a bottle one of my selfish personal wishes would be to have perfect eyesight. I hate wearing glasses. And the genie is the best way for me to fix that. Maybe I’d wish for world peace or to end world hunger before perfect eyes. But if I had a wish just for myself, it’s going to be perfect eyesight.

I can hear you saying, “But Isaac! What about contacts?”
I wore contacts in high school but because my body hates me, I developed an allergy to them. If I wear contacts for more than an hour or two I start getting itchy eyes.

So that leaves laser eye surgery or a genie as my options for perfect eyesight. There are two basic types of laser eye surgery available at the moment, LASIK and PRK/LASEK. To understand how the options work I’d like to first describe why people have bad vision in the first place.

Why Are My Eyes Bad?

My eyes, and everyone else’s eyes, work similar to a camera. Light comes to the front of my eye and passes through my pupil, the black part at the center. The light passes through my eye’s lens. The lens focuses the light onto the back of my eye where all my sensory nerves are. The perfect spot to focus on is called the macula where the most nerves are clustered together.

Unfortunately, my eyes are shaped incorrectly. Eye lens’s are designed to focus light onto the back of a perfectly circular eye. Because I have a big head, my eyes are more like long ovals. So the light reaches a focal point too early and becomes slightly unfocused when it actually hits my macula.

Glasses and contacts work to correct my long eyeballs with an additional lens. Light passes through two lenses, my glasses, and my eye lens. With the extra lens, light is correctly focused upon my macula making everything look crisp and clear.

My specific eye problem is called myopia or nearsightedness where I can’t see things that are far away clearly without my glasses. There’s also hyperopia or farsightedness where people can’t clearly see things up close. Hyperopia occurs when your eyeballs are too short instead of too long. Glasses and contacts correct that problem the same way, by altering the focal point so that it falls upon the macula for clear vision.

Now on to the corrective surgeries!

LASIK

LASIK stands for Laser Assisted In Situ Keratomileusis. In more common terms it’s a surgery performed by a doctor using a laser that’s controlled by very fine tools. The laser cuts a flap in the outer part of the eye called the cornea. The doctor then uses another laser to change little bits of eye underneath the flap. The flap is then put back and heals naturally. The changes under the flap correct the focal point in the same way that glasses or contacts do.

There are two main post-surgery problems with LASIK, dry eyes and halos. The laser does slightly damage the eyes. Sometimes that damage affects the ability of the eye to generate sufficient tears to keep your eyes nice and wet. Dry eyes feel scratchy and irritating. Halos are a visual effect that appears around lights in the dark. You can see something similar if you squint your eyes while looking at car headlights or lamps in the dark.

Dry eyes occurs frequently after LASIK. It’s only long-lasting about 1% of the time though. Halos occur about 20% of the time and don’t go away. An additional complication is flap dislocation where the cut flap comes up years later. That occurs about 0.01% of the time.

PRK/LASEK

PhotoRefractive Keratectomy and Laser Assisted Sub-Epithelial Keratectomy are two similar methods to correct vision. They work pretty much the same way. In PRK/LASEK the laser is used directly on the eye to reshape the cornea. The effect is the same as LASIK, leaving a corrected focal point. PRK and LASEK avoid any complications with the cut flap because there is no cut flap. The laser damage healing takes a bit longer than LASIK, but with no larger trauma to cause problems with recovery.

PRK/LASEK have the same dry eye and halo complications as LASIK. Persistent dry eyes occurs in about 3% of cases and persistent halos occur in about 12% of cases. No flap complications at all!

Between dry eye and halos, dry eye is definitely worse. Dry eyes are irritating and hurt. Halos around headlights are typically minor enough that people who had surgery can ignore them. So LASIK seems like the best option. Flap dislocation usually only occurs if someone doesn’t follow their post operation instructions.

But there is another option!

Ortho-K Contacts

OrthoKeratology is another method for correcting vision. In orthokeratology special contacts are used to reshape the eye. The contacts are worn at night. They apply pressure to lightly smoosh the cornea into a better lens shape for your eyes. The treatment is persistent as your eyes will return to their natural shape within three days if they are not routinely smooshed.

The best part is that Ortho-K contacts have no significant side effects. I wouldn’t have to risk part of my eye popping out, dry eyes, or halos. Or if something bad does happen I can just stop using the contacts and go back to my glasses. The main issue would be finding some contacts I’m not allergic to!