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    What is LASIK Eye Surgery?
    Why is LASIK done?
    Types of Refractive Errors
    Causes & Symptoms
    Diagnosis
    Severity
    Risks & Complications
    When to consult an eye doctor?
    Surgery Options & Cost
    Recovery Rate

    What is LASIK Eye Surgery?

    LASIK stands for laser in-situ keratomileusis which is a common procedure used for the treatment of refractive errors, i.e., myopia, hyperopia, and astigmatism. It is a type of refractive surgery that works by reshaping the cornea with the help of a laser beam. As the refractive ability of the cornea is restored, the patient becomes able to see clearly without the help of visual aid.

    The most common reason for irreversible blindness in India is undercorrected refractive errors. Not only this, but vision problems can also make regular life difficult. For instance, you won’t be able to swim properly or watch 3D movies without comfort. Even on an everyday basis, you will have issues while driving, watching TV, or reading books. Besides this, wearing eyeglasses and contact lenses also has numerous problems. You will have to be careful not to break them and also need to replace them as your eye power will continue increasing with age due to the corneal or eyeball defect.

    Due to all these reasons, most people are eager to undergo minimally invasive LASIK eye surgery and correct the refractive errors in their eyes.

    Why is LASIK done?

    Refractive error is a problem in which the eyes lose their ability to focus the light on the retina with precision due to irregularities in the shape of the eye or cornea. Each type of refractive error forms due to any of the following reasons:

    • The eyeball length either grows too long or too short
    • The shape of the cornea becomes irregular
    • The eye lens start to age and loses its ability to focus light.
      Due to any of the above reasons, people of all age-groups experience vision loss. With age, refractive errors only progress and become more problematic. LASIK surgery is performed for the correction of these refractive errors:
    • Myopia, also known as nearsightedness, is a condition in which the eyeball becomes long or the cornea becomes curved. Due to this, the image is formed in front of the retina, making it difficult for the person to see faraway objects.
    • Hyperopia, also known as farsightedness, is a condition in which the eyeball becomes short or the cornea becomes too flat. In hyperopia, the image is formed behind the retina making it difficult to see nearby objects.
    • Astigmatism is a condition in which the cornea curves and flattens unevenly. Due to this, both distant and nearby vision is affected.
      With the help of laser technology, all these refractive errors can be corrected with precision.

    Types of Refractive Errors

    • Myopia
    • Hyperopia
    • Astigmatism

    Lasik Eye Surgery Causes & Symptoms

    Causes

    • Short or long eyeball
    • Curved or flattened cornea
    • Aging of the eye lens
    • Corneal inflammation
    • Eye injury

    Symptoms

    • Blurry vision
    • Double vision
    • Headaches
    • Seeing a glare or halos around lights
    • Squinting and strain in the eyes
    • Inability to see closer or farby objects or both

    Diagnosis

    Tests

    Comprehensive Eye Examination
    Both visual acuity tests and refraction tests are done as a part of a comprehensive eye exam that is done once a year. It also involves other tests like a corneal exam, pupil exam, extraocular muscles exam, etc.

    Refraction Test
    A refraction test is also called a vision test which helps the eye doctor to determine the prescription of the eyeglasses or contact lenses you will need. The doctor will assess how the light bends as it travels through the cornea and lens of the eye.

    Once it is confirmed that you need corrective lenses, the doctor will either use a computerized refractor or shine a light into your eyes to find what type of prescription you’ll need. The amount of light that bounces back off your retina will tell the refractive score A phoropter will be placed in front of your eyes and the doctor will use different lenses to accurately identify your refractive power.

    Visual Acuity Test
    A visual acuity test is done to see your ability to see the details of a letter or symbol at a specific distance. This test is meant to evaluate the eye’s ability to identify the shapes and details of the objects. Visual acuity tests can be done for color vision, peripheral vision, and depth perception.

    There are two tests done for visual acuity, Snellen and random E test.

    In Snellen, the doctor uses a chart of letters or symbols in which letters are arranged in different sizes in rows and columns.
    In the random E test, the doctor asks the patient to identify the direction of the letter.
    The results of both these tests combined help the doctor to calculate the refractive error which will be used during the surgery.

    Pachymetry Test
    The test is done to determine the thickness of the cornea. As the surgery involves the removal of corneal tissues, it is important to know how many tissues will remain after the correction. People who have a thin cornea are often not considered an ideal candidate for LASIK surgery.

    Corneal Topography
    In this test, a 3-D map of the cornea is created with the help of a computer-assisted diagnostic tool. It produces a detailed visual description of the shape and power of the cornea. It will help the doctor to determine how much corneal tissue will be removed and the right ablation pattern.

    Self Diagnosis

    Normally, refractive errors cannot be diagnosed by the person himself/herself. You can only identify that you have been having issues in seeing nearby or farby objects. Other than that, the best you can do is visit an ophthalmologist or an optometrist to get diagnosed properly.

    Diagnosis by Doctor

    During your visit to the eye specialist, the doctor will ask you to describe your symptoms. Inform the doctor about your symptoms and the doctor will suggest some tests to determine the reasons for vision problems. As there are no visible symptoms of refractive errors, the doctor won’t be able to simply examine your eye and tell you the problem.

    The results of the tests recommended by the doctor will help to determine the eye power and refractive error, which will be ultimately used during the LASIK eye surgery for correction of vision.

    Severity

    Myopia

    Mild myopia has eye power up to -3.00 diopters. Moderate myopia has a power in the range of -3.00 to -6.00 diopters. High myopia has a power of more than -6.00 diopters.

    Hyperopia

    An error of +2 diopters or less is considered mild hyperopia. The power range between +2.25 to +5.00 diopters is moderate hyperopia. And the eye power greater than +5 diopters is regarded as high hyperopia.

    Astigmatism

    The severity of astigmatism is measured in a slightly different way. It is said to be mild if the power is less than 1 diopter, moderate when the eye power ranges from 1.00 to 2.00 diopter, severe if power is 2.00 to 3.00 diopter, and extreme if the power goes above 3.00 diopters.

    *The eye power in astigmatism is given by cylindrical and axis values.

    LASIK Eye Treatment Risks & Complications

    During the Surgery

    LASIK eye surgery is most commonly performed by experienced ophthalmologists who have successfully performed over 500 surgeries. Moreover, the laser is rarely manually operating. A computerized machine is used to control and operate the laser machine that removes the corneal tissues. The laser has an automatic detection system that will identify the movements of the eyes and stop functioning to ensure that other eye components are not harmed under any circumstances. Therefore, there are negligible chances of complications during the surgery itself.

    If Left Untreated

    If the refractive errors are left uncorrected, the conditions will continue to progress and your vision will only decline. In some people, the refractive power also stops increasing after some time until they reach the age of 40. After 40, the eye health itself starts declining due to which the refractive power increases rapidly.

    In the worst-case scenario, the uncorrected refractive errors can also lead to permanent blindness.

    After the Surgery

    • Dry eyes- There is a chance that your eyes will be dry as there will be less tear production. This may impact the quality of vision due to which you’ll need eye drops.
    • Glare, halos, or double vision- You may experience difficulty in seeing at night for a few days and have increased sensitivity to light. Halos or double vision may also occur around bright lights.
    • Night Vision Issues- Another post-surgery complication after LASIK is night vision issues. Though the results are great in visual acuity, your night vision may be affected in dim light making it harder for you to see in fog or at dusk.
    • Undercorrection- If the laser fails to remove enough corneal tissues from the eye, you won’t achieve the 20/20 vision from the surgery. Under corrections are more common in people who are nearsighted, due to which you will have to undergo another procedure to achieve the ideal vision.
    • Overcorrection- It is also possible that extra tissues are removed from the eye due which you may further experience vision problems.
    • Astigmatism- This complication usually arises in cases when doctors manually operate the laser. The corneal tissues are removed unevenly due to which the patient ends up having astigmatism.
    • Regression- It is less likely to happen but there are chances that your vision will slowly change back to the original prescription sooner than expected due to some reasons.
    • Vision loss or changes- It is a rare surgical complication of LASIK eye surgery. You may experience a complete loss of vision or may not be able to see sharply or clearly as before.

    Prevention

    The eyes are a very important part of our body and their health matters a lot to see the world around us. What most people don’t realize is that vision problems can be avoided and eyes can be kept healthy if they follow the steps below:

    Focus on maintaining your blood sugar levels. Higher sugar levels can increase the blood pressure significantly and may affect the optic nerve that can impair your vision.
    Know your family’s eye health and history to know if you are potentially at risk of developing certain eye diseases. Refractive errors can be hereditary, i.e., if your parents had some kind of refractive error, you are more likely to get it at a young age.
    Eat healthy food to protect your sight. You must have heard from many people that carrots, green leafy vegetables, fruits, etc. are good for your eyes. It is true as some food items are rich in omega-3 fatty acids that are good for eye health.
    Wear protective eyewear while playing sports or other activities in which there is a risk of eye injury. If your eyes get injured, the vision is the first thing that will be affected.
    Quit smoking as it is bad for your overall health as well as your eyes. It will damage the optic nerve which will ultimately impair your vision.
    Go for a regular eye checkup to ensure that the vision problems can be detected at an early stage. This will help to get proper treatment for the condition and prevent it from advancing.
    Give your eyes proper rest if you spend your entire day watching a computer screen. Take breaks throughout the day and use some eye exercises to keep the ciliary muscles strong.

     

    When to consult an eye doctor?

    You should see an eye doctor at least once or twice a year at a younger age. After you reach the age of 40, it will be better if you go and visit an eye specialist every year as eye health declines considerably with age.

    Besides this, if you experience the following things, you should immediately see an eye doctor:

    • If you have problems with near or distant vision.
    • If you get frequent headaches.
    • If a foreign object enters your eye, such as grit, dirt, chemicals, or debris.
    • If you experience eye pain that is intense and consistent.
    • If your eyes always feel tired or you have eye fatigue.
    • If you can’t focus with one or both eyes.
    • If your eyes are becoming sensitive to light.
    • If your eyes become dry or itchy.
    • If you see flashes, floaters, or spots in your field of vision.
    • If you have double vision in one or both eyes.

    Lasik Eye Surgery Options & Cost

    Non-Surgical

    The non-surgical treatment options for refractive errors involve the following:

    Spectacles or Eyeglasses 

    Spectacles are the first line of treatment for refractive errors. There are three types of lenses used in eyeglasses:

    • Concave lens to correct myopia or nearsightedness
    • Convex lens to correct hyperopia or farsightedness
    • Cylindrical lens to correct astigmatism

    As your refractive error increases, the power of the glasses will also increase. In mild stages, the thickness of the lens is small which will increase over time when your eye power increases.

    Contact Lenses 

    This method of refractive error treatment is more suitable for young adults. There are different materials and types of lenses available that are prescribed after proper diagnosis.

    • Soft contact lenses are used to correct myopia and hyperopia with astigmatism which is less than 1.00 diopters.
    • Rigid lenses are used to correct both regular and irregular astigmatism.

    You will have to follow certain guidelines to use contact lenses, which is why people often use either eyeglasses or consider undergoing LASIK eye surgery.

    Types of Surgery

    There are two most common types of LASIK surgery done for the treatment of refractive errors:

    • Intra-LASIK- In this type of LASIK, the surgeon will use the laser to cut and reshape the cornea.
    • PRK- For the people whose corneas are thin, they can rely on the PRK (photorefractive keratectomy) technique to correct their vision. During the surgery, the entire layer above the cornea is removed to reshape the cornea. Then the layer is left to be repaired itself.
    • Topography-guided LASIK Surgery or Contoura LASIK- In this technique, around 22,000 points are marked on the cornea through topography and then the abnormalities in the cornea are corrected through the excimer laser.

    In case you are ineligible to undergo LASIK surgery, the doctor will also recommend alternative treatment methods, such as Implantable Collamer Lens, also known as ICL to help you restore vision effectively.

    Surgery Preparation

    The steps you need to follow to prepare for the surgery include the following:

    • Make sure that the doctor is aware of your medical history and the health conditions that you have.
    • Stop wearing eye makeup entirely one or two days before the surgery.
    • Switch from contact lenses to glasses if you wear them at least one week before the surgery.
    • Avoid using creams, perfumes, or lotions before the surgery.
    • Make sure that you organize a carer who will stay with you on the day of surgery and take you home.
    • Also, wear comfortable clothes as you’ll have to lie on your back for at least 30-40 minutes.

    What to expect during the surgery?

    The surgery is done on an outpatient basis in a clinic or hospital depending on the availability or patient’s preference. You can expect the following during the procedure-

    • Your eyes will be numbed using eye drops or a solution will be injected through a syringe.
    • The surgeon will place a lid speculum to hold your eyelids open and a suction ring will also be placed to prevent your eyes from moving.
    • The microkeratome laser will be used to create a flap in the cornea tissue.
    • The flap is lifted to expose the cornea and the doctor will ask you to focus on a target to ensure that your eyes don’t move during the procedure.
    • A programmed laser will be used to reshape the cornea. The laser will remove the corneal tissues little by little until the shape of the cornea is fixed.
    • Once the ideal shape of the cornea is achieved, the flap will be placed back in the original place and it will be left to heal over time.

    During the procedure, you will hear the laser machine running which can be slightly disturbing. For this, the doctor will give you anxiety pills. Other than that, you may also be able to smell the burning tissues.

    After the Surgery

    The ophthalmologist will place a see-through shield over the eye and ask you to use a protective cover while sleeping for a few days. This will help you to protect the eyes as it heals.

    Immediately after the surgery, the surgeon will advise you to take proper rest at home. For a few hours, you will feel scratchy or a burning sensation in the eyes. The doctor may prescribe some eye drops to reduce dryness in the eyes.

    Cost of LASIK Eye Surgery

    • Average cost of LASIK eye surgery in Delhi is Rs. 45,000 approximately.
    • Average cost of LASIK eye surgery in Mumbai is Rs. 74,000 approximately.
    • Average cost of LASIK eye surgery in Bangalore is Rs. 68,000 approximately.
    • Average cost of LASIK eye surgery in Pune is Rs. 65,000 approximately.
    • Average cost of LASIK eye surgery in Hyderabad is Rs. 60,000 approximately.
    • Average cost of LASIK eye surgery in Chennai is Rs. 45,000 approximately.
    • Average cost of LASIK eye surgery in Kolkata is Rs. 40,000 approximately.

    Insurance coverage

    LASIK eye surgery is usually not covered under the health insurance policy as it is not a critical illness. Refractive errors can be corrected easily through prescription glasses or contact lenses. The treatment is not medically necessary and it is done as an elective procedure. Thus, LASIK is generally not covered by insurance.

    However, there is one exception to this rule that is included in all medical policies. LASIK eye treatment will be covered under insurance if your eye power is more than 7.0 diopters. Then you can file a claim for the treatment and cover all expenses.

    Lasik Eye Surgery Recovery Rate

    The eyes start recovering immediately after the LASIK eye surgery and the initial healing occurs rapidly. Your vision will stabilize within 24-48 hours. Thus, the recovery rate is quick. However, you will have to follow specific instructions for at least a month to ensure that no complications arise until the eyes heal completely.

    It is the flap that will take around a few weeks to heal. As soon as the flap heals, you will be able to resume daily activities without any problem. The doctor will advise you to come back for a follow-up after one week of having surgery to monitor your recovery. After that, you can get follow-ups after six months or longer to monitor your vision and eye health.

    Dr. Rahul Sharma (TEJFraQUZY)
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    FAQ

    What is wavefront LASIK?

    It is a type of LASIK surgery in which the surgeon creates a 3-D map of the cornea with the help of topography and uses the map to perform the surgery with higher precision.

    Is LASIK a permanent way to correct vision problems?

    Yes. LASIK is a permanent vision correction solution as it effectively and safely corrects the current refractive error with precision. The cornea is reshaped properly to ensure that no refractive error is left. So, you can rest assured knowing that LASIK surgery is indeed a permanent solution.

    Can LASIK results last for a lifetime?

    Yes. LASIK can last for 10 years, 20 years, and even for a lifetime in some cases. The lasting effects depend on multiple factors, such as the age of the patient, medical conditions, and how much the patient pays attention to eye health.

    Is it a good idea to undergo LASIK surgery after 40?

    Yes. No matter what your age is, LASIK is most certainly a good method to prevent further vision loss due to refractive errors. It is safe for patients over 40 and also has long-term value if the patient’s eye health is optimal.

    Who is not the right candidate for LASIK surgery?

    A person is not considered an ideal candidate for LASIK eye surgery if the individual has:

    • Fairly good overall vision
    • Severe nearsightedness
    • Serious eye disease
    • Large pupils or a thin cornea
    • Age-related eye problems

    In case of any of the above-mentioned points, you won’t be eligible to undergo LASIK surgery.

    When can I watch TV after having LASIK eye surgery?

    You can watch TV after taking a nap following the surgery. There are chances that small digital screens may irritate your eyes. Hence, it will be beneficial if you wait for a few days to watch TV and use other digital devices like phones, tabs, or computers.

    What if I cry after having LASIK surgery?

    Normally, crying won’t affect your eyes or the results of LASIK surgery as long as you don’t rub them. The only risk with tears is that you would want to rub your eyes after crying which can displace the flap and disrupt the healing process.