Laser Vision Surgery for Developers? 741
cyclops asks: "I have been contemplating about going for LASIK surgery for a couple of years. I want to get rid of my dependency on glasses or lenses because I really find them cumbersome. The main thing that is stopping me now is that like you, programming is my livelihood and thus I spent a major part of my day staring into the monitor. I have readthat there is always a certain percentage of patients not regaining 20/20 vision but it's OK for them since most of them don't need that sharp vision during work. I am about to consult with a LASIK surgeon but I would love to hear anecdotal evidence about your experiences, to hear if it works out for you eventually. (I have stable myopia of -5.50 and astimagtism of -1.00 for 3 years already)." Ask Slashdot has handled this issue in the past in two previous articles: this one from 1999, and a related article from 2000. With at least 2 years since the last time this question was posed, how has medical technology improved in this aspect? For those unwilling or unable to take advantage of Laser Surgery, have other viable alternatives arisen in the past two years?
I'm probably going to have it done... (Score:2, Informative)
Night vision (Score:5, Informative)
I don't know much about this site, but I'd just heard about it: http://www.lasiktruth.com/ [lasiktruth.com]. Look around, I've heard a lot of bad stuff second hand about it.
Don't Do It! (Score:2, Informative)
There are reversable alternatives, such as Intacts [americaneye.com], but they may not work with your degree of astigmatism.
Aberrations (Score:4, Informative)
At present, opticians measure and correct defocus and astigmatism. The eye has many higher orders of aberration (spherical aberration, coma, trefoil etc), which are not measured and are not corrected. The problem is that, for laser surgery, the astigmatism and defocus are corrected over a small area of the pupil, smaller than the area of the dilated pupil. Outside this area, aberrations are exacerbated, and not currently measurable (although there is a lot of work in this area). Hence, if you have laser eye surgery, your corrected vision will (barring complications), be fine during the day or when in a brightly lit area, but vision may be worse than pre-correction at night. Doesn't sound too bad, unless you drive at night...
BIG FONTS ARE YOUR FRIENDS :-) (Score:5, Informative)
Bruce
Re:The see clearly method? (Score:2, Informative)
Mariette Hartley
The website:
http://www.seeclearlymethod.com/
Be smart! (Score:3, Informative)
However!!
Don't take my word for it. It was the right decision for me, it may not be for you. Do your research, and above all do not let price be your primary factor. It's the only eyes you have, be smart about it.
Mox
Worked great for me (Score:4, Informative)
Re:I'm probably going to have it done... (Score:2, Informative)
I did it (Score:5, Informative)
I notice my eyes getting a little tired near the end of the day, which is normal for folks with naturally good vision. And I know that I'll need reading glasses eventually. Big deal. I can see my wife in the morning, swim with my kids, fall asleep while reading, wear decent sunglasses, etc... All trivial things when you've got normal vision, but oh-so-worth it when you've needed glasses for 20+ years just to find your frelling shoes.
Oh yeah, it's worth it. Find a decent surgeon -- research! ask questions!
Great Experience: Strongly Recommend (Score:5, Informative)
I had laser surgery (LASIK) last spring. It was a fantastic experience. I basically have had contacts forever (-4.5 in one eye, -4.25 in the other, slight astigmatism in one but I don't know the number value for it). I went in for a consult and they deemed me an ideal candidate after checking my vision and doing some measurement of the size of my cornea (mine is thicker than average which is good for them because they effectively reshape your eye by getting rid of some of the cornea).
I went in for the surgery on an afternoon. I had both eyes done on that day. I basically sat in this chair and focused on a little red light. They put some numbing drops in my eyes and then lowered this eyeball sized tubish thing over my eye. It basically sucked onto and grabbed hold of my eye, then a blade comes out of that to slice a thin layer of the cornea. The surgeon then lifts up that layer and the world goes super foggy. I focused as best I could on the red light (with the sucker thing on my eye, I couldn't have moved it anyway). And they basically fired a laser at my eye for 50 seconds or so. Then they flipped the cornea layer back over my eye and the world became clear. They then did the same process for the other eye. It did not hurt in any way during the process.
When it was done, I could immediately see better but it did hurt to look at bright light so I basically got patches over my eyes and was driven home. I took some Tylenol PM and went to sleep with these plastic things covering my eyes to protect from rubbing during the night.
The next morning I drove back to the eye center without my glasses. At that point my eyes were about 20/40 or 20/30. I went to work that day as well so I basically missed an afternoon of work. I had to wear the eye covers at night for the next few nights. Over the next week or so as my eyes completely healed, my vision became 20/15 in both eyes. It has been that way ever since. I do notice slightly more haloing (halos around point light sources) at night but nothing that might not have been there before and I just didn't notice.
I can't recommend it strongly enough. Not having contacts has been a pleasure and the whole surgery experience was a breeze. The worst part of it was the anxiety as they did the surgery but it only lasts about 15 minutes and was well worth it.
Re:Don't Do It! (Score:5, Informative)
Hogwash. There is a chance, but night vision problems (like haloing) typically go away over time.
I had Lasik a couple years ago. I never had nightvision problems, even temporarily. My wife had hers done a week before mine. She had haloing for about 6 months, but it eventually went away.
It's different for everyone. General statements like that are just FUD. We /.ers don't like FUD.
Mox
It worked great for me (Score:2, Informative)
Even staring at a computer all day and half the night doesn't bother me.
About my only minor complaint, is that my eyes get a little dry, and I have to carry wetting drops with me. I understand that about a year post surgery, this goes away, and after 8 months, I need the drops less and less often.
I would highly recommend it. Just make sure you see a reputable doctor, and talk to some of his/her previous patients. That's what I did, and they were all quite happy.
It cost about $2800, but I would pay it again.
Cheers!
Re:Night vision (Score:2, Informative)
1- People notice more halos around strong light sources (mostly in high-contrast nighttime)
2- Some people don't get perfect results (i.e. no guaranteed 20/20)
3- The guy who wanted to bring the technology to market was trying really hard to shirk responsibility if anything failed.
But the study this site refers to is from 1999. So I strongly suggest reading the discussion here for an update...
Horror stories (Score:5, Informative)
Wish I'd found that site before I had my eyes fubared.
Short version...its been a year+..I'm spending over $50 a week on eye drops due to major dry eye issues....reading which used to be a pleasure in my life is now a nightmare....most importantly, due to the dryness and constant tiredness of my eyes, long term comp work is flat out. Also, caffine is majorly restricted due to how my eyes react to it... Nightvisions pure hell.
So..if contemplating it....do ALOT! of research...any doubts, dont do it.
See also : http://www.martialtalk.com/showthread.php?&thread
Good luck
My case is pretty typical, I think (Score:4, Informative)
I was like -4.00 and -3.75. I had Lasik a few years ago. Now I see about 20/25 and 20/20. I have the halos at night.
I have to admit, initially I was somewhat disappointed because my vision definitely wasn't as sharp as it was when it was fine-tuned with my contact lenses. But to tell you the truth, now I don't even think about it. My vision is definitely "good enough" and I'm glad I did it. Being free of any vision correction is really, really nice. The halos at night used to be somewhat annoying, but I've pretty much gotten used to them and they don't bother me.
One big advantage is that my eyes don't get as fatigued from wearing contact lenses at the end of the day, and I find that to be an advantage in late night programming sessions.
For me, the positives outweighed the negatives, but unfortunately there's no way to really know for yourself without doing it.
Thrilled with Mine (Score:4, Informative)
I had the procedure mainly because glasses interfered w/hunting and other outdoor sports.
From what I understand- the greater the correction needed, the greater the risks. My vision was not too bad prior to the procedure and better than 20/20 in both eyes after it was done.
I would do it again in a heart beat.
.
i had lasik done.. (Score:3, Informative)
18 months ago and have had better than 20/20 vision since.
my advice is to very carefully research your doctor and the equipment he uses. you get what you pay for, cheap prices usually means cheap service. much of the equipment they use can be looked up on the web (my doctor used a system developed by B&L, i could look up the stats and success & failure rate on B&L's web site as well as the FDA).
i'm very happy with having it done.
oh. i had it done at lasik plus [lasikplus.com].
Orthokeratology (Score:2, Informative)
About 8 months ago one of the local eye doctors started offering orthokeratology [allaboutvision.com]. I wanted to do this instead of lasik because I don't trust anything that has to do with cutting my eyes, the "oops, you know there is always a chance of something bad happening" factor bothers me. With orthokeratology, if you stop wearing the lenses, your eyes go back to how they were. This lets me have good vision with a minor inconvinience (less than wearing soft contacts) and give me the option of getting lasik when it is $50 an eye and there is no chance of anything bad happening.
My eyes started out at -6.5 / -5.5, which is at the far end for successful treatment. Important lesson, don't go from eyesight this bad to 20/20 in one step, use two different sets of lenses.
After about 6 weeks I had 20/20 20/25 without the lenses 20/15 with. Now I wear the lenses all day and night one day, leave them out the next. If I only wear them at night, after the second night I have 20/40.
I have no trouble working on computers all day, and I don't have to worry about losing a lens while rafting or diving. Getting dirt in my eye while biking though is a very interesting experience, one of the drawbacks of hard contact lenses.
Not like buying toothpaste (Score:5, Informative)
However, if you take one quote away from this post, it should be this: This isn't like buying toothpaste. This is surgery. You will get what you pay for.
In other words, do your homework before even talking to doctors. Be aware that this is surgery, even if it is outpatient surgery. I ended up paying much more than the "average" rate because the doctor I chose had done over 10,000 procedures (successfully), and was an instructor of the procedure. If you can afford it, the extra money for someone really experienced in the procedure is worth it.
Not for the Squeamish (Score:4, Informative)
My brother had it done. He does not regret it, but he did say that the experience can be phychologically very uncomfortable. If you are the least bit squeamish about people playing with your eyeballs with scary tools and having your head and eyes locked into one position for a duration, then forget it.
They can't put you under anesthesa (sleeping gas) because you must keep your head and eyes still, and sleeping people tend to move both. Bummer.
Re:Night vision (Score:3, Informative)
I have a pretty rare eye condition that pretty much eliminates me as a candidate for Lasik, but some people still have similar symptoms and have had less than desirable results. If you have sensitive eyes to light for whatever reason, make sure to really talk it over with your eye doctor and get more than one opinion. My problem doesn't permit my eyes to contract normally, and apparently this produces some pretty serious havok amongst Lasik patients. If you get your eyes dialated, or sensitive to light, I've heard don't do it from a few sources. Halos around lights are a common tale, but I've also heard of glare that reflects around your eyes and things along those lines.
Best advice I can give: Talk to more than one doctor/surgeon about it before even considering it. Their informational videos are meant to get you to want to do it, so don't take their advice. Talk to people who have had it done that have similar prescriptions/eye conditions. Those are the people you really care about.
Make sure to check fda.gov first (Score:5, Informative)
I'm not sure if you've already looked at the FDA's When is LASIK not for me? [fda.gov] site but you'd better have a look at their suggested restrictions. Among them: your vision has not stabilzed yet and history of autoimmune diseases.
GMD
Re:Dangerous (Score:3, Informative)
However, except in extreme circumstances, you can live a perfectly good life for just as long with glasses as with lasik. If you prefer, you could consider it 'unnecessary' surgery. There's probably a fancy word for that in the medical world.
=Brian
uhh.. where? (FAR Part 67.103, 67.203, etc) (Score:2, Informative)
US Department of Transportation: Title 14 of the Code of Federal Regulations (14 CFR)
Federal Aviation Regulations (FAR)
Subpart B - First-Class Airman Medical Certificate
67.103 Eye.
Eye standards for a first-class airman medical certificate are:
(a) Distant visual acuity of 20/20 or better in each eye separately, with or without corrective lenses. If corrective lenses (spectacles or contact lenses) are necessary for 20/20 vision, the person may be elegible only on the condition that corrective lenses are worn while excercising the privileges of an airman certificate.
(b) Near vision of 20/40 or better, Snellen equivalent, at 16 inches in each eye separately, with or without corrective lenses (&etc..)
(c) Ability to percieve those colors necessary for the safe performance of airman duties
(d) Normal fields of vision.
(e) No acute or chronic pathological condition of either eye or adnexa that interferes with the proper function of an eye, that may reasonably be expected to progress to that degree, or that may reasonably be expected to be aggravated by flying.
(f) Bifoveal fixation and vergence-phoria relationship sufficent to prevent a break in fusion under conditions that may reasonably be expected to occur in performing airman duties. Tests for the factors named in this paragraph are not required (&etc..)
-----
No mention in the entire FAR section, or in the Aeronautical Information Manual (AIM) about having had surgery in the past. If you pass the tests, then you can get your medical. If you get your medical, then you meet the qualifications.
If you are flying under a First Class medical certificate (Part 135 Regs) for an air-carrier, then you have to have your medical retested every 6 months anyway, so any degredation would hopefully disqualify you for a 1st class medical before it became dangerous.
A third class medical (for General Aviation flying, for instance) is even more forgiving that that.
If anyone knows of any documented reference against LASIK by the FAA, then let me know. I'd be interested to know where they keep undocumented medical rules like that. (Seriously.)
- PM
Re:Don't Do It! (Score:2, Informative)
Re:Don't Do It! (Score:3, Informative)
No it doesn't. LASIK uses a laser to vaporize parts of the cornea, which causes the cornea to change shape before healing, just like with RK (I wouldn't say that either method "causes the eyeball to collapse in on itself" though). Read up for some more info [fda.gov] on LASIK, as well as comparisons to RK and PRK.
There are no procedures to reshape the lens itself. You can, however, get your old lens removed and an artificial lens implanted. This is usually done to people with cataracts--my mom just had it done a few weeks ago, and she no longer needs glasses. Some people do get their lens replaced even when they don't have cataracts, but that seems a bit too extreme to me.
get computer glasses (Score:5, Informative)
Beyond that, if you are nearsighted and don't suffer from stress-related vision problems, there is no way to "improve" your eyesight through eye exercises; eyes just aren't built that way. Most likely, the "improvements" you are seeing are the onset of presbyopia. Moving monitors further and further away is a common way of dealing with it. Most people get reading glasses when they reach the limits of their desk--it's more convenient. And, no, there is nothing to be done about presbyopia--everybody gets it sooner or later. Some people are just more willing to tolerate inconveniences for vanity--that's the only reason you don't see everybody over 50 running around with reading glasses.
Re:I did it (Score:3, Informative)
The actual surgery was performed by the New England Eye Center (affiliated with Tufts), at their Boston facility. The eyes were done 2 weeks apart - my left (weaker) eye first and then my dominant eye. My right eye is corrected from close to 20/200 myopia to around 20/15 - my left eye was corrected to 20/20. I do have a insignificant amount of astigmatism in my left eye, which I was given the option to further correct if necessary but so far I haven't noticed it except on the eye tests themselves.
All in all, it was a very worthwhile experience. One thing to check - see if your emloyer has a flex spending plan for medical expenses. If they do, you can potentially contribute to the fund pre-tax, and then use the money to pay for the surgery. Depending on your bracket, you can potentially save as much as $1000 doing it that way (I did).
And reading glasses are pretty much a certainty by the time I'm in my mid-to-late forties (I'm 36 now). But I consider that to be no biggie, as I'd have probably needed bifocals eventually without the surgery.
I agree on finding a good surgeon. Preferably one affiliated with a real hospital rather than a free-standing opthamalogy center. And I'd say discount sushi and discount LASIK are two things to potentially avoid.
Overview of different methods (Score:2, Informative)
* Radial Keratotomy
NEVERY DO THIS. It's a small disaster. they use diamond cutters to carve into your eye so it bulges out and changes the shape of your cornea.
At first this works, but because the different scars heal in unpredictable ways, it completely messes up the shape of your eyes after a longer period. You can never wear contacts again and glasses won't help because you vision is distorted, not near- or farsighted.
* Laser surgery/LASIK
This seems to work well, but some people have had problems with it.
The main problem I've read about (on Slashdot) is that the laser has an disc-like area it treats, and an area it doesn't treat and there is a sharp border between the two.
It vaporises away the treated area leaving a ridge at the start of the untreated area.
The ridge will stay with some people and act like a lense, giving them haloes around light sources at night (and during the day, but you can't see them then).
One other note for Laser surgery. They need to vaporise the cornea and for that, they need to remove the "skin" of the eye first. They used to just scratch it away with a spoon-like thing and give you eye-drops till it healed, but nowadays a newer technique is said to give better result. They cut 3 sides of a square shape and fold away a flap of your "eye skin", do the surgery, then fold the flap back like it was. Ask about the newer technique.
* "Plastic" rings
Don't know the name of the procedure, but it involves changing the shape of the cornea to correct your vision by inserting pieces of "plastic" in the upper tissue layer of the eye. The insertions are shaped like a wheel cut in half.
This bulges the parts of your cornea at the edges, thereby making the outer lens of your eye a flatter shape. Thus curing your near-sightedness.
The inserts are very thin and therefore only need tiny cuts to be inserted. They can be removed or replaced if needed. Seems to be a limit to the amount of near-sightedness they can correct.
*Insertion of internal lens
Don't know the name of this procedure either but it has it's history in the treatment of patients who's internal lens had been clouded by cataracts or other diseases. The diseased internal lens would be removed in these patients and replaced by an articicial lens held in place by two rounded "arms" attached to the lens acting like springs that radiate outward and hold the lens in place. The arms look like a bit like the bottom 3/4 of the letter J.
The technique to cure near-sightedness is to do the same procedure, but to leave the original internal lense where it is. The artificial lens will sit between the cornea and the internal lens (I think there's a natural "canyon" where the arms will press into that is between those 2).
The cut needs to be big enough for a folded lens to fit into but it is made at the edge of the iris so it should not be visible. Don't know if you can wear contact lenses over the scar but the implant can be removed or replaced if needed.
I myself am planning to have the last procedure perfomed when I have the money because it seems to me to give more control over the correction than the "half wheel inserts" approach. I still have to ask if they can rotate the artificial lense in such a way to cure my other sight deviation (cylinder/astimagtism?) but if not, then that's no big problem at all.
I also wonder if it's possible or wise to have the artificial internal lense block UV rays. This would prevent damage and cataracts to my eyes by sunlight and I would never become snowblind
Are there chemically stable transparent UV blockers?
Re:Not for the Squeamish (Score:3, Informative)
1. complexity - general anesthesia requires a fully equipped operating suite and lots of extra equipment.
2. cost - cost of above mentioned equipment, plus the services of an anesthesiologist to take care of the medications, intubation, artificial ventilation, etc.
3. risk/benefit ratio - with general anesthesia, the risks suddenly become much, much higher--too high for an outpatient elective procedure when a safer alternative exists.
The bit about not being able to keep sleeping peoples' eyes still is not a problem. It's a simple matter of medication to completely paralyze a patient during general anesthesia.
Ortho-keratology (Score:5, Informative)
Essentially, with ortho-k you wear hard contacts while you sleep. These contacts are engineered in such a way that they reshape your cornia to adjust for myopia or astigmatism. I also depend on staring at a monitor both during my job and when I get home (as a hobby). My vision has changed from a -3.5 lens to about +0.25. (The slight far-sightedness is actually a good thing.)
One of the advantages (or perhaps disadvantages depending on your perspective) is that ortho-k is not permanent. As a result, it's less risky. If you stop wearing the contact lenses, your eyes will slowly revert (however probably never as bad as they were when you started).
I've been using ortho-k for over a year now and I love it. I don't have to worry about dry eyes from contacts (since when I do wear the contacts I am sleeping, so I don't feel them) nor do I have to deal with the inconveniences of glasses. Plus I don't have to undergo the scary LASIK surgery. The risks and the costs are much less with ortho-k. I highly recommend it.
Jason.
Anecdotally speaking (Score:3, Informative)
I was fairly nearsighted and also mildly astigmatic, both eyes were almost equal.
Anyway
After the first day I could open my eyes and see. After the 3rd day I didn't have any measurable irritation. By the 7th day my vision was better than 20/20 except for the normal halo patterns.
However, after about 3-4 months my vision got a little worse. I'm not quite 20/20 in either eye. My right eye is better (but I'm left-eye dominant, so it's frustrating). My left eye is able to pass the Colorado driver's exam, but just barely.
My biggest problem is "ghosting" as I call it. I think it's just the healed version of the halos that I had bad at first. It is only a problem in very bright light or in high-contrast images (like driving at night
The ghosting is enough to give me a mild eye-strain headache every once in a great while, but usually it just makes me squint a bit. I have no problems working on a computer monitor for 10+ hours a day and I don't have any problems reading in bed (I had gotten so nearsighted that I had to wear my glasses to read at night).
My eyes have been stable since about 6 months after the surgery. My cost was $1500/eye, but it was at a well known clinic and they give as many free tune-ups as required for 3 years after the procedure. I would have gotten a tune-up by now, but I've moved.
I'm waiting for our vacation back to the place where it was done (Dr. Arrowsmith in Nashville, TN) this winter to get my tune-up. That will give me 14 months left on the policy to heal and see how things go. I doubt I will go for more than 1 tune-up though, as I am worried about causing scarring.
The best part is, I went in to get a tuneup in June and the doctor actually told me to wait because they were getting in a new machine (Wave laser) that was much more accurate. Apparently my nearsightedness is gone and the ghosting (which is exacerbated by my having had astigmatism) is a result of a barely uneven surface from the old laser. The new laser handles this much better. I like a doctor who will tell you that instead of just trying to clear their schedule.
Overall I'm very happy I did it. I never liked my glasses and am very happy that I can read at night. Plus, now I can buy ski goggles and motorcycle helmets that are comfortable
Recommendations:
1) I had both eyes done at the same time. DON'T DO THAT. While I turned out ok, if my eyes had healed any less "ok" than they are I would be upset that I did them both. I would recommend doing 1, waiting 2-3 months, then doing the other if you're satisfied.
2) If you get a free tune-up, especially if it's valid for a couple of years like most reputable clinics are wont to do, wait at least 6 months, maybe 12, before having a tune-up. Not only will your eyes continue to heal the first few months, but more refined technology is continuously being rolled out.
Re:Don't - just don't (Score:2, Informative)
When is LASIK NOT for me:
"You actively participate in contact sports. You participate in boxing, wrestling, martial arts or other activities in which blows to the face and eyes are a normal occurrence."
http://www.fda.gov/cdrh/LASIK/when.htm [fda.gov]
Re:nonsense! (Score:2, Informative)
Oh-please! Don't fall for this nonsense! The mechanisms of myopia and the like are very well studied and understood.
While your "looking habits" probably can do something to your vision during eye developement (i.e. childhood) this whole eye-training thing is totally bogus.
Myopia is not caused by tensions of muscles - strain on those is a result of the (insufficiently corrected) myopia. The reason for myopia is that the eye bulb is too long and thus the image projected by the lens system would be in focus a little in front of the retina. In the case of close objects (e.g. computer screen) this can be compensated by "accomodation" (i.e. focussing closer). Of cause a person with myopia has to focus "harder" compared to a person with regular vision which causes the strain on the eyes, that people experience while reading without glasses (headache, burning eyes, blurred image after some time).
If a myopic person stets the lens for infinty (i.e. focusses on a distant object) the immage remains blurred because we can't focus beyond a certain point which unfortunately is not sufficient for the too long eye ball. Thats why you call it shortsighted: close objects can still be seen in focus while distant ones can't.
If the eye ball is too short the opposite happens.
So what happens if you throw the glasses in the bin and decide to give your eyes some excercise? At first you feel blind becasue you are used to corrected vision and the uncorrected images are impressively bad. After a while you start to get used to be back to bad vision and get the impression of improving vision. Maybe your perception even improves a little over the initial situtation because you (your brain) adapts to the the poor input from the eyes and does all it can to compensate. And our brain is extremely good at dealing with missing or poor data (thats why we don't see our blind spot). If you measure the vision of someone who underwent "eye-training" you find that the vision is just as bad as it was but the person still believes in a miraculous improvement.
Oh and a final personal note: I've been suffering from myopia for a long time now and although I can read without glasses I never do because my eyes get tired of the effort quickly.
Philipp
Re:I'm probably going to have it done... (OT) (Score:2, Informative)
Now the important bit: I'm English, and I hold honours in both physics and maths. I investigated LES in great detail before having it done, and I was totally happy.
Now, you're a /. reader, you must be reasonably smart (hah!), so my recommendation is that you do the same. Learn about the structure of the eye, and what the laser is actually going to do. Don't ask people their opinions cos for every one like me who's been there, there are ten people who tell you their friend's friend had a hole burnt in their retina or whatever.
Just one more thing: I only had one done. It's fine for everything, from coding (I do ~7 ours a day) to driving. It also means that when you get to 40/50 years old, you won't need reading glasses. Neat huh? There was also the minor detail that even though it was (for me) completely pain-free, it scared the living s%^& out of me!
Justin.
Just had my LASIK a month ago... (Score:2, Informative)