Laser Vision Surgery for Developers?

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?

Be Patient and very careful

[twistedcubic]

You should patiently seek out a surgeon you can trust. Be especially careful about going to those "chop-shop" surgeons. I listened to a surgeon at UCLA explain the risks, and he seemed to be honest. He would even refuse to operate on people (including a friend of mine) if he thought that the surgery would result in non-optimal results, like the "halo" effect at night, which I think happens if your pupil (or whatever it's called) is the wrong size. You should expect to pay a one-time fee with free followups until everything is just right. Try to avoid a surgeon who doesn't give a damn about you. Really important, in my opinion. Anyway, I've found that vigilantly using pretty fonts in Linux and switching to a nice laptop display has incredibly reduced the strain on my eyes caused by the CRT monitors (I'm -9 nearsighted in both eyes). Though this may not be a solution for everyone :)

Then there's the risk

[hatless]

Me, I wear glasses, ones with a pretty thick lens on the left at that. The frames get a little in the way of my peripheral vision. But I don't want Lasik. Why? Because of the failure rate--even if it's somehow down to only 1%, and I'm not sure it is.

Forget worrying about not achieving the 20/20 vision you want and that many people get from it. Worry instead about the real risk of corneal damage that will leave your vision worse than it was before, with permanent starbursts and haloes like you're looking through scratched, scuffed glasses all the time.

Will this happen to you? Probably not. In fact, if you have the sort of vision that Lasik corrects, you have a well over 95% chance of getting the great vision without glasses that you want. It's just that if you draw the short straw, you could find your ability to read a screen pretty thoroughly ruined, with or without glasses.

Weigh the benefits against the risks, and if you decide to do it, note that most surgeons have you sign a boilerplate contract that bars you from suing them if your vision is ruined. Who's the real winner?

Wrong

[Johnboi Waltune]

I had LASIK 2 years ago and have no night vision problems. For the first couple months, there was a slight 'ghosting' effect around bright lights at night. That has completely disappeared. My night vision before the surgery was excellent and it continues to be so.

LASIK works well but ....

[joe_n_bloe]

I would recommend LASIK for overall lifestyle improvement but not just to see a computer monitor better.

If you can't see what you're doing when you get out of bed in the morning (5 diopters is borderline for that) then LASIK will help you. My SO was about 8 diopters and it made a big difference.

The downsides aren't all that bad but there are tradeoffs. I have a 3-4 diopter correction and I have the option to work on a laptop without my glasses or contacts on. Also my vision corrects to 20/15-17. I would not expect such a good result from LASIK. My expectations would be more like 20/40 which would probably be significantly worse in dim light and better in bright light. If you can focus sharply in the dark now, you will probably lose that after LASIK.

I would not expect serious adverse health consequences from LASIK but they are possible.

I think that all in all LASIK will probably make it harder for you to stare at a CRT all day, but it may greatly improve other aspects of your life. Think about it carefully beforehand.

You might consider corrective optics that undercorrect your eyesight, specifically for working near CRTs. Being undercorrected by .5 diopter doesn't significantly worsen your distance vision, except at night, and it makes focusing close much more comfortable. Some people cannot attain sharp focus at night anyway, so what does it matter?

Actually, I say working near CRTs ... one of the best things you can do is work in front of an LCD monitor instead. Makes a huge difference eyestrain-wise.

-joseph

Re:Long term risks unknown

[Zelig321]

Being an optometrist, it's not likely he'll recommend something that would make him lose business.

However, the comments he made seem to make sense. But I'd try finding a similar opinion from an unbiased professional.

I myself wear lenses, and have thought of having laser surgery, but surgery is surgery. There's always a chance that it goes wrong. Unless you REALLY find it cumbersome (I know I don't: wearing disposable lenses is not more complicated than brushing my teeth every day), I wouldn't take the chance.

A friend of mine had the surgery and everything is fine for him (after 4 years)

Net worth: 0.02$

Re:I'm probably going to have it done... (OT)

[GeekDork]

I'd be careful about wildly comparing everythings "danger factors" with driving at rush hour. Especially eye surgery. It is morbid, but chances are high that in a car accident you either won't really have to handle the results or get over it rather quickly. In eye surgery however, you're quite unlikely to die if the surgeon hits the "disintegrate" button, but you'll probably be blind as a mole for the rest of your life. Now, I would think that most of us are at an age where it would be very difficult at least to adopt to a completely changed lifestyle, especially if your defect was rather minor beforehand (nothing really requiring glass bricks).

I don't want to say that eye surgery is a bad thing. It has its merit in repairing defects that are otherwise incorrectible. But if it's (ab)used as purely cosmetic surgery, then I think the dangers outweigh the use.

Also note that my sight is rather good (-1.0 on both eyes, with a nasty embryonal core in the left which makes me see double on this eye), and so I might be unqualified to say this. But what I know is that every kind of surgery has very real dangers and that it should be regarded as a last resort.

Re:Same night vision problem with contacts

[Xerithane]

Anyone know if the LASIK halo problem stems from the same reason of the Contact Lens halo problem(over large pupil dialation)?

Yes, this is coming from late 1999 so maybe they have more work. I have abnormally large dialation ranges, and abnormally large contraction ranges as well. My eyes pretty much stay dialated.

I have talked to a few doctors about it, they all said don't do it. Even in normal light, my pupils would expand past the area that Lasik can modify so I would get constant ghosts and halos. If you have a large dialation area, anytime you hit that point you will experience it as well. But, like I said, this may be different now.

I'm waiting for a surgery that corrects my contraction problem, then I can worry about Lasik... sigh

Better than contacts but sometimes "normal" is bad

[GlenRaphael]

Personally, I think that if there is any chance at all that a cosmetic surgery will prevent me from doing serious computer work, then the cosmetic surgery is not worth it.

If you wear contact lenses, there is a small chance you may permanently screw up your eyesight due to a scratched and/or infected cornea. The risks of serious negative outcome associated with LASIK are smaller than the normal risks associated with contact lenses, so people who wear contacts now are probably on net helping their odds of keeping decent eyesight if they get LASIK.

Me? I got LASIK a few years ago. Best $4400 I ever spent. The main caveat I might add is that for a computer geek sometime it sucks to have "normal" vision. Back when I was nearsighted it was possible for me to read ultra-fine print. I could print program listings 8 or 16 pages to one side of a laser-printed page and still read it. I could squint a bit and easily make out individual pixels on my Newton or CRT monitor - often useful when doing graphic work.

Now, my vision is just normal. Meaning I no longer need glasses to read stuff 20 feet away, but the flip side is I can't take them off to read stuff 2 inches away. Sometimes I miss that ability.

Re:I'm probably going to have it done...

[barfomar]

Talk to your eye surgeon about intra-ocular lens (IOL) implants too. These are same clear plastic replacements for the lens that millions of the elderly have had for cataracts. They're now being used for vision correction too. A "multi-focal" lens implant allows a broad range of focusing. Its a 10 minute surgery, done under local anesthetic drops. A tiny incision is made along the border of the lens and a pencil-like phacoemulsifier (ultrasonic) probe liquifies the old lens. A new lens, rolled up like a taco, is inserted and allowed to unfold. Stitches are rarely needed. There's a lot more history behind this technology than the lasik approach. It's true that it's more invasive, but it doesn't purposefully involve scarring the lens.

Re:Don't - just don't

[sessamoid]

A friend of mine is a senior uni researcher in optometry. She's told me that the flap of cornea that they open up in order to do the surgery never heals properly and that even mild trauma is able to re-open the cut. This can result in infection, scarring and permanent damage. She wears glasses and preaches openly against this technology.

Hmm... conflict of interest? Optometrists are largely in danger of becoming an obsolete species thanks to vision correction surgery. I detect some possible bias here. Mild trauma is NOT going to open up the cut, any more than mild trauma is likely to rebreak a formerly broken bone, any more than mild trauma is likely to open a cut that healed on your skin years ago. LASIK is fairly prevalent now, and I've NEVER heard of a single case of the corneal flap avulsing, let alone see one (and I see lots of bad car accidents every day, none of which complain of vision loss without other severe trauma to the eye, i.e. denucleations, hyphemas, etc.).

Basically, I'd take your friend with a grain of salt. Get more than one side of the story, preferable one whose livelihood isn't endangered by the new technology.

You may not see this....

[aengblom]

...since I am posting late.. but
(haha, pun originally not intended, but it is now)....

Find someone who will turn you away!

One of the big things about this surgery is that, most (all?) Dr's will tell you the average risk. But they will not tell you your specific risk. For people with certain eye characteristics, the rate for having complications is much higher than others. I'd have serious reservations (if I couldn't see 20/20 already :P) if I couldn't get someone to tell me if I was above or below.

In fact, I'd be willing to pay a fair some of money to a doctor to evaluate me who KNEW he wouldn't be getting me as a patient. Second opinion is one thing. Objective opinion is another.

Re:I'm probably going to have it done... (OT)

[n9hmg]

A: This is not OT.
B:I chose to comment at this level because you're talking about my prescription, or close to it - 10.0 and 10.5 nearsighted, with a couple of diopters of astigmatism.... at least, it was. It was a scary decision, but i figured the chances of permanent crippling vision damage was miniscule, and the chance of some degradation was still pretty small. I figured i could wear even worse coke-bottle-bottoms, switch to a larger font, and maybe squint a bit, maybe even use a screen reader, for my job. On a mountainside, glasses can be a real hassle. Fogging in the cold, sliding down your nose in the heat, and, the possibility of them falling off and leaving me hoping for a high-altitude rescue (contacts are even worse when you're that far out on your own) made me take the chance.
I had to go with PRK, as my cornea is only about as thick as the flap they cut for LASIK. During my post-procedure phase, I accidentally took the cortisone drops a few days too long, and ended up making myself slightly farsighted. I'm only 39, so i've still got good focal range, and can focus down to about 8 inches, but I'm going to need reading glasses sooner than I should have. I still don't regret it. I'm a solid 20:15, and can jump out of bed in the middle of the night seeing perfectly.
Note that if you're much past 10, nobody will do you, so it can't get rid of 2-inch-thick lenses. What it comes down to is your own priorities, what losses you can live with, what risks you can stomach. If you're a couch potato, barfly, gamer, or otherwise sedentary, vision correcting surgery is probably a waste of time, stress, money, and karma. For me, not a day passes where I don't think about it and giggle about the fact that I'm no longer a cripple when I sleep.

Re:Don't - just don't

[Anonymous Coward]

Optometrists are largely in danger of becoming an obsolete species thanks to vision correction surgery.

Say what?

After laser surgery you will still need to see your regular eye doctor once a year -- in fact that will be even more important. Some LASIK companies (e.g., TLC) have lifetime service contracts that are forfeited if you don't get an annual exam.

Also, where will those who aren't candidates for eye surgery go for vision correction?

The only difference is that maybe your eye doctor won't be selling you as many contact lenses -- though that's not true in my case.

Wild horses couldn't drag me into the clinic

[Misfire]

I've worn glasses for myopia full-time since my ninth birthday. I turn 40 in just a few months. Sure, glasses are a pain sometimes, but they work well for me. I've had the same prescription for over twelve years; it still corrects my vision to 20/15.

I'm a programmer/analyst by trade. There is no bloody way I am going to risk my vision on a wacky, unnatural invasive procedure like LASIK. I don't care how good the surgeon is or how minimal the risk is. With my luck, I'd end up being one of the poor souls whose eyesight has been permanently and irretrievably screwed by this procedure.

No, thanks--I'll keep my glasses and my eyesight. To the daredevils out there, I only have one thing to say:

Good luck.