Common questions about the LASIK procedure
You have questions, we have the answers! The following section provides the most frequently asked questions from our patients about our different vision correction procedures. Below, you'll find the answers you need. Just click on your question to reveal the accompanying answer.
About the laser vision correction procedures
You may wonder if there is a difference between LASIK and Lasic, but there is actually no such thing as Lasic. Despite the fact that an internet search for Lasic may lead to some search results, Lasic is simply a common misspelling of LASIK which stands for laser in situ keratomileusis. There are however some variations of the term LASIK, such as LASEK, but Lasic isn’t one of them.
LASIK is the acronym for laser in situ keratomileusis. The name refers to the use of a laser to reshape the cornea without invading the adjacent cell layers. In situ is Latin for "in the natural or normal place". Medically, in situ means "confined to the site of origin without invasion of neighbouring tissues". Kerato is the Greek word for "cornea" and mileusis means "to shape".
LASIK vision correction has been performed around the world for over 25 years. It was first performed in the U.S. in 1991, while PRK was first performed there in 1989. In Canada, both LASIK and PRK were first performed in 1990. The major components of the procedure have a long history. Ophthalmologists have been reshaping the cornea for over 50 years, creating a protective layer of tissue over the cornea for over 35 years, and using the excimer laser since the 1980s.
PRK, or photorefractive keratectomy, laser eye surgery is similar to LASIK eye surgery in the sense that both procedures employ a computer-controlled excimer laser to reshape the cornea of the affected eye. However, during the LASIK procedure, the surgeon preserves the epithelium (the outermost protective layer of the eye) by creating a flap. During PRK vision correction, the epithelium is removed by gently scraping the surface (i.e. no flap is created). Anesthetic drops in the eye ensure that the patient experiences as little discomfort as possible. PRK laser eye surgery is also characterized by a lengthier healing process and greater discomfort than LASIK eye surgery.
There are a number of factors that doctors must evaluate before they can determine who is an eligible candidate for LASIK. Some doctors deem certain pre-existing conditions contraindications to the procedure and will not perform surgery if you possess them. Other conditions may complicate the laser eye surgery and increase your risk of developing a complication. Patients with these conditions need to consult their doctors in regards to eligibility and expectation levels. Learn more about eligibility.
Most surgeons agree that if you are comfortable wearing contact lenses and are not bothered by being dependent on them, you should carefully evaluate the risks and benefits of LASIK. Ultimately, it will depend on your needs and lifestyle.
Patients who have autoimmune disorders (Lupus, rheumatoid arthritis), a history of aggressive scar formation after a skin incision (called Keloids) or those with certain degenerative eye disorders are not eligible for PRK surgery. Your candidacy for PRK surgery will be determined at your preoperative evaluation.
No, you can come in for our free preoperative consultation and even undergo laser vision correction without a referral from your eye doctor. Our team of eye doctors and eye care professionals can evaluate your prescription. During your preoperative consultation our eye doctors will also be able to assess your vision correction needs. However, it is always beneficial to seek the advice of your own eye doctor or your family doctor. We also have a list of LASIK MD affiliate eye doctors in your area.
Results & safety
Most studies show that the LASIK procedure poses minimal risks of complications. The overall complication rate is a fraction of one percent. Even if complications do occur, most of the complications are resolved within three months and do not result in long-term interference with vision. More precisely, the complication rate cited in large studies is between 0.001% and 0.05%. LASIK surgery is a surgical procedure done on a delicate part of the eye and therefore, complications can occur. Learn more about safety. For additional information, read our LASIK Information Booklet by downloading it here.
LASIK surgery improves the uncorrected vision—one's visual capacity while not wearing corrective lenses—in most patients who have the procedure. At LASIK MD, over 96% of patients with low to moderate myopia achieve 20/20 vision or better after the initial laser procedure, which is the visual acuity similar to that with contact lenses. This number increases to over 99% when an enhancement procedure is included, if needed.
However, there are no guarantees that you will have perfect vision. Patients with high myopia (more than -8D) and high hyperopia (more than +4D) should have realistic expectations. People who are most satisfied with the results of laser correction clearly understand the potential risks and complications and possess realistic expectations as to what their vision will be like after surgery.
The effects of the LASIK procedure are permanent. However, it is important to realize that a person's eye can still change internally. That is why many vision correction surgeons recommend having the procedure done after the major eye changes have occurred in one's life. For instance, LASIK eye surgery is not recommended on children because their eyes change a great deal and their vision would need to be fine-tuned in a few years. If the procedure is performed after the age of 18, the chance of long-term stable correction is more likely. Even the eyes of patients over the age of 18 can still change. Therefore, we recommend a good conversation with your eye surgeon so that they can review the changes you have undergone and, if applicable; they can help you make a decision in regards to whether or not you should wait until the changes have slowed down.
Patients should also note that while results are usually stable, they can be modified by enhancement procedures – procedures performed after the initial one – if necessary.
Retreatment may be a viable solution to vision changes later in life. However, it is important to be aware that other treatment options also exist. In due course, you should consult your eye doctor to determine the cause of the change and to determine which option is best for you. If a retreatment is required, a patient must wait at least 3 month after the initial laser eye surgery. Only 1 eye is done at a time (4 weeks between each eye.)
Most patients who have the LASIK procedure do not wear glasses for their daily activities. However, patients may need to wear reading glasses if they are over the age of 40. This is caused by the normal aging of the eye, also known as presbyopia. It is important to note that this condition occurs with or without LASIK vision correction. It is also possible that some patients need a minimal prescription for certain activities, such as night driving. For these instances and more, LASIK MD offers an innovative treatment called Laser PresbyVisionTM. This advanced form of monovision can help you correct blurred vision and restore clarity to your everyday.
Most people in their 40s or older will need reading glasses whether or not their eyes are corrected for distance vision. As we age, our eye loses its lens flexibility, causing blurred vision. This condition, called presbyopia, cannot currently be treated by the LASIK procedure. However it can be treated through other methods, such as Laser PresbyVisionTM, a treatment offered exclusively by LASIK MD.
People in this age group choose Laser PresbyVisionTM, an advanced form of monovision, to correct their presbyopia. This option allows patients to use one of their eyes for distance and the other to better see up close. Compared to other presbyopia procedures, patients who choose Laser PresbyVisionTM see incredible results and adapt even quicker to their enhanced and improved eyesight.
Before making a decision, it is recommended that those interested should discuss the different options to correct presbyopia with our eye care specialists. Most doctors will suggest testing this treatment first with contact lenses for a few weeks prior to getting Laser PresbyVisionTM. Be sure to ask our staff if this trial option is available to you. Learn more about Laser PresbyVisionTM here.
If you undergo LASIK eye surgery to correct your distance vision, you can expect clear overall vision. However, images close to you may not appear as clear after having LASIK eye surgery if you are over 40. After the age of 40, expect to need reading glasses for up-close work.
With LASIK eye surgery, the vast majority of night vision disturbances are eliminated since the area of cornea treated is larger than the dilated pupil size. Some patients may see mild glare, halos or starbursts around lights in dim or low-light conditions temporarily following surgery. These symptoms do not usually interfere with driving at night, or night time activities. For the vast majority, these symptoms are temporary, usually lasting a few days to a week. With newer laser technology, it is extremely rare for these symptoms to be permanent.
Although occurring very rarely, all patients should be aware that dry eyes are a possible complication following LASIK eye surgery. Laser vision correction makes everyone's eyes somewhat dryer afterwards, but only temporarily. Your surgeon will carefully test you for the potential of developing this complication after surgery if you suffer from a history of dry eyes or are bothered by contact lenses. After surgery, all patients should use tear drops as required.
For example, a 2012 study that was published in the journal Ophthalmology had patients undergo LASIK in one eye and PRK in the other. The conclusion was that patients found no differences in perceived dryness from one eye to the other.
Research suggests that post-operative dry eye symptoms are best managed by ensuring a healthy ocular surface prior to laser vision correction, and following the post-operative drop instructions.
Price & payment options
As prices may vary, depending on each patient's specific condition(s), the final quote will be established during your free preoperative consultation. The quoted amount includes Standard or Advanced Custom Wavefront LASIK or PRK surgery, as well as all post-operative visits. Plus, you pay no GST or QST on laser vision correction at LASIK MD.
Although LASIK vision correction is not a cosmetic procedure, it is considered an elective surgery. Such surgeries are covered in many European and Asian countries. However, in the United States and Canada, insurance policies - including Medicare - often will not cover the procedure.
If you reside in the U.S. you should check with your insurance company to see if your policy offers partial or full coverage. In some cases, the cost of the procedure can be covered by medical flex plans that allow pretax dollars to be set aside for medical expenses.
You should check with your employer to see if your company offers this type of benefit, either through the group insurance plan or through a corporate partnership with LASIK MD. Also, you should check with your accountant to see if you can deduct LASIK from your income taxes as a health expense. See more information on insurance coverage.
Patients are given a topical anesthetic (eye drops) to numb the eye, so they experience no pain during the procedure. When the surgeon applies the vacuum ring, the patient experiences a sensation of slight pressure just before his or her vision fades away for a few seconds. Neither the precision flap-making instrument - nor the laser cause any pain or discomfort. For several hours after the procedure, many patients describe a mild "foreign body" sensation, such as after opening the eyes while swimming in chlorinated water. Some people feel as though there is a dirty contact lens in their eye. After the first few hours, this uncomfortable feeling usually subsides.
The procedure is performed with a topical anesthetic (eye drops) that numbs the eye. Patients may be given a small amount of oral sedative to help them relax.
You can have bilateral simultaneous LASIK eye surgery (both eyes done at the same time). In the vast majority of cases, bilateral LASIK eye surgery has been shown to be safe and effective. In fact, more than 95% of people choose to have both eyes done at the same time. If the surgery of your first eye is not perfect, your doctor will likely hold off on proceeding with the second eye.
During the healing process, a number of factors occur that allow the corneal flap to stick back onto the eye.
- The corneal flap made during the LASIK procedure is able to lay flat and aligned for 2 reasons:
- The hinge: The corneal flap is created with a superiorly located hinge. When the flap is laid back down (after the procedure is completed), this hinge allows the flap to remain attached and aligned.
- The "trough": When the corneal flap is created, a trough (the "bed") is created in the cornea which is the exact same size as the flap. A flap that is replaced properly will lie perfectly in this trough. This is more stable than a contact lens which sits on top of the cornea and moves with each blink.
- The sequence of events for corneal flap adherence is as follow:
- Negative suction: During the first few seconds to the first few hours after surgery, the corneal flap begins to stick with the help of negative suction pressure exerted by the cornea. This is the same suction that allows contact lenses to stick to your eyes. If the eye is too dry during this time, the eyelid can spontaneously stick to the flap. Friction with the surface can cause the flap to move. This can occur in about 0.1-0.5% of patients. For this reason, it is important that patients ensure that their eyes are well lubricated with artificial tears. Hitting the flap can also gently move it. This is why it is important not to rub your eyes after surgery.
- Epithelial sealing: During the first few minutes and up to 24 hours after the surgery, the surface epithelium (the transparent surface skin) grows over the incision and seals the flap. Simple lid contact with the flap should not move a flap with sealed epithelium. Moderately hitting the flap (with a finger, mascara, or a drop bottle) will move it.
- Cornea stromal scarring: Finally, after a few weeks to a few months, a scar begins to form around the edge of the flap. This results in the flap being well sealed. Only a severe blow (punch, squash ball) can now move the flap. After 6 months, surgical instruments are required to move a flap.
Recovery from the procedure
It depends on your occupation. Certain jobs that require intense clarity of vision (dentistry and surgery, for example) may be difficult to perform for one or two days. Most patients can return to work the next day, assuming their vision is adequate for their job. However, some people may feel fatigued for a day or so following surgery. Learn more about our recommended activity schedule after surgery.
Patients may experience some discomfort and/or blurred vision for a few hours after laser eye surgery. In addition, most patients receive a sedative prior to vision correction surgery. Therefore, you cannot drive home after undergoing the LASIK procedure and you should plan not to drive for at least 24 hours. Learn more about our recommended activity schedule after surgery.
You can resume most normal activities immediately after laser eye surgery. However, for at least two weeks you will need to avoid activities that could cause perspiration to run into your eyes. You should wear safety glasses while playing contact sports whether or not you have had surgery. If you do not routinely wear safety glasses, your eye surgeon may recommend wearing them for at least one month after LASIK surgery. You will also need to avoid certain activities, such as contact sports and swimming, for at least 1 week. It is important to consult your doctor in regards to the limitations on specific activities following LASIK eye surgery. Learn more about our recommended activity schedule after surgery.
Fast visual recovery characterizes this operation. Most patients achieve good vision the day of surgery and find that their eyes feel fairly normal within a day. However, vision can continue to improve and best vision can still take two to three months to occur, particularly with higher prescriptions. If necessary, adjustments to the surgery, called enhancements, can be done. Hyperopic patients who undergo LASIK vision correction often need to wait longer to see clearly. Typically, it takes one or two weeks to see very fine details, with the final result arriving several months following surgery.
No. Your eyes will look exactly the same.
Common questions about cataracts
A cataract is the clouding of the lens in the eye, which ultimately affects vision. The appearance of cataracts is usually an age-related occurrence, and most people begin to notice them by age 80. At this age, more than half of all North Americans will either have a cataract or have already had cataract surgery. A cataract can occur in either or both eyes but cannot spread from one eye to the other.
The lens is the clear part of the eye that helps to focus light, or an image, on the retina. The retina is the light-sensitive tissue at the back of the eye. In a normal eye, light passes through the transparent lens to the retina. Once it reaches it, light is changed into nerve signals that are sent to the brain. In order for the retina to receive a sharp image, the lens must be clear. But if the lens is cloudy from a cataract, the resulting image will be blurry.
Age-related cataracts develop in two ways: First, clumps of protein reduce the sharpness of the image reaching the retina. Because the lens is mainly made up of water and protein, when the protein begins to clump together, it can cloud the lens and reduce light from reaching the retina. The clouding may become severe enough to cause blurred vision. Most age-related cataracts develop this way. When a cataract is small, the cloudiness affects only a small part of the lens, so you may not notice any changes in your vision. Cataracts tend to "grow" slowly, so vision can worsen gradually. Over time, the cloudy area in the lens may increase, and the cataract may grow, thus making seeing more difficult. Vision will become more dull or blurrier.
The second way in which a cataract can develop is when the lens begins to change colours, taking on a yellow or brownish hue. As the clear lens colours with age, vision may appear to be browner. At first, the tinted vision may not be noticeable. But over time, increased tinting may make it more difficult to see clearly. The gradual change in colouration does not affect the sharpness of the image transmitted to the retina. Those with advanced lens discolouration may not be able to see blues or purples.
The risk of cataract increases as we age. Other risk factors for cataract include:
- Certain diseases (i.e, diabetes);
- Personal behaviour (such as smoking or overconsumption of alcohol);
- The environment (such as a prolonged exposure to ultraviolet sunlight).
The most common symptoms of a cataract are:
- Cloudy or blurry vision.
- Faded colours;
- Glare: Headlights, lamps, or sunlight may appear too bright. Sometimes, the person may notice a halo around lights.
- Poor night vision.
- Double vision or multiple images in one eye. (This symptom may clear as the cataract sizes increases.)
- Frequent prescription changes to your glasses or contact lenses.
These symptoms also can be a sign of other eye problems. If you are experiencing any of these symptoms, check with your ophthalmologist.
Yes. Although most cataracts are related to aging, below is a list of less-commonly occurring cataracts:
- Secondary cataracts: Cataracts can form after surgery for other eye problems, such as glaucoma. Cataracts can also occur in people with other health problems, such as diabetes. They are also sometimes linked to steroid use.
- Traumatic cataracts: Cataracts can sometimes develop following an eye injury. This may take years.
- Congenital cataracts: Some babies are born with cataracts or can develop them in childhood, often in both eyes. These cataracts may be so small that they do not have any effect on vision. But, if they do obstruct vision, then the lenses may need to be removed.
- Radiation cataracts: Cataracts can develop after exposure to certain types of radiation.
Cataracts are detected through a comprehensive eye exam that includes:
- Visual acuity test: This eye chart test measures how well the patient sees from various distances.
- Dilated eye exam: Drops are placed in the patient’s eyes to widen—or dilate—the pupils. An eye care professional uses a special magnifying lens to examine the retina and optic nerve for signs of damage and other eye problems. After the exam, near vision may remain blurred for several hours.
- Tonometry: An instrument measures the pressure inside the eye. Numbing drops may be applied to the eye for this test.
Your ophthalmologist also may conduct other tests to learn more about the structure and health of the eye.
The symptoms of early cataracts may be improved with new glasses, brighter lighting, anti-glare sunglasses, or magnifying lenses. But if any of these steps do not help, surgery may be the only effective treatment. Surgery involves removing the cloudy lens and replacing it with an artificial lens. A cataract only needs to be removed when vision loss interferes with everyday activities, such as driving, reading, or watching TV. An eye care professional will determine the best option.
Sometimes, a cataract should be removed even if it does not interfere with vision. For example, a cataract should be removed if it prevents examination or treatment of another eye problem, such as age-related macular degeneration or diabetic retinopathy. If a patient has cataracts in both eyes that require surgery, the surgery will then be performed unilaterally (on each eye at a separate time).