Hyperopia

Hyperopia is the medical term for `farsightedness.' It occurs when an eye is too short for the cornea's curvature. Light rays entering the eye focus behind the retina, and as a result a blurred image is produced.

Farsighted individuals, however, can use their focusing muscles to 'pull' the image forward onto the retina. In a young person with severe hyperopia, or once presbyopia sets in around age 45, distant objects are seen more clearly than near objects. Certain laser technologies, such as holmium lasers and hyperopic LASIK may correct this condition. 

Presbyopia

Presbyopia is the normal process of aging, where the natural lens of the eye loses some of the flexibility that characterizes a younger eye. This usually occurs at age 40-50. Everyone experiences presbyopia, some sooner, some later. Because of this normal process, nearsighted people begin to wear bifocals in their forties, and those who never needed glasses before may require reading glasses.

The one advantage to mild myopia is the ability to remove your glasses after age 40 and continue to read (your myopia effectively counteracts your presbyopia). After having the excimer laser procedure, you will lose this ability. You will typically be normally sighted after the procedure, and you will need reading glasses for small print, like every other normally sighted person at age 40-50.

The excimer laser has no effect on your focusing muscles. Patients who are experiencing the effects of presbyopia cannot be helped by the excimer laser, however, there are new techniques being developed for this condition. Ask your doctor if you are a candidate for these new procedures.

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Q: What is "LASIK"?

A: "LASIK" stands for Laser Assisted in-Situ Keratomileusis.

LASIK is the most technologically advanced method to reduce dependence upon eyewear. Technically speaking, it is extremely precise--removing 0.25 microns/pulse of a surface which amounts to 1/200th of a human hair, 1/40th of a human cell, and 39 millionth of an inch in 12 billionth of a second. Basically said, LASIK correct the curvature of the cornea so light can properly enter and be translated for clearer vision. LASIK DOES NOT ELIMINATE THE NEED FOR READING GLASSES OR MONOVISION.

LASIK is a combination of PRK (>8 yr hx) and Keratomileusis (>40 yr hx). To date, no signs of long-term progressive damage have been observed.

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Q: What Are The Steps In The LASIK Procedure?

A:The entire LASIK procedure, including the surgery, takes only about 15 minutes to complete. LASIK procedures are completely painless. Patients are always amazed at the ease of this procedure because of their speed and comfort. We use a topical anesthetic drop to numb the eye for the procedures. An eyelid holder is inserted to prevent blinking while the drops eliminate the reflex to blink.

Step 1. A suction ring is placed on the eye to secure the eye and maintain pressure within the eye while the corneal flap is created.

Step 2. A microkeratome, an automated microsurgical instrument similar in design to a carpenter's plane, is used to create a thin corneal flap which remains hinged by the nose or beneath the upper eyelid. The corneal flap is 160 to 180 microns thick, about 30% the corneal thickness which is typically about 550 microns. The creation of corneal flaps has actually been performed for four decades providing us with a long history of safety and stability. Patients do not feel or see the cutting of the corneal flap, which takes only a few seconds.

Step 3. The corneal flap is then laid back and the inner stromal layers of the cornea lasered with the patient's prescription.

Step 4. The corneal flap is then closed and the flap and interface rinsed.

Once the procedure is completed, we will wait a few minutes to ensure the corneal flap has fully re-adhered. At this point, patients can blink normally and the corneal flap remains secured in position by the natural suction within the cornea. While it is possible to dislodge the corneal flap during the first day or two by physically rubbing the eye, this event is actually quite rare. After the first week, LASIK patients can resume their full exercise activities.

Since the protective layer remains intact with LASIK, no bandage contact lens is required and an examination is only required on the first post-operative day. LASIK patients are only placed on an antibiotic and anti-inflammatory drop for 4 days. Vision is usually quite good the following day with LASIK.

LASIK patients are instructed to wear a protective eye shield while sleeping for 4 days to prevent accidental trauma to the cornea flap during the early healing period. Patients are able to fly immediately after both procedures and exercise and swim after 1 week.

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A:  Before you proceed with laser vision correction, we strongly suggest you have an in-person pre-procedure consultation with your eye doctor, even if you were pre-qualified on our site. The primary objective of the in-person consultation is to determine whether you are truly a candidate for laser vision correction, and if so, which procedure would be most appropriate for you. If you schedule a consultation, there is no obligation to move forward with the procedure.

In general, to be a good candidate for laser vision correction you should:

• Be at least 18 years of age or older.
• Have stable vision for a year prior to the procedure.
• Be free of certain diseases of the cornea and retina.
• Be in good general health.

Aside from these general requirements, we recommend you have a number of visual tests to determine whether you are a candidate. Your eye doctor can perform most of these tests.

It is important for you to realize that even if it is determined that you are NOT a candidate today, it does not mean that you will not be a candidate in the future. However, laser vision correction is not for everyone, and some patients (for example, those with certain diseases of the eye), will never be candidates. The best way for you to find this out is by having a thorough examination with your eye doctor.

The secondary objective of the in-person consultation is to educate you regarding all aspects of laser vision correction. Learning everything you can about your options is the key to making an informed decision. The consultation process will help you to understand what you can reasonably expect from the procedure.

Your Eye Doctor’s Role

The pre-procedure part of your care is typically provided by your own eye doctor, in an environment, which is familiar and comfortable for you. Your eye doctor's role is to:

• Educate you about the laser and your other vision correction alternatives.
• Perform your pre-procedure testing and evaluation.
• Provide your post-procedure follow-up care.
• Prescribe glasses or contact lenses for any visual problems not treated (e.g. reading glasses for presbyopia), or those needed between treatments.
• Monitor the health of your eyes, on an on-going basis.

We believe that having your own eye doctor co-managing your care at every possible stage makes the procedure a more comfortable and positive experience for you. We will work very closely with your eye doctor to provide you with the highest level of care and results.

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