Refractive Error

No two sets of eyes are the same.  Some eyeballs are too long, or have too much focusing power, causing myopia (nearsightedness).  Others are too short, or have too little focusing power, causing hyperopia (farsightedness). Some eyeballs have uneven curvature, called astigmatism.  Ways to correct such “mechanical” problems include eyeglasses, contact lenses or refractive surgery such as LASIK. Other vision problems are caused by disease or injury, and are not correctable by these means.

The Ideal Candidate for LASIK

The individual should meet the following criteria and discuss them with their eye care professional:

  1. Be at least 18 years of age.

  2. Have a stable prescription for glasses or contacts for at least two years.

  3. Have adequate corneal thickness.

  4. Have naturally occurring myopia, hyperopia, and or astigmatism.

  5. Have no medical disease or vision impairment that could reduce the effectiveness of the procedure.

  6. Be adequately informed of the benefits and risks of the procedure.

  7. Have a desire to reduce their dependence on corrective eyewear.

  8. Have reasonable expectations.

What You Can Expect from LASIK

Following a LASIK surgery, the majority of patients with low to moderate levels of nearsightedness, farsightedness and astigmatism achieve 20/20 vision or better.  That translates to being able to pass the vision portion of their driver’s license test without glasses or contacts and enables them to perform the daily tasks of life.  (In Indiana the level of vision required to drive without glasses is 20/40.) 

The majority of patients also report that the quality of their vision after LASIK is better than what they saw previously with their glasses or contacts.  Each person’s goals are determined by their age and the general health of their eyes, and any special needs should be addressed candidly with the laser surgeon prior to surgery.  If these goals are not fully reached after LASIK, an enhancement follow-up procedure may be able to be performed to further improve vision. 

As with any surgery, there are post-operative instructions and steps to be followed as directed to ensure a complete and successful recuperation and results. LASIK, and related surgeries like PRK and advanced surface ablation, can also be used to treat nearsightedness (myopia), farsightedness (hyperopia) or astigmatism after cataract surgery, corneal transplants, other eye surgeries or corneal injuries.

Finding the Right LASIK Surgeon

The results of LASIK will directly relate to the overall experience of the surgeons and staff within a practice.  To get optimal results, seek a surgeon who:

  • Has completed fellowship training in LASIK

  • Is a corneal specialist

  • Is an active member of the American Society of Cataract and Refractive Surgery

  • Is certified and trained on the latest laser technology

  • Has a proven history of refractive surgery

  • Understands the intricacies of laser vision correction

  • Continually monitors surgical outcomes (LASIK results) and makes them available to patients

  • Is able to provide continuity of pre- and post-operative care after LASIK

Increased Nearsightedness among Americans

A study released in late 2009, conducted by the National Eye Institute, shows that the rate of nearsightedness, or myopia, in Americans has increased from 25% in the ‘70s to 41% this year.  The study included people with a range of myopia from mild to severe.  Myopia occurs if the eyeball is too long or if the cornea, the clear lens in the front of the eye, is too curved. Under these conditions, the eye can’t correctly focus the light entering the eye, making distant objects look blurry.  Typically, myopia occurs in childhood and can continue to worsen until early adulthood.

The study did not point to specific causes other than to note that the increase may be due to genetics, poor outdoor lighting and an increase in close eye work done on computers, video games, and interactive digital tools, such as texting.  Improved access to vision screening and treatment may also be a contributing factor.

The study’s author and research epidemiologist, Susan Vitale of the National Eye Institute, said more research is necessary, and that identifying the problem was an important step.  Myopia is easily treated, but when so many people are impacted - perhaps as many as 40 or 50 million people - it could end up costing the U.S. about $2 to $3 billion annually to diagnose and treat.  The three most common treatments are eyeglasses, contact lenses and refractive eye surgery, such as LASIK.

Eyecare professionals have debated the role of genetics in the development of myopia for many years. Some believe that a tendency toward myopia may be inherited, but the actual disorder results from a combination of environmental and genetic factors.