Oh, well, I guess I had to wade in on this one. Here's what I tell my patients:
LASIK (Laser In Situ Keratomileusis) can be a miraculous procedure for some people, dramatically, nearly instantly changing their entire lives, by allowing them to function without glasses. The great majority of patients are happy with their outcome.
It is, however, not right for everyone.
While it can correct distance vision, it is unable to correct presbyopia, the age related decline in near focusing ability that afflicts us all, usually beginning in our mid forties.
Many myopic (nearsighted) people can continue to read and see up close without glasses for their entire lives, because their eyes are relaxed up close, and do not have to actively focus. When they have LASIK, they become just like the rest of the 'normal' people, and gradually lose their near focusing ability.
As we age, the ability to see clearly up close becomes more and more important, especially as our activities become more limited. The superior near vision of the nearsighted person can offset the effects of eye disease, and allow good near function as old age and more limited activity set in. If you have LASIK, you lose this advantage.
So there's a trade off, diminished near vision for improved distance vision, and it's hard to understand how it feels to be unable to focus up close until it happens to you.
Whether that trade off is right for you depends on a number of factors, among them how nearsighted you are, what kind of activities are most important to you, and how old you are.
If, like Piggy in "Lord of the Flies" you are young and so dependant on your glasses that if they broke you'd starve to death because you couldn't find your food, LASIK could well save your life.
If, at the other extreme, you are old, forgetful, and couldn't see to eat if you misplaced your reading glasses, you might be better off being nearsighted. At least you can see your food.
Most of us fall somewhere between these extremes, and the decision must be individualized.
I, myself, am in my early 50's, mild to moderately nearsighted (-1.50, both eyes).
When I was in my 20's and 30's, I resented wearing glasses or contacts.
When I hit my mid 40's, I became less able to see up close with my glasses on, fine without them.
Today, I still see fine up close, while most of my friends need reading glasses. I've got no glasses on while I'm typing this.
Moreover, my distance vision is not really as bad as I once thought. I can function, if I have to, and get around without my glasses on. As a single guy (again), I can see a woman across the table from me in a restaurant just fine, and don't have to whip out a pair of specs to read the menu. I don't have a pair of "readers" dangling from my neck.
If one of my colleagues said to me "Poof, you're no longer nearsighted", with no surgery, no chance of complications, instant results, I'd say "No, thanks". I'm functioning better than I would be if my distance vision were perfect, both for work, and most of my play. I can get it for free from the best LASIK surgeons around. I haven't. Not because I'm afraid of it, but because I think I'm better off this way.
Personally, I think it might be worth it if you're beyond a -4.00 or so, the point at which you're in trouble without your glasses, and have to hold things really close to read without them, so you're wearing reading glasses anyway. LASIK really can change your life.
Your age enters into it as well. If you're 25, you'll have 20 good years before you need reading glasses. Maybe worth it. If you're 38, you'll have only 6 or 7 good years, maybe you should keep your glasses. Depends on just how thick they are. Get it?
For many people the trade off comes at a lower number, for many, a higher number. Just remember, it's not a panacea, and you have to understand the whole picture when you make the decision whether or not to have LASIK.
All of the above assumes no complications. Generally the procedure is safe and effective, and the large majority of patients are happy with their result. There are, however, a small percentage of patients who will be forever miserable, even in the hands of the best surgeon. Put that into your equation, too. You pays your money and you takes your chances. Good luck.
To sum it all up, yes, LASIK can change your life. Just not right for everyone. Be informed.
Richard E. Charney, M.D.
New York, New York
[This message has been edited by drmyeyes (edited 06-12-2001).]
