Refractive surgery (glasses prescription)
Refractive surgery reshapes the cornea to try to reduce dependence on glasses. Not everyone is a candidate, and some people still need glasses afterwards. This page helps you come to the examination with the right questions.
What is refractive surgery?
A refractive error means the eye does not focus light exactly on the retina. Common types:
- Short-sightedness. Distant objects look blurred.
- Long-sightedness. Near objects look blurred.
- Astigmatism. Both near and far may look blurred or distorted.
- Presbyopia. From middle age, seeing up close becomes harder.
Glasses are the simplest and safest way to correct vision. Contact lenses are another. Surgery is a further option that some people choose after an examination. The most common type reshapes the cornea, the clear layer at the front of the eye, with a laser. In some people, lens surgery is also considered. There are different methods, and the examination decides which is most suitable.
Who is it for?
Common requirements, according to the source we read:
- Age 18 or over, and preferably after 21
- A prescription that has been stable over about the past year
- A thick, healthy cornea and good general eye health
- Realistic expectations of the result
Usually not suitable:
- An unstable or very high prescription
- Severe dry eye
- A thin cornea, corneal scars or keratoconus
- Advanced glaucoma
- A cataract that affects vision
- Some past eye infections
- Diabetes that is not under control
Not everyone is a candidate. If the examination shows you are not suitable, that does not mean there is anything wrong with your eyes. Glasses and contact lenses are good, safe options.
How is it done?
The full examination before the operation includes measuring vision, checking eye health, measuring corneal thickness and mapping the corneal surface. The results help plan the laser.
The details of the operation depend on the method chosen. In LASIK, a well-known method:
- It is done as an outpatient and the eye is numbed with drops.
- A thin flap of the cornea is lifted, the tissue is shaped with a laser, and the flap is put back in place.
- After the operation an eye shield may be given, and sometimes it is needed for a few nights.
There are other methods too, each with its own advantages, disadvantages and healing time. At the examination, ask which method is being considered for your eyes and why.
Recovery
- Stinging or a scratchy feeling in the eye may last a few hours. Lubricating drops are usually given.
- The source says dry eye and changes in vision through the day are very common and usually lessen within about a month. For some people it takes longer.
- We have no set time for returning to work and driving. It depends on the method and on how your eye heals, and the doctor decides.
- Use the drops and attend the follow-up visits as instructed.
Risks
Common and usually temporary:
- Discomfort, dryness and blurring of the eye
- Halos, glare or starbursts around lights, especially at night
- Double vision
- Sensitivity to light
- A small red patch on the white of the eye, which goes away by itself
Rare but serious:
- Infection
- Worse vision even with glasses
- In very rare cases, loss of sight
Vision may be corrected less or more than intended. Sometimes this is made up for with glasses, contact lenses or a further procedure. Some people need glasses for reading or at night after the operation.
When to call
After the operation, contact the doctor or the treatment centre the same day if you have:
- Pain that gets worse or is not eased by simple painkillers
- Redness that gets worse
- Falling vision
If you suddenly get a dark curtain, new flashes, many more floaters or a sudden loss of vision, go to the emergency department at once. See the full list in the guide “When should I get urgent help?”.
Frequently asked questions
Will I definitely not need glasses after the operation?
No. Many people need glasses less, and some do not need them at all, but you may still need them for things like reading or driving at night. No honest doctor guarantees the result.
Why do I need reading glasses again after forty?
Because of presbyopia. With age the lens loses its ability to focus on near objects. Refractive surgery does not correct this. A source says almost everyone, with or without surgery, needs reading glasses at around forty to forty-five.
Who is not operated on?
According to the source, they include people whose prescription is not yet stable or is very high, people with severe dry eye, a thin cornea, corneal scars or corneal disease (such as keratoconus), advanced glaucoma or a cataract that affects vision, or diabetes that is not under control. A careful examination shows whether you are a candidate.
From what age can it be done?
The source says from age 18 and over when the prescription has become stable, and preferably after 21. A stable prescription has to be confirmed by examination.
Are there serious side effects?
Side effects such as dry eye, halos, glare around lights and temporary blurring are common and usually improve. Serious complications such as infection or worse vision even with glasses are rare but they do exist. Go over the risks with the doctor before you decide.