My Lasik Experience
A Journey from Blurry to Clear
"With eyes that look'd into the very soul--bright--and as black and burning as coal." ~ Lord Byron
Glasses have been a part of my life since I was six years old. After a few failed attempts of trying to find out why I was suffering from headaches I was taken to the eye doctor where a rather thick pair of lenses were fitted on me.
As I aged the lenses got thicker until, at sixteen, a friend introduced me to the world of contact lenses. For over fifteen years I lived in my contact lenses. So much so, at one point my eye doctor threatened to take them away from me unless I gave my eyes a bigger breather every day.
For the last twelve years I have pretty much gone back to glasses, only occasionally wearing the contacts if I was going out somewhere special or was participating in an activity where contacts were easier than glasses (there is nothing more annoying than having to keep pushing up your glasses when you are hiking uphill on a hot day).
For the last four years I have been thinking about corrective eye surgery. Yes, four years. I like to dwell on things before I make a decision especially if it involves something as invasive as eye surgery. This year I finally decided to take the plunge and asked my eye doctor about it. It just so happened he works with the TLC Laser Eye Center in Toronto and they were meeting with people in a few days in his clinic to assess candidacy.
I scheduled an appointment and my husband and I went to see what they had to say. For both of us this seemed to be the big sell -- and opportunity for them to assess our interest and an opportunity for us to ask questions. Since I had had my yearly eye exam with my doctor already they only tested my corneal thickness by numbing my lens and applying a reader of some sort (sorry I do not know the technical term). It was easy breezy anyway.
We both left with lots of information about what TLC has to offer and tentative plans to visit the Toronto clinic for further tests. So far I was a candidate for their procedures but further tests were in order for accuracy.
Because it would involve a two and half hour drive to Toronto for further examination we decided to check out another option for laser surgery with a closer clinic. We made an appointment with Lasik MD which was only an hour away.
Citation: images copyright M. E. Wood.
Are You Considering Eye Surgery?
TLC or Lasik MD
At Lasik MD I went through a battery of tests on my vision to find the perfect correction and check for any serious problems. The good news was I had healthy eyes and they also considered me a candidate for one of their procedures.
Both eye clinics provided viable options. My final choice didn't come down to one necessarily being better than the other. It came down to the type of surgery I was able to have and what each clinic offered, based on their experience, technology and equipment.
Based on my prescription, pupil size etc Lasik MD would only perform the PRK operation which is more painful and requires a longer healing time because there is NO protective flap created. The post-op care was also more intensive and I would require more help. PRK has been around the longest and is the most common corrective eye surgeries out there.
TLC was offering me a Intralase Bladeless Lasik surgery which involved making a flap with a laser instead of the standard blade. This allows for less of the cornea to be involved as well as leaving the possibility for touch ups in the future should they be required. The bladeless flap method heals quicker and is less painful than PRK. I decided to go with TLC because I felt I would get an excellent result with less pain and shorter healing time; both very important to me.
Pre-op, my vision is completely blurry without my glasses. I can read with one eye if I hold literature about five inches away. If I look in the distance I can see blurry shapes and colors but have no idea what I'm looking at. Could be a tree, could be a person. With my glasses on I can read and see distances like the average person although I have to squint and push the glasses up close to my eyes to read in the distance.
Here is the medical lowdown on my eyes.
As you see, I have a pretty high prescription and what is considered nearsightedness or myopia. It is fairly common. According to the TLC literature "one in four people in North America are nearsighted".
One Week Before Surgery
It is one week before surgery. I am nervous and of course having second thoughts (but not really). Reading about complications and "fraud" within the Lasik community is not helping but I think it's important to get another perspective... but with a grain of salt.
I have no questions about what is going to happen. I just wish I could fast forward to a few days after. I am worried about the pain and discomfort that will come from burning off some of my cornea. I am worried that I will move and they will have to start over making the surgery longer. I am not worried about complications. The percentage of complications compared to the number of surgeries performed is low compared to others surgeries.
I am going to try to relax over the next week. Get lots of rest when I can and drink lots of water so I can go in with healthy and refreshed eyes.
My Procedure - Intralase Bladeless Lasik
This procedure happens in five basic steps:
* Anaesthetic eye drops
* Protect flap created with laser
* Inner cornea lasered to prescription
* Flap replaced and smoothed out
* Go home and sleep
Day of Surgery
When I arrived to TLC Toronto we went over the contract before passing it over. We were directed to the waiting room but before we even had a chance to sit down I was taken to have topographical images of each eye. Then it was back into the waiting room.
Shortly, I was brought into an antechamber (with husband in tow) to sit with four other patients awaiting Lasik. An assistant discussed our eye kits which contained a box of lubricating drops, 4 ativan tablets (to encourage sleep over the next few days), sunglasses, paper tape and two eye patches.
Meeting the Surgeon
We were each taken out one at a time for a mini meeting with the surgeon (Dr Nick Nianiaris) who looked at my eyes and answered any last minute questions. I mentioned I was on a low-dose seizure medication and he said he had successfully completed surgery on higher-dose patients and was confident there wouldn't be a problem unless my seizures were previously related to flashing lights (they are not).
Drugs and Drops
Back in the antechamber I sat in a recliner and had freezing drops put into each eye. An ativan was offered to calm me and I accepted (we all did!). They worked quickly. There was lots of humor to be found amongst the other patients which helped too. It probably had something to do with the cute head bonnets and little booties we all had to wear. One by one we were taken into the surgical room.
The Surgical Room
When my time came up I was taken into the room next to the antechamber where I was instructed to sit on a table between two machines and had to shimmy my way back and lie down with my head toward the Doctor. Throughout the whole procedure he talked me through the steps. In the beginning I was asked to stare at a red light while he put a suction cup like device over one eye to keep it from moving. The other eye was closed with a piece of cotton and taped.
The incision was made, I was asked to close my eye and it was covered while the incision was made on the other eye. The table I was on was pivoted so the other eye could be done. Next up was the laser that shapes the cornea. Back to the right eye. The machine made a loud clicking sound as it worked and it almost reminded me of being in an MRI machine (but a little quieter). Some people told me this process would smell like burning hair but it smelled like something else to me. I can't put it into words but it was something familiar. Then the other eye. When it came time to return the flaps to the closed position I could see a little plastic brush as it brushed the flap smooth. It was actually kind of cool. Vision wise, I was able to follow the red light; sometimes it was clear, fuzzy or completely blacked out. They helped me to get up when it was over. The surgery was quick, about 15 minutes total, including the time to get me settled and into position.
The assistant was gracious and took a picture of me and the doctor when my husband asked. He was able to watch the whole procedure from outside the windowed room on a monitor that was turned toward the window.
I Can See (sort of)
When I sat up from the table I could see clearer than without my glasses but everything had a fuzzy hue to it (almost dreamy) and I was a bit out of it from the ativan. I had a hard time keeping my eyes open; I think because they stung so much. I was directed back to the antechamber and sat in the recliner with my eyes closed before going to see an optometrist to confirm the flaps were properly closed. Then I was ready to go.
At this point the freezing was well off. I was a bit off balance and my eyes stung like I had stuck my head into a vat of freshly chopped onions with my eyes open. We had a two hour drive home and this feeling seemed to get worse. We stopped at one point so I could take an Advil and put in a bunch of Refresh Plus Lubricating Eye Drops. I slept for another hour on the way home and when I woke up I felt a bit better. I could open my eyes and actually look around at this point. This is going to sound weird but things were clear but not clear... When we got home I had some more drops and went to bed for two hours. I woke up feeling substantially better. I couldn't believe what a difference a few drops and a couple hours sleep made.
Support, Laughter and Distractions
My husband has helped a lot. Driving me to and from the appointment, instilling the drops when I can't get them into the eye, making meals, doing dishes and providing entertainment. Since I couldn't watch TV for the first 24 - 48 hours, a friend from work loaned my husband that we listened to with supper and into the evening (when I wasn't sleeping). I highly recommend it. Laughter is good medicine (and a good distraction). The night before surgery I downloaded a few audio books from Stuart McLean's The Vinyl CafÃ© Stories CDProject Gutenburg to listen to over the next week.
12 Hours Later
When I got up from the table things were blurry from the drops in my eyes but I could definitely see peoples faces. At the moment when I remove the mandatory sunglasses to look around everything seems pretty clear. Objects are visible and clear but light sources have an aura around them. Rest definitely helps.
I have a bit of eye bruising on the whites of the eyes that I expected to be worse and really have no concern about. My eyes are puffy and I'm looking forward to seeing what the doctor has to say tomorrow when I go for my 24 hour check up.
I started one of my audio books - Dracula by Bram Stoker; which is fabulous.
During the Surgery
15 Minutes Later
They Be Angry
For the days, weeks and months following my eye surgery there are a number of restrictions to my activities of daily living until my healing process is complete.
- For two days following surgery, protective eyewear must be worn at all times (I wore my shades in doors and outdoors for one week then just outdoors).
- Night shields are worn at night while sleeping for two nights (I wore mine for one week).
- No showering for first 24 hours and no water or shampoo in eyes for 3 - 4 days (I did a 1/2 shower with a wand for one week and leaned backwards over the tub to have my hair washed).
- No soaps or creams near eyes for one week (two weeks before I used a gentle eye make up remover on eyes).
- No make up for one week and all eye make up must be replaced, especially eyeshadow, mascara and eyeliner (I went two weeks without makeup).
- No swimming or other water activities for one week.
- No gardening for two weeks (this was very hard for me. I cheated and dead headed my daisies and other spent plants but regretted it afterwards - big nap).
- No exercise or weights for two weeks.
- No contact sports for one month.
- No driving for first 24 hours until approved by optometrist.
- No reading, computer, or television for first 24 - 48 hours (Killer!, but I did it for three days. Audio books and sleeping filled my days).
- Avoid dirty environments for at least one week.
- Unpreserved eyedrops for one week (I went for four).
One Day Later
Thirty-six hours later and there is significant improvement pain wise. I went to see my optometrist a few hours ago and I've been cleared for driving! Although, I really don't want to. He did a simple reading of the eye chart with each eye and I did really well. The second up from the bottom. I was so excited I for got to ask what it was but I remember him saying it was good. He looked at my eyes with the microscope and that was it for today. Everything looks good.
It feels weird to be able to see every thing. The optometrist will wait until the one month point before he sends a letter to the MTO clearing me from glasses and contacts while driving. I'm not too worried about that at this point though.
I'm feeling better today and it definitely helps to sleep a LOT (or at least rest with my eyes closed) and keep up with the lubricating drops. I had a two hour nap this afternoon and every time I wake up I feel an improvement. My next visit is in one week.
My Subcojunctival Hemorrphages
Saturday / Sunday / Tuesday
I got up a few times during the night for drops. My right eye feels perfectly fine to me but my left eye still has a tender prickly spot that I feel when I blink. I'm going to nap a bit after breakfast in the chair.
Last night my husband and I went for a drive and I noticed large halos around vehicle lights. I don't think they will be an interference with my night driving (I had glares before surgery), not that I do a lot of night driving anyway. It's also really early in the healing process and I expect it to improve at least somewhat.
Another day of resting! The Prednisone drops have been reduced from every hour to four times a day for the next 5 days, which helps but I expect the inflammation will pick up a bit.
Drops reduced. Vision better, still some ocular tenderness and a bit of fuzziness around lights. Vision appears sharper. Reading is normal.
My vision is almost perfect today. I can't see clearly up close, like to look at a hangnail on my finger, but my vision was like that prior when I wore contacts. I definitely have a wider range of vision now.
I'm quite impatient for perfection which is funny considering how bad my vision was and how improved it is. When I think about it I'm mesmerized by all the things I'm able to see around me.
I have been increasing my activity level and reducing my naps which I've noticed has increased my need for lubricating drop. I'm currently using Refresh Plus Lubricant drops with no preservatives. They are single use ampules (recommended by TLC). I will probably continue to use them for another week before switching to a more economical form of eye drops. My eyes were sensitive to regular drops and I can only imagine how my eyes would react now.
A few more days and I visit the optometrist for my one week check-up.
A Necessary Tool After Lasik Surgery - Lubricating Eye Drops
I'm familiar with Allergan products, having worn contact lenses for over 15 years. This product has been a lifesaver for my ultra sensitive eyes during my recovery from Lasik surgery. The handy ampules are easy to open and fit in the little pocket of my purse for easy access.
One Week Later
It was an interesting day. My eyes have been bothering me since I stopped the medicated drops yesterday morning. They are a lot dryer and seem swollen. I can't seem to use enough lubricating drops. The optometrist said there is some swelling in both eyes but a little more so in the right eye. There is also a ripple in the cornea of the right eye. Hearing that kind of freaked me out a bit.
Vision wise, I've lost some acuity -- 2 lines from the reading chart from last week (I also had a hard time seeing signs when we were out and about). My optometrist consulted with TLC about the swelling, ripple etc to see if I should go back on the drops but they decided against it. I have to go back in on Tuesday to have them looked at again. This is an extra visit but I'm obviously willing to do it.
My prescription was really high and it could be a recession. They mentioned the possibility of a retreatment depending on how the next few weeks go. I'm hoping not. I'm a bit concerned but at the same time I know logically it's only been a week and I've always been a bit of a slow healer to begin with so I'm going to try to rest with my eyes closed as much as possible (apparently they heal better that way) over the weekend. I will continue with my lubricating drops (I don't think all the air conditioning helps either--it's so bloody hot out).
Regardless of the regression I think I still see better than when I had my glasses. More to come...
It was a good visit. My vision has improved back to the original reading the day after surgery. Phew! I still have a ripple in my right eye as well as some swelling so he wants me to come back in a week to check on it. He expects it to be improved but wants to be cautious. I can live with that.
He also suggested that I step up the lubricating drops to every hour while I'm awake. Otherwise he said the other eye looks perfect. There's still some swelling but it is to be expected. I have another appointment scheduled for next Monday and if all goes well the next one will be a month after that.
Enlist the Help of a Friend or Loved One
Having my husband drive me and knowing he was just on the other side of the window during the procedure was a significant help.
So was the fact he was able to drive me, feed me, and administer eye drops when I just couldn't find the target.
The Following Week
It's been almost a week since my last visit. I was counting on this being it until the one month mark but it doesn't look like it will be so.
My vision is good today and the ripple in my right eye, as well as the swelling, has improved since last week. My left eye still appears to be suffering from dryness, so much so that the optometrist thinks that my eyelid may have stuck to my cornea on getting up one morning.
This sounds incredibly serious, but it is only visible on a microscopic level. So no, my flap isn't hanging on my eye. The dryness has affected the edges of the flap enough that it feels like a little needle poking my eyelid when they become dry. Kind of like a hangnail of the cornea. The good news is the right eye is doing really well.
I have to continue with my hourly lubricating drops and have set a timer to make sure I'm getting them accurately. The optometrist has also given me some GenTeal Gel drops for bedtime. It kind of looks like Vaseline that's been mixed with a bit of water. He suggested I try using them when I'm on the comptuter for long periods (we blink less when concentrating).
He wants to see me again on Wednesday which kind of got my radar up a bit.
Both eyes are better than Monday but because I'm still complaining of discomfort, edema is still present and so is the little lip on the flap; he wants to see me again on Friday.
He's suggested some more drops to try. For the next few days I'll be using the Refresh drops every hour, the Gen Teal Gel drops 3 - 4 times a day (especially before I go on the computer) and MURO 128 ointment at night. The Muro is to help with the edema that occurs at night.
The optometrist says my eyes are significantly better than 48 hours ago. The edema has reduced, the ripples are almost gone and there are only a few dry patches on the left eye. He wants me to continue with the current regiment and see me again next Thursday. Almost a week later, so that's progress.
Vision wise, I don't feel it's changed much from the other day; although, from his testing he says it has. From a feeling perspective they feel incredibly better. I don't have that dried on contact sensation which I think was probably produced by the edema pushing against my eyelids. I still feel like I definitely need the hour Refresh drops so I'm glad to continue with those. I'm hoping another week of the MURO ointment will produce even better results for my Thursday appointment.
One Month Later
In two days it will be one month since I had my laser surgery. I was told today I haven't had the average recovery but things are definitely improving in regard to the dry spots and edema. Unfortunately, I had quite a bit of nearsightedness when he tested my acuity today. I have noticed a change since yesterday, having difficulty reading advertising signs and the subtitles on the television. The headaches started a few days ago. This could be a combination of the eye strain and the fact my neck is incredibly sore from having to tilt my head back every hour for eye drops.
My vision seems fine for everyday stuff around the house and working on the computer. In fact this past week working on the computer has been much easier although after a few hours I find I need to rest with my eyes closed to recover a bit. I can't imagine having to go back to work at a 8 - 10 hour standard job three days after the surgery. It's been a good thing I work from home and DH is off from school. Pain wise, I don't have that picking feeling I've been suffering from. I'm going to owe that to the MURO ointment at bedtime for the edema and lots of resting with eyes closed. They still feel a bit raw (too strong of a word) in general but overall I've definitely noticed progress in healing.
The bruising on the whites of my eyes is virtually gone.
He wants to see me in two weeks. Progress! Normally, if all was going according to schedule my next visit would be in three months. Until then he wants me to continue with the MURO ointment at night, the gel tears 3 - 4 times a day and to gradually try and wean off the hourly lubricating drops. Beginning with every two hours for the next 3 - 4 days to see how it feels. If I need more then I'm to use more.
Other than the near sightedness that has developed over the last few days I'm feeling better than my check in a week ago. I think I mentioned before that a regression would lead to a touch-up surgery down the road (3 month mark) but I'm not really open to that at this point. My vision can change numerous times over the next few weeks before I'm completely healed which is why they wait a least three months to do any touch-ups.
See you in two weeks!
"Complete visual recovery can take 3 - 6 months."
Two Weeks Later (6 Weeks Total)
The past two weeks have been interesting. Overall, they almost feel normal. Last week I had a picky feeling for about a day or so in my left eye as I adjusted to reducing the drops from hourly to a more manageable schedule.
Current eye drop schedule: Muro at bed time, Gel Tears 3 - 4 times a day with Refresh drops in between these and as needed. So about every 2 - 3 hours depending on how they are feeling and what I'm doing.
Vision: I still don't have clear distant vision and last week reading the sub-titles on the television was difficult without squinting. This week I find that my vision seems to become a bit clearer later in the day; around supper, and then gets a bit blurry into the even. Close vision is fine. And really, my vision is incredible when compared to what it was like pre-surgery.
Doctor's Visit: He told me that the visual health of the eye looks great and has improved in the last two weeks. He wants me to continue with the Muro, gel tears and other drops. There's still a raised dry area on the left eye but he says it is very very very small. At this point he doesn't think I will need another corrective surgery. He's thinking I have pseudo-focus myopia which is caused by my eyes trying to focus too hard after having a high index for so long. The muscles controlling the focusing haven't learned to relax yet. He thinks given time they will adjust. Totally good news.
Other good news? He doesn't want to see me for a month. Wahoo!
Another Month, Another Appointment (11 Weeks Total)
It has been one month (actually 5 weeks) since I last visited the eye doctor. My vision has improved 50%. I actually knew that before I went, well not the percentage but I knew there was an improvement as I've been able to read the street signs that I couldn't a month ago.
The amount of correction required is so much that they wouldn't do a surgical correction and he said he'd be embarrassed to actually prescribe my glasses for such a small prescription. I'm not in any hurry to go under the laser again and I don't want to jump into another pair of glasses yet. I think my eyes still need time to adjust and I'm patient enough to wait.
There is still a tiny dry spot on the left eye so he wants me to continue with the Muro eye ointment at bedtime and my other drops a few times a day as needed.
Overall, he says that the eyes look good and that the pseudo-focus myopia I mentioned last month is a definite based on my descriptions and what he's seen in improvement. It could continue to improve or it could come and go in the future based on my degree of tiredness, eyestrain or night driving.
It is such a wonderful thing to be able to look around me and see without some kind of corrective eyewear. I'm feeling so much better about having had the surgery. Time and healing really do make a difference on perspective.
My next visit will be in six weeks.
Three Months Later
Actually it has been four months since my surgery. Things are going great. I only need to use my Refresh eye drops once or twice or day. My distance vision has improved although it seems to worsen if I have an intense day or an abundance of eye strain or haven't had enough sleep. I still use the Gen Teal drops or the Muro 128 at night.
My visit with the eye doctor went well. I have perfect vision in the right and just less than perfect in the left. The left one still maintains the little dry spot which he thinks might be what's spoiling the vision. He wants me to continue with the Muro at night but he said I can taper it off over the next few weeks. He doesn't want me to stop using it cold turkey in case it causes a regression.
My next visit will be in four months (only because I had my regularly scheduled appointment all ready booked).
Six Months Later
It's been six months since I had my laser eye surgery. Things are so much better today. I have been enjoying the freedom of not having glasses and have a good laugh every morning when I reach for the bedside table to grab the spectacles that no longer reside there.
My greatest problem these days is dryness. Some days it seems unbearable while others I may not even think about it. The joy of having dry heat in the winter months. I still don't have to use as many drops as I had to in the beginning but they sure do feel good when I need to. My best advice is to have your drops with you at all times because you never know if it's going to be dry or windy.
My next visit to the Eye Doc is in a few months and in the mean time I'm just going to enjoy seeing the world around me in a whole new way.
One Year Later
I had my last eye surgery exam today. The doctor gave my eyes a good bill of health. He said I still have a fraction of nearsightedness but nothing he would prescribe frames for. He gave me a regular daily low preservative drop to try (Systane) and recommended that I continue to use the Muro as needed.
Currently I'm using the Muro about once or twice a month. Eventually I won't need to use it at all. I'm still using the Refresh Plus but only one to six times a day depending on the day and activities.
Overall, I'm pleased and feeling more comfortable about the results. I can't say however that I would run out and go through the process again. But I'm happy that I had the guts to go through with it and that the majority of the healing stage has passed.
Feel free to ask me any questions in the comments below and I'll do my best to answer.
The Future Looks Bright!
A Few Years Later
I had an appointment with my optometrist yesterday so I thought it would be a good time to give an update. I still suffer with dry eyes throughout the day --- I guess I really should not use the word "suffer" because I am hardly suffering. My eyes get dry, I add a few drops, probably a couple times a day and before bed. When there is air conditioning I tend to need more. That being said, I had to use a lot of drops when I wore contact lenses too. I have completely switched over to the Systane drop which has less preservatives in them so I do not have to worry about stinging eyes.
On the brighter side, he said my vision had actually improved a bit since my last visit so that was definitely good to hear.
I never get tired of waking up in the morning and being surprised that I can see everything in the room -- no more leaning over and squinting at the clock to see what time it is! It is the little things that make me happy.
Five Years Later
In one month it will have been five years since I had my surgery. It is hard to believe how quickly the time has passed. Five years seems like a long time to get used to not having worn glasses but I still occasionally stretch across the bed in the morning to grab them or reach up to face to adjust them. It always makes me smile to myself, "Oh, yeah".
I just had my yearly exam last week and was told my eyes look great. There is some minor recession but not enough to warrant glasses unless I feel the need. Sometimes I find myself squinting at subtitles on the TV but otherwise I feel like I have clear vision.
The clearness is still affected by air dryness from air conditioning, wind etc and I find I will have to use extra drops.
Speaking of drops, they have become a part of my life. I lubricate my eyes first thing in the morning when I rise and will use drops throughout the day from two to five times depending on what I am doing and what the air quality is like. At night I am still using the Muro 128 drops and the eye doctor thinks I should continue to use them even though there is no sign of edema. I am more than willing to do that to keep the eyes healthy. It is a minor inconvenience as I had to use eye drops with contacts anyway.
It seemed like a good time to touch base. This will probably be my last update unless there is a significant change in my vision. I am thinking I will check back in another five years (and to answer any comments of course).
The Downside of Lasik
I was good at detecting spiders across the room before I had Lasik surgery, now I am phenomenal at it. Even in the shower -- where previously a spider may have had the opportunity to go undetected because I did not have my glasses on. I pity the spider who comes under my radar -- boxes of Kleenex will fly!
The downside for me is that I am probably seeing all the spiders I missed before so my anxiety level is high, especially in the summer time. And so is my husband's as he is the official designated spider caregiver -- the one who puts them back outside -- or if it is 3 a.m. smushes them.
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