Wednesday, August 02, 2006

My Lasik Review

I know, an odd title for a medical procedure. But I had to write about it.


Last summer my wife had Custom Vue Lasik done at the local eye doctor (Dr. Coleman’s in Fredericksburg, VA). She went from 20/800 to 20/20 in a day. Yes, her vision was that bad. She couldn’t see the alarm clock in the morning nor her toes in the shower. She was pleased with the outcome and insisted that I do the same.

My vision was never that bad. I was about 20/200 at the time of the procedure, so I didn’t expect that much of a reaction to the improvement. I didn’t even have to wear glasses until I was in high school. In college I started wearing contacts and continued to wear them. Pushing glasses up your sweaty nose every 30 seconds wasn’t fun. Contacts were much easier.

Over time my vision got a little worse each year until it started to level out some the past few years. I figured I’d stay at that range for a decade or so until old age started to hit harder.


So a few months ago I went to Dr. Coleman’s for my preliminary exam for Lasik. We had planned it with our insurance since last year, but it was finally time to get things going. My preliminary exams all looked good and everyone I talked to was pleasant and professional. Then comes the stunning news.

I have a droopy eyelid. Nothing too major, but it was pronounced enough to be noticed. It was news to me. I never noticed any change in my eyelid in all the years I had been able to look in the mirror. Not even when I put my contacts in.

During my second check-up (still pre-Lasik) there were more tests done, including a trip to another eye-doctor (same office, just a different doctor) to give a second opinion on the droopy eyelid (as well as the original intent to check my retina). My corneas were slightly damaged from wearing contacts for so long, so I got to take drops for that. And he scheduled another appointment for more tests for the droopy eyelid. He also told me more about the droopy eyelid (medically known as a ptosis) and believed it to be a mild case of Horner’s Syndrome.

During my next visit I got to take a Vision Field Test. The most bizarre eye test I’ve ever taken. You stick her head in an egg (think Mork from Ork) and stare at a light. When you see little dots appear, you click a button. After awhile you start to hallucinate and see spots everywhere. Not fun but the results were good. After that, he looked at my corneas and said I could stop the drops. In case I hadn’t mentioned it already, by this time I had stopped wearing contacts for about a month.

During the next visit I got to meet with Dr. Coleman himself and he checked out the droopy eyelid situation. We were a few days from the procedure, so time was short. He didn’t see any need to cause alarm or not do the procedure. He tested my color vision (I’m not color-blind) and my pupils (another symptom of Horner’s Syndrome) and asked about my general health in the past. There was some interest in my previous eye injury (I banged my right eyebrow on a table corner in middle school and got a black eye and some busted blood vessels in my eye) but no positive link to the injury and the ptosis (which is the same eye, the right one).

But he advised me he would be checking with my regular doctor to see if he had an opinion. After a couple of phone calls, it was decided I needed to see my regular doctor for a general checkup before I could get approved for Lasik. A first for the Lasik people. My regular doctor said I was fine for Lasik (he even put in a call to a neurologist) but recommended a visit to a neuron doctor for further tests when I had time (I go later this month).

Now we’re up to the day before the procedure. The Wavescan. You simply stare at a light for a few minutes while they take pictures of your eye. Don’t focus on the light, just look down the “tunnel.” I’m also taking some drops and scrubbing my eyelids (both to prevent infection).


The procedure itself was bearable. There was some pain involved, but not the kind you might be thinking. The morning of, you take more drops and a pill (it was supposed to calm me down and slightly sedate me, but I must be too big because it didn’t do much). You get there and take more drops (to numb your eyes). You get to wear fancy shoe covers and a head cover (slightly itchy on your head but you soon forget about it). The Lasik room was supposed to be super-cold, but it was comfortable to me, so bring a jacket. My thermostat is “broken” according to my wife.

You lay down on the little bench with your feet slightly higher than your head. They swing you under the laser after more drops. Then the fun begins. They start by taping your upper eyelid and putting in a “spreader” (for lack of a better word) for your bottom lid. Your other eye is covered with a patch. The “spreader” feels a little funny but your eye doesn’t dry out and the tape doesn’t even hurt when it comes off.

Time for more fun. They mark your eye (I assume) for where they’ll be cutting the cornea open (they cut a single flap like a C, not several flaps like a pie slice). Then the pain sets in. The put the cutting device on your eye, line it up, push down, and cut. You hear a little buzzing when they cut, but nothing as bad as a dentist’s drill. The pain comes from the pressure, which on my right eye I think they had it kind of funny because it hurt more than my left eye. How much pain? Stick your thumb in your eye until it “blacks out” a bit. It hurts a little more than that. The cutting, scraping, lasering, drops, nothing else hurts. Just this one moment. Total time of pain was maybe 5 seconds.

After they make the flap, they take this little scraper (think of a plastic putty knife) and scrape things down. Not sure why, but they did. Looked funny because everything was blurry, but you could still see what they were doing.

Now we get some lasers in the eye. You focus on a light and do your best not to move your eye, your head, or your body (answer there questions with words, not head nods). The laser looks blue with a hint of purple. You can actually see it moving around your eye doing its job. Sometimes in a solid beam, sometimes split up. And be ready to smell some burning flesh. They are using a laser on your body after all. It doesn’t smell much, but enough to notice.

They scrape again and move the flap back into position and remove the lid spreader. The whole process is repeated for the other eye. Again, not a lot of pain involved, but some when they push your eye in for the cut.

Total time for the procedure was about 20 minutes.


Be ready to take a nap after your Lasik. They tell you to take the other sedative pill, but I didn’t. I just slept on and off all day. Which of course made it hard to sleep that night. You get to wear the “birth control” goggles to protect your eyes and put in countless drops over the next week. Space out your drops (in other words don’t put them all in at once, wait five minutes before putting the next one in) and don’t rub your eyes. No swimming either. And no water from the shower splashing into your eyes either.

The day after wasn’t all that exciting. Just lots of sleeping and resting in a dark room. Things were blurry for some of that day, but by nighttime I could start to see clearly enough to notice a difference.

You’ll have another appointment the day after to check your vision and to make sure things are healing okay. I scored 20/15 at this appointment with only one missed letter in my left eye (one missed on the 20/15 line). The hardest part for me the day of and the day after was not being able to read or watch TV. Granted, you should be resting as much as you can, I’d recommend getting a book on tape to listen to when you can’t sleep. After a day you can watch TV, read, and do most anything. But take it easy if you can. Don’t go right back to staring at the computer monitor if you can help it.

More drops, resting, and goggle-induced days later, I had another appointment yesterday (6 days after Lasik). I scored a perfect 20/15 and was able to make out about 25% of the letters on the 20/10 line. You’ll have more appointments to come (1 month, 6 months, and 1 year I believe) but all should be good by now.


- Total time spent at appointments (including the procedure): about 4 hours*
* Results not typical due to mild case of Horner’s Syndrome.

- Total time for Lasik: about 20 minutes

- Total cost: just under $3,000 (but worse starting vision will increase the price)

- Worst part: tied between the limited pain from pressure on eyes during the procedure and not being able to read or watch TV that day

- Best part: still having better vision than my wife

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