Throughout your life, you may go through several changes to your vision. Many people experience refractive errors, which affect your ability to focus on objects at certain distances. These are often correctable with glasses or contact lenses. Astigmatism affects the curvature of your corneas and causes vision to become blurry. Due to injury, medical conditions, or genetic factors, you may also experience a clouding of the lens of one or both eyes. This is called a cataract, and it can affect your vision by distorting the light that enters through the lens. Cataract refractive eye surgery is a relatively new technique that can correct all of these problems at once.
1. What Happens During Cataract Surgery?
Regardless of whether you choose traditional cataract surgery or more advanced cataract refractive eye surgery, the procedure involves the following steps:
- Incision: The cataract eye surgeon makes a small incision into the side of your cornea. In traditional cataract surgery, this is performed with a small hand tool. With advanced surgery, the surgeon uses a laser.
- Phacoemulsification: This is a process of breaking up the clouded lens using ultrasonic waves. The surgeon then uses suction to remove the remaining fragments from your eyes.
- Implantation: An intraocular lens is inserted into your eye through the same incision to replace the clouded one.
2. How Is Cataract Refractive Eye Surgery Different From Traditional Cataract Surgery?
Traditional cataract surgery involves a monofocal intraocular lens (IOL). This type of IOL only corrects your vision at a distance. To correct your close-up vision, you may still require bifocals or reading glasses, even after surgery. Cataract refractive surgery involves implanting a multifocal IOL that can correct your vision both close up and at a distance.
A computer programs the laser used in cataract refractive surgery to be extremely precise. This laser can reshape the cornea to correct astigmatism and get rid of the blurriness associated with it. Not only should you see more clearly due to the removal of the cataract, but you should no longer require the use of any corrective lenses following cataract refractive surgery.
3. How Do You Prepare for Surgery?
We will schedule an appointment for you about a week before surgery to perform a test to determine eye shape. This test is painless and lets us know the correct size of IOL that you need. At that appointment, we will give you specific instructions to prepare for surgery.
Typically, we ask patients to arrange for someone to drive them home from surgery and stay with them for a few hours afterward. To avoid increased pressure on the eye, we ask you to refrain from bending over or lifting anything for a few days after the procedure. We may also ask you to fast for 12 hours before the procedure or stop taking certain medicines.
4. What Happens During Recovery?
Immediately following surgery, you may experience some irritation or redness of the eyes, which is normal. Contact your cataract eye surgeon if this persists for more than a few days. Otherwise, this discomfort should resolve shortly. You may start seeing more clearly within a few hours, with your vision improving a little more each day.
5. Will Insurance Cover Advanced Cataract Surgery?
Typically, insurance coverage only extends to basic cataract surgery. Advanced cataract refractive eye surgery using lasers typically is not covered. You should check with your insurance provider to make sure of what specifically is covered and what is not. Even if your insurance does not cover your advanced surgery, we offer financing options to make the procedure more affordable for you.
We want you to feel completely comfortable with the surgery before you proceed. Feel free to ask us any specific questions you may have about the procedure.
If you’re like most people, your vision is less than perfect, and you rely on glasses or contacts to improve it. But what if you didn’t have to? What if your vision could be restored to 20/20 or considerably closer to that ideal than it is now? That is what corrective vision surgery, such as LASIK eye surgery, can accomplish.
As its name implies, corrective vision surgery is a procedure that a trained, licensed, and experienced eye surgeon performs on your eyes, generally on an outpatient basis, that substantially improves your vision.
Numerous corrective vision surgery types exist, including the following:
- LASIK, i.e., laser in-situ keratomileusis
- PRK, i.e., photorefractive keratectomy
- LASEK, i.e., laser epithelial keratomileusis
- ALK, i.e., automated lamellar keratoplasty
- RLE, i.e., refractive lens exchange
- PRELEX, i.e., presbyopic lens exchange
- Phakic Intraocular Lens Implants
- AK, i.e., astigmatic keratonomy
While the medical names for these procedures can be more than a little overwhelming for prospective patients, your eye care professional can recommend which one best suits your precise vision difficulty and its causes.
LASIK Versus PRK
LASIK and PRK are the two most widely performed procedures to improve vision. Both modify your cornea, the five layers of transparent tissue that cover the front of your eye, and bend, i.e., refract, to focus light that lets you see. Both can improve myopia (nearsightedness), hyperopia (farsightedness), and astigmatism, which is an imperfection in the curvature of your cornea that causes blurry vision.
You feel no pain during either procedure because your eye surgeon puts numbing drops in your eye and may also give you a mild sedative to relax you.
The main differences between LASIK and PRK are the methods used to correct your vision and your recovery time afterward.
In LASIK, your eye surgeon uses a laser or extremely tiny blade to make a small flap in your cornea. After raising this flap, he or she then uses a laser to reshape your cornea. The flap is then lowered and ultimately repairs itself without the need for stitches. The results are almost immediate, and you’ll see an improvement in your vision by the end of the fourth day.
In PRK, your eye surgeon removes the epithelium, the top layer, of your cornea. He or she then uses a laser to reshape your cornea. Again, no stitches are needed because the cornea repairs itself. You will, however, need to wear an eye patch for as long as 30 days while your eye heals.
Both procedures cost between $2,500 and $5,000, depending on the area of the country where you live. In general, PRK tends to be somewhat more expensive because of the need for more post-op check-ups.
Unfortunately, health insurance plans usually don’t cover either procedure because they’re considered elective surgeries.
What Happens During LASIK Surgery
If you wear contacts, your eye surgeon will likely ask you to stop wearing them at least two weeks before your scheduled procedure. Why? Because contacts can temporarily alter your cornea’s natural shape.
After putting numbing drops in your eyes and, if necessary, giving you a mild sedative to relax you if you’re nervous, the procedure proceeds in three steps:
1. Your eye surgeon uses a femtosecond laser tool to make a flap in your cornea.
2. He or she next raises this flap and moves it to the side while using lasers to reshape your cornea. If you’re nearsighted, he or she will flatten your cornea. If you’re farsighted, he or she will create a steeper cornea. If you have astigmatism, he or she will use an excimer laser to smooth out your cornea’s irregularities.
3. Finally, he or she replaces the flap over the rest of your cornea so everything can heal naturally.
That’s it! You’re good to go after only about 15 minutes. Remember, however, that someone will need to drive you home and drive you back for your next-day follow-up appointment.
When you notice that your vision has changed and think you may need glasses or contacts or notice that your current glasses or contacts aren’t doing the job anymore, you head to an eye care center for an exam.
But what you may not realize is that there are two types of exams: routine eye exam and comprehensive eye exam. Which one you’ll get depends on where you go and who performs the exam.
An optometrist, i.e., doctor of optometry or O.D., is a licensed eye care provider who can test you, diagnose any eye conditions you have, and treat you for them. On the other hand, an ophthalmologist is a licensed medical doctor (M.D.) or doctor of osteopathy (D.O.) who has received specialized education in eye care. Not only can he or she do what an optometrist can do, but he or she can also perform any surgeries or other medical interventions that you need.
Optometrists most often work for the company that owns the store or other location that provides vision testing. Usually, these vision centers are attached to a store where you can buy glasses and contacts.
Optometrists are more likely to give you a routine eye exam.
Ophthalmologists usually have their own medical practice and provide comprehensive eye exams as well as follow-up care.
Routine Eye Exam Versus Comprehensive Eye Exam
The whole purpose of a routine eye exam is to check your vision, screen for eye disease, or update your glasses or contact lens prescription. In other words, you can expect to receive a diagnosis of such things as nearsightedness, farsightedness, or astigmatism.
As its name implies, the purpose of a comprehensive eye exam is to go well beyond the basics and determine whether or not you have an eye disease or condition, such as conjunctivitis, dry eye, glaucoma, cataracts, etc.
While routine eye exams usually take only 30 minutes or less, be prepared to spend at least an hour in your ophthalmologist’s office, probably more like 90 minutes. This is because of the increased number of examinations your doctor will perform and the time it takes them to analyze the results.
Tests Your Comprehensive Eye Exam Cover
Regular comprehensive eye exams should be part of your overall health maintenance. Why? Because your doctor can diagnose eye conditions and diseases and diseases such as diabetes and hypertension, i.e., high blood pressure.
After having you fill out a personal and family medical history form and asking you questions about various things he or she needs additional information about, your doctor will perform numerous eye tests, likely including the following:
- Visual acuity test that determines how close to 20/20 your vision is
- Retinoscopy test that determines how light affects different lenses your doctor places in front of your eyes
- Refraction test that determines which lens pairs give you the best vision
- Keratometry test that measures the shape and curve of your corneas
- Peripheral visual field test that assesses the extent of your peripheral vision
- Intraocular pressure test that measures the amount of pressure the fluid in your eyes puts on them
- Color blindness test that determines if you cannot see one or more colors and which ones they are
- Cover test that lets your doctor determine how well your eyes work together
- Ocular motility test that measures the quickness and smoothness of your eye movements
- Stereopsis test that measures your depth perception
- Slit-lamp test that allows your doctor to examine your eyes under high magnification, including your eyelids, cornea, conjunctiva, iris, and lens
- Glaucoma test, commonly called the puff-of-air test, wherein your doctor puffs a small, painless burst of air into your eyes to determine your eyes’ resistance and, therefore, your possible glaucoma risk
- Pupil dilation test wherein your doctor puts special drops in your eyes to temporarily make your pupils larger, allowing him or her to see your eyes’ internal structures better
- Visual field test to check for blind spots in your vision
The importance of receiving a yearly comprehensive eye exam cannot be overstated. Schedule yours today with Dr. Michael Sherman at Physician Eye Care Associations in Garden City, Michigan.