I can haz glasses now?

[Bob in a quantum-state-of-faith]

    saw my eye doc Thursday
bi-focals are next
he on the otherhand thinks it is very funny.

I was "advised" to go bifocal much too soon.

By my eye "care" professional.

Now that I've had lasic, and do not need glasses anymore, I find that my myopia is improving, due to the actual exercise of my eye's focusing abilities.

Bifocals let your eyes get lazy, and accelerate myopia (loss of ability to focus).

Put off the bi's as long as you are able-- eye exercises are better.

[Alpaca]

Would you recommend lasic? It'll still be a number of years before my eyes get done changing shape naturally, and there's nothing wrong with the focusing ability, but I wonder if it would be worth the cost.

[Bob in a quantum-state-of-faith]

Would you recommend lasic? It'll still be a number of years before my eyes get done changing shape naturally, and there's nothing wrong with the focusing ability, but I wonder if it would be worth the cost.

In a flash.

I was 49 when I had it done, and had been wearing bifocals for a number of years.

The doctor I went to was very open and honest about the procedure-- and answered ALL my questions, even the (now I see) silly ones.

Some of his answers were "We do not know the answer to that one, but we're working on it".

That a doctor actually admitted his knowledge was not god-like was refreshing. 

Anyway, he warned me that because of my age (more than 42 birthdays) I would likely suffer from presbyopia-- the inability to change focus.  It's due to the stiffening of your eye's natural lens, and the muscles that pull it into different focus inability to stretch it diminishes with age, too.

However, eye exercises can slow this down--- those consist of looking very far away until you can see/focus.  Then looking close until you see clearly, then far away, then close, etc.

This causes your eyes to change focus, which in turn exercises those muscles (and stretches your natural lens, too-- I don't know if that keeps it limber or not-- but I do know that ANY muscle can be exercised, and can become flabby with dis-use).

I am truly sorry I listened and got bifocals as early as I did-- had I just started a program of eye exercises instead, I could've put off the bifocals for several more years....

But, all is not lost-- with the lasic, and me needing reading glasses now, oftimes I'm too lazy to go get the reading glasses out-- and I make my eyes focus.  After a minute or three I can often read the print sans glasses.

But, my lasic went slightly better than expected (I expected 20-30 vision at best) and I ended up with 20-15.  Both my doctor and I were delighted.

The best part, is that the process my doctor used compensates for astigmatism, too.  They literally custom-mapped my eyeball's shape, and how images reflected against my retina.  This gave them a mathematical model of the distortions of my eye's visual system.    And these numbers were fed into the computer doing the actual "cutting".

There was zero pain, and only a bit of discomfort.

I did have a bit of anxiety later-- when I couldn't see my fingers very well.  This mostly happened in the early mornings, when I just woke up, and felt a hangnail or something.  Then I couldn't see my fingernail to give it the attention it needed-- and I felt a bit anxious about that-- but it passed, as my habits became accustomed to the new seeing paradigm.

At Chatty's advice I picked up some premium +3.5 reading glasses (I had been purchasing as cheap as I could find...).

The difference between the premium lenses and the bargin-bin ones was substantial.   So I save these for reading and correcting those pesky hangnails.... 

I still use the cheapies at work-- but mostimes I use safety glasses that have +2 molded into the bottom.... work can be hazardous to eyes, and this encourages me to wear the safety glasses... 

...........

But, yes-- I highly recommend lasic.

BUT RESEARCH YOUR DOCTOR FIRST!   Be sure he has the very latest equipment-- if you've ANY astigmatism.  If you're basically just out of focus, without any astigmatism, then any old accredited process ought to work... 

I can outline my start-to-finish, if you like, in detail.  It's [my memory] quite vivid, and you're awake during the whole thing...

[Alpaca]

I would love to hear all about it.

[Sibling Zono (anon1mat0)]

The other thing I heard (Chatty correct me if I'm wrong) is that using hard contact lenses will help reduce or even stop the progression of myopia, the only thing is that those tend to be uncomfortable to wear and some people never adapt. Given that you will have to wait at least 5-10 years before eye surgery it could be an option.

[Sibling Chatty]

Zono, you're right on the hard lens thing. It literally forces the eyeball to hold that shape. BUT, it also can cause some serious eye problems, irritation and sometimes vascularization of the eyeball. NOT good in the long run.

OTOH, Bob's TOTALLY off base on ANY lens making your eyes worse in ANY way. Sorry, Bob, EL WRONGO!!

And "eye exercizes" can ONLY change the muscles, they DO NOT NOT NOT affect the function of the lens of the eye, which is WHY you have a prescription change. As to eye muscles needing exercise?? Generally, only to change the problems of weak eye muscles. Amblyopia, for instance, runs in my family. I have a 'weak' case, others have such lack of muscle strength that they've got no vision in that eye, unless you patch the other eye to force it to work. THEN, yeah, eye muscle exercises can be actually worth the effort.

iff your eyes can cut to the side and cross reasonably well, eye exercises are generally a time waster. They DO NOT affect focus. Not physically possible for the muscle to affect the lens, which is what focuses. There's a lot of bogus bullshit "focus improvement" stuff on the internet (pinhole glasses, anyone?) but physiologically it's still bullshit. Doesn't work. CANNOT work. The muscles hold the eye in place and move the eyeball, they DO NOT change the focus of the lens. The ciliary muscles do, but the ONLY help that gives is for myopics, who can focus up close anyway. It STILL takes time, but that 'exercise' will hasten that time a few seconds.

Moving the steering wheel on your car doesn't affect the way the tires work either.

The "glasses make your eyes weaker" bullshit is just that, bullshit. YES, you wear them more, because you want to SEE as best you can. (Having listened to these jackasses that refuse to get their kids the glasses that they NEED because "it makes them need glasses more" or "it makes them ALWAYS need glasses" and crap like that?? Oh, HELL no. Eye muscles DO NOT change a DAMN thing having to do with the actual lens function. Period. End of story. FULL STOP.)

Getting bifocals?? WHY the HELL?? would anyone get "bifocals" and have to deal with that stupid-ass LINE?? NO NO NO NO!! Progressives. AKA multi-focals or 'no-line' bifocals.

If you've never had multi-focal correction before (aren't accustomed to that stupid-ass line) then wearing a progressive is as simple as learning to look AT what you're looking at.

A'Babe, start saving your extra change, the progressives are more expensive (not THAT much more, but some) and, YES, you ALWAYS want a good AR coating. ALWAYS.

==============

Now, as to LASIK, Ladar, PRK, et al...

I've worked with doctors that DO those procedures.

You'll note that THEY wear glasses or contacts. Ask them WHY they don't have it done. "My eyes are too precious to me."

When it works well, it's GREAT!! Spectacular, like Bob's case, where the 20/15 is why he can focus, it just takes longer and NO the muscles aren't doing a thing, it's the flexibility in the lens (possibly still 'supple' because it has been shaved so thin.)

WHEN IT DOESN'T....
http://www.kathygriffin.net/lasik.php

Alex, you're a MILD myopic, so far. (.25 to go to moderate, in one eye.)

With nearsightedness, a refractive or focusing error less than -5 diopters is considered mild "myopia." Myopia is the medical term for nearsightedness and is corrected with a "minus" lens. Five to 7 or 8 diopters is in the moderate range, and greater than 7 or 8 is called severe. About 90 percent of nearsighted people have a refractive error of less than -6 diopters. Only about one nearsighted person in ten has severe myopia. Nevertheless, even if you have only -4 diopters of nearsightedness, you may feel that your correction is severe because you are almost totally dependent on your glasses or contact lenses.

--------------------------------

OK, let's clear up the 20/20 and 'what my prescription is' stuff.

http://www.enotalone.com/article/9622.html

(This is from an article on LASIK, you can click back to the first page.)

Many people confuse their eyeglasses prescription, which is measured in diopters, with their eye chart readings, which assess visual acuity (VA). By ascertaining the smallest line of figures that you can distinguish at a specified distance, your physician can determine your VA. If you can read the 20/20 line at 20 feet (about 6 meters), your visual acuity equals 20/20 (or 6/6 in meters), which is normal. If you read the 20/40 line at 20 feet, you see at 20 feet what the normally-sighted person sees at 40 feet.

Your VA, as measured by the Snellen eye chart, cannot be accurately converted to diopters. Nonetheless, assuming that your eyes are healthy, and you have no refractive error affecting distance vision, you should be able to read the 20/20 line or better. If your myopic refraction is -1 diopter, you should be able to read the 20/40 or 20/50 line of the eye chart. If you have significant astigmatism, however, you probably wouldn't have 20/20 visual acuity. In addition, if your eye has some underlying pathology - even though light is perfectly focused on your retina - you may be unable to read the 20/20 line.

Note the qualifiers. There's no real correlation, and 20/20 is NOT 'perfect', it's average. Bob's 20/15 is BETTER than average. (My 20/5 at age 17 was considered astounding...and a precursor of the hyperopia I have today.)

Oh, the bottom of that page has an excellent lesson in reading your prescription and understanding what it means.

AND!! If you just wait until you have cataracts and have to have the clouded lens removed, they can now replace it with a multifocal implant lens!! Woot! Grannies without glasses!! (They're 'spensive, Medicare won't pay, and lots of oldies LIKE their glasses. Plus, with ANY cataract surgery, ya gotta protect the eyes from sun and glare.)

I'm a big fan of just wear yer dang glasses, and if ya need them, buy 1.67 or 1.71 index lenses. Why?? If you read the Kathy Griffin thing... OK, now imagine that you're an architect. A top guy in one of the most successful firms in one of the largest cities in the US. And ya go have this done by THE top guy in your city. And somehow, it goes badly. I know that guy, I helped him with his glasses changes after all 6 of his 'touch-up' surgeries. Heck, I took him to the airport and picked him up after he flew to New York for another surgery with THE most practiced LASIK surgeon in the world.

He can see 'cloudy shapes' with his right eye. He can see a little better with his left. He can't drive, ever. He can't work at his chosen profession. He's legally blind. Worst case scenario?? Yes. Because it was BOTH eyes. Most folks only have a screw up on one. WHY?? Power outages during his surgery. The jump and surge of the back-up generator cutting on, then off... Not even doctor error. Not 'prone to epithelial growth'.

Me, I ain't takin' chances...3-5% is the LOW 'reported problems', and it's been more like 18-20%.

Now, refractive surgery was 'perfected' in Japan and in Russia. Guess where it's the most restricted today? The long term history of the newer processes is yet unknown. The "wonder surgery" of PRK from a decade back? Totally NOT favored anymore, illegal in Japan. It doesn't age well. (Ask yourself why the Japanese lensmakers are the ones coming up with the thinner and lighter lenses. They've got people that, thanks to failed 'corrective surgery' have -22.00 prescriptions, that's why.)

Not to completely discourage you, Alex, but...you're a long way from really bad, and it's...surgery. Surgeries have risks. ALL surgeries. And now I'm scaring myself, so I'm going to shut up.

[Bob in a quantum-state-of-faith]

While normally I would hesitate to disagree with Chatty, I must on a couple of points.

The lens in your eye is completely unaffected by lasic.  The CORNEA is what is shaved, not the LENS.  The CORNEA is more or less permanently shaped from the day you're born, unless you have physiological issues or glaucoma (too high internal pressure of the eyeball.   

The cornea is the outer part of the eye-- the part you'd place contact lenses directly onto.  The lens of the eye sits just behind your iris-- the colored part that changes size in response to light.  Both of these are clear tissue, and both affect your focal length.  When your focal length does not match up to your retina at the back of your eyeball, you are either nearsighted or farsighted. 

Nearsighted is by far the most common ailment among young people.  Farsighted will eventually happen to everyone who has "normal" vision, due to age, but can affect young people, too.

Nearsighted people's eyeballs can be thought of as "too long" for their cornea/lens combination:  it wants to focus light in front of the retina.   For young people with farsighted vision, their eyeballs are "too short"-- their cornea/lens focuses behind the retina, all the time.

Old age farsightedness is simply due to the lens no longer being able to stretch, so that when relaxed, the person can see far away just fine, but close up-- out of focus. 

People with nearsightedness, who age, eventually discover that their ability to focus at different distances (all of which are close or near) changes, until it stops at the farthest distance they had.

Why does your prescription change? Your eyeball is what changes-- it elongates with your skull, thus your eye-focus changes, thus your glasses prescription changes.

Chatty is both right and wrong with regards to the eye muscles-- I was not talking about the ones that track the eyes.  I was referring to the ones that change your lens shape, which are very tiny muscles beneath your iris.  They are anchored to the sides of your eyeball and to the sides of your lens.  When they contract, they stretch your lens, which changes your focus.  When they relax, the lens, being elastic, bounces back.   Relaxed-- far vision.  Stretched/tension-- near vision.  Is why staring at a book or screen all day long gives you eyestrain--your focusing muscles are under tension all day long.  You can reduce this stress, by every 15 minutes looking away from the book/screen out the window, or anything farther away than about 20 feet or so.  This lets your focusing muscles relax.

The ONLY thing bifocals are good for is to give you 2 (or several in the case of progressives) different fixed focal lengths.  But.  It means your focusing muscles are used less and less.

Myopia is the inability to focus from far to near.  It is primarily due to the stiffening of the lens inside your eye, and has zero to do with your cornea (the part that is LASIC'd).   Eventually, even with exercise, your focusing muscles will be unable to stretch your lens, and you'll be unable to focus at all. 

Fortunately, the "relaxed" state for most, is out to infinity.  Sadly, for nearsighted individuals (what I was before LASIC) "infinity" is anywhere from 1" or so out to a coupla feet.  For me, it was about 8".

I was 20/500 and 20/550 in either eye.   I had moderate astigmatism.

And yes, my LASIC eye doctor has had LASIC himself.  AND he performed it on his wife.  Twice, so far.    Why twice? 

Because as we age, our skulls grow somewhat.  This causes our eyeballs to grow/lengthen a bit, too.   This change the focal point of our vision....  So a 20/20 LASIC may degrade into a 20/30 or 20/40 LASIC after many years.

At 50, I'm liable to require a "touch-up" process before I kick the bucket.   Will I have it done, when I'm, say, 70?  Maybe.  It will depend on how much my vision has drifted by then.  AND if I'm in good health otherwise, AND if I'm still around by then (unlikely).

Would I get LASIC from a doctor that wears glasses?  Maybe: it would depend on if he answers the "why not" question.  Some people are not good candidates:  their cornea tissue is too thin or not dense enough.  (tissue density is one of the things they measured on me-- it varies widely from person to person, and needs to be factored into the machine, when the LASIC is done).

If a doctor doing LASIC blithely states that he wouldn't have it done because he's afraid of it?  I would go to a different clinic-- someone who won't trust his own process has NO BUSINESS BEING IN PRACTICE! He ought to be barred from performing them.....

-----------

As for the bifocals too soon?  I have a personal story about THAT, too.

Years after I was talked into bifocals by the idiot eyecare "professional" (note:  NOT a medical person), I read up on eye physiology.   And, yes--before you ask, I had the "noline" progressives.  I always had those.

So, I started reading exclusively without my glasses (I was nearsighted).   This allowed my focusing eyemuscles to work again (something the stupid bifocals prevented).  After a number of years of this, I discovered I could see with my non-bifocal lenses!  (I had prescription sunglasses for driving, but to save money, these were single-lenses).

The ONLY change was that I was regularly exercising my eye's ability to focus near and far-- something the stupid progressive bifocals prevented.

It may be a statistic case of 1, but I stand by what I experienced-- AND what I've read about eye physiology.   

Eventually, I suppose, I would've really needed bi's.  But not as soon as was suggested... I personally think it harmed my eyes.

Eyeglasses for kids-- certainly!  A nearsighted person must be able to see his/her surroundings.   No amount of exercise of any sort will overcome an eyeball that is too long for it's lens to focus properly (the problem with nearsightedness).   But never bifocals!  Unless there is a physiological problem with the kid's lens or focusing ability, obviously.

Bifocals in general?  Not until it's clear that your eye can no longer focus at all, on it's own.

....

Eyestrain?  Instead of jumping into glasses that can make your focusing ability diminish, practice eye-resting every hour or so.   Look away from the screen for a minute or three.  When you go to coffee break, go somewhere you can look at distance objects-- like outside.  Or near a window.   Same for lunch.

"doctors" are too quick to prescribe these things, I think.  To the detriment of one's vision.

Or, better still -- look for other possible sources of eyestrain.  It MIGHT NOT BE your screen's fault.   It MIGHT be the idiotic lighting in your office is too bright, or off-color.   It might be simple glare on your screen-- something you can alleviate by tilting the monitor slightly, or adding a "baseball cap" along the top of your screen.

Or, it could be reflected glare from your actual DESKTOP itself.  A too shiny or too light a color of surface can put reflections into your eyes that are not immediately obvious.  (Easy to test:  cover it with a dark material temporarily).

Too bright of lights is a very common problem, when looking at computer screens-- it requires you to turn your screen's brightness up too high.

Or worse, lights that subtly flicker.  Some florescents are notorious for this-- they will flicker just below perception.  At say, 30 times a second.  You probabily won't be able to tell consciously, but your eyes can.  It is especially a problem if the florescent bulbs are old or near the end of their life-- these can flicker at rates as low as 15 times a second-- which IS visible.

Finally, your screen itself may be set to refresh too slow.  This is quite rare these days, as most do at least 60 times a second.  But some older screens go as low as 45 times (and I've seen 30 on some real dinosaurs).  Check your screen's properties, and set the refresh as high as it will allow. 

It's easy to just throw glasses at the problem without really understanding what the problem really IS. 

[goat starer]

While normally I would hesitate to disagree with Chatty, I must on a couple of points.

If you want to take your life into your own hands far be it from us to stop you.

[Alpaca]

Oof! A lot of information and opinion, I see. Thanks for all of it, sibs.

Looking at it realistically, I have a solid decade or so before laser surgery even becomes an option. During that time, the technology will definitely change, so I'm sure there will be more information to consider. I'll also have to see if my vision deteriorates significantly, if the price of the procedure decreases significantly, if my insurer/employer will cover it, and so on.

Thanks for telling me about it, though, guys!

[Sibling Chatty]

Bob, it's LASIK.

As in laser-assisted in-situ Keratomileusis.

Myopia was the first, and is the easiest, type to correct.

Most MD's with which I have dealt refer to the corneal lens and the regular lens...I wasn't dealing with them as a patient, but as a clerical support worker and optician.

I'm glad your operation worked, but one's prescription can change greatly for no apparent reason, and the whole "exercises for your eyes" is a touchy subject. If you say they've worked for you, that's nice, but there's not objective evidence that they do work in the manner which most people describe. there is a 'cause and effect' thing that doesn't bear going into in some cases.

[Bob in a quantum-state-of-faith]

While normally I would hesitate to disagree with Chatty, I must on a couple of points.

If you want to take your life into your own hands far be it from us to stop you.

Bob, it's LASIK.

As in laser-assisted in-situ Keratomileusis.

Myopia was the first, and is the easiest, type to correct.

Most MD's with which I have dealt refer to the corneal lens and the regular lens...I wasn't dealing with them as a patient, but as a clerical support worker and optician.

I'm glad your operation worked, but one's prescription can change greatly for no apparent reason, and the whole "exercises for your eyes" is a touchy subject. If you say they've worked for you, that's nice, but there's not objective evidence that they do work in the manner which most people describe. there is a 'cause and effect' thing that doesn't bear going into in some cases.

See?  I'm still here-- Chatty's not an Ogre-- she's just certain.   

I think it's a matter of semantics and terminology.

And yes, I did stipulate it was an example of one (1)-- me, and that does not constitute evidence.

I think my operation worked so well, in part due to the extreme professionalism of my clinic.

As I said-- cheaper is automatically not cheaper.    Especially over the long haul.

And, Chatty's spot-on, too, with regards to myopia or nearsightedness.

But, now they can correct chronic farsightedness-- that is both the near AND the middle distance are out of focus, and only the far distance is clear.


Alpaca, do you wear glasses/contacts at all?  If not-- then you don't need LASIK (I never remember how to spell what is essentially an artificial word... )

[Alpaca]

Bob, I most certainly do - I'm -4 in one eye and -4.75 in the other, which makes me totally dependent on glasses to function in any way that involves seeing more than a few inches in front of my face. I haven't finished growing yet, so I don't know what my vision will be like in ten years or so when I would potentially qualify for lasik.

Many factors, much time, just harvesting information now (as always).

[Sibling Chatty]

Bob's spot on about researching the doc, and especially about the cost factor.

LASIK can be performed legally by anyone with an MD that has taken what's essentially a weekend course in how to run the machine and smooth the flap.

The difference between $300 an eye and $2,300 an eye is the involvement of competent ophthalmic techs and optometrists in the prep and in the surgery, assisting an MD ophthalmologist with a LOT of eye surgery and eye care experience. While the $2,300 seems excessive, it may be the best excessive amount one ever spends.

Also, the more procedures the doc does, the better the chance he's not on a 'timeshare' laser, but on one that's primarily his, or his medical group's. They're generally better maintained and more up-to-date than the 'rent-a-laser' ones that have been set up for anybody with a weekender certificate to use.

I told a guy that was going to talk to a cheapie place that he was nuts for going to Earl Schieb Eye Surgery...

(Note for non-USA'ns and non-motorheads. Earl Schieb's is a car painting place, where you can get a paint job for $99! Yes, just $99! May be higher now, but you get the drift. And it includes all the painted over bugs and dirt that happen to be present when they slap newspaper and masking tape over the windows, and MAYBE the chrome trim...)

The most expensive LASIK I know of is done at a spa in the Texas Hill Country. You sign up for a two week stay, and are pampered and massaged and toned and facial-ed and all, and they sneak in your LASIK in the middle of this. At only $8,500 a week, $17,000 for the package, you get new vision and up to two inches off your waist and butt!!

For $17,000 I think I'd want it to include a face lift and maybe a boob job...

[Bob in a quantum-state-of-faith]

Chatty, as usual, has nailed the issue.

My doc owned his entire clinic-- well, he and the people that work there own it.  (which was pretty cool, too, when you think about it)

Check them out-- if your pre-LASIK eye exam is NOT 100%, neither will your LASIK be 100%.

It all hinges on a complete, thorough eye exam.

Imagine trying to go from NYC to Los Angeles, based on measurements you took ONLY in NY state... You'd be luck to hit the STATE of California, let alone LA.

They HAVE to do a very, VERY complete eye exam FIRST.

Ask them about follow-ups.  Are the costs of the follow-up exams (REQUIRED!) included in the up-front price?  Or do you get dunned with each follow-up?  Ask how many follow-ups they recommend-- AND DO THAT MANY.  No stinting, on after-care, either.

Ask them what drugs they use before, during and after treatment.  Research the drugs yourself-- one of the common drugs (eyedrops) my doc uses is Prednazone.  Being a recovering Colitis patient (remission for going on 15? no, more like 20 years, now) I'm quite familiar with this drug.  I used it for the first week only... (but then, I heal skin trauma faster than most folk-- I suppose it's because of near-daily practice... I cut my skin frequently in my line of work, and in my hobbies...)

Ask them to explain what each drop is for, what it's supposed to be doing for you, and why they want to use it. If the doc's answer is "we've always done it that way" get out of there! Fast!

If the doc/technicians cannot answer WHY/WHAT FOR a particular drug is being used--- what ELSE are they doing without really understanding what it is?

I only paid $1,800 for both eyes.  This included the pre-LASIK screening, the comprehensive eye exam, and follow-ups out to 6 months.  After 1 year, they want to see me again, but I must pay $99.  I'm going, and will pay cheerfully.   After that, I'll likely visit every 2 years or so.

But, I live in Oklahoma, and everything is cheaper here-- including income. 

Oh!  Check out your doc's insurance-- is he covered if there is an "oops!"?   If not... NEXT!

[goat starer]

While normally I would hesitate to disagree with Chatty, I must on a couple of points.

If you want to take your life into your own hands far be it from us to stop you.

Bob, it's LASIK.

As in laser-assisted in-situ Keratomileusis.

Myopia was the first, and is the easiest, type to correct.

Most MD's with which I have dealt refer to the corneal lens and the regular lens...I wasn't dealing with them as a patient, but as a clerical support worker and optician.

I'm glad your operation worked, but one's prescription can change greatly for no apparent reason, and the whole "exercises for your eyes" is a touchy subject. If you say they've worked for you, that's nice, but there's not objective evidence that they do work in the manner which most people describe. there is a 'cause and effect' thing that doesn't bear going into in some cases.

See?  I'm still here-- Chatty's not an Ogre-- she's just certain.   

thats how it always works... she lulls you into a false sense of security then WHAM!

...and the rest of us are left picking bits of you out of the doorframes, replacing windows and mopping up gooey puddles for days afterwards.