Here are 2 very frequently asked questions:
(1) I have been told it is better to under-correct my spectacle (or contact lens) power in order to prevent my short-sightedness from increasing. True?
(2) Can my vision get worse if I use under-correct spectacles (or contact lenses)?
Here is the answer:
Using under-corrected spectacles or contact lenses will not stop your short-sightedness (myopia) from increasing. The best way to prevent the increase or slow the increase of your myopia is to have good eye care habits. In fact, there are 2 studies which show that wearing a lower power than what you need can actually cause an increase in myopia:
Here is where you can learn more about good eye care habits to reduce the progression of myopia: https://drleesb.wordpress.com/2011/11/17/good-eye-care-habits/
So, it is a good idea to wear spectacles and contact lenses that give you good vision. This is especially important for children younger than 8 years old. This is the time when the brain and visual system is still developing. If the eyes and brain gets used to blurred vision by the use of under-corrected spectacles, this leads to the development of amblyopia (lazy eyes), that is, the eyes cannot see well not matter what power of spectacles you use as an adult.
I still come across quite a few people who are not sure if astigmatism can be treated by LASIK.
What is Astigmatism?
This focusing problem of the eye is usually due to an uneven cornea. Cornea is the front layer of the eye, the transparent curved portion that you can see when you look into the mirror.
Think of a soccer ball, cut this in half, all the meridians of this ball have the same curvature… so there is no astigmatism.
Now think of a rugby ball, cut this ball in half, one surface is more curved than the other. This is like a cornea with astigmatism.
Check out this animation on the Shinagawa website to learn more about astigmatism.
LASIK can treat astigmatism. LASIK works by reshaping the cornea. The laser will laser more in one meridian of the cornea than in the other meridian in order to change the rugby ball shape into more of a soccer ball shape. Most lasers can treat up to 600 degrees (6 diopters) of astigmatism. Learn more about LASIK from this site.
Here are 3 commonly asked questions I get regarding pregnancy and LASIK.
(1) I am currently pregnant, can I have LASIK done?
Pregnancy causes fluid changes in the body. In the later stages of pregnancy, the feet gets swollen and for some women, their cornea of the eyes also gets swollen. It is less accurate to laser a swollen cornea. Threfore, I would advise ladies to wait till 3 months after their pregnancy before having LASIK.
(2) I am still breast-feeding, can I have LASIK done?
There are still fluid changes in the body during breast-feeding. So for the same reason above, I would suggest to wait till 3 months after you have stopped breast-feeding before having LASIK. However, I have gone ahead to perform LASIK for ladies who have breast-fed for many many months and their swelling of their feet and fingers have all subsided.
(3) When can I plan to get pregnant after my LASIK surgery? or When can I make love after my LASIK surgery?
You can immediately plan to get pregnant after LASIK. Fluid changes in the body do not occur until the later stages of pregnancy. This also means you can make love anytime you like after LASIK, just be sure you do not injure your eyes, especially in the first 24 to 48 hours when the cornea flap is still fragile. 🙂
Interested in getting LASIK done? But not sure where to go? What questions should you ask the doctor?
Here are some answers I provided AsiaOne in an interview in 2011:
1. Will you be the doctor managing my pre- and/or post-operative care?
The answer should be yes. Ideally, the same doctor should walk you through the whole procedure from start to finish to ensure that each detail of your eye condition is well tracked.
2. Do all the post-operative visits include a consultation with the doctor?
The answer should be yes. Side effects after LASIK are very, very low, but it is always good for a doctor to examine your eye and be there to formulate your post-operative treatment plan. One example would be to treat dry eyes, which is a common post-op concern.
3. What should I expect my vision to be like for the first few weeks after surgery?
Your doctor should provide you with an explanation on minor fluctuations, regression, minor halos, minor ‘starbursting’, etc. These side-effects may occur, but will resolve over time, with some side effects lasting only a few weeks and others lasting about 3 to 4 months.
4. Will the surgeon perform an examination before and after surgery?
The answer should be yes. The pre-LASIK assessment must include an examination and consultation by the eye doctor. The doctor will then review the data of all the tests done, and can discuss with you all the pros and cons of surgery.
5. How long, if at all, will my vision fluctuate after surgery?
While most people get almost instant improvement; healing and fluctuations in vision may take up to six months. Small fluctuations are very normal for the first 3 months.
6. How often and when will you perform post-operative examinations?
Most doctors will check on your eyes one day after surgery, one week later and one month later. Thereafter, it depends on the patient’s condition.
7. How many patients do you do surgery on in one day?
This is quite variable among different surgeons. It is generally felt that by keeping the maximum to 10 patients per day by each surgeon will allow for a better quality of care.
8. How well can I see after LASIK?
The accuracy of LASIK is dependent on the degree of your eyeball. It is more accurate if one has lower myopia and/or lower astigmatism. Your doctor will be able to counsel you on the accuracy of vision to expect after LASIK based on one’s conditions.
9. Side effects.
a. From the diagnostic tests done on my eyes, am I at a higher risk of side effects than other people?
This is a good question to ask your doctor to find out more about your eyes. Some people are more susceptible to dry eyes, or to glare/haloes, or to fuzzy vision. Your doctor will be able to look at the data of your eyes and tell you if you are at greater risk of experiencing such side effects.
b. I have heard of this side effect called ectasia, in which the cornea becomes too weak and changes shape. Am I at risk of developing this condition?
This is a very rare condition after LASIK. Your doctor can tell from the topographic map of your cornea if you are at a greater risk of developing this condition. Patients with thinner corneas, steeper (more curved) corneas and irregular corneas are at a greater risk of developing ectasia post-LASIK.
There is a way to help strengthen the cornea with a procedure called Cross-linking. The term LASIK Xtra is used when LASIK is combined with Cross-linking. This is suitable for people with high spectacle power and thin corneas.
10. How should I take care of my eyes after LASIK?
Always follow the post-operative instructions given by your doctor. For example, adhere closely to the frequency of using your eye drops and do not rub your eyes for 1 week.
There will also be instructions on when to resume various sport activities. Keeping your eyes well lubricated with the lubricant eye drops is very important in maintaining good vision. In the long run, good eye care habits prevent your myopia from returning.
You may also be interested in my previous posts:
Have you seen this growth in anyone’s eye? It’s a fleshy growth on the surface of the eye that can grow into the cornea and block the vision. It’s called pterygium (ter-ree-germ).
What is pterygium?
This is a growth of tissue on the surface of the eye. It is not a cancer. It is usually due to excessive exposure to sunlight. This can cause problems with vision if it distorts the cornea. It also will often cause irritation and redness of the eye.
How is it removed?
If the pterygium causes discomfort or affects vision, it can be excised (cut off). The bare area is then covered with a normal conjunctiva (skin of the white surface of the eye, underneath the eyelid). This is like a skin graft done on other areas of the body. It is easily done and reduces recurrence rates to about 10%. The traditional way to perform the surgery is to stitch on the graft. There is a special medical grade glue available for use such that stitches are no longer needed. This reduces the scratchy sensation, reduces inflammation and also the chances of the growth recurring.
What will it be like after surgery?
The procedure is done under local anaesthesia. Eye drops are to be used about 4 times a day. The eye will feel scratchy as the surface is uneven. This will last for about 1 – 2 weeks.
When can one return to work after the surgery?
One can return to work after about a week. The eye will look red, this is normal and will gradually go away by about 1 week after surgery. The wound heals nicely over time and the eye appears normal again.
What can go wrong?
The surgery is very safe, with chance of sight threatening problems at less than 1 in 5000. Occasionally there is some bleeding or a mild infection, but this is rare.
Pterygium is often confused with cataract (lens of the eyeball turning opaque with time) since they are both called “mo” in Hokkien as a layman term for a veil. Pterygium is on the surface of the eye and can easily be seen – the patient looking in the mirror or his relative telling him there is a pink growth in his eye.
I was interviewed for an article that was published in the Stratis Times about this eye disease in July 2011: