Getting Started With LASIK

Lasik Free Guide

We believe that lifetime periodic eye examinations with an ophthalmologist are important to assess the ongoing health of the eye and to identify, at an early stage, any eye conditions that may require treatment. This is true regardless of whether one undergoes LASIK. We want our patients to be aware of the fact that good vision doesn’t always mean the eyes are healthy. Please ask New York LASIK eye surgeon Dr. Kelly how often someone like you should be examined.

It is critical to success that during your consultation you undergo a comprehensive examination. A comprehensive eye examination is performed during the consultation for LASIK or other vision correction procedures. This is necessary for several reasons. It must be determined whether you are a candidate for LASIK. If not, there may be other vision correction procedures that could improve your vision.

If you are a candidate, the comprehensive exam will enable Dr. Kelly to counsel you on realistic outcomes and expectations for your individual set of circumstances and visual needs. A list of tests with explanations appears below. Please note the testing is painless and usually takes under an hour.

To Experience the Kelly Difference and start seeing better, sign up for your free consultation online today, or call us at 1.877.377.EYES.

What happens during the consultation?

1. Medical History

A complete medical, medication, and eye history is obtained. This is important as certain conditions and medications may render individuals ineligible for LASIK. In addition, we are interested in an individual’s routine of contact lens use. Contact lenses may change the shape of the cornea. It is therefore imperative that a patient discontinue use of lenses for at least three days before the evaluation.

Dr. Kelly believes knowing an individual’s motivation for and expectations of laser vision correction to be an important variable in planning the procedure. There are certain occupations or hobbies that make one laser vision correction procedure better than another. Please keep in mind that certain government and non-government agencies allow only certain types of eye surgeries for their personnel. It is the patient’s responsibility to ensure he or she obtains the correct information that applies to him or her regarding job requirements.

Visual acuity is assessed with and without correction. This is done both before and after the eyes are dilated. The magnitude of the visual error is established in each eye in order to plan for the correction. At this time, the dominant eye is determined for those patients choosing to have monovision. Monovision is a visual technique where one eye is corrected for distance vision and the other eye is corrected for near vision, thus minimizing the need for reading glasses.

2. Motility

This is a test of muscle balance. We check the ability of the eyes to align and remain straight. Occasionally we make the diagnosis of a lazy or wandering eye through this test. This measurement allows us to know if the eyes are working together.

3. Corneal Topography

This measures the smoothness and curvature of the cornea’s surface and creates a “map” of the cornea. The map is used to ensure that there are no irregularities that would preclude surgery such as a cornea that is too steep.

4. Wavefront Aberrometry

This test measures all irregularities of the eye from surface to retina and provides the “blueprint” to correct vision to the best possible level. The information obtained from this test is unique for every eye and is downloaded to the laser to design the treatment. Read more about Customized/Wavefront LASIK.

5. Pupil Size

Pupil measurements are taken with an infrared camera in a dark room. The results are useful because we can: 1) design the appropriate treatment diameter that optimizes each person’s vision, and 2) counsel patients about their potential risk of having more glare or haloes at nighttime.

6. Corneal Thickness/Pachymetry

Corneal thickness is determined with an ultrasound. In order to be a candidate for LASIK, your cornea must have sufficient thickness in multiple locations for the amount of your visual error.

7. Tonometry

This is the calculation of eye pressure to detect glaucoma. Glaucoma is a disease in which the eye pressure is elevated causing damage to a structure in the back of the eye known as the optic nerve. Patients with glaucoma are not candidates for LASIK.

8. Refraction

This is the measurement of a patient’s prescription. It is the level of vision that laser surgery is meant to equal. LASIK usually can not make vision better than the vision determined in the refraction part of the examination. This principle is being challenged by new wavefront technology. The refraction is performed with and without dilating drops.

9. Tear Film Evaluation

This is a test of the eye’s ability to produce the appropriate quantity and quality of tears. In order to feel comfortable and see clearly, there must be sufficient tears. There are specific treatments that can be instituted before and after LASIK to assist with the tear film so that the healing process is optimized.

10. Slit Lamp Examination

The eyes are examined under a microscope in order to evaluate overall eye health. Sometimes diseases are detected that may require treatment other than LASIK.

11. Dilated Funduscopy

Dilating drops are placed in the eyes during the consultation in order to examine the structures in the back of the eye. We carefully check for diabetes, macular degeneration, and retinal holes. Occasionally we refer to a retinal specialist prior to proceeding with LASIK.

All of these tests are performed by the surgeon, and results are discussed openly with the prospective patient by the surgeon. The consultation is complimentary with no obligation. On occasion, supplemental testing, such as visual fields, must be done before LASIK candidacy is confirmed. If any conditions requiring treatment are discovered during the consultation, a treatment plan will be developed. Please be aware that we recommend ongoing care of your eyes well after LASIK is performed. The eyes go through the same aging as the rest of the body and conditions may develop over time that require treatment.

To Experience the Kelly Difference and start seeing better, sign up for your free consultation online today, or call us at 1.877.377.EYES.

LASIK Surgery Checklist

Even though the LASIK procedure takes only a few minutes, there are many steps that you must take to prepare for consultation day, surgery day, and recovery. Please read about the LASIK process below to get an idea of how the LASIK experience works.

Before Surgery

Upon or before your arrival to our Manhattan or Long Island office, you will be asked to complete a questionnaire regarding basic information and medical history. It is helpful if you complete the history form before your consultation and bring it with you. It is important to fill in this form completely and accurately.

Prior to your consultation you will need to discontinue the use of soft contact lenses for at least 3 days so that accurate corneal measurements can be taken. For other types of lenses (e.g., spherical, toric, rigid, extended wear, gas-permeable) please call the office for details regarding the length of time for which they should be discontinued.

During your consultation Dr. Kelly and staff will personally perform a thorough and detailed eye exam to determine your candidacy for and appropriateness of LASIK for the treatment of your vision problem. He will be glad to address all of your questions and concerns regarding laser vision correction. Please note that Dr. Kelly often dilates patients’ eyes during the exam to assess the health of the entire eye. Dilation typically results in blurry vision and light sensitivity for 3 hours following the exam and may make computer work, reading, and driving difficult.

We suggest taking this into account when scheduling your consultation and consider bringing a companion if you need to drive. Overall, a full consultation with dilation will require a 60-minute office visit.

We require that all patients read the consent-for-surgery forms as well as the pre- and post-op instruction forms before surgery. We also ask that you have payment arrangements taken care of on or before the day of surgery. Prior to surgery, we require that you have signed all consent forms. For those patients interested in using one of our popular financing options, we ask that you apply prior to your visit in order to save time. If you have questions regarding payment or financing please visit our Financing page.

If you decide to have LASIK after your consultation, we will coordinate the best time for your surgery and post-op exams. There are typically 3 to 4 brief postoperative visits throughout the year following the procedure that are extremely important to ensure the best possible outcome. You will also be given prescriptions for eye drops prior to surgery. We strongly advise having the prescriptions filled prior to your surgery date so that you can use the eye drops on the day of surgery.

Please note there are distinct advantages and disadvantages of having one or both eyes operated on the same day. Although the vast majority of patients have both eyes operated on the same day, there are situations in which Dr. Kelly operates on the two eyes on separate days. As with any vision correction issue, specific questions can be referred to the office by telephone or e-mail.

Day of Surgery

In anticipation of surgery, a mixture of anxiety and excitement is perfectly normal. On the day of surgery your vision and depth perception will be temporarily altered. In addition, you may be given a relaxant medication. For theses reasons we require that you arrange for a companion to accompany you home.

While the procedure itself takes only minutes, you should expect the total time at the laser center to be approximately two hours. There are no restrictions on eating, drinking, or medications before the procedure. However, alcohol should be avoided. Please do not wear any makeup or use any fragrance on laser day. Fragrances and makeup interfere with the laser. Ensure your contact lenses have been discontinued long enough preceding your LASIK. Wear comfortable clothes.

Overall, the majority of patients describe the LASIK procedure as mildly uncomfortable. For more detailed information on the LASIK procedure click here.

Please be aware that blurry vision is typical during the first 18 hours after the procedure. Burning, tearing, discomfort, and the inability to open the eyes for the first several hours after the procedure is normal. We often prescribe extra-strength Tylenol to alleviate the temporary discomfort. Driving is not permitted during the first 24 hours following the procedure. The majority of patients resume normal activities after 24 hours! In the unlikely event that an enhancement is needed to maximize your outcome, Dr. Kelly provides two years of no-cost LASIK enhancements if medically eligible and appropriate.

After Surgery

Having realistic expectations after LASIK is critical. Your eyes may feel irritated, uncomfortable, and dry. Dr. Kelly will instruct you on eye-drop usage. We suggest you keep your eyes closed for the first 5 hours following the procedure to allow healing to begin. After approximately 5 hours, your eyes will feel more relaxed and you’ll notice a significant improvement in your vision. Most patients can drive and return to work the day following the procedure as long as their vision meets certain state requirements and Dr. Kelly clears them to do so. Most patients also notice a continued improvement for the several weeks following LASIK.

We prescribe antibiotic and anti-inflammatory eye drops to be used for one week following the procedure. Some patients develop a temporary dry eye sensation that is treated with the use of artificial tears. We provide a clear protective eye shield to be used while sleeping for the first couple of nights after the procedure and also recommend using sunglasses for a few days because the eyes may be sensitive to bright light. There are typically 3 to 4 brief follow-up visits after the surgery. It is important that every patient adhere to all follow-up visits because success depends not only on the measurements before surgery, and on the surgery itself, but also on postoperative care. If you cannot keep an appointment before or after surgery, we would greatly appreciate your notifying us as far in advance as possible.

There are certain activities we require patients refrain from for about a week following LASIK. They are such things as: touching or rubbing the eyes or eyelids, engaging in contact sports or swimming, and wearing makeup. Patients should avoid hot tubs and whirlpools and smoking. Showers and baths are fine, but avoid having the water pressure contact the eyes or eyelids. Avoid dusty and dirty environments for several days. Watching television or using the computer is fine but may cause some temporary light sensitivity. Airplane travel is fine after Dr. Kelly clears you to do so; usually this is just after your 24-hour postoperative visit.

For a complete list of precautionary measures, please contact a patient coordinator for a printed instruction sheet on the matter. Also please note that routine aerobic and weight training can be resumed within three days of the procedure.

Because everyone’s eyes are different, we cannot promise you perfect vision. We can, however, give you a good idea of what your outcome will be. This is based on your current eye health. While not all patients will have 20/20 vision following surgery, 99% of patients will see 20/30 or better, which is vision necessary for driving, and 98% will see 20/25 or better. Although most patients are able to see clearly without glasses or contacts after LASIK, some will require reading glasses or night-driving glasses.

It is precisely for this reason that a thorough examination and discussion occur with the surgeon before the procedure. Each patient is informed of the risks and benefits of LASIK and needs to feel comfortable that they are making an educated decision based upon facts.

Risks and Side Effects

Dry Eye – During flap creation, corneal nerves are disrupted and a dry eye condition may develop that requires using eye drops postoperatively.  Most of the dry eye induced by LASIK surgery resolves over several months but in a small percentage of cases may persist much longer.

Undercorrection/Overcorrection – Even though LASIK surgery is precise, it is not a perfect science.  As such, a patient may respond less or more than intended, resulting in the possible need for an enhancement surgery to achieve more optimal results.

Nighttime Glare/Halos – It is a normal aspect of human vision to have a certain amount of nighttime glare when viewing light sources.  This is because of the shape of the eye and is present even in individuals with naturally 20/20 vision.  However, LASIK can increase the level of glare, even when using customized wavefront technology. Most of the additional glare induced by LASIK lessens over time because of healing and patient adaptation.  Nonetheless, there is a small percentage of patients with chronically increased glare.

Presbyopia – Most people over age 45 require some form of corrective lenses for reading and close-up vision. LASIK does not correct for this condition, and it is common that patients feel their need for reading glasses accelerates after LASIK.

Please be aware that this list is not meant to be exhaustive but to serve as a guideline to some of the most common side effects. Details will be discussed with you personally during your consultation

Read more about LASIK Surgery Risks and Side Effects.

To Experience the Kelly Difference and start seeing better, sign up for your free consultation online today, or call us at 1.877.377.EYES.