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As promised, here is some general information about Laser Refractive Eye Surgery, as opposed to Laser Eye Surgery to treat eye conditions.

For those of you who missed my earlier posting: As some of you already know, I'm an Optometrist (Ophthalmic Optician). I work for myself as a permanent locum. I carry out eye examinations only, for which I am paid a fixed fee for the day, with no connection whatsoever to the number of new prescriptions issued or spex/contact lenses sold. Pressure has been applied by some 'employers' in the past with no effect.

Therefore, I feel that my views on Laser Eye Surgery are balanced and not biased by the sale or lack of sale of spex etc. The need for spex or not does not prevent me giving the very good clinical advice that every person at any age should have an eye examination every two years at the outside. This is especially important for the detection of abnormalities, both ocular and non-ocular, that are symptomless.

The excimer laser can be used to treat short-sightedness (myopia), long-sightedness (hypermetropia or hyperopia) and astigmatism (where the eye is a little egg-shaped rather than spherical). Astigmatism is present to a degree in most people in addition to the presence or lack of any other visual defect. Long-sightedness is not the same as the normal loss of reading focus with age - this is called presbyopia and cannot be corrected with the laser. This develops from the age of about eighteen, progressing gradually to about the age of sixty and usually starts to be a nuisance for most people from about the mid-forties onwards.

The two main procedures in use in the UK nowadays are PRK (photorefractive keratectomy) and LASIK (laser in situ keratomileusis). LASIK is the newer procedure of the two.

Both procedures are carried out by an ophthalmic surgeon under local anaesthetic as an outpatient procedure. Eye drops are used to anaesthetise the cornea (the outer shiny window of the eye) and not injections. Anaesthetic eye drops usually sting for a few seconds. The rest of the procedure is painless and the whole things lasts about fifteen to twenty minutes. It is normal to treat only one eye at a time. The second eye is usually treated in one to six months for PRK and one to three months for LASIK. Treatment of both eyes at the same time is specifically not recommended in case of infection or major complication. Managing with only one eye treated can be very difficult in spex, especially if the untreated eye has a high prescription. A contact lens in the untreated eye may well help during this period.

In general, it seems that LASIK produces more predictable and permanent results. The post-operative pain with LASIK is much less than with PRK. Nobody can say that there is no post-operative pain because we're are all different is our levels of pain threshold and wimpness ;)

There is often some residual error after surgery and spectacles or contact lenses (though much weaker than before treatment) may still be required to achieve the best possible sight for driving etc. In most cases it is possible for an eye to be treated again should the initial treatment be inadequate.

Some people will not be suitable for laser treatment due to health, eye and other issues.

Remember that if your sight is 'corrected' by laser, you will still need reading spectacles from about mid-forties or so onwards. Furthermore, there are some careers where this sort of treatment is not allowed. Information and restrictions relating to the police and the three armed forces is constantly under review and I currently have conflicting information about these. Do check with the relevant force's medical department whether this sort of treatment is acceptable.

Click here for the Refractive surgery pages from Moorfields Eye Hospital, London.

Click here for a brochure about refractive surgery from the Royal Eye Hospital, Manchester. You will need the freely available Adobe Acrobat Reader, version 4 or above, to read this document. If you do not have Adobe Acrobat Reader you can download it free by clicking here.

Click here and here for information from the Royal College of Ophthalmologists' web site - a professional body for Eye Surgeons. It has explicit details about the different procedures and collated information on success rates, complications etc.

Click here for some patient comments and experiences about individual clinics and surgeons.

If any of the information on this web page is unclear, let me know and I'll try to explain it.

It is not possible for me to recommend that you undertake treatment or not. Everyone should have a thorough eye examination at least every two years, no matter what their age or vision. Some people need to go more often e.g. diabetics, those with a family history of glaucoma and so on.

As has been stated by many people, advice from the clinics offering treatment could be biased and information and statistics in the above URL should be un-biased.

I hope this information helps.