LASIK is about how you feel about the world not just how you see it

When a patient comes to us or any doctor, we are supposed to not be treating just a complaint or an illness, but rather the whole individual.  This means taking into account a broad range of factors that includes not only what brings them to visit with us today, but also, what they are about and where they have been and where they hope to be going in the future.  It is much more than taking a reading from their glasses, and then putting them under a laser for a few minutes.  We must make a clinical determination if and what would be the best treatment for a particular patient.  Also we consider what would suit their particular needs not only now but into the future.  Contrary to popular opinion, most of the patients that we treat have significant corrections that without help will only let them see the big E (20/400) on the eye chart or worse.  These people have concerns that since their vision is bad perhaps their eyes are weak and cannot be helped with Lasik or other methods.  Others are so dependent on their contact lenses, that they are hesitant to leave them out even with wearing glasses for the few weeks that is needed so that their vision can stabilize.  We are not providing a cosmetic surgery, the vast majority of patients who undergo laser vision correction have significant visual impairment without it.  Everyone is different, and as such each person deserves an individual assessment as to what is the best option for them.  This is where co-managed care has been so helpful in that patients who are very familiar to their primary eye care provider has the benefit of that relationship in guiding their treatment path.  With or without this kind of referral, we still make an individual assessment of each patient prior to actually performing a procedure on them.

While it is not possible to discuss the entire decision making matrix that we employ it might be helpful to discuss a few important considerations.  For instance, occupation is an important consideration.  A person involved in contact sports such as boxing might be better off with a PRK than LASIK due to the risks of trauma to the eyes.  An accountant might prefer mono-vision whereas a professional golfer would want the best distance vision possible.  A policeman could have varying needs dependent on his/her particular duties.  While some laser centers like to tout that they have treated professional football players and then paid them for their endorsements and while their eyes are certainly important, it is not as critical in some respects as the vision of a commercial airline pilot or a heart surgeon or a SWAT team member.  We have treated patients from all of these categories and many more.   Long haul drivers need to be concerned about their night vision and pianists need to read the score and see the conductor.  This is just a smattering of occupational considerations that we encounter daily.

While we have the latest and the greatest technology including diagnostic scanners, in the end it comes down to judgment in each particular case as to what and how to treat a particular patient.  Should we do mono-vision and if so how much should we leave one eye nearsighted?  Is there a dry eye problem and how is best to treat this before and after vision correction?  Are there other medical issue to consider, and if so what will be the impact on our results?  Do the scans suggest that a particular patient would be best served with alternative treatments?

The point of all of this is not to imply that we have all of the answers, or that doctors all agree in every case.  It is to say that laser vision correction and LASIK is part of the art of medicine.  It is not Walmart, it is not something where it fits very well with a corporate model or franchise cookie cutter approach.  In fact it is much more like all other things medical that a team of intelligent and dedicated professionals are involved in a process to improve the quality of life of an individual with their patients best interest as the paramount goal. 

We try to remember that LASIK is the procedure but good vision is the benefit that we are working to achieve and have been for the 25 years that I have been in practice and for the almost 50,000 LASIK procedures that I have performed.  My goal is to make the people who come to us for care feel good about their eyes again.