Laser Eye Surgery in Denver, Colorado & Surrounding Areas

LASIK and Corrective Eye Surgery FAQ

Many of our patients share common concerns when exploring laser vision correction. Whether you are interested in LASIK or some other refractive procedure, we at the Dishler Laser Institute want to make sure that you have all the information you need. If the answer to your question about LASIK eye surgery cannot be found here, please contact our practice, serving Boulder, Littleton, and Arvada as well as the rest of Colorado and surrounding states, or check our corrective eye surgery technology FAQ for more information about the equipment we use.

Dr. Dishler- Colorado’s Leader in Refractive Surgery

Top Faqs

Am I eligible for LASIK?

Most healthy adults are eligible for LASIK. In order to be a good corrective eye surgery candidate, you must be over 21 years of age with a stable corrective lens prescription. LASIK patients must also have corneas thick enough to support the creation of a corneal flap, and you must be free of eye diseases, scarring, and other medical conditions.

If for some reason you are not eligible for LASIK, you may still be a good candidate for another corrective eye surgery, such as PRK or implantable contact lenses. With the help of our seasoned staff, Dr. Jon Dishler will evaluate you meticulously to determine which procedure best fits your needs.

How good will my vision be after LASIK?

While it is difficult to predict the exact outcome of any procedure in advance, our patients reliably achieve excellent vision after surgery. Almost every patient who undergoes blade-free custom LASIK enjoys at least 20/20 vision, and many are able to see much better. Our techniques and equipment also minimize the incidence of LASIK risks, including halos and other side effects.

How long will it take me to recover?

Complete LASIK healing and recovery usually takes about two months. However, most patients notice improved vision the same day and are able to return to most normal activities within a week or two. Recovery times for other types of corrective eye surgery vary.

How will I pay for my procedure?

Though insurance may pay for certain procedures, it is often the case that LASIK and other corrective eye surgery are not covered by insurance. We are committed to offering some of the lowest prices available anywhere on refractive procedures, including the guaranteed lowest price for custom LASIK. Additionally, we work closely with financing companies that specialize in elective medical procedures to offer affordable, flexible financing plans for our LASIK patients.

Is corrective eye surgery painful?

Before corrective eye surgery, we always administer anesthetic eye drops and other medications designed to ensure a calm, pain-free procedure. Most patients report that treatment is free from pain or significant discomfort. After LASIK, the recovery period should also be pain-free. Some patients experience mild discomfort during the early stages of recovery, but any pain is likely a sign that something is wrong and should be reported to Dr. Dishler immediately.

Is LASIK eye surgery safe?

LASIK eye surgery is a very safe procedure, and the Dishler Laser Institute has a particularly impressive safety record. With over 45,000 procedures completed in more than two decades of practice, Dr. Dishler is one of the most experienced LASIK surgeons in the United States. Additionally, we use the newest and most effective LASIK technology, ensuring a reliably safe, precise, and effective procedure. The incidence of serious LASIK complications among our corrective eye surgery patients is extremely low, and the vast majority enjoys amazingly clear, sharp vision.

Contact the Dishler Laser Institute for LASIK Corrective Eye Surgery Near Boulder, Littleton, and Arvada

Our staff is happy to help if you have more questions about LASIK corrective eye surgery. Please contact our practice, serving Arvada, Littleton, and Boulder as well as the entire state of Colorado and the surrounding area, to request further information or to schedule a LASIK consultation with Dr. Jon Dishler. We can help you learn what you need in order to make an informed decision.

Bottom Faqs Left

3 Questions to Ask when Choosing a Lasik Doctor?

A: The Four C’s of LASIK
You asked for three but there are four important things to look at when considering LASIK vision correction.

Most everyone has heard of the four C’s of diamonds that are carat, color, cut and clarity (not necessarily in that order). We have found that there are also four C’s in LASIK which gives a basis to begin to evaluate LASIK providers and the decision to have this procedure. The first one that comes to mind is COST (this could be for diamonds also but they don’t mention it for some reason). The second is COMFORT since nobody or almost nobody wants to experience pain. The third C is Convenience of the visits, the procedure, and lifestyle impact in general. And the final C is the most important one, credibility.

Are Eyelash Extensions Safe?

I am 44 years old, with short eyelashes. I would love to have lash extentions done, but am concerned that the fumes from the glue used would cause harm to my eyes when my eyelashes get wet.
A: You should consider Latisse instead of lash extensions
Why not get the real thing? Lash extensions are at best temporary and potentially harmful. With Latisse you can grow your own lashes longer, thicker, and darker in just a few months which is preferable to an artificial extension. This is the situation that Latisse was made for, and reports are that it is virtually 100% effective.

Best Treatment to Grow and Volumize Lower Eyelashes?

My lower eyelashes are short and sparse. I am hoping to find a product that will help my lower eyelashes grow longer with more volume. I read that Latisse cannot be used on lower eyelids. Could you please recommend the most effective product to use on the eyelashes in the lower eyelids? Also, is the product safe? Thank you.
A: Only apply Latisse to your upper lashes
Latisse is powerful in that application of it to the upper lashes will transfer enough to the lower lashes to make them also grow longer, thicker, and darker. Do not attempt to apply it directly to the lower lashes.

Blurry and Fluctuating Vision One Week After Lasik

I had my Lasik performed on July 2 and and it is now July 12. I constantly have flucuateing vision and its really hazy in dim light and I cant drive at night because it looks foggy. I figured it could be because my prescription was so high. My left eye was -5.25 and my right eye was -4.25. I can see great close up but cant focus on anything distant. Is anything wrong or am I not giving myself enough time to heal?

A: You Need to See Your Eye Surgeon

Although it has only been one week since your procedure, most patients have fairly good distance vision at this point and you should go back to your eye surgeon for an evaluation. Your prescription, while significant, is fairly commonly treated with LASIK and is not a very high prescription. I suspect that you may have some dry eye or other cause for the blurry vision that needs attention.

Can I Combine a Blepharoplasty with Lasik in One Surgery?

Can Lasik surgery be combined with eyelid surgery? I would rather only have one surgery but I want both procedures…Would it be hard to find a doctor who can do both?

A: Not a good idea to combine LASIK and Blepharoplasty
It seems hard to imagine that someone would even propose combining these two procedures in a single surgical encounter, but my opinion is that this is not a good idea. If the blepharoplasty was performed first, there would be difficulty opening the eyes in a way needed to perform LASIK and if LASIK was first then the bleph might very well disturb the corneal flap.

In addition, most blepharoplasty patients have significant lid swelling making it difficult to open their eyes very much for several days, and it would be almost impossible to examine or treat the cornea in this situation.

It seems that none of the doctors giving opinions prior to this one are in favor of such an idea, and I would have to agree that this does not make much sense.

Can I Stil Get Lasik if I’ve Abused Contact Lens Wear in the Past?

I admit that I am a contact lens abuser. For many years I have slept in them and my doctor has told me my eyes have been deprived of oxygen and I now have ghost vessels. Am I still a candidate for lasik even though I have ghost vessels? I still sleep in my contacts but now replace them more frequently (every month).
A: Yes, you are a candidate for LASIK but you must stop the lenses first!
Many people abuse their contact lens wear and can make for very successful LASIK candidates. You must stop wearing the lenses until your vision and eyes stabilize. This may take up to several months and should be monitored by your doctor. The ghost vessels are not a problem, but you may need some additional steroids to reduce inflammation during healing. Also, if there are any active vessels you could have some bleeding at the time of your procedure but this can be controlled and should not affect your result.

Can Latisse Be Used by Contact Lens Wearers?

Will I be able to use the new Latisse eyelash extension mascara if I wear contacts?
A: Contact lenses no problem with Latisse
First let me state that Latisse is NOT a mascara or any type of eyelash cover up or extender. It is a medication that actually causes the existing lashes to grow longer, thicker and darker over a period of weeks to months.

Contact lenses should be removed before the Latisse is applied and not reinserted for at least 15 minutes according to the manufacturer Allergan.

Can Latisse Be Used if One Has a Permanent Tattoo Eyeliner?

Can Latisse Be Used if One Has a Permanent Tattoo Eyeliner?
A: Latisse will work even with permanent eyeliner
When there is permanent or implanted pigment in the eyelids, this will not have any influence on the effectiveness of Latisse so long as the lash follicles have not been damaged. In general the follicles are much deeper than the pigment and therefore will not be injured by the pigment that was applied.

If one has not had permanent eyeliner, it is recommended to try Latisse first since the benefits may be so marked that there will be no need for a permanent eyeliner. In addition to making the lashes darker, thicker, and longer, the Latisse will increase the pigmentation at the base of the lashes to further enhance the effect. Although this is not a permanent effect, it will last so long as a maintenence dose of Latisse is applied a few times per week.

Can You Have LASIK Twice?

I had LASIK eight years ago and have now begun to lose the clarity of my vision again. Can I do another LASIK surgery?
A: Repeat LASIK is sometimes possible even years later
There is no certain answer to this and it depends on your particular case. If the eye is well healed, there is adequate tissue left, and there is a significant benefit in doing more surgery, then a repeat LASIK may be performed. Our experience is in lifting flaps for retreatments this many years out there is a higher chance of complications such as epithelial ingrowth and you need to discuss this with your doctor. Sometimes a surface or PRK treatment can be performed, but this is definitely off label and not an FDA approved treatment (nor is any repeat laser treatement FDA approved).

Some patients only have very minor changes in their vision, and a repeat surgery is not always in their best interest. It is up to you and your doctor to evealuate your case individually and make that determination.

Can You Use Latisse at Any Age?

Hi, i am 13 years old. I have red hair and blonde eye lashes. If i don’t pile on mascara (as i did in the picture below)my eyelashes are not even noticable. They are thin and not vey long, and defanantly not thick. Would I benefit from Latisse, or would you not recommend it for my age, or do you think it would even be worth it? Or is there even an age limit? I would greatly appreciate any answers.
A: Mimimum age for Latisse
I would recommend that you wait a few years. At 13 your body is still developing and no one knows for sure if their might be problems for such a young person down the road. This is a medication, and I would recommend that you wait until you are 18 to use it. I suspect it would work for your lashes but it is unlikely that many doctors would feel comfortable prescribing it for someone at your age.

Concern with Daytime Glare 6 Weeks Post IntraLasik

Pre-op I was -3.75 Left -3.5 Right. One week after had 20/15L and 20/20R. 6 weeks out I am still experiencing Daytime Glare. Even in very good lighting, light sources look hazy or blurred like looking through dirty contacts. Edges seem to bleed over from things like TV and backlit trees. This effect is worse in my right eye. Just finished steriod treatment for TLS, but did not help glare. I know it could take months for the nightime starbursts to fade. But Is this the case for the daytime glare?

A: Check eye pressure ASAP!

Since you have been using steroids for TLS and you are experiencing daytime glare, my first thought is that the steroids could be raising your eye pressure, causing edema of the cornea. This is potentially a dangerous situation, so it is important to get the eye pressure measured immediately.

Other causes of daytime glare at this point include swelling of the cornea from other causes, and a thorough eye examination should be able to help determine the cause.

Cost of Doctor’s Fee for Latisse Prescription?

Since Latisse can only be purchased with a prescription, how much is the doctor’s fee? I know Latisse cost around $130.
A: Look for a free consultation for Latisse
In our market many doctors offer a free consultation for Latisse which is a short evaluation and answering a few questions. The reasons for this are to familiarize you with their offices, and if they dispense, there is a small profit in the Latisse product that is sold to you. You may also learn valuable tips when you have your consultation. It is typically offered by dermatologists, plastic surgeons, and ophthalmologists as part of their practice.

Does Excessive Sweating Affect Latisse Results?

I would like to know if Latisse would be effective if you work out in the gym and sweat a lot?
A: Apply Latisse at bedtime as directed
You should apply Latisse at bedtime, not right before going to the gym. Once it has “soaked in” over night it is not likely to be washed off or sweated off at the gym. This is not a cosmetic but a medication that if applied correctly will absorb into the base of the lash follicles and not be subject to sweating or washing. As directed, it should be applied with the applicator to the upper lashes only in a very thin film and some will transfer to the lower lashes with blinking.

Does Eye Dryness After Lasik Affect the Vision?

i make the lasik after a month i feel unclear vision and a doctor told me that i have -1 in my eye and the doctor who made me the surgery told me thats from my eye drynes.
A: Dry eye is the most common cause of blurred vision after LASIK
Many patients seeking LASIK have borderline dry eye to begin with and this is why they are having difficulty wearing contact lenses. LASIK many times makes dry eye worse, mostly on a temporary basis while healing is occurring. This is not always felt as dryness by the patient, but the surface of the eye needs to be properly covered in the tear film for normal vision. Many patients who report symptoms of blurred vision will be found on exam to have signs of a dryness problem.

Fortunately we can easily treat this problem, restoring the clear vision while the eye heals. This is done with artificial tears, punctal plugs, or other medications such as Restasis. Your doctor will be able to diagnose and treat dry eye appropriately after LASIK if needed. This is one more reason to pick your doctor and not just a “brand” for LASIK vision correction.

Does LASIK Cause Night Vision to Change?

I’m almost convinced that I should go through with LASIK but I’m quite concerned about changes to my night vision, ie halos – how often does this side effect occur and what can be done to prevent it?
A: Night vision usually NOT a problem after LASIK any more
In the early days of LASIK there was a high incidence of night vision problems, especially in patients with larger pupils, or flat corneas. Today we have more understanding of how to reshape corneas and avoid this problem and this is described as prolate optimized or wavefront optimized custom treatments.

In simpler terms, the eye is prolate or comes to a steeper area in the center and this is the same shape that eagles have which gives excellent distance vision. The early LASIK procedures flattened the center of the eye, creating an oblate or flat shape, similar to that of a cow, which gives good daytime distance vision but poor night vision. This was made even worse because the earlly lasers did not have eye trackers which are standard today, and there were many eyes with slight decentrations that gave symptoms at night.

The newer treatments are “prolate optimized” and thus even in large pupil patients do not interfere much with night vision. It is still possible in particular cases to have problems with night vision after LASIK and it is important to discuss this risk with your doctor in your particular case based on all of the measurements and scans made of your particular eye.

Does Latisse Grow New Lashes?

I have very sparse eyelashes. Does Latisse just enhance what you have or will it actually grow new lashes?
A: Latisse can make tiny lashes much bigger
No, Latisse does not grow new lashes in places that none existed before, but what it does do is to make the existing lashes grow longer, thicker and darker. This effectively makes it appear that new lashes have grown, but in fact it requires the follicle to already be present but just “dormant” and the Latisse increases and emphasizes the active phase of your lashes.

ecovery After LASIK Eye Surgery?

How many days does it take to recover from LASIK eye surgery? Can you have it on a Friday and go back to work on Monday?
A: WOW effect after LASIK
The initial healing after LASIK is so fast that it has been termed the “wow” effect because so many patients say “wow I can see already.”

This is from the fact that the flap only needs to heal at the edges, and the central vision part of the cornea is not disturbed. Although the initial healing is fast, so that most patients achieve close to 20/20 vision in less than 24 hours, sometimes it can take longer for the vision to stabilize. In addition, the vision can continue to change slightly throughout the healing process for several months.

Mechanically the flap is not really healed this quickly, and one needs to be careful to avoid eye trauma, especially during the first few weeks.

Ghost Vision After Two Lasik Treatments

I’ve had Double or “Ghost” vision after my first Lasik treatment, and my right eye had the brunt of the effect, making it hard for me to read. I had another one two months ago, but to no avail. Is this part of the healing process and will pass afterwards? Thank you.
A: Ghost vision may not go away but may be treatable
Some patients experience ghost vision or halos or glare after LASIK or PRK. This was much more common with older laser platforms and is rare in cases done today. It can be from a variety of causes, some treatable and others not.

If the ghost vision is from dry eye, residual uncorrected astigmatism, or a decentered treatment there may be hope of improving the situation. If it is from very large pupils at night, then certain medications can be helpful.

On the other hand if there is irregular astigmatism, or some other eye problem such as a cataract forming then further LASIK will not be helpful. A thorough evaluation by a trained LASIK doctor would be helpful. A hard contact lens trial sometimes can help to make the diagnosis.

Hazy, Unclear Post-op Lasik Vision

I had Lasik six days ago. Since the surgery, I have not had any periods of sharp, clear vision. I cannot read signs while I am driving, I have to get closer to things to read, and I feel like I am in a fog most of the time. I really did not expect it to be this way. Was I just not informed properly? I am a surgical resident, and I am very concerned because I will be returning back to performing surgeries in a few days. Is there anything that can be done to help me? Is the post-op course longer, and harder for people with higher prescriptions? I am trying to be patient, but I am getting really frustrated.
A: Blurry vision at six days after LASIK not common, but not necessarily abnormal
Most patients regardless of their prescription have fairly clear vision within a few days, but it is not unusual to have slightly blurry vision for several weeks, sometimes for unexplained reasons. The most important question is what is your vision best correctable to and if at least 20/30 then you may just be healing a little slower than average. If it is worse than this I would ask your doctor for an explanation as to specifically what is the problem. On the other hand if it is correctable and it is just that there is some residual correction, this may clear in a few weeks, or you may need to have an enhancement at some point.

Since you are a medical resident, you should pursue a technical explanation, and your doctor should be able to give you a plausable explanation. If not you may wish to seek another opinion as to your progress if your vision does not improve in another week.

How Does Latisse Change the Eye Color?

One of the side effects of Latisse is increased brown pigmentation of the colored part of the eye which is likely to be permanent. Is that because some of the solution gets in the eye? Does this side effect occur with Revitalash? I am wanting to purchase Latisse but not at the risk of changing my eye color or getting dark blotches.
A: Latisse activates pigment and cell growth — that is how it works
Latisse activates hair follicles and the pigment within them which is how it works to make lashes longer and darker. This same effect happens to the pigment cells of the iris in rare cases when the medication is placed directly in the eye. This was all learned from Lumigan which is the same Brimatoprost medication but used for glaucoma. It turned out that these patients grew longer lashes as a side effect and that is the basis of using Latisse. The idea with Latisse is not to get any in your eye, or at least not very much, so this should not be much of a worry and there are no reported cases to my knowledge of darkening iris pigment in Latisse patients at this time. To the extent that the medication in other preparations is the same or similar to that in Latisse it would also have the possibility of darkening the iris.

How Long After Having Permanent Eyeliner Can You Use Latisse?

A: Permanent eyeliner can be followed by Latisse but why?
If you had permanent eyeliner in the past, then Latisse can be used without any problem. The question of when after permanent eyeliner can you begin Latisse suggests that one might want to do both. Since Latisse is so successful at making eyelashes thicker, longer, and darker — and since Latisse also sometimes makes the base of the lases darker by hyperpigmenting the skin, it seems not necessary to also do permanent eyeliner.

So my suggestion is to try Latisse alone by itself, and if you are not happy with the appearance, then consider permanent eyeliner later.

From a medical perspective, you could start Latisse about one week after the permanent eyeliner has been completed.

How Long Does Dry Eye Last After Lasik?

Did you have dry eye after LASIK? If so, how long did it last?

A: Dry Eye after LASIK is Common but usually Temporary

In LASIK, we are creating some stress to the eye in the creation of a corneal flap and the ablation of corneal tissue. There is loss of nerve endings and this in turn leads to dry eye of varying degrees. In patients who already have borderline dry eye this can tip them into a symptomatic situation.

Fortunately, as the eye heals, these nerve endings are restored naturally and the typical symptoms of dry eye after LASIK are limited to a few months. In some cases it can last longer.

Diagnosing dry eye pre-operatively, treating it appropriately when it occurs, and newer surgical and medicines all have helped to make this a problem that usually can be controlled.

Some types of treatment like farsighted treatments are more prone to dry eye symptoms after surgery.

How Much Does PRK Cost?

How much does PRK cost? Is it more or less expensive than Lasik?
A: PRK costs about the same as LASIK
At first one might think that PRK should cost less than LASIK, but in most cases it is about the same. One thing to realize is that because PRK involves removing the epithelium from the eye, the recovery is longer and many times requires more visits.

Because the visits are bundled into the cost in most cases, the increased intensity of care offsets the fact that a flap does not need to be made in PRK like it does in LASIK. Also, the patients who have PRK are in general higher risk which is the reason that they are having PRK rather than LASIK in the first place. The exception to this is PRK when the patient has occupational reasons for this choice.

Another factor is many times PRK patients are also treated with Mitomycin C to prevent hazing and this must be purchased as a freshly compounded medication from a special type of pharmacy and this is an expensive medication.

Patients also have a slightly greater chance of needing a repeat treatment or enhancement with PRK as compared to LASIK and this is included in the cost and needs to be considered in the overall costs as well.

Finally, and most importantly, the doctor should be providing the care which is in the patient’s best interest. For this reason, many doctors do not want to discriminate between similar procedures based on cost and simplify the process by providing one price regardless of the exact procedure. This way patients do not have to make a decision about which procedure to have based on cost considerations.

All doctors and centers set their own pricing, so there is no absolute rule here, but in general expect to pay about the same for either procedure.

I Found on the Internet That Latisse Only Contains 5% of a Lumigan Drop

Wouldn’t it be dangerous to be using Lumigan on the eyelashes in such a high strength dosage instead of Latisse?
A: Lumigan for glaucoma is exactly the same medication as Latisse
As was already mentioned, the medication for Glaucoma, Lumigan, and the mediciation for eyelash enhancement, Latisse are exactly the same, they are both:

bimatoprost ophthalmic solution 0.03%. They are both the exact same bottle, the same amount, and the same vehicle. They are the same. What is not the same is that when used as directed, a much smaller amount of the medication is applied to the lash margin in the case of Latisse which is a good thing to keep this medication out of the eye if it is not needed there. This helps to be the reason why in clinical trials there were no cases of darkening of the iris, or significant periocular pigmentation changes.

The packaging for Latisse provides special applicator brushes that should be used to apply this medication for best results.

I have a very high level of farsightedness (+9 in my left eye, +8 in my right eye) as well as astigmatism. Can I get LASIK?

Is it possible for me to have the surgery to at least drastically reduce my level of eye care needed? I received a LASIK screening and the doctor informed me that I would have to wait for new technology because LASIK isn’t suitable for me. They did say that my cornea tissue was thick enough but my prescription was just too bad. However, I have come across articles that say people with high farsightedness can in fact get LASIK.

A: Probably Not but Maybe

It depends. Usually the most farsightedness that can be corrected is +6 Diopters, and some doctors believe that this is really at the edge. However, if your astigmatism is nearsighted, such as +8 -4 astigmatism, then this is really +4 with +4 astigmatism, and it might be treatable since the spherical equiv. is +6 — but I would not count on it. You might be better with a refractive lens exchange type of procedure.If you are only looking to reduce the amount of far sightedness and understand you will still need some glasses, this is also a possibility for LASIK. You might want to get another opinion, just to be sure.

If Latisse Gets in Your Eyes Can It Cause Damage?

If you are wearing Latisse on your eyelashes and it gets in your eyes, like by rubbing your eyes or something, would it do any harm to your eyes or your vision? I know it just got approved, but does anybody know? Thx.
A: Latisse should not damage your eyes
Latisse is the exact same medication as Lumigan, which is a glaucoma medication, and in the same strength and formulation. Although it is best not to get Latisse into your eye, and there is the theoretical possibility that it can interfere with glaucoma treatment in patients with glaucoma, it should not harm your eyes. If you get very much of it in your eye and you have light or hazel colored eyes it could permanently darken your eyes. It can also darken the skin around the eyes. If applied correctly, you should not get any significant amount of the product into your eye. There are rare patients that have experienced eye irritation.

IntraLase Lasik Vs Traditional Lasik

My friend just underwent lasic eye surgery but using a new technique called Intralase. She told me that intralase was better than lasik. She really couldn’t explain why other than saying that intralase makes thinner cuts into the cornea. I imagine thinner the better, but can someone help explain why this is better than lasik?
A: Intralase is better for most patients
We were the third site in the United States to introduce Intralase, and completed 900 of the first 1000 Intralase cases ever performed, so there is some bias perhaps in my answer. If you look at the statistics, there is an increasing percentage of eyes that are treated with the Intralase as compared to the microkeratome, which is now over 50%.

There are many benefits to Intralase, which I believe is clearlly safer than the microkeratome, and this is coming from someone who had previously performed tens of thousands of microkeratome cases. It is the achilles heal of LASIK surgery in that most complications of the procedure are microkeratome related.

As to effectiveness, it is probably slightly better than microkeratome but the differences are less substantial than the safety aspect.

There are even newer femtosecond lasers available and we are one of the few sites, but there are others, using the new Zeiss VisuMax laser which is even better than the Intralase in my opinion. It is more accurate, uses a lower suction pressure, and cuts a more precise flap in our experience.

You should not have to pay much more for a femtosecond (this is the technology behind the Intralase and other laser cutting lasers) than for the blade, and the small extra cost is definitely worth it. We only do all laser lasik, and like other centers to not add a premium charge for this better technology which all of our patients deserve.

Rarely, there is a case such as a corneal scar where we do need to use the microkeratome, but only about once a year.

Is ICL Better Than Lasik?

Does the ICL eye surgery really give you better vision than LASIK?
A: ICL can sometimes be a better choice than LASIK, but not always
The ICL is a lens which is placed inside the eye to correct refractive error. It has the potential advantage of being removable, and does not require the cornea to be modified as in LASIK. It does require a small hole to be made in the iris or colored part of the eye, and can cause cataracts in some cases. It is also more expensive to have performed than LASIK, potentially can have more serious complications since it is within the interior of the eye, and currently is not approved for correcting astigmatism.

The ICL is a lens made by Staar which is placed inside the eye during a surgical procedure to correct nearsightedness. The Staar lens is made of a very biocompatible material and therefore does not cause inflammation within the eye. It may soon also be able to correct astigmatism when this version is approved by the FDA. It is one of several brands of lenses that go into the eye along with the natural lens to improve the vision as opposed to LASIK which works by reshaping the front corneal tissue of the eye.

The ICL is most often used in high corrections or in cases where the cornea is too thin or unstable preventing LASIK. Some doctors offer the ICL as a “premium procedure” but it has not been proven to provide results better than LASIK in most cases. In cases where the ICL does not fully correct the vision it needs to be removed/replaced or LASIK can be done in addition to “fine tune” the results.

In summary, the current status of the ICL is that it is potentially a good option for certain situations but at this time is used mostly for cases where LASIK is not a good option.

Is It Safe to Fly After Lasik Surgery?

I am considering Lasik surgery and have an upcoming vacation that will keep me away from too much eye strain for at least a week, which I hear is helpful. The only catch is I have to fly. Will the change in altitude or pressure changes affect my results or cause any discomfort?
A: Flying is safe after LASIK
We are often asked this questions since many patients travel from far away to have LASIK at our center. There is no problem with flying even shortly after LASIK surgery from a medical standpoint. There might be a problem immediatelly after surgery in negotiating the airport, dealing with travel stress and delays, and more importantly what to do if having some discomfort during the flight, or needing to return to be checked if problems arise.

We recommend that patients be checked one day post op before traveling home for these reasons. Also planes are dry, and frequent tears and good hydration are important. If traveling for vacation, sun protection, sports eye protection, and staying out of the water for a week is probably a good idea.

Is It Safe to Use Latisse After Lasik Eye Surgery?

I’ve had Lasik on both eyes 2 years ago and had no problems. Can I use Latisse?
A: Latisse after LASIK
I was just discussing this very issue with the Allergan representative and no formal studies have been completed. Since Latisse only goes on the lashes, and since even if a small amount made it into the eye it is a safe glaucoma medication (Lumigan), it is not believed that Latisse should be a problem after LASIK.

A better question might be how soon after LASIK can you use Latisse, and this is more difficult to answer. We are telling patients to discontinue Latisse a day prior to LASIK and not to resume it for at least a month to allow the flap to heal without the potential of trauma from the application, and to avoid any possible interference with healing. Our recommendation is that it be on hold for 6 weeks and restarted after the 6 week post op visit. If there are any signs of dry eye at six weeks we might ask them to wait a little longer.

The good news is that it takes Latisse 8-12 weeks to have a maximum benefit, and it takes about that long for the effect to disappear. Therefore, waiting six weeks will not result in a significant loss of the lash enhancement benefit.

Is It Safe to Use Latisse when Breastfeeding?

Is it safe to use Latisse while breastfeeding? I can’t find this information anywhere!
A: No, do not use Latisse when breast feeding
The labeling for Latisse states that it is contraindicated during pregnancy or nursing and I would recommend that you follow this advice. The amount of medication absorbed by the mother would be expected to be very small, and the real risks may also be limited, but better safe than sorry on this question.

Is Lasik Surgery a Good Investment?

I was comparing costs of contacts, glasses and LASIK. In my situation the bifocals and frames with coated lenses are quite expensive. I understand that I might be able to deduct the cost of LASIK making it more affordable.
A: Here is why LASIK may be a great investment for you in 2010
Many people have sticker shock about the cost of LASIK vision correction. While there is some disparity in pricing, when one compares the cost of this procedure to that of other options, it is surprisingly affordable. This depends on many factors which includes whether and the type of contacts being worn, the type and cost of glasses, and other considerations. In general, most people pay about a dollar a day for contact lens wear when one considers the cost of contacts, solutions, exams, etc. This is about the cost of a LASIK procedure over ten years. Now if you also have a pair of backup glasses every two years, it can make the costs higher and therefore the amortization period shorter, say 7-8 years. For those who wear toric contact lenses, these are more expensive to fit and replace, and the glasses worn are usually more expensive also. In this situation where there is some astigmatism (that is why the toric contacts are needed) the costs are higher, and it takes about five years to pay for LASIK.

But what about the person who wants designer glasses with all the “bells and whistles”? The frames alone can be over five hundred dollars, and add the special lenses and it approaches a grand. Then you might also want designer sunglasses — another big chunk of change, and it is easy to see that even without the eye exams, which are not free, it can be very expensive to have glasses and/or contact lenses. In fact some patients have told us that they spend the amount that LASIK costs in just two years on average, and that is every two years which makes this a much MORE expensive proposition than LASIK.

Because LASIK is a medical and not cosmetic procedure, it is eligible for both flexible spending accounts and in many cases as a tax deduction. While we cannot give any tax advice, and you should definitely discuss this aspect with your employer and/or your accountant, it is possible to pay for some or all of LASIK with pre-tax dollars. In addition, we are among the centers that offer two year no interest financing (wac) which allows a patient to make time payments on their LASIK over 24 months with no additional cost, while they are saving a good piece of this by not needing glasses or contacts during that time (at least in most cases).

Almost half of the patients that we see are over 40 years of age, and many of these people need bifocals which are very expensive, especially the no line variety. While after LASIK it is necessary for some to have reading glasses, these can be purchased for a fraction of the cost of bifocals. Also, over the counter sunglasses, even nice ones are much less expensive than prescription eyewear, unless you want to have Prada, Gucci, or Chanel to sport your new eyes behind.

If you are looking for a good investment for 2010, look no further than your own eyes, or those of your family. Because there are very few investments that make such good sense both financially and in terms of dividends that you can enjoy year after year. As the commercial for a popular credit card would say, “For everything else there is MasterCard, (including paying for your LASIK)……..but when it comes to enjoying clear vision without glasses….. priceless.”

Is Latisse Safe to Use While on Restasis?

I’d like to try Latisse but I use Restasis for dry eyes. Any problems?
A: Restatis and Latisse should not be a problem
This is a good question. Restasis is cyclosporin A and is used as a drop twice a day for dry eye conditions. It is actually cyclosporine which has an anti-inflammatory action. Specifically it inhibits T cells which are a type of inflammatory cell and thought to be responsible for the inflammatory component of dry eye. Latisse or Lumigan are a different type of medication. They are protoglandin like (prostamide) medications which reduce intraocular pressure and on the skin stimulate the growth of lashes.

Fortunately, the interaction of these two medications should not occur in that the Latisse is to be applied to the skin of the lashes and the Restasis is placed into the eye. Further, they are probably frequently used together in that it is the same demographic who would use both. Women, especially middle aged women are the ones who both suffer from dry eye the most and also are the most interested in Latisse for their lashes.

Since both medications are made by Allergan it would seem that the manufacturer would be aware of any untoward interactions between these two medications, and this has not to my knowledge been reported. It is certainly a good question and always a good policy to be aware of possible drug interactions.

Is Lumigan Drops the Same As Latisse?

Does Lumigan Drops have the same effects as Latisse for the eyelashes?
A: Exactly the same down to the bottle but you should use Latisse for eyelash growth
Lumigan is Brimatoprost 0.03% which is prescribed for Glaucoma. Latisse which was discovered as an accidental side effect of Lumigan, was repackaged with applicators and remarketed as Latisse once it was FDA approved for this indication. My understanding is that they are both exactly the same down to the bottle and the dropper because if there were any changes then Allergan would have had to do more extensive studies.

That being said, it is still a good idea to get Latisse for promoting eyelash growth and not Lumigan. There is the need for the applicators which have been specially designed for the usage, and it is being prescribed for that product which provides a safety net for the consumer/patient. Also, I do not believe that there is a significant pricing difference between Lumigan and Latisse, and it would be unethical to prescribe Lumigan stating that it was for glaucoma when in fact it was not.

Therefore the short answer is yes they are the same medication but if you want Latisse then get Latisse.

LASEK Procedure: Who Should Consider Lasek Surgery?

I am tired of wearing glasses and contacts, but my vision is very bad, and I don’t know if lasek surgery will work for me. How do I know if I’m a good candidate for this procedure?
A: The only way to find out is to ask if you are a good LASEK candidate
Many patients believe that due to the severity or astigmatism, or other issues that they may not be a good candidate for LASIK. With modern technology, ultrathin flaps, and the newest laser technology, there are many patients who can be successfully treated that were not candidates previously. Some patients need other treatments such as PRK or in rare instances an ICL. LASEK is a version of PRK and for some patients with thin corneas or slightly irregular corneas a surface procedure can be recommended. The differences between LASIK is significant as opposed to LASEK vs PRK.

Usually we find other reasons that limit patients from being good LASIK candidates, but overall most patients can benefit from laser vision correction. It is important to have consideration of things like dry eyes, the size of your pupils, and the shape and stability of your eyes. In general we say that patients must have healthy bodies and healthy eyes to be good LASIK candidates, but this gets into the art and not completely the science of medicine. It is important to pick a doctor you trust, and if in doubt get a second opinion.

Almost all laser centers and doctors who perform this procedure offer as an incentive to visit them a free LASIK consultation, so what have you got to lose to see your doctor and find out if you might be a good candidate for this procedure.

Laser Eye Surgery or Bates Method Therapy for Myopia?

Is there any different cure for curing myopia except for laser surgery and wearing glasses? I have heard of Bates method therapy but I have not practiced it yet. Is this method effective and does it have any side effect? What about laser surgery? Will I be better off if I have the surgery done instead? I am 22 years old and have -3.00 D for the right eye and -3.50 D for the left eye.
A: You cannot train your eyes not to be nearsighted
There have been many false cures touted for all kinds of things, including the Bates method for fixing vision. While vision training in children can be legitimate in certain circumstances, your situation can only be helped with an optical correction.

Nearsightedness is when the image at a distance is focused by the optics of the eye (the cornea and lens) in front of the retina which is the nerve layer that perceives vision. Whether this is due to an eye that is too long, or a cornea that is too steep, or a combination of both, the result is an eye that can not see well at distance. your eye is a -3.00 diopter which is perfect for vision up close, but anything further away than a few feet begin to get fuzzy. The only treatments for this are optical and include glasses, contact lenses, LASIK, an intraocular lens of some sort, or surgery to shorten the length of your eyeball (the last is not a good solution). From a practical “cure” standpoint a laser treatment like LASIK or a surface treatment like PRK are your best ooptions.

The best place to start is to get recommendations from your eye doctor who has spent many years learning about this issue and will steer you in the right direction.

Lasik for $299: is This a Scam?

One lasik clinic quoted me $2,000 an eye. Another advertises only $299. Is the expensive clinic trying to rip me off? They told me to watch out from something called the “Nidek” brand machines.
A: Low LASIK price
Whether it is $299, $599, or some other very low price, it is unlikely that you can have the procedure you want or need for this amount. As the price gets lower, the restrictions are greater, and more remote. I was once told that at one center that advertised $299 LASIK only 1% of patients qualified for that price, that is not very many. And everyone else paid a price that was close to market. It is difficult to get LASIK for less than $1000 per eye, and for custom blade free procedures it usually has a street price ranging from $1500-$2500 per eye. That is what LASIK really costs.

Lasik Plus Vs Wavefront Lasik

not sure i understand how each lasik is different. cheers
A: LASIK plus is just a name
Lasik plus (+) is a marketing concept or name that a corporate entity (LCA Vision or trade name LCAV) uses to give the impression that one is getting something extra at their centers. It has nothing to do with the laser treatment itself. Most of the care is from employees of the company and the surgery is performed by a doctor under contract.

Wave front or custom LASIK is a reference to a type of laser vision correction which treats or is optimized for a better result potentially than plain LASIK with older technology. The benefits of this type of treatment are real and vary in importance to each individual patient.

Lasik Vs. Wavefront Lasik – What’s the Difference?

A: New information on Customized LASIK
LASIK is the correction of “lower order aberrations” which is exactly what glasses correct. Wavefront or Custom LASIK was developed to treat small imperfections in the vision but in reality mostly was helpful in reducing the creation of new aberrations that were a side effect of the laser treatment. These corrections were popular at first but didnt always fix the lower order aberrations as well and thus not as popular as was originally hoped. Wavefront optimized is the current state of the art for most people since this maintains the normal shape of the eye and induces few new aberrations while very effectively treating the lower order aberrations giving most patients the desired 20/20 result that they seek.

There are several laser platforms that provide this optimized custom treatment. Some patients need a more customized treatment, and for these patients, a topography guided treatment or topo guided may be best. This is because we only want to fix the aberrations which come from the cornea when we laser treat the cornea, and not those from other eye structures such as the lens.

Lasik with Corneal Scar?

I have a corneal scar on my right eye due to a pseudomonas ulcer I had a month ago. I’ve told it is deep but is not close to the center of cornea and so it did not affect my vision. I’ve been not examined by lasik surgeons yet but the other doctors said lasik in the future will be too risky and no one will like to touch my eye because the scar will be always deep. Dose my deep scar ( even if it is not close to the centre) disqualify me from the operation? …Thanks so much

A: You were probably told correct information about LASIK

LASIK requires making a corneal flap and although it can be performed in small superficial scars, and long standing scars, the type you describe may make it a better option to consider PRK or surface treatment even if the scar is not directly over your pupil. Of course, this depends on the size, depth, healing, and other factors that can only be made by your LASIK surgeon. Pseudomonas is a very virulent infections and can create significant damage, which is why I am leaning in this direction. You may also get some extra reactivation and need to have longer steroids post operatively.

Latisse for Patients Under 18?

I am 17 years old and I have very short, thin eyelashes. Sometimes I end up without my eyelashes, because the area where the eyelashes grow, itches a lot and I have no choice but to rip off my own eyelashes. All I want is to have long and thick eyelashes. Do I have to wait until I’m 18 years old to use Latisse?
A: This is a practice of medicine question to ask your doctor about Latisse at 17 yrs
You are younger than the labeling for Latisse is approved and therefore it cannot be recommended for you officially, although doctors can prescribe medications “off label” when they believe it is in the best interest of their patients. Therefore you should discuss this with your doctor, and if there are no other reasons not to use Latisse, she/he might prescribe it for you.

Latisse in Drop Form?

Does Latisse come in drop form? Or how do you apply it?
A: Latisse is actually in an eye dropper bottle
Latisse is the same medication as a glaucoma eyedrop, Lumigan, so it comes in a small eye drop bottle. It is packaged with applicators and you place a drop on the applicator and then use this to place the medication at the base of your lashes. It is packaged so that one applicator is used for each eye, and therefore it comes with 60 applicators for a month supply. Some doctors recommend to use one applicator for both upper eyelids, which effectively doubles the length of time that a bottle will last, although this is not the manufacturers recommendation and you should check with your doctor. Enough transfers from the upper lid to the lower lashes for it to be effective on these lashes as well.

Latisse Safety and Pressure in the Eyes?

I have been losing my eyebrows and lashes slowly for years. I would love to use the product, Latisse but I am concerned about the safety of pressure in the eyes. Is it something I would need to get directly from a dermatologist and have regular eye examinations, or is it something I can just purchase online? Thanks.
A: Latisse would probably, if anything, lower your eye pressure and not raise it
Latisse is the same thing as Lumigan which is a medication used to treat high eye pressure. Although it is advised not to get Latisse into the eyes, and you shouldn’t if applied properly, the most likely effect of getting it into the eyes would be to lower eye pressure and not raise it. This is not to say that it is a good idea to get Latisse into your eye. You might also want to get your eye pressure checked by your eye doctor especially if you have a family history of glaucoma.

There are some eye medications like steroid drops which can significantly increase eye pressure and these are definitely a risk to cause glaucoma. Latisse is not a steroid and does not have this risk profile.

If properly applied to the lid margins you should not get Latisse into your eyes and this issue will not arise. Should you have concerns, see your eye doctor and get your eye pressure checked which is a good idea regardless.

Redness and Blurred Vision After Lasik Eye Surgery

I had Lasik Eye Surgery done around two weeks ago, and I’ve been really worried about the amount of redness in my right eye. I have perfect vision on my right eye, but my left eye is really hazy and doesn’t seem to be getting any better. I went to see a specialist and he said that my left eye is just taking time to heal, and the redness is fine. Is this normal, and will it be okay soon?
A: Trust your doctor on LASIK recovery
AS to your right eye being red, it may be due to a slight amount of blood on the white part of your eye known as a subconjunctival hemorrhage. This can happen more likely with traditional LASIK than the all laser method, but is not harmful, although it looks bad. If your vision is good, you probably do not have a problem in your right eye.

As to your left eye the blurry vision may just be healing. It may also be that there is some uncorrected error that may need more treatment. You may also have a more serious cause of blurriness but you will need to rely on your doctor for making this determination. If your vision does not clear or you do not feel confident with your doctor’s explanation it is possible to get a “second opinion.”

It is not possible to diagnose problems such as this without an examination so this information is general and not intended to be relied on other than as general information.

Risks of Using Lumigan Instead of Latisse?

Is Lumigan and Latisse the exact same thing or is one stronger than the other. My doc prescribed Latisse but told me that if I use Lumigan that I could run into all kinds of problems.
A: Latisse and Lumigan are the same
Both of these medications are the exact same down to the packaging of the bottles. The difference is the labeling and the applicators supplied with Latisse. As was stated above, they are both brimatoprost 0.03%.

Spoiler title

there is a posting on realself about someone getting “no touch” laser eye surgery. they said its different from lasic in that the eye isnt cut. can you explain this technique and whether its better than lasic
A: No touch laser vision correction is NO LASIK vision correction
No touch laser eye surgery is not LASIK. It is a variant of PRK which is the older and original laser vision correction. In PRK the surface epithelium is removed and then the laser treats the eye which leaves a large raw area that has to heal over 5-7 days. In LASIK a flap is made, and the eye only has to heal at the “seam” which happens in a matter of hours. This is the reason for the rapid recovery and minimal discomfort of LASIK as opposed to PRK.

For the PRK procedure, there are varying ways of removing the skin or epithelial layer of the eye. It can be removed mechanically with a rotating brush, chemically with alcohol, or using the same laser that is later used for the vision correction. This last method is the so called “no touch” because only a laser touches the eye. In reality, sometimes the laser will not remove all of the outer layer evenly and a manual “scrape” still needs to be done before the actual treatment. No matter which method is used, there is still the time needed to regrow a new surface layer and during that time the vision is blurry and there is some discomfort.

There are cases where PRK is preferable to LASIK, but which PRK method is used does not have a significant effect on the recovery or result. The no touch technique is an option for PRK, but it is not LASIK.

Blade free LASIK is no touch with a blade where a separate femtosecond laser is used to create the flap. This advanced method should not be confused with “no touch” PRK laser eye surgery.

Spoiler title

I was googling Bladeless LASIK and found information saying the incidence of dry eye complications from Lasik may be reduced with Bladeless LASIK. Can a doctor explain more about this procedure and why this is the case. Is it the gold standard for vision correction?
A: Bladeless is better LASIK
To say bladeless LASIK is the gold standard, or the standard of care are strong statements subject to interpretation. What I can say is that since introducing bladeless LASIK in 2001 we have progressed to a point that in the last several years we only offer bladeless to our patients because we believe it is a much better way to do LASIK.

There are several reasons for this. First as you say there has been shown to be less dry eye problems due to the increased gentleness of the procedure. There are also less risks of other serious complications such as loss of suction resulting in a partial or abnormally cut flap. These complications do occur with a microkeratome but are virtually nonexistent with the all laser method.

Studies have been performed that show the results are better with the blade free method which may have something to do with how exact the cutting of the flap has been with the laser as compared to a blade.

Finally there is the accuracy of depth which is far greater with the all laser procedure than the blade procedure. All of these reasons probably account for the fact that now about 50% of all LASIK is blade free. The only reason not to have all blade free is cost, and it seems that the extra cost is worth it for all of these reasons. Since blade free is so much more common, you can find centers to offer this at no or little additional cost from standard LASIK.

Taking Contacts out 24 Hours Before Lasik Surgery, Too Soon?

I had an evaluation to see if I am a Lasik candidate yesterday. They instructed me to take my contacts out for 24 hours before the appointment. They did all of the tests yesterday then offered to get me in to surgery tomorrow.

Everything I am reading online is saying to have your contacts out at least 2 weeks prior to your evaluation. Is this Lasik company pushing this too fast? Do I need to give my eyes more time to adjust to their natural shape?
A: You are wise to be concerned about this advice
I totally agree with your concern of being told that you only need to leave your contact lenses out for 24 hours prior to LASIK. And you are correct about the reason as well. The shape of the eye can change with removing contact lenses and this period of waiting is needed to allow the eyes to stabilize. In general most doctors wait at least a week for soft lenses, and two weeks for toric soft lenses prior to performing surgery. It is sometimes also helpful to have a second exam to be sure that there is no further change in the prescription. For hard or gas permeable lenses this period of time needs to be longer, sometimes several months.

Any laser center that tells you to just leave your lenses out overnight and have the procedure is not taking this into account and you may wish to get a second opinion from another doctor in your area.

LASIK is an elective procedure, and you should also have some time to think about the advice you have been given prior to making a final decision on having LASIK performed and where you will have it performed.

I certainly do not want to be critical of any other practice, especially without knowing all of the facts. But from what you have told me, I agree that you should proceed with caution. All of the FDA studies for the approvals of LASIK required patients to leave their contacts out for some period of time consistent with what was already mentioned above.

Wearing Contacts Before LASIK?

I had a consult for Lasik surgery 5 or 6 years ago, and at the time I was told I couldn’t wear my contacts during the 3 weeks before surgery, which was why I never went through with it. I can’t stand to wear my glasses for more than a few hours. Has anything changed?
A: You must give up contacts before LASIK
Contact lenses often cause what is called “spectacle blur.” This means that the contacts make your glasses not exactly correct due to the swelling or distortion of the shape of your eye which can affect the readings doctors take of your eyeglass prescription.

The laser must be programmed with your correct prescription to achieve a good LASIK or PRK result. It takes some time for the cornea to return to normal. In the case of hard contact lenses this can be months, and with soft lenses it is weeks, but you will need to leave your contacts out as your doctor requests. There is no shortcut around this requirement except that sometimes soft lenses can be worn for a period of time in hard lens patients, and then the time is shortened to the soft lens out time.

To get the best results doctors need accurate data, and your contacts must be out long enough to attain these readings.

What Are Good Lasik Eye Surgery Alternatives?

A: LASIK alternatives medical and surgical
There are nonsurgical alternatives — glasses and contacts.

There are surgical alternatives- PRK (surface laser treatment) and ICL (lens inside the eye) and in some cases refractive lens exchange (a type of cataract surgery)

You should discuss with your doctor which is the best alternative for you.

What is PRK? Is It Painful?

What is PRK? Is It Painful?

A: PRK can be painful for a few days

PRK is the process of lasering the front of the eye after removing the protective skin or epithelium that covers the eye and has many nerve endings. It is not the PRK itself that is painful, but the denuded surface which is a large corneal abrasion which must heal.

Many things can be done to minimize discomfort such as topical medications (drops), contact lenses, systemic analgesics (pain pills) and cool compresses. Usually the pain is relatively short in duration lasting just a few days, but sometimes it can be severe.

This is why LASIK is so popular because it is relatively pain free and accomplishes the same visual result. Some people are better suited to PRK and in these cases, the discomfort is worth it. We have had a number of patients who report only mild discomfort with PRK so it is variable.

What is the Range of Lasik for Vision Correction?

as far as I know, I can’t get LASIK because my prescription is a +5.50 which exceeds the range. that true?
A: Today, you might be able to have LASIK even with an extreme correction
Advanced laser vision correction is able to treat up to +6.00 diopters of hyperopia or farsightedness. It can also treat astigmatism up to six diopters and nearsightedness up to -12.00 diopters, depending on the laser chosen for the treatment. Of course it is necessary to otherwise be a good candidate for these procedures, and not everyone is capable of having this programmed into the laser for their particular eyes.

Assuming that the shape of the eyes is symmetric and normal on scans and testing, there are no history problems or extreme dry eye type problems, it is now possible to treat fairly high levels of correction by LASIK. Some patients treated above +4.00 will experience a degree of regression, and repeat procedures may be possible in some of these cases.

Nearsighted patients have about double the range where treatments as high as twelve diopters can be done if there is enough corneal thickness preoperatively.

There are other considerations, especially in these higher prescriptions, so it is important to get an opinion from your local LASIK expert. For instance, if the cornea is already very steep, it may not be able to be steepened the additional amount necessary for the higher end of the correction range. The values given here are the FDA range for a particular laser where the treatement has been shown to be safe and effective, other lasers may not have the same range available.

What’s the Catch with Lasik for $599/eye?

Obviously the bargain Lasik deals are a scam somehow… what’s the truth? How can they afford to offer LASIK at those prices? I heard once that they use old machines.
A: LASIK pricing
When applied to another medical procedure, this seems absurd, and it is not prudent to make a decision for something this important based only on price.

That being said, it is usually a bait and switch type of offer, please read the fine print that says STARTING at $595 or some other price. This is usually not for all prescriptions, not for state of the art technology, and may not provide everything you will need. It took me awhile to understand this strategy, but here is what I think.

Most people realize, hey, I might not get it for that price, but these people will probably still be less expensive than those higher priced centers no matter what. While this might be the impression, it simply is not true. Typically the cost for LASIK will with the same technology, the same experience quality, will cost about the same price. Therefore pick the center you like the best, and try to get the lowest cost for what you want. Chances are, you will not be saving any money at the lower advertised price center unless you have very little correction and are willing to make compromises.

Where Can I Find the Best Lasik Eye Center?

please suggest resources that can help me find the best lasik doctor!
A: Word of mouth and Trusted LASIK Surgeons
The best way to find a good doctor is by word of mouth from other satisfied patients. If you do not have this resource or in addition to it I think that an independent source such as Trusted LASIK Surgeons (at is a good option since they are limited to the top 1% of all LASIK surgeons.

Which Between Blepharoplasty and Lasik Should Come First?

I know that you cannot have both Eyelid Surgery and Lasik at the same time. But which is better to do first? And how far apart should the procedures be?
A: LASIK before Blepharoplasty
If a blepharoplasty has been performed years ago, then the eyes can be evaluated for LASIK in relation to dry eye risks and in most cases the LASIK can be performed. When the procedures are to be done in close time proximity, I would recommend doing the LASIK first, wait until there is healing without dry eye for about 3 months, and then do the blepharoplasty.

Immediately post blepharoplasty is the time that eyes can be dry, and there can be a problem with the lids not completely closing and this would not be an ideal time to perform LASIK. The LASIK flaps also need to be well healed so there is no chance of damage during manipulation of the blepharoplasty procedure.

Why can you wear contact lenses prior to eye exam but not prior to Lasik?

If you’re not supposed to wear contact lenses prior to having LASIK surgery, shouldn’t the same thing apply to your regular eye exam? I would think that, in order to get the most accurate prescription, you’d want to refrain from wearing contacts for the same period of time that you would refrain from wearing them prior to LASIK. Can someone please explain this? Thanks!

A: Yes

The most accurate examination of your eyes is with leaving your contacts out for a few days to weeks so that the natural shape of the eye is measured. This is not as critical for glasses which can be changed relatively easily. For surgery, we want to know that we are getting the best measurements, so that is why your doctor wants for the contacts to be left our prior to your surgery.

Will Green Irises Change After Using Latisse?

I’ve been using Latisse for 9 weeks and I’m seeing wonderful results with it. However, I’m very concerned about iris color change. My iris color is a really pretty green/gold. What is the chance of my iris turning brown?
A: You are the high risk group but still unlikely
Latisse was discovered when Lumigan, the same medication used for glaucoma, was applied into the eye and some patients had darkening or changing eye color which is permanent in some cases. It is of greatest risk when there is a degree of brown pigment already present.

That being said, there have been no cases reported of darkening of the iris with Latisse and the reason is that it is carefully placed on the lashes and not in the eye if used as directed. Therefore you are probably safe to use Latisse and not have any problems, but it might be best to apply it sparingly to avoid any getting into your eyes. Even if some were to get in your eyes, the chances of pigment changes is still low.

You may wish to discuss this further with your doctor who can help you make the final judgement.

Will I Need Reading Glasses After Lasik?

Is there anything that can be done before or during Lasik to prevent the need for reading glasses?

A: Reading glasses after LASIK

Like paying taxes, virtually everyone will need some help with near vison when they have full distance correction and are older than 45-55 years of age. The issue is that for people who are nearsighted, they can take off their glasses and read well even beyond this age. When the vision is corrected at distance with glasses, contacts, or LASIK there is a need for help up close.

The alternatives include having monovison which leaves one eye slightly nearsigted, wearing reading glasses, or some newer surgery options being developed to improve near vision which are not yet available.

Careful discussion with your doctor and trying monovision with contact lenses can help to make this decision.

Will Latisse Cause Hair Growth if It Gets in the Eyes?

I heard a story that if you got Latisse in your eye or underneath your eyelid, hair would grow on your eye, or under your eyelid. Apparently, it happened to one woman. Is this possible?
A: And hair will not grow on your eyeball no matter what you do but….
Hair can only grow where hair has grown before, and it requires a complex known as the hair follicle. There are no hairs growing on the eye itself, and in fact the same exact medication is used for glaucoma marketed as Lumigan. There are no “hairy eyeballs” in patients who use Lumigan in their eye for glaucoma, and likewise if some accidently got into the eye when treating the eyelases, there would be no hair growth on the eyeball.

Some people have hair in their medial canthus in the area of the caruncle which is the fleshy area in the inner corner of the eye. This tissue having hair elements and some skin elements, might have this hair grow thicker or longer if stimulated although I am not aware that this has been demonstrated with Latisse. Furthermore, if Latisse is applied correctly, it should not ever get into the eye in any case.

Although there is an expression of giving someone the “hairy eyeball” it was not caused by Latisse.

Will Latisse Work on Someone Who Has Been Pulling Lashes?

I’ve been pulling my top lashes for 8 years now. If i were to try Latisse, would it work for me?
A: As long as there are still lash follicles, Latisse will work
Even though you have been pulling your lashes for eight years, chances are that you still have lash follicles remaining, otherwise there would be nothing left to pull on. Latisse will stimulate the follicles to grow longer, thicker, and darker. However, you need to address the issue of pulling the lashes. Is this psychological or is there some kind of irritation present? You should first have an eye exam to be sure that there is not a medical reason for pulling your lashes, and if not then you should see someone to address the psychological component.

Will Using Latisse Cause my Entire Eyelid to Darken?

Would Latisse cause darkening of the entire eyelid or just the line where drops are applied?
A: Latisse action limited to where it is applied
The reason for the brush applicators is to allow precise application of Latisse just to the base of the lashes, and that is the only place where the skin may darken. If it is applied carefully, it will not spread this effect beyond the lash line. With blinking, some is transferred to the lower lash line, and darkening may occur here also.

The large blotchy darkening that is talked about is from patients who used Lumigan for glaucoma as an eye drop, which is the same medication. In these patients, some of the medication was blinked out onto the entire lid area, and in some cases caused a darkening around the eye over a larger area.

Fortunately, even if this happens, the effect on the skin is temporary and will fade with time once the medication is discontinued.

Bottom Faqs Right

Are TLC Lasik Doctors the Best for Laser Eye Surgery?

I am looking for a laser eye surgeon to do Bladeless LASIK. Is TLC the best lasik clinic. TLC has really attractive financing avail, so would be great to know their docs are great too!
A: TLC is only as good as the local doctor
TLC is an excellent organization, but the care you get with LASIK is personalized, and is only as good as the local doctor who is treating you and their staff. Concerning financing, the same type of financing and programs are available from many different providers. You may want to check more about TLC from the information available about their public traded stock TLCV which is TLC vision.

I would recommend you consider lasik care from a personal recommendation, from a doctor referral, or from visiting a few different providers before making this decision. You may also want to investigate the technology available at that particular TLC center, since they are not all the same.

Please be aware that just because Tiger Woods had his LASIK at TLC does not mean that he would have had it done by any doctor at any TLC center nor does it mean that you cannot get just as good or better a procedure with the doctor who you believe has the best overall program for your particular eyes.

Again, TLC overall has an excellent reputation and I believe that they can be an excellent choice for laser vision correction, but youshould do your homework and investigate carefully before making this decision.

Best Lasik Technique to Minimize Side Effects?

I read that lasik side effect can incl night vision reduction and halos. Obvuisly want to avoid these. whats the best lasik technique, newest technology that avoids these?
A: Minimizing night vision and other problems in LASIK
First it is important that you are a good candidate for LASIK, that accurate measurements are taken to do the correct treatment for your particular case. Second it is also equally important that the best technology is used to avoid these problems.

It is a bad idea to go to a center using older technology, even if it is at a lower price because some of the problems of night vision, halos, etc are more likely in my opinion by being treated on these technologies. Once something is FDA approved, it remains so virtually indefinitely, and it is important to seek out the best treatment possible.

The newest way of having LASIK is to both have a laser created flap by Intralase or by VisuMax which minimizes side effects caused by the flap itself. Even more important is the laser that does the actual correction. The newest lasers use scanning spot technology with a prolate wavefront optimized profile. This includes both the Alcon Wavelight and the Zeiss Mel 80 lasers which give excellent clinical outcomes and high degrees of patient satisfaction.

If you are concerned about minimizing side effects, do your research on both the doctor and the equipment that he or she uses for LASIK or PRK vision correction.

Blurred Vision After Second Lasik?

My sister did lasik eye surgery second time after 10 years for her left eye as she was having blurred vision (distant no.) However, after the second time surgery, her vision has become more blurred compared to earlier and after two weeks also she has not got a sharp vision.

Her doctor says to wait for a month. We are really worried. Can you please guide us and tell what could be the reason and what can be done now for her blurred vision?
A: Late LASIK enhancements have increased risks
This very question brings up an issue that is commonly encountered by LASIK surgeons, which is the late enhancement request. Sometimes, patients after doing well for a number of years develop residual refractive error and request retreatment. This theoretically can be done by repeat LASIK with the same flap, cutting a new flap, or by a surface PRK type of treatment. Each of these procedures can have additional risks not present at the time of theoriginal procedure. The repeat LASIK with the same flap may have technical difficulties lifting the flap, or an increased chance of epithelial ingrowth at the edges of the flap. Cutting a new flap can have its own issues, and a surface treatment can be unpredictable and has an increased risk of haze formation. There can also be microstraie created in the flap.

Before even considering the retreatment though, one must ascertain why the vision has changed in the particular case. Is there some cataract formation? Is there some instability of the cornea? Or is this simply a residual refractive error that now needs to be resolved.

I mention all of these things to point out that there is no simple answer that can be given in this type of a forum. Fortunately, it has only been two weeks, and the healing may not be complete so there is a good chance that the vision will improve. She should stay in close contact with the doctor, be sure that the vision is making progress, and ask for a specific reason if the vision does not improve within the next few weeks. If the vision is correctable with glasses that is a very good sign.

Blurry Left Eye After Lasik?

Have you experienced a change in your vision after Lasik? My left eye is blurry and I am wondering if this will change.
A: Blurry vision can be caused by many different reasons
You did not mention how long after surgery the vision is blurry, whether is was clear and now has become blurry, whether it is clear with corrective lenses, and whether it is clear or blurry at distance or at near. It also depends on what type of procedure you had and how bad your eyes were before the procedure.

If you are only a short time (days to weeks) past your procedure, this may be a normal healing response. It also may be from something simple like dryness of the surface, or there could be a more serious cause to your blurriness. I would ask your doctor why your vision is blurry and what the plan is for your situation. Typically patients have a series of post operative visits and this is a good time to have your questions answered. If your vision has suddenly changed, then call your doctor and ask for an appointment to evaluate your condition.

Can Lasik Cause Eyelids to Sag?

I had nice deep eyelids and had Lasik and now the skin hangs down to my eyelash. What could have happened during Lasik to cause this?
A: LASIK is not the cause of sagging eyelids
LASIK per se is not the cause of sagging eyelids but having LASIK might be. How can this be so? It is because for LASIK there is a lid clamp that opens the eyes widely and it can stretch the lids in a way to cause ptosis or droopy eyelids although this is a rare complication.

This is one more reason why I like the all laser method of doing LASIK. In particular we are using the newest Zeiss techology called VisuMax which only requires a very slight opening of the eyelids to accomplish the first step of making the flap. The Intralase is also better than the blade method concerning the risk of ptosis, but not as safe as the VisuMax.

The LASIK or reshaping of the eye itself cannot cause any damage to the eyelids and thus no droopy lid. If the eyes are irritated temporarily after lasik or if there is some light sensitivity then there can be some squinting, but this not what you seem to be talking about.

Can my Eye Doctor Assist Me with Latisse?

A: Eye doctors are a good source for Latisse
Although Latisse is most often prescribed by plastic surgeons and dermatologists, the other group which often dispenses this medication is your medical eye doctor or Opththalmologist. In some states it may also be available by your Optometrist, but here in Colorado, this is not possible. It makes some sense to get Latisse from your eye doctor in that they can best examine your eyes and lashes, are the ones experienced with Lumigan for glaucoma treatment which is the same medication, and can help with any eye questions related to the use. On the downside, plastic surgeons provide an overall cosmetic opinion which is comprehensive beyond just eyelash enhancement and for some this is certainly a great choice.

The best recommendation is to see the doctor you are most comfortable with to receive information and Latisse, but eye doctors are definitely one of your choices.

Can You Have Lasik Surgery if You Have Graves Disease?

A: Graves’ disease means be cautious about LASIK

Although people with thyroid medical problems can have LASIK, when it becomes clinically expressed as Graves’ disease, there is greater risk of problems. In Graves’ patients can have a combination of problems which can lead to excessive dry eye conditions. Tissue and muscles behind the eye can swell forcing the eye forward in additon to the condition causing less blinking and a wider opening of the eyelids. All of this can make the healing after LASIK more difficult.

After Graves’ has been treated and the situation has quieted down, it may be possible to have LASIK or in mild cases. This situation is best decided by you and your doctor.

Can You Have Regular Lasik and then Change to Mono Vision Lasik?

Can You Have Regular Lasik and then Change to Mono Vision Lasik?

A: Not Always a Good Idea

It depends on many things whether having another LASIK procedure for monovision is a good idea. If the original LASIK was many years ago (as I suspect) then you run a much higher risk of complications having it done again for monovision. Specifically, the risks of epithelial ingrowth which is when a layer of the skin of the eye grows under the flap can be problematic. In general it is best to decide what the refractive goal is and not make a later change.

Continued Latisse Use Everyday After Full Results?

Is it true that you have to continue using Latisse everyday once maximum eyelash growth is achieved or your lashes will return to their previous state?
A: Maintain your lashes with a low dose is all you need with Latisse
Latisse works best to use it daily for about six weeks until the lash follicles are fully stimulated and the growth is evident. At this point, most patients find that they can reduce the dosage to every other to every third day which is both less of an inconvenience and also reduces the expense by about half from the original application frequency.

Correcting Astigmatism with Intralase with Lasik?

I am going to be getting the Intralase with wave-guided Lasik with the Visx Star4 laser. The astigmatism is at a cylinder 3.75 and 2.75 in the other my SPH numbers are moderate at 3.25 and 3.50. My glasses prescription has been stable for about 6 years. Should I be concerned that the surgeon will be able to correct the astigmatism?
A: Intralase has no effect on amount of astigmatism treated
The laser you describe should be able to treat both the astigmatism and the spherical portion of your prescription, and using the Intralase to make the flap should not have any effect of the potential results of your treatment. As another doctor mentions we have found for high astigmatism corrections that the Wavelight laser, now marketed by Alcon, does a superb job in correcting higher amount of astigmatism up to 6 diopters. With your treatment I would expect the VISX should perform well. Sometimes in high astigmatism cases, especially with large optical zones there can be laser “spillover” beyond the area of the flap bed but this does not usually have any significant consequences.

Correcting Laser Eye Surgery Side Effects

I had laser surgery done 4 years ago and still have starbursts, halos, and glare. Is there any help for me?
A: Updating old LASIK surgery sometimes is possible
If your blurry vision is form something related to the previous surgery, it may be possible to do a repeat LASIK or a surface treatment to improve your vision. It is difficult in a short answer to cover all of the possibilities, but you should get an evaluation to find out if this is possible. There is a chance that the problem stems from an internal eye problem unrelated to your LASIK, or your corneas might be too thin to be able to withstand additional surgery.

Many times though, it is possible to retreat undercorrected eyes. If there was a decentered ablation, then newer treatments coming onboard in the next few years will be able to help. In some cases existing custom treatments can help. We also see patients who have dry eye issues where a relatively simple fix such as punctal plugs can help quite a bit also.

Curious About Using Latisse on my Eyebrows. Is It Ok?

My eyebrows are as sparse and light as my eyelashes. I cannot express how much I hate having to practically draw them in daily. Is Latisse an option for this, or do you have any other recommendations?
A: Latisse works on eyebrows too!
Latisse grows hair, and it reportedly works on eyebrows also. This is considered an “off label” use which means it has not been tested or approved by the FDA and can only be recommended by an individual doctor for an individual patient. Therefore I can not advise you to use it this way, but in theory it should work so long as their are hair follicles present which can be stimulated. It may darken the skin beneath the eyebrows although this effect should be reversible and may enhance the appearance. Be very careful if used this way not to go beyond the eyebrows.

Again, this is an “off label” usage and you should consult your doctor before trying this method.

Do You Have to Be over a Certain Age to Have Lasik Eye Surgery?

A: LASIK is best when your eyes are stable
More than age, refractive stability guides when LASIK is appropriate. The minimum age for LASIK is generally considered to be 18 years, although there are exceptions for special circumstances. Most people have vision changes until at least 18 years of age, and some until their mid 20’s. If there has been no change in prescription for at least a year in glasses or contacts, then LASIK is a consideration. MOst FDA approved lasers state that the minimum age approved is 18 years which relates to the people who were studied during the approval process.

Some doctors will purposely overcorrect the younger near sighted patient to give them some “room to grow” in that if their vision was to progress slightly more nearsighted, a very low amount of farsightedness will maintain good vision even with this change. For farsighted patients that are young, it is especially important to have a good cycloplegic or dilated eye exam to be sure to unmask all of the farsightedness.

There is also a condition where the amount of nearsightedness does not stabilize, called progressive myopia, and these patients will become nearsighted again at some point after LASIK. Usually these are the more nearsighted patients to begin with but it is sometimes hard to detect who will continue to change.

In summary, it is not so much a matter of age, but a matter of when the vision is stable and this is typically in the early to mid 20’s but sometimes sooner. Information from past eye exams can be very helpful in making this determination.

Does Latisse Burn when Applying It?

A: Latisse should not burn on application to your lid margins
If there is burning on application of Latisse, chances are you have some inflammation of the skin of your lid margins which is being irritated by the Latisse or its vehicle (what it is mixed in). This suggests that you may have blepharitis or eczema, or a skin condition which makes you sensitive to it. You may also be allergic to the Latisse but this would more likely cause itching. There is also the possibility that you are rubbing too hard with the applicator and it only needs to be gently applied.

It would be worthwhile to discuss this with your provider and have an exam of your eyelash margins by an ophthalmologist to rule out any other medical conditions.

Dry Eye Causing Light Sensitivity After Lasik?

Had custom lasik 4 wks ago and am experiencing terrible dry eye, light sensitivity, and daytime glare. Is dry eye causing this? The light sensitivity occurs with all types of lighting including sunlight. I am not only experiencing daytime glare but also some nightime glare as well, small halos and glare off headlights. Are these caused by abberations or dry eye?

A: You may have dryness or something else causing these problems

While it is true that dryness can cause both light sensitivity and disturbances of vision such as glare, it is possible that you have some other problem. Sometimes, especially after “all laser” LASIK, patients can experience something known as TLS or transient light sensitivity. This causes severe sensitivity to light and is helped with certain medications almost immediately. It is important to know whether your symptoms are simply due to dryness or something else so that they can be best treated for your successful recovery.

Fuzzy Night Vision After Lasik

I had lasik 2 weeks ago today and my night vision still hasnt seem to return. When I get in dim light things kinda get fuzzy. What could be the cause of this? Or does my eyes need more time to heal and adjust since my RX was high?

A: Relax, you will probably get better

Two weeks is not a long time after LASIK and your vision may not be fully corrected at night during the healing period. Although many patients see well day and night within days of LASIK, some people take longer. This may be because you have large pupils, you may have “nightime myopia” where your vision is not fully corrected at night, or it may be from other causes. You should be patient for 3 months but be sure to check with your doctor and have them be sure that nothing is wrong.

Glaucoma Eyedrops for Eyelash Growth?

I read on some web sites that they use the glaucoma medication as an eye drop for lash growth instead of brushing it on lids (like Latisse). They said that worked fine. Is there any harm in doing it that way if you do not have glaucoma?
A: Glaucoma medicine grew eyelashes as a “side effect”
It was discovered that Lumigan which was prescribed for glaucoma had the effect of growing lashes, and the manufacturer, Allergan, studied this effect and received an approval to market the same medication for application to the eyelids to grow eyelashes. It works well for both, but in the case of Latisse, the application is planned to be on the base of the eyelashes, and not in the eye.

How Does Latisse Affect Eye Color?

Clarify the browning of the iris issue please. This could happen to people. In what way does Latisse affect the iris color? Does this affect blue eyes?
A: Latisse activates pigment to make eyes darker
The iris of the eye has pigment in it, much like hair. This pigment, or melanin in some cases of patients using the glaucoma drop Lumigan, had their eyes become darker by the activation of the cells that produce pigment. It was most noticable in lighter colored eyes that became darker, and the change was permanent.

In the case of Latisse, it is exactly the same medication (Brimatoprost 0.03%) but if applied properly, does not go into the eye, or in very tiny amounts and there has been no evidence of it darkening eyes in the Latisse studies.

My understanding is that the most susceptible eyes are green or hazel, not blue for this effect but it could happen to any color eye.

The bottom line here is if using Latisse, to use it as directed, and not get it into your eyes in the first place.

How Long Before Eye Color Change from Latisse Occurs?

I have really blue eyes, and have used Latisse about 3 days. I get a lot of comments on my eye color and I was wondering, if they do change color, how long will it take for me to notice a difference? And if I see a difference then stop using it, will the color change even more? I know that it’s permanent if this happens, but can I stop using it before it gets worse?
A: Change your eye color with Latisse
Patients who have LASIK sometimes joke with me asking if I can change their eye color at the same time which I obviously cannot. Latisse is Lumigan, and when used in glaucoma, in much much higher concentrations in the eye, has in a small percentage of patients darkened their eye color permanently. Most of the time this has been in “hazel” colored eyes where there was some pigment to begin with. Blue eyes with no pigment are more difficult to have this effect, and with dark eyes to begin with it would not be very apparent. I do not think it is known if you were to stop the product once you did notice a change in color if that would arrest the change at that point or if it might continue to darken for some period longer. I would suspect that the effect could become more pronounced even with stopping the Latisse.

To avoid this risk, be very careful to only apply Latisse as directed to the base skin of the upper lashes, and in small quantity so that no significant amount of the product gets into your eyes. We have just begun to dispense Latisse, and I am not an expert in this question beyond what I have learned about it and my basic knowledge of eyes as an ophthalmologist.

How Long Does Lasik Results Last?

I am 24 y/o and considering doing Lasik! Is it a one time procedure? Am I too young to get it?
A: LASIK can last a lifetime

We are often asked about how long LASIK will last, and there is no absolute answer. In the fifteen years we have been performing this procedure it is permanent for most patients. A small percentage of patients will have some decrease in the effect over many years, but in most cases the remaining vision is still very good and although it may be noticed by the patient, objectively almost all of the effect of the LASIK remains.

The most important factors are that the vision is stable to start with. At age 24 a person usually has a fully mature eyeball and thus the vision is unlikely to change, but it is certainly possible that the natural amount of correction could still increase for the next few years. Therefore the question that we would ask in response is whether there has been any change in the prescription for the last few years.

Sometimes patients also have a corneal structure which is not as strong as it should be and LASIK can weaken this structure even further, resulting in a loss of effect of the procedure and in rare cases the vision being made worse than it was to start with. We look at scans of the eyes carefully and avoid doing LASIK in these particular cases. It is sometimes difficult to pick out the cases where the LASIK may not be as effective or as permanent, and as such it is possible to have LASIK and still have regression of the result.

For most patients, LASIK creates a permanent change in the shape of the eye. Until advancing age requires reading glasses, or other problems such as cataracts occur, the results from LASIK are very long lasting. In the unusual case where there is a change in the vision most of the time a “touch up” or “enhancement” can be performed to further improve the results.

How Long is One Prescription for Latisse Expected to Last?

Does one supply of Latisse last for one month, two months, etc.? At these prices, I want to know what I can expect.
A: You can double the amount of time a bottle of Latisse will last or more
Latisse has instructions to use one applicator per eyelid per night and it is packaged with 60 applicators so that is a month supply (except for those months with 31 days). Although it is not officially approved and “off label” many patients use one applicator and one drop for both upper eyelids which will extend the package twice as long.

Further, after an effect has been reached, many will reduce their usage to 2-3 times a week or roughly every other night starting at about week 6. This will again double the length of time a package will last with this ‘maintenence dose.’

Therefore, once clinically you reach the endpoint of effectiveness it may be possible to only need 3 packages a year which is much more affordable than the labeled usage of 12 packages per year.

This is not meant to be medical advice and you should consult with your individual doctor about any medication and dosage.

How Much Does Laser Eye Surgery Cost?

A: Cost is important in LASIK, but there are other things to consider
Cost is always a difficult thing for doctors in particular to discuss, but it is a reality and a very important consideration for any purchase.

LASIK is not like buying a refrigerator, and usually people do not pick their brain surgeon based on the low bidder, so LASIK is not a commodity, but there is a cost aspect to consider.

Be very careful of both centers that offer “as low as” pricing as well as a menu with upgrades available that make you choose between safety and effectiveness vs cost.

The reality is that there is not as much variation in LASIK cost as one might think looking at all of the advertising. There are fixed costs which all laser centers incur, and these to some extent drive the price. It is best to have an experienced surgeon (look for a member of an organization such as “Trusted LASIK Surgeons”) and it is best to have a center that uses the all blade free approach, such as Intralasik since it has a much better safety profile. With these two considerations, you are looking at about $1500 to $2500 per eye and you will need to make the choice between price and what you perceive that the value is at a particular provider.

I do not recommend lifetime guarantees as they cost a lot extra, are not always helpful if you cannot have more surgery, and are not for your lifetime but for your centers. Most doctors offer a no charge 1 year enhancement policy, which for 95% of people is all you will ever need.

How Much Does LASIK Eye Surgery Cost?

I have seen the bargain ads for Lasik, and I know those deals can be dangerous or misleading. I’m just wondering what the appropriate price range should be per eye, for a safe LASIK procedure?
A: LASIK cost is fairly consistent despite advertising
Some centers try to entice patients by offering extremely low pricing, but on further investigation this is either something that only applies to a tiny percentage of patients or uses older equipment and methods. What you really want is an experiences surgeon using the best technology in a qualified center. For this expect to pay no less than $1000 per eye and with the most advanced methods that we recommend such as the all laser procedure, you will pay from $1500 an up per eye with an average price of about $2000 per eye depending on your locale.

How Often Should Latisse Be Used?

Is it suppose to go in the eye?
A: Do NOT put Latisse in your eyes. Less is more!
While it probably would not hurt anything, since Latisse is really Lumigan and this is used for glaucoma treatment as a drop, it is best not to get Latisse in your eye. For one thing there is a chance of darkening your iris if you do, and for another, it is not advisable in general. That being said, you probably do not have to worry about this if you follow the manufacturers recommendations of applying with the applicator that comes packaged with the Latisse to just the lash base at bedtime. A tiny amount is all that is required, and enough will transfer from the upper to the lower lashes to work on those as well. More is not better and in this case less is more!

How to Tell if I Got PRK or Lasik?

Last month, I underwent what I believed to be PRK (at least that’s what I wanted). However, there is no mention of PRK or (photo-refractive keratectomy) on the “Operative Report.” In the pre-op and post-op paperwork, “PRK” is present.

My mother, who was watching the says that the “VISX” machine that was used for the CustomVue treatment listed the procedure as “LASIK.” So, how can I be sure that I received PRK and not LASIK?

The operative report also indicates that “Physician has specified a LASIK Treatment, Superior Flap.” I chose PRK to avoid the flap. Please advise. Thanks.
A: If you had PRK it probably hurt for a few days
It is possible that the paperwork was not correct as to what you had, but you should have signed an operative permit and discussed with the doctor the procedure that was performed. If you had PRK, you would have had to wear a contact lens for about 5 days and your vision would be blurry for part of that time. You should have had mild to moderate discomfort for a couple of days.

With LASIK you would have had a flap made first either with a separate laser or with a microkeratome and you would have not had a contact lens placed in most cases. Your vision would be clear within 1-2 days and you would have minimal discomfort.

Another doctor or your own could examine your eyes and quickly tell which procedure you had especially if it was recently performed.

You should be able to call your doctor and find out which procedure was in fact performed.

I Was Told That I Have a Scar on my Cornea and Glasses or Contacts Wouldn’t Help. Would Lasik Help?

A: PRK might help

You do not need to treat the scar unless it is blurring your vision. If you have correction that you want to fix, then PRK would be the best option as it will reduce the scar and at the same time fix the vision correction. Sometimes it is not possible to perform LASIK with a significant scar.

IFS Intralase Vs. Lasik – Will IFS Reduce Risk of Complications?

a eye clinic near me is promoting iFS intralase for vision correction. their ads say iFS is safer and faster than Lasik because its the latest technology. Is it really safer and better or is this just a marketing gimick?
A: Femtosecond LASIK is the emerging standard of care and is recommended
Since LASIK first began in the mid 1990’s one of the biggest advancements was that of making the flap with a femtosecond laser rather than a blade. I was one of the first three doctors in the world to introduce this technology and continue to be a consultant in the field. The newest Intralase, iFS, has some improvements over the previous generation, but the important thing is to have some sort of femto LASIK rather than a blade. This particular laser is faster than its predecessor, running at 150,000 spots per second or Hz. It is also able to modify the side cut angle to a reverse bevel which may have some advantages. The greater speed gives a faster procedure and can be done at a lower energy setting, but it is fundamentally the same as the 60,000 spots per second Intralase that most doctors currently employ for their procedures.

We are one of a few sites now using an even more advanced technology, the 500,000 spots per second Visumax femtosecond laser, which also can make the reverse bevel sidecuts. There are other femto lasers on the market which have varying features, but these two are currently the best technology in my opinion.

Again, I think that the femto LASIK has matured into the emerging “standard of care” for LASIK because of the increased safety, accuracy, and results from this type of method over the microkeratome bladed LASIK which is based on very old technology. Many doctors still feel comfortable with the bladed method, and it is usually less expensive for the patient.

In summary, iFS is an evolutionary improvement, but not enough to choose a particular provider on that basis alone. Also investigate other makers of femtosecond lasers but choose one of these over a bladed LASIK procedure.

Is It Safe to Have Laser Eye Surgery?

I had cataracts removed from both eyes and now the I am told that I need laser to clear up my vision. Is this a safe procedure?
A: LASIK is safe after cataract surgery, in most cases
You can have LASIK after cataract surgery in most cases, but it is important that the eye is well healed from the cataract procedure, that it was done with a small incision (phaco) and that an all laser approach is used since the eye pressure can be increased more with a microkeratome than with a femtosecond method. Residual near sightedness or farsightedness along with astigmatism can be corrected, but another alternative is a lens exchange if the power of the lens is very far from what was anticipated.

Is Lumigan or Latisse Mixed with Mascara Effective?

My doctor (an ophthalmological surgeon) mixed Lumigan with my mascara because he said side effects were less likely as I was concerned about my light eyes darkening.

I have been using the Lumigan-mixed mascara for 6 weeks and hardly seen any difference. I have naturally rather long lashes to begin with. I’m wondering if Latisse still works when mixed in with mascara?
A: Creative but not necessarily effective to mix Latisse with eyeliner
The Latisse must be in contact with the skin at the lash follicle and be able to influence the lash follicle to grow. Mixed with mascara you may not be delivering the Latisse where it was designed to go and thus may not be getting the effect you desire.

I would recommend that you strictly follow the prescibed application method of application to the base of the lashes, thus having the best chance for success.

The clinical study did not have any cases of darkening of the iris in cases where Latisse was applied as prescribed.

Is Lumigan Safe to Use?

I ordered Lumigan over the internet for eyelash growth. When I received the prescription, the bottle had a label stating “For use in India only”. Is this safe?
A: Lumigan works if it is really Lumigan but…
The biggest risk you have of buying this or any drug over the internet is knowing what you are really getting. There are also concerns about dosage, formulation, and expirations. Even in the US it is not recommended to use Lumigan for eyelash growth even though it is the same medication as that in Latisse. The Latisse has been packaged with applicators and getting the official packaging assures you that you are using the right medication and in the right way.

Be cautious of purchasing any medications over the internet, there are risks.

Lasek Vs. Lasik: Pros and Cons

My research of laser eye surgery has found that most doctors appear to strongly prefer Lasek over Lasik becs with LASEK you don’t have to relift the flap, laser the flap. Also I saw that LASEK won’t induce astigmatism or striae, wrinkles, scarring. My question is, what are the benefits of LASIK over LASEK, since I can’t find this information?! What are the Pros and Cons?

A: LASEK is essentially PRK

There are only two ways to laser the cornea to restore vison, either it is done on the surface with removing the epithelial cover (PRK) or that layer is preserved and covers the eye after the treatment (LASEK) but in fact the layer does not survive and essentially LASEK is PRK. So to answer your question compare PRK to LASIK. There are potential issues with LASIK and the flap, but modern all laser methods have reduced these risks. PRK requires a longer, more painful healing process and many times the off label use of medications to control healing such as Mitomycin-C.

Most laser centers perform both procedures and choose the procedure that is best for an individual patient. You should explore both options with your doctor. Currently LASIK is much more frequently performed than PRK.

Laser Eye Correction Before or After Blepharoplasty?

When is it better to have eye laser correction before or after Blepharoplasty? I have a bags on a lower eyelid and thinking to have a plastic surgery. Also I need to do eye laser treatment. Which surgery should be first?
A: Blepharoplasty and LASIK can be done but not together
With blepharoplasty and LASIK both procedures can increase dry eye problems so the most important thing is to evaluate the eyes after the first procedure before proceeding with the second, and to wait a reasonable amount of time between them. We see many patients for LASIK who have previously had blepharoplasty and as long as the eyes can close easily and the healing is complete, LASIK can be done without much problem. We do hold the eyes open during LASIK and your doctor needs to be careful not to stretch the lids excessively if there has been a blepharoplasty done recently.

My preference would be to have the LASIK first and then look at blepharoplasty after at least 3 months, preferably 6 months once the healing is complete. Be sure to have the eyes checked after the blepharoplasty to avoid any dryness issues, and tell your plastic surgeon about your LASIK (and his/her anesthesiologist) so that they are extra careful with your eyes to avoid any trauma to the cornea.

LASIK is not a cosmetic procedure, but many patients once they “loose” their glasses become more concerned about their facial appearance, and are interested in improving their appearance with lid or facial cosmetic surgery.

Lasik Complications

what are the most common complications following lasik surgery? how often do complications occur?
A: Complications are unlikely after LASIK
LASIK is one of the most frequently performed surgeries in the world today, and fortunately, complications are relatively uncommorn. This somewhat depends on how one defines complication. If it includes getting a result that is less than a perfect correction, then one might say that the rate is higher. Most consider complications to be something that was unanticipated or unwanted. Most complications had to do with the first step in LASIK, making the corneal flap. By having the procedure peformed with the blade free, Intralase, or other femtosecond laser methods, the risks of these problems are greatly reduced. Other complications can occur with healing such as wrinkled flaps, light sensitivity, or decreased best corrected vision. Most of these problems are transient or can be repaired if caught early.

There are also what is known as side effects in LASIK surgery such as dry eyes, halos at night, or difficulty with low constrast conditions. These are again usually temporary or mild but with the older laser technology especially, can be moderate or severe.

Serious sight threatening complications are rare such as infection, but need to be watched for nonetheless.

Overall, it is important to understand that LASIK is extremely safe and some studies have shown it to be safer than wearing contact lenses for an extended period of time. It is a process of not only having the procedure, but one that starts before the procedure with proper screening and continues into the post operative period for several months and sometimes longer. Be sure you have a doctor who you are confident in not only to do the LASIK but to manage and coordinate any care you may need however unlikely problems may be.

Lasik Doctor Consultation

have a lasik appointment and need help on what to ask the lasik doc!
A: Top questions to ask your prospective LASIK doctor
Fortunately, most qualified ophthalmologists can perform LASIK and the results have overall been excellent. It is important to have a referral to the doctor if possible from another patient, the word of mouth rule. Also, you want to have a doctor who has a number of years and many thousand cases if possible since experience counts for a lot in this area. Technology is important and I would choose a doctor with the blade free method available and a newer generation of laser.

Also, diagnostic equipment is important with the ability to measure many parameters of the cornea. A doctor who has been involved in clinical research studies is a good sign in that they understand very well who is and who is not a good candidate for vision correction. Finally, membership in an organization such as “Trusted LASIK Surgeons” only accepts the top doctors in the area and is something to consider.

It is not essential, but doctors who track their own outcomes, and can show you the likely results with your prescription is helpful, and a low retreatment and complication rate history are also helpful. I would also look at the facility and ask for a tour of the location where the procedure will be performed to make sure it is an appropriate medical environment.

Lasik for -0.5D Power to Get 6/6 Vision?

dear sir,i have to join my training soon as i have qualified as a cadet in merchant navy. i have been given time for eye correction surgery by my sponsoring company. the requirements are 6/6 vision unaided in both the eyes. i just have -0.5d power in both the eyes. i see 6/6 line as readable but a bit hazy which results in sometimes a problem to read each word of the snellen line sir pleeez tell me if laser vision correction will help me or not.bcoz my power is too small.sir please advise me.
A: LASIK will work for mild corrections
The thing you have going for you is that you are young I would assume, so even a small overcorrection would still leave you with 6/6 vision or better. In the USA we refer to 6/6 as 20/20 since we discuss feet and not meters. Better than 20/20 is 20/15 or in your case 6/5 vision. Since you have a small correction, LASIK should be able to accomplish giving you sharp 6/6 vision or better assuming that your eye exam is otherwise normal.

For many people, your current level of vision is excellent and the small risks of LASIK would not be warranted. Also, for older patients (and yourself in many years) near or reading vision could be reduced with this kind of treatment.

Depending on your age, it might be best to try to correct your vision from -0.50 to +0.50 so that if your nearsightedness became worse, you would still have sharp vision.

Lasik for Astigmatism?

Can Lasik fix astigmatism and make vision better in general?
A: Astigmatism can be fixed by LASIK
In a perfect world, all eyes would have a nice spherical shape and be perfect optical lenses. In the real world, it is amazing that as many eyes are as good as they are. And the eye is formed during development there is a seam and to make a perfect eye is very difficult and not always accomplished.

The eye has a shape like a football on end when astigmatism is present, and this scatters light rays traveling through it so that simple optics cannot correct it. This is why soft contact lenses will help but only to a limited degree the patient with astigmatism. In the case of glasses, there are distortions created by the lenses that look like a fun house mirror when they are rotated around and looked through. These distortions make wearing glasses in severe astigmatism a suboptimal solution.

LASIK can fix astigmatism, even fairly bad cases of astigmatism to totally remove it or at least reduce it to a level where it is not much of a problem. Some patients who have their astigmatism fixed can see better than they could with glasses or contact lenses. It is one of the really helpful areas for LASIK surgery. In addition, the astigmatism repair can be accompanied by treatment of any near or farsightedness at the same time.

Of course, one has to be a candidate for LASIK in general and astigmatism treatment in particular. Some people with astigmatism have other conditions such as keratoconus where LASIK is not helpful, so it is important to have the astigmatism evaluated by a LASIK expert.

Lasik Possible Post Cataract Surgery?

i had cataract surgery, however i was not corrected to 20/20 due to the dr inserting the incorrect lens. Can lasik surgery correct the vision of the implant lens to 20/20?
A: LASIK can be done after cataract surgery.
Many people who have cataract surgery have some residual correction and this can be improved with either relaxing incisions or with laser surgery. LASIK with a blade free approach can be done safely in most patients as long as the cataract incision is well healed. The VisuMax laser is particularly good for this application in that it raises the eye pressure the least of any method for creating the corneal flap. If your vision is correctable with glasses to 20/20 then LASIK should help, but if there is some other problem reducing your vision then LASIK will not be of much value. Your eyecare professional can help guide you in this decision. Most often this will not be covered by either Medicare or health insurance.

Lasik Side Effects

i fear complications or side effects of lasik. what are typical problems?
A: LASIK complications are numerous but rare
The most common LASIK complication is not achieving the endpoint vision that was desired and thus sitll needing glasses or contact lenses or another procedure. The incidence of this was about 10% with older laser technologies but now is less than 5% in most practices.

There are serious complications possible including but not limited to infection, damaged or lost flaps, scarring, dry eye, DLK, loss of vision, and others.

Minor complications such as mild dry eyes, light sensitivity, glare and halos are also possible.

Before having LASIK you will sign an informed consent which should be available to you before the day of your procedure. It will list many of the potential side effects and complications of LASIK for you to understand. You should discuss anything that you do not understand or concerns you with your doctors.

Fortunately, serious complications are extremely rare after LASIK and most patients enjoy good results with few problems.

Latisse Application with Contact Lenses on

What exactly happens if Latisse is used without taking out the contact lenses? I know contact lenses must be removed prior to the daily use of Latisse. I was just curious what effect does the Latisse have on the eye if the lense remained intact. Would it cause irritation, infection, destroy the lense etc.?
A: Removal of contact lenses is precautionary with Latisse
During the “labeling” process for approval the makers of Latisse agreed to have the instructions state that contact lenses should be removed before application and not be replaced for at least 15 minutes. The risk is that the product could get on the contact lens and have delayed washout from the eye. I am not aware that the Latisse could harm the lens, and the risk is theoretical but it is certainly a good idea and I highly recommend it. In the evening when the contact lenses are removed is a good time to clean the lids and then apply the Latisse as directed. If for some reason you forget once to do this I would not panic just remove your contacts and clean them thoroughly.

Lumigan As an Alternative to Latisse?

How likely are doctors to prescribe Lumigan off-label for the same use as Latisse (it’s cheaper)?
A: Not much difference but it will not happen.
Yes, Lumigan for glaucoma is exactly, exactly the same medication down to the bottle. However, it is FDA approved for glaucoma, not eyelash enhancement. And doctors will not likely prescribe it off label when there is an on label option. Also, the Latisse comes with the correct applicators that were used in the trials. Finally, there would be no cost savings unless a doctor prescribed the Lumigan for a non-existent glaucoma and that will just never happen. Be happy that you can get Latisse, on label, for its approved purpose.

One Eye Blurry 6 Months After Lasik

I had lasik surgery 6 months ago and have since seen clearly out of only one eye. The vision in my left eye is slightly blurred (enough to annoy me). Sometimes the blurriness is worse than other times.

A: Blurry Vision After LASIK Tips

There are several reasons why you may have blurry vision after LASIK and at 6 months the results should be stable as was already mentioned. There are several possibilities and only your doctor can help you resolve this issue. You may have some uncorrected vision than can be helped by another procedure although this is not always possible. Also, you could have dry eye problems that are blurring your vision and sometimes medication, tears, or punctal plugs are helpful. A lot more information and an examination should reveal what your problem is and the best way to treat it.

Please Recommend a Great Lasik Surgeon in Seattle?

Anyone have a recommendation for a Lasik surgeon in the Seattle area? Also I have put away $2040 for the surgery via flexible benefits and I also have VSP vision insurance. Do you think that will be sufficient to get the procedure done? My eyesight is -3.75 in each eye.
A: Go to David Lin in Vancouver
The best LASIK surgeon in the Pacific Northwest is David Lin in Vancouver. He has advanced technology not available anywhere in the USA and he is sent difficult cases from throughout the USA.

PRK for Thin Cornea and Dry Eye?

I have been diagnosed as good for PRK, as I have thin cornea and dry eye. I know there are risks with the dry eye. What’s your opinion on going ahead? I have 2 prescriptions. Many thanks.
A: PRK may be your best option
When patients have thinner corneas that are a normal shape, and a relatively high prescription then PRK may be the best option for vision correction by laser.

PRK is photorefractive keratectomy and this is essentially the same type of procedure as LASIK but unlike LASIK it is not done under a protective corneal flap. Instead, the outer skin of the eye is removed either mechanically or with alcohol, and then the laser reshapes the eye cutting through a thin Bowman’s membrane and into the corneal stroma. Bowman’s does not heal but a new skin or epithelium grows over the front of the eye and gradually over several days to weeks the vision is recovered. This procedure is less invasive than LASIK, meaning it goes less deep into the surface of the eye, since a flap would have some additional thickness and thus make the treatment deeper. In cases of thinner corneas, it may be prudent to leave more tissue beneath the treatment and PRK can make sense for these cases.

There are some other considerations however. First is that with all laser femtosecond LASIK the flap can be made very thin where the invaseiveness is only minimally increased. Second, with PRK there can be scarring, so an “off label” treatment is often done of using a drug called mitomycin to stop potential scarring but this can have an unknown effect on healing and the cornea in general. Although this is thought to be safe, it is a consideration when deciding on which procedure to have.

As to dry eye, this is an open question. Some believe that PRK causes less dry eye due to the reduced cutting of corneal nerves, whereas others believe that the increased healing of the epithelium required in PRK can lead to greater dry eye problems post operatively. There is no clearcut answer as to an advantage from this perspective.

Therefore the real question becomes, how thin are the corneas, how high is the correction, how large must the treatment zone be, and how strong is the cornea to begin with. In other words, there is much to consider before one can accurately and completely answer this complex question.

PRK or Intacs for -5 Myopia?

I would like to reduce my myopia and dependancy on glasses without needing reading glasses. Intacs or PRK could correct me to around -2, greatly improving my distance vision while preserving my near vision. I am leaning towards Intacs as ive read they were safer and reversable.

Me and my parents were wondering why Intacs isn’t done often for myopia. Wouldn’t Intacs be a great option for many, especially since Intacs can be removed if you aren’t satisfied? I would love to learn more about my options, thanks for your time!
A: PRK is probably your best option
You did not say what your corneal thickness readings were or if there were other considerations that make corneal surgery risky, but assuming that there is no problem with having PRK this is a safer, simpler and more predictable option.

I am also not sure why you would want to have only 3 out of 5 diopters corrected unless this is a limitation of corneal thickness or you are older than it sounds like from your question, where you may want monovision in one eye. If both eyes are only corrected to -2.00 you will still need correction full time and this is probably not a great idea. It is also not clear why LASIK is not an option for you but might be a consideration especially with the newer all laser method. Intacs cannot correct any astigmatism, are slightly riskier for serious complications, and are usually used in higher corrections or when corneal surgery cannot be performed.

PRK Vs. Lasik

Which laser vision correction would have less chance of complication such as hazy vision after surgery: Lasik or PRK?

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A: Hazy vision and corneal haze
Hazy vision can be from many things including swelling, infiltrates, refractive error, internal eye problems and corneal haze.

Corneal haze is a medical term where the clear cornea becomes somewhat opaque and this can interfere with vision in some cases. This type of haze was common after PRK due to the healing response but is much less likely due to newer and better lasers and medical treatment after the PRK procedure. A major change is the usage of Mitomycin C off label to reduce post operative corneal haze.

Haze can also occur with LASIK, although due to the location of the treatment, it is much less likely than with PRK and thus the Mito C is not required.

Again, patients complaints of hazy vision needs to be distinguished from true corneal haze which is a medical condition.

Pulling out Lashes Effect on Latisse Results?

I have an obsessive compulsive disorder called trichotillomania–I pull out my eyelashes. Does this damage the hair follicle in such a way that it would somehow make Latisse more dangerous or less effective?
A: Treat the underlying disorder if you pull your lashes
Sometimes patients pull on their lashes due to an underlying irritation or blepharitis of the lashes where they are bothered by sensations at the lash line, and getting this medically evaluated and treated is important before considering Latisse. Likewise, if this is a psychological problem it would be best to have this treated to curb that behavior before trying Latisse in my opinion.

As to the effectiveness, it requires follicles that can be stimulated by Latisse for it to work. If there are still a number of viable follicles, which there probably are, then Latisse should work for you. Of course, if you grow new lashes only to pull them out, there is not going to be much benefit.

Too Old for Lasik?

Is there an age at which Lasik would be ill advised because you might still need glasses to correct age-related eye issues, or does Lasik preclude these problems?
A: Never too old to see with LASIK
LASIK can be theoretically performed at any age and there have not been problems associated with advanced age and LASIK. From a practical perspective, prior to cataract surgery, many patients past the age of 70 would benefit more from a lens extraction procedure than LASIK for their visual complaints. After cataract and IOL, a LASIK can be performed to fine tune the vision and this is not age dependent.

Younger patients seem to heal more quickly in this area as in all others, and there can be a longer recovery period in older patients. Also, other medical problems in the elderly may make LASIK less practical.

Unsatisfactory PRK Results

I had my PRK surgery done last month, my right eye seems to do well and then fluctuate throughout the day, however my left eye feels the same as the day of surgery…I am not happy with the results. What went wrong? Does this mean my left eye will need an enhancement? Is this normal? Will it get better?
A: PRK takes time to heal
The first laser procedure introduced was PRK since it seemed at the time that it was more straight forward, and it was rapidly eclipsed by LASIK for the very reason that the visual recovery is so much faster. In LASIK patients regain excellent vision in just a day or two, whereas PRK is much more variable.

From your question, it sounds like it has been about a month since your procedure, and in some cases PRK can take longer than this to fully stabilize. Usually the vision with modern PRK methods is fairly good after 1-2 weeks, but depending on the amount of correction and other factors it can take longer, sometimes 3-4 months.

You should talk to your doctor, and find out if something unusual is going on in your case or if this is just a normal healing process. If in doubt get a second opinion. You may have dry eyes, or other issues with the healing. In some cases, after 6-12 months if there is still some residual correction a repeat surgical procedure can be performed.

For some patients PRK is preferable, and the long term results are excellent, but it requires more patience to get the final results.

Using Latisse Forever to Maintain Eyelash Growth?

Do you have to keep using Latisse forever to keep the longer lashes?
A: When the Latisse stops so does the effect
Latisse works by stimulating lash growth and when it is stopped the lashes will return to their baseline status over a few months. It has been found however that once an effect is established, the maintenance amount of Latisse necessary to retain the effect is much less and usually application just a few times a week is all that is necessary.

That is why Allergan expects to make so much money on this product over time:)

Using Lumigan with Lash Extensions?

Can I use my lash extensions and still use Lumigan, like Latisse? Will I still get the same effects?
A: You may not need your lash extensions any longer
Most Latisse users find that they only need to use it a few times per week once it has had its effect at about 8 weeks, and in patients who were using Lumigan for glaucoma where this effect was discovered, they actually have to trim their lashes to keep them from getting too long.

Therefore, you may find that by regulating the amount of Latisse used, you will be able to have your lashes as long as you wish them to be and not need lash extensions any longer! If you do use lash extensions, other than some irritation possibilities, you should not have any problems. It would be best to discuss this with your Latisse provider in your particular case.

Wavelight Allegretto Wave Eye-Q Flying Spot Laser from Alcon

What is the Max Optical Zone and Treatment Zone that this laser could correct? How good is this laser? So far its been 6 weeks and my night vision only improves when I put on a pair of prescription glasses they gave me minus the halos, glare and starbursting. My left eye is my dominant eye and is -.75 my right is -.25. Will this clear up by 3 months or do I need an enhancement? Headlights are bright in daylight. Is this caused residual refractive error? Just getting nervous night vision.

A: The Allegretto is one of the finest lasers currently available

Without getting into the details of your question, the Wavelight laser has the greatest range of corrections available in the USA. It produces excellent results in most cases but in all lasers it is possible to have undercorrections and vision disturbances. In your case it sounds like you have a slight undercorrection at this point, but you are onlly 6 weeks post op and without knowing the full scope of your situation it is hard to comment. You should return to your provider and explain your concerns. Most likely your vision and quality will improve with more time.

Wearing Contact Lenses for Short Time Before Lasik?

I am considering Lasik and am going to make an appointment for a consultation this week.

My question is, I have not worn contacts for months but wore them for a few hours about five days ago. Because of that, do I need to wait two weeks to have my consultation?
A: Contact lenses before LASIK
It is not possible to give a complete answer to this question because it depends on many factors. In general, soft lenses have a more limited effect on the stability of the baseline refraction before LASIK than hard or gas permeable lenses. If you are wearing the hard type, it may take longer for your eyes to stabilize. In addition, toric or astigmatism correcting soft lenses also can distort the eye shape for some period of time.

It may be possible to have your consult, but what we look for is several measurements separated in time with minimal change to the refraction or we might not give the best results possible for a particular patient. There are other things we can look at such as topography patterns and other technical information.

The basic concept is that we want the eyes to be at their baseline level without the influence of contacts since there will not be contacts influencing the eye after the LASIK procedure. Sometimes contacts can change the prescription, and hide some of the correction that is necessary and this could result in a higher chance of needing a second surgical procedure.

What Are the Side Effects of Latisse on Eyebrows?

My eyebrows got very thin after my pregancies and I’d like to try Latisse to bring back their fullness. Can this work? What are the side effects?
A: Latisse works on eyebrows but it is “off label” for this indication
My understanding is that Latisse works very well on thin eyebrows due to the same mechanism that it works on eyelashes. The company will not say whether they are involved in studies for this indication, and this use is considered off label. Some patients after application to the eyelid, use the same applicator and brush some Latisse on their eyebrows. There is a chance of darkening pigment of the skin of the eyebrow area, but this shoud be reversible and if carefully applied may be cosmetically enhancing.

Officially, I cannot recommend this use since it is off label, but you should discuss it with your doctor before proceeding.

What Happens when One Stops Using Latisse?

As I understand it, once the desired results have been obtained, one must continue to use Latisse on a maintenance schedule. If one stops maintaining, do the new lashes fall out and the old thin out?
A: When the Latisse stops so does the effect
Latisse stimulates the lash follicles to grow longer, thicker, and darker. It takes about six weeks for this to be fully stimulated, and it takes about the same amount of time for the existing lashes to cycle and fall out to be replaced by lashes similar to those prior to beginning the Latisse. In other words there is no permanent effect on lash growth, however, a smaller maintenance dose is usually only two or three applications per week depending on the individual.

What if the LASIK Doctor Says That They Are Unable to Answer Additional Questions?

I had a consultation recently with a LASIK doctor who is offering a discount price on the Wavelength Allegretto Process. I thoroughly researched him on the Internet before the consultation. After the consultation, I emailed the doctor’s office to ask some additional questions about my diagnosis and future testing (as well as ask for some patients to talk to) and was told he was unable to provide patient names due to HIPAA regs and was unable to answer my other questions. Should I run?
A: That Depends on The Questions
Some doctors have patients who have expressed interest in being a referral source but usually this will be someone who had an excellent result and will known to be positive about their experience and results. In general doctors do not like to burden their existing patients with such inquiry whether it is a HIPAA violation or not.

Also, the internet can create a back and forth discussion which is not always productive. A few reasonable e-mail questions is appropriate, but if you have many questions then another visit and consultation would be the best alternative.

I would be more concerned about the issue of the offer of “discount” services. You should probably go to another provider and get a second opinion since you have unanswered questions anyway. It is important that you are well informed and comfortable in your decision.

What is the Ideal Age to Have Lasik Eye Surgery?

At what age should you be before you undergo Lasik Eye Surgery to correct your vision? Is there any sort of age requirement or age limit to have laser eye surgery?
A: Ideal age for LASIK is when your vision is stable
As a general rule, we recommend that patients are at least 21 years of age for LASIK or PRK vision correction. Some patients have been treated younger than this with excellent and stable results and the minimum is probably 18. More important than age is the health of the eyes and the stability of the refraction. This means that the eyes are no longer changing for the previous year so that the treatment has a higher likelihood of being permanent.

One benefit of being younger is that there are more years to enjoy the benefit of improved vision, the eyes tend to heal quicker and stabilize faster, and there is less side effects with things such as dry eyes. There is also less problems with reading vision than in older patients.

At first LASIK seemed to be most popular with an older demographic of average age around late 30’s or early 40’s but now we are seeing many more generation Y patients in their 20’s who have discovered the benefits of laser vision correction.

What is Visian Icl?

and is it an alternative to Lasik?

A: ICL is another way to see
The ICL is an implantable lens which is essentially a contact lens placed within the eye. It is made of a special material called Collamer (The C in ICL) which is very well tolerated by the eye. Since it can be ordered in specific prescriptions, it can provide a very accurate correction of vision. It also has the benefit of being removable and thus is reversible in a way that modifying the cornea with LASIK is not.

On the downside, it is an intraocular procedure, requiring the doctor to enter the eyes internal structures, thus making potential complication risks although rare, more serious. The most dreaded risk is that of an infection within the eye and thus this needs to be done in a much more sterile environment than that of LASIK which also should be performed in a sterile fashion.

Another limitation of the ICL is that it is not yet approved for the treatment for astigmatism and can only correct part of the prescription for many people. That being said it is a valuable adjuunct and is most useful in higher corrections and in those people with thin or abnormal corneas.

Will I Have Hazy Vision After Lasik?

A: No hazy vision after LASIK
You will certainly have some blurring of the vision the day that the procedure is performed and you may have some hazy vision especially at night for a few days to weeks especially at night. Typically the vision clears rapidly with LASIK, but the ultimate visual quality will not be known for up to 3 months when the healing is complete. It is rare for patients to complain of hazy vision and most patients report a quality of vision comparable to that of contact lenses. If you have heard of complaints of hazy vision it may be in someone who had some difficulties in their recovery process or who had PRK with some haze developing in the cornea. This is different from halos which are rings around lights at night which can occur after LASIK but again tends to get better over time, and is much less likely with the newer laser treatements available today.

Will my vision keep on clearing after Lasik?

I did Lasik 2 days back. My prescription was -4.00 (L), -3.00 (R). Left eye is now perfect. Crisp clear but my right eye is not as clear as my left eye. Its clear but when I close my left eye and see with right eye vision is not crisp but when I close my right eye and see with left my vision is crystal clear. Will my vision in right eye improve more or it will compensate with my left eye. I see very clear with both eyes open. Its just my right eye is not perfect.

A: The Odds are In Your Favor

Most patients continue to have slight improvement in their vision for up to 3 months or more, so likely it will clear more in your less clear eye. There are many unknowns here whether this blurry vision is due to lack of full correction, overcorrection, or some other medical problem with the healing of the eye. Also, it is sometimes difficult for patients to judge a small deviation between the eyes and there might not be a real problem in that many times both eyes are not exactly the same vision after LASIK. If you do not find your vision clearing after another week, i would go back for another examination with your doctor.

With a Prescription of -10.5, Am I a Candidate for Lasik?

I keep hearing two different opinions: one that it’s OK and people with higher prescriptions had Lasik done and have perfect vision now, and the other that all I could get is reducing my prescription to around -4. My eyes are healthy, only very near-sighted. Can you give me some advice?
A: LASIK in high Myopia is possible for many patients
Nearsightedness or myopia above 7 diopters is considered high myopia and can be treated effectively on several different laser platforms. Whether you are a candidate for this treatment depends on several factors. Most important is the thickness of your corneal tissue, since more correction removes more tissue and there has to be enough left for safety.

The other important factor is the shape of your eye to begin with. If your eye is in the normal range, then it is more likely that you would be a candidate, and this is measured as k readings values. Also important is that the shape of your eye is normal and symmetric without signs of preexisting weakness in the structure. Also a consideration is the size of your pupils, since this plays a role in your outcome.

Another possibility for a laser correction procedure is surface treatment or PRK. This is less invasive than LASIK so for high corrections we can sometimes perform PRK when there is not enough tissue for LASIK.

As with many of these type of questions, you really need to have an evaluation by an experienced LASIK surgeon who can evaluate and discuss your particular case. There are other options for high myopia, the most popular one is the ICL which is a lens placed inside the eye to correct the myopia rather than having a LASIK procedure.

We have treated a number of patients with a -10.50 prescription by LASIK with excellent results so I would not be discouraged from investigating this further but be prepared that there is a chance that you would not be an ideal candidate.

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