Health - September 2002

My fingernails dug into a rubber squeezie ball as I settled back into a reclining chair and watched the surgeon position a laser over my right eye. He'd given me Valium to relax and drops to numb my eyes, but my heart still thumped wildly the day I went in for surgery to correct my vision. I'd sworn back in the 1980s never to undergo such a procedure, after writing an article about the serious problems some people experienced from a pioneering form of the surgery, radial keratotomy. But with friends touting the newer, most common type of refractive surgery, LASIK, the idea of being able to see without glasses or contacts was too enticing to pass up.

So nearsighted I couldn't read the clock on my nightstand from bed-much less watch TV--I'd worn glasses since fourth grade. While I didn't mind wearing my specs around the house, I preferred contacts out in the world since I disliked how frames looked and felt. And at 47, I would soon need bifocals to correct presbyopia, the aging-eye condition that makes it hard to read small print. The goal: reshaping my 20-600 corneas to 20-20 in my right, dominant eye, and 20-40 in my left, a slight undercorrection that would leave me nearsighted enough to read a menu or price tag (but not a novel) without reading glasses. The hope was to live daily life virtually glasses-free. I figured the $4,000 fee (not covered by insurance) would be recouped over time by savings on glasses, contacts, and lens solutions. Despite initial misgivings, I expected perfection, and even plotted to give away my glasses to Goodwill. I imagined how roomy my purse would be without my "eye gear" -- never dreaming I'd need a bigger one for eye drops, glasses, and contacts after the surgery.

The procedure took minutes and was painless. I stared at a red light and was plunged into darkness for a few seconds while the laser vaporized tissue. My strongest memory is of the surgeon exclaiming, "Perfect!" as he completed his work on each eye.

The next morning I awoke to a miraculous sight: the clock on the VCR across the room--in focus. I tested 20-20 in my right eye and 20-40 in my left, just as expected. But my excitement was tempered with concern over a lingering blurriness and stickiness of my eyes, which I was told would improve in a week or two.

Instead, the dryness continued and the blurring grew worse as my vision regressed. A month after surgery, I could no longer read street signs, tested about 20/50 in each eye, and had to order new lenses for my glasses so I could drive. My eyes were so irritated I couldn't wear contacts for nearly two months and had to use drops constantly. It appeared that the surgery I'd hoped would free me from glasses instead made me even more dependent on them.

Over the next few months, however, the scratchiness subsided enough for me to tolerate contacts for short periods of time. At the six-month marker, I could get through a day without needing drops every few hours. And now, after about a year, both eyes have stabilized around 20/70, and contacts are relatively comfortable, although I still see some haloes and glare at night and use drops occasionally. My surgeon recommends a second surgery--free--but there's no way I'd go through again what was, for me, an excruciating healing process, especially with no guarantee of the outcome.

The good news is that my near vision is great. Ironically, this means I don't need glasses or contacts in the house, but rely on them to navigate the outside world. I can read the clock on my nightstand and see individual hairs on my legs when shaving in the shower. And my distance vision is better, so the world is no longer a big blur--it's a little blur.

Hindsight may be 20/20, but mine is fuzzier. Now that the worst is over (I hope), I'm not sorry I had LASIK. I'm less dependent on glasses-I'm just not living in the glasses-free world I envisioned.

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SIDEBAR: LASIK Basics

With celebrities such as Tiger Woods and Reese Witherspoon correcting their vision with LASIK, it's not surprising that some experts estimate that as many as 20 percent of people who wear glasses or contacts will undergo the procedure by 2015. While serious adverse complications rarely occur, according to a recent report from the American Academy of Ophthalmology (AAO), many people will experience dry eyes and nighttime starbursts, at least temporarily. The key is to set your sights on realistic goals-don't expect eagle eyes post-LASIK.

Research suggests that people with mild to moderate nearsightedness or astigmatism experience the best results. Poor candidates include people who have an eye disease, take certain medications (such as steroids) that cause fluctuations in vision, have a disease such as diabetes or rheumatoid arthritis that may affect healing, are pregnant or nursing (they might have "refractive instability, which means their vision may change), or are in their early 20s.

Before you go under the laser, visit these sites:

• To help you determine if LASIK is right for your, check out the new guidelines from the American Society of Cataract and Refractive Surgery at www.eyesurgeryeducation.com.
• The U.S. Food and Drug Administration offers a checklist at www.fda.gov/cdrh/lasik for prospective patients as well as information on risks, expectations and choosing a surgeon.
• The American Academy of Ophthalmology provides information about LASIK on its site, www.aao.org, and through the Medem, Inc., Medical Library, www.medem.com.