Scott Hanselman

What to think about before getting your eyes lasered (LASIK)

March 1, '04 Comments [4] Posted in Musings
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I've received a bunch of emails congratulating me on getting my eyes lasered.  I've also got a lot asking questions about the results and my philosophy around the process.  This post was actually going to go out as the 4th email response, but here is it as a post instead.

Yep, I was a -9.25, that's like 20/1600.  Now (3 weeks later) I'm actually "officially" 20/20 in both eyes, but IMHO the right has some glare at night.  I'd say I'd like to be 20/10 or 20/15, but it's never effortless, is it? I'll let you know how it settles in a few months.  :) 

I will say, it's CRYSTAL CLEAR in the day time, but at night there are some "Comet Tails" on things like LEDs and there are areas of extra high contrast, like looking at a TV in the pitch black.  I have been researching this for years. Make sure to have a WaveFront 3d Topology on your eyes, and that the guy who does the surgery has done at least 10,000.  My guy has done 21,000 and had 7 problems.  If they won't get stats, don't bother with them, IMHO.

I'd totally do it again, but I'll give you these warnings:

  • ASSUME you will need a 2nd surgery to get it perfect. Just assume that.  If you don't, good for you, but best to expect the worst.
  • Know that your eyes will LITERALLY change from day to day, and sometimes from hour to hour as they heal.
  • TAKE the percoset after the surgery, from 3 hours to 6 hours afterwards you will experience a great deal of pain like hot sand in your eyes.  Best if you sleep through it and miss the whole thing.
  • ASSUME you will need to wear glasses for reading and driving.  (see above ;) )  
  • ASSUME you will get to 20/40, where you can go to the mall and walk around, but might not be able to read subtitles at a foreign film.  (same reason)
  • YOU WILL have visual artifacts around lights at night and in low light situations, small auras and comets.  I can still drive at night, but sometimes it's irritating.
  • It takes 6 months to REALLY know how your eyes will end up. 
  • When you are > 40, you WILL need reading glasses.  LASIK has zero to do with presbyopia.
  • If you are hyper-detail oriented and you'd regret it if you didn't see 100% perfectly, don't bother.

Overall, I'm very happy with the results, and it was $3K (total) worth spending.  Plus, I'm going to deduct the whole thing.  If you do happen to go to my guy to get your eyes lasered, be sure to tell them I sent you.

The other thing that's interesting, is that while everyone says that you'll wake up and revel in the fact you can see the alarm clock, that hasn't struck me as interesting.  What's REALLY amazing is being able to see the shower drain and your feet.  20 years of glasses and I've never actually seen water go down the shower drain.  After my first shower with new eyes I had to clean the bathroom. 

About Scott

Scott Hanselman is a former professor, former Chief Architect in finance, now speaker, consultant, father, diabetic, and Microsoft employee. He is a failed stand-up comic, a cornrower, and a book author.

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Monday, March 01, 2004 3:54:11 PM UTC
Does your eyes feel dry in the morning or evening?

I did Lasik about 42 months ago, and this was the most annoying sideeffect for me.
Torgeir
Monday, March 01, 2004 3:57:45 PM UTC
Thanks for talking me out of Lasik surgery! (My eyes aren't as bad as yours were, I think I'll stick with the glasses...)
Monday, March 01, 2004 7:44:20 PM UTC
I had RK done 10 year ago (yup 10 years ago!) and it was awesome.
Wednesday, March 03, 2004 4:11:25 AM UTC
My Lasik journal:

January 25, 1999:
Two days ago I was:
OD -11.75, -1.5
OS -12.00, -1.5

Yesterday I had lasik at TLC Manhattan.

Today I'm around 20/30 or so, and 20/20 if I douse my eyes with eye drops... the vision is there, just not the crispness. (I still have some surface irritation, so that's clouding things a bit.)
But ... I can see! Two days ago, I literally could not make out distinct objects beyond about 18 inches, today I walked around Manhattan without glasses and could see street signs from blocks away...
This is way more than I expected... I had been expecting at least a week or so to go by before I felt comfortable driving, and while due to the post-op glare I'm not going to try night driving yet, I'm certainly fine to drive during the day. (Two days ago, sitting in the car without glasses I couldn't see the steering wheel, much less the road.)


February 9, 1999:
My screen is back to 1024x768 and normal fonts, though it's a bit blurry still. Significant ghosting at night -- night driving is not pleasant on unfamiliar roads as signs are unreadable until 2-3 seconds away at 55mph.
Eye chart test says I'm 20/40 left, 20/80 right -- but that fluctuates every day. I am using Bion Tears every hour, and everything clears up quite a bit for a few minutes after putting those in. My Dr says that the surface of my cornea is extremely dry and not smooth and that is causing the blurriness. I'd have to say he's right, considering I can see nearly 20/20 for a few minutes after using eye drops. He says that as long as I keep using the drops for a few more weeks, the roughness will go away. My flaps were completely invisible by 1-week postop, with no wrinkles.

June 26, 1999:
Post-surgery:
OD plano, -0.50
OS plano, -1.00

Post-correction (same MD, 30 June 1999):
OD plano, 0
OS plano, 0

I've had serious problems with healing due to dry eye and my vision has been consistently cloudy. My co-manage eye doctor says my eyes are gunked up with sloughed-off epithelial cells. Dry-eye is made worse by my eyelids not closing all the way at night.

Although my eyes are technically zero sph/cyl, I get about 20/40 OD and 20/80 OS on the Snellen. Problems with photophobia since the June correction -- I need to wear sunglasses outside even in very overcast weather.

At no time since the original procedure in January has my vision been better than 20/40 for more than a day or two.

The dry-eye is treated with lots of drops (celluvisc) during the day, and Refresh PM at night with eyes taped shut. I've had significant improvement in the past week or so since I've started taping my eyes shut at night, but still no better than 20/40 or so.

My night vision is worse than 20/100.

December 28, 2000:
I wear glasses again. Thin ones, granted, and I don't always have to wear them -- in fact, sometimes I forget to put them on, and don't realize so until hours later...

... but wasn't the point of LASIK to not have to wear glasses?

I think the technology still has a ways to go before it's ready for primetime.

I still have NO night vision. I need at least a 25-watt bulb to navigate.

April 2001:
If I could go back in time and undo my LASIK, I would.

June 2002:
No change in my opinion.

March 2004:
Still no change in my opinion.

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Disclaimer: The opinions expressed herein are my own personal opinions and do not represent my employer's view in any way.