Here's what to expect at each stage of the laser vision-improvement process based on our interviews with experts and information from the U.S. Food and Drug Administration and theFederal Trade Commission.
Before surgery: Evaluations
Two to four weeks before your baseline evaluation
If you wear contact lenses, switch to eyeglasses two to four weeks or more before your initial evaluation. That's because contact lenses change the shape of your cornea for up to several weeks after you've stopped wearing them. That could lead to inaccurate measurements that surgeons use to determine how much corneal tissue to remove, and could result in poor vision after surgery. If you wear toric soft lenses or rigid gas permeable lenses, stop wearing them for at least three weeks before your initial evaluation; stop wearing hard lenses at least four weeks before. At your baseline evaluation be sure to ask the doctor how long before you can use contacts so they won't interfere with follow-up measurements.
During your baseline evaluation
Expect to meet with an eye doctor, provide a thorough medical history, discuss your expectations and goals, and receive a thorough eye exam to determine whether you are a good candidate for laser vision-correction surgery.
To provide the most accurate information possible, bring along your eye prescription records and a written summary of your medical history and eye conditions, including dates of significant events, treatments, and tests. And bring an up-to-date list of your current medications and dosages.
Your doctor should perform a thorough eye and vision exam. He or she should dilate your pupils and examine your eyes to make sure they're healthy. That includes:
- Assessment of dry eye
- Tests for thickness of your cornea
- Tests of the curvature of your cornea
- Tests of the pupils
- Tests for astigmatism and a cone-shaped cornea
- Test for glaucoma
- Retinal exam
Afterward the doctor will discuss whether you are a good candidate for laser vision-correction surgery and, if so, what procedure is most appropriate. The doctor should talk with you in detail about the potential harms and benefits, including your own expectations and goals, and whether the results are likely to meet them. The doctor should also explain what you should do before, during, and after surgery, and also discuss the alternatives to surgery.
Take notes and ask questions. Bring along a spouse or friend if possible so he or she can help make sure you ask all your questions and understand the answers. Ask how long it will take for your vision to improve after surgery or whether it will fluctuate. Ask whether follow-up laser eye surgery, called "enhancements" or "touch-ups," may be needed, what improvements might be expected, whether they are covered by your contract—the agreement that specifies the services you're paying for—or can be written into it, and for how long. Ask whether the contract covers medical care or surgery to fix complications that may arise (and ask your insurer whether your plan covers complications from laser eye surgery).
If you're not comfortable after this discussion or think you might prefer another practitioner, get a second opinion about the surgery at another practice or vision center.
After your baseline evaluation
You should not feel pressured by the doctor, a staff member, or anyone else about signing a consent form for having surgery. Give yourself plenty of time to review the form and information your doctor and the center provided, ask additional questions, and carefully consider the potential risks and benefits.
Do not sign the consent form unless you feel satisfied that you thoroughly understand the possible risks, benefits, and alternatives, and what the likely outcome will be for you. Then tell the doctor or staff member at the center whether you're signing the form and going forward with the surgery. Closer to the surgery date, eye measurements may need to be repeated.
A week before surgery
Your doctor may tell you to stop wearing makeup, lotions, perfume, and cologne for a few days before surgery since they can interfere with the laser treatment or possibly increase the risk of infection after surgery. He or she may instruct you to wash any residue or debris from your eyelashes with scrubs for several days before surgery. Talk with your doctor about whether he or she will be prescribing any preoperative antibiotics, moisturizing eye drops, or other medications, and if so, how to use them.
The day of surgery
Wear comfortable clothing (and low-heeled shoes) and be sure you are still free of makeup, perfume, cologne, hairspray or hair gel, and earrings. Lasik is an outpatient procedure, but your doctor may give you medicine to help you relax. Because your vision may be blurry after surgery, arrange for transportation to and from the facility. Generally, the surgery takes only about 10 to 15 minutes per eye, but because of preparation time and other factors, plan on spending two hours at the office.
It's helpful to keep your eyes closed for the first few hours and sleep while wearing the protective glasses provided by your doctor. You may experience a mild burning sensation for a few hours after Lasik surgery but there should be minimal pain. Do not rub your eyes. Contact your doctor immediately if you experience severe pain or irritation, or if your vision or other symptoms get worse instead of better.
Do not shower until after your postop doctor's visit, which tends to be on the next day. At that visit you can schedule the rest of your follow-up visits, usually for the following week, month, and then as directed.
Healing is fast, but you may want to take a few days off from work after surgery. Don't drive until your vision has improved enough to safely do so. You'll need to avoid getting water in the operated eye or eyes for a few days. Do not wear eye makeup, lotion, or sunscreen for a week after surgery. Avoid impact sports or similar activities for four weeks, and then use protective safety glasses. Avoid pools, hot tubs, and whirlpools for up to two months after surgery.
Healing and side effects
Your vision may fluctuate during the first few months after surgery, and it may take three to six months for your vision to stabilize. Glare, halos, difficulty driving at night, and other visual symptoms may also persist during this "stabilization period," the FDA says. If further correction or enhancement is necessary, the agency advises, wait until your eye measurements are consistent for two consecutive visits at least three months apart before considering another operation.