What is myopia?

Myopia, also known as nearsightedness, results when the cornea is steeper or the eye longer that average and light is focused in front of rather than directly on the retina. Near vision is clear, but distance vision is not, unless corrected by glasses, contact lenses, or procedures such as laser vision correction.

What is hyperopia?

Hyperopia, also known as farsightedness, happens when the point of focus is behind the retina. A farsighted eye sees distant objects more clearly than near objects, but lacks crisp focus at any range. Hyperopia worsens after the age of 40. Remedies for farsightedness include glasses, contact lenses, and hyperopic LASIK.

What is astigmatism?

Astigmatism results from an irregularly shaped cornea with more than one curvature (football-shaped). Light rays scatter within the eye, do not focus on a single point, and blurred vision results. Astigmatism can occur by itself or with nearsightedness or farsightedness. Laser vision correction can be used to reduce or eliminate astigmatism.

Am I a candidate for laser vision correction or refractive surgery?

If you are 18 years or older with stable vision and healthy eyes, Dr. Goldberg can give you a thorough examination and determine if your refractive problem is within the range of effective treatment. He can then help you decide which procedure is appropriate for your particular case.

What is an excimer laser and how is it used in laser vision correction?

The excimer laser delivers pulses of high energy, cold, ultraviolet light, used to break the bond between corneal tissue cells, allowing Dr. Goldberg to literally vaporize the tissue away, one microscopic layer at a time. The excimer laser’s operation is controlled by a computer that Doctor Goldberg programs to provide precise, individualized treatment for each patient.

How does removing corneal tissue change my vision?

Removal of a thin layer of tissue from the surface of the cornea changes its shape. To counteract myopia, the cornea is flattened; to remedy hyperopia, it is steepened. In case of astigmatism, the spherical shape is restored. The thickness of the layer removed is less than that of a human hair. These changes provide better focusing of light rays on the retina, significantly improving vision. Laser vision correction will reduce or eliminate your dependence on glasses or contact lenses.

What is the success rate for laser vision correction?

More than 95 percent of patients receiving laser vision correction have achieved 20/40 uncorrected vision or better. Our statistics at Atlantic Laser Center show 99 percent of laser vision correction treatments achieve 20/30 or better. These patients no longer need glasses or contact lenses to pass a driving test or perform most everyday functions.

How long before my initial exam do I need to leave my contacts out?

Soft contact lenses should not be worn for least three days (72 hrs) before your initial exam. Hard contacts should not be worn for at least three weeks before your initial exam.

How soon after my consultation can laser vision correction be scheduled?

We can normally schedule your procedure for a week or two after your initial consultation.

What can I expect on the day of surgery?

On the day of your surgery, we will have you arrive at our offices 45 minutes before the scheduled surgery time, so that we can review the procedure before starting and answer any last-minute questions.

Will Dr. Goldberg perform my surgery?

Not only will Dr. Goldberg be performing your surgery, no one else uses the equipment. Dr. Goldberg is the only individual who uses our lasers

What type of anesthesia is used for laser vision correction?

There are no needles or shots required for anesthesia. We’ll put topical anesthetic drops in your eyes to numb them. You will be given Valium by mouth to relieve anxiety.

What happens during the procedure?

First, we’ll make you comfortable in a reclining chair like the one in your dentist’s office. A special laser will be used to create a flap of corneal tissue. When this is lifted, the excimer laser will be used to a thin layer of the underlying corneal tissue. When that’s finished the flap will be put back in place and will seal itself.

How long will the laser vision corrections take?

The length of the procedure depends on the amount of tissue depth to be removed for your particular correction. The laser will be in operation for between 10 and 90 seconds. Your total time in the procedure room will be less than 15 minutes per eye.

Will I feel any pain during laser vision correction?

There is a feeling of pressure during the creation of the corneal flap, but usually no pain during any part of the procedure. The anesthetic eye drops numb the eyes to any other sensations.

What can I expect after laser vision correction?

Your vision will be blurry for the first day, but progressively improve as the day goes by. Your eyes will feel as though you were underwater with them open. Most patients can see well enough to drive the next day.

How soon after laser vision correction will I be able to see?

Significant vision improvement should begin the day after the procedure. Complete recovery depends on the degree of refractive correction required and your individual rate of healing, but most patients achieve stable vision within two or three weeks.

Can I return to my normal activities immediately after laser vision correction?

We advise that our patients rest for the remainder of the day and night following surgery. Most patients resume normal activities within 48 hours. It is very important not to rub eyes during the early post-operative period and to take extra care to avoid even the slightest trauma to them.

Will my vision fluctuate following laser vision correction?

Following successful laser vision surgery and complete healing, your eyes should be as stable as they were before surgery. Once the eye is completely healed, your vision will be stable. Vision may occasionally fluctuate when you are extremely tired or under a lot of stress, as it does for those who wear contact lenses and even those with perfectly healthy eyes.

Will I feel any pain after my procedure?

There is often a mild gritty sensation in the eye, and some slight discomfort. Ocular lubricants normally relieve this. For any additional discomfort, Tylenol or Advil is usually sufficient.

Will there be follow–up with Dr. Goldberg?

The doctor will have you return the day after treatment for a follow-up. There will be another appointment within 10 days to two weeks, and you may be asked to come in two to four times during the next year to ensure your eyes have healed properly and vision has improved as expected. After that, annual eye exams with your regular eye doctor are important to ensure continued good vision.

What are the risks of laser vision correction?

There are risks associated with laser vision correction, but occurrences are rare. Dr. Goldberg will provide a thorough review of risks before you consent to have any procedure performed. These potential risks include the following:

  • Most eyes are sensitive to light after the procedure. This sensitivity usually diminishes quickly and goes away altogether in most cases. Some patients experience a slight halo effect from bright lights at night.
  • Temporary overcorrection (farsightedness) is possible in a few cases. This is often part of the post-operative experience and generally stabilizes to near predicted results within two to three weeks.
  • Undercorrection: In some cases, laser vision correction does not fully correct vision. Some patients may achieve improved results with an enhancement procedure. Our enhancement rate is 5–10%.
  • Decreased Visual Acuity: This rarely occurs and if it does, it can usually be corrected with an enhancement procedure or contact lenses. Your particular case should be discussed with your eye doctor.
  • A problem with creation of the corneal flap occurs in about 1 of 500 cases. If so, the procedure is halted and usually can be repeated in a few months.
  • Infection occurs in about 1 of every 2,000 to 3,000 cases, odds similar to any eye surgery.

Definitions


Cornea

The cornea is the primary focusing element in the eye. It is made of transparent tissue that bends light rays towards the lens.

Epithelium

The epithelium is the cornea’s protective outer layer.

Lens

The lens is the secondary focusing element in the eye. It bends the light entering the pupil, directing it to a focal point on the retina. The lens changes its curvature to adjust the focal point at different distances.

Retina

The retina is a layer of photosensitive cells on the back of the eye’s interior surface. It converts light images into electrical impulses for the optic nerve, which relays these impulses to the visual part of the brain.

Refraction

Refraction is the bending of light waves as they pass through the eye, to focus them on the surface of the retina. If the shape of the cornea is such that light doesn’t focus properly, the eye has a refractive error. There are three kinds of refractive errors: nearsightedness, when a patient has blurred vision of distant objects; farsightedness, when a patient has blurred vision of near objects; and astigmatism, when a patient has trouble focusing at any distance.

Diopter

Refractive errors are measured on a numerical scale of units called diopters. Nearsighted people have negative diopters and farsighted people have positive diopters.

Nearsighted

Technically known as myopia, nearsightedness is the most common refractive problem. Nearsighted people have trouble seeing at distant objects, because the eyeball is longer or the cornea steeper than average, causing light rays to focus in front of the retina.

Farsighted

Also known as hyperopia, farsightedness occurs when the eyeball is shorter or the cornea flatter than average. Light rays aren’t properly focused before reaching the retina. People with farsightedness have trouble seeing near objects clearly.

Astigmatism

Astigmatism can occur alone or in combination with either myopia or hyperopia. It’s caused by an uneven or asymmetrical curvature of the cornea, which prevents the eye from focusing clearly at any distance.