One Year Since LASIK

So, one year ago today I had LASIK surgery. It was meant to stop my reliance on glasses, which I have worn since early childhood. The catch being, I still have issues with my vision. Weirdly, it might not be because of my eyes.

First and foremost, this is my experience with this particular form of vision correction. Your experience may be vastly different, better or worse than my own. But it has been a year for me, I’m still working from home thanks to the seemingly unending pandemic, and I have little else to write about. Still with me? Strap in, this is a long one.

I had always been nearsighted. I could read without glasses, work on a computer without glasses, and so on. Distance vision was the issue, and I needed corrective lenses to be able to focus on anything more than a few feet in front of me. My eyeglass prescription, I came to find out, was actually not that strong. More middle of the pack, as prescription strengths go. Thus, in early 2020, I decided to look into getting LASIK and eliminating my need to purchase prescription glasses.

The initial eye exams went fine, save for two points that were mentioned to me. First, in order to correct my eyes for distance vision, I might lost my ability to read without glasses. Second, the fact that I am over 40 made that almost a certainty. It seems that all people, even those with perfect vision, will notice their vision start to degrade a bit after their 40th birthday (give or take). It might happen later, it might happen sooner. But it starts with an inability to read fine print, and goes from there. It’s called presbyopia, if you want to look it up. Basically it is the lens of the eye losing some of its flexibility, so focusing on the really tiny print becomes difficult as the lens can no longer adjust as needed. Thus, people turn to those over-the-counter reading glasses you can get just about anywhere.

The doctor showed me what my vision might be like after LASIK using the standard eye exam machines. And, while my distance vision was now perfect, I could not read something held at arm’s length. I was a bit dejected, to say the least. This meant that to sit a few feet from a computer screen for my work would require that I still wear glasses all day long. What would be the point of the surgery then?

The doctor then informed me of an alternative to pure distance correction. It is called “monovision” correction. With monovision, the dominant eye (you can search online to see how to determine your dominant eye) is corrected for distance vision per normal LASIK procedure. The other eye is corrected (as needed) for close up vision. Again, the doctor adjusted the values in the machine and had me look through it. I could read the eyechart on the wall, and I could read a paper held in my hand. I seemed to have little problem shifting focus between the two distances.

I did some extra research on the Web about this type of procedure, and decided I would go for it. The biggest issue for most patients is simply adjusting to the changes. Training your brain to trust the focus of one eye for up close things, and the other eye for far away things. This adjustment could take from a few days to a few months to fully achieve, depending on the individual. And in the end if the patient simply cannot make the adjustment, the near vision eye can be corrected for the distance vision, and reading glasses can be used going forward. I scheduled the surgery.

LASIK surgery is strange. If, like me, you are very sensitive about your eyes and decide to get LASIK, heed these warnings. It is a scary and uncomfortable experience. But also really short — like 15 minutes short. But again, my sensitive eyes made it one of the scariest experiences of my life. It took longer for the numbing eyedrops to do their job than for the doctor to do the corrections to my eyes. And while you won’t feel any pain during it, you will still feel pressure on your eyes, and you can still see the entire time. Nothing like seeing a machine get closer and closer to your eye that you can’t close! If you don’t have overly sensitive eyes, none of this will likely bother you. I just figured I’d mention it.

…anyway…

My surgery done, I followed all after care instructions to the letter. Mostly just various eye drops at various times during the day, and then wearing eye guards to bed at night. Truth is, the day after surgery I was absolutely shocked at the fact that my distance vision was really good. Not perfect yet — eyes have to heal just like any other part of your body — but way better than I expected less than 24 hours later. Obviously adjusting to distance vision wasn’t going to be a problem.

Close up reading and such took some getting used to. Again, my dominant eye was corrected for distance, so I definitely had to do the brain training thing to favor my other eye for reading and such. I did succeed, though it isn’t perfect. Since your vision can vary at different points in the day, or because you are tired or feeling under the weather, or what have you, the focus can still drift a bit and require me to concentrate a bit to snap it back into place. But this is now the exception. More often than not, I can read things just fine.

While it sounds like everything is great, at the start of this story I said I still have vision problems. And I do. To recap: distance and close up vision are fine. So what’s left? Intermediate distance vision. The definition of intermediate vision is roughly anything past arm’s length and up to something like 8 feet or so. In this range, things can be out of focus for me. Not completely, of course, just a little fuzzy around the edges.

I discussed this with the eye doctor at my 30 day check up appointment (which luckily was still before the lockdowns started happening here in the USA). The problem was, he said, my eyes were seeing what the surgery intended to make them see. My up close vision was fine, my distance vision was fine, and the machine measurements of the changes to my eyes showed they were as they were supposed to be. Essentially, nothing went wrong with the surgery.

The problem wasn’t objective — it was subjective.

What does that mean? Well, if we simply looked at facts and figures, my eyes were now as the doctors expected them to be. My experience with them, however, was not as it was supposed to be. Just as I had to train myself to focus up close by switching — for lack of a better word — focus pull from my dominant eye to my other eye, I might need to train myself to utilize both in the intermediate distance. In the meantime, odd as it seemed, I could utilize +1 reading glasses to help.

Of course that was roughly 11 months ago, and I still have issues with the intermediate distance, and I still turn to the glasses when I truly need them. I have also discovered some weirdness about it, that also makes me think it isn’t my eyes that are the problem. It may very well be my brain trying to interpret what I’m seeing, and failing at times. I say “at times,” because I have come to realize the intermediate distance vision issue isn’t with images — it’s with words.

If I watch a movie on my TV, sitting a normal distance from the TV, I notice nothing wrong. If I put subtitles on the movie, the subtitles are readable, but slightly out of focus. It’s very weird. I suppose the image might also be slightly out of focus, but I don’t notice if it is. Play a video game and I can admire the HD graphics, but make me read something in the game and it doesn’t look so good anymore. And much like I mentioned above when training my focus while reading…if I concentrate on it hard enough, I can get that text to appear in focus — I just can’t seem to hold it.

That’s where I stand. There is the inevitable question most people ask: knowing this now, would I do it again? Glasses aren’t perfect (I despise contact lenses — see above about my overly sensitive eyes), but I never had this issue when wearing them. I also think what would my experience have been if I had done this a decade ago, when I wouldn’t have needed the monovision correction. I suppose none of it matters, cause I will never know. I had this done, and now I live with the results. Would I do it again? Unsure.

I would say if you are considering LASIK, and are over 40, think about what I’ve said here. There are ways for you to “try out” the monovision correction via contact lenses if you don’t mind wearing them. If you are under 40, no LASIK doctor will probably even discuss monovision correction with you, and you likely won’t even need it. I have certainly known people who have had LASIK and absolutely love the results. If I’m out walking around, or driving my car, I do love it myself. I don’t have to worry about glasses, I can use normal non-prescription sunglasses, etc. But that fuzziness on words in the intermediate distance? That is just an annoyance I’m learning to live with.

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