Common Eye Problems
When considering LASIK surgery, it's important to first have a comprehensive eye exam with your optometrist or ophthalmologist to make sure you are a good candidate for laser vision correction.
During the exam, your eye doctor will evaluate the health of your eyes, looking for common eye problems. Some general eye problems are a contraindication for LASIK surgery, at least until the problem is successfully treated and stabilized.
Common eye problems your optometrist or ophthalmologist will be looking for during a comprehensive exam include (in alphabetical order):
Blepharitis. This is inflammation of the eyelids and follicles of the eyelashes, causing the eyelids to become red, swollen, irritated and itchy. Another sign is the formation of dandruff-like crusting at the base of the eyelashes. Blepharitis usually is caused by bacteria (anterior blepharitis) or irregular secretions from the oil glands at the eyelid margin (posterior blepharitis). Generally, blepharitis must be treated with medicated eye drops and/or ointments and lid hygiene prior to LASIK surgery.
Conjunctivitis is inflammation or infection of the thin inner lining of the eyelids and the surface of the "white" of the eye (sclera). Commonly called pink eye, conjunctivitis often is contagious and causes symptoms and signs that can include itchy, watery eyes; sensitivity to light; a feeling something is in your eye (foreign body sensation); and a sticky, mucous-like discharge. Like blepharitis, conjunctivitis should be successfully treated before considering LASIK or other laser vision correction surgery, such as PRK or epi-LASIK.
Dry eyes are a common cause of contact lens discomfort that makes many people consider LASIK surgery to correct their vision. But it is important for dry eyes to be successfully treated prior to LASIK surgery. In fact, LASIK often increases dry eye symptoms (at least for a limited period of time) after surgery. Symptoms of dry eye syndrome include burning, stinging, a foreign body sensation and intermittent blurred vision. If your eye doctor finds you have dry eyes, he or she usually will treat the problem with artificial tears and perhaps medicated eye drops designed to decrease inflammation and help you produce more tears. In some cases, your eye doctor might also recommend the insertion of tiny silicone "stoppers" (punctal plugs) in the tear drainage ducts of your eyelids to keep more tears on your eyes for longer periods of time. Sometimes nutritional supplements like flaxseed oil and fish oil also are recommended to help relieve dry eye symptoms.
Eye allergies can cause problems for people who want LASIK, and should be treated prior to vision correction surgery. Symptoms of eye allergies include red, itchy and watery eyes. The problem generally is caused by sensitivity to airborne irritants (allergens) such as pollen, dust or pet dander. In most cases, eye allergies can be treated with medicated eye drops. If you have seasonal eye allergies, your eye doctor might recommend that you postpone your LASIK surgery until after allergy season.
Eye Twitching is an annoying, but harmless, firing of nerves in the eyelid that cause the lid to twitch uncontrollably. The cause of most eyelid twitches (or eye twitching) is unknown, but it's possible the problem is related to stress, lack of sleep and too much caffeine or other stimulants. Most cases of eye twitching resolve without treatment in a day or two. But, depending on the severity and duration of the twitching, your eye surgeon might want to postpone your LASIK surgery until the twitching has completely ceased.
Floaters are small bits of organic material that reside within the clear, gel-like material (vitreous) that fills the back of the eye. Because this material is embedded in the semi-liquid vitreous, it tends to drift or "float" inside the eye. When this material floats directly in front of the retina, it casts a shadow that our brain perceives as something floating in front of our eyes, usually appearing link tiny strands of lint or cobwebs. Eye floaters generally are harmless and are not a contraindication for LASIK surgery. But if you experience a sudden increase in vitreous floaters—especially if accompanied by occasional flashes of light—see your eye doctor immediately: these symptoms could indicate the beginning of a retinal detachment, which is a medical emergency. Failure to promptly treat a detached retina can lead to permanent vision loss, even blindness.
A stye is an infected oil gland at the edge of your eyelid. Most styes resemble a pimple and they typically drain and heal on their own within a few days. Applying a warm compress to the eyelid often will help a stye open and drain faster. Most LASIK surgeons will want your eyelids to be free of styes prior to LASIK surgery. If you have a history of styes, your surgeon might recommend lid hygiene practices and possibly use of antibacterial eye drops prior to surgery.
A subconjunctival hemorrhage is a painless, bright red appearance to the "white" of the eye (sclera) that commonly looks like blood on the eye. This is caused by the leaking of a blood vessel on the surface of the eye. The blood fans out under the conjunctiva, sometimes causing the entire sclera to turn red. A subconjunctival hemorrhage (SCH) looks scary, but is harmless. It can be caused by physical exertion, such as lifting, coughing, sneezing or vomiting. Trauma to the eye also can cause a SCH. People who are taking blood thinners are at greater risk for subconjunctival hemorrhages. The red eye resolves on its own without treatment, generally over a period of a few days or a couple weeks. Your LASIK surgeon might prefer that a SCH is fully resolved before LASIK surgery. Also, it is not unusual for the suction device applied to the eye to create the corneal flap in LASIK surgery to cause a subconjunctival hemorrhage immediate after surgery. The only time a SCH is of significant concern is if it occurs from trauma to the eye. Any trauma sufficient to cause a SCH might also cause other, more serious problems within the eye. See your eye doctor immediately after any episode of significant eye trauma to rule out possible bleeding inside the eye (hyphema) or a traumatic detached retina.
This is just a partial list of common eye problems that may or may not interfere with your ability to have LASIK surgery. Having a comprehensive pre-operative exam with your optometrist or ophthalmologist is the only way to know for sure if you are a good candidate for LASIK or other refractive eye surgery.