The LASIK experience

Warning: This post has virtually nothing to do with video games.

Some time around the age of 10, it was decided for me that I had to wear glasses. Between that time and today, I decided getting my eyes fixed via laser was a good idea. I finally went through with it and I figured it would make an interesting blog post.

Glasses are a mild annoyance; they're fairly un-invasive, but they start getting in the way as soon as you start doing anything physical, anything involving water or anything that can end with you getting punched in the face.

The idea of contacts never appealed to me; something about sticking a piece of plastic onto your eyeball freaked me out. Getting bits of your eye burned off by a laser seemed like a much more palatable solution.

I liked that it was a permanent solution; glasses break, contacts get lost, but it's very hard to undo laser surgery. I also liked that it removed a material dependancy; suddenly I didn't rely on a tiny piece of plastic to function. Losing or breaking my glasses wasn't a disaster.

As Bruce Lee says, it is not about daily increase but daily decrease. Design teaches us to remove anything that can be removed. I saw laser surgery as a way to remove a weak link from myself.

If you're considering laser eye surgery, here's what you can expect, speaking from my experience in a Canadian clinic.

You'll contact a clinic that does laser eye surgery. It will be surprisingly easy and painless to get whatever information you want, as well as book a commitment-free examination, free of charge. As a refreshing contrast to most customer-facing businesses (especially anything involving personal health) service is very, very good.

You will show up to your appointment and handed a number of brochures and forms. Everything will be done to put you at ease, from the free fruit, free coffee, free cookies, giant fish tanks and TV screens extolling the virtues of their processes. The brochures will tell you of their dozens and dozens of potential side-effects, as well as their staggeringly low chance of happening, likely as an artifact of government regulations.

All the people that you meet will be exceedingly nice, again as an effort to make you comfortable and take your mind off the prospect of having your eyeballs cut open and burnt by a laser.

Your pre-examination will involve the standard "this lens or that lens" exam, followed by shining uncomfortably bright lights into your eyes, then dropping various liquids into your eyeballs, followed by waiting as your vision goes blurry (this is intentional) followed by more tests involving things being placed uncomfortably close to your eyeballs.

After a solid hour or two of having them do uncomfortable things to your eyes (warning: eyes are sensitive) you will meet someone who will congratulate you on being eligible for laser eye surgery. This person will tell you that the surgery costs $Money, You probably already knew this going in. (If you didn't know this going in, expect to pay somewhere between $3000 and $4000). Your insurance probably doesn't cover it.

Your appointment will end with the person offering you to set a tentative date for your procedure, assuring you that you can call at any time later to cancel it with no hassle. Think very long and hard about this. As Dan Ariely teaches us, setting an option as the default (in this case, booking a cancelable appointment) has a massive effect on our decision making. In this case, if you book this tentative appointment, you will probably not cancel it.

Consider the appointment booking as permanent and irremediable. Your unconscious mind will essentially treat it as such. If you have any doubts or reservations, do not book this appointment.

Once you leave the pre-examination, your vision will still be blurry; you will be disoriented. Get someone to help you home, or at the very least don't plan on driving home. You will probably get lost (I did).

You will need to go out and buy eyedrops. You will go to the pharmacy and pay roughly a hundred dollars for two small bottles of eyedrops. You will come to hate those bottles.

You will spend the days before your appointment worrying about all the things that could go wrong, asking yourself if you've made the right decision. Rational advice, such as "it probably won't go wrong" will not help. Your body has a strong negative response to the idea of getting cut open and played around in, especially in an area as important as your eyes.

Still, the day will roll around and you will go to your appointment. You will receive a few dozens sheets of paper to read, initial and sign; these will re-iterate all the things that can go wrong with your operation, how the long-term effects of the procedure are unknown (since we've only been doing it for 20 years or so) and how there are no guarantees of success or perfect vision. Moments later you will be handed a sheet of paper guaranteeing you perfect vision (or your money back).

You will again go through the standard "better or worse" eyesight test. Pay attention during this test. The choices you make here will be burnt into your cornea.

You will need to pay. It is an unusual feeling be handed a credit card reader asking for a 4-digit amount of money, but you will pay.

They will sell you a third bottle of eyedrops.

They never state this out loud, but most of their literature mentions it; you can ask for a sedative before your operation. I asked for it and received a tiny beige pill, as well as a reassuring talk from my surgeon.

You will take this pill and discover how Xanax affects you. For me, it got me mildly tired, disoriented and vaguely high, but did little to calm my instinctual fear of getting my eyeballs cut open and burnt.

After some more waiting and tests, you will be escorted to the surgery area. Chemicals will be dropped into your eyes to make them numb; having numbed eyeballs is a very peculiar sensation. It feels like having very dry eyes, as if you were dehydrated or sleep deprived.

You will enter the surgery room, where more liquids will be dropped into your eyeballs, and you will be made to look at uncomfortably bright lights.

Then they motion for you to lie down on the surgery table.

You will be handed a pair of foam stress balls.

Note that during the entire procedure, you are fully conscious and unrestrained; there is never anything stopping you from shaking, twisting or standing up to run away. Instead, you have a pair of $1 stress balls in your hands: you can squeeze them if you like.

The view from the surgery table is a dozen white lights arranged in a pattern reminiscent of a spider's multiple eyes. In the center is a single green LED, which you are repeatedly told to stare at. On each side of that LED, roughly 5 centimeters away are two red LEDs. I never asked, but I assumed that looking at the red LED mid-operation would mean going permanently blind.

Your eye will be taped shut, while your other eye will be taped open. Blinking becomes impossible, which will make your body believe something is terribly wrong. This is when a metal cylinder ("l'écarteur") will be placed forcefully around your eyeball, to force your eye to stay open.

Note that at this point you still have complete control over your eyes. You can look around and move your head, and while your panicked lizard brain may command you to do so, don't. Just squeeze the stress balls instead.

A machine will then be pressed into your eye (this hurts). This is when your vision will fade to black, and you will become temporarily unable to see. Your body will go into panic mode as this happens; this is when you will hear the sound of a small buzzsaw. This is no cause for alarm; that is simply the machine cutting your eyeball open, not unlike a can opener.

You will be told not to move while this is happening, and to stare at the green light. Given that your vision is completely black during this time, you have no way to tell if you are moving or not. Consider, in your panicked thoughts, if you are not unvoluntarily thrashing your eye around, causing the saw to slice through parts of your eye it wasn't supposed to.

After a few seconds of blackness and buzzing, the sound will stop, the machine will be removed and your vision will return, blurred. The blurriness comes from the fact that the front part of your eyeball has been severed and is only holding on by a small flap of flesh.

This is when you will see, coming from above you, two sharp, pointy metal instruments. These will approach uncomfortably close into your vision until they reach your eyeball and will grab the severed part of your eye, pulling it away. Your vision will become completely blurred as this happens.

As your body becomes aware that your eyesight has now been damaged beyond repair and goes into survival mode, you should remain calm, squeeze your stress balls and breathe deeply (without moving). Breathe in the smell of burning eyeball, as this is when the laser will power on with a loud, constant beep. Stare at the green light, and appreciate that you can smell your own burning flesh. Take this time to contemplate if lens #1 really was better than lens #2.

Don't dwell on it for too long though, because you won't be able to change your mind. There is no possibility to unburn your eye if you change your mind. You will be told that a smell of burnt hair is perfectly normal. Relax, those are just bits of your eye burning. You didn't really need them.

Stare into the laser as it burns you; looking elsewhere, even momentarily, may cause it to burn things it wasn't supposed to. Certainly don't move your head. Certainly don't get up. Just squeeze the stress balls.

Take in the relief as the loud beep stops (but the smell lingers). The pointy metal instruments will return, this time giving you your eyesight back (mostly). The metal cylinder holding your eyeball in place (oh? did you forget about it during all this time? Don't worry, you won't forget mid-operation, it'll be very present in your mind) will be removed. The tape holding your eye open will be removed, taking some of your eyebrows with it.

Appreciate your newfound freedom to blink; you will have it only for a few seconds as they tape your eye shut and go after your other eye.

[...]

It stuns me that people take this operation in stride. If that didn't sound harrowing or nightmarish, you're a stronger individual than I am; I've had more pleasant experiences during episodes of sleep paralysis.

[...]

Finally the operation will end; it only lasts for a few minutes, but your body will remember every detail. As you stand up, you will be told the operation went well, and you will be free to leave the surgery room to experience...

The Disappointment

Laser eye surgery is not a case of Jesus laying his miraculous healing hands upon your forehead and restoring your perfect eyesight. You have sustained major eye trauma, and your vision will be appropriately damaged. Your vision will be very blurry following the operation, your eyes will be sore, sensitive, dry, painful, uncomfortable and vulnerable.

To illustrate this, consider that your current vision, with glasses, is a 10. Your vision without glasses is a 5. Your vision immediately following the operation will be around 5 or 6. Marginally better, but you will want for your old glasses.

You will be handed a set of large, plastic sunglasses that dig painfully into your temples; you are to wear these at all time for the next 24 hours, even when sleeping.

You may look into your old glasses; these will be of no help to you any longer. They are completely alien and unusable; keep them as a memento or give them away. Your eyesight has been permanently altered.

Your best course of action at this point is to go home and try to sleep. If you were sleep deprived, consider this an opportunity to catch up on missed sleep, because you will not be able to do much else without putting your eyesight in danger.

The recovery process begins. For 24 hours, you will not be allowed to read, look at screens or perform any strenuous activity. Showering is prohibited; touching your eyes is verboten. Instead, you will be required to perform the following fun activities:

-Dropping liquids into your eyes

This will be your new normal for the next few days. Prepare to become very familiar with those three bottles of eyedrops you bought, because you will be using them copiously. Applying eyedrops is not fun™ and you will be doing it several times per hour.

You will wake up after a few hours to crusty, painfully dry eyes. There is no way for text to properly convey how it feels; you will want to rub your eyes, but this is not allowed. They never explain why you aren't allowed to touch your eyes; my personal theory is that the bit of flesh they sliced off during the operation is still just barely hanging on, and rubbing your eyes might rip it off. (UPDATE: I asked. That is exactly why. Don't rub your eyes, folks.)

Your eyes will thirst for those unpleasant eyedrops, and you will become a master of applying them. At first, this will freak you out and you will splash sticky medicine all over your eyelids (the hardest part is fighting your instinct and keeping your eye open as you know something is about to come into contact with your eyeball).

When you apply the medicine, you are told to keep your eyes closed for one minute; you cannot do much with your eyes closed. Use this time to stretch your arms, and try not to bump into anything.

At this point you will learn something that nobody warns you about. This is never mentioned in any brochure or consent form, and it is the aftertaste.

Somehow, in a delightful evolutionary idiosyncracy your tear ducts and your tastebuds are connected. As such, the eyedrops will flow down your tear ducts and allow you to taste what you are applying to your eyeballs. Unsurprisingly, it tastes terrible. You cannot get rid of this taste by washing your mouth; the liquid is not in your mouth. This aftertaste will stick around and will become a common part of your life as long as you use the eyedrops, which will be for a solid week.

After applying some eyedrops, taking a nap and applying some more eyedrops, you may attempt to remove your sunglasses (do this inside, if you must). This is when you will experience...

The Epiphany

Your vision will have well and truly improved. Not perfect, but good enough; a solid 8 or 9. There is nothing on front of your eyes; nothing refracting light onto your retina other than your (half-burnt) cornea and vitreous humour. You can see, truly see, for the first time in how-many-years-has-it-been-I-can't-even-remember.

For me, the first thing I noticed truly seeing was a piece of art taped on a wall above my desk. Appreciate for a moment this fact; you can see now. I mean, you could see before, but now you can see without that annoying chunk of plastic. Your eyes have been improved. Fixed. Your vision is augmented.

You will have a follow-up visit the next day, after putting in dozens of drops in your eyes. Your vision will fluctuate and take months to heal. It may not be perfect; it may require going under the laser a second time. But for now, just appreciate your newfound eyesight.

Your human rights will slowly return as time passes; you will be allowed to look at your phone and computer screen again (as if you really didn't look at your phone for 24 hours, hah). You will be allowed to shower again. Showering with good eyesight will feel profoundly strange and alien after years of blurry showers. Waking up in the morning (and seeing) will feel wrong. You will often reach for your glasses and not find them there. Whatever you do, don't stick your finger in your eye.

Your eyes will take time to recover. Focusing on something (like a computer screen) for a long period of time will be difficult, and will give you headaches. Eyedrops will be recommended but not all that helpful. Exercise will be prohibited, for a while. Going outside will require those thick sunglasses, even at night. Traffic lights and car headlights will now be surrounded by enormous, bright haloes; while this may sound cool at first, it is disorienting and dangerous. Coupled with the sunglasses darkening your vision, seeing outside at night will be extremely difficult.

After all this, is it worth it? I can't say yet, but I can't exactly undo my decision. Ask me again in a few months.

Now, if you'll excuse me, I have to put in some eyedrops.

PS: I was told (after the operation) that there is no risk of your movement affecting the operation negatively; the laser can supposedly track you faster than you can move and will adapt to your movements. I don't recommend testing this.

PPS: Taking a hot shower may cause a sharp pain in your eye, as though your eyeball were expanding or trying to escape from your skull. This is normal, or so they tell me.

Comments

  1. I'm ecstatic to say that my LASIK experience was nearly nothing like yours.

    The short of mine was:
    Eyedrops for days before the procedure.
    Valium just prior (maybe 30 minutes?).
    Lay on my back on a reclined chair.
    With dimmed lights, the procedure started.
    For each eye:
    Instrument held my eye open.
    Numbing eyedrops (no pain).
    Dr. warned of pressure while they applied the 'vacuum ring'. (this was the most uncomfortable part. Vision blackened but the whole bit only lasted about 5 seconds)
    Dr. swung a big machine over my face an told me to look at a dot. Ticking sounds (that I was warned about).
    Dr. Swung that one away and lifted the flap.
    Dr. Swung another machine in from the other side and told me to look at the orange light. More ticking.
    Dr. flushed the eye w/ something like eyedrops and closed the flap.
    Repeated for the other eye.

    I stood up and Dr asked me to read the time. I could read the clock across the room with only slight haziness. Before the surgery, I couldn't see more than 6-8 inches away.

    My eyes felt like I had sand in them. Got driven home and napped for a few hours. Woke up feeling great seeing near 20/20 and ready to put in more eye drops.

    ReplyDelete
  2. Thanks for sharing your story! I have a buddy that just got Lasik and his experience was pretty good. They scratched part of his eye during the surgery by accident but it healed within a week (very minor) and he has 20/20 vision now in both eyes! It's definitely a life-changing operation.

    http://www.mylasikmd.com/ilasik-lasik

    ReplyDelete
  3. Where did you get your LASIK done, Anonymous?

    Thanks for sharing both of you!

    ReplyDelete
  4. It proved to be Very helpful to me and I am sure to all the commentators here! yaldoeyecenter.com/lasik-detroit/

    ReplyDelete

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