Help me decide

Hello.

I have been considering surgery to correct my (approximatly) 2.00-2.50 diopter
astigmatism. I can't recall my exact presciption but the astigmatism is the
only correction in it. I am 40 years old and can function without my glasses
or contacts if I squint.

I don't like glasses.

I have tried soft toric lenses and RPG lenses. I had problems with both
including alergy to most every preservative used. I don't like the idea of
having to be tied to having a few bottles of cleanser and saline and a lens
case and a glasses case (just in case) everywhere I go and having to
remember which bottle is fresh. You get the picture... I feel that
contacts are a pain in the butt and the solutions I have to use are
expensive and don't last long.

I have tried ortho-K but the doctor warned that I shouldn't expect much of
a result since its more for myopes and that my astigmatism was on the
margin for showing any improvement. He was right.

So now I'm left with 3 choices:

1. Stay with what I'm using which is nothing.
2. Get some glasses and be thankful I have eyes at all.
3. Some sort of surgery.

Choice 3 has issues, namely:

a. My understanding is that LASIK is for myopia and hyeropia and actually
induces some astigmatism. I also don't like LASIK because it is so invasive
and I don't want dry eyes or halos.

b. Wavefront LASIK is interesting but too new AND we are back to the dry
eyes and halos again.

c. RK is out because it involves incisions in the focal area. (read
starbursts at night)

d. Presbyopia is right around the corner.

SO. I'm looking at AK (Astigmatic Keratotomy) or perhaps Limbal Relaxing
Incisions and have some questions.

I. Are AK and LRI the same thing?
II. How accurately can these procedures reduce astigmatism? In
other words, is this an iterative process?
III. Its still surgery, so what side effects are expected?
IV. Is there any other surgery that corrects astigmatism mostly with
minimal side effects?

Thanks for any information.

 

(Randy Smith) wrote in message
Dear Randy,

Re:> Thanks for any information.

The FAA requirement is for less than 2 diopters of astigmatism
and 20/20.

Therefore you are "legal" on those terms.
Cylinder lenses will of couse make your distant vision sharper.
Do you pass the DMV 20/40 level test.

There are many on this site who would be VERY HAPPY
to be able to see with out glasses. Count your blessings.
Eventually, in another 5 to 10 years you are going
to need +1.5 diopter lenses for reading. Age takes
its toll.

I would never get lasik for the circumstance you
describe. Too much (permanant) risk for too little
gain. If you were 20/300 the story would be different.

The other methods (AK) will probably run $1,000 or
so. Your choice -- but at least very low risk.
AK is like Ortho-K, but the goal is to "remold" the
cornea to take out the astigmatism. The problem?
Stop wearing the AK lens, and the astigmatism returns.

LRI (I think) means cutting the cornea with a laser to
shape the cornea to take out the astigmatism. Permanent
(mostly) but with the attendant risks of the laser proceedure.

That is the best information I have.

Best,

Otis
Engineer

^^^^^^^

Your Doctor was right.

 

(TomKopan) wrote in

Perhaps it would be good for this person to know what your center's results
were with mixed astigmatism (sphere and cylinder of different signs). My
hunch would be that the results aren't as predictable as doing simple
myopia or compound myopic astigmatism.

DrG

 

The person asked for general advice from the group. Cutting
the retina involves a certain degree of risk. Are you
suggesting NO RISK. If so -- say so.

The person involved apparently passed the DMV eye chart.
If she had 6 diopters of astigmatism, then perhaps
Lasik would be OK. As always -- that is her
choice.

Then that is wonderful. And not doubt the right
decision for you. Indeed, I have friends who
have done the same thing. But of couse
the issue is with the risks if you
pass the DMV test. I stated my opinion
as an engineer, and she understood it that
way.

THT IS NOT MEDICAL ADVICE MY FRIEND>

^^^^^^^^^^^^^^^^^^^^^^

Dear Tom,

I have made statements about the effect the minus lens
has on the focal status of the natural eye.

These are NOT MEDICAL STATEMENTS. I have always
identified myself as an engineer, not an optometrist.

In fact I never wish to "practice" optometry -- and
you understand the reasons. I could never put
a minus lens on the eyes of the public, without
FIRST discussiong the effect the minus lens has on
the natural eye.

Only after the person had reviewed these facts,
should he use the minus lens.

From my long friendships with ophthalmologists,
and my experience with the FAA requirements, I can
post these items. You are free to contradict
them as you see fit. The intelligence of
the reader can decide the issue.

Medicine (and optometry) are the practice of
opinions. When "experts" contradict each other
(concerning the prevention of a situation),
then the person involved should hear both
sides of the story -- not just one side.

After careful review, he might well decide to
use the minus lens -- it is sooo easy and quick.
But then there would be no doubt about
who was responsibile for the long-term
effect and consequence of using that minus lens.


Best,

Otis
Engineer

 

I did ask for general advice. I have been lurking on this board for several
months now and I have yet to see many discussions regarding correction for
small (some would say insignificant, but annoying none the less) amounts of
astigmatism. My opinion is that LASIK would be a really big hammer for
such a small nail. The risks and complications are too great for me to
seriously consider this. Especially with presbyopia just around the corner.

I have passed the DMV eye test recently without glasses (only squinting).
Yeah ME! I guess I'm more disheartened to learn (according to Otis) that
I am now a woman. What am I going to do with all those power tools now?
Wait...I don't have any power tools. I'm ok then. Does this mean I have to
start to learn to LIKE to watch Lifetime and the Lifetime Movie Network?
Just having a little fun with you Otis.

[deletia occured on irrelevent IMHO stuff ]

I really just wanted to see if there was something out there that I was
overlooking wrt reducing/eliminating astigmatism. I guess I'll just go
get some snarky (my daughters will ensure that) glasses and thank the
good Lord that I can see at all. I can't imagine what someone with a real
Rx must have to endure.

Thanks!

 

(Otis Brown) wrote in message

CORRECTION:

Re> The person asked for general advice from the group. Cutting

Should be: ... cutting the cornea involves a certain
degree of risk. ...

^^^^^^^^^^^^^^

 

otis> The person asked for general advice from the group. Cutting

Again Otis, the problem is that your knowledge of the
anatomy of the eye is off, at least in this case:
the cornea, not the RETINA, is involved in lasik.
The retina is not involved- and it's certainly not cut.

You do come across to other posters (especially those who
are new) as indeed giving advice to situations that are
beyond your scope as a layperson. If you want to "dabble"
in the eye/vision fine- but don't mislead posters.

frank

 

You want to see like this the rest of your life? Actually it's worse
than this because it's in 3 dimensions and changes quickly as the
pupil adjusts size (frequently depending on light) or the eyes move.
http://www.lasikinfocenter.net/Webpages/Visual Simulations Webpage.htm

Individual variation means that it is very important to screen people
beforehand in terms of their ability to deal with the kind of vision
that Lasik can leave you with. Wouldn't want to do surgery on someone
with a pre-existing vulnerability to anxiety, depression, any vision
or eye sensitivity (dry eyes, night or day vision problems, who needs
good vision because LASIK reduces vision), etc.

I believe that LASIK is very dangerous. For most people who have had
LASIK, their likelihood of being injured for life was the single most
dangerous thing they ever did or ever will do in their entire
lifetime. Check out my posts, others, and other websites.

www.lasikcourt.com
www.lasiksos.com
www.lasikdisaster.com
www.lasikmemorial.com

I think this indicates refractive surgery can have serious
consequences. I wish all the websites had information like this-
right up front.

"If you are here, you are probably pretty anxious about your vision."

"Suffering a personal injury has been rated almost as stressful as the
death of a close relative. Sometimes the depression, loss of
confidence, feelings of isolation, self-blame, anger, and other
emotional responses that some people manifest because of a refractive
surgery induced complication are more debilitating than the
complication itself. "
http://www.complicatedeyes.org/lasik_complications_anxiety.htm

These are just samples- there are a lot more than this.

http://posting.google.com/post?cmd=...ns93F94AEC3852Fdrgleukomacom%40216.148.227.77

http://groups.google.com/groups?hl=

http://groups.google.com/groups?dq=

http://groups.google.com/groups?q=&rnum=1

http://groups.google.com/groups?q=&rnum=8

http://groups.google.com/groups?hl=...08261750.74a6957e%40posting.google.com&rnum=4

 

I had already published a "correction". Yes, Lasik
is cornea cutting. For a my background and experience
(and that of Dr. Stirling Colgate) you can read
my book on:

http://www.myopiafree.com

Yes, indeed, I a made a typo.


Anyone who reads chapter 3 will understand the parts
of the eye -- as the optics of a box-camera or
optical bench.

***********

Otis> See above.

Otis> I think I have been absolutly clear about
my statement of the dynamic behavior of the
natural eye. If a person wishes to learn
more -- he can listen to our coversations.
He can then develop his own judgment about
these various issues -- and a choice he might
wish to make.


If you want to "dabble"

I do not "dabble". Sorry. I present analysis
and facts concering the eye as a sophisticated
system. If you wish to state that the eye
is not sophisticated in the manner -- do so.

If you wish to affirm the the minus lens has no
effect on the focal state of the natural eye -- then
present experimental data to that effect.

The title was, "help me decide". And so we
discussed the value of Lasik for improving
vision that passes the DMV (20/40) level test.

With our collected analyis she can now form
here own judgment. I think we have done
her good service by discussion the
risk/benifit ratio for her decision.



Best,

Otis
Engineer

 

(Otis Brown) wrote in message > I had already published a "correction". Yes, Lasik

Yea, you're still a layperson in the eye care field who likes to dabble.

COMET study. My last patient yesterday was a college soph
that I've been seeing since he was in 6 th grade. Guess what?
Initial exam was -125-25x90 ou. Exam yesterday was -125-50x95 ou.
Minus lens for about 8 yrs- no increase.Explain that! Oh ,never mind.

frank