Posted on 03/11/2003 2:38:24 PM PST by Nachum
http://www.NewsAndOpinion.com | (UPI) Vision-correcting LASIK surgery can cause double vision, but this problem can be minimized if ophthalmologists exclude people with certain eye conditions from undergoing the procedure, two eye experts said in a study released Monday.
"People who have a history (of particular eye disorders) are at higher risk, and they should call that to the attention of their doctor," Dr. Burton Kushner, an ophthalmologist at the University of Wisconsin in Madison and lead author on the study, told United Press International.
The patients also should ask if they are likely to have double vision after the surgery, Kushner said. "That should raise the red flag for the doctor to do appropriate testing to determine if they are at risk for it," he said.
The conditions that put people at higher risk of double vision include a history of lazy eye or having worn a patch or done eye exercises for a lazy eye. Other risky conditions include a history of double vision, eye muscle problems or having a prism in glasses, Kushner said.
Having these conditions would not necessarily mean a person would develop post-LASIK double vision, Kushner said, but it does put them at higher risk. Additional testing done by an ophthalmologist can determine their level of risk, he said.
The additional screening should include taking a general history of the patient, doing a basic eye exam and perhaps more advanced eye tests if necessary.
LASIK surgery -- which is short for Laser-Assisted In Situ Keratomileusis -- is used to correct vision disorders such as myopia (near-sightedness), hyperopia (far-sightedness) and astigmatism (an irregular-shaped lens). About 1.5 million LASIK procedures are performed worldwide annually, and complications can include infection, scarring and cataract formation.
Although it does not directly cause double vision, "by changing the optics of the eye, (LASIK) can interplay with how someone was controlling an eye muscle problem" and ultimately result in double vision, Kushner explained.
It is uncertain how commonly double vision occurs but Kushner and co-author Dr. Lionel Kowal of the University of Melbourne in Australia have noticed more patients coming to them in recent years who developed this problem after undergoing LASIK surgery.
Dr. Ernest Kornmehl, an ophthalmologist in Boston and spokesman for the American Academy of Ophthalmology, told UPI that double vision is avoidable if the patient is thoroughly evaluated by the surgeon before the procedure.
"It's elective surgery, there's no rush and the patient should be thoroughly evaluated before the procedure to avoid any problems," Kornmehl said. He added that he turns down four out of every 10 patients who come to see him for LASIK because they have conditions that put them at risk for complications.
Patients considering the procedure should seek out "a board-certified ophthalmologist who is going to be doing the evaluation him or herself and not rely on a technician or optometrist," Kornmehl said.
In the study, which appears in the March issue of The Archives of Ophthalmology, Kushner and Kowal reviewed cases of 28 patients who developed double vision after undergoing the procedure.
The researchers found double vision was more common in those who developed scarring, needed prisms in their glasses prior to the operation or had other vision disorders, including aniseikonia (in which each eye perceives the same object as different in size), surgically induced monovision or improperly controlled crossed-eyes
Does that mean you can see twice as good?
Yes, but I'm 57 and can read and use the computer without glasses. Nearsightedness has advantages when you get old.
There IS no "minor" surgery, especially on something as precious as my eyesight. My lousy vision is correctable to 20-20 with eyeglasses, and eyeglasses I will continue to wear.
I worked for the company that developed both the LASIK procedure and the laser system used in the surgery. The company's principal specialist in the physiology and optics of the eye, the LASIK procedure and who was responsible for designing the UV laser, itself, wore eyeglasses.
--Boot Hill
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