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Bascom Palmer Eye Institute

Lasik evaluation session

Good candidate for vision correction surgery

Your eye care professional can determine if you are a good candidate for vision correction surgery after a comprehensive examination.

LASIK or other vision correction surgeries can be used to treat nearsightedness, farsightedness, and astigmatism and to decrease, if not eliminate, a patient’s dependence on glasses or contact lenses. Patients who have reasonable expectations from the procedure and who understand that any surgical procedure always has certain risks associated with it are the best candidates for the procedure.

Patients may not be candidates if they have certain corneal diseases or collagen vascular diseases, such as rheumatoid arthritis, or significant problems with wound healing. Individuals who are pregnant or nursing are not candidates. Lastly, it is important that your refraction or prescription for glasses or contact lenses is stable and not constantly changing.

Although age is not necessarily a factor, patients should be over age 18 and have no ocular or systemic disease that would inhibit healing or adversely affect the surgical outcome.

Good candidates for the procedure include:

  • Those with stable refractive error (no change in glasses or contact lenses for 1 – 2 years)
  • Individuals who do not like or cannot tolerate glasses or contact lenses
  • Individuals involved in sports or jobs where contact lenses or glasses are inconvenient or interference (such as driving, skiing, tennis, etc.)

Anyone interested in pursuing vision correction surgery needs a complete evaluation to determine if they are a good candidate for the procedure. Often at this visit you are given further information about the surgery and have the opportunity to have your questions answered as well as view the facility. Since vision correction surgery is a permanent surgery, it requires careful consideration, understanding, and planning by you and your physician.

Both medical and lifestyle factors should be considered in deciding whether to undergo surgery for laser vision correction.

The primary medical considerations for an individual are:

  • General health of the patient and their eyes
  • Amount of correction required
  • Shape of the individual’s cornea
  • Corneal thickness
  • Pupil diameter in the dark

Vision correction safety

Overall, vision correction procedures are very safe, and the vast majority of patients do quite well. There is a small chance of complications during the procedure. Although extremely rare, if any aspect of the procedure is not ideal, the surgery can be aborted and can usually be reattempted several months later. Problems with healing or infection can also arise after surgery, but fortunately these are quite rare and can usually be treated medically. On occasion additional surgery may be necessary.

Risks or complications from refractive surgery

The minimal risks or complications range from residual refractive errors, such as under-correction, to rare complications (occurring less than 0.1 percent of cases), including infection and irregularities in the LASIK treatment. In addition, there is a slight chance of halos or starbursts around lights at night (5 percent), ghost imaging from bright lights (5 percent) and slightly decreased night vision (5 percent).

What to expect during the screening

Bascom Palmer Eye Institute has three South Florida LASIK Centers, which perform all types of vision correction surgeries, available for your convenience. In Miami, we have our largest patient care center at the University of Miami Miller School of Medicine campus, the second facility is in Palm Beach Gardens, and the third in Plantation. These centers are inviting, state-of-the-art facilities created to provide a comfortable, educational environment for patients. Upon arrival, patients view an informative video explaining different types of vision correction procedures, with and without lasers. At Bascom Palmer Eye Institute, there is no cost for this screening.

Then a LASIK Center staff member completes a comprehensive evaluation that may include the following:

  • Comprehensive Refraction Examination: A series of visual eye tests to evaluate the amount of refractive error as well as the size of the pupils.
  • Slit Lamp Evaluation: This examines the cornea and anterior chamber of the eye. The size of the pupil is measured using “pupillometry.”
  • Orbscan Screening: The Orbscan is an instrument used to measure the thickness and size of the cornea.
  • Corneal Mapping: Images that compute the anatomy of the eye are captured.
  • Wavescan Screening: This device measures pupil size and refraction.

After completing the screening process, the patient meets with a LASIK Center physician to review test results, maps, and charts. The doctor evaluates the shape of the patient’s cornea, examines the back of the eye using an indirect lens, and discusses the patient’s ophthalmic history. Finally, the doctor determines if the patient is a candidate for refractive surgery and answers any questions.

At Bascom Palmer, there is no cost for this evaluation if the patient has not undergone prior refractive procedures.

A full evaluation appointment takes longer than the shorter screening visit. If you are reasonably interested in pursuing vision correction surgery, this full evaluation appointment would be appropriate for your initial visit, since it is ultimately required to determine if you are a good candidate for the surgery. Scheduling for surgery can be addressed at this visit.

If you choose the screening session, no preparation is required. However, if you are a contact lens wearer and you choose to schedule the full evaluation, you will be asked to remove your lenses for a time period prior to your visit in order to improve the efficiency and accuracy of the examination. If you wear soft lenses, they must be removed for at least one week prior to your visit. If you wear hard, or gas permeable lenses, you must remove your lenses for at least three weeks prior to your visit. All contact lenses can cause molding of the cornea and will affect the measurements that are the basis of surgical planning. If you are a contact lens wearer, you should review these specific guidelines with the laser vision correction coordinator at the time you schedule your appointment.

During your appointment you will be asked about your medical history, ocular history, medications, allergies, visual needs for work and recreation, and your visual goals. Giving this some thought in advance will help us counsel you toward your best option for laser vision correction.

The full evaluation requires that your pupils be dilated with eye drops. This enables us to examine and accurately measure the eye. The drops that are used are longer-lasting than what you may be accustomed to from past visits to the eye doctor. We recommend that you bring a pair of dark sunglasses with you and you may want to have a friend or family member drive you home from the appointment.

Additionally, we recommend that you bring your glasses and current lens prescription with you as it will be helpful in determining if there appears to be any change in your vision.