Will LASIK allow you to never need glasses again?
LASIK reduces your dependence on glasses or contact lenses, but will not make you glasses-free forever... wait, WHAT?
YES - this is an important point to understand to set realistic expectations.
There are a few reasons for this:
Presbyopia
Most people who pursue LASIK are young and haven't given much thought about aging. But just like grey hair and wrinkles, presbyopia is inevitable and will hit us all eventually. Presbyopia is the age-related decline of our natural crystalline lens' ability to focus on near objects. The lens hardens over time, and this loss of flexibility means a loss of ability to focus up close, like when reading. Have you noticed how your parents have to push reading material further out in order to see it? That's presbyopia, and it will start becoming noticeable in your 40s.
When you get LASIK correction as a young person, you are correcting your distance vision only.
So what this means is that if you're getting LASIK at 25 years old, you'll be able to enjoy good distance vision without glasses correction. Then when you're around 40 years old, you're going to start needing reading glasses even though your distance vision will still be good without glasses. But you'll still be able to enjoy the results of your LASIK for about 15 years without needing any glasses!
On the other hand, if you're over 40 years old and considering LASIK, you basically have to choose what distance you want your eyes to be corrected for, and there are 3 options:
Do you want your eyes to have good distance vision but need reading glasses?
Or would you prefer to have your eyes corrected for reading but need glasses for distance?
Sometimes people can do Monovision which means one eye is corrected for distance, and one eye is corrected for near, allowing you to see both distance and near. The downside to this is that it can take time to adapt, and not everyone can adapt well. You also lose your depth perception. Your optometrist can help you with contact lens trials to allow you to experience Monovision and see if it's something that would work for you, BEFORE you commit to LASIK.
I usually have a long discussion about these various options with patients over 40 who are considering LASIK. Some realize that their expectations don't match reality and change their mind about LASIK.
Regression
LASIK corrects your refractive error at the time of the surgery, but sometimes your eyes continue to change. This is why it's important to make sure you have a stable refractive error / glasses prescription prior to committing to LASIK. Regression is more likely with higher refractive errors, and in hyperopes (far-sightedness).
Sometimes, your corneas simply don't heal in the expected way, and end up not reaching the target after healing. But likely, your residual refractive error will be much lower than what you started with, and can be correctable to 20/20 with glasses or contact lenses.
The LASIK surgeon may re-treat your corneas within12 months of the initial surgery, if and only if:
The residual refractive error is stable
The residual refractive error is at least 0.75 D or your vision is worse than 20/30
You have enough corneal thickness left to be able to re-treat safely
Often the surgeon may only re-treat the cornea with PRK (photorefractive keratectomy) rather than with LASIK, due to the risks involved with re-lifting the flap.
If you are okay with the fact that you will need glasses again in your 40s and beyond, then great! Keep reading!
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