Vision correction surgery - DON'T

[BillSWPA]

Additional information about my wife:

With more information transmitted by cooler heads, I now understand that it wasn't the entire cornea that was torn, but the top layer of the cornea, which has multiple layers. The cornea itself is now 100% healed, but there is still a lot of irritation. She is still seeing her Dr. daily. The physician's assistant in the ER had given her an antibiotic that was adding to that irritation, so her current Dr. switched her to a better antibiotic, as well as liquid Advil eye drops for the pain. She tested at 20/30 at 70% healed, and better than that (but not 20/20) at 1005 healed. She is wearing safety glasses - either in the form of sunglasses provided by the Dr. or a pair of my clear safety glasses - for most of her waking hours. It will be awhile (will hopefully find out soon exactly how long) before it is advisable for her to take unnecessary trips in the car due to the risk of damage if she is in an accident.

Along the way, we have also received contradictory information about whether the lasik may have made the eye more susceptible to injury. After reading the information above, I remain convinced that it did.

It looks like there has been some good discussion in this thread since my last post, with many posters showing a good understanding of the advantages and disadvantages of the various forms of surgery. It is undeniable that many are happy with their surgery, and that it fits their risk/benefit analysis well. I started this thread to throw some more information into the risk/benefit analysis. For me, it is definitely not in favor of the surgery.

Regarding the use of a physician's assistant, I know some very smart people who are presently in PA school. One who comes to mind would likely make a good physician, but doesn't want to take that much time away from her daughter. I have also seen some good physician's assistants. The biggest problem I have with this particular PA is that she should have realized 1) when something was an emergency, and 2) when she was in over her head, and referred the case to an eye specialist for immediate treatment. At the very least, the ER attending physician should have become directly involved when my wife asked the PA if her eye would heal back to normal, and the response was "I don't know."

In any profession, one has to realize when one is in over their head, and when to get some additional help. I am an intellectual property attorney. I regularly refer out work that, although simpler than what I do every day, is not in my practice area, and is therefore better done by someone who does it every day.

Everywhere I drive around here, I see signs for optometrists and opthamologists. I can't imagine the hospital would have any difficulty finding some who would be happy to do an on-call rotation for some extra $ (paid for by the patient when they are actually called in).

[USMC_Anglico]

If are going to get corrective surgery, PRK is the way to go. The military does it all the time now, with priority for folks being deployed. PRK is more painful and recovery is slower than LASIK, but it is the original procedure with over 20+ years of results and no flap being cut.

Don't go for the cheapest eye mill. Do some research on the doctors in your area, the experience of the Dr. will certainly pay off. I had my PRK done by a former head of the Air Force Acadamy's program. Couldn't be happier.

[BigBen66]

Wife had LASIK done a couple of years ago,Lifetime guarantee !! Went back for a correction and was told her cornea was now to thin to correct the problem.We weren't told this up front. So she's back to square one with glasses or contacts and out a lot of money.

[ROGOPGEAR]

Got LASIK ten years ago and still have 20/20. I get mild halos at night but still think it is very worth it. I did have to get it wavered for the military though.

[HawaiianM4]

Had PRK done four years ago. Eyes are now 20/10 and 20/20. Prior to PRK I bolo'd on the M16 range. Now I shoot very well. Take the time to understand the procedure and ask alot of questions. It took me 6 months to a year to fully realize the benefits of PRK.

Just because it went fine for them, may not be the case for you Complications are not uncommon.

FYI - some people should not have it done.

[uwe1]

Additional information about my wife:

With more information transmitted by cooler heads, I now understand that it wasn't the entire cornea that was torn, but the top layer of the cornea, which has multiple layers. The cornea itself is now 100% healed, but there is still a lot of irritation. She is still seeing her Dr. daily. The physician's assistant in the ER had given her an antibiotic that was adding to that irritation, so her current Dr. switched her to a better antibiotic, as well as liquid Advil eye drops for the pain. She tested at 20/30 at 70% healed, and better than that (but not 20/20) at 1005 healed. She is wearing safety glasses - either in the form of sunglasses provided by the Dr. or a pair of my clear safety glasses - for most of her waking hours. It will be awhile (will hopefully find out soon exactly how long) before it is advisable for her to take unnecessary trips in the car due to the risk of damage if she is in an accident.

Along the way, we have also received contradictory information about whether the lasik may have made the eye more susceptible to injury. After reading the information above, I remain convinced that it did.

It looks like there has been some good discussion in this thread since my last post, with many posters showing a good understanding of the advantages and disadvantages of the various forms of surgery. It is undeniable that many are happy with their surgery, and that it fits their risk/benefit analysis well. I started this thread to throw some more information into the risk/benefit analysis. For me, it is definitely not in favor of the surgery.

Regarding the use of a physician's assistant, I know some very smart people who are presently in PA school. One who comes to mind would likely make a good physician, but doesn't want to take that much time away from her daughter. I have also seen some good physician's assistants. The biggest problem I have with this particular PA is that she should have realized 1) when something was an emergency, and 2) when she was in over her head, and referred the case to an eye specialist for immediate treatment. At the very least, the ER attending physician should have become directly involved when my wife asked the PA if her eye would heal back to normal, and the response was "I don't know."

In any profession, one has to realize when one is in over their head, and when to get some additional help. I am an intellectual property attorney. I regularly refer out work that, although simpler than what I do every day, is not in my practice area, and is therefore better done by someone who does it every day.

Everywhere I drive around here, I see signs for optometrists and opthamologists. I can't imagine the hospital would have any difficulty finding some who would be happy to do an on-call rotation for some extra $ (paid for by the patient when they are actually called in).

It's good to hear that your wife is doing well and chances are that she'll make a full recovery.

Regarding LASIK making an eye more susceptible to injury...I guess that depends where you'd like to place liability, counselor. One can argue that the treatment site was perfectly healed and would never have caused any future problems except that a fingernail managed to lacerate the flap off. Wouldn't the owner of the fingernail be the most culpable? Just playing devil's advocate, no offense intended.

Any refractive procedure weakens the cornea to some extent. It is removing material and thus making it thinner. It doesn't change the fact that almost everyone who has the procedure done is made well aware of the risks and most still choose to do the elective procedure. Flap complications are usually listed in the literature.

With most choices in life there are pros and cons. I know of a case where a pilot was warned that there were risks of halos and blindness inherent in the procedure. He chose to take the risk because he wanted to see better and in his mind, he minimized the risks for the greater goal of perfect vision. Well, unfortunately, he got haloes as a side effect and couldn't continue flying at night. Guess what? He sued....

Regarding the actions of the PA and the emergency room, I'm not sure if any of this would have changed the outcome. Once that flap came loose, there was going to be issues either way. If someone (a specialist) managed to lay it back over, there would still be risks of epithelial ingrowth and possible corneal erosion. Usually, fingernail injuries to the cornea are very slow to heal.

What time did this happen? How much time elapsed between your wife leaving the ER and visiting her optometrist? It sounds like your big beef happens to be that your wife never got to see the attending ER doc and I can understand your frustration there. From your description, the PA noted an eye issue that the hospital probably couldn't treat. She wrote a script for antibiotics and instructed your wife to see an eye specialist ASAP, but you weren't clearer on the timeline.

[dgraing]

When I met with an FBI recruiter in my last year of law school (1997), he informed me that anyone who had vision correction surgery would not be accepted as a special agent. Now I know why - even more than 10 years later, the eye is more susceptible to injury.

That's not true anymore. They require you to wait 6 months after getting it done. If you have no issues after the 6 months and are signed off by your doctor then you are GTG.

I hope your wife gets better.

David

[BillSWPA]

Regarding the actions of the PA and the emergency room, I'm not sure if any of this would have changed the outcome. Once that flap came loose, there was going to be issues either way. If someone (a specialist) managed to lay it back over, there would still be risks of epithelial ingrowth and possible corneal erosion. Usually, fingernail injuries to the cornea are very slow to heal.

What time did this happen? How much time elapsed between your wife leaving the ER and visiting her optometrist? It sounds like your big beef happens to be that your wife never got to see the attending ER doc and I can understand your frustration there. From your description, the PA noted an eye issue that the hospital probably couldn't treat. She wrote a script for antibiotics and instructed your wife to see an eye specialist ASAP, but you weren't clearer on the timeline.

The injury happened early evening, with the wife and kids at her parent's house. I immediately got a call to come get the kids so her mom could get her to the ER (only a couple of minutes away from the house). She had also tried to call her eye Dr., but for some reason the emergency procedure for contacting the Dr. on call fell through that evening (once the eye practice learned of this, they took immediate steps to correct the problem and ensure that my wife received good care). She was then able to see someone at her Dr.'s practice early the next morning.

The physician's assistant recognized what could have been a very serious problem (didn't know if the vision would ever return to normal), but did not bring the attending physician into the picture or try to get immediate help from an eye specialist. She just recommended seeing the eye Dr. the following morning, and when we did, we were informed that the injury likely got worse overnight.

My beef isn't at all likely to result in a suit against the hospital - my wife appears to be fully recovering. I am actually happy that the PA didn't do more herself in some ways - with her lack of knowledge of the issue, she could have done more harm. My big concern at this point is making sure the hospital understands how bad this could have been so that the next time a PA does - or should - realize that they are in over their head, they seek and get help. The other hospitals in the area are much farther away, and I'd really like to know I can count on this one in an emergency. They did do a very good job during another emergency that arose 18 months ago during the birth of my son.

[maximus83]

I don't know who to believe about LASIK surgery. A close friend, and my own brother, have had it, and they both assure me that all concerns are BS and this is the greatest thing ever.

But then I read about the potential risks, and it doesn't seem so airtight. Especially when you have healthy, corrected vision going into the procedure. Is it really worth risking your eyes for something that as many as 20% of patients are still experiencing issues 6 months after the surgery, and some have permanent issues? IMHO, the procedures are not currently solid enough to risk healthy eyes, when your main complaint is merely that "I don't like glasses and contacts." It's just too risky for a strictly elective procedure.

Yes I think the following source is somewhat biased AGAINST LASIK. But it seems like many more sources are biased FOR it as well, particularly those who stand to gain from it. It is worth reading this stuff before you forge ahead, if you have otherwise healthy corrected vision:

http://lasikcomplications.com/

BTW, my eye Dr. and my primary care Dr. still both wear their glasses, for some of the same reasons cited in the above source. Yes I've asked them why. I'm going to wait a bit longer to pursue eye surgery.

[Hammer27]

Navy doesn't allow Lasik, only PRK. Nature of the surgery (cutting the flap vs essentially shaving the eye) being the reason. Take that for what its worth.