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Very interesting things to wonder about, especially dioptric blur
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| "If I don't have enough cornea left for enhancement then I'll be very
annoyed because they measured the thinkness to make sure there was
enough for two shots."
I see no reason you wont have enough for at *least* one enhancement and
especially an enhancement as small as yours. When I got my own lasik
consultation, I also was told I have enough cornea for two enhancement
shots. Hypothethically if I were to get anything now, it would be PRK
and I will ask for a slight undercorrection(-1 to -1.5 diopters) to
greatly reduce the risk of overcorrection and also preserve most of my
near vision so ill never need readers. My distance vision will be very
slightly blurry, not enough to "need" glasses in my opinion except for
driving and other occasional uses.
"I would consider IOLs to be a very last resort seeing as you will end
up
with no focal capacity at all."
You can get phakic IOLs which go behind the iris and does not remove
your natural crystaline lens. Personally I would never consider IOLs
unless I was a high myope and over 40. If someone isnt a candidate for
lasik, best to just stick with glasses till cateracts develop then get
cateract surgury where IOLs are inserted.
"Perhaps not at the moment but I'm still only half way through the
process. If this time next year I still see like I do now or worse then
you can put me in the 10%."
Even if you end up not being satisfied, you still got alot out of lasik
that being you see more than 10x better than before lasik and your
glasses dependancy is reduced by at least 75% and not only that, you
can look forward to not needing readers for a long time 
"I don't expect perfection and, if you remember, I went into this
accepting that if I still had to wear glasses I'd be disappointed but
not devastated. I am undercorrected so I think I should have a shot at
going for plano if the opportunity is available. Whether I get it or
not
I am better off than I was before - although whether the cost was worth
it is arguable."
youd still need to wear glasses at some point in your life after lasik
anyway. If you were presbyopic, the only way youd not need glasses is
monovision lasik. Theres a reason why lasik is touted as "reduced
dependancy on glasses" because of regression, overcorrection and of
course presbyopia. Even plano eyes need reading glasses when they get
old(er) so in my opinion, the best pescription to have depends on your
lifestyle. Because I read alot, id say -1.5 diopters would be the best.
My distance vision will still be reasonably good and at the same time,
I wont need readers except for reading tiny fine print.
"Near perfect is not an unrealistic expectation. Perfect probably is
though."
In my opinion, I would consider near perfect 20/40 vision for myopes
less than -6 and 20/60 vision for high myopes -6 and higher.
"That is where I'm trying to get to. I'm kind of there at the moment
but
it is really not good enough for the long term."
Then you can wear your glasses whenever you feel like it. For reading,
eating and using the computer you can take them off. When you become
presbyopic you wont need readers
"Do you want to buy my old glasses ;-)"
nah, they may be a bit off for me and with natural vision improvement
they will become too strong. Frame them on the wall and laugh at them
;)
"It's very sharp with correction but without then it is not all that
good. In very bright light then I was OK identifying aircraft at an
airshow but once the ambient light comes down or my eyes get tired it
becomes tricky to see much far away."
Sounds like high order aberrations and slight loss of contrast which
make things appear dimmer, blurrier, hazier in low light.
"I'm pretty sure I could see the 20/20 line corrected and maybe a
little
of the 20/15."
Well find out once you print your eyechart. You did get an eye exam
last month and were 20/70 -1.25 gets you to 20/40 and 20/50 -1 gets you
to 20/25.
"No it is still less than 20/40 even if I squint. Snellen is a good
indicator but it doesn't directly link prescription to the line
readable."
Squinting doesnt help me either and it just strains the eye. There is a
close relationship between pescription and uncorrected visual accuracy.
For hyperopes anything goes because of accomodation but for myopes
and/or astigmastims more diopter results in expotentionally more blur.
I know I was 20/50 correctable to 20/25 at -1 back when I was 12. Do
you have your pescription records with you, what is it exactly in each
eye, including exact amount and axis of cylindar?
"I'm pretty sure there is a loss of contrast night or day but it is not
major and I'm not concerned. At night then things are blurrier, not
necessarily darker, and light points do have halo and star bursts
extending from them. A candle at 6 yards might have about a half inch
of
halo so it is not a big deal and not much different from before."
Gotcha. I am just trying to understand what you are seeing now. I can
describe what 20/50 vision is for me with my slightly weaker
glasses(about -1) Everything is of course perfectly clear at 1 meter.
There is a very slight softness or fuziness in the distance. I can
still see and read almost anything, its just not razor sharp and black
but grayish. I can reconize faces quite a ways. All the details of the
objects I am seeing are there, just a little soft. My brother is 20/60
uncorrected and goes around without glasses. Likewise, nearly all of my
friends with 20/40 to 20/60 vision choose to go without glasses(they
didnt have lasik, were just like that) I guess you can consider them
less picky than you. I am not going to argue that, each person has a
different tolerance to blur. My tolerance to blur would be 20/50 to
20/100 depending on where I am. If im at home, I can get around easily,
including use the computer at 20/100. Your tolerance to blur may be
much less, another reason your not happy when others would be happy.
"I mean that I can just about get by
for a month but any longer will require a better solution."
which you did but now that you have glasses, you can wear them whenever
you want.
"That's more or less where I am now. Whilst you're happy with that I
would say that you are exceptionally tolerant of it. I don't think I
have unrealistic expectations to ask for better vision that this."
The enemy of good is better. If you pass the plano mark and end up
hyperopic you are going to be just as unhappy if not more. You dont
even need to be presbyopic to feel the effects of farsightness. Its
like wearing glasses that are *too* strong. Gives you a headache and
eyestrain, especially from up close. I know someone in his early 20s
who ended up +.75 in each eye and while he sees 20/20 distance and
clear enough from near, hes not happy. The surgeon doesnt want to
enhance him because hes 20/20 and can even see well enough from near to
read. He told the surgeon he doesnt like being farsighted, its a strain
on the eyes when reading and in 10 years he will need bifocals so he
wants to get enhanced now..............Its easy to overshoot such a low
residual pescription and besides, enhancement has its risks, its
basically getting lasik again, giving it a second round under the
laser. There is no guarantee where youll end up or what complications
can occur. Surgeons are very reluctant to enhance better than 20/40
and/or less than -1 which you supposedly are less than -1. Why you
arent seeing good despite such a low residual pescription is very, very
puzzling. You were 20/50 when you were -1 so why are you still 20/50
now that your less than -1?
"I don't have a snellen target. It must be good enough for me to go
about
my day without having to think about my eyesight. That deosn't require
perfection but I guess it would need to be at least 20/30 for me to
have
the confidence to pick out other aircraft when I'm gliding (I think you
guys call it soaring?). It's not an unrealistic expection for an
enhancement considering they are just fine tuning now I am a low
myope."
It would be much more simple to just wear glasses for driving, flying
or other mission critical objectives. Even I would do the same but for
anything else, no glasses needed. see above for my reply about
enhancement
"I certainly wouldn't want to force the surgeon into anything unless it
was obvious he was making a commercial decision rather than a medical
one."
I suggest you talk with him carefully reguarding the decision. ask
about possible overcorrection as well. Even if he says yes, he may tell
you theres a chance for overcorrection.
*countinued in next post*
| |
| Tom Lucas 2006-07-07, 8:28 am |
|
"Ace" <acemanvx@yahoo.com> wrote in message
news:1152226525.129313.308000@j8g2000cwa.googlegroups.com...
> Hypothethically if I were to get anything now, it would be PRK
> and I will ask for a slight undercorrection(-1 to -1.5 diopters) to
> greatly reduce the risk of overcorrection and also preserve most of my
> near vision so ill never need readers.
In which case I think you'd really be wasting your time. Why not just
have them done right? You're 24 and I'm 26 so there's likely to be at
least 15-20 years before presbyopia becomes a real concern and by then
there may well be technological advances to counteract it. I'd rather
have 20 years of great vision and chance the readers than spend the time
with distance glasses on.
>
> Even if you end up not being satisfied, you still got alot out of
> lasik
> that being you see more than 10x better than before lasik and your
> glasses dependancy is reduced by at least 75% and not only that, you
> can look forward to not needing readers for a long time
If nothing else I am no longer functionally disabled without glasses and
that in itself is a success.
>
> "Near perfect is not an unrealistic expectation. Perfect probably is
> though."
>
> In my opinion, I would consider near perfect 20/40 vision for myopes
> less than -6 and 20/60 vision for high myopes -6 and higher.
I think those over -6 can expect 20/40 as well - that is what the Lasik
clinics are aiming for. It's quite a wide target to hit so it makes
sense to aim for that.
> Then you can wear your glasses whenever you feel like it. For reading,
> eating and using the computer you can take them off. When you become
> presbyopic you wont need readers
You seem to really loathe the idea of reading glasses. I wouldn't have
much of a problem with it and very few of the older people I hang out
with consider it to be a burden either. The only time it is ever a
problem is when I'm in the pub and want to show them something on my
phone or a book/newspaper and none of them have brought their readers
with them. That is a logistics problem more than a medical one.
> Sounds like high order aberrations and slight loss of contrast which
> make things appear dimmer, blurrier, hazier in low light.
I do have an high level of spherical aberrations and quite high coma and
trefoil so that is bound to be a factor. I haven't got my prescription
to hand but my astigmatism was never particularly bad. Contrast loss is
neither here nor there and is something that doesn' t have any real
impact.
> Squinting doesnt help me either and it just strains the eye.
Squinting certainly helps me but there is good physics behind it because
it creates the pin-hole camera effect which greatly improves focus. Well
it would if your eyelids formed a pinhole. With skin and eyelashes the
effect is somewhat reduced :-)
> Gotcha. I am just trying to understand what you are seeing now. I can
> describe what 20/50 vision is for me with my slightly weaker
> glasses(about -1) Everything is of course perfectly clear at 1 meter.
> There is a very slight softness or fuziness in the distance. I can
> still see and read almost anything, its just not razor sharp and black
> but grayish. I can reconize faces quite a ways. All the details of the
> objects I am seeing are there, just a little soft.
Faces become tricky for me at about 20 feet unless it is so in bright
light and less if it's darker. Things are quite clear for me up to 4 to
6 feet, although small text is a probelm (but that has always been the
case). The distance I can read license plates from has pushed out very
slightly from when we last discussed it but I can now tell the time on
the Windows XP clock from about 4 feet which is better than a few weeks
back. My blur at distance is more than what you're describing though.
Looknig at the edge of a wall 10 feet a way then the edge blurs to about
a quarter inch either side of where it should be.
> "That's more or less where I am now. Whilst you're happy with that I
> would say that you are exceptionally tolerant of it. I don't think I
> have unrealistic expectations to ask for better vision that this."
> The enemy of good is better. If you pass the plano mark and end up
> hyperopic you are going to be just as unhappy if not more. You dont
> even need to be presbyopic to feel the effects of farsightness. Its
> like wearing glasses that are *too* strong.
As I say, I'm not being unrealistic. The equipment should be able to
consistently achieve 20/40 on nearly all patients so I'd be very unlucky
not to get there after an enhancement. The cahnce of overcorrection is
as high as it was on my first zap.
> Its easy to overshoot such a low
> residual pescription and besides, enhancement has its risks, its
> basically getting lasik again, giving it a second round under the
> laser.
The equipment is accurate and an overshoot is not very likely and would
only be small anyway. I could live with a little hyperopia while my eye
is young enough to accommodate it. Good 'ol regression will probably
take care of it long term. A lot of the risks are reduced on the second
time round. The flap is already cut so they can't make a mess of cutting
it and the big correction has already been applied and found to have few
side effects.
> I also am used to glasses but isnt it nice to depend less on them?
> Yea I can understand having to think if glasses should be worn or not
> when your vision is not terrible. Doesnt it feel good when you take
> your glasses off that everything is only a little blurry instead of
> just disapearing into a blob of colors?
It is nice to be free of glasses but it would be better if I could be
truly free of them.
> I was under the impression if you exercised your eyes and improved
> them
> enough, you could avoid an enhancement.
You seem very against my enhancement but you were against me going for
the surgery in the first place. There are risks in the enhancement but
they are low and I have come to terms with them. I've had so much
improvement from the original surgery that I have every reason to hope
that an enhancement will go well too. I do appreciate your concern and
understand that you have reservations about all RS but the statistics
are in my favour and I have already thought about how I might live with
certain complications.
> Probably more like a lifetime of good vision(in my opinion)
> nonwithstanding a long term complication. Either way, you will never
> have eyes anywhere near as bad as it was before lasik, that much you
> can agree.
Yes, in terms of reducing my dependency on glasses then the Lasik was a
huge success. However, I have a chance to make it even better with the
enhancement.
>
> This is an interesting discussion about lasik and vision. Try to make
> time to check out your own vision with and without glasses using the
> eyechart to print.(page 3 of 5, 100% actual size) and also find out
> exactly what pescription is in each eye both myopia and astigmastim. I
> wish you luck on improvement :D
I'll see if I get a chance this weekend but my dad is coming down to
stay so we'll have to go and do the touristy thing around London. I
spend three hours a day travelling there and back so I'm sick of the
place but the relations always want to see the sights and at least it
makes a change to be there without having to go to work :-)
| |
| Ragnar 2006-07-07, 4:25 pm |
| You are wasting your time trying to drum any sense into Ace... but
good luck trying.
His other alias has had lasik performed. Maybe chat with that alter
ego of his.
On Fri, 7 Jul 2006 10:09:47 +0100, "Tom Lucas"
<news@REMOVEautoTOflameREPLY.clara.co.uk> wrote:
>
>"Ace" <acemanvx@yahoo.com> wrote in message
>news:1152226525.129313.308000@j8g2000cwa.googlegroups.com...
>
>In which case I think you'd really be wasting your time. Why not just
>have them done right? You're 24 and I'm 26 so there's likely to be at
>least 15-20 years before presbyopia becomes a real concern and by then
>there may well be technological advances to counteract it. I'd rather
>have 20 years of great vision and chance the readers than spend the time
>with distance glasses on.
>
>If nothing else I am no longer functionally disabled without glasses and
>that in itself is a success.
>
>I think those over -6 can expect 20/40 as well - that is what the Lasik
>clinics are aiming for. It's quite a wide target to hit so it makes
>sense to aim for that.
>
>
>You seem to really loathe the idea of reading glasses. I wouldn't have
>much of a problem with it and very few of the older people I hang out
>with consider it to be a burden either. The only time it is ever a
>problem is when I'm in the pub and want to show them something on my
>phone or a book/newspaper and none of them have brought their readers
>with them. That is a logistics problem more than a medical one.
>
>
>I do have an high level of spherical aberrations and quite high coma and
>trefoil so that is bound to be a factor. I haven't got my prescription
>to hand but my astigmatism was never particularly bad. Contrast loss is
>neither here nor there and is something that doesn' t have any real
>impact.
>
>
>Squinting certainly helps me but there is good physics behind it because
>it creates the pin-hole camera effect which greatly improves focus. Well
>it would if your eyelids formed a pinhole. With skin and eyelashes the
>effect is somewhat reduced :-)
>
>
>Faces become tricky for me at about 20 feet unless it is so in bright
>light and less if it's darker. Things are quite clear for me up to 4 to
>6 feet, although small text is a probelm (but that has always been the
>case). The distance I can read license plates from has pushed out very
>slightly from when we last discussed it but I can now tell the time on
>the Windows XP clock from about 4 feet which is better than a few weeks
>back. My blur at distance is more than what you're describing though.
>Looknig at the edge of a wall 10 feet a way then the edge blurs to about
>a quarter inch either side of where it should be.
>
>
>
>As I say, I'm not being unrealistic. The equipment should be able to
>consistently achieve 20/40 on nearly all patients so I'd be very unlucky
>not to get there after an enhancement. The cahnce of overcorrection is
>as high as it was on my first zap.
>
>
>The equipment is accurate and an overshoot is not very likely and would
>only be small anyway. I could live with a little hyperopia while my eye
>is young enough to accommodate it. Good 'ol regression will probably
>take care of it long term. A lot of the risks are reduced on the second
>time round. The flap is already cut so they can't make a mess of cutting
>it and the big correction has already been applied and found to have few
>side effects.
>
>
>It is nice to be free of glasses but it would be better if I could be
>truly free of them.
>
>
>You seem very against my enhancement but you were against me going for
>the surgery in the first place. There are risks in the enhancement but
>they are low and I have come to terms with them. I've had so much
>improvement from the original surgery that I have every reason to hope
>that an enhancement will go well too. I do appreciate your concern and
>understand that you have reservations about all RS but the statistics
>are in my favour and I have already thought about how I might live with
>certain complications.
>
>
>Yes, in terms of reducing my dependency on glasses then the Lasik was a
>huge success. However, I have a chance to make it even better with the
>enhancement.
>
>
>I'll see if I get a chance this weekend but my dad is coming down to
>stay so we'll have to go and do the touristy thing around London. I
>spend three hours a day travelling there and back so I'm sick of the
>place but the relations always want to see the sights and at least it
>makes a change to be there without having to go to work :-)
>
| |
| Tom Lucas 2006-07-07, 4:25 pm |
| "Ragnar" <ragnarsuomi@yahoo.com> wrote in message
news:djrsa2dj8ojir75llf9tl5bhu3oktmtcgn@4ax.com...
> You are wasting your time trying to drum any sense into Ace... but
> good luck trying.
I'm not trying to drum anything into anyone. This thread may be useful
to others as a discussion of the pros and cons of enhancement and hasn't
been too polluted with turfwars and point scoring. There are some
unecessary insults though :-(
> His other alias has had lasik performed. Maybe chat with that alter
> ego of his.
With a bit of luck Malcontent has seen the error of his ways and won't
be troubling this group any more.
| |
| Ragnar 2006-07-07, 4:25 pm |
| You don't seem to realize that Ace and Malcontent are the same person.
On Fri, 7 Jul 2006 16:04:59 +0100, "Tom Lucas"
<news@REMOVEautoTOflameREPLY.clara.co.uk> wrote:
>"Ragnar" <ragnarsuomi@yahoo.com> wrote in message
>news:djrsa2dj8ojir75llf9tl5bhu3oktmtcgn@4ax.com...
>
>I'm not trying to drum anything into anyone. This thread may be useful
>to others as a discussion of the pros and cons of enhancement and hasn't
>been too polluted with turfwars and point scoring. There are some
>unecessary insults though :-(
>
>
>With a bit of luck Malcontent has seen the error of his ways and won't
>be troubling this group any more.
>
| |
|
| "In which case I think you'd really be wasting your time. Why not just
have them done right? You're 24 and I'm 26 so there's likely to be at
least 15-20 years before presbyopia becomes a real concern and by then
there may well be technological advances to counteract it. I'd rather
have 20 years of great vision and chance the readers than spend the
time
with distance glasses on."
Theres a risk of overcorrection with laser surgury. Because I spend
much of my time at the computer, a slight undercorrection isnt going to
matter for using the computer. I read about ways to combat presbyopia
and it seems the only real way is a bifocal design. I read that bifocal
lasik was in clinical trials where they undercorrect a part of your
cornea so you see clear from near thru that part and clear from
distance thru the other part. There is already bifocal and multifocal
IOLs but some people complain vision isnt very clear and looks strange
thru those IOLs. whatever tricks they find to counteract presbyopia
will require additional surgury or monovision. Keeping some myopia
sounds like the most efficient way to counteract presbyopia in my
opinion. From the looks of it, any bifocal design has some compromise,
you see blurry in a part of your vision at all times. I know a bunch of
people who were annoyed with bifocals and would rather have two pairs
of glasses instead.
"If nothing else I am no longer functionally disabled without glasses
and
that in itself is a success."
Thats the biggest perk by far. Not only that, the many hours a day you
spend on the computer can now be done without glasses.
"I think those over -6 can expect 20/40 as well - that is what the
Lasik
clinics are aiming for. It's quite a wide target to hit so it makes
sense to aim for that."
If theres enough cornea, if enhancement is decided, if regression
doesnt reoccur. In my opinion, if someone is that myopic, he should be
happy not to be "blind" without glasses. Would you get lasik if you
were say a -9 and were told youll end up a little shy of 20/40? If -5
is rather bad vision, -9 is downright terrible.
"You seem to really loathe the idea of reading glasses. I wouldn't have
much of a problem with it and very few of the older people I hang out
with consider it to be a burden either."
Were they nearsighted and got lasik or always had good vision
naturally? You see, been nearsighted much my life, I have taken my
ability to see perfect from near for granted. Reading glasses is still
glasses and without them you see blurry from near and not just for
reading, everything is blurry from near. Low myopes depend on glasses
as much as those who are plano do from what ive seen and if you spend
most of your time doing near work, mild myopia is actually an asset. No
one knows for sure what the future will bring in terms of presbyopia
correction, but for someone looking at that, he may need two surguries,
one to correct myopia then an additional one to correct presbyopia and
if it doesnt go exactly right, he may still need glasses for some
activities.
"The only time it is ever a
problem is when I'm in the pub and want to show them something on my
phone or a book/newspaper and none of them have brought their readers
with them. That is a logistics problem more than a medical one."
someone else would have to read it for them. However when they talk to
you or others, they see a blurry face. When they drink their beer, its
all blurry. For someone like me whos nearsighted, I dont tolerate any
blur from near. I am used to seeing blurry in the distance so it has
become a normal thing. Funny I know
"I do have an high level of spherical aberrations and quite high coma
and
trefoil so that is bound to be a factor. I haven't got my prescription
to hand but my astigmatism was never particularly bad. Contrast loss is
neither here nor there and is something that doesn' t have any real
impact."
When you find out your exact pescription, lemmie know. So far you
believe it to be between -.5 and -.75 with less than -1 astigmastim.
Thats a spherical equivalent of -1 at most. No matter, I bet it is
still improving. If its not stable by the time its time for
enhancement, give it more time
"Squinting certainly helps me but there is good physics behind it
because
it creates the pin-hole camera effect which greatly improves focus.
Well
it would if your eyelids formed a pinhole. With skin and eyelashes the
effect is somewhat reduced :-)"
What I do is take my thumb and index finger and look thru the tiny hole
I make between the two fingers. Works far better than squinting and
lets me read at 20/70 without my glasses!
"Faces become tricky for me at about 20 feet unless it is so in bright
light and less if it's darker. Things are quite clear for me up to 4 to
6 feet"
Seeing clear at more than 1 meter would mean your less than -1 by now.
With my computer glasses, I can see clearly up to 3 feet. I see 20/80
on the snellen chart and see fairly clear in real world. I think I can
see faces to 40 feet in good light. Is it true people see differently
in the real world reguardless of their snellen vision score? I consider
my real world vision fairly good actually despite 20/80 snellen with my
computer glasses. This could be why im tolerant of an undercorrection
and how much itll reduce glasses dependancy.
"Looknig at the edge of a wall 10 feet a way then the edge blurs to
about
a quarter inch either side of where it should be."
ditto with my computer glasses. without them theres a huge 2 inch blur.
"As I say, I'm not being unrealistic. The equipment should be able to
consistently achieve 20/40 on nearly all patients so I'd be very
unlucky
not to get there after an enhancement. The cahnce of overcorrection is
as high as it was on my first zap."
I wouldnt be supprised if you improve to 20/40 at the time of
enhancement. If not you will be better than 20/40 after enhancement and
hopefully see clear in the real world too. There is more chance of
overcorrection when your so close to plano from what ive read. But if
your willing to accept.
"The equipment is accurate and an overshoot is not very likely and
would
only be small anyway. I could live with a little hyperopia while my eye
is young enough to accommodate it. Good 'ol regression will probably
take care of it long term."
Good point. I think the best analogy is golfing and you overshoot the
hole. I can be 3 feet from the hole and swing a bit too hard and
overshoot by 3 feet. You could be +.5 to +1 which you could accomodate
but itll be a real strain for near work. You might not be happy with
overcorrection either, especially when reading.
"A lot of the risks are reduced on the second
time round. The flap is already cut so they can't make a mess of
cutting
it and the big correction has already been applied and found to have
few
side effects."
Theres still risks of the flap not setting right. Also youll need to go
thru healing again.
"It is nice to be free of glasses but it would be better if I could be
truly free of them."
Of course, but not always possible for everyone. I could consider
myself free of glasses if I ignore a slight myopic blur or if plano,
hold things away at arms length and read blurry. I would still want to
wear readers if plano to make things really, really clear from near.
"You seem very against my enhancement but you were against me going for
the surgery in the first place."
I am like that in general, its my nature not to take elective risks.
Thats one reason I havent gotten lasik. I read about all the risks and
its irreversable, if your unhappy there is no going back. Also when
new, safer technologies come out to reduce myopia, ill be able to
consider those instead of being locked with lasik. Also some people
dont have a good reason or relistic expectations regarding lasik. I
know a story of a lady with low myopia who asked if she should get
lasik. Based on what she said, others said it was a bad idea and that
she wouldnt be happy. They were right. I also know people who ended up
worse after enhancement.
"There are risks in the enhancement but
they are low and I have come to terms with them. I've had so much
improvement from the original surgery that I have every reason to hope
that an enhancement will go well too."
Same here. But if you and/or your surgeon feels you dont need an
enhancement or that it wouldnt be worth it, then one wont be granted.
It feels like im trying to talk you out of one, but again thats my
opinion and only YOU and your surgeon can decide the facts. It would
suck if your still not happy after enhancement or end up with a
complication.
"I do appreciate your concern and
understand that you have reservations about all RS but the statistics
are in my favour and I have already thought about how I might live with
certain complications."
Your welcome. Only you can decide for yourself what action to take. All
I provide is opinions of what I think.
"Yes, in terms of reducing my dependency on glasses then the Lasik was
a
huge success. However, I have a chance to make it even better with the
enhancement."
The odds are in your favor, but its a risk netherless. Ive seen people
end up worse.
"I'll see if I get a chance this weekend but my dad is coming down to
stay so we'll have to go and do the touristy thing around London. I
spend three hours a day travelling there and back so I'm sick of the
place but the relations always want to see the sights and at least it
makes a change to be there without having to go to work :-)"
Ive been there before! Have fun!
| |
| Tom Lucas 2006-07-10, 8:27 am |
|
"Ragnar" <ragnarsuomi@yahoo.com> wrote in message
news:4ucta2trs8delp4h0mpt83n21iqjn4m53e@4ax.com...
> You don't seem to realize that Ace and Malcontent are the same person.
>
Nowhere in that post did I say that they weren't. I would hate to be as
vulgar as to accuse someone outright and I would hope that anyone using
sock puppets may take the hint from this post.
[vbcol=seagreen]
> On Fri, 7 Jul 2006 16:04:59 +0100, "Tom Lucas"
> <news@REMOVEautoTOflameREPLY.clara.co.uk> wrote:
>
| |
| Tom Lucas 2006-07-10, 8:27 am |
| "Ace" <acemanvx@yahoo.com> wrote in message
news:1152318944.235657.57560@s13g2000cwa.googlegroups.com...
> I read that bifocal
> lasik was in clinical trials where they undercorrect a part of your
> cornea so you see clear from near thru that part and clear from
> distance thru the other part.
Are you sure it wasn't early April when you heard this? I'm not sure how
you could choose to see out of the top of your cornea verus the bottom
and the glare and halo would encroach onto either half from the other. I
guess this is why it's only a trial at the moment, however, if they can
crack dual focus then I would imagine that the big pupil problem will be
solved by the same mechanism as well.
> Would you get lasik if you
> were say a -9 and were told youll end up a little shy of 20/40? If -5
> is rather bad vision, -9 is downright terrible.
I would say that to get from -9 to -3 doesn't really achieve anything
other than allow the person to function in an emergency. If it got you
to -1 then it would be a personal choice really. You would still need
glasses for some of the time but it would be immeasurably better
than -9, I guess it would depend on whether you personally thought it
was worth the money.
> much of a problem with it and very few of the older people I hang out
> with consider it to be a burden either."
>
>
> Were they nearsighted and got lasik or always had good vision
> naturally?
No these are just ordinary old crumblies. They need their readers just
like most older folk but mypint is that they don't seem to be worried by
it and accept it as a fct of life.
> "The only time it is ever a
> problem is when I'm in the pub and want to show them something on my
> phone or a book/newspaper and none of them have brought their readers
> with them. That is a logistics problem more than a medical one."
>
>
> someone else would have to read it for them.
As a rule, they all borrow the landlady's magnifying glass and try to
squint it out in turn. I've found it's easier just to not bring in
anything small :-)
> When they drink their beer, its all blurry.
Which is the desired effect of course ;-)
> When you find out your exact pescription, lemmie know. So far you
> believe it to be between -.5 and -.75 with less than -1 astigmastim.
> Thats a spherical equivalent of -1 at most. No matter, I bet it is
> still improving. If its not stable by the time its time for
> enhancement, give it more time
Well it seems to have been pretty stable for the last 4 weeks now. My
next appointment is the middle of August so by giving it that longer
period then the stability will be easier to judge.
> Well
> it would if your eyelids formed a pinhole. With skin and eyelashes the
> effect is somewhat reduced :-)"
>
> What I do is take my thumb and index finger and look thru the tiny
> hole
> I make between the two fingers. Works far better than squinting and
> lets me read at 20/70 without my glasses!
With a clean well cut hole it is suprising what a difference it can
make.
> Seeing clear at more than 1 meter would mean your less than -1 by now.
Well that ties up with the prescription.
> Is it true people see differently
> in the real world reguardless of their snellen vision score?
I'm certain of it. I also think that vision is a highly personalised
thing anyway. Who's to say that the "blue" signal your eye sends to your
brain isn't the same as my "red" signal. Describe "blue" to me as if I'd
never seen it before. Perhaps this goes part of the way to explaining
why people have different favourite colours.
> I wouldnt be supprised if you improve to 20/40 at the time of
> enhancement.
I would certainly hope that would be the case or something will have
gone wrong. I'd like to hope for 20/30 or 20/20 seeing as it's only a
little touch up now.
> There is more chance of
> overcorrection when your so close to plano from what ive read. But if
> your willing to accept.
That it something to be considered. I'll have to see what the surgeon
says.
> Theres still risks of the flap not setting right. Also youll need to
> go
> thru healing again.
My healing response hasn't been to much of a big deal. A few drops every
so often and that damn mask at night for a month. There is the flap risk
but much of the risk lies in the cutting and that has already gone OK.
There are risks in the setting but the surgeon got it right once so I
see no reason why he couldn't do it again.
> "You seem very against my enhancement but you were against me going
> for
> the surgery in the first place."
>
> I am like that in general, its my nature not to take elective risks.
> Thats one reason I havent gotten lasik. I read about all the risks and
> its irreversable, if your unhappy there is no going back.
Well that is not strictly true. There are a lot of things that can be
done to control or fix a bad outcome, mainly with glasses and contacts,
but I do accept that ultimately there is a very small risk that you'll
end up with worse vision with no way to fix it.
> Also when
> new, safer technologies come out to reduce myopia, ill be able to
> consider those instead of being locked with lasik.
You can't really say that Lasik isn't safe. Plus you could wait a long
time for the new technology - they are not likely to spend much money on
it until they can think of anything that will be as profitable as Lasik.
> "There are risks in the enhancement but
> they are low and I have come to terms with them. I've had so much
> improvement from the original surgery that I have every reason to hope
> that an enhancement will go well too."
>
> Same here. But if you and/or your surgeon feels you dont need an
> enhancement or that it wouldnt be worth it, then one wont be granted.
As I've said, I wouldn't do anything the surgeon didn't want to do
unless it was obvious that the decision was commercial and not medical.
The surgeon is a consultant so I wouldn't imagine he has to toe the
Optical Express political line overly and leaves it up to the
councellors to handle that.
> "I'll see if I get a chance this weekend but my dad is coming down to
> stay so we'll have to go and do the touristy thing around London. I
> spend three hours a day travelling there and back so I'm sick of the
> place but the relations always want to see the sights and at least it
> makes a change to be there without having to go to work :-)"
>
>
> Ive been there before! Have fun!
We went to Kew gardens which was good if anyone is in town for a few
days. Don't put it above the other sights though, if time is limited,
and don't bother with the palace because there are much better ones
around. They also have the world's rarest tree there which was rescued
from a gorge in Australia (if you're into that sort of thing). It has a
cage all round it to protect it from people but it's more fun to tell
small children that the cage is to stop it chasing and eating small
children and then come up behind them and put a leafy branch on their
shoulder :-D
| |
| Ragnar 2006-07-10, 4:27 pm |
| OK... I was just making sure that Ace wasn't fooling you.
On Mon, 10 Jul 2006 09:13:37 +0100, "Tom Lucas"
<news@REMOVEautoTOflameREPLY.clara.co.uk> wrote:
>
>"Ragnar" <ragnarsuomi@yahoo.com> wrote in message
>news:4ucta2trs8delp4h0mpt83n21iqjn4m53e@4ax.com...
>
>Nowhere in that post did I say that they weren't. I would hate to be as
>vulgar as to accuse someone outright and I would hope that anyone using
>sock puppets may take the hint from this post.
>
>
>
| |
|
| "Are you sure it wasn't early April when you heard this? I'm not sure
how
you could choose to see out of the top of your cornea verus the bottom
and the glare and halo would encroach onto either half from the other.
I
guess this is why it's only a trial at the moment, however, if they can
crack dual focus then I would imagine that the big pupil problem will
be
solved by the same mechanism as well."
http://www.revoptom.com/index.asp?A..._2001/ro323.htm
Theres several more articles. The above article also talks about
"curing" presbyopia by working around it. However it may compromise
some aspects of vision. There is bifocal IOLs and even the surgeons are
saying monofocal IOLs give better vision. I still say good old myopia
is the best workaround for presbyopia anyday.
"I would say that to get from -9 to -3 doesn't really achieve anything
other than allow the person to function in an emergency."
-3 isnt that good vision but -9 is so much worse. It wouldnt hurt to be
-3 if you are presbyopic then youll never need readers. But for younger
people, they might still not be happy at -3 even though thats 20/200 to
20/300 vision which is as much as ten times better/clearer than -9! I
dont know anyone that got lasik to go from -9 to -3. I did hear stories
of very, very high myopes of -10, -11, -12, as high as -15 getting
lasik for a partial correction. The reason is their cokebottle glasses
are so thick its unpleasent and heavy. If they ever drop or lose their
glasses, they might as well be blind.(I read a story of one woman who
was a -10 something who couldnt count the doctor's fingers held two
feet away from her face/eyes!) so in other words, its a liability to be
blind without cokebottles.
"If it got you
to -1 then it would be a personal choice really. You would still need
glasses for some of the time but it would be immeasurably better
than -9, I guess it would depend on whether you personally thought it
was worth the money."
Not just money, also worth taking a chance, a risk. You shouldnt really
need glasses at -1 except for driving at night perhaps. Feel free to
disagree but I have friends who are -1 that wear their glasses very
seldom, some not at all. I wouldnt really bother with glasses if I
improved to a -1 except perhaps for driving. The hassles of glasses is
more than a very slight blur.
"No these are just ordinary old crumblies. They need their readers just
like most older folk but mypint is that they don't seem to be worried
by
it and accept it as a fct of life."
I guess its different if you are myopic.
"Well it seems to have been pretty stable for the last 4 weeks now. My
next appointment is the middle of August so by giving it that longer
period then the stability will be easier to judge."
If its stable, there would be no improvement, no change in your myopia
and astigmastim. If theres a change, its not yet stable and more
waiting may be needed. Try not to rush an enhancement. I know someone
that rushed and got it two weeks after lasik. He got impatient and
didnt wait, hes now farsighted.
"With a clean well cut hole it is suprising what a difference it can
make."
Gets me from 20/600 to 20/60! I do have pinhole glasses but I see a
dragon eye effect thru them and im much happier and see better with
real glasses
"I'm certain of it. I also think that vision is a highly personalised
thing anyway. Who's to say that the "blue" signal your eye sends to
your
brain isn't the same as my "red" signal. Describe "blue" to me as if
I'd
never seen it before. Perhaps this goes part of the way to explaining
why people have different favourite colours."
Color is different than visual accuracy. Even I see a subtile color
difference between my eyes. Some people have more of one color cones
than others so they see that color better. Do you know anyone thats
colorblind? My bro is a protanope. Where I see six colors in a
rainbow(red, orange, yellow, green, blue, purple), he sees only
three!(brown, yellow, blue)
"I would certainly hope that would be the case or something will have
gone wrong. I'd like to hope for 20/30 or 20/20 seeing as it's only a
little touch up now."
Yea, at least 20/30 would be nice as far as distance goes. Quality of
vision is much more important.
"There are risks in the setting but the surgeon got it right once so I
see no reason why he couldn't do it again."
Theres some independant variables when getting lasik and enhanced. Its
both skill and chance.
"Well that is not strictly true. There are a lot of things that can be
done to control or fix a bad outcome, mainly with glasses and contacts,
but I do accept that ultimately there is a very small risk that you'll
end up with worse vision with no way to fix it."
Logic tells me if someone tolerates contacts fine, there really isnt
much of a reason to get lasik. He would also be alot pickier than a
glasses wearer. I know I would be if I wore contacts then I would
accept nothing less than 20/30. With glasses the benefits are much more
cause this means thinner glasses, less dependancy and able to take your
glasses off to read. Glasses dont always fix a bad outcome. They can
only fix refractive errors and not other complications. If you already
read this here, youd see he had a complication in one eye. Its all part
of the risk.
http://groups.google.com/group/alt....c339d69b79e65dd
"You can't really say that Lasik isn't safe. Plus you could wait a long
time for the new technology - they are not likely to spend much money
on
it until they can think of anything that will be as profitable as
Lasik."
relativately speaking, but no absolutes. The anti lasik crowd considers
lasik a dangerous, un-neccessary elective surgury that gives you worse
vision than glasses. They speak of all those horrible complications. I
dont know how long the wait is, but its not like I cant see as long as
my glasses are on(or off when reading, eating) Its not just about the
money, its about benefiting society. Ive read of several new
alternatives to lasik being proposed. No guarantee when/if they will
manifast into a reality. I read about contacts that can be glued to the
eyes. That was shot down and buried under the rug. Intacs was another
alternative that has fallen out of favor but I liked the idea of Intacs
and it sounds as good, if not better than lasik for low myopes less
than -3. Theres natural vision improvement and even atropine therapy
that will reduce your myopia if you have any tonic accomodation. Almost
every young guy under 30 has .5 to 1 diopter of tonic accomodation. I
suspect I have 1 to 1.5 diopters, possibly more. Then theres orthoK
which is based on contacts but are much more convinent than regular
contacts. I belive I mentioned some of those options to you before you
got lasik and you werent interested since your myopia was too high.
Mine is also high but im reducing it with natural vision
improvement(costs nothing, no risk) What would you say to someone like
me with huge 9mm pupils? Thats one reason I havent gotten lasik, would
hurt my night vision.
| |
| Tom Lucas 2006-07-11, 8:26 am |
| "Ace" <acemanvx@yahoo.com> wrote in message
news:1152561575.401746.190390@35g2000cwc.googlegroups.com...
>
> http://www.revoptom.com/index.asp?A..._2001/ro323.htm
>
>
> Theres several more articles. The above article also talks about
> "curing" presbyopia by working around it. However it may compromise
> some aspects of vision. There is bifocal IOLs and even the surgeons
> are
> saying monofocal IOLs give better vision. I still say good old myopia
> is the best workaround for presbyopia anyday.
It is interesting stuff but I'm not convinced that bifocal corneas are
the answer. Removing the tissue crowding the lens seemed like a more
sensible method but the answer lies in reversing the presbyopis
mechanism rather than working around it. This is why Lasik will
eventually be superseded because it doesn't fix the mypopia - it just
works around it.
> "I would say that to get from -9 to -3 doesn't really achieve anything
> other than allow the person to function in an emergency."
>
>
> -3 isnt that good vision but -9 is so much worse. It wouldnt hurt to
> be
> -3 if you are presbyopic then youll never need readers.
I would say that it would hurt because, although you may be able to do
without reading glasses you still can't see any distance.
> But for younger
> people, they might still not be happy at -3 even though thats 20/200
> to
> 20/300 vision which is as much as ten times better/clearer than -9!
My point is that it is certainly better than it was but it is still not
nearly good enough to live by. It's akin to whether you'd prefer to miss
your train by 2 minutes or ten minutes.
> I dont know anyone that got lasik to go from -9 to -3. I did hear
> stories
> of very, very high myopes of -10, -11, -12, as high as -15 getting
> lasik for a partial correction. The reason is their cokebottle glasses
> are so thick its unpleasent and heavy. If they ever drop or lose their
> glasses, they might as well be blind.
That is really the main reason and was certainly a fairly major factor
in my decision, although I wasn't a particularly high myope.
> "If it got you
> to -1 then it would be a personal choice really. You would still need
> glasses for some of the time but it would be immeasurably better
> than -9, I guess it would depend on whether you personally thought it
> was worth the money."
>
>
>
> "No these are just ordinary old crumblies. They need their readers
> just
>
> like most older folk but mypint is that they don't seem to be worried
> by
> it and accept it as a fct of life."
>
>
> I guess its different if you are myopic.
I don't think many of them are myopic. None of them wear distance
glasses but, it must be remembered, that this is in the pub so I don't
see them driving or watching TV. However, they can't see anything up
close without readers so whether they are myopic or not doesn't really
matter. What I was trying to say is that, while you seem to dread the
prospect of readers, most of the older folks I know accept them as facts
of life and think no more about it.
> If its stable, there would be no improvement, no change in your myopia
> and astigmastim. If theres a change, its not yet stable and more
> waiting may be needed. Try not to rush an enhancement. I know someone
> that rushed and got it two weeks after lasik. He got impatient and
> didnt wait, hes now farsighted.
That's why my clinic make you wait 3 months. I wouldn't rush into the
enhancement but realistically everything is going to be pretty stable
after 3 months.
> "I'm certain of it. I also think that vision is a highly personalised
> thing anyway. Who's to say that the "blue" signal your eye sends to
> your
> brain isn't the same as my "red" signal. Describe "blue" to me as if
> I'd
> never seen it before. Perhaps this goes part of the way to explaining
> why people have different favourite colours."
>
>
> Color is different than visual accuracy. Even I see a subtile color
> difference between my eyes.
I know, I've gone off on a tangent.
> Some people have more of one color cones
> than others so they see that color better. Do you know anyone thats
> colorblind? My bro is a protanope. Where I see six colors in a
> rainbow(red, orange, yellow, green, blue, purple), he sees only
> three!(brown, yellow, blue)
I had a couple of mates at school who couldn't tell red from green but I
think there is a pretty high percentage of kids colour blind. We used to
badger them to explain what they were seeing but, of course, language is
not up to the task.
> "There are risks in the setting but the surgeon got it right once so I
> see no reason why he couldn't do it again."
>
> Theres some independant variables when getting lasik and enhanced. Its
> both skill and chance.
You imply that it is 50/50 skill and chance when it is more likely to be
99/1
> Logic tells me if someone tolerates contacts fine, there really isnt
> much of a reason to get lasik.
There is logic there but it is incomplete. "Tolerate" may mean that the
contacts are completely compatible with their eye and there is no
irritation and great vision but may not address that they loathe putting
them in and taking them out. Or perhaps you do mean that but it is not
immediately clear. For some people who have money to burn it is a simple
way of doing away with the hassles of contacts - whether they bother you
or not it is still nicer to be free of them.
> He would also be alot pickier than a
> glasses wearer. I know I would be if I wore contacts then I would
> accept nothing less than 20/30.
I wouldn't accept anything less with glasses either.
> relativately speaking, but no absolutes. The anti lasik crowd
> considers
> lasik a dangerous, un-neccessary elective surgury that gives you worse
> vision than glasses. They speak of all those horrible complications.
The anti-lasik crowd ARE a horrible complication of Lasik. There are
people out there who think the medical community are part of an evil
conspiracy to get your money and prefer to use nefarious tricks and bad
procedures to do it. That is only partly true - the procedures are well
tested, sound and give pleasure to millions of people.
> I belive I mentioned some of those options to you before you
> got lasik and you werent interested since your myopia was too high.
I am always interested but it became apparent quite quickly that those
options weren't a complete enough solution.
| |
|
| "It is interesting stuff but I'm not convinced that bifocal corneas are
the answer. Removing the tissue crowding the lens seemed like a more
sensible method but the answer lies in reversing the presbyopis
mechanism rather than working around it. This is why Lasik will
eventually be superseded because it doesn't fix the mypopia - it just
works around it."
work arounds are all we have seen and from the looks of it, its often
easier to work around than reverse. To reverse myopia for good, youd
need to physically alter the eyeball itself by shrinking it from an
oval shape to a round shape. It was tried on an old dog years ago and
blinded that eye. Myopia is the best work around for presbyopia and
there are alot of people whod rather be myopic than need those dreaded
readers, me included.
"I would say that it would hurt because, although you may be able to do
without reading glasses you still can't see any distance."
With presbyopia, it wont matter if you are -3 or plano, you still need
glasses. Therefore a partial correction with lasik will reduce, but not
eliminate your dependancy on glasses. Might as well be functional than
blind.
"My point is that it is certainly better than it was but it is still
not
nearly good enough to live by. It's akin to whether you'd prefer to
miss
your train by 2 minutes or ten minutes."
And if you prefer waiting 5 minutes or an hour to catch the next train
;)
"I don't think many of them are myopic. None of them wear distance
glasses but, it must be remembered, that this is in the pub so I don't
see them driving or watching TV. However, they can't see anything up
close without readers so whether they are myopic or not doesn't really
matter. What I was trying to say is that, while you seem to dread the
prospect of readers, most of the older folks I know accept them as
facts
of life and think no more about it."
I dont have to accept readers, thats the thing
"I know, I've gone off on a tangent."
Id love to chat more about it when we instant message each other.
"I had a couple of mates at school who couldn't tell red from green but
I
think there is a pretty high percentage of kids colour blind. We used
to
badger them to explain what they were seeing but, of course, language
is
not up to the task."
I know alot about that subject and my brother has helped explain what
his world looks like. Ill discuss that in instant messages as its off
topic for this lasik forum.
"You imply that it is 50/50 skill and chance when it is more likely to
be
99/1"
a good surgeon is important but no one can predict the individual
healing response. You could have ended overcorrected instead which
would be far worse or you could have other complications. The surgeon
can do his best and the rest is up to chance.
"There is logic there but it is incomplete. "Tolerate" may mean that
the
contacts are completely compatible with their eye and there is no
irritation and great vision but may not address that they loathe
putting
them in and taking them out. Or perhaps you do mean that but it is not
immediately clear. For some people who have money to burn it is a
simple
way of doing away with the hassles of contacts - whether they bother
you
or not it is still nicer to be free of them."
This has been the topic of intense debate. Most people dont believe in
lasik for successful contact wearers and id have to agree. If the worst
part about contacts is taking a minute to insert or remove them then
dont be lazy! OrthoK also takes a few minutes a day. Contact wearers
are much more picky about their vision because they have none of the
hassles of glasses. I know alot of contact wearers that werent happy
with anything less than perfect because perfect vision comes so easy to
contact wearers and they forget about their poor vision. They have none
of the hassles or reminder of glasses. Most contact wearers that get
lasik are because they cant tolerate them or lost tolerance. I would
love to wear contacts instead of glasses but contacts irritate my eyes
in an hour or two. OrthoK avoids(rather minimizes) this problem because
you sleep thru it and when you wake up with slightly irritated eyes,
you just remove them and keep your clear vision for many hours or even
days.
"I wouldn't accept anything less with glasses either."
Well if you had unrelistic expectations and wanted perfect vision,
perhaps lasik wasnt for you. I know I would never be happy with lasik
with less than perfect if I was a successful contact wearer. But its
different with glasses.
"The anti-lasik crowd ARE a horrible complication of Lasik. There are
people out there who think the medical community are part of an evil
conspiracy to get your money and prefer to use nefarious tricks and bad
procedures to do it. That is only partly true - the procedures are well
tested, sound and give pleasure to millions of people."
The anti-lasik malcontents tend to exaggerate a bit but they are an eye
opener to anyone oblivious of the risks to lasik. I have learned alot
from them and realize the faults and shortcommings of lasik. This is
why I suggested alternatives to you and that lasik was a last resort as
not everyone is happy or gets the desired results.
"I am always interested but it became apparent quite quickly that those
options weren't a complete enough solution."
No option is perfect with todays technology but there is an arnsel of
ways to reduce dependancy on glasses. There will be new ways to improve
vision in the future. I have explored every option and orthoK is my
best. Natural vision improvement is what im doing as well. That
combined with orthoK should get me to where glasses become an optional
thing rather than neccessery to function. If you dont get your
enhancement or decide not to, you can easily improve your vision
naturally when you are already so close to plano.
| |
| Tom Lucas 2006-07-12, 8:26 am |
| "Ace" <acemanvx@yahoo.com> wrote in message
news:1152668593.578100.83010@i42g2000cwa.googlegroups.com...
> To reverse myopia for good, youd
> need to physically alter the eyeball itself by shrinking it from an
> oval shape to a round shape. It was tried on an old dog years ago and
> blinded that eye.
Poor old dog. However, I suspect his is likely to be the future target
for refractive surgery. Obviously it will take a lot of time and
research but having a round eye has got to be better than an oval one
with a lens etched in the front.
> "I would say that it would hurt because, although you may be able to
> do
> without reading glasses you still can't see any distance."
>
> With presbyopia, it wont matter if you are -3 or plano, you still need
> glasses. Therefore a partial correction with lasik will reduce, but
> not
> eliminate your dependancy on glasses. Might as well be functional than
> blind.
I don't follow. You get the choice of either seeing close to or far
away - either way you'll have to wear glasses all of the time. At least
after the Lasik you would (should) only need them for reading.
> "I don't think many of them are myopic. None of them wear distance
> glasses but, it must be remembered, that this is in the pub so I don't
> see them driving or watching TV. However, they can't see anything up
> close without readers so whether they are myopic or not doesn't really
> matter. What I was trying to say is that, while you seem to dread the
> prospect of readers, most of the older folks I know accept them as
> facts
> of life and think no more about it."
>
> I dont have to accept readers, thats the thing
No but you trade your distance vision in order to do so. To my mind, and
the mind of these old folks I'm talking about, that seems to be the
wrong way round to do it. It makes sense now, while you are spending
lots of time in front of the PC but pretty soon you'll get married and
have kids and then the wife won't let you near the computer. You'll
spend your spare time driving kids about and coaching baseball and
you'll need distance vision of that.
> "I know, I've gone off on a tangent."
>
> Id love to chat more about it when we instant message each other.
I'll have to find out how that works. Do you use Yahoo Messenger? I sent
you an e-mail last night from home, did you get it? The chat might have
to wait a while because I'm going to Bulgaria for a week on Friday night
but I'll see if I can find time to have a look tonight.
> The anti-lasik malcontents tend to exaggerate a bit but they are an
> eye
> opener to anyone oblivious of the risks to lasik. I have learned alot
> from them and realize the faults and shortcommings of lasik. This is
> why I suggested alternatives to you and that lasik was a last resort
> as
> not everyone is happy or gets the desired results.
I agree it is important to see both sides of the argument but there is
danger in losing a sense of proportion which can be alarming for people
just starting down the Lasik path. People with bad Lasik complications
have my sympathy but there really are very very few of them compared to
the numbers of people who are delighted with their outcome. It would be
a terrible thing for someone to go under the laser without being
informed of the things that might possibly go wrong but neither should
they go under thinking it's a coin toss whether they will ever see
again.
The malcontents are very vocal and may scare off potential candidates.
Some have got deeper personal problems that have somehow become attached
to a Lasik complication and others are just downright psychopaths. This
makes it very hard for a newbie to assess what the risks of Lasik really
are. If they are prepared to do their homework and lurk in the group for
a few weeks then they will get there but not everyone will do that and
some people whose life could have been turned around by Lasik may run
away scared needlessly.
| |
|
| We have been exchanging posts back and forth for a while. Lots can be
learned by reading this thread. Prospective lasik candidates will gain
valuable insight by reading this thread.
> Poor old dog. However, I suspect his is likely to be the future target
> for refractive surgery. Obviously it will take a lot of time and
> research but having a round eye has got to be better than an oval one
> with a lens etched in the front.
It would be major and risky surgury to attempt to physically change or
shrink your eyeball. May be an option for very, very high myopes with
oval eyes at risk for retina detachment. But for over 99% of us,
something simple is much safer.
> I don't follow. You get the choice of either seeing close to or far
> away - either way you'll have to wear glasses all of the time. At least
> after the Lasik you would (should) only need them for reading.
This is why lasik is not approperate for some presbyopes if they do
alot of reading or other near work, especially if they have a low
pescription. I disagree with you there, you do NOT need full time
glasses wear if you are anywhere from plano to less than -3(mild
myopia) so lasik isnt going to reduce your glasses dependancy unless
you almost never use your eyes for near.
> No but you trade your distance vision in order to do so. To my mind, and
> the mind of these old folks I'm talking about, that seems to be the
> wrong way round to do it. It makes sense now, while you are spending
> lots of time in front of the PC but pretty soon you'll get married and
> have kids and then the wife won't let you near the computer. You'll
> spend your spare time driving kids about and coaching baseball and
> you'll need distance vision of that.
Well if you are already plano, thats easy to say. If you are myopic and
leave things be, at least you will enjoy being free of readers. Myopes
dont have perfect distance vision but plano presbyopes dont have good
near vision. Which is preferable is up to debate and is an opinion but
the fact remains is myopes wear glasses for distance, presbyopes wear
glasses for near. Both of them depend on glasses. Wife wont let me near
the computer? Not to worry, marriage and kids isnt in my life's plan.
For some, good distance vision may be important but it depends on your
lifestyle. Right now I wear no minus for reading and eating, reduced
minus for computer and high minus for distance. If I had refractive
surgury, I would need high plus for near, reduced plus for computer and
hopefully no glasses for distance. It would be worth it if my eyes were
really bad. They are bad but getting better. I am going to be getting
atropine to do away with all tonic accomodation and find out my
cycloplegic refraction which is my true structual or axial myopia. Some
of the optometrists told me I could be a -3 or even -2 under
cycloplegia. Eye exercises and natural vision improvement should get me
to whatever my cycloplegic refraction turns out to be. I am excited and
really hope my axial myopia is low
My vision used to be as bad as yours in my better eye and a little
worse in my worse eye. Now its a little better than yours. You were
-4.75 in the better eye. Lets assume I am a -3 in the better eye under
cycloplegia, that would be much, much better than -4.75 as you can see,
myopia is expotentional, not linear.
> I agree it is important to see both sides of the argument but there is
> danger in losing a sense of proportion which can be alarming for people
> just starting down the Lasik path. People with bad Lasik complications
> have my sympathy but there really are very very few of them compared to
> the numbers of people who are delighted with their outcome. It would be
> a terrible thing for someone to go under the laser without being
> informed of the things that might possibly go wrong but neither should
> they go under thinking it's a coin toss whether they will ever see
> again.
Everyone should do dillegent research on lasik and know everything
about it and all the possible complications. I know "everything" yet I
am still learning as new facts get discovered. The complication rate is
something everyone argues about. No one knows for sure because many
people with less serious complications dont mention it or dont consider
it a big deal. Also surgeons often sweep complications under the rug as
they dont want to make lasik look bad. They refuse to publish bad lasik
results or to report it to the FDA. One anti-lasik "expert" says from
his research, he estimates the complication rate to be 1 in 3! Does
being delighted with your outcome mean accepting a tradeoff that is
less bothersome than wearing glasses? Its all how picky someone is.
Surgeons will reject picky people with unrelistic expectations.
> The malcontents are very vocal and may scare off potential candidates.
> Some have got deeper personal problems that have somehow become attached
> to a Lasik complication and others are just downright psychopaths. This
> makes it very hard for a newbie to assess what the risks of Lasik really
> are. If they are prepared to do their homework and lurk in the group for
> a few weeks then they will get there but not everyone will do that and
> some people whose life could have been turned around by Lasik may run
> away scared needlessly.
Would you be vocal if your lasik result was bad, say you are refused an
enhancement or your enhancement still doesnt leave you with vision as
good as it was with glasses. You stand correct that some malcontents
are just not happy with their life in general and are overly dramatic
and wildly exaggerate their complications. I know some who ended with
20/20 vision who are really miserable. I offer my condolences but if
you are seeing 20/20, your complication isnt that bad. The ones with
real complications cant see 20/40, not even with glasses. There are
some picky people who should have never gotten lasik in the first place
because any minor glitch(not even bad enough to be considered a
complication) and they are unhappy and go around warning others away.
You are right, it can be difficult for some noobs to assert the true
risks but all they need to be is aware that lasik has risks and if they
arent a risktaker or in doubt, much, much better to just avoid lasik
and stick with glasses. If someone is really serious about lasik, he is
not going to easily be scared away like you for example. Hopefully you
had done your research before lasik. I did explain your options before
lasik and discussed some of the risks. Yet you were willing to accept
and deal with them. You may be wondering why I have chosen not to get
lasik.
I emailed an orthoK practicioner with my info. He said people with
large pupils, like mine at about 9mm are guaranteed to experience some
problems and tradeoffs with their vision in low light and at night. It
will be even worse for me because of astigmastim and instead of an 8x8
circle orthoK zone, it will be 8x6.5 oval toric zone. If I get orthoK,
it may be best to ignore the cylindar as its not bad anyway and I can
always correct any residual pescription, both sphere and cylindar with
thin glasses worn part time. OrthoK flattens the cornea(oblate) just
like lasik and in fact it may be a good idea to try orthoK first to
simulate many of the effects of lasik. OrthoK is more forgiving because
theres no flap and no cornea ablated/removed. All orthoK does is
flatten your epithelium and cornea slightly and can reduce small
amounts of myopia unless you get a very small orthoK zone.
Reading the bad lasik results, many of them could have been avoided
with proper screening, especially pupil size. Your pupils are 6.5mm and
your lasik zone is also 6.5mm so your night vision has been largely
peserved with very little loss. Imagine 9mm+ pupils on 6.5mm or even an
expermental unapproved oversized 8mm zone. The problems dont stop
there. Large pupils will make the high order aberration effects worse
because I am looking thru an area of 63.585 with 9mm pupils. Your 6.5mm
pupils look thru an area of 33.166 so ill be looking thru almost twice
as many aberrations. Also an oblate cornea scatters light and causes
spherical aberration type defocus. A prolate cornea of 9mm+ is the only
way to preserve vision quality, especially at night. They are working
on this with next gen lasers. It will only be good for lower
pescriptions because much much more cornea needs to be removed to
preserve the prolate profile, and with a 9mm+ zone like mine we could
be looking at a significent amount removed, possibly 100 microns. Ill
still have enough for surface ablation because mines 550 microns so 450
microns is safe. For lasik, leave at least 300 microns below the flap
to be safe. If your cornea was 530 microns and the flap was 160 microns
and the ablated zone was 60 microns(12 times 5) you have 310 microns
left, barely enough for one small enhancement.
Todays lasers dont do a good job of removing high order aberrations,
they tend to induce more aberrations as you have found out. I have been
shown research articles that show not a single case of someone ending
with less aberrations than they started out, provided they had normal
virgin eyes. Broadbeam lasers are several milimeters big and even
flying spot lasers are half to one milimeter. Aberrations are tiny, a
micron or less usually. Todays wavefront just attempts to average out
the imperfectations on a macro scale and does induce more aberration in
different locations but its much more forgiving than tradational lasik.
What can be done is a half mm flying spot laser to take care of the
refractive error then a tiny micron laser to do fine sculpting to
remove your aberrations one by one in rapid succession. By the way, it
will need to be surface ablation because a flap induces aberrations and
also wont fit perfectly on the reshaped cornea. The tiny
straire(wrinkles) in the flap is aberrations. Something like this could
be a ways off. I read articles about technological advances in the
future and how better than 20/10 vision can be obatained(if your retina
is capable) by doing away with all aberrations!
My best bet for the near future is epithelial thinning where they
remove your epithelium(like they do for prk) but do no surgury and just
it regrow back a little thinner. pupil size wont matter and prolateness
will be preserved. A slight reduction in myopia will be experienced, up
to -1.5 I read.
check out my thread on orthoK
http://groups.google.com/group/alt....acf06b1afa74793
| |
|
| Bump for Tom to read and comment. Welcome back from vacation!
| |
| Tom Lucas 2006-07-25, 4:28 pm |
| "Ace" <acemanvx@yahoo.com> wrote in message
news:1152848811.628880.59760@m73g2000cwd.googlegroups.com...
> We have been exchanging posts back and forth for a while. Lots can be
> learned by reading this thread. Prospective lasik candidates will gain
> valuable insight by reading this thread.
Oh people shouldn't listen to what I say, I'm only here to avoid doing
any work ;-)
>
>
> It would be major and risky surgury to attempt to physically change or
> shrink your eyeball. May be an option for very, very high myopes with
> oval eyes at risk for retina detachment. But for over 99% of us,
> something simple is much safer.
Well of course it would be major but not that long ago Lasik was a
far-out dream. I'm sure it is not beyond humanity to work out a way to
safely reshape an eyeball. After all, it managed to get mishapen all by
itself without bursting - very few people are born with -10 myopia.
>
>
> This is why lasik is not approperate for some presbyopes if they do
> alot of reading or other near work, especially if they have a low
> pescription. I disagree with you there, you do NOT need full time
> glasses wear if you are anywhere from plano to less than -3(mild
> myopia) so lasik isnt going to reduce your glasses dependancy unless
> you almost never use your eyes for near.
We both agree that Lasik is not suitable for everyone but I'm know that
some presbyopes with myopia less than -3 are keen to have it done so
that they can see for mid to long range and only have to worry about
glasses for close too. My dad is one of these people and he wears
contacts a lot of the time these days but before that he was
continuously swapping glasses.
I honestly think that most myopic presbyopes I've met are irritated by
their myopia but don't give two thoughts to the presbyopia. Even though
their myopia mitigates the presbyopia a little, they would much prefer
to have to use readers a bit more often if they could do away with the
distance glasses. These are the sort of people that Lasik can help. They
are not interested in monovision and are fine with readers but they
would just like to be able to drive and walk in the country and that
sort of thing.
>
>
> Well if you are already plano, thats easy to say. If you are myopic
> and
> leave things be, at least you will enjoy being free of readers. Myopes
> dont have perfect distance vision but plano presbyopes dont have good
> near vision. Which is preferable is up to debate and is an opinion but
> the fact remains is myopes wear glasses for distance, presbyopes wear
> glasses for near. Both of them depend on glasses.
This is what I've been saying. A myopic presbyope would nearly always
need readers and distance glasses because the world is not perfect and
the myopia may not completely counter the presbyopia. Getting Lasik to
go more myopic may get rid of the readers but your distance vision would
be greatly reduced and you would probably have distance glasses on most
of the time. However, having the myopia reduced will mean stronger
readers will be needed but it is then possible to do away with the
distance glasses. I believe that is preferable to a lot of people.
> Wife wont let me near
> the computer? Not to worry, marriage and kids isnt in my life's plan.
In that case, would you mind dating some ugly chicks to get them off the
market for the rest of us ;-)
> For some, good distance vision may be important but it depends on your
> lifestyle. Right now I wear no minus for reading and eating, reduced
> minus for computer and high minus for distance. If I had refractive
> surgury, I would need high plus for near, reduced plus for computer
> and
> hopefully no glasses for distance. It would be worth it if my eyes
> were
> really bad.
Do your eyes have no focal accomodation at all then? Mine were about as
myopic as yours and even with the wrong prescription I still managed to
see fine close up and far away. Perhaps all your natural eye improvement
exercises have left you stuck up at one end of your focal capacity?
> They are bad but getting better. I am going to be getting
> atropine to do away with all tonic accomodation and find out my
> cycloplegic refraction which is my true structual or axial myopia.
> Some
> of the optometrists told me I could be a -3 or even -2 under
> cycloplegia.
That's as maybe but is is no use when the drops wear off and you go back
to -5ish. I'd be wary of measuring yourself in abnormal conditions
because with the right tests you can get any answer you look for.
> Eye exercises and natural vision improvement should get me
> to whatever my cycloplegic refraction turns out to be. I am excited
> and
> really hope my axial myopia is low
> My vision used to be as bad as yours in my better eye and a little
> worse in my worse eye. Now its a little better than yours. You were
> -4.75 in the better eye. Lets assume I am a -3 in the better eye under
> cycloplegia, that would be much, much better than -4.75 as you can
> see,
> myopia is expotentional, not linear.
It may well be better but you need to paralyse your eye to do it. I'm
not sure this is the right road to follow.
>
>
> Everyone should do dillegent research on lasik and know everything
> about it and all the possible complications. I know "everything" yet I
> am still learning as new facts get discovered.
Quotation marks noted but I think only the surface of the subject can be
scratched with information found on the internet. There's a lot more
knowledge required otherwise anyone could be a surgeon after a bit of
research. These guys (there may be girls but not many) are very highly
trained and it takes a very long time to train them. You have much more
knowledge than someone starting out but it's a little premature to claim
you know everything because there is always something more to learn.
Bear in mind that theoretical knowledge is only part of the story and
that experience plays an important role here.
> The complication rate is
> something everyone argues about. No one knows for sure because many
> people with less serious complications dont mention it or dont
> consider
> it a big deal.
In which case I would say that those complication are not a big deal.
> Also surgeons often sweep complications under the rug as
> they dont want to make lasik look bad. They refuse to publish bad
> lasik
> results or to report it to the FDA.
I'm not convinced that that is particularly widespread. Besides, if
there was anything to hide then the military would know about it but it
doesn't stop them sending servicemen in their droves to have it done.
> One anti-lasik "expert" says from
> his research, he estimates the complication rate to be 1 in 3!
Come on Ace, this is beneath you.
> Does
> being delighted with your outcome mean accepting a tradeoff that is
> less bothersome than wearing glasses? Its all how picky someone is.
> Surgeons will reject picky people with unrealistic expectations.
Being delighted is what it is. If you have halos and starbursts and eyes
like raisins but you wake up with a smile every day then the surgery was
a success. If someone has a major complication but is not bothered by it
then it is not a major complication. Pickiness is a factor but most
people get results good enough to please all but the very pickiest of
people - most of whom had glasses that were too strong so they could see
like eagles but forget they had headaches on the computer.
>
>
> Would you be vocal if your lasik result was bad, say you are refused
> an
> enhancement or your enhancement still doesnt leave you with vision as
> good as it was with glasses.
I certainly wouldn't be as maliciously vocal. If I can't have an
enhancement then I'll get a pair of decent glasses and write the whole
thing off to experience. Perhaps I'll dabble in NVI and see what that
achieves. However, I wouldn't warn anyone away from Lasik just because
mine is less than ideal. I explored the various outcomes before I went
into this and thought about complications. If nothing else my dependency
on glasses is greatly reduced.
> You stand correct that some malcontents
> are just not happy with their life in general and are overly dramatic
> and wildly exaggerate their complications. I know some who ended with
> 20/20 vision who are really miserable. I offer my condolences but if
> you are seeing 20/20, your complication isnt that bad. The ones with
> real complications cant see 20/40, not even with glasses.
I agree. However, if the 20/20 person is not happy then I suspect there
is something else going on. What is the stat on the number of people
left with BCVA less than 20/40 after six months? It must be fractions of
a percent.
> There are
> some picky people who should have never gotten lasik in the first
> place
> because any minor glitch(not even bad enough to be considered a
> complication) and they are unhappy and go around warning others away.
And these are the ones doing the most damage.
> You are right, it can be difficult for some noobs to assert the true
> risks but all they need to be is aware that lasik has risks and if
> they
> arent a risktaker or in doubt, much, much better to just avoid lasik
> and stick with glasses.
Not at all. Knowledge will defeat the doubt. There is very little risk
in Lasik and, as long as they don't run screaming from the first horror
story, reading and learning about the procedure will show that Lasik can
be the right decision.
> If someone is really serious about lasik, he is
> not going to easily be scared away like you for example. Hopefully you
> had done your research before lasik. I did explain your options before
> lasik and discussed some of the risks.
I don't believe in going into anything without the relevant facts to
hand. There was a girl getting surgery done at the same time as me who
wasn't sure whether she was getting Lasik or Lasek or whether it would
be wavefront guided or not. She knew nothing about the procedure and was
perfectly happy not to - she just wanted to see well. This horrifies me
but some people do seem to live their lives that way.
I looked into all the risks and thought about how I would live with a
serious complication. Now that I have had a minor complication then it
is not a shock and I already had a contingency plan to deal with it.
> Yet you were willing to accept
> and deal with them. You may be wondering why I have chosen not to get
> lasik.
>
> I emailed an orthoK practicioner with my info. He said people with
> large pupils, like mine at about 9mm are guaranteed to experience some
> problems and tradeoffs with their vision in low light and at night. It
> will be even worse for me because of astigmastim and instead of an 8x8
> circle orthoK zone, it will be 8x6.5 oval toric zone. If I get orthoK,
> it may be best to ignore the cylindar as its not bad anyway and I can
> always correct any residual pescription, both sphere and cylindar with
> thin glasses worn part time. OrthoK flattens the cornea(oblate) just
> like lasik and in fact it may be a good idea to try orthoK first to
> simulate many of the effects of lasik. OrthoK is more forgiving
> because
> theres no flap and no cornea ablated/removed. All orthoK does is
> flatten your epithelium and cornea slightly and can reduce small
> amounts of myopia unless you get a very small orthoK zone.
But why go to all that effort? If your pupils are right and your cornea
is right then get the Lasik and save yourself all the trouble. OrthoK
only becomes an option when Lasik isn't.
> Reading the bad lasik results, many of them could have been avoided
> with proper screening, especially pupil size. Your pupils are 6.5mm
> and
> your lasik zone is also 6.5mm so your night vision has been largely
> peserved with very little loss.
A lot of the problems are from several years ago as well. There are not
that many recent problems coming through and it might be time to
re-examine the statistics. I won't be able to make too much of a
judgement on my night vision until after the enhancement. My glasses are
a cheap nasty pair and they give plenty of starburst and halo on their
own.
> For lasik, leave at least 300 microns below the flap
> to be safe. If your cornea was 530 microns and the flap was 160
> microns
> and the ablated zone was 60 microns(12 times 5) you have 310 microns
> left, barely enough for one small enhancement.
Barely enough is enough. Less than a dioptre is needed in each eye so it
would fit OK. However, my corneas were 595um and the flap may not have
been as thick as that so there is more room to play with.
> Todays lasers dont do a good job of removing high order aberrations,
> they tend to induce more aberrations as you have found out.
But that is not necessarily a problem. The low order stuff is what
you're paying for and the high order is just tweaking.
> I read articles about technological advances in the
> future and how better than 20/10 vision can be obatained(if your
> retina
> is capable) by doing away with all aberrations!
How many retinas are capable though? Technology is likely to advance
quickly in this area due to the amount of money in the market.
> My best bet for the near future is epithelial thinning where they
> remove your epithelium(like they do for prk) but do no surgury and
> just
> it regrow back a little thinner. pupil size wont matter and
> prolateness
> will be preserved. A slight reduction in myopia will be experienced,
> up
> to -1.5 I read.
The epithelium is not an optional part. It is there for the protection
of the eye so I wouldn't go monkeying around with it. If you've seen the
battered look of someone who has just had Lasek then you'll see what the
effect of interfering with the epithelium is.
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