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Blue light, which is part of the visible light spectrum, reaches deeper into your eye and its cumulative effect can cause damage to your retina and it is connected to the development of age-related macular degeneration. Blue light is not just entering your eye from natural sources like the sun. Sunlight is the main source of blue light, and exposure outdoors during daylight is the main source for most people.

Blue light lenses have become increasingly popular in our digital age. While there’s no proof they protect against certain eye conditions, there are well-documented benefits, particularly in regulating our sleep-wake cycle.

Hormone Regulation

Exposure to blue light, particularly during the evening, has been shown to disrupt melatonin production, the hormone responsible for regulating our sleep-wake cycle. This disruption can lead to difficulties falling asleep and achieving restful sleep.

Blue light lenses can help mitigate the impact of blue light by limiting how much reaches your eyes, supporting the natural release of melatonin and promoting a more restful and rejuvenating sleep.

There are also many man-made, indoor sources of blue light, including fluorescent and LED lighting, and flat-screen televisions. The display screens of computers, electronic notebooks, smartphones, and other digital devices emit significant amounts of blue light, although it is only a fraction of the amount of blue light emitted by the sun. In a laboratory,sources of blue light are blue LED arrays and intense white light sources (projection lamps, floodlights, microscope lights,welding arcs, etc.).The most common type of LED used in electronic devices is a white-light LED, which actually has a peak emission in the blue wavelength range (400 – 490 nm).

Depression & Anxiety Management

Research has consistently indicated a connection between disrupted sleep and susceptibility to depression and anxiety. Blue light lenses can effectively regulate our sleep-wake cycle and indirectly support mental health. These lenses promote healthier sleep patterns and overall well-being. eResearch by Navid Ajamin -- winter 2017

Blue light lenses may contribute to improved hormone regulation and alertness and provide benefits for managing depression and anxiety.

But blue light lenses are not only helpful for those who spend time in front of digital devices—they can also be beneficial for outdoor use, such as when engaging in activities in direct sunlight. These lenses help reduce glare and make it easier to focus on your activity or enjoy the scenery around you.

Always consult an eye care professional for personalized advice and recommendations regarding your eye health needs.

During daylight, blue wavelengths of light can be beneficial, playing an important role in setting circadian rhythms, boosting attention and mood. But we didn’t evolve to be exposed to it as much as we are. In addition to the ample blue light in sunlight, most of the light we are exposed to via digital devices is also blue.

For example,Moreover, the eye’s cornea and lens are unable to block or reflect blue light.

If you have presbyopia and routinely wear bifocals or progressive lenses, prescription computer glasses give you the additional benefit of a much larger field of view for seeing your entire computer screen clearly. (Keep in mind, though, that this type of computer eyewear is exclusively for seeing objects within arm's length and cannot be worn for driving or other distance vision needs.) Also, a number of lens manufacturers have introduced special glare-reducing anti-reflective coatings that also block blue light from both natural sunlight and digital devices.

Advice when using smartphones and tablets

• Set your device to auto brightness.
• Hold your tablet or smartphone at arm’s length (or about 70cm) from your eyes.
• Make the font bigger to stop strain on the eyes.
• Only use the device for a couple of hours a day in one sitting.Then take a break and come back to it later.

In addition:

• Have your eyes tested regularly and take regular breaks from your computer and hand held device.
• Use good sunglasses with a UV filter when outside.
• Have a healthy and varied diet rich in Vitamin A, lutein, zeaxanthin and mesozeaxanthin which comes from spinach and peppers which will protect the eyes.

Key Points About Blue Light

• Blue light is everywhere.
• HEV light rays make the sky look blue.
• The eye is not very good at blocking blue light.
• Blue light exposure may increase the risk of macular degeneration.
• Blue light contributes to digital eye strain.
• Blue light protection may be even more important after cataract surgery.
• Not all blue light is bad.
• “Health clock” hormones like melatonin are controlled by your body’s exposure to blue light.

Damaging effects of blue light

Too much light in the ultraviolet and blue-violet bands can damage the human eye.

As well as leading to painful inflammation of the conjunctiva and cornea, it can also cause damage to the eye's crystalline lens (e.g. cataracts) and especially to the retina (macular degeneration).

That's why it is so important to wear sunglasses with 100% UV protection in strong sunshine, especially in situations where there is a lot of glare such as on water or snowy mountain
slopes.

According to Harvard researchers, exposure to blue light at night “throws the body’s biological clock—the circadian rhythm—out of whack” and may contribute to an increase of sleeping disorders, blood sugar, hunger, depression, cancer,diabetes, heart disease, and obesity. Blue light during the day helps us feel awake and sets our bodies’ schedule to fall asleep at night, which is critical for migraine sufferers.

All digital devices with viewing screens emit significant amounts of blue light (also called "high-energy visible light" or "HEV light") which might increase a child's risk of macular degeneration later in life.

Though the sun emits significantly more HEV light than computers and other digital devices, the added exposure to blue light kids receive from these devices and how close these electronic screens are to a child's eyes for hours each day have many eye care providers worried about potential eye damage over time.

And many eye care practitioners who specialize in children's vision believe prolonged computer use among children puts them at risk for progressive myopia.

Kids and computers are nearly inseparable these days. With many school-age kids and even preschoolers spending hours in front of a computer every day, it's worth considering what effects computers might have on your children's eyes and their vision. When you work at a computer for any length of time, it's common to experience eye strain, blurred vision, red eyes and other symptoms of computer vision syndrome(CVS). This is because the visual demands of computer work are unlike those associated with most other activities.

To reduce the risk of focusing fatigue that can cause advancing nearsightedness among kids who spend a lot of time on a computer, many eye doctors recommend frequent breaks from computer work. Some call this the "20-20-10" rule: Every 20 minutes your child should take
his eyes off the computer and look at an object at least 20 feet away for at least 10 seconds.

Blue Control lenses reduces the symptoms of digital eyestrain such as dry eyes, sticky eyes, and the feeling of grittiness or "sand" in the eye. Protect your lenses against water, dirt, grease and dust, keeping them clean for longer!

The following symptoms are characteristic of someone who uses the computer/phoneset/tablet for a very long period of time:

1. Dry eyes
2. Red eyes
3. Eyestrain
4. Backache
5. Headaches
6. Visual Fatigue
7. Light sensitivity
8. Lower self-esteem
9. Weight gain or loss
10. Progressive myopia
11. Disturbances in sleep
12. Premature presbyopia
13. Loss of cognitive ability
14. Neck and shoulder pain
15. Carpal tunnel syndrome
16. Burning or stinging eyes
17. Impaired socialising skills
18. Leads to screen addiction
19. Weakened emotional judgment
20. Delayed learning in young children
21. Blurred or strained vision/double vision
22. Lack of concentration and focus of mind
23. Susceptibility to chronic health conditions

Which is better blue cut or blue control?

The choice between Blue Cut and Blue Control lenses depends on your specific needs and lifestyle: For Heavy Screen Users: If you spend long hours in front of digital screens, Blue Cut lenses might be the better choice due to their strong blue light blocking capabilities.

Continuous exposure to blue light after sundown can disturb the sleep-wake cycle and make it difficult to fall asleep in the long run. Tinted lenses mimic the conditions of nature by blocking all artificial blue light and regulating a normal sleep-wake cycle, thus promoting good eye-health and sleep.

Is it okay to buy cheap blue light glasses?

Cheap blue light glasses don't target the complete range.

For all we know, the lenses could be ineffective at shielding your eyes from the peak wavelengths.

Reference:
healthrising.org healthline.com health.clevelandclinic.org migrainekey.com ap.lbl.gov/ehs/safety forbes.com/sites/fionamcmillan gundrymd.com/blue-light-warning activesgcircle.gov.sg/activehealth riverheightseyecare.com/what-are-the-benefits-of-blue-light-glasses eyekit.co eyeacademy.com allaboutvision.com reviewofoptometry.com crew.co/blog psychguides.com zeiss.com blockbluelight.com health.harvard.edu/staying-healthy/blue-light-has-a-dark-side

See also:

• Does blue light keep you awake at night?
• How Blue Light Effects Your Eyes and Brain
• Is it bad for your eyes to watch TV too close?
• Is dark mode better or worse for your eyes?
• Is it bad for your eyes to watch TV in the dark?
• Why Is Blue Light before Bedtime Bad for Sleep?
• How Blue Light Could Damage Cells In Your Eyes?

Essential newborn care (ENC) is a comprehensive strategy designed to improve the health of newborns through interventions before conception, during pregnancy, at and soon after birth, and in the postnatal period. -- The components of essential newborn care.

1st eye examination

1. Family history of eye disease including lazy eye, eye turns and glaucoma; check at 2 years
2. Premature infants evaluated immediately in hospital
3. Signs of problem including unequal eyes, eye turns, mucous in one eye, red eye lid (one only) or premature birth – have evaluation post-natally up to 6 months of age
4. Clogged tear ducts are common – they usually fix themselves, but if actively clogged for more than 1 week, consult your obstetrician – may have you gently massage the skin over the tear duct and may.
   Supplement with erythromycin ophthalmic ointment – consult with physician only before massaging or instilling anything into your childs eyes.
5. One pupil may be larger than the other – this is common, don’t panic. Make sure both pupils react to light and have a pediatric ophthalmologist evaluate any pupil differences – most likely ok but check anyway.
6. Remember, learning is 85% visual, so any problem with eye coordination or vision may lead to slower visual and learning development.
7. Many eye vision related problems can be helped up to around age 7, so don’t delay having your childís vision checked – many problems can be avoided.
8. Between 3rd and 4th grade, print in school gets noticeably smaller, and many advanced children read chapter books earlier, so a bright child who suddenly has problems in school may just be having trouble with smaller print or eyestrain. This is especially true if the.
9. Child passes the school screening – farsighted children will often go undetected, because they can over-focus through any test a School nurse can administer, but since they are farsighted, they see well far but are strained or blurry at near. Be sure an eye doctor screens for farsightedness – the pediatrician usually only screens for nearsightedness and other problems that are easily detected.

Even if you have 20/20 vision, it’s important to have your eye health evaluated periodically.

Certain eye diseases may be present without symptoms, such as glaucoma, peripheral retinal holes, and early-stage macular degeneration.

The Canadian Association of Optometrists recommends the following specific guidelines:

• Children should visit the optometrist:
  • For the first time between six and nine months of age
  • again between two and five years of age
  • annually after starting school
• Adults between 19-65 with no ongoing health concerns should visit the optometrist every two years.
• Adults over the age of 65 should visit the optometrist every year.
• Patients with diabetes require an annual eye examination to check for diabetic retinopathy, serum glucose-related refractive changes, and neuropathies
• Patients wearing contact lenses should visit the optometrist every year.
• Make an appointment to see your optometrist if you:
  • have been diagnosed with a systemic disease that can have ocular complications such as hypertension, thyroid disease, rosacea, arthritis, or multiple sclerosis.

    

  • are taking medication with known ocular side effects, such as steroids, Plaquenil, Accutane, or amiodarone
  • are experiencing transient vision loss, sudden visual acuity change or visual disturbances, such as flashes of light, floaters, or distortions.
  • are experiencing red eye(s). Your eyes need to be assessed using a biomicroscope to accurately diagnose the cause and determine appropriate treatment. Conditions could include conjunctivitis, uveitis, keratitis, corneal ulcer, allergy, episcleritis, scleritis, or dry eye syndrome.

The red reflex test is a non-invasive test that can show early warning signs of serious eye conditions in children. Your GP or optician will usually perform a red reflex test during your child's routine appointments using an ophthalmoscope (a magnifying instrument with a light at one end).

There are also some things you can look out for at home. When using a camera flash, a red reflex is usually produced in the eye as it lights up the blood-rich retina. If the eyes are looking directly at the camera lens and the colour of the reflex in both eyes is red, in most cases that's a good indication that the retinas of both eyes are healthy.

An "abnormal red reflex" is a white, yellow or black reflection in one or both eyes. This can be a warning sign for the presence of a serious eye condition.

Other important signs to look out for are:

• a squint
• a change in the colour of the iris – in one eye or sometimes only in one area of the eye
• a red or inflamed eye – though your child won't usually complain of any pain
• poor vision – your child may not focus on faces or objects, or they may not be able to control their eye movements

How can I test my baby's eyesight?

The pupil reflex test involves shining a light into each of your baby's eyes to check how their pupils (black dots at the centre of the eyes) react to light. Your baby's pupils should automatically shrink in response to the light. If they don't, it could be a sign of a problem.

Reference:

• nhs.uk/conditions/eye-tests-in-children
• youreyesite.com -- Vision Changes After Giving Birth
• mb-opto.ca - Manitoba Association of Optometrists
• moorfields.nhs.uk/news/checking-red-reflex Moorfields Eye Hospital NHS Foundation Trust

See also:

• Your Baby's Vision
• Your baby's first hours of life
• How Pregnancy Impacts your Vision

Fatigue, lack of light, compromised night vision, rush hour and impaired drivers all contribute to making driving at night more dangerous than during any other time of day. In fact, the risk of a fatal crash is three times greater at night, according to National Safety Council research.

Common night vision problems that sometimes develop after having Lasik include glare, halos, and starbursts, which can make driving at night difficult. For some people, these can become long-term problems after surgery.

Night vision is the ability to see in low light conditions. Whether by biological or technological means, night vision is made possible by a combination of two approaches: sufficient spectral range, and sufficient intensity range. Humans have poor night vision compared to many animals, in part because the human eye lacks a tapetum lucidum.[1]

Causes of Night Vision Problems After Lasik

Glare, halos, starbursts and difficulty seeing in dim light are common problems after having Lasik due to swelling of the cornea. Some night vision problems persist past the recovery period, however, and may be due to the following:

Residual refractive error: This refers to remaining refractive error including myopia, hyperopia or astigmatism. Refractive error may be caused by an over- or under-response of your cornea to the procedure, causing your eyes to either over- or under-correct your refractive error.

Enlarged pupils: Sometimes after Lasik your pupil dilates to a size that is larger than the actual treatment zone, causing persistent night vision problems. The pupil sometimes becomes so large that light passes into the eye and causes glare and halos. Because the pupil naturally becomes larger in the dark, the effects are more noticeable at night.

Corneal flap problems: Sometimes the corneal flap produced by the laser does not adhere correctly to the eye after it is replaced. There are cases where it will not be centered perfectly on the eye. These problems can cause light to bend irregularly at the point where the treated and untreated cornea meet, causing night vision problems.

LASIK, PRK, and other forms of refractive surgery sometimes cause double vision. When the corneas are altered, it may initially cause light rays to scatter instead of focusing properly. Fortunately, this issue usually clears up on its own within a few weeks or months.[10]

Decentered ablations: A decentered ablation occurs when the laser treatment is not perfectly centered over the pupil. Decentered ablations occur infrequently, as newer lasers contain advanced eye tracking systems. While decentered ablations do not produce a detrimental effect during the day, they occasionally result in night vision problems.[2]

Night vision problems / disturbances (NVD) is a hot topic of refractive surgery. It will always be a hot topic, and will never be fully resolved (due to the inherent problems of how much tissue can be safely vaporized, and the distortions created when tissue is vaporized). When we talk about night vision, what we are actually talking about is visual distortions in dim light or artificially lit (not specifically very dark) environments.

some basic terminology :

Photopic – Vision in bright daylight
Mesopic – Vision in artifical light, down to quite dim light (like in a movie theatre)
Scotopic – Vision in no lighting – A moonless night outdoors in the countryside , with only starlight to see by (pretty dark!)

Your pupils will be very small in photopic light, bigger in mesopic light and largest in scotopic light. As your pupil expands, more light comes in. Like the arperture of a camera, it allows more light in, so that you can see better in these different environments. Maximum pupil size varies from person to person.

The laser however, can only safely create an optical zone up to 6.5mm, this is due to limitations in how much tissue can be ablated (vaporized) safely.

Above 6.5mm, they create a blend zone which is not a fully corrected area, but acts to smooth out the surface.

Night vision disturbances generally occur when the optical zone created is less than the size of scotopic pupil size. Now there is a caveat, there is something called the effective optical zone and target optical zone. The surgeon may target you for a 6.5mm optical zone, but you could easily end up with a 4mm effective optical zone. This is because the laser loses power on the periphery of the cornea (the outer bit), and it therefore does not recieve the amount of treatment it should have recieved. This results in a smaller optical zone than intended, meaning that even people with 6.5mm scotopic pupils, can end up with night vision disturbances (there are other reasons that result in small optical zones also).

Wavefront ablations attempt to compensate for this, but it generally doesnt work that well, which is why so many people who have had wavefront have night vision disturbances also. eResearch by Navid Ajamin -- spring 2017

Small optical zones are also referered to as something called spherical aberration, and is what generally causes distorted vision, mostly in very dim light (when the pupil is large), but for many with severe spherical aberration it will affect them in anything other than photopic environments.

If you have a scotopic (maximum size) pupils larger than the target optical zone of the laser, you will have a 100% chance of having worse quality vision, and will to some varying extent suffer from halo / glare, starbursting and ghosting.

Distortions can be defined as (but not limited to)

Halo
Starburst
Glare
Ghosting (multi-focal vision)
Poor contrast sensitivity

These distortions can be debilitating, and cannot be corrected with standard contact lenses or glasses.

What is rainbow glare?

Rainbow glare is a rare side effect of femtosecond optical LASIK. It was first described in 2008 by Krueger and al. It affects has very few percentage of the patients that benefit from femtosecond LASIK technology to become spectacle and contact lens independent.

Rainbow glare is usually transient, but may take some months to disappear. In some rare cases, it leads to persistent and disturbing visual symptoms, on which this page will focus.

Femtosecond laser technology to create the corneal flap (which is specific to the technical LASIK) was introduced about 15 years ago. It has progressively replaced the conventional microkeratome (blade cut of the flap) in the hands of most high volume refractive surgeons.

Patients affected by glare describe seeing rainbow has spectrum of colored bands proceeding in rainbow-like fashion. The effect is most prominent in the dark when looking at pinpoint light sources, such as oncoming car headlights at night.

When looking at monochromatic sources (for example a green neon gold traffic light), lacross vertical and "ghosts" or replications or the source can be perceived.[6]

Rainbow glares are caused by femtosecond laser spots which cause constructive interference due to plasma disruption leading to splitting of light into its constituent colours with blue being closest to point light source and red colour being farthest. So defect lies in the poor laser alignment during raster type pattern of corneal flap formation. But if the laser spots are made in a random array rather than in a regular pattern, this phenomenon usually disappears. Patients who undergo this treatment develop around 4 to 12 bands usually with 6 being the commonest. With study it has been found that there's no relationship of developing rainbow glare with age, gender and refractive error but a positive association has been found with laser energy used particularly seen with 1.0 microJ or 1.1 microJ.34 Another study has reported the corneal flap interface to be the source of rainbow glare postoperatively.[5]

It can be impossible for the brain to adapt, and remember, as pupils get larger, more light is let in, and the worse the distortion. Those with large pupils are particularly at risk of problems. It is almost impossible to correct these problems once introduced, have a google, and you will see many websites written by people with these specific problems, many of whom have tried ‘retreatments’ to no avail. In fact for many people, retreatments have made their problems far worse.

A large number of post LASIK patients initially have very good visual acuity, perhaps 20/20 in bright daylight, but are partially sighted in other environments, such as in the office, where there is only artificial lighting. Incidentally, artificial lighting has less of the spectrum of light that normal daylight has and therefore does not provide enough light for the post LASIK eye.

If you enjoy having an active lifestyle, driving at night, going to the movies, watching TV, using a computer (under artificial lighting – not necessarily in the dark), then we believe you are a poor candidate for Laser Vision Correction.[3]

Many people struggle with night driving. Some have a terrible time with the glare of oncoming headlights. Others have difficulty seeing street signs or judging distance especially when it is raining or foggy.

Why is night driving so dangerous? One obvious answer is darkness. According to the National Safety Council 90% of a driver’s reaction time depends on vision, and vision is severely limited at night. Depth perception, visual acuity, colour recognition, and peripheral vision are compromised after sun down. Older drivers have even greater difficulty seeing at night. A 50 year old driver many need twice as much light as a 30 year old. Older drivers also take longer to recover from glare.

Corneal irregularities vary widely among LASIK patients. Consequently, visual aberrations reported by LASIK patients also vary widely. Patients may complain of blurry vision, ghost images, starbursts, smeared vision, halos around lights or illuminated objects, and loss of contrast sensitivity (inability to distinguish detail in dim light). Glasses and soft contact lenses cannot correct these aberrations.[7]

Fortunately, you can take steps to minimize after-dark dangers by preparing your car and yourself. Be sure to mention your night driving difficulties at the time of your eye examination.

Prescription lenses may need to be worn for night driving. This prescription may be different than your daytime distance glasses due to night myopia. The prescription may require prism.

Headlights, tail lights and street lights create glare which can make night driving more difficult. Glare is a distracting problem that may cause the driver to lose sight of the road. Optometrists recommend an anti-glare coating on your glasses to reduce glare and provide more comfortable night-time vision.

Contrast enhancement or glare reduction filters may need to be prescribed. These lenses are usually yellow or orange in colour. They are quite effective especially in rainy conditions. If you find yourself wearing sunglasses at night, you might be better off with one of these filters instead. These lenses are available in both prescription and non-prescription.

Dry eyes can make night driving worse. Artificial tear drops are helpful.

Central vision could be affected by dry eye, macular degeneration, diabetes, high blood pressure or medication.

Clean your windshield inside and out.

Apply a water repellent such as Rain X to the outside surface of all windows and windshield.

The faster your speed, the less reaction time you have. With objects already more difficult to see because of reduced lights, adjustment to lower speeds is necessary. Avoid driving when you feel fatigued and take breaks during long trips.

Avoid smoking while you drive. Smoke’s nicotine and carbon monoxide hamper night driving. The residue is also left on the inside of the windshield.

When approaching oncoming vehicles keep the eyes roving especially to the right.[4]

Does night glare go away after LASIK?

In most cases, the halos and glare you see after LASIK will not go away for about two to three weeks. However, it is common for you to see the halos and glare for a month after the LASIK surgery or possibly even longer than this.[8]

Reference:

1. en.wikipedia.org/wiki/Night_vision
2. verywell.com/night-vision-after-lasik-3421969
3. lasikscandal.com/What/LASIK-Visual-Quality-Night-Vision-Problems-Disturbances-NVD
4. lidkea.com/services-night-driving.html
5. jpma.org.pk/article-details/8166
6. gatinel.com/en/recherche-formation/diffraction/rainbow-glare-symptoms-causes-treatment
7. lasikcomplications.com
8. ccrsclearvision.com/blog/glare-and-halos-after-lasik-everything-you-should-know
9. gatinel.com/recherche-formation/diffraction/rainbow-glare-symptoms-causes-treatment
10. raleigheyecenter.com/blog/seeing-double-common-causes-of-double-vision-laser-eye-surgery-raleigh.html
11. modestoeyecenter.com/lasik/lasik-night-vision-and-dry-eye
12. sightmd.com/blog/lasik-and-night-vision-problems

See Also:

• Night Vision after LASIK -- lasikdisaster.com
• LASIK and Poor Night Vision -- chicagocornea.com
• Night Vision Problems After LASIK -- lasikcomplications.com
• How long after LASIK can I use my phone?
• How many days after LASIK can I wash my face?
• For Some, Lasik Brings More Problems Than Solutions -- npr.org
• Night Vision And Driving: How Safe Are Older Motorists? -- allaboutvision.com
• How many days after LASIK can I sleep without goggles?

Decentered ablation is when the area reshaped by the laser in PRK, LASEK, Lasik, Epi-Lasik, and other laser assisted refractive surgery techniques is not centered to the eye's visual axis. This often means the edge of the ablation zone is within the visual axis, producing ghosting, starbursts, and/or halos. It is possible that an enhancement will correct the decentered ablation, but that process may increase refractive error and make you overcorrected.

What is decentered ablation?

A decentered ablation is a complication of LASIK eye surgery that occurs when the laser treatment is not properly centered over the pupil. Laser ablations that are off-center by as little as 0.5mm can cause visual symptoms, including glare and halos, ghost images, and blurred vision.

A decentered ablation will cause a shift in the refractive error across the visual axis, resulting in poor vision quality.

Excimer lasers that use high frequency eye tracking systems significantly reduce the probability of a decentered ablation, however a decentered ablation can occur even with a tracker. It is important for the patient to fixate on the target within the laser during surgery.

Decentered ablations: A decentered ablation occurs when the laser treatment is not perfectly centered over the pupil. Decentered ablations occur infrequently, as newer lasers contain advanced eye tracking systems. While decentered ablations do not produce a detrimental effect during the day, they occasionally result in night vision problems. eResearch by Navid Ajamin -- winter 2017

There are two types of refractive surgery: surgical procedures that involve actually cutting the cornea and the more common laser procedures which include:

1. Laser Assisted in-Situ Keratomileusis, or LASIK/IntraLASIK
2. Custom Wavefront LASIK
3. Photorefractive Keratectomy, or PRK
4. Laser Assisted sub Epithelial Keratomileusis, or LASEK
5. Epi-LASIK/Epi-LASEK
6. Custom, Transepithelial, One-Step, No Touch Ablation, or cTEN

Latest Innovations and Advancements in LASIK

As we embark on 2024, let us delve into the latest innovations and advancements in LASIK technology that are revolutionizing the field of vision correction.

Femtosecond Laser Technology

One of the significant strides in LASIK procedures is the use of femtosecond lasers for creating the corneal flap during surgery. These ultrafast lasers offer a level of precision and safety that surpasses the traditional microkeratome blade, reducing the risk of complications and enhancing the overall surgical experience. This technology enables surgeons to create corneal flaps with incredible accuracy, contributing to better visual outcomes for patients.

Wavefront-Guided and Topography-Guided LASIK

Wavefront-guided and topography-guided LASIK are advanced techniques that provide highly customized treatments. Wavefront-guided technology maps the eye’s unique irregularities and guides the laser to correct specific imperfections, addressing higher-order aberrations for more precise vision correction. Topography-guided LASIK uses corneal topography to create a highly personalized treatment plan, further enhancing visual outcomes and reducing side effects like glare or halos.

Smart LASIK Systems

The integration of artificial intelligence (AI) and machine learning in LASIK technology has given rise to smart LASIK systems. These systems use AI algorithms to analyze vast amounts of patient data, aiding surgeons in making more precise treatment plans and predicting post-operative outcomes. By improving the accuracy of diagnostics and treatment, smart LASIK systems contribute to higher success rates and improved patient satisfaction.

Enhanced Eye-Tracking Technology

Eye-tracking systems have also undergone significant improvements. The latest advancements in eye-tracking technology allow for real-time adjustments during the surgery, compensating for any subtle eye movements. This ensures that the laser remains precisely aligned, enhancing the accuracy and safety of the procedure.

Less-Invasive LASIK Alternatives

For individuals who might be hesitant about traditional LASIK surgery, less invasive alternatives are viable options. Advanced surface ablation techniques, such as PRK (Photorefractive Keratectomy), offer vision correction without creating a corneal flap, appealing to those concerned about flap-related complications.

The Evolution Continues...

What happens after 10 years of LASIK?

As time goes on, some people might see some blurriness return. This sometimes occurs with age-related changes but can be corrected. Most people still see the effects of their LASIK forever. However, some may need to have enhancement LASIK surgery after 10 years.

Why is my vision not 100% after LASIK?

While LASIK offers remarkable immediate results, it's essential to recognize that achieving optimal vision is not instantaneous. Patients often experience temporary side effects (including blurry vision) as part of the healing process, and vision can take up to 4-6 weeks to fully stabilize.

Why is my vision worse 5 years after LASIK?

It permanently reshapes the tissue in the front of your eye, and these changes last your whole life. However, most people's vision gets worse over time as part of the natural aging process. LASIK can't stop this, so your vision may become blurry again as you get older.

LASIK Eye Surgery Risk Factors And Limitations

Not everyone is a suitable candidate for LASIK eye surgery. Certain conditions and anatomical factors can increase your risk of an undesirable outcome or limit optimal LASIK results.

These include:

1. Too thin or irregular corneas
2. Large pupils
3. High refractive error
4. Unstable vision
5. Dry eyes
6. Your age
7. If you are pregnant
8. If you have certain degenerative or active autoimmune disorders

For a full checklist on LASIK risk factors and whether or not you are an appropriate candidate

Left: What someone with post-op starbursts might see at night. Right: Nighttime halos.

Some problems associated with LASIK flap complications include:

1. Irregular astigmatism. This is caused by an unequally curved corneal surface. Irregular astigmatism also can occur from laser correction that is not centered properly on the eye or from irregular healing. Resulting symptoms may include double vision (diplopia) or "ghost images." In these cases, the eye may need re-treatment or enhancement surgery.
2. Epithelial ingrowth. This is when cells from the outer layer of the cornea (epithelium) grow under the flap after LASIK surgery. In most cases, epithelial ingrowth is self-limiting and causes no problems. But in some cases (reported to be 1 to 2 percent of LASIK procedures), symptoms of discomfort and/or blurred vision can occur, and additional surgery is needed to lift the flap and remove the epithelial cells.
3. Diffuse lamellar keratitis (DLK). Nicknamed "Sands of the Sahara," this is inflammation under the LASIK flap that may have several causes. Some inflammation of the cornea after LASIK surgery is normal. But if it is uncontrolled, as in DLK, it can interfere with healing and cause vision loss. If DLK occurs, it usually responds to therapies such as antibiotics and topical steroids. Also, the flap might need to be lifted and cleaned for removal of inflammatory cells and to prevent tissue damage.
4. Keratectasia or keratoconus. This is a very uncommon bulging of the eye's surface that can occur if too much tissue is removed from the cornea during LASIK or if the cornea prior to LASIK is weak as evidenced from corneal topography mapping. Rarely does keratoconus develop after LASIK with no known risk factors. Enhancement laser surgery is usually not suitable, and gas permeable contact lenses or corneal implants (Intacs) may be prescribed to hold the cornea in place, or a treatment called corneal collagen crosslinking may be performed to strengthen the cornea.

Side effects of LASIK:

1. Dry eyes
2. Flap complications
3. Glare
4. Infection
5. Light sensitivity
6. Undercorrection or overcorrection
7. Double vision
8. Corneal ectasia
9. Astigmatism
10. Eye infection
11. Halos around lights
12. Regression
13. Vision loss
14. Dry eyes after LASIK
15. Night vision problems
16. Blurred vision
17. Fluctuating vision
18. Eye bruises or redness
19. Pain
20. Diffuse lamellar keratitis
21. Epithelial ingrowth
22. Glares and halos
23. Scratchy eyes
24. Eye discomfort
25. ...

Reference:

• ophthalmology.wustl.edu/lasik-technology-advancements-dr-stephen-welxer-expertise-innovations-shaping-vision-correction
• coheneyeinstitute.com/media/blog/understanding-how-long-your-vision-may-stay-blurry-after-lasik
• healthproadvice.com/procedures/Definition-of-Lasik-Vision-Correction
• allaboutvision.com/visionsurgery/lasik_complication_1.htm
• healthline.com/health/eye-health/how-long-does-lasik-last
• laserfitlens.com/cornea_facts/decentered-ablation
• carroteyecenter.com/how-long-does-lasik-last
• verywell.com/night-vision-after-lasik-342196
• usaeyes.org/lasik/faq/decentered.htm

See also:

• LASIK: COMPLICATIONS AND THEIR MANAGEMENT
• Contribution of Optical Zone Decentration and Pupil Dilation on the Change of Optical Quality After Myopic Photorefractive Keratectomy