Is LASIK worthwhile if I am 35 and concerned about having to wear glasses again due to Lao Hua?

Doctor's Answers 2

The most important thing to remember is-the only person who can ultimately decide whether LASIK is worthwhile, is yourself.

And in the process of making your decision, you should try to understand and imagine what you are in for, in all the various possible scenarios.

To start off, presbyopia/Lao Hua does not entirely or necessarily defeat the purpose of LASIK. But let's consider the various scenarios first.

1. You decide to stick with glasses. In this case, without glasses, you can only see clearly out to about 11cm from your face (for most of your life until eventually you have cataract surgery done in old age). When you get to 40 years old and Lao Hua kicks in, you will need to get progressive glasses (where the top part is for far and the bottom is for near). All the inconvenience of glasses apply, eg fogging, blur vision outside the frames etc.

2. You decide to wear contact lenses. Without the lenses, you can only see right in front of your face, like glasses. When you get to 40 years old, you will either have to wear reading glasses on top of your contact lenses, or purposely undercorrect the lens on one side, so that one eye sees clearly in the distance and the other eye sees clearly for near. Contact lenses can give very good quality vision but can be a hassle to maintain and also can be a problem for people who are into eg watersports.

3. You decide to have refractive surgery (LASIK or ICL if cornea is not thick enough). Most people who do LASIK at 35 will aim to correct both eyes to have good vision in the distance, and for the next ~5 years everything will be clear both far and near. After that, reading glasses will become necessary for near, but far vision will still be clear without glasses.

If you consider the different scenarios, you will see that each has its pros and cons. No matter what option you choose, you will have to make an adjustment once Lao Hua kicks in.

But which scenario would you like? Would you like to be eg 50 and have to wear progressive spectacles all the time, or would you like to be 50 and be spectacle free except when looking at near things?

There is no right or wrong answer, and it's very much each to his or her own, depending on things like individual preferences, hobbies, occupation, and so on.

Laser vision correction (LVC) is intended to help achieve spectacles independence by way of correcting myopia, hyperopia and/or astigmatism. Generally speaking, patients should remain independent of glasses for both far and near distance until the mid to late 40s when most individuals will start to feel the effects of presbyopia (老花眼). At that age, patients will have to start using reading glasses for focusing near distances for activities like reading and sewing. They should still be able to maintain good far distance vision without the need for glasses.

Understand that LVC was never intended to correct presbyopia as the causes for it are occurring at the level of the lens which lies deep in the eye.

At 35 years of age or for that matter any age, you are the best judge as to whether LVC is still a worthwhile effort to enable you to be completely independent of glasses for at least the next 10 years, after which you should still be capable of focusing far without glasses. Reading glasses will only be needed for near visual tasks.

Your question is a good example why we encourage all out patient to analyse for themselves what their personal aims or goals are with regards to LVC. Different individuals will benefit from it in different ways.

For example, a person in their 40s who maintains a physically active lifestyle may very well benefit from having LVC at his or her age for activities like skiing, scuba diving, hiking or cycling. The patient may also avoid the need for expensive progressive glasses.

Ultimately, you are the best person to decide if LVC and being spectacle independent is a worthwhile endeavour. The surgeon’s role only becomes useful after you have made up your mind that it is so. That’s when we can help guide you on what treatment/s would best suit your needs.

Similar Questions

What are good LASIK options for very high grade myopia and floaters?

Hi Karen! Thanks for reaching out. Your myopia sounds very severe! It’s important in patients who report severely high degrees of myopia to consider concomitant ocular or systemic disorders including Marfans, Weil-Marchesani, Sticklers / Wagners syndrome etcetera. Such conditions don’t automatically disqualify you from refractive surgery, however a comprehensive assessment would be required to exclude these conditions. Even patients with severe myopia alone may have concomitant problems like retinal holes or detachment, early cataracts or retinal pathology.

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Answered By

Dr E-Shawn Goh

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How long is the recovery period for Epi-Lasik before my vision stabilizes? Can I still go for enhancement after Epi-Lasik?

Epi-LASIK (which is essentially photorefractive keratectomy/PRK) refers to laser treatment of the surface of the cornea, after the surface layer of epithelial cells has been peeled away. After treatment, the surface of the eye/cornea is ‘raw’ and has no epithelial covering. This epithelial layer grows back eventually, but the time it takes to grow back and become normal again is what causes the delayed healing of epi-LASIK/PRK versus conventional bladeless/femtosecond laser LASIK.

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