LASIK patients have faced an elevated risk of vision loss from glaucoma, but that may be changing. LASIK does not cause glaucoma but can interfere with detection of the condition. Early detection plays a critical role in preserving eyesight. Since glaucoma does not present symptoms in the early stages it can only be discovered during an eye exam.
Glaucoma causes damage to the optic nerve which eventually leads to vision loss. Normally this damage is caused by high intraocular pressure (IOP). The standard method of initial detection of glaucoma is to test IOP. The problem with this method is that people with thin corneas will test with a lower IOP than they really have, leading doctors to believe that they do not have glaucoma. A few people have naturally thin corneas, and LASIK surgery thins the cornea.
It is not uncommon to develop glaucoma in the later years of life. With LASIK vision correction becoming more popular, the fear is that in a few years glaucoma will go undetected on a regular basis. This inaccurate form of testing may also lead to a false spike in “normal pressure” glaucoma.
In early 2005 the Food and Drug Administration approved a device called the TonoPach which measures both IOP and corneal thickness simultaneously in order to produce a more accurate reading.
If you have had LASIK surgery you must discuss it with your ophthalmologist before your eye exam and make sure that he or she is equipped to test IOP and corneal thickness together.
LASIK surgery if you already have glaucoma.
IOP is drastically increased during the LASIK procedure. For this reason, glaucoma patients may not make good LASIK candidates. Some ophthalmologists will recommend against LASIK for anyone with glaucoma. Many will recommend PRK as an alternative since it does not raise IOP as much as LASIK.
In reality, having glaucoma does not necessarily mean that you cannot have LASIK. Patients with mild glaucoma or who have their IOP under control with medications can still make good candidates for the procedure. If you have glaucoma and refractive error look for an ophthalmologist who has experience with LASIK procedures for glaucoma patients to find out if you are a good candidate and if not which alternatives may be right for you. Your ophthalmologist will need to determine the health of your optic nerve before making a recommendation.
Glaucoma patients must have their IOP measured on a regular basis. After LASIK measurements will need to be taken in a manner that adjusts for a thinner cornea. If you change doctors you must always tell your new doctor that you have had LASIK surgery so that he or she can measure your IOP properly.
LASIK is a wonderful option for correcting refractive error. As new technology emerges, the long term outlook for LASIK patients becomes even better. Just like any other surgery or procedure you may have, you should always talk openly with your doctor if you have had LASIK and discuss any concerns that you may have.
If you are considering LASIK surgery, contact an experienced ophthalmologist such as Dr. Stuart Lewis of Denver, Colorado.
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