Pre-LASIK Eye Exam
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Free LASIK Consultation Are You a Candidate? Pre-LASIK Eye Exam Preparation for LASIK |
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LASIK Procedure After LASIK Enhancements Alternatives to LASIK |
As part of preparation for LASIK, you will receive a dilated pre-operative eye exam. At Cutarelli Vision, we believe this can be one of the most important steps of your procedure.
If you are having your LASIK Candidacy Screening performed through your own eye care professional, you are still required to complete a pre-operative LASIK exam in our office before your LASIK procedure. We will be unable to confirm your candidacy for LASIK or alternatives until these tests are completed.
Dilation of Your Eyes:
A comprehensive LASIK eye exam requires that your pupils be dilated with eye drops so we can thoroughly examine and accurately measure your eyes. We recommend that you bring a pair of dark sunglasses or we’ll be happy to supply you with disposable sunglasses to wear after your appointment. Although rare, some patients may not like being dilated, or might have extreme light sensitivity. Because of this, we recommend you bring someone with you to drive.
Eye Health Assessment:
Current prescription: In order for LASIK to be appropriate at this time, your current prescription needs to have been stable during the last two years.
Contact lens wear: Wearing contact lenses warps the corneal surface of your eyes. This causes measurements that are not representative of your true refraction. We ask that you stop wearing contact lenses prior to your LASIK procedure. The time interval required depends upon the type of contact lens you wear and how long you have been wearing them. While we've listed the minimums below, the actual time will depend on your initial topography results. Follow this advice in order to avoid unnecessary risk of complications or reduce the effectiveness of your LASIK surgery.
Soft contact lenses
- Before your LASIK exam: remove at least two weeks prior
- Before your LASIK surgery: remove at least two weeks prior
Gas permeable and hard (PMMA) contact lenses
- Before your LASIK exam: remove at least three weeks prior to your LASIK exam - if you have worn them for more than 10 years an additional week for each decade of wear is usually required.
- Before your LASIK surgery: remove at least 3 weeks prior to laser eye surgery
Ocular Conditions: Some ocular conditions, such as lazy eyes, strabismus, or double vision, can affect your suitability as a candidate for LASIK.
Eye Injuries: Be sure to inform Dr. Cutarelli about any eye related injury, regardless of how long ago it occurred.
Your Pre-operative Eye Exam:
Refraction: The refraction test is an eye exam that measures a person's prescription for eyeglasses or contact lenses. You sit in a chair and look through a phoroptor or refractor and focus on an eye chart 20 feet away. The device contains lenses of different strengths that can be moved into your view. The test is performed one eye at a time.
Motility: This exam will assess the ability of the muscles that align your eyes to work properly. Strabismus is a motility disorder in which the two eyes do not line up in the same direction, and therefore do not look at the same object at the same time.
Eyelids: This test exams your eyelids to see if your eyelids might possibly cause problems by turning inward (possibly scratching the cornea ) or outward (possibly directing tear flow away from the eye).
Conjunctiva: The conjunctiva is the thin membrane that covers the outer surface of the eye and lines the inner surface of the eyelids. This test will check for conjunctivitis, which makes the white of the eye appear red due to irritations, irregular blood vessels or other abnormalities.
Cornea: The cornea is normally a nearly invisible, clear structure covering the iris of the eye. Its purpose is to transmit and focus the light entering the eye. This test will examine the cornea for overall health, scarring, any previous trauma, and pathology, using slit lamp via a microscope.
Crystalline lens: The crystalline lens is a transparent, biconvex structure in the eye that, along with the cornea, helps to refract light to be focused on the retina. This test will examin the crystalline lens inside your eyes to determine if clouding of the lens (a cataract ) or other abnormalities are present.
Intraocular pressure: Intraocular pressure (IOP) is the fluid pressure inside your eyes. A tonometer will be used to measure the IOP to evaluate patients who are at risk from glaucoma. Glaucoma is a visual loss caused by damage to the optic nerve from excessively high pressures in the eye. It is one of the most common causes of preventable vision loss.
Posterior segment: The dilated (fully open) pupil exam is used to assess the health of the posterior segment, which is the back two-thirds of the eye that includes the anterior hyaloid membrane and all of the optical structures behind it. This test allows Dr. Cutarelli to screen the vitreous humor, retina, choroid, and optic nerve for a number of eye and systemic disorders.
Tear film: It is very normal for patients to experience temporary dryness after LASIK. However, patients who have inadequate tears before surgery are at higher risk of prolonged dry-eye symptoms after surgery. Keep in mind that feeling of dryness while wearing contact lenses is not the same thing. Experiencing dry eyes while wearing contact lenses does not mean that the eyes are dry when contact lenses are not being worn.
Different methods to evaluate tear function include:
- Placement of colored agents in the tears
- Physically measuring the tears themselves
- Inspection of the tear film with a microscope
Pupil size: The pupil is a hole located in the center of the iris of the eye that allows light to enter the retina. Most glare, halos, and diminished night-vision following LASIK surgery is due to a combination of larger pupil size and a high amount of nearsightedness or farsightedness. This is because large pupils allow light rays to enter from the periphery of the cornea.
Custom programming the laser for a larger optical and ablation zone can minimize glare and halos. However, this can only be accomplished with lasers that have an adjustable zone from 6.0 mm to 8.0 mm, such as the ones we use here at Cutarelli Vision.
Corneal epithelium: The epithelium is a thin clear layer of skin cells that covers the front of the cornea. In some people, this layer of cells is not attached firmly. Loose epithelium may lead to a higher risk of complications. This test will determine if a loose epithelium condition exists by microscopic examination of the cornea.
Corneal pachymetry: This test is used for measuring the corneal thickness, and will be used to calculate precisely how deep the laser will be allowed to penetrate. Since LASIK involves creating a flap on the surface of the cornea and using a laser to reshape the cornea by removing tissue, knowing the corneal thickness is vital to setting the laser to remove the right amount of tissue.
Corneal topography: This is a non-invasive medical imaging technique for mapping the surface curvature of the cornea, the outer structure of the eye. As no one has a perfectly rounded cornea, the topographer machine will display the degree of astigmatism you have - any irregularities in the shape of your cornea, which cause your vision to be less than perfect. Occasionally patients have keratoconus, which is a cone-shaped cornea. Keratoconus corneas often are weaker than normal corneas and thus should not be treated by LASIK.
Wavefront Mapping: The VISX CustomVue Wavefront Analyzer will provide a detailed analysis of your entire visual system. Dr. Cutarelli will use this information to further validate that you are an appropriate laser eye surgery candidate and formulate a highly customized vision correction plan specifically for your eyes.
Vocational and lifestyle: Your work or recreational requirements can influence vision correction choices. For example, some choices can affect depth perception or the ability to see well at a particular distance.
Reviewing the results: You and Dr. Cutarelli will go over the results of your exam together and further plan your LASIK eye surgery.
Next: Preparation for LASIK.
