Note to those with naturally perfect vision: we half-blind folks certainly do appreciate good
vision a whole lot more than y'all.  Starting at the age of 12, my days began with vision fuzzier
than an Al Gore mathematical analysis.  That is, until I had my eyes zapped by the friendly
doctors at Laser Vision Centers in St. Louis.  Why'd I do it?  It's sort of like asking a guy in a
wheelchair if he'd spend $3,000 and an hour of his time in exchange for walking again.  Poor
vision is a handicap, and LASIK is an easy fix.  So I called the Laser Vision office, got
educated, and ended up with perfect vision for the first time in 18 years.

Poor Vision + Dirt Bikes = Expensive
One afternoon in 1995, while stranded on a muddy hillside with a dozen other racers, I
received my first lesson in what corrected vision can do for you in the woods.  I took off my
fogged-up goggles, began dragging my bike back down the hill, and got hit with mud spray
from a guy charging up the hill.  A piece of mud shot into my eye and that was the last I saw
of a $75 contact lens.  After that, switching to disposables for races kept the replacement
costs down, but I was never completely satisfied with the clarity of soft lenses.  And when I
was riding, the contacts dried out my eyes and I had to remember to blink frequently. So the
dirt-bike-related issues were part of the equation that led me to LASIK.

LASIK Education
In the 1990's, a guy I knew had the old-style RK procedure, where they actually cut your
eyeballs with small knives. To me, that would rank right up there with having my bowels
surgically removed. Actually, it worked out good for him.  With RK, the idea was to make
some cuts that would weaken the cornea so it flattened out and improved distance vision.  
Problem was, it permanently weakened the eyes to the point that eye protection was highly
recommended for contact sports.  We've come a long way since then, and LASIK is now the
most common corrective surgery for myopia.  The concept is fairly simple: reshape the
cornea back to the way it was in your pre-corrective days.  It's done with a laser that sculpts
the cornea.

LASIK prices have generally come down from 3-5 years ago when the procedure was fairly
new.  I've heard of prices as low as $500 per eye and as high as $2,500 per eye.  Laser
Vision's cost was $1,500/eye.  For the cost-conscious, look for referral discounts or choose a
less popular day for surgery (early in the week) and you might get the cost reduced a little.  
For me, it wasn't the cost as much as is was my comfort with the doctor performing the
surgery and the equipment that was used.  Here are some of the key questions to ask:

  • How many procedures has the doctor performed? (I'd be comfortable with 1,000 or
    more)
  • What are the doctor's qualifications and background? Does the cost of surgery
    include post-op visits? (it should)
  • What percentage of patients have to come back for additional corrective procedures?
    (i.e. problems with the procedure that required another session under the laser)
  • What kind of equipment is used, how new is it, and what is the maximum pupil size
    that the laser can handle? (if the laser resembles the rifle-mounted scope you saw in
    last month's Guns & Ammo, move on to the next doctor)

Even if you've asked all the questions and were satisfied with the responses, be cautious if
the doctor downplays the risks and/or encourages you to proceed even though you have
above-average risk of side effects.  Most doctors are very upfront in explaining the risks and
will usually recommend other options if you're not a good candidate, but a small minority are
all about volume.

The Procedure
On my first visit to Laser Vision, I watched a cool video of someone getting his eyes worked
on.  The procedure doesn't last long - maybe 5 minutes per eye.  Dr. Steve Wexler and his
crew have done about 10,000 of these and they don't waste any time.  I had them set up my
pre-op exam for two days before the actual surgery and I was instructed to take out my gas
permeable contact lenses 3 weeks ahead of the exam.  Hello, glasses.  The pre-op exam is
where they take measurements of the eye and make sure that you're a good candidate.  Most
people qualify just fine, but if your corneas are too thin, you probably won't want to have
LASIK.  Pupil diameter is also taken into consideration, as those with wider pupils have
higher risk of side effects like "halo" and "starburst" (most noticeable at night, when you look
at a light fixture and see a glow around the light).

The pre-op exam was cool because they dilated my eyes and I looked like I'd just got back
from a 24-hour rave.  This lasted well into the following day, and when I mentioned the rave
comparison to my banking co-workers, they didn't know what they hell I was talking about
(they just thought I was stoned).  Overall, my pre-op exam was good, except that one pupil
was just a little large.  The laser is designed for a maximum pupil diameter of something like
6.5mm, and I was 7.0mm in one eye.  However, they assured me that this was a relatively
minor difference that shouldn't cause any undue risk of side effects.  So I went ahead with
the scheduled surgery two days later.

The Day My Life Changed
On a Friday morning, my friend Resmi drove me to the office.  She and her husband both had
LASIK performed by Laser Vision Centers and highly recommended Dr. Wexler's gang.  
Patients are not allowed to drive home afterwards, for a couple a reasons.  They administer
half a pill of valium to help you relax before the procedure.  The half-valium isn't enough to
have much noticeable effect, but regardless, you are technically drugged up so driving is out.
Afterwards they tape on some cool-looking eye shields (would make that Boner dude from
U2 proud) to keep foreign objects out of your eyes, which distorts vision.  Along with the
drugs and distortions, some people's vision can be a little fuzzy right after the procedure,
before the eyes have a chance to heal.  So everyone leaves the office with a driver.

Friday is the most popular day to have LASIK because recovery can take place over the
weekend.  Most people are back at work the following Monday.  I came in at 8:00 a.m. and
was given my half-Valium (the other half of the pill was supposed to be for when I got home,
but I didn't use it).  Even without the Valium I didn't really feel tense or nervous, since several
of my friends and co-workers have had LASIK.  Hearing their stories gave me a pretty good
idea of what to expect.  I was also given some eye-numbing drops and a lovely hair net to
wear throughout the procedure.

At 8:30 a.m. I entered the "laser room" and lay down on a comfortable, fully-reclining table.  
One eye was taped shut, and with the other eye I was instructed to focus on a flashing red
light above me.  The first step was taping back my eyelashes to keep them out of the way.  
Next, a device was put around the eye to keep the eyelids wide open.  The pressure was a
little uncomfortable, but I got used to it.  Along with this was plenty of lubricating liquid to keep
the eye moist.  Another device was placed on top of the pupil/cornea area, the purpose of
which was to cut a thin "flap" to give the laser access to the cornea (note: I'm telling this the
way I understood it...the folks at Laser Vision can explain it a whole lot better).   For a
moment, I lost vision and saw nothing but black "sky" and shooting red stars.  A moment
later my vision returned and I focused intently on the red light while they fired the laser into
my eye for about 20 seconds.  The "flap" was put back into place, the instruments removed
from the eye, and they did the same thing to the other eye.

Afterwards, eye shields were taped to my face and I was sent home.  On the way out, I
deposited my glasses in a box full of eyewear from some of the many people who left the
office with fully corrected vision.  As instructed, I tried to keep my eyes closed for the next 12
hours, which wasn't too hard.  I went to sleep for awhile, listened to some music, and talked
on the phone.  I had some burning for a couple of hours after the numbing drops wore off,
but nothing unbearable.

The Follow-Up
The next morning I went back for my day-after exam and had 20/20 vision in the right eye and
20/25 in the left eye.  At the 3-day exam my vision was perfect.  My previous vision was
20/400, which means I could see at 20 feet what a person with normal vision could see at
400 feet (the prescription numbers were something like 3.50 and 4.00).

For one week after the procedure, I used two sets of eye drops four times a day.  One was an
antibiotic and the other was an anti-inflammatory.  I also used non-preservative lubricating
drops for when my eyes became dry (which was pretty frequent) and some gel-type lubricant
at night. I was back at work the next week and felt pretty good unless I spent too much time at
the computer (had to curb the at-work web surfing). There was some variation in the quality
of vision for the first couple weeks afterwards, but that was usually a result of dry eyes.

The Conclusion
Six months later, I'm generally satisfied with my 20/20 vision. At night, I do get the "starburst"
effect when looking at lights, which is kind of annoying when I drive.  Staring at computer
screens for an extended period makes my eyes more dry and tired than they used to be, and
I'm still fighting dryness at night.  But the benefits far outweight the minor inconveniences,
especially when I'm outside in windy or dusty conditions.  For dirt biking, I never have to worry
about a dry contact lens, or worse, losing a contact lens.  I consider LASIK to be one of the
best investments I've ever made.

Update 5/19/03
It's been about 16 months since LASIK and my eyes are great. Depending on the days I had
them tested, my eyes were never worse than 20/25. The dryness that persisted for the first 6
months after the procedure went away shortly thereafter . I was never so happy to wake up in
the morning with crud in my eyes. I still have some "starburst" at night, but I'm used to it. The
benefits far outweigh the trade-offs.
Four-eyes No More
LASIK
Education
January 2002