Post: What’s the difference between PRK and LASIK?

Price: Both improve vision by reshaping the eye’s covering or cornea with a cool ultraviolet light beam. The difference lies in how the surgeon reaches the inner layer of the cornea in order to treat it. PRK involves removing tiny bits of the cornea’s top surface that gradually grow back. With LASIK, surgeons make a corneal flap that can be repositioned after treatment. LASIK is the more comfortable and convenient option. But when a thin cornea rules out LASIK, PRK is often the treatment of choice.

Post: How do newer lens implants work?

Price: Standard lens implants such as those used in cataract surgery replace the eye’s natural lens. But the implantable contact lens (ICL), or Visian lens, leaves the crystalline lens in place. ICLs are situated in front of or behind the colored part of the eye and can be removed if necessary.

Post: Who is a good candidate for an ICL?

Price: ICLs are especially beneficial for those with moderate to severe astigmatism or nearsightedness. For instance, research shows that ICLs provide better visual acuity than LASIK for people who can only read the top few lines of an eye chart. These lenses are also excellent options for those with very dry eyes that can worsen after laser surgery, and when the cornea is too thin for LASIK, which, as mentioned, requires making a flap in corneal tissue.

Post: Does vision-correcting surgery offer more than an improved appearance and convenience?

Price: Certainly. LASIK and lens implants improve functional vision compared to glasses and contacts, especially when people engage in outdoor activities or exercise. Safety is another big plus of “unaided” visual correction because people don’t need to change and clean their contacts—not just when camping, but in day-to-day living. Additionally, people who require thick lenses due to severe astigmatism often experience less visual distortion with these surgeries than with glasses or contacts.

Post: What about cost and insurance coverage?

Price: The costs of PRK and LASIK are similar and some policies offer partial coverage. ICLs run about $2000 more, an amount generally paid out-of-pocket. Most practices offer payment plans.

Of course, do your homework. Talk to friends who had vision correction. And before scheduling your procedure, ask your surgeon how often he or she has done it.

Francis Price, M.D., is medical director of Price Vision Group in Indianapolis and founder of the Cornea Research Foundation of America (cornea.org).

Optical Options for Getting Rid of Glasses The Saturday Evening Post

A thin layer of tear film covers and lubricates our eyes. But when cold or dry air disturb its balanced mix of water, oil, and protein, the results can range from pain, blurred vision, a scratchy or burning sensation, or even watery eyes as the body tries to rehydrate.

How do you know it’s not allergies? Pennsylvania Medical Society member and Pittsburgh-area ophthalmologist Michael Azar, MD, explains, “Dry eye usually causes a sandy, burning, tired eye feeling while allergies usually cause itching. Because both dry eye and allergies can cause watery eyes, differentiating the two conditions can be difficult and may require an eye exam.”

Dr. Azar adds that dry eye syndrome can occur at any age, but is more common in older individuals.  Post-menopausal women are especially prone to the condition, that may also be related to certain medications like diuretics (water pills), antihistamines (for colds) and beta blockers (for high blood pressure).

“Most dry eye is a simply a nuisance,” says Dr. Azar, “and artificial tears or warm compresses can assist with tear secretion if you have classic dry eye symptoms. At home, a furnace humidifier or room humidifier can help. More severe symptoms, however, may require a doctor’s care or prescription and include oral doxycycline, punctal [tear duct] plugs, topical steroids or topical cyclosporine (Restasis).

“Severe dry eye can make you vulnerable to corneal infections which can permanently affect your vision. If artificial tears don’t seem to help, please contact an ophthalmologist for a thorough eye exam.”

Editor’s note: I’m going to try using artificial tears for my scratchy eyes. Do you have dry eye symptoms? What works for you?

Dry Eye Season The Saturday Evening Post

In the Nov/Dec 2009 issue, Shirley H. (who has worn hearing aids for many years) 
wondered why her own voice has started sounding gravelly to her, and she’s finding it hard to sing on key. Since then, other readers have reported similar problems. Bill W., writes that doctors believe his garbled hearing may be related to x-ray treatments he received as a child for 
earaches, a then common procedure.

In the Jan/Feb 2010 issue, Helen M. asked about treatments to relieve dry eye. Virginia E., reports that taking an omega-3 supplement has done wonders for her. She also uses TheraTears nutrient and eye drops on occasion. Ralph B., discovered that his problem basically disappeared after switching from a facial tissue with added moisturizers to the plain variety to dab his weeping eyes.

Readers Talk About Dry Eyes, Leg Pain, and Hearing Loss The Saturday Evening Post

Helen,

Olathe, Kansas

First of all, you’re not alone. As many as 22 percent of Americans suffer from some form of dry eye, according to Dr. Mark Abelson, dry eye specialist at Boston’s Schepens

Eye Research Institute and a clinical associate professor at Harvard Medical School. Certain medicines (such as antihistamines or blood-pressure drugs) can make dryness worse, and so can some eye drops that ease redness but don’t lubricate the eye surface.

To help relieve dry eyes, Dr. Abelson suggests:

—Drink plenty of water and avoid windy and arid conditions. Blink often. Take breaks while working on the computer and watching television. Consider taking an omega-3 supplement to help reduce eye inflammation.

—Avoid products that offer “redness reduction” and opt for a long-lasting lubricant eye drop that targets specific dry eye problems. For example, research shows that Systane® Ultra (Alcon) drops improve vision after 90 minutes.

—Prescription options may include Lacrisert, a small, clear insert that dissolves throughout the day to stabilize the eye’s tear film, and Restasis (cyclosporine A) eye drops, which increase tear production. For a more permanent solution, eye specialists insert “punctal plugs” into the drainage holes in the corners of the eyelids.

No More Dry Eyes The Saturday Evening Post

I find so many helpful ideas in the Medical Mailbox that I wanted to share my cure for dry eyes. This column is the main reason I continue to subscribe.

I had severe dry eyes, and my ophthalmologist said to try fish oil before a more expensive prescription product. When I told him I already took fish oil, he said to take more of it. For me, the daily dose became three one-gram capsules of EPA and DHA, divided.

It made all the difference in the world. Now my eyes feel perfectly normal. I would take any amount of fish oil to relieve my painful dry eye syndrome. It felt like sandpaper in my eyes with constant tearing. Please pass the word on.

Gera
Pompano Beach, Florida

Fish Oil Helps Reader’s Eyes The Saturday Evening Post