Eye1st Vision & Laser Center
Please visit Am I A Candidate? page for more details.
The aging process is inevitable and leads to the need for reading glasses for those approaching and those beyond 40 years old. The medical term is Presbyopia.
The first symptoms include the need to push reading material further away, requiring more light to read comfortably, or tired eyes at the end of the day. Over-the counter reading glasses might be helpful, but they should not be purchased until a comprehensive eye examination is performed to rule out cataract, glaucoma, refractive errors such as astigmatism and other pathology.
When planning laser vision surgery, it is very important to decide beforehand what your visual goals are with regard to near and distance vision, especially if you are approaching or beyond 40 years of age.
Presbyopic patients who are near-sighted (myopic) can see close-up without their glasses or contact lenses. High myopes (e.g. over -5.00) will hold material uncomfortably close in order to read.
There are four options regarding refractive treatment in a presbyopic patient:
Call our center at (404) 442-9577 or complete the form on the LASIK Consultation Page to schedule a complimentary laser vision correction consultation. We will conduct a through examination to determine whether your eyes are healthy and suitable for the procedure. You can have Laser Vision Correction as soon as you’re ready and eligible for it.
IMPORTANT: Contact lenses can alter the results of your eye exam. For accurate measurements, your contacts must be removed before your consultation. See "What can I expect at my consultation?" below for more details.
You will be in our center for approximately 1 to 2 hours. Contact lenses can alter the results of your eye exam. For accurate measurements, your contacts must be removed before your consultation as follows:
- Daily Wear Soft Lenses: remove 4 days
- Extended Wear (Sleep in contacts): remove 14 days
- Soft Toric Lenses: remove 2 weeks
- Rigid Gas Permeable (RGP) or Hard Lenses: remove minimum of 4 weeks
You will complete a patient information packet including medical history. Conditions we should know about:
- Amblyopia (Lazy eye)
- Strabismus (Muscle imbalance)
- Severe dry eye
- Previous eye surgery or injury
- Any recurrent, residual or active eye condition which may affect healing
- Back problems or claustrophobia
You will receive an individualized eye exam – providing the precise analysis we need to determine if your prescription/vision are stable and if laser vision correction is right for you. The exam may include:
- Dilated retinal exam
- Subjective refraction
- Cycloplegic reinoscopy
- Subjective cycloplegic refraction
- Cornea measurements with Topographer and Pachometer
- Eye pressure measurement
- Slit-lamp exam
- Test to rule out dry-eyes
You will view a 7-minute informative video presentation and/or read information about laser vision correction.
You will have a meeting with Dr. George O. Waring, who will review your refractive options.
You will receive a final review with a Patient Counselor including:
- Payment options
- Day of surgery protocol
- Post-operative protocol
Arrange for a driver to bring you to and from our Center. You will not be able to drive yourself home. We kindly ask that you make arrangements to keep children at home.
- No contact lenses prior to your surgery date as directed during your consultation:
- Daily Wear Soft Lenses: 4 days
- Extended Wear (Sleep in contacts): 2 weeks total
- Soft Toric Lenses: 2 weeks total
- Rigid Gas Permeable (RGP) or Hard Lenses: Minimum of 4 weeks
- Make-up schedule as follows:
- Avoid all eye make-up 3 days prior to LASIK.
- Avoid all make-up on day of LASIK.
- Avoid mascara and eyeliner 1 week after LASIK.
- Wear loose and comfortable clothing.
- Avoid perfume, after-shave and heavily scented deodorant or body lotion on the day of LASIK.
- Eat a light meal on the day of LASIK and no alcohol.
- Be prepared to spend 1 - 2 hours at the LASIK Center.
- Avoid eye ointments for one day before LASIK.
- Take all regular medications unless otherwise directed.
NO hairspray, scented mousse or gel
NO perfumes, cologne or scented body lotions
NO strong tobacco odors on hands or clothing
NO face make-up including blush and scented facial creams
NO earrings or facial jewelry
Please visit our LASIK Procedure page.
The first 24 hours after your surgery are very important to ensure that the corneal flap adheres perfectly. In order to make you feel most comfortable and to speed-up your recovery, please adhere to the following instructions:
- Please wait one minute between drops to keep from washing medications out of the eye.
- Instill the eye drops with the help of a mirror. Simply look straight into the mirror, pull down your lower lid, and instill one drop. One eye drop is sufficient.
- IMPORTANT: Do not rub your eye(s) for the first week.
- Should you accidentally rub your eye(s), return immediately to the center for a flap check, especially if your vision is blurry or the eye is red or uncomfortable.
- Wear provided sunglasses on the way home to protect the eye(s) from accidental rubbing after surgery.
- Use the provided eye shield while sleeping for the first week after surgery.
- IMPORTANT: Do not make plans after your surgery. A four to six hour nap is required after your surgery. A sedative will be provided.
- No hot tubs for 2 weeks. Goggles while swimming are acceptable.
- No eye make-up for one week.
- Normal bathing/showering is acceptable; please try to keep water and shampoo out of your eye(s). Dab eyes gently to dry – DO NOT rub.
- Avoid contact sports for one month. (Please ask the doctor about limitations for other activities.)
- You may exercise 24 hours after surgery. If perspiration gets in an operated eye it may sting, but will not harm the eye.
- Your eye(s) may have red spots, which will diminish over the next couple of weeks.
- It is normal for your eye(s) to feel dry - this will improve. Use lubricating drops as directed above.
- There might be slight visual fluctuations in your vision. This will subside as the eye(s) heal.
- Please remember that everyone heals differently. Your progress will be monitored at your regularly scheduled post op exams.
Most patients have wonderful vision after LASIK surgery, and if we have determined that you are a good candidate for the procedure chances are you too will be very satisfied with your vision.
Although all LASIK candidates go through a very selective screening process and the most gentle and most precise surgical techniques available are used, minor irritations that last a few days sometimes occur. The following is a brief discussion of possible side effects and complications of LASIK. Some are common and some are extremely rare.
- The most common side effect after LASIK is “dry eyes”. This usually lasts a few days, and resolves spontaneously. Rarely this may cause intermittent blurred vision, and persist for up to three months. It can be helpful to place “punctum plugs” in the lower eyelids. This quick and painless office procedure reduces the normal drainage of tears into the nose, and keeps the eyes moist. Temporary plugs which dissolve after 90 days are often used. Permanent plugs last indefinitely and might be recommended as an alternative. An extra charge is applied for this procedure.
- Some patients experience night-time glare and halo effect around headlights or neon signs after LASIK. This typically resolves after 4-6 weeks. It is more severe in patients with high corrections and large pupils. Pre-existing night-time visual difficulties may be unchanged after LASIK. Custom ablation using Wavefront technology has a greater chance of reducing night-time glare and halo.
- Some patients require enhancement surgery to improve their vision after LASIK. This might occur in 5-15% of patients. Patients with high prescriptions, or who have had prior refractive surgery such as RK, are more likely to require an enhancement. It is important to wait 4-12 months to allow the vision to completely stabilize before an enhancement is considered. Occasionally, temporary glasses or contact lenses may be necessary during the waiting period.
- Eyestrain might occur if the vision is slightly different in the two eyes after LASIK. “Mono-vision” or “partial mono-vision” is often planned to allow the dominant eye to see at a distance, and the non-dominant eye to read up close. It is important to allow the eyes to work together and allow the brain to adjust to this vision. It is not helpful to compare the vision in the two eyes. Patients receiving mono-vision usually require reading glasses as they age for very small or detailed close work.
- Flap complications rarely occur. In order to obtain an excellent result, a perfect flap is required. In less than 1 in 1000 procedures the flap is either incomplete, has an irregularity or other problem. If such a situation arises, it is best for the procedure to be stopped, allow the eye to stabilize and continue the procedure a few months later. Most patients do very well if such an event occurs. Contact lens patients are usually permitted to wear their lenses during this waiting period.
- Dislocated flap . The flap may shift after LASIK, especially within the first 24 hours. This can cause visual distortion and requires prompt attention. Often this can easily be dealt with in the exam room, but sometimes a return trip to the OR is necessary. Avoid rubbing the eyes or getting debris in the eyes, especially for the first two weeks after LASIK.
- Inflammation under the flap (DLK) can arise. The cause of DLK is unknown, but DLK responds very well to frequent use of cortisone eye drops and tablets. Sometimes irrigation under the flap is helpful to speed up the resolution of the inflammation.
- Infection under the flap occurs in less than 1 in 10,000 procedures and responds well to treatment. It is important to keep all follow-up visits and report any redness, pain, blurred vision, or discomfort.
- Ectasia is a condition where the cornea progressively thins and becomes irregular after LASIK. LASIK is not recommended for persons with thin corneas or who may be predisposed to develop ectasia.
In summary, millions of people now enjoy the miracle of LASIK refractive surgery. The procedure is safe and effective. Major complications are extremely rare especially when proper pre-operative, surgical, and post-operative protocols are maintained.