As of Friday, July 5, 2013
DEAR DOCTOR K: I’m in my 50s and considering LASIK surgery. Should my age be a factor when deciding whether to have this procedure?
DEAR READER: I can understand why you’re considering LASIK (laser-assisted in-situ keratomileusis). It can correct common eye problems — nearsightedness (myopia), farsightedness (hyperopia) and astigmatism — and can eliminate your need for glasses or contact lenses.
LASIK corrects vision by reshaping the cornea, the clear dome at the front of the eye. The procedure is painless, and complications are few when the doctor is experienced. (I’ve put a detailed illustration of the procedure on my website, AskDoctorK.com.)
As LASIK has become more popular, many of us have contemplated having our vision surgically corrected. Even in your 50s or beyond, if your eyes are otherwise healthy, LASIK surgery can produce excellent results.
Age itself isn’t a big factor in deciding whether to have LASIK surgery. Surgical outcomes are similar regardless of age. But you and your doctor should consider the following age-related eye conditions when making the decision:
— Cataracts. With age, the lens of the eye can become clouded. If this happens, the clouded lens can be removed and an artificial one implanted. If you’ve already had LASIK surgery, it’s trickier to choose the correct lenses for cataract surgery. If there’s any sign of clouding, your ophthalmologist may recommend cataract surgery first, and to reconsider LASIK surgery only after the cataract surgery has healed.
— Glaucoma is caused by increased fluid pressure within the eye. The pressure affects the optic nerve, which starts in the back of your eye, leads to the brain and allows you to see. If glaucoma is untreated, it can lead to blindness. Ophthalmologists screen for glaucoma by checking intraocular pressure (fluid pressure inside the eye) and looking for optic nerve damage.
LASIK surgery leads to lower intraocular pressure readings. This may interfere with early diagnosis. Tell your ophthalmologist if you’ve had LASIK when you are being screened for glaucoma. You should not have LASIK if you have moderate or severe glaucoma. If your glaucoma is mild and easily managed, you may still be a candidate for the surgery.
— Dry eye syndrome. With age, your eyes produce fewer tears. LASIK often worsens dry eye. Any ophthalmologist you see about LASIK should ask you about whether your eyes have a tendency to be dry, but just in case they don’t ask, be sure to mention it.
— Presbyopia. In our 40s and 50s, we become less able to focus clearly on near objects. That’s because the lenses inside our eyes get stiff, and a stiff lens can’t bend light in the way that’s necessary to see near objects. The usual remedy is to wear reading glasses. LASIK doesn’t prevent presbyopia. If you have LASIK in your 40s, you’re still likely to need reading glasses within the next 10 years or so.
The price for LASIK varies by doctor and by community. The average price may be around $2000-$2500. Health insurance generally does not cover the cost.
Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, r write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.