Louis Probst, MD
LASIK Surgeon

We use our eyes in virtually everything we do and depend on our vision perhaps more than any other sense we have. Sight is the most precious of the five senses, and many people fear blindness more than any other disability.

The eye allows us to see and interpret the shapes, colors, and dimensions of objects in the world by processing the light they reflect or give off. The eye is able to see in dim light or bright light, but it cannot see objects when light is absent. The eye changes light rays into electrical signals then sends them to the brain, which interprets these electrical signals as visual images.

The eye is set in a protective cone-shaped cavity in the skull called the orbit or socket and measures approximately one inch in diameter. The orbit is surrounded by layers of soft, fatty tissue which protect the eye and enable it to turn easily. Six muscles regulate the motion of the eye. Among the more important parts of the human eye are the iris, cornea, lens, retina, conjunctiva, macula, and the optic nerve.

Cornea
The cornea is sometimes referred to as the "window of the eye." It provides most of the focusing power when light enters your eye. The cornea is composed of 5 layers of tissue. The outer layer (the epithelium) is the eye's protective layer. This layer is made up of highly regenerative cells that have the ability to grow back within 3 days, and therefore, allow for fast healing of superficial injuries. Most of the inner layers provide strength to the eye. The laser vision correction procedure is performed on this part of the eye.

Lens
The lens is the clear structure located behind the pupil. Its primary function is to provide fine-tuning for focusing and reading. The lens performs this function by altering its shape to become thinner or thicker as necessary. Between the ages of 40 and 50, the lens becomes less flexible and presbyopia sets in. As people reach their 60's or 70's, the lens sometimes becomes cloudy and hard (cataract formation), preventing light from entering the eye.

Pupil
The pupil is the 'black circle' that you see in people's eyes. The primary function of the pupil is to control the amount of light entering the eye. When you are in a bright environment, the pupil becomes smaller to allow less light through. When it is dark, the pupil expands to allow more light to reach the back of the eye.

Iris
This is the colored part you see in people's eyes (i.e. blue/green/brown/hazel). The primary function of the iris is to control the size of the pupil. This is achieved through contraction or expansion of the muscles of the iris.

Vitreous Body
This is the clear 'gel like' substance located inside the eye's cavity. Its purpose is to provide a spherical shape to the eye. The vitreous may develop small clumps known as 'floaters,' which are more common in nearsighted people than in the rest of the population.

Optic Nerve
The optic nerve carries images from the retina to the brain.

Retina
The retina consists of fine nerve tissue which lines the inside wall of the eyes and acts like the film in a camera. Its primary function is to transmit images to the brain. When your vision is perfect, the light rays coming into your eye focus precisely on this part of the eye.

Sclera
This is the 'white part' that we see in people's eyes. The sclera's purpose is to provide structure, strength and protection to the eye.

The primary function of your eye is to focus light. You need glasses or contacts when your eye cannot properly direct light rays on the retina. The cornea, at the front of your eye, provides most of the eye's focusing power. The lens inside your eye provides the fine tuning of light, contributing to your ability to read. Light rays must focus precisely on the retina for you to see clearly. If you wear corrective lenses, you may have one of the following common refractive problems:

Myopia (Nearsightedness) occurs when your eye is too long in relation to the curvature of your cornea. With myopia, near objects are seen more clearly than distant objects.

More than 70 million people in North America (about one in four) are nearsighted. Myopia is the medical term for nearsightedness. It occurs when your eye is too long in relation to the curvature of your cornea. Myopia causes light rays entering the eye to focus in front of the retina, producing a blurred image.

The term "nearsighted" means that you can see objects that are "near" to you more clearly than distant objects. The more myopic you are, the more blurred distant objects appear, the higher your prescription in diopters and the thicker your glasses.

The table below shows the categories of severity for myopia:
Mild Myopia < -3.00 diopters
Moderate Myopia -3.00 to -6.00 diopters
Severe Myopia -6.00 to -9.00 diopters
Extreme Myopia > -9.00 diopters

Every patient and prescription at TLC is looked at individually to decide what is best for them. TLC doctors are very prudent and thorough in deciding whether you are a good candidate for laser vision correction and will be happy to discuss the potential outcome and risks involved for a patient with your particular prescription.

Hyperopia (Farsightedness) occurs when your eye is too short in relation to the curvature of your cornea. With hyperopia, distant objects are seen more clearly than near objects.

Light rays entering your eye focus behind the retina, producing a blurred image. Some farsighted people can use their focusing muscles to pull the image forward onto the retina, allowing them to see clearly. But others, who cannot overcome the effects of severe hyperopia, need glasses for distance vision as well as reading glasses or bifocals.

The table below shows the categories of severity for hyperopia:
Mild Hyperopia < 2.00 diopters
Moderate Hyperopia 2.00 - 4.00 diopters
Severe Hyperopia 4.00 - 6.00 diopters
Extreme Hyperopia > 6.00 diopters

Every patient and prescription at TLC is looked at individually to decide what is best for them. TLC doctors are very prudent and thorough in deciding whether you are a good candidate for laser vision correction and will be happy to discuss the potential outcome and risks involved for a patient with your particular prescription.

Astigmatism occurs when your cornea is shaped like an oval. With astigmatism, more than one focal point within the eye distorts what you see.

Many patients with myopia and hyperopia have some degree of astigmatism, or an oval shape, to their cornea. It occurs when your cornea is shaped more like a football than a basketball. As a result, you experience distortion or tilting of images due to the unequal bending of light rays entering your eyes. People with high degrees of astigmatism have blurred vision for both near and distant objects.

The table below shows the categories of severity for astigmatism:
Mild Astigmatism < 1.00 diopters
Moderate Astigmatism 1.00 - 2.00 diopters
Severe Astigmatism 2.00 - 3.00 diopters
Extreme Astigmatism > 3.00 diopters

Every patient and prescription at TLC is looked at individually to decide what is best for them. TLC doctors are very prudent and thorough in deciding whether you are a good candidate for laser vision correction and will be happy to discuss the potential outcome and risks involved for a patient with your particular prescription.

Presbyopia occurs as you reach your 40's or 50's. The lens inside your eye loses its elasticity, making it more difficult to read smaller print. Because laser vision correction does not deal with the lens of your eye, it can not correct this problem.

Presbyopia is part of the normal process of aging. It develops as the lens of the eye loses some of the flexibility that characterizes a younger eye. Everyone experineces the effects of presbyopia, typically between the ages of 40 and 50. Nearsighted people who become presbyopic may require bifocals in their forties, and those who never needed glasses before may require reading glasses.

Mild myopia counteracts presbyopia. That is why, if you're slightly myopic with presbyopia, when you remove your glasses you may still be able to read. Laser vision correction may treat your myopia, but you may need reading glasses for fine print to correct your presbyopia. Some presbyopic patients opt for monovision.

Every patient and prescription at TLC is looked at individually to decide what is best for them. TLC doctors are very prudent and thorough in deciding whether you are a good candidate for laser vision correction and will be happy to discuss the potential outcome and risks involved for a patient with your particular prescription.

Common refractive disorders of the eye such as myopia, hyperopia, astigmatism, and presbyopia are measured in units called diopters. Diopters represent the amount of correction you need to normalize your vision. The more nearsighted, farsighted, or astigmatic you are, the higher your prescription in diopters.

Your prescription is composed of three numbers:
-5.00 -1.50 x 180 represents a typical prescription

The first number -5.00 identifies your degree of nearsightedness or farsightedness. The sign identifies whether you are nearsighted (- sign) or farsighted (+ sign).

The second number -1.50 identifies your degree of astigmatism. The number can be written either with a (+ sign) or a (- sign).

The third number 180 identifies the axis, which indicates the direction of your astigmatism. An axis of 180 degrees, for example, means the astigmatism is horizontal.

Therefore, a prescription of -5.00 -1.50 x 180 indicates that the patient is moderately nearsighted, with a moderate degree of astigmatism in a horizontal direction.

In most cases, LASIK can treat the most severe degrees of nearsightedness, farsightedness and astigmatism. Candidates must have realistic expectations about their results- LASIK is not right for everyone. That's why TLC Laser Eye Centers affiliated doctors must be prudent when determining if you are a candidate.

To be a potential candidate for LASIK you must be at least 18 years old, in good general health, and have good eye health with no diseases such as cataracts or glaucoma. Only an in-depth examination of your eyes, your individual case, your expectations and your lifestyle by an experienced, licensed optometrist or ophthalmologist can determine if you are a candidate.

Eligibility
Good candidates are at least 18 years of age, in good general health, and with no eye diseases such as cataracts or glaucoma. A screening with your TLC eye doctor is the best way to determine if you are a candidate and what your probable outcome may be. If you do not have an eye doctor who is trained in laser vision correction, your local TLC Laser Eye Center will refer you to an experienced laser doctor in your area. TLC Laser Eye Centers also offer complimentary consultations.

Good candidates should be free of eye diseases including keratoconus, glaucoma, cataracts and certain retinal and optic nerve diseases. Candidates should be free of certain eye viruses including herpes simplex and herpes zoster. Good candidates should also be free of certain health problems including uncontrolled diabetes, autoimmune or collagen vascular disease, and any medication or condition which renders the patient immunocompromised.

Patients should make their doctor aware of certain eye problems including amblyopia (lazy eye), strabismus (muscle imbalance), severe dry eyes, previous eye surgery or injury, or any recurrent, residual or active eye conditions which may affect healing. Other conditions that should be related to the doctor include keloid scarring with previous surgical healing, back problems, claustrophobia or other psychological problems, which may affect the surgery or recovery.

It is critical that a potential laser vision correction candidate has obtained a stable prescription for at least one year. Since hormones may affect the stability of your prescription, pregnant or nursing women are not eligible to pursue laser vision correction until two menstrual cycles after nursing has been discontinued. This is to make sure that the best results are achieved with the surgery, and to try to limit fluctuations in prescription that can occur with hormonal shifts.

If you'd like to talk with someone who has had laser vision correction with TLC, we'd be happy to put you in touch with patients who can describe their experience to you firsthand.

TLC Laser Eye Centers offers FREE consultations to help determine if you're a good candidate for laser vision surgery (LASIK, Custom LASIK and Bladeless LASIK). Please call 1 877.TLC.2020 or click here to book your FREE consultation online NOW!

Pre-Operative Education
In general, to be a candidate for laser vision correction you should:

• be at least 18 years of age or older
• have stable vision for a year prior to the procedure
• be free of certain diseases of the cornea and retina
• be in good general health

Aside from these general requirements, we recommend that before you proceed with laser vision correction, you take advantage of TLC's complimentary pre-procedure consultation at one of our centers. This consultation, or a similar screening from a TLC affiliated doctor, is mandatory prior to having your procedure at TLC. This is because we feel it is critical that you have both the correct testing and education prior to proceeding with having laser vision correction.

The primary objective of the consultation is to determine whether you are a candidate for laser vision correction, and if so, which procedure is most appropriate for you. Equally as important, we educate you about whether or not laser vision correction is right for you, and the benefits and risks associated with this type of surgery.

Learning everything you can about your options is the key to making an informed decision. We will help you understand what results you can reasonably expect after the procedure given your particular prescription and circumstances. If you schedule a consultation, there is no obligation to move forward with the procedure.

It is important for you to realize that even if it is determined that you are not a candidate today, it does not mean that you will not be a candidate in the future. The technology for vision correction is constantly being enhanced, enabling higher and more difficult prescriptions to be qualified. However, laser vision correction is not for everyone, and some patients (those with certain diseases of the eye involving the cornea and retina) will never be candidates. The best way for you to find out is by having a thorough examination with TLC.

Procedure Day
On the day of your procedure, you should arrive at the TLC center as rested and relaxed as possible. You will need to sign an informed consent (at some Centers, this may occur prior to the procedure day), which we will go over with you prior to your procedure. It's natural to feel a mixture of eager anticipation and nervousness before your procedure.

The day of your procedure, you should avoid alcohol and medications that cause drowsiness. Otherwise, there are no restrictions on eating, drinking or medications. On your procedure day, wear comfortable clothing, but do not use creams, lotions, eye makeup, perfume, hair spray or wear earrings.

Contact lenses change the shape of your cornea. Since LASIK treats your cornea, it's important to allow time for your cornea to return to its normal curvature by not wearing contact lenses prior to your exam or to your procedure. See the chart on this page for exact details.

Prior to your procedure, your eyelids and lashes will be cleaned and antibiotic, anti-inflammatory and anesthetic drops will be placed in your eyes. A mild sedative may be given. Although most patients say there is no pain during the procedure, some report feeling mild pressure or vibration.

Be sure to bring someone to drive you home, or make other arrangements for transportation. You should allow approximately two to four hours for the entire process.

Once you are prepared for your procedure, you will be escorted to the laser suite for treatment. You will enter the laser suite and lie on your back in a reclining chair. Your surgeon uses information from your extensive testing to set a surgical plan that is then programmed into the laser. The computer calculates the required corneal treatment and directs the laser. Your TLC surgeon programs and operates the laser during your procedure.

The success of your laser procedure depends on several factors including the expertise of your doctor and staff, and the sophistication of the equipment. At TLC Laser Eye Centers, our primary objective is to provide you with the best results, the greatest degree of safety and the most advanced technology.

Post-Operative Care
After the LASIK procedure, your eye may feel irritation or a foreign body sensation, or your eye may tear or water for a few hours. If you experience discomfort, your doctor may suggest you take a mild pain reliever. Most patients are quite comfortable after taking a short nap while wearing the protective eye shields. Some LASIK patients may wear the eye shields while sleeping during the first few days. Do not rub your eyes during the early healing stage. It is not unusual for dryness in your eyes to last for several days. In some patients this can be longer.

Most LASIK patients notice dramatic visual results within the first few days following their procedure. However, the speed of visual recovery depends on personal healing patterns, patients with higher prescriptions may recover more slowly.

Returning to Normal Activities
Many patients return to work within a day or two of the procedure. You will need to follow the restrictions mentioned below. Otherwise, as long as you follow your doctor's instructions, you should be free to resume all your normal activities.

• Wait one full day before taking a shower.
• Wait one day to one week, as your doctor advises, before resuming driving.
• Wear sunglasses for the first few days.
• Read and watch TV in moderation the first few days.
• Do not wear eye makeup for four days.
• Do not rub your eyes for one week.
• Do not exercise for one week.
• Avoid swimming, hot tubs and whirlpools for one week.
• Avoid gardening and dusty environments for one week.
• Avoid contact sports that could result in an eye injury for one month.
• Smoking is allowed, but you will probably find smoke very irritating.

Follow-Up Care
Follow-up care and eye medications are just as important to your results as your actual procedure. Ideally, your own eye doctor provides this care, but it may also be performed at TLC Laser Eye Centers. Periodic examinations are required to ensure that your eye is healing as expected, to verify that there is no evidence of infection, and to measure your visual progress. Each appointment takes between 5 to 15 minutes.

Patients must also use prescribed antibiotic and anti-inflammatory eye drops during recovery. LASIK patients use eye drops for four to seven days.

Annual eye exams are important, we strongly recommend that everyone, not only laser vision correction patients, have a dilated eye exam performed by their eye doctor every year. This is a proactive way to ensure that your eye is healthy and functioning properly.

Follow-up Appointment Schedules After LASIK:
1 Day
1 Week
1 Month
3 Months
6 Months