Eyesight Getting Worse? Learn More About Laser Vision Correction

Learn why Cleveland Clinic Cole Eye Institute is among the world’s most advanced eye centers, and is ranked best in Ohio, according to US News & World Report’s Best Hospital Survey, offering the latest in prevention, diagnostics and treatment options for a wide spectrum of eye conditions — from the routine to the complex.

If you have 20/20 vision, or wear glasses or contacts to correct your vision, you may think you’re doing everything right to protect your eyesight. But as you get older, you have a higher risk of common causes of blindness, including cataracts, glaucoma and age-related macular degeneration.

Reduce Your Risk

“You can take steps to reduce this risk,” says J. Scott Lane, MD, an ophthalmologist at Cleveland Clinic Willoughby Hills Family Health Center. To protect your vision long term, Dr. Lane recommends that you:

• Mind the sun. It’s just as important to protect your eyes as it is to protect your skin. Excessive exposure to ultraviolet (UV) rays can damage the front and back of your eyes and contribute to a number of problems that lead to vision loss. Choose a good-quality pair of sunglasses that wrap around your eye area. And make sure the lenses provide 100 percent UV spectrum protection.
• Get your vitamins. Research shows that a number of nutrients can help protect your vision. They include vitamin A (found in animal-based foods such as liver, oily fish and cheese), vitamin C (found in many fruits and vegetables), vitamin E (found in sunflower seeds, nuts, avocado and plant oil) and lutein (found in leafy green vegetables).
• Follow the 20/20/20 rule. Staring at a computer, smartphone or tablet screen for hours every day strains your eyes. (Computer vision syndrome is a real thing.) Take a 20-second break every 20 minutes to look 20 feet away, relax your eyes and let yourself blink.

When To Get Your Eyes Checked

The most important way to keep your eyes healthy, however, is to have regular eye exams.

“Seeing an eye doctor isn’t just for getting an updated glasses prescription,” says Dr. Lane. “Eye exams can help detect early signs of eye disease, even those not yet causing symptoms. It’s best to treat these conditions early to minimize vision loss.”

The American Optometric Association recommends this schedule for healthy adults:

• Ages 18-39: At least one eye exam every two years.
• Ages 40-64: One eye exam per year.
• Ages 65 and older: Two eye exams per year.

If you have an eye condition or other medical condition, schedule eye exams as recommended by your health care provider. And if you notice a sudden change in your vision, see your eye doctor — either an optometrist or ophthalmologist — as soon as possible.

Both optometrists (who have an "OD" after their name) and ophthalmologists (who have an "MD" or "DO" after their name) can conduct exams and prescribe glasses or contact lenses. Both also can prescribe medication and treat most eye diseases, although only ophthalmologists perform eye surgery. If you have a serious eye condition, you’ll typically see a specialist (ophthalmologist).

What Are the Best Options For Laser Vision Correction Surgery?

Explore three common options

Laser eye surgery is one of the most commonly performed elective surgeries in the country today. But it’s not the only vision correction surgery out there.

Today, a variety of laser procedures can correct nearsightedness, farsightedness and astigmatism by reshaping the cornea so that it reflects light properly onto the retina. This can cut down your need for glasses or contacts — in most cases, it might even eliminate the need for them altogether. And most of the time, it can be done in an outpatient center in under an hour.

See the appeal?

“All laser vision correction or refractive surgeries work by reshaping the front part of the eye, so that light traveling through it is properly focused onto the retina located in the back of the eye,” explains Cleveland Clinic ophthalmologist James Randleman, MD. “There are a number of different surgical procedures used to reshape the eye.”

Dr. Randleman discusses the three types of laser vision correction surgery:

Photorefractive keratectomy (PRK)

PRK was the first laser-based refractive surgery approved by the Food and Drug Administration (FDA). During the procedure, the surgeon removes the outer surface layer of the cornea and uses a laser to reshape the cornea into a new curvature that fits the prescription of the patient’s eye.

PRK is generally associated with some post-procedure discomfort and a slightly longer recovery time. However, it may be recommended because it yields better long-term results in cases where the eyes are not suitable for LASIK, such as when the patient’s corneas are thin.

Laser in-situ keratomileusis (LASIK)

LASIK delivers the same outcomes as PRK but with a quicker recovery time and less discomfort.

In LASIK, a thin flap is created in the top layer of the cornea and the underlying tissue is reshaped by the laser. The flap is then replaced and serves as a buffer to protect the newly treated tissue from irritants, such as your blinking eyelid. Visual recovery and healing are more rapid than in most other procedures.

Small incision lenticule extraction (SMILE)

SMILE, the newest iteration of laser eye surgery for nearsightedness, uses a very precise laser to create a disc-shaped piece of tissue inside the cornea that can be removed through a small incision.

It delivers similar vision correction as LASIK but without creating the flap, so there is less disturbance to the corneal nerves, and SMILE may be a better option for people who have dry eyes or higher corrections who may have been told they were not LASIK candidates in the past.

Lens-based refractive surgery

Even for patients who are not candidates for any laser vision correction surgery, there may still be great treatment options available.

For patients with high nearsightedness, the implantable collamer lens (ICL) functions similarly to a permanent contact lens that is placed within the eye and yields excellent visual results even for patients who have astigmatism. Refractive lens exchange (RLE), a procedure similar to cataract surgery, is also an option for patients with extreme prescriptions or those who have early cataract formation.

“As technology and lens implants continue to evolve, patients have many choices when it comes to correcting their vision,” says Dr. Randleman. “You may want to have a comprehensive eye examination with a specialist to determine which procedure will result in the best outcome for your eyes.”

Vision Changes After 40

As you age, the muscles in your eyes gradually lose their ability to focus at different distances (presbyopia). The lens in your eye, which is normally clear, begins to get cloudy (cataract). These changes happen to everybody, usually starting around age 40.

But not every vision change is age-related. See your doctor if you notice:

• Changes in color perception.
• Worsening peripheral vision or parts of your vision that are missing.
• Double vision.
• Sudden vision changes.
• Vision that does not improve with reading glasses from the pharmacy.

Rest assured, presbyopia and other eye conditions are treatable. From glasses and contacts to implants and surgery, there is a wide range of options to help you see clearly again.

Your Eyes Can Reveal Other Health Problems

Eye exams can reveal more than just eye health. They can reveal diseases affecting your whole body. For example, your eyes can show signs of:

• Diabetes. The blood vessels in your eyes can be damaged by diabetes even before you have any vision problems. Laser treatment and medication can repair these blood vessels. Severe bleeding may require surgery.
• High blood pressure. Impaired blood flow to your eye can be the first clue that you have a blood pressure problem. Blocked blood vessels in your eye could even predict a future stroke.
• Inflammatory conditions. Inflammation in the eye — which can cause permanent damage if not treated — can be a sign of Crohn’s disease, ulcerative colitis, multiple sclerosis and lupus.
• Metastatic cancer. Melanoma can show up in your eyes. So can breast cancer, which can be detected in your eyes before other tests show it has spread.

26 Convenient Locations Across Northeast Ohio

Cleveland Clinic Cole Eye Institute offers a comprehensive range of eye care services including routine eye examinations and evaluation and treatment of the following: cataract, glaucoma, diabetic eye disease, pediatric eye conditions, macular degeneration, dry eye, eyelid disease, laser vision correction, advanced technology lens implants and cosmetic eyelid surgery.

Visit Cleveland Clinic Cole Eye Institute to learn more, or call 216-444-2020 to schedule an appointment with an ophthalmologist or optometrist today.