Vision On High
Visual complications can occur at high altitudes in those who
have not undergone conventional or custom
wavefront
Lasik,
All-Laser Lasik,
PRK, or similar
refractive surgery. Those who have had Lasik may be at an elevated
risk due to changes in the cornea after surgery, however many mountain
climbers who have had Lasik have had no significant problems.
Climbers who have reported serious problems including severe
corneal surface changes, corneal
edema, retinal hemorrhaging,
retinal
ischemia
and cerebral ischemia which sometimes lead to blindness.
Emmetropic
patients have also reported transient changes in visual acuity at
higher altitude. The primary concerns for mountain climbers is with
dry eyes and lack of oxygen to the cornea.
In all reported cases of vision problems when mountain climbing,
visual acuity returned to normal levels after a few weeks at lower
altitudes.
Dry Eyes
A concern with extended mountain climbing is the drying effect
at altitude. It may be necessary to keep the eyes wetted with preservative-free
eye drops. Cleaning contacts in the environment of mountain climbing
is often difficult. Fogging of spectacles is a common problem that
is worsened when using supplementary oxygen. Supplemental oxygen
supplies often do not provide moisture at levels consistent with
sea-level humidity.
Eye Surgeons On Top
The change in the oxygen levels, atmospheric pressures, extreme
cold, and other factors may cause fluctuation in visual acuity in
patients who have had conventional or custom wavefront Lasik, All-Laser
Lasik, PRK,
LASEK,
Epi-Lasik, and
RK, however a recent climb of Mt. Everest organized by ophthalmologists
Geoff Tabin MD and Jason Dimming MD, who are also mountaineers,
shows that long exposure to elements at high altitudes with Lasik
is not significantly more problematic than for climbers without
refractive surgery. Dr. Tabin's climb is one of the few studies
to look at the effects of
hypobaric
hypoxia
on the cornea following Lasik and the only one examining the phenomenon
at such altitude.
Five of the six climbers reported no subjective visual changes
at up 26,400ft. One team member reported some blurring of vision
above 16,000ft and two climbers reported similar problems above
27,000ft.
Lens Based Unaffected
Lens based refractive surgery procedures like
RLE and
P-IOL are less likely to be abnormally affected by altitude
because they do not dramatically change or weaken the cornea.
Little Limitation, However...
Many recipients of refractive surgery continue to participate
with extreme sports without difficulty. Any person intent on participation
in any extreme, unusual, or strenuous sport should first talk to
a doctor about how it may affect their particular situation. Discussing
the concerns with others who are familiar with the sport may provide
additional insight. Chances are someone who already has experience
with the activity of interest has had refractive surgery.
Always error on the side of caution. Although it is obviously
possible, It is not likely that an ophthalmologist is going to be
on Everest to help if you experience vision trouble.
Like In The Movies
In the movie Into Thin Air, an account of an ill-fated
Mt. Everest expedition based on Jon Krakauer's book of the same
name, one of the climbers abandons his attempt to the summit after
losing his eyesight. He blames the problem on having had RK, and
the extreme altitude. The guide in the movie chastises the climber
for not disclosing the surgery in his medical history. Once the
climber returned to lower altitudes, his eyesight returned to normal.
The movie is based on a true story but is only a movie and is
anecdotal at best. The story does illustrate the need for disclosure
and knowledgeable information,. As an increasing number of ‘tourists’
are found showing up at base camps at mountains throughout the world,
an understanding of the effect of extended exposure at altitude
altitudes above 10,000ft and the eyes is too often overlooked.
If you are ready to choose a doctor to be evaluated for conventional
or custom
wavefront
Lasik,
All-Laser Lasik,
PRK,
LASEK,
Epi-Lasik,
NearVision CK,
RLE, or any
refractive surgery procedure, we highly recommend you consider
a doctor who has been evaluated and certified by the USAEyes
nonprofit organization. Locate a USAEyes Evaluated & Certified
Lasik Laser Eye Surgery Doctor.
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