severe myopia, astigmatism and 41 years of age.

[beetle]

My last exam showed a prescription of:

right eye -7.5 diopters, -1.75 x 040
left eye -7.5 diopters, -1.75 x 140

I know I have severe myopia, significant astigmatism, and steep corneas. I am a professional writer and historian, writing about 5-6 hours a day, sitting in front of the computer, and doing a lot of close work deciphering handwriting in old manuscripts. So while I don't think my myopia will get worse, it won't get better!

Am I a candidate for lasik? I am also 41 years old, and I think it is a real possibility that I'll fall prey to far sightedness, requiring bifocals. Should I just forget it at my advanced age, or would it be worth doing? I've never remembered getting up in the morning being able to see clearly, as I've worn glasses since I've been six, and it is a bit of a dream of mine to do so.

Thanks.

[LasikExpert]

Lasik may be an appropriate option for you, but the question would be what amount of correction would be best.

Because you are age 41 you are likely starting to have the effects of presbyopia. Presbyopia is when you become less able to focus on near objects and reading glasses or bifocals are required. Being myopic (nearsighted) is actually an advantage when you are also presbyopic. To see near objects a myopic person can just remove his/her glasses and focus is for near. Your problem is that your myopia is much too high to be very functional without corrective lenses.

If you decide to go for Lasik, I suggest you consider a deliberate undercorrection. Rather than target total correction of your myopia and run the risk of sudden presbyopia and requiring reading glasses to see objects near, consider a target of between 1.00 and 2.00 diopters myopic. You would need glasses when excellent distance vision is required, but you would likely be able to do your close work without any corrective lenses and you may be able to accommodate almost all tasks with a small amount of myopia .

You can try this before having Lasik. Ask your doctor for contact lenses that will make you about 1.00 to 2.00 diopters myopic, plus a pair of distance glasses. Try this for a few weeks and decide if this is for you.

Also, because of your high myopia you may want to be evaluated by a retina specialist. High myopia puts a lot of pressure on the retina to detach from the back of the eye and verifying the retina's health before any elective eye surgery is often a good idea.

[DocH]

Hi I am older than you and was a higher precription to boot. I also have worn glasses since an early age. I had lasik about 3 weeks ago. I have been left with an undercorrection in one eye (about -1.5) and although I had perfect vision in my othe eye at first, I have now regressed to an under corrected other eye (about -1) I have good near (reading) vision and computer/TV sight as I use my -1 eye most of the time but I need glasses still for distance (ie driving).
As I am only 3 weeks out I expect more changes but I def need a script for glasses now for far vision. From my reading of other posts from this excellent site, being undercorrected is better than being overcorrected.

[LasikExpert]

Lasik regression is common for people with more than 6.00 diopters of myopia (nearsighted, shortsighted) and almost all hyperopic (farsighted, longsighted) vision correction.

[tack77]

I appear to have a similar situation. Im -7.5 in each eye with -1.5 atigmatism. I asked about regression during my recent consultation and the dr told me that regression will often occur in the first year and will require an enhancement, is this true? With the package I was looking at, enhancment procedures are included within one year of the initial procedure.

[DocH]

Hi, I had both eyes done in June 09.
My right was never fully corrected and my left eye after surgery was. However the perfect left eye quickly regressed (ie within weeks, but I did start out at over -10!) but is great for close vision. So I decided to have my Right eye redone and to leave the L eye alone. I now have monovision and I love it (brain took a bit of a while to adjust).
I use my Right eye for distance and my Left eye for reading. No need for readers!
My Right eye has been stable since the re-do (7 months ago). I was worried as I had a lot of dry eye after the fist surgery but the second was much less.

[tack77]

Does anyone know about long term regression in severe myopes after LASIK? I mean let's say after the initial procedure and an enhancement you end up with satisfactory results. How is it typically 5 or even 10 years down the road?

[LasikExpert]

A March 2010 article published in the Journal of Refractive Surgery, entitled
"Comparison of LASIK and photorefractive keratectomy for myopia from -10.00 to -18.00 diopters 10 years after surgery."

PURPOSE: To compare the long-term outcomes of LASIK and photorefractive keratectomy (PRK) for high myopia (> or = -10.00 diopters [D]).
METHODS: This retrospective study included eyes with high myopia that underwent PRK (51 eyes) and LASIK (141 eyes) at the Instituto Oftalmologico de Alicante, Spain, and returned for 10-year follow-up.
RESULTS: Ten years after surgery, 45.5% of eyes in the LASIK group achieved uncorrected visual acuity (UCVA) of 20/40 or better compared to 31.3% in the PRK group. Mean efficacy indices after 10 years in both groups were similar (0.87 in the LASIK group and 0.82 in the PRK group, P=.51). Twenty-one (41%) eyes in the PRK group were within +/-1.00 D whereas 60 (42.5%) eyes from the LASIK group were within +/-1.00 D 10 years after surgery. Six (14%) eyes from the PRK group lost 2 or more lines of BSCVA compared to 7 (6%) eyes from the LASIK group.
CONCLUSIONS: LASIK and PRK have been shown to have similar visual acuity efficacy in the treatment of eyes with high myopia in the long-term, with LASIK having superior visual acuity efficacy and safety over PRK within the first 2 years after surgery. However, treatment of myopia > or =-10.00 D by LASIK is no longer routinely advocated whereas the treatment of high myopia by PRK is no longer performed due to potential complications associated with the treatment. Haze in postoperative PRK eyes was a significant long-term problem in our study.

BSCVA is Best Spectacle Corrected Visual Acuity (how well you see with glasses).