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Lasik and Mountain Climbing, Skiing, Alpine Sports

Altitude considerations with Lasik, Bladeless Lasik, PRK, LASEK, Epi-Lasik, etc.

Topographical map of a central island after Lasik  
An expedition to Mt Everest including six climbers who had Lasik proved that refractive surgery can be safe for extended altitude exposure.  

Vision On High

Visual complications can occur at high altitudes in those who have not undergone conventional or custom wavefront Lasik, Bladeless 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, Bladeless Lasik, PRK, LASEK, Epi-Lasik, and RK, however a 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.

Looking For Best Lasik Surgeon?

If you are ready to choose a doctor to be evaluated for conventional or custom wavefront Lasik, Bladeless Lasik, PRK, or any refractive surgery procedure, we recommend you consider a doctor who has been evaluated and certified by the USAEyes nonprofit organization. Locate a USAEyes Evaluated & Certified Lasik Doctor.

Personalized Answers

If this article did not fully answer your questions, use our free Ask Lasik Expert patient forum.

Recent Lasik and Extreme Sports Medical Journal Articles...

Related Articles

Effects of refractive surgery in extreme altitude or space.

J Cataract Refract Surg. 2012 Aug;38(8):1307-8

Authors: Kohnen T

PMID: 22814035 [PubMed - indexed for MEDLINE]


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