Vision – Separating Fact from Fiction
I googled a basketful of folk tales about ophthalmology and took them to eye surgeon Arthur Benjamin. Some were debunked, but some were confirmed.
“The results from laser correction surgery don’t meet expectation. Doctors would never perform Lasik on their own eyes”.
Laser vision correction is an operation that doctors willingly perform on themselves (I am one of the examples), their children, parents, wives, and mother-in-laws. I’ll be straight-forward: the operation to get rid of myopia and astigmatism has stable results and is safe-enough, if you’re in the hands of an experienced surgeon with modern equipment. Candidacy for surgery depends on a multitude of factors. If your vision is -10, it’s unlikely you’ll be suitable for Lasik, but there are other methods of surgical correction.
And with farsightedness it works out the same?
Not quite. In that case, laser correction is not permanent, but it will be good for 10 years. The fact is that the processes that lead to farsightedness do not stop.
There’s an idea that glasses negatively affect vision. The eyes become accustomed to good vision and then deteriorate.
Wearing glasses neither hurts nor helps vision. When in doubt, it’s generally better to go with glasses. You put on glasses and the brain adapts to good eyesight, but anatomically and physiologically nothing changes. However, if you stop wearing them, the brain forgets again how you saw every single needle on the fir tree. If you have age-related farsightedness, you’re 43, and you can’t see your phone or make out a price tag, you can put on glasses and see everything again. But upon removing them, you decide that now you see everything worse than before. The only time you need to be exceedingly careful as to when to wear or not wear glasses is with children and children’s myopia.
Then there’s the thing about carrots again. In all grandmothers’ recipes are blueberries, honey, spinach, carrots, as the surest means to preserve visual acuity. Is this the case?
In earlier times, and in countries that will remain nameless, there was not enough produce, and thus there was a shortage of micronutrients, vitamins, and minerals. Now you can find them in any supermarket. Even if you eat the simplest and most inexpensive meals, there’s enough of all these elements. But with macular degeneration, exposure to ultraviolet light, or exposure to cosmic radiation, it can start to not be enough. One study found that if you take beta-carotene and zinc in certain doses, it really slows down the process of macular degeneration. You should be careful here, as well, because there are several different kinds of vitamins. Supposedly, this same beta-carotene (found in carrots) is dangerous for smokers, and makes them more susceptible to lung cancer.
So is it better for a smoker not to eat carrots?
It’s better for smokers to just quit smoking.
Or start smoking carrots.
Do poor-quality cosmetics affect vision, or leaving it on overnight?
It’s about the same as never changing your underwear. Makeup can clog the small glands that are responsible for the irrigation of the eyes, and it creates an environment for bacteria. It’s better to use a warm compress, remove your makeup every night, and apply drops.
And computer or tv screens? What if you’re around them 10 hours a day, like I am?
In the context of large monitors, like televisions, there was a thing called “computer vision syndrome”. Among the electronic rays shown on the screen was a frequency that the eyes couldn’t see, but the brain could perceive, and this affected vision: it reduced the nictitans reflex and increased dryness, as well as expose the viewer to some level of radiation. Current LCD monitors do not have this frequency, so they are most likely safe.
But what about sitting in front of a monitor in the dark? Still bad?
“Do not watch tv at night” and similar slogans are all untrue. Watch tv in the dark, if you like, or read under a blanket with a flashlight.
My eyes quickly get tired in the dark, though.
That usually happens: when you watch something up close for a long period of time, a spasm of accommodation might occur. Even if you have artificial lenses, the eyes still try to accommodate and the muscles fatigue. The eyes need to periodically shift from close-up to distant objects, like glancing out the window at birds.
And mobile phones? Many are reading “Arabian Nights” and “War and Peace” on their phone and using Facebook.
It’s the same; no harm is done. Just look up sometimes and remember there’s more to life. There was a theory that blue light tires out the eyes, so on the iPhone there’s a function called night time, and it replaces blue light on the screen with yellow, which will supposedly tire you less. But there’s no evidence to support this.
Is it true that sunglasses do more harm than good?
When you wear them, the world becomes darker and your pupil expands. So if your glasses don’t block ultraviolet light, then an even greater amount enters your eye. All glasses sold in the United States, however, are legally required to have this protection. The glassware, of its own accord, does not allow UV light through.
But usually these glasses are plastic. Jack Nicholson always wears sunglasses indoors; isn’t that harmful?
In this case, there must be a special protective coating, and it’s only harmful in the sense that you might trip over something.
And the eternal question – reading lying down.
When you lay down, your eyes gravitate toward the nose, and this causes the muscles to get more tired than usual, but in principle reading while lying down is not dangerous.
Many believe that Lasik is more dangerous than contact lenses.
It’s actually the opposite. Contacts are much more dangerous – they can cause eye infections and dryness, and sooner or later everyone who wears contacts will have these problems, which can potentially translate into a loss of vision. Lasik, on the other hand, is not just the safer option, but also the cheaper one. Contact lenses are a foreign body in the eye, which once again can attract bacteria.
“Lasik increases light diffusion or halo effect, reducing quality of vision.” Is this true?
Now that’s a myth. It was like that with the old lasers, where spherical aberration took place. With newer Lasik, the patient won’t experience this. The technology has been updating for 5 or 6 years now.
And after Lasik you might get dry eye syndrome? Is that a myth?
That’s true. All Lasik in some way causes dryness, but it’s temporary. If the candidate for Lasik has very dry eyes, the procedure cannot be done. When you plant new grass, it needs to be watered a few times a day until it takes root. After this happens, you can cut back to once a day. It’s the same thing here: you create a flap with the laser and cut the nerve endings, and until they grow back there will be some dryness. The younger the person, the faster the healing; a 20-year-old won’t have any dryness after a week or two. I was 40 years old, so I had to use drops for a couple of months.
Are there often complications after Lasik?
There are, just like with any operation, but with an experienced surgeon no more than 1-2%. And 99% of the complications are related to the flap, which can be done manually with a keratome device, or with a laser. Yes, it’s significantly more expensive, but complications are very rare and there’s less dryness. And there isn’t an age limit on Lasik.
After Lasik, sooner or later, comes age-related farsightedness and cataracts, and the operation needs to be done again. But this time it’s in difficult conditions…
It’s true. People who have Lasik need to keep all of their medical data. With cataracts, they do measurements that calculate how the lens sits. They are made with specific estimates, but if you’ve had Lasik before, it makes those calculations ineffective. For example, results might say that everything should be 20/20, but it turns out it’s +2, and the guy has become accustomed to getting along without glasses. So don’t forget that you’ve had Lasik and remember how your vision was up until then, because there’s no guarantee that your former doctor retained all that data (like we do here). Data should be kept for 7 years, but if the doctor retires, boards up the office, and no one knows where he is… in that case, we can make special measurements, and, by the grace of God, we have a machine that can scan the eye after cataract removal and give you data, on the basis of which you know how the lens sits. Clearly, this is reflected in our prices.
“Yoga treats myopia.” Indeed, one thing that I have not seen is people wearing glasses in yoga.
Yoga is very useful; it strengthens the body and soul. But it has no effect on vision.
“There are eye “gymnastics” that can prevent these problems.”
The muscles of the eye are the fastest in the body, and they don’t need exercises. The muscles exercise themselves; vision is a passive process. The ciliary body also doesn’t need to be inflated. The less you “exercise” it, the better. I would advise, rather, to develop the brain – puzzles, crosswords, and intelligent conversations.