People considering surgical vision correction should make sure they are clear about their options, advises Richard Abbott, MD, UCSF professor of ophthalmology and co-director of the UCSF Vision Correction Center. "There are important issues that people need to be aware of in order to make a knowledgeable decision," says Abbott, who has developed guidelines to assist ophthalmologists in ensuring that their patients are adequately apprised.

Abbott discussed these factors from the patient's point of view at a media briefing Tuesday during the American Academy of Ophthalmology annual meeting in San Francisco.

He encourages patients to:

• Understand the risks and benefits of the surgical and nonsurgical procedures for correcting vision.

• Request a demonstration of under- and over-correction as possible outcomes of surgery.

• Learn the pros and cons of having a particular procedure performed in both eyes at the same time.

• Ask about the options for correcting reading vision, in addition to nearsightedness, if the patient is approaching, or has reached, middle age.
  While laser and corneal ring implant procedures can correct nearsightedness, patients who are in their late 30s or 40s may still need correction for near vision, which usually means wearing glasses. An alternative option is obtaining "monovision," in which the nearsightedness in one eye is corrected to its full extent but is undercorrected in the other eye, to help the person read. People with monovision wear contact lenses. "President Reagan wore a strong contact lens in one eye and a weaker contact in the other," says Abbott. "This is not a consideration for 20 year olds, but it often is for older patients."

• Be aware that there is a very slight increased risk of eye damage from air bags--or any other form of trauma--in the first few years following radial keratotomy surgery.
  In this procedure, deep surgical incisions are made in the cornea in a spoke-like pattern, flattening the cornea to shorten the distance light rays must travel to the retina.
  "A tennis ball, racket or other cause of a blow to the eye can slightly increase the risk of eye damage following radial keratotomy, but probably only in the first few years following the procedure," says Abbott.
  Radial keratotomy is now used much less frequently than it once was. The procedure has been replaced to a large extent by laser procedures and other forms of vision correction.

By Jennifer O’Brien

1st appeared 10/30/97

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