Thinking About LASIK in Alpharetta? What to Know Before Your Consultation

Short answer: LASIK can free many nearsighted, farsighted and astigmatic adults from glasses and contacts, but it is not right for every eye. A good candidate is 18 or older with a prescription that has stayed the same for at least a year, a cornea that is thick enough and regular in shape, and healthy eyes with dry eye under control. Before you book a consultation anywhere in the Atlanta area, it helps to know your own eyes. At Reimbold Eye Group in Alpharetta we map your cornea, check for dry eye and keratoconus, explain which procedures fit your numbers, and refer you to a refractive surgeon when surgery makes sense. If it does not, we have very good options that need no surgery at all.

What LASIK actually does

Glasses and contact lenses bend light before it enters the eye. LASIK changes the eye itself. The surgeon uses one laser to create a thin flap in the front of the cornea, folds it back, and uses a second laser to reshape the tissue underneath so light focuses on the retina. The flap is laid back down and heals on its own. The procedure takes minutes per eye, and most people see well within a day or two.

Because LASIK works by reshaping the cornea, the health and shape of your cornea decide almost everything: whether you can have it, how much correction is safe, and which alternative might be better.

LASIK is not the only laser option

When people in Alpharetta, Milton and Johns Creek search for LASIK, they often do not realize there are several procedures, each suited to different eyes:

• PRK: no flap. The surface layer of the cornea is removed, the laser reshapes the tissue, and the surface grows back. Recovery is slower and more uncomfortable for the first few days, but PRK can suit thinner corneas or people in contact sports and some careers where a flap is a concern.
• SMILE: the laser shapes a tiny disc of tissue inside the cornea, and the surgeon removes it through a small opening. It is used for nearsightedness with or without astigmatism.
• Implantable lenses (ICL): a thin lens is placed inside the eye in front of your natural lens. It is an option for high prescriptions or corneas too thin for laser surgery.
• Refractive lens exchange: the natural lens is replaced with an implant, much like cataract surgery. It is usually discussed in the 50s and beyond. Our guide to cataract symptoms and when to consider surgery explains lens implants.

These procedures are done by ophthalmologists. If you are not sure who does what, our post on choosing an optometrist or an ophthalmologist explains how the two work together.

Are you a good candidate?

You are more likely to be a good fit if:

• You are at least 18, and your prescription has been stable for a year or more.
• Your corneas are thick enough and evenly curved on a corneal map.
• Your eyes are healthy, with no active infection, uncontrolled glaucoma or significant cataract.
• Any dry eye is treated and under control before surgery.
• You are not pregnant or nursing, since hormones can shift your prescription.
• You understand the trade-offs, including a chance of night glare or halos and the need for reading glasses later in life.

Reasons a surgeon may say no, or not yet

The most important one is keratoconus, a thinning and bulging of the cornea that often starts in the teens and twenties. Laser surgery that removes corneal tissue can make it much worse, so it has to be ruled out first, and a corneal map is the way to do it. Others include a prescription that is still changing, very high prescriptions, large pupils in dim light, autoimmune conditions that slow healing, and moderate to severe dry eye, which LASIK can make worse for months.

Why a thorough eye exam comes first

At our office on Old Milton Parkway, just off GA-400, a pre-LASIK visit is a full medical eye exam plus measurements that matter for surgery:

• Corneal topography, a color map of the shape of your cornea that can reveal early keratoconus or irregular astigmatism.
• A careful refraction, compared with your past prescriptions to see whether your eyes have settled.
• A dry eye workup, looking at your tear film and oil glands. If drops have not been enough, read why dry eye drops stop working.
• A dilated look at the retina, especially for nearsighted eyes, which have a higher risk of retinal thinning and tears.

You can see the instruments we use on our eye exam technology page. We share the results and images with the surgeon you choose, so nothing is missed and you are not paying to repeat basic tests.

Questions to ask at a LASIK consultation

• Which procedure do you recommend for my eyes, and why that one over PRK, SMILE or an implant?
• What do my corneal thickness and topography show?
• What are my chances of needing a touch-up, and is it included in the price?
• How will you treat my dry eye before and after surgery?
• What will my vision be like for reading in my 40s and 50s?
• Who handles follow-up visits, and how many are included?

Clear vision without surgery

If LASIK is not right for you, or you simply prefer not to have surgery, there are good choices:

• Ortho-K: custom lenses you wear while you sleep gently reshape the cornea, so you can see clearly during the day without glasses or contacts. It is reversible, and it works best for mild to moderate nearsightedness. Learn about DreamSculpt ortho-K. One caution: ortho-K changes the cornea, so if you later decide on LASIK, you will need to stop wearing the lenses for a while first.
• Daily disposable or toric contacts, which correct most prescriptions, including astigmatism. See how to correct astigmatism without surgery.
• Scleral lenses for irregular corneas that are not safe for laser surgery. Read about our scleral and specialty contact lenses.
• Great glasses. Thin, high-definition lenses in a frame you love are still the simplest answer. Our custom luxury lenses and face shape glasses guide can help, and our post on glasses or contacts compares everyday wear.

After LASIK

Most people are back to work in a day or two. Dry, scratchy eyes are common for the first weeks to months, so keep up with the drops your surgeon recommends. Glare and halos at night usually fade as the eye heals; our article on night driving glare covers habits that make headlights easier to handle in the meantime. Keep up your yearly eye exams: LASIK changes the focus of the eye, not its health, and glaucoma, cataracts and retinal problems still need to be checked. Protect your eyes outdoors with quality sunglasses, too. Our guide to UV protection in sunglasses explains what to look for, and you can browse our designer sunglasses.

And in your 40s, close-up focus will start to fade even after a perfect result. That is presbyopia, and our page on presbyopia options covers readers, progressives, multifocal contacts and eye drops.

Frequently asked questions

How old do you have to be to get LASIK?

The lasers used for LASIK are FDA approved for adults 18 and older, but age alone is not the test. Surgeons want your glasses or contact lens prescription to be stable, usually for at least a year, because an eye that is still changing can drift out of focus again after surgery. Many people in college or their early twenties are still changing, which is why a yearly exam history helps.

Can I get LASIK if I have astigmatism?

Often, yes. LASIK, PRK and SMILE can all correct common amounts of regular astigmatism. Irregular astigmatism from a misshapen cornea, such as keratoconus, is a different story: laser surgery that thins the cornea can make it worse, so it is usually ruled out. A corneal map at your exam tells the two apart.

How long do I need to stop wearing contacts before a LASIK consultation?

Your surgeon will give you exact instructions. Contact lenses press on the cornea and change its shape a little, so measurements taken while you still wear them can be off. Soft lenses are usually stopped for days to a couple of weeks, and rigid, scleral or ortho-K lenses for longer, because they change the cornea more. Bring your glasses so you can see in the meantime.

Will I still need reading glasses after LASIK?

Probably, at some point. LASIK fixes the focus of the eye at the time of surgery, but it does not stop presbyopia, the normal loss of close-up focus that starts in the 40s. Some people choose monovision, with one eye set for near, and others simply use readers later. Our page on presbyopia options covers the choices.

Does insurance cover LASIK?

Most medical and vision plans treat LASIK as elective and do not pay for it, though some vision plans offer a discount through partner surgeons. Many people use a health savings account or flexible spending account. Ask the surgeon's office for a written quote that lists what follow-up visits are included.

Start with an eye exam in Alpharetta

Wondering whether LASIK, ortho-K or new lenses are the best fit for you? Schedule an exam with our eye doctors, and we will map your corneas, check for dry eye, and give you an honest answer before you spend money on a consultation. Book online or call 770-776-9000. Reimbold Eye Group is at 4180 Old Milton Pkwy 1-D, Alpharetta, GA 30005.