I got my eyes done on Friday, November 23, 2007, the day after Thanksgiving, with a procedure called Lasik Intralase. I'm quite happy with how things turned out, but I'm still far from seeing perfectly.  I'm seeing well, so well that I can make out the tiny twigs at the tops of trees at a distance, but my vision sometimes gets cloudy. My doctor told me that vision would fluctuate for some time, but that I can expect to see 20/20 after my full recovery. After the surgery, I was back to work Monday (3 days since surgery), and almost everyone asks how it was, and wants to know how it works. Here's as detailed an explanation as I can give.

Understand when you read this, that this may not be the kind of surgery that your eye doctor recommends, or that you may not even be able to have this surgery. Your vision needs to be stable for at least a year, and to be on the safe side, a bit longer. Luckily mine was. Want to see some pictures of my eyes? ( They're NOT works of art!)

The procedure I had is called Lasik Intralase, which is a bit different from the original Lasik. I'm not going to get into all the differences between Lasik, PRK, and other procedures here. You need to look this up yourself. Frankly, I really didn't care about the differences, I just trusted my doctor to know what he was doing, and luckily I didn't need to worry.

But worry I did. As a photographer, this could have been a nightmare, but I was ready to do the procedure because I had waited and seen 3 people I knew go through laser eye surgery 10 years ago, and have seen that they're ok. Two of those three had their surgeries done at these facilities.

Along the way, I'll have some photos and diagrams, though, again, your experience may differ based on the kind of surgery you can have.

UPDATE: I had my 1-week post-op exam, and managed to pick up a brochure which I'd not seen before. With Dr. Donnenfeld's permission, I've posted important pages from it here.

Are you eligible? 

So, first, let's start at the beginning. When you decide to do this, the first thing that happens is you go to a place to find out if you're even eligible for laser eye surgery. I went to Opthalmic Consultants of Long Island, at Mercy Hospital in the town of Rockville Center back in August of 2006 on the recommendation of my friend Cheryl. Their phone number, if you wish to pursue this, is 516-766-2519. Dr. Eric Donnenfeld was my surgeon, and his site is http://www.lasikli.com .

There, after filling out the usual forms, I was seated in a waiting area until my turn. Again, this was going to be a test to see whether my vision could be corrected in the first place, and whether my insurance covered it. When I was next, I went with a technician who first assessed my eyesight with a regular eye chart. After that, I was asked to stick my chin on some chin rests of very neat-looking machines which image the shapes of your eyeballs as you look through a tiny hole with a farm scene inside. There were, perhaps, 2, or 3 machines with different tasks, and I moved from one to the next.

After this initial phase, I was given some eye drops to dilate my eyes, and sent back to the waiting room, with some magazines and a TV. Of course, while in a waiting room at the doctor's what does one do? Read magazines, you say. So there I was trying to read magazines with my glasses on, and I couldn't focus. I couldn't read one damn thing.

After I got smart about it, I found I could read if I took my glasses off, or I could just watch TV. It was actually some  kind of cruel joke, if you ask me, to send patients into a waiting room full of magazines that they wouldn't be able to read. But once the wait was over, and they were sure my eyes were dilated enough, I went with another tech so that they could so some more checking.

Finally, I landed in a room where I got to meet my doctor, Dr. Donnenfeld (a rather tall man), and he checked my eyes, looked over the pretty graphs, looked at the computer-generated diagrams and told me that while my cornea was a little on the thinner side, I was still a good candidate, and he was confident that Intralase was going to be a good option for me. I think he also gave me the option of PRK, but it seemed that Intralase's description appealed to me more.

I then went into an office to meet with David, a client relations representative from TLC (The Laser Center), the company that contracts with doctors to use its facilities to do the procedure. David gave me some paperwork to read, explained some of what I'd be going through, and then we shook hands, and I went off happily to consider the procedure. The biggest problem in my mind was that, even with all discounts for using our Insurance Carrier, the bill would come to $5300. No small chunk of change, and I'd need to use the medical Flexible Spending Account (FSA) to pay for it. 

So I waited

For almost a year. When I finally decided that we'd indeed have the money in the FSA (and nothing crazy happened to deplete it), I contacted David from TLC again. After a few more questions on my part, I made the appointment for the procedure, and David told me to make a separate appointment with Dr. Donnenfeld again, for the "Pre-Op" exam, and a third appointment at TLC before the exam.

At the Pre-Op with Dr. Donnenfeld, I was again given some dilating drops and my eyes were checked. One of the machines had concentric circles, in the middle of which was a little hole to look through. There was a small light inside, and I was asked to keep looking at that. As the technician did her job, the concentric circles lit up from inside to outside, one at a time, and again my eye was imaged. Second eye, same thing.

When all was over, I again met with Dr. Donnenfeld who sat me in a regular eye doctor's chair, and examined the inside of my eyes ("Look at my ear... look up...uh-huh...") while shining a terribly bright light into them. And again, he said he was confident about the procedure. When I was getting ready to go out, I realized that having my eyes dilated would be a difficult situation. The sun shone brilliantly outside, and everything had a white aura. It was too bright! I squinted as I drove myself all the way home (I should have been warned to bring some shades).

The visit to TLC's facilities for the other appointment was generally the same thing, with different instruments, so I won't spend time on this part of it.

The Big Day

So, leading up to Thanksgiving, I was pretty calm. Even on the morning of the procedure, Friday, I was still calm. I was actually more excited than nervous. On the way there, my wife asked what would be the best thing about getting my eyes fixed up.

In true Photography Geek fashion, I said, "The feeling of my camera up against my nose, with nothing to get in the way!" And I stand by that still, even if I haven't been able to use my camera yet. In close second, would be the ability to go to the beach or pool, and swim without my glasses, and still be able to see; and in third place, getting up in the morning and knowing what time it was on the digital clock on my wife's side.

Yes, it's the little things. 

When we got there, I was given some forms to fill out, permissions and waivers to sign (that's always worrisome) and then I paid. One small problem. The credit card I'd brought, though with more than enough room, was expired, and they would not accept it. As a last-ditch effort, I had to pony up my AMEX Corporate Card for the payment. After all, it's my corporate expense card for work, but it's still my responsibility, so ... 

Dr. Donnenfeld had told me that I could if I wanted, request a Valium. And so, when asked, I accepted, though I don't think it did much. Once past the legalities and paperwork, I was taken inside to be prepped: my eyes were cleaned with saline; blue surgical covers were put over my shoes and hair, and cotton pressed up next to my ears, held in place by the elastic of the surgical hair net. And then an anesthetic was dropped into my eyes.

I had signed a waiver for my wife to be able to see the procedure, and as we waited my turn we saw someone else's procedure on the video monitor from behind the glass of the laser room.

My turn

So finally, it was my turn. The written instructions I had received had told me to wear warm clothing as the laser room is kept cool, but of course, I had underestimated how cool. But lucky for me they had a blanket handy for all the patients.

I was asked to lie down on what seemed like a dentists chair. The chair was situated between two machines. It was explained to me that one machine would make the cut so Dr. Donnenfeld could flip open the retinal flap, and then the second computer-controlled machine would do the actual restructuring of the lens.

Cheryl, my friend, had told me of her experience that they put an eye cup on you to keep your eye open, and that during the second eye, she got a little queasy because of the pressure. I didn't think much of it then, but would soon find out what she meant. She had also told me that you can smell a little burning when they do the procedure. I wondered how it was I was supposed to keep my eye so perfectly still for the whole procedure.

When everyone was in the room (Dr. Donnenfeld, and 2 assistants) we began. Numbers were read aloud, checks were done. Then came the eye cup. What a surprise! The pressure was much more than I expected, and I reacted instantly by stiffening up, and trying to regulate my breathing so as not to panic. The cup serves to keep your eyes open, allow it bulge out a little, and keep it perfectly still. So much for worrying about how to keep still.

Once the eyecup was on, my vision began clouding up a bit. I felt them swing me under the first machine. A point of light was shining, I was looking at it, and Dr. Donnenfeld explained that they were about to make the flap cut. Once it was done, I felt some light rubbing on my eye and saw some shapes, and all of a sudden the sharp point of light spread out and dissipated. From having seen the other patients' procedures on the monitor, I knew that he had just lifted the flap and lightly folded it over. 

The second laser was lined up. The actual reshaping was beginning, and I remember Dr. Donnenfeld walking me through it all, though I can't remember anything he said. All I could see at that point was a purplish, translucent, "sense of light" that circled the periphery of my vision, and I could hear the "tick-tick-tick" of the Femtosecond laser firing. Oh, yes, and the very slight waft of burning, as if someone had singed a hair.

And then finally, when the ticking had stopped, I felt and saw something happening in front of my face again. The flap was put back in place, and I began to see the cloudiness return, and things stopped looking like I was seeing through a frosted glass block. Dr. Donnenfeld was putting finishing touches on my retinal flap.

Then, the second eye, same thing all over again.

The full procedure took no more than 10 minutes. I was asked to get up, and was guided out of the room, and into an examining room, where I sat in the chair as Dr. Donnenfeld examined his work, looking into my eyes with one of those giant optometrist's devices that let him see inside my eyes.

"Uh-huh, uh-huh, I like it,  ... I like it!" he grinned.

Nothing like that kind of confidence from your doctor to make you feel like you made the right choice, and that you weren't going to go blind after all!

After the exam, he brought out a pair of clear plastic eye shields, and taped them over my eyes (see the picture). Then he brought out a kit in a small black bag and gave me instructions on how to use it. it contained a solution, some more tape for the eye guards, and a pair of pretty cool shades. 

I would have to wear the eye guards for the full first day, and for 4 nights when sleeping. I imagine this was probably so I wouldn't accidentally poke myself in the eye. And I would have to use the solution and another one I'd be picking up from the pharmacy, every 4 hours. He also said, as did others, that it might be best if I slept a little when I got home.

After all was said and done, the good doctor made an appointment for me to come back the next day to make sure all was kosher.

My wife and I went out to the car, and she drove us home. 

The days after 

The first few hours, my eyes were a bit light sensitive, but nothing painful in that regard. The discomfort I felt was mostly due to the stinging and tearing, which was normal. I could have taken Advil or Tylenol, but it really wasn't that bad at all.

We had left the kids at my parents, so we went back there. I saw in the mirror that my eyes had some pretty nasty blood spots, but I was told they'd go away. After milling around some, I took the advice of the doctors and technicians from before, and went upstairs to sleep awhile. When I came down, we took the kids home, and my friend Cheryl showed up to do some work with my wife. For some time, I took my plastic eye protectors off, just to see what it was like. And though I was seeing as if I had my glasses on, it was still too early, and I had the feeling that there was some film I was seeing through. My eyes still stung, and I put the protectors back on.

That night, I slept great. 

The next morning, I kept my eye protectors on when I went to get examined again. I was told I didn't have to wear them during the day, but that I should keep them on when sleeping.

For the next few days, I began reveling at my re-found vision. Sometimes things would go blurry, and then clear up. At times it was like looking through fog. Once again, I could see the very smallest twigs at the tops of trees. However, navigating lights is tricky: I was warned that for a while I'd see halos and starbursts, and see them I did. Driving, especially, though doable, is not comfortable.

I've been taking the eye drops I was given. One is clear, the other milky, and I also have some lubricating drops I need to keep on hand.

Today, Wednesday, 5 days after my procedure, I find that my vision has regressed slightly. In the morning I could feel that my left eye was not in focus. Reading a newspaper on the train, I sensed was more difficult than in the previous days. And then when I sat down in front of my computer at work, it was a struggle to see the letters, though with my distance-vision a little better, I could see the Citigroup building that stands just north of us, perfectly. 

I read that it could take upto 2 weeks to rid my eyes of the superficial blood spots. And my vision may fluctuate for upto 6 months, and reading could be a little difficult. But as long as it's normal, I'm happy that my vision is back.

I can still remember that day back in junior year in high school, when I determined I needed glasses. Back then, I thought it would be cool. And while it's nothing tragic really, to have glasses, again, it's the little things you miss.

Saturday morning, the day after my procedure, I woke up, brushed my teeth, washed my face, and was greeted by my 5 year old asking me how I was. And at that exact moment, I was able to see from 6 feet away, without glasses, how big and beautiful her eyes really were!

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