Customized LASIK Procedure to Correct Blurring of Vision

The LASIK procedure has significantly enhanced vision for millions worldwide by correcting common refractive errors such as nearsightedness, farsightedness, and astigmatism.

What is Custom LASIK?

Custom LASIK uses advanced wavefront technology to map individual corneal irregularities, ensuring a more precise correction than traditional LASIK. Unlike conventional methods that rely on standard prescriptions, custom LASIK tailors treatment to each patient's unique corneal characteristics.

Advantages of Custom LASIK

• Enhanced precision in vision correction by addressing corneal aberrations.
• Improved contrast sensitivity and night vision.
• Reduced risk of visual distortions such as halos and glare.

Potential Side Effects

Like any medical procedure, LASIK may have side effects, including:

• Dry eyes
• Glare, halos, or starbursts around lights
• Blurred or hazy vision
• Light sensitivity
• Overcorrection or under-correction

These effects typically subside over time, though in rare cases, they may persist.

Understanding the Cornea and Its Importance

The cornea is the outermost layer of the eye and plays a crucial role in vision by allowing light to enter and contributing about 70% of the eye's focusing power. It measures approximately 12mm in length and 11mm in height.

Structure of the Cornea

The cornea is composed of five distinct layers, each serving specific functions:

• Epithelium: The outermost layer, which acts as a barrier against dust, debris, and bacteria while also absorbing nutrients and oxygen.
• Bowman’s Layer: A tough layer made of collagen fibers that protects the stroma.
• Stroma: The thickest layer, consisting of collagen fibrils and keratocytes, which maintain corneal transparency.
• Descemet’s Membrane: A thin but strong layer that protects against infections.
• Endothelium: The innermost layer responsible for maintaining fluid balance within the cornea.

Keratoconus: A Progressive Corneal Disorder

Keratoconus is a condition where the cornea becomes thin and bulges into a conical shape, causing distorted vision and high astigmatic error. It typically begins during puberty and progresses faster in younger individuals.

Symptoms of Keratoconus

Symptoms vary by severity and may include:

• Frequent changes in eyeglass prescriptions
• Increased astigmatism
• Blurred or distorted vision
• Inability to achieve 20/20 vision with corrective lenses

Diagnosis of Keratoconus

Diagnostic tools for keratoconus include:

• Keratometry: Measures the curvature of the cornea.
• Corneal Topography (Pentacam): Provides a detailed map of the corneal shape.
• Anterior Segment Optical Coherence Tomography (ASOCT): Assesses corneal thickness.

Treatment for Keratoconus

Step 1: Halting Disease Progression

Corneal Collagen Cross-Linking (CXL): A non-surgical procedure that strengthens the cornea using riboflavin drops and controlled UV radiation. This treatment is especially beneficial for adolescents with a high risk of progression.

Step 2: Vision Rehabilitation

• Glasses and Contact Lenses: Useful in mild cases but may be insufficient in advanced stages.
• Rigid Gas-Permeable (RGP) Lenses: Provide better visual clarity by masking corneal irregularities.
• INTACS (Intracorneal Ring Segments): Clear plastic rings inserted into the cornea to reshape its curvature.
• Topography-Guided Custom Ablation Treatment (T-CAT): A laser-based procedure that improves corneal symmetry.
• Implantable Collamer Lenses (ICL): Permanent lenses placed inside the eye for refractive correction after corneal stabilization.

Neuro-Ophthalmology

Neuro-Ophthalmology is a super specialty that merges the fields of neurology and ophthalmology. Neuro-ophthalmologists diagnose and manage complex nervous system diseases affecting vision, eye movements, alignment, and pupillary reflexes.

When Should You Visit a Neuro-Ophthalmologist?

Your eye doctor may refer you to a neuro-ophthalmologist after a comprehensive eye exam if special care is needed. Symptoms requiring attention include:

• Visual hallucinations
• Sudden vision loss
• Double vision (diplopia)
• Intractable headaches
• Sudden light sensitivity
• Color identification difficulties
• Pupillary abnormalities

Common Neuro-Ophthalmology Diseases

• Optic Neuritis: Inflammation of the optic nerve, often linked to Multiple Sclerosis.
• Papilledema: Swelling of the optic nerve due to increased brain pressure.
• Toxic or Nutritional Optic Neuropathy: Damage due to tobacco, alcohol, or nutrient deficiencies.
• Strabismus: Misalignment of the eyes causing double vision.

Diagnosis and Treatment

Tests such as MRI, CT scans, and optical coherence tomography help in diagnosis. Treatments vary based on the underlying condition and may include medication, surgery, or vision therapy.