Health: Sweet beams

Alison Cork had her eyes opened to how laser treatment could correct shortsightedness - and it was well worth a little pain

Alison Cork
Monday 25 November 1996 19:02 EST
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`You can stop me any time you wish. It's not a problem with laser treatment." Very reassuring. However, with one eye clamped open and frozen with painkilling drops, the other covered with a patch, and a laser beam poised to zap my shortsightedness, I didn't feel in a position to give orders. In any case, before I could even contemplate doing so, the operation was over. Twenty seconds from beginning to end was all it took.

I always resented wearing spectacles; they made me feel defective. Consequently, I left them off more often than not. Contact lenses were never a serious alternative as I couldn't bear fiddling with my eyes, so laser treatment seemed like a gift from heaven. There was virtually no pain and lots of gain, not to mention instant freedom from the tyranny of glasses and, best of all, the chance to be a fully functioning human being once more.

"You must be mad," was most people's comment. Undeterred, I did my research and ended up in a Harley Street practice having an exhaustive eye test to establish whether I was suitable for treatment. The consultant explained carefully the pros and cons, namely that although most patients can throw away their glasses, there are occasionally side-effects such as over- or under-correction. The most obvious catch is that the procedure is relatively new and long-term results are still unknown. Despite the cost (from pounds 595 per eye depending on prescription) and dark looks from my family, the promise of life without glasses was too enticing. I decided to go ahead.

Operation day came. I woke up feeling positive, but as the time approached, I began to get apprehensive. What if I couldn't keep still enough and the laser burnt the wrong part of the eye? What if I was one of the unlucky ones who come out with a droopy eyelid? I wasn't the only nervous soul, by the look of others in the waiting area. One by one, we were moved to the pre-op room. I felt like a condemned man, sitting there surrounded by fresh orange juice and a huge television. Even worse, I could hear the thud of the laser machine next door - what was meant to be a gentle ticking sounded more like a faulty washing machine.

Just as I composed myself, the consultant came in and asked if I wanted to be part of an experiment. He had just returned from an American conference where he had heard that putting a lens into the eye after treatment resulted in much less pain than if the patient wore the standard eye patch. Would I like to be among the first to try? At that stage, I wasn't feeling argumentative - I decided to go along with it.

Moments later, I was in the laser room on a couch with the consultant's assistant putting freeze drops, which act as a local anaesthetic, into the right eye, the one being treated, and the one with the worst vision (they prefer treating one eye at a time). The consultant then clamped that eye to prevent blinking and put a patch over the left one. I didn't feel but saw a scalpel descending to scrape the surface of my cornea to prepare it for treatment. The consultant positioned the laser and told me to keep both eyes open and concentrate on the red dot. I was just girding myself for an acrid burning smell when we were finished. No smell, no pain, nothing. He put a soft contact lens on my eye and gave me sterile eye-drops and painkilling drugs. I was on my way home, wearing good sunglasses, 15 minutes after entering the laser room.

That afternoon, I drew the curtains and stayed in bed waiting for the pain, which normally starts a couple of hours after treatment. There was nothing except a slight pricking sensation, a watery eye and extreme sensitivity to daylight. On day two, I returned to the clinic as arranged. They said everything was proceeding as normal and that my right-eye vision had already improved to 6:15 (6:6 is equivalent to perfect vision and I was 6:60 in my right eye before the operation) - a massive leap in just 24 hours. I wasn't aware of much improvement because the eye-drops kept blurring my vision. Worse, I could feel the onset of a rather unpleasant pricking sensation. I felt a vague sense of panic - had I jeopardised what was left of my precious sight?

As the day progressed, my eye began to water profusely, and there were frequent sharp stabbing pains. I kept checking in the mirror to make sure I wasn't developing a droopy eyelid and went to bed early with another painkiller. At three in the morning, I was stamping about trying to counter the discomfort.

By the third day, the stabbing was so intense that I called the clinic and asked for more painkillers. They wouldn't give me any but suggested I come in. When I got there, they took out the lens - I felt more comfortable immediately. I was tested again - vision had improved to 6:12. "Excellent," was the consultant's verdict. I was still disappointed, as I didn't seem to have made much progress in reading the eye chart, and concerned that my right-eye vision seemed so blurred. They said they didn't want to see me for several days, which would give me time to take stock. I put on my sunglasses and scuttled back to my darkened bedroom.

The next day, I woke up to no pain and a very unfamiliar sight - the end of the bed. Something had happened during the night and I could see clearly out of my right eye. The laser treatment was working - what a glorious feeling. I braved the sunlight and spent the day on a complete high, rushing around reading out car number plates and street signs, just because I could.

On day eight, a further test confirmed that I had perfect vision in my treated eye - a week after the laser treatment. The consultant told me to go and live life. For the first time in 15 years, everything was clear. It felt fantastic and well worth two days of discomfort and anxiety. I threw away my spectacles in celebration.

A week later, I've concluded that laser treatment has changed my life. I love waking up and being able to see without having to reach for glasses. In the street, I look ahead rather than down at my feet - there's a whole new vista I don't want to miss. Colours and outlines, even those in the distance, are sharp and bright. I can leap into the car and drive without having to search for prescription shades. Running, swimming and gardening are infinitely more pleasurable when you're not getting steamy lenses or bashing into things. I have been to my first post-spectacle party, where I could see people before they saw me - very useful when you want to stay one step ahead of the game. Best of all, I feel like a whole person - working perfectly and unaided. It may not be a miracle cure, but in my opinion it's pretty close and I can't wait to have the other eye donen

fact file

l Laser treatment for permanent correction of short sight and astigmatism has been available in the UK for the past five years and has recently been introduced to treat long-sightedness. More than 1.5 million people worldwide have had laser surgery on their eyes.

l Myopia, or short sight, means the eye is unable to focus accurately because the eyeball is too long. With astigmatism, the eye focuses unevenly because the cornea varies in thickness.

l Using ultraviolet radiation, laser surgery removes microscopic quantities of tissue from the cornea, making adjustments to the eye's shape and focusing power. Most of the improved vision occurs within a week of surgery, but it can take up to three months for the eye to settle completely. Patients with higher degrees of myopia or astigmatism may still need glasses or contact lenses after treatment.

l The worse the problem, the greater the probability of post-operative complications. These include over-correction, under-correction, droopy eyelid and reduced quality of vision. More than 90 per cent of patients say they are satisfied with the results of laser treatment.

l The procedure is considered as elective surgery and is not available on the NHS or covered by health insurance.

l Laser surgery is irreversible. It does not, however, eliminate presbyopia (the need for reading glasses), a condition related to age and prevalent in the over-forties.

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