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LASIK & Refractive Surgery Co-Management

If you are considering undergoing refractive surgery, co-management is an option which has many benefits as it involves a team of eyecare specialists including the surgeon who will perform the operation, in addition to your optometrist who will be with you before and after the procedure to provide all the care you need and to answer your questions every step along the way.

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There are a variety of refractive surgery methods, all which require proper supervision before, during and after the procedure by eyecare professionals. The surgeon performing the refractive surgery may not be the same eye doctor who provides your eyecare before and after the procedure, in which case it’s referred to as ‘co-management’. The benefits of co-management are that your optometrist who is your primary eye care professional knows you well and can guide you throughout the process. Your optometrist will spend as much time with you as you need and will answer your questions every step of the way. Your optometrist can recommend a surgeon that you can use who is an ophthalmologist that specializes in refractive surgery. You will go to the surgeon’s clinic for the refractive surgery. 

If you are considering refractive surgery, please schedule an appointment at our office to meet with our optometrist. The optometrist will discuss with you in depth both the advantages and disadvantages of each type of procedure and together you will decide what is best for your lifestyle and health. The optometrist will perform an initial evaluation to decide if you are a candidate for the surgery. If you decide to proceed with refractive surgery, your optometrist will do a very comprehensive eye exam with pupil dilation and will take various measurements of different parts of your eyes. After the operation, you will need to be monitored by your optometrist who will make sure that your eyes are healing properly and will assist you if any complications arise. 

The most common refractive surgery is LASIK which stands for laser-assisted in situ keratomileusis and is used to correct nearsightedness, farsightedness or astigmatism. It is a very effective surgery with quick results as most people can see 20/20 within 24 hours of the surgery. There are a variety of refractive surgery methods, each comes with their own benefits and risks and require proper medical supervision before, during and after the surgery.

Prior to Surgery

Your optometrist will play an important role in planning your refractive surgery. If you are considering refractive surgery, please schedule a consultation at our office to meet with your optometrist.

This appointment will involve:

  • Detailed medical history
  • Comprehensive eye exam
  • Measurement of corneal thickness
  • Measurement of pupil size
  • Thorough check of ocular health
  • Discussing different refractive surgery options in depth to figure out the best method for you
  • Setting realistic expectations for procedure and results
  • Discussing normal side effects of surgery, possible complications and post-operative care

Your optometrist will decide if you qualify for refractive surgery and if you meet the requirements, you will be referred out to a clinic where there is an ophthalmologist who specializes in refractive surgery and he or she will be the surgeon who performs the operation. Your optometrist will send your medical information to the surgeon and you will have a consultation with the surgeon prior to the procedure. In this case, there will be co-management which involves the surgeon and your optometrist who will be there for you before and after the operation.

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Post-Operative Care

After surgery, you will be scheduled for post-op care at your optometrist’s office, often the day after surgery, then a week after, followed by a month afterwards. Some people are monitored for up to a year after surgery, depending on their experience and results. These appointments include:

  • Eye exams to check vision
  • Monitoring of the healing process
  • Review of patient medication 
  • Diagnosis and treatment of any complications
  • Evaluation of further necessary vision improvement such as reading glasses or laser enhancement procedures

The Role of the Optometrist for Co-Management

The actual refractive surgery will be performed by the surgeon who is an ophthalmologist that specializes in refractive surgery. However, going through LASIK or refractive surgery requires more steps than just the operation itself. Your optometrist will be with you before and after surgery to help with the decision making process, the preparation prior to surgery and the post-op healing process.

The role of your optometrist in this process includes:

  • Providing information and guidance to patients debating if to go through refractive surgery
  • Evaluating if a patient is a proper candidate for the operation
  • Performing comprehensive eye exams to establish if the patient qualifies for surgery and to provide the surgeon with necessary information prior to surgery
  • Monitoring patients throughout the process and answering their questions
  • Providing glasses or contact lenses if needed (such as in between surgeries of each eye)
  • Continuing to monitor the patient post-op and continuously afterwards, as even patients who no longer depend on glasses or contact lenses still need eye exams and eyecare, including during the ageing process
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Common Questions

Age 18+, Healthy eyes, Good overall health, Prescription of glasses/ contact lenses that qualify for LASIK, Sufficient corneal thickness which will be measured by the eye doctor, Stable vision with a prescription that hasn’t changed in at least a year, Not pregnant or breastfeeding, Pupils that are not too large.
Please consult with your eye doctor to find out if LASIK could be the right approach for you. It is often not recommended if you have: Overall good vision, Very thin corneas, Keratoconus or a family history of this or any other corneal disease, Large pupils, Dry eyes or other eye conditions. It is also not recommended to people who are prone to eye injuries, such as athletes who participate in contact sports. In addition, this surgery is not performed on patients who are pregnant or breastfeeding.
It is extremely unlikely that LASIK surgery will result in blindness or severe vision loss, although complications can occur. No cases of blindness have been reported due to LASIK. In fact, 99% of LASIK patients achieve better than 20/40 vision after the procedure. Over 90 percent of people achieve 20/20 vision or better. The LASIK procedure is so successful that more than eight out of ten people no longer need to wear glasses or contacts as a result.
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Summary

LASIK and other refractive surgeries are performed in order to reduce the need to wear glasses or contact lenses. There are high success rates for these procedures, but you need to be monitored by a professional eye doctor before, during and after the surgery. Your surgeon may co-manage your case along with your eye doctor who will perform the tests before and after the operation. If you are considering refractive surgery, please schedule an appointment with your eye doctor to see if it’s the right choice for you.

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