LASIK (Laser-Assisted in Situ Keratomileusis) corrects vision by reshaping the cornea, allowing many people to shed their glasses and contact lenses. While freedom from corrective lenses benefits water sports enthusiasts, the high-pressure environment of scuba diving poses a unique concern. The procedure creates a delicate corneal flap, and this structural alteration conflicts with the intense pressure changes experienced during a dive. This guide provides safety guidelines for a successful return to underwater exploration after vision correction.
Understanding LASIK and Pressure Risks
Caution after LASIK stems from the temporary structural vulnerability of the cornea. During the procedure, a thin, hinged flap of corneal tissue is created, lifted, and then replaced after the underlying tissue is reshaped by a laser. The flap does not bond immediately; it adheres over time via natural suction and healing processes.
The rapid changes in ambient pressure during scuba diving ascent and descent pose a risk to this healing flap. Pressure differentials could theoretically cause micro-movement or displacement, compromising the surgical outcome. If microscopic gas bubbles were trapped beneath the flap during the procedure, they would expand upon ascent (Boyle’s Law), placing outward stress on the healing tissue.
A rare complication is epithelial ingrowth, where surface cells migrate underneath the flap. While this can happen spontaneously, mechanical stress from pressure changes could encourage this migration. A sufficient period of complete corneal adhesion is necessary before a diver can safely return to depth.
Recommended Waiting Times for Diving
A phased approach to water activities is advised to protect the healing cornea and prevent infection. Non-submersion activities like showering or light exercise are typically allowed within the first 24 to 48 hours. Exposure to surface water, such as swimming or snorkeling, requires a longer waiting period, generally one to two weeks, often requiring protective goggles to prevent contact with contaminants.
The timeline for returning to scuba diving is significantly longer due to pressure and infection risks. Most ophthalmologists recommend a minimum waiting period of four weeks before attempting shallow, recreational dives. This four-week mark is when the corneal flap has usually achieved sufficient adhesion to withstand minor pressure fluctuations.
For deeper or more technical dives, specialists advise extending the waiting period to two or three months. Deeper dives subject the eye to greater absolute pressure changes, increasing strain on the healing tissue. Clearance to dive should only be granted by the treating ophthalmologist after an examination confirms stable vision and secure flap adhesion.
Ongoing Ocular Management for Divers
Once clearance is secured, former LASIK patients must adopt specific management techniques to protect their eyes while diving. A primary concern is mask squeeze, which occurs when pressure inside the mask is lower than the surrounding water pressure. Mask squeeze can cause localized suction on the eye, potentially leading to corneal irritation or minor bleeding.
Divers must ensure their mask fits properly to create a comfortable seal. It is important to equalize mask pressure frequently during descent by exhaling air through the nose into the mask. Maintaining excellent mask hygiene and avoiding contaminated water is important, as infection remains a risk even after full healing.
Post-LASIK dry eye is a common side effect, often exacerbated by the dry, compressed air from a scuba tank. Divers benefit from using preservative-free lubricating drops immediately before and after a dive to maintain corneal moisture. Staying well-hydrated throughout the dive trip also supports the eye’s natural lubrication.
How Other Eye Surgeries Compare
The risks associated with diving are largely specific to the flap created during LASIK. Other refractive surgeries, such as Photorefractive Keratectomy (PRK) and Laser Epithelial Keratomileusis (LASEK), offer a different risk profile. These surface ablation techniques involve removing the outer layer of the cornea (the epithelium) and reshaping the underlying tissue directly without creating a permanent flap.
Since the epithelium regenerates and heals naturally, there is no risk of flap displacement or flap-related complications under pressure. This is why surface ablation procedures are often favored for individuals in high-impact professions, such as military pilots, where the eye may be subject to extreme trauma or pressure. The long-term structural integrity of the cornea is considered stronger with these flap-free methods.
The trade-off for this stability is a significantly longer and more uncomfortable initial recovery compared to LASIK. While LASIK patients often see clearly within a day, PRK and LASEK patients may require several weeks for the epithelium to heal and several months for vision to stabilize. The choice between LASIK and surface ablation depends on the patient’s corneal thickness, lifestyle, and willingness to endure a longer recovery for potentially greater long-term stability.