While the idea of eye surgery may cause anxiety, LASIK (Laser-Assisted In Situ Keratomileusis) is not considered a painful procedure, though patients should expect intense pressure and temporary discomfort. This common procedure corrects vision problems by reshaping the cornea using a precise laser. The entire process is performed while the patient is awake, but measures are taken to ensure the experience is virtually pain-free. Understanding the sensations felt during the brief surgery and the recovery period can help manage expectations.
Preventing Pain During the Procedure
The primary method for eliminating pain during LASIK is the application of topical anesthetic eye drops, which temporarily block nerve signals. These drops are administered just before the procedure and ensure the patient does not feel the laser or instruments. The anesthetic effect lasts long enough to cover the surgery’s duration, typically only 10 to 15 minutes for both eyes.
To prevent blinking, a small instrument called a lid speculum is gently placed beneath the eyelids to hold them open. A suction ring is also applied to the eye’s surface to stabilize it and maintain a precise position for the laser. While the speculum may feel unusual, it does not cause pain since the anesthetic drops have taken effect.
The suction ring raises the pressure within the eye, which is the main source of the feeling of intense pressure. This apparatus prevents eye movement, ensuring the correct area of the cornea is treated. Sometimes, a mild oral sedative is offered before the procedure to help a patient relax, reducing anxiety and the perception of discomfort.
Sensations Experienced During LASIK
Although the eye is numb, the patient will experience several distinct sensations. The most significant is intense, firm pressure when the suction ring is activated to create the corneal flap. This pressure often causes a temporary loss of vision, described as a blackout or dimming, which is a normal occurrence as blood flow is momentarily affected.
This blackout is temporary, lasting only a few seconds to up to 35 seconds, and vision returns immediately after the suction is released. While the excimer laser reshapes the cornea, some patients report noticing a unique smell. This odor results from the laser vaporizing microscopic amounts of corneal tissue, often described as similar to burnt hair.
The laser itself is a “cold beam” that does not generate heat, producing a rapid clicking or buzzing noise. The patient is asked to focus on a target light during this process. The sensations felt during the brief procedure are generally pressure, sound, and smell, not sharp pain.
Managing Post-Operative Discomfort
The numbing drops typically begin to wear off about 30 to 90 minutes after the surgery, marking the start of discomfort. This recovery phase is characterized by a “foreign body sensation,” where the eyes feel gritty, as if sand is stuck beneath the lid. Other common symptoms include burning, excessive tearing, and increased sensitivity to light.
This post-operative discomfort is generally mild and peaks in the first four to six hours. Patients are advised to go home immediately and sleep for several hours with their eyes closed to minimize irritation and help the cornea heal. Protective eye shields are worn, especially when sleeping, to prevent accidental rubbing, which could dislodge the corneal flap.
Managing discomfort involves a specific regimen of medicated eye drops, including antibiotics and anti-inflammatory drops. These drops reduce the risk of infection and control swelling, alleviating uncomfortable symptoms. Over-the-counter pain relievers can be taken if needed, though they are often unnecessary.
The gritty feeling and burning sensation usually subside significantly by the morning after the surgery, though light sensitivity and some dryness may persist for a few days. Using preservative-free artificial tears regularly keeps the eyes lubricated and reduces irritation. Following the surgeon’s post-operative instructions ensures a quick and comfortable healing process.