FAQs about LASIK Surgery, Macular Degeneration, Contact Lenses and More at Our Laser Eye Practice in London

General Ophthalmology Questions

What is a refractive error?

A refractive error is a problem with the focusing power of the eye. Ideally, the cornea (clear window of the eye) should be symmetrically shaped and its curvature should be matched to the length of the eye. If the cornea is not shaped properly then light bends (refracts) at the wrong angle when entering the eye. If the eye is too long or too short then the image is focused in front of or behind the retina. Either way the images appear blurry or distorted.

There are three main refractive errors: myopia, hyperopia, and astigmatism. In patients with myopia (short sight), the eye is too long (or occasionally the cornea is too curved). This causes items far away to appear out of focus. In patients with hyperopia (long sight), the eye is too short (or occasionally the cornea is too flat), and items nearby appear blurry. In those with astigmatism, the cornea is curved asymmetrically so there is not a single plane of focus. Spectacles and contact lenses correct refractive errors by compensating for the focussing problem in the eye.

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What is presbyopia?

Presbyopia is a vision problem that occurs due to aging. It typically begins in the forties and causes nearby items to appear blurry. Presbyopia is unrelated to the shape of the eyeball. Rather, it is believed to stem from a loss of flexibility in the lens of the eye. Because presbyopia is not caused by a refractive error, it cannot be prevented by laser eye surgery. Contact lenses and laser eye surgery can, however, help compensate for the loss of near focus.

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What types of contact lenses do you offer at your London practice?

We offer almost every type of contact lenses at our London practice. Disposable contact lenses are soft contacts that can be thrown away either daily, weekly or monthly. For patients with astigmatism, we offer both hard and soft Toric contact lenses. Gas Permeable (GP) contact lenses can be harder to get used to than soft lenses, but often offer London patients a crisper, better quality of vision than other contacts. Bifocal Contact Lenses can improve both distance and near vision for people who also need reading glasses. For patients looking to alter the colour of their eyes, we offer coloured contact lenses. In addition we specialise in fitting complex lenses for medical indications.

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What is radial keratotomy (RK)?

Radial keratotomy was an eye surgery method that involved making cuts into the surface of the eye to change its shape. RK was used for the treatment of short sight and astigmatism. Those who have had radial keratotomy can suffer difficulty with nighttime vision, and most have fluctuations in vision. RK was mostly abandoned around 1990, but is still available in one clinic in the London area. We have never recommended or performed RK treatment, which is now widely considered obsolete.

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What are thermal techniques for treating vision problems?

Thermal techniques (radio frequency thermokeratoplasty, diode laser thermokeratoplasty, holmium-YAG thermokeratoplasty) have been used to treat low degrees of hyperopia and astigmatism in people over the age of 40. The effects depend on age. The maximum correction that can be expected in a 40 year old is about 1.5 dioptres, rising to about three dioptres for a seventy-five year old. The main disadvantages with all thermal techniques is that they are relatively inaccurate, the eyes can take a year or more to reach reasonable stability, and there may be a tendency for the effects to continue to wear off with time.

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Laser Eye Surgery Questions

Am I suitable for refractive surgery?

You may be suitable for refractive surgery if:

• Your spectacle or contact lens prescription is stable
• You do not have any major health problems or a history of eye disease/injury
• You have a prescription that is within the recommended range for the procedure you are undergoing [for LASIK: up to around -12.00 (short sight) or +4.00 (long sight)]

You may not be suitable for refractive surgery if:

• You are taking or have taken medications that affect wound healing
• You are pregnant or breastfeeding or are within six months of pregnancy or breast feeding

There are various other factors that may determine if you are suitable for laser eye surgery. Please visit our laser eye practice in Central London to find out if refractive surgery is right for you.

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What are the possible risks and side effects of LASIK surgery?

Although LASIK has proven to be very safe, it can occasionally cause side effects such as visual disturbances (such as night vision problems, haze, haloes and glare) or temporary dry eye. As with any surgery, there is the possibility of surgical complications, or infections or inflammations. It is important for patients to be aware that LASIK surgery does not always result in "perfect" vision. Although there is now two decades of experience with laser eye surgery, data about its safety and effectiveness continues to be collected.

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Will LASIK surgery completely eliminate my need for glasses or contact lenses?

After receiving LASIK surgery at our laser eye practice in London, patients usually find that they no longer need spectacles or contact lenses for most day to day distance vision purposes. However, they may still need to wear glasses or contact lenses for some purposes. Patients who undergo LASIK will also usually need to wear reading glasses when they reach their forties.

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What is the difference between PRK and LASEK surgery?

The two refractive procedures differ only slightly - with PRK, Mr Bailey uses an excimer laser to reshape the surface of the cornea after removing the thin superficial skin of the eye. When performing LASEK surgery, however, the superficial skin is loosened, set aside and is replaced at the end of the procedure. Either way, a new superficial skin regenerates in a few days.

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BOTOX ® Cosmetic Injections

What are the possible side effects of BOTOX ® Cosmetic?

Many patients experience no side effects from BOTOX® Cosmetic. Bruising at the injection site occasionally occurs and can usually be covered by make-up. Temporary alteration of the position of the eye-brows or temporary drooping of the eyelids can occur with some treatments. Very rarely reported associations have included headache, respiratory infection, flu syndrome, nausea, pain in the face, redness at an injection site, and muscle weakness.

How long do the effects of BOTOX ® last?

The effects of BOTOX ® usually last about three to four months, but can sometimes last longer. Once patients receive BOTOX ® injections regularly, there is often a longer lasting effect.

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Will I still be able to make facial expressions after receiving BOTOX ® Cosmetic injections?

Through BOTOX ® Cosmetic will improve the appearance of facial creases, it will not dramatically alter your appearance. After receiving the treatment, you will still be able to frown or look surprised - only without the wrinkles between your brows.

Contact Mr Bailey with questions about BOTOX ® Cosmetic, laser eye surgery, contact lenses, or the other types of vision correction offered at his ophthalmology and laser eye practice in London.

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