Choosing Between Glasses, Contact Lenses or Corrective Eye Surgery
Mypoia (near sightedness) is a very common condition of vision which affects our ability to make things out from a distance. It becomes apparent when you have hard time reading something from a distance and someone else at the same spot can read it without problem. The distance depends on the severity of the condition. Physiological causes are the inability of the eye lens to focus on an object at a distance. In physical terms it is the refractive distance of the lens which gets shortened. The condition may be inherited genetically or placing undue restrain on the lens with too much reading or reading in low light, among many other real or imagined causes.
The opposite of myopia is far sightedness, which is essentially the inability or difficulty to make of nearby objects. In this case, the focal distance of the eye increases.
Fortunately, the condition is correctable by wearing glasses, or contact lenses. And, fortunately it is an affordable solution available to most people. Nevertheless the cost may vary based on the type and quality of lenses and frames. They quality of lenses depends om the type of glass or plastic materials used for lenses. And quality of frames ranges from simple design to serve the purpose, to very expensive designer brands to serve prestige and fashion orientation.
People of younger ages find wearing glasses a cool thing to have. As you grow older, you may start feeling inconvenience of carrying an object on your face all the time, observing a permanent over the nose and the affect in cold weather when outside, and fogging up lenses coming inside to warmer settings. As in all other conditions, humans are dissatisfied with the current state, and seeking solutions to eliminate the use of glasses
Over the past 5 or 6 decades, practical and affordable alternatives to wearing glasses have developed. These are contact lenses for short time daily wear, and extended wear. Over the past 3 decades, corrective surgery has come into practice and is becoming a very common procedure. In most cases it has been successful,
As the saying goes, “nothing comes for free”. Each of these measures of corrective vision come with pros and cons. One has to make a choice based on your desires, budget and willingness to spend.
I started wearing glasses in 1978 at the age of 13. Over the course of 15-16 years after glasses, I gradually experienced all available solutions to correcting vision care. So my thoughts are purely based on my personal experience.
Glasses/Spectacles
This is the most common solution adopted by a great majority of people. It is the most economical, convenient and flexible solution. The lenses are ground to set focal point according to requirements of eyesight. Furthermore, they are ground into convex or concave shape for nearsighted and farsighted vision corrections accordingly.
I started wearing glasses in 8th grade at the age 13. At this age I was fascinated with extra gadgets like glasses and braces, on your face. I thought it made you look cool and intelligent. So I foolishly made sure I was prescribed glasses, even though I could have done without them. But being fascinated with the glasses, I chose to keep them on all the time. Even though I was called “four eyes” and other names, but I kept the glasses on. I did not realize this would lead to dependency on the glasses and deteriorate my focus with continued use of glasses.
Further flexibility is offered into the duration of using glasses. You can choose to wear them all the time, or for reading and activities requiring clarity nearby. In some cases, magnifying lenses attached to the eye can also be made for microscopic procedures.
If you need correction on one eye, you can even wear a single lens on one eye if the problem is in a single eye. This is what Mr.Jinnah used to do.
The price of glasses varies depending on your location of city and country. Ironically, the price of frames often exceeds the price of lenses. The frames come in a variety of sizes, designs, shapes and materials consisting of plastic and metals. One makes a choice to suit their age, taste, and shape of face.
Eye glasses are indeed the oldest and most practical solution. The results with glasses are seen immediately. If you went to the right optometrist/optician for eye examination, chances are you will experience clear vision (20-20) with glasses.
It is often the case that wearing glasses gives you a look of intelligence and wisdom. And in later age, glasses may provide some cover to aging eyes and remove a number of years from the face.
But glasses also have additional tasks associated with maintaining them and minor issues. The lenses require daily cleaning to remove fingerprints and dust to give clarity of vision. The frames sitting on your nose and grabbing ears may leave permanent dent between eyes and behind ears. In cold weather the lenses fog up when you come inside, blurring your vision completely.
I started wearing glasses in 1978 at the age of 13. By the time I crossed 15, with my face developing its features and taking an attractive shape, I was longing to have a natural look without the presence of a body covering the defining part of my face. So I opted for a costlier solution of contact lenses in 1981.
Contact Lenses
By the end of 8th grade in 1979 I noticed a classmate who was always in glasses suddenly coming to school without glasses. When I asked her, she said she is wearing “contact lenses”. This was the first time I heard of such a thing but did not know what it meant.
Over the next few years, the use of contact lenses seemed very common among my school mates especially among girls. But it was still a rare and a very expensive change as the cost ranged from $150-$300 depending on where you get them from. In 1981 this was a very expensive purchase for a student.
By this time my prescription was at -2.5 something. I was tired of wearing glasses all the time and was longing to have a natural look. The freezing cold weather and cold plastic on the face and lenses fogging up on you when you go inside made it all the more inconvenient to keep on the face.
So in 1981 I purchased a set of contacts for $150 of my own earnings. The lenses felt natural and it felt wonderful to have a natural look. But they had a running cost of buying cleaning and storing solutions every month, which were not very cheap. And the added inconvenience was to remove and washing them daily before going to bed.
Contact lenses (simply contacts) are membrane-like thin lenses which replicate the shape and feel of your natural lens within the eye known as cornea. They are easily inserted into the eye and removed as needed. They must be removed prior to sleeping at night, Now a days extended wear allows you to keep them on and sleep with them for a few days at a time.
Contact lenses are a practical but expensive solution to corrective vision. They also provide immediate results for clear vision with a natural look. They are priced much higher than standard glasses and have carrying or maintenance costs.
They need to be soaked in a saline solution all the time when they are not in the eye and must be cleaned daily after removing them from the eye to keep them clear of dirt and debris. The clearing and soaking solution are not very cheap and have a shelf expiry date.
However, being extremely thin and fragile they require extreme caution and care in handling. If you drop them, it is hard to find them. There is a risk of drying out and stepping over them until you relocate them. Or there is a risk of being discarded if thesy are placed in a container other than their own. I had one dropped and stepped over; however it survived miraculously after being flattened out with steps and later peeled off from the floor. And on a number of occasions, the fallen one took time to be relocated.
Contacts do offer relief from wearing something on the face for cosmetic purposes but may be inconvenient in having to place the thin lens into the eye and removing it from the eye daily or frequently. After continued use for a number of years, allergies and eye irritations are likely to develop. This happened to me after 10 years. I was always having watery and red eyes.
The contacts need replacement every 2 years and with significant changes in prescription. Now a days there are also disposable contacts which you can discard after a few uses. So the new purchases are made in multiple sets.
My contacts also needed a replacement every year or two and especially with a significant change in the prescription. My number kept increasing each time I went for eye examination and even reporting astigmatism. However, each doctor assured me that it was normal to expect an increase in prescription with age and this will continue to happen until the age of 26 something. My eyes were so out of focus without contacts or glasses that I could not make out faces from a distance of 15 feet. All I saw was a blurred ball on a body. In 1982 while skimming through the newspaper in the library, I remember coming across a news item that Russians have discovered a technique to correct the vision by placing cuts inside the lens. It gave me hope that there was a way to correct your vision and be natural without the use of aids.
By the end of 1993 I resorted to wearing glasses most of the time and took to contacts only for special events. In 1994 I accidentally learnt about corrective surgical procedures to bring back your vision without having to wear contact lenses or glasses. In 1995 at the age of 29, I underwent a successful procedure of RK, which resulted in 20-20 vision and complete freedom from glasses.
Corrective Eye Surgery
There are two possible techniques of correcting vision through surgical procedures; (i) Radial Keratotomy and (ii) Lasik.
Radial Keratotomy (RK)
In searching Google, the following definition comes up:
“Radial Keratotomy (often abbreviated RK) is a type of refractive surgery meant to correct myopia or nearsightedness. Developed in the 1970s in Russia, RK was the very first refractive surgical procedure to gain ground in North America.”
The procedure involves using a diamond blade to place cuts inside the cornnea to correct refractive errors. It is performed manually by a trained Opthamalogist
LASIK has similar purpose and outcome, but instead of the diamond blade, high intensity laser beam is applied to make cuts and reshape the cornea.
LASIK Vs. Radial Keratotomy (RK)
By early 1990s, the use of laser to perform corrective surgery was emerging in Pakistan and other countries. Some doctors expressed reservations about it at that time but continued to perform the surgery. Now LASIK is the procedure of the day for corrective surgery.
Google specifies the difference between RK and LASIK as:
“Radial keratotomy is different from LASIK in that the procedure involves using a diamond blade to reshape the cornea to correct refractive errors. LASIK surgery is performed using laser technology to improve visual acuity. LASIK is more precise and exhibits fewer complications than radial keratotomy.”
LASIK is much more expensive than RK. I know a few people who have undergone this procedure. Initially they are happy with it. But shortly after within a year or two they start wearing glasses and complain that they are observing a reversal of correction. I cannot say more about it because I have personally not experienced it. I myself underwent a successful operation for RK in 1995. My doctor who performed the operation on me has adopted LASIK after a few years of my operation. In 1995 he was apprehensive about LASIK in comparison to RK.
Here I would like to share my story on how I discovered Corrective Surgery-Radial Keratotomy by Pure Coincidence and experienced success with it in 1995 when medical practice in Pakistan was still a noble practice and this procedure had very nominal cost. If you are not interested or find it boring you may skip to the outcome of operation.
In 1994 before the age of internet and any access to resource, while working at Marriott, I was dictated a letter by the GM. The letter was on behalf of his son and addressed to Pakistan Airforce (PAF) Selection Board. It was an appeal for reconsideration of the decision to reject on grounds of myopia. He was informing the Board that he had undergone a corrective surgical procedure known as Radial Keratotomy, performed by a Dr. C in Islamabad. The letter enclosed a report of recovery from the procedure and contacts of the doctor for reference. Needless to say that I made note of the contact details. I left the job after a few months so I do not know what PAF decided on his case.
A few days later, I contacted the clinic and got an appointment for the same evening at 6pm. When I went to the clinic I was so shocked to see the crowd in waiting. I (im)patiently waited for My turn which did not happen until 8:30 or 9pm. After bearing up my protest for the long wait, the doctor examined my eyes and informed me that my eyes where at -7.5 and -8.5 in right and left eye and that was far too low to be corrected in a single round of procedure. In the first round, the number may come down to 3 or 4, much improvement from where it is now. But I would still need glasses. He further stated that I would have to go under two or more procedures and even then I would still be wearing glasses.
I came out of the clinic with disappointment. I even refused to pay the doctor his fees for not doing anything on the eyes and not even giving me hope. I displayed very stupid behavior indeed. This was in March 1994 sometime.
A few months later in February 1995, at a different job I met a senior Allergy Specialist doctor (Dr. B) who had a clinic in Islamabad. In a casual conversation about eye sight and corrective surgery I mentioned about my experience with Dr. C and how pessimistic he was about my case. Dr. B said he is aware of a doctor in Blue Area somewhere who is doing this procedure successfully. Maybe I should go consult him. He did not even remember his name but he promised he would find out for me.
A few days later he called me at the office and gave me the name of and number of Dr. J. He even said that he had spoken to him about my case and Dr. J is confident that he can help me.
I called Dr. J right away at the number. He answered the phone himself. His voice and manner of talking sounded like that of a young kid having a high pitch voice. I mentioned to him that Dr. B had given had shared his number and maybe discussed my case with him. Dr. J sounded very confident and asked me to come the same evening to the clinic. I located the clinic in Blue Area and went up to the clinic. The clinic was crowded with so many patients waiting to see him. I paid the consultation fee of Rs. 350 upfront and gave my name and reference of Dr. B.
In a few minutes I was called and went to see the doctor. Dr. Jahangir was much older than Dr. C. He had a gentle face with a thick black beard. He had such noble disposition and positive energy coming out of him that I felt very comfortable. He started the conversation with a few personal questions about me on my age and occupation. After breaking the chill, he said he is a little distracted mentally because his father is in a very critical condition at the hospital and he would have to go there right away. He mentioned that his father is 90 years old and maybe taking his last breaths. So he has to be with him and he would leave right after examining me. I was grateful for his consideration and giving me the time in this situation.
He gave me a thorough examination on the eyes and confirmed that I had a number of -7.5 and 8.5 in both eyes.
After examination he said right away that he can perform the procedure of RK on my eyes and he is confident that the problem would be corrected in a single procedure. The cost was Rs.5500 per eye. And the procedure would be completed in a few minutes, but less than an hour. It will be done on one eye at a time. After a gap of 2-3 days and results, the second eye can be worked on in the same manner.
When I asked if he thought the number was very high for a single procedure he said he has corrected upto -19 in a single round. Mine is a very easy case and I am in the right age group. He would not perform this on patients younger than 19 and older than 70 because until the age of 26, the eyesight continues to deteriorate and after the age of 70 the deterioration is irreversible. And he further stated that he would not perform this procedure on a prescription below -2.0 because this would require a very slight cut and has risk of causing far sightedness (going into + number) if cut too deep. Therefore he found my case to be ideal and very likely to have a successful outcome.
Although I was convinced of his confidence and assurance I foolishly asked what kind of guarantee he can offer if I proceed with it. He was annoyed and replied that there are no guarantees in life. He further said that he does not have much to gain by charging Rs.5500 per eye to deceive me into being convinced. He can assure that nothing will go wrong or my eyes would not be worse off after the process.
I was immediately sold into it and asked when can we do this? He said he could have done this today but he is mentally very disturbed because of his father’s condition. So let us schedule this for Sunday at 10am instead. I should arrive at the clinic at 9am to start with preparations. This was a Thursday evening when we met.
My husband thought I should seek another opinion, but I was fully convinced. I felt if I consult more people I would be discouraged with negativity. It was better to proceed with positivity and faith in the doctor’s skill and confidence.
The RK Operation Experience
We took a taxi to the eye hospital in Melody or Abpara area…I don’t remember exactly where it was but it was certainly not in Blue Area.
When I saw Dr. Jahangir, I immediately asked how his father was. He said he passed away that same night when we last met. He was surprisingly very calm and composed in conveying this news. I offered my condolences and prayers. He asked me to lie down.
He started with placing eye drops in my eyes. And then without any warning, he inserted a syringe needle immediately below my eyes. I felt a strong pinch and squinted my eyes. I was recovering from this horror when I saw another needle dart into my eye socket right behind the eyeball. At my convulsions, he said just count to 10 and it would be over. At the count of 10, the needle was indeed withdrawn after being emptied into the socket and I felt the numbness taking effect. Then I asked in crying voice if there was any more of this coming. He said there were no more of needles and I should be relaxed.
He then placed a thin clip over my eye to hold it open from one end and the other end gripped green rubber sheet around the eye socket. For the next 15-20 minutes I felt movement of hands over my eyes and slight vibrating sensation only. After this he removed the rubber flap and clip from my eye. After placing a bandage he asked me to get up and get ready to go home.
He advised to keep the bandage on until evening, but place eye drops after a few hours and bandage the eye again.
I came home in the taxi. After reaching home, I lied down immediately feeling very exhausted and drowsy in the eyes. I think it was more from the shock of taking needles iinside and below the eye. I was still coping with the shock
After a few hours, I opened the bandage to place eye drop. I immediately felt the difference in the vision of both eyes. The operated eye felt more clear and sharp in focus in comparison to the total blurr in the other eye. By late evening with the second dose of the eye drops, I was convinced that the procedure had worked and looked forward to having it on the second eye.
I went to see Dr. Jahangir on Monday to have an examination. After examining, he assured me that all worked well and we may schedule the next eye for Wednesday.
On Wednesday the same procedure followed. Except that this time my anxiety level was very high in anticipation of receiving needles in the eyes. I had a first slight cry seeing the needle below my eye. And for the next when into the eyeball,, I actually started kicking my legs in protest and he asked me to count to 20. I actually started counting and by 20 the needle was pulled out. Then I relaxed and let him work on the eye without disturbance.
Going through the same routine of bandages, eye drops and recovery the next day on Monday I felt my eyesight was quite normal. Only sharp light was uncomfortable. So I kept sunglasses on all the time.
Outcome of my RK Operations
After one week I returned to the office normal. I was driving myself without any glasses or contact lenses. I could even read the computer screen from a distance of some10 feet.. For a few weeks my eyes were sensitive to sunlight and sharp light so I kept sunglasses on even at night sometime. But I was quite satisfied with the outcome.
I went for eye examination after a week. Everything was good. I felt I was at 20:20 vision. I did not need any vision aids anymore. It seemed within a period of 10 days from coming into contact with Dr. J, I had found my eyes.
And overall it costed my about 13,000 in total with the operation and few doctor’s visits for examination. It was the most useful expense on for my well-being I ever made.
Between 1995 and 2008, I underwent a number of eye examinations in connection with a routine medical check up, by different doctors. Every eye doctor admired the cuts placed in my cornea and enquired who had done it.
RK has proved to be very successful in my case. I give this credit to the skill of the doctor. I had a perfect vision until 2010, without even needing reading glasses. By 2010 at the age of 45 I started feeling strain on my eyes and dryness. I sought out Dr. J again in Islamabad and had my eyes checked out. He prescribed reading glasses but stressing that it is my choice if I want to use them. I can read fine without glasses as well. He did recommend regular use of tear plus eye drops to keep eyes lubricated. This is a normal occurrence with age and until present I am using the same glasses for reading only, and continue to use eye drops.
Within a couple of years after my surgery, I realized that LASIK had replaced RK completely. The procedure was simpler with use of eye drops and apparently a single sitting to treat both eyes.
Should One go for corrective eye surgery or not?
If I am highly myopic and wear strong prescription glasses (above -3.0) all the time, I would opt for RK if I can find another doctor like Dr. J who performs it with diamond edge blade. If not, I would opt to wear glasses. With LASIK, other than the high cost, I would be afraid of some unintentional exposure to such high energy beam and collateral damage.
Wearing glasses is the safest and most non-invasive solution to maintain the health of your eyes and enjoying a clear vision. Glasses offer the flexibility in design to highlight your looks and personality. Just one word of caution… Try not to be too dependent on wearing glasses to wear them all the time. This will keep you safe from getting hurt if you are punched in the face or fall down on your face with glasses on.
