Three weeks ago, on Saturday 27th September, I had laser eye surgery at the Optimax clinic on the Finchley Road in London.
I decided to write a blog piece about this experience on the Technology section of Thameside Media because I’ve been smitten with laser technology. In an operation lasting merely ten minutes, a skilled surgeon using the latest techniques in Lasik, Intralase and Wavefront reshaped my rugby-ball-shaped lenses into neat spheres, wiping out the distorted vision of more than 20 years.
The procedure was only slightly uncomfortable, and the immediate after-effects of cloudiness and weeping wore off within 24 hours. Three weeks on from the operation, I still have slightly bloodshot eyes and occasional stinging, but these are very, very minor irritations in comparison with the joy of being able to see the world naturally with my own eyes again.
Don’t get me wrong: I don’t think there’s anything terrible about wearing spectacles or contact lenses. Indeed, I think the technology behind artificial lens-making in itself is a high human achievement, from the earliest lenses of 400 years ago that allowed Galilei to discover the moons of Jupiter, and the finest Nikkor lenses we use in our Slippery Fishes Photo Studio, to the affordable £300 everyday wonders of technology that were my old Specsavers varifocals. It was actually my appreciation of the skill involved in making glass lenses that led me towards the appealing idea to have my own imperfect human tissue lenses reshaped by technology.
As my husband pointed out after a week of listening to me being endlessly thrilled because I can see all sorts of things with my very own eyes, I accept that I have turned into an Eye Bore.
So continuing the Eye Bore theme, I thought I’d write a detailed account of the experience.
A bit of background
I wasn’t born with rubbish eyesight. It was when I was in my mid-20s that I started grumbling about my computer screen failing and going fuzzy. I was annoyed that no-one else in the office seemed to agree about my screen. Then one day I was stroking my cat and suddenly realised that I couldn’t make out the individual strands and delicate colours of the fur. I stopped grumbling and went to an optician instead.
The optician confirmed that I had a medium level of astigmatism and expressed surprise that my eyes must have deteriorated rapidly for me not to have known this earlier. I received my first pair of glasses and, over the next five years or so, was issued with increasingly stronger prescriptions until my astigmatism was classified as high.
My eyes stabilised with high astigmatism for the next 15 years until I hit my mid-40s when I started to develop presbyopia as well – the ubiquitous long-sightedness of older people, which means we increasingly can’t focus on near things. We hold the book at arm’s length and eventually cave in and buy reading glasses.
The combined effect of presbyopia and high astigmatism meant that I needed varifocal lenses in my spectacles, which roughly halved my field of vision at different distances, and also meant that my toric contact lenses were barely worth the effort of putting in, as they only worked for middle distance. “There simply isn’t the technology to make toric contact lenses any better than this”, was what Specsavers told me when I kept going back to moan.
(The problems with the toric contact lenses weren’t helped by me mislabelling a six-month supply and wearing them in the wrong eyes, but that’s another story.)
It was at that point that I started to look seriously into laser eye surgery.
My rather long road to laser eye surgery
I had first heard about laser eye surgery in the early 90s, because a colleague’s father, Dr William Jory, was one of the pioneers of laser eye surgery. At that time, the procedure cost about £20,000 I think, which was considerably more than I earned in a year at the time. But apparently people such as trainee air pilots, who are required to pass 20:20 natural vision, were queueing up for their services. A few years later, when my eyesight had really started to deteriorate, the cost of laser eye surgery had halved to about £10,000, but was still way beyond what I could spare – or dare. However, by the time presbyopia started kicking in alongside the astigmatism for me, the cost had halved again, and started to look financially on a par with the cost of replacing varifocals every few years.
I started making enquiries about laser eye surgery in the summer of 2013. This was prompted in part when my Specsavers optician said that my eyes were suitable for laser treatment. (Praise to Specsavers for being honest about an alternative treatment they don’t offer themselves.) I soon established that the cost to treat my level of astigmatism would be between about £4,000 at one of the three main high street chains for laser eye surgey – Optical Express, Optimax and Ultralase – and £8,000 at a more exclusive clinic or Moorfields practitioner.
Naturally for someone who spends all her working life on the computer, I read reams of information on the Internet and spoke to people who had had the surgery. It turned out that a surprising number of friends had been treated in the last ten years, and the feedback was mostly very positive (bar the odd few horror stories on the Internet). I then went for full consultations at Optical Express in Kingston and Ultralase in Guildford, both of which were offering discounts, bringing the cost down to about £3,500.
At Optical Express I was given a slightly harder sell than I felt comfortable with, though I have to admit I was attracted to the idea of “20:20 or your money back”. Ultralase, by contrast, put off my plan to have the surgery within two weeks of the consultation, because they wanted to wait a month to check if my vision was stable enough for surgery following some recent fluctuating prescriptions. I decided I liked Ultralase the best and that I would book the procedure if given the thumbs up at the next consultation.
Two days before the second consultation at Ultralase in Guildford, I was phoned by the head office to say that Ultralase had been bought by Optimax, and the Guildford branch was closed with immediate effect. Could I go to the Croydon or Chiswick branches of Optimax instead? Absolutely floored by this sudden development, I ummed and ahhed for a few moments on the phone, then said “No”. I then spent the next few weeks feeling on the one hand deflated about not having the surgery after psyching myself up for it, and on the other hand very relieved that I hadn’t had the surgery at the original planned time, just before Ultralase went bust.
By December last year I was reconsidering the surgery and went for a third consultation, this time at Optimax in Chiswick. This branch also expressed concern about the stability of my prescription, and invited me back for a third consultation. However, with other, far more pressing events going on around me, including a death in the family, I cancelled that appointment. Laser eye surgery seemed like the most ludicrous, self-indulgent risk to take in the depths of last winter.
What persuaded me in the end
Over the spring and summer of 2014, Optimax sent a few marketing letters and increasingly deep discounts. The weather was warm, I was feeling positive, and one day in late August I was drawn to a letter from Optimax with the extraordinary offer of laser eye surgery at a cost of just £1,995. One tenth of the original cost. Option to pay on 24 months’ interest free credit.
I sat down to read all the information again and I very carefully considered statistics such as these:
- A survey of 95 Optimax patients of my age with a similar prescription showed 98.44% achieving 20:40 vision (driving standard) or better.
- 89.06% of that survey achieved 20:20 vision or better.
- Laser eye surgery is the most commonly performed operation in the world; there had been about 35 million procedures undertaken globally since the time my colleague had first told me about the technology.
- Dry eyes and poor night vision are common side effects for a few months following surgery.
- In the hands of an experienced surgeon, the chance of having a complication leading to a worsening of vision is around 1 in 1,000. With a less experienced surgeon, the risks increase.
- All three clinics – Optical Express, Optimax and Ultralase – had given me details about the possibility of complications ranging from infection, droopy eyelid and floating shadows (possibilities in the order of 1 in a few hundred) to very rare possibilities (a handful of cases worldwide) of conditions such as Central Toxic Keratopathy, leading to cloudy vision.
So I weighed it all up. I was fully aware that I would still need reading glasses as the presbyopia of old age advances, and that even if fully corrected, astigmatism could return as a natural hereditary process.
- I decided that even if I did not achieve driving standard I was almost guaranteed to have better natural vision.
- I didn’t mind the idea that I might still need glasses for specific activities, such as reading and driving.
- I would be delighted simply to be able to go running or do pilates without needing to fiddle around with contact lenses.
- If the astigmatism was naturally going to worsen later, I convinced myself that at least this would be from very mild to mild or medium, rather than from high to severe.
- Friends’ stories about being back at work within a couple of days after treatment helped hugely with confidence.
By the end of the day I had convinced myself that the potential benefits outweighed the risks. I went to the Chiswick branch of Optimax for another consultation, then booked in to have the surgery at Finchley Road two weeks later.
The day before surgery: nerves kick in
I didn’t want to make myself the centre of attention over having the surgery – particularly not if the treatment was not going to be very successful – so I barely told anyone about it. Work was ferociously busy in the two weeks leading up to treatment, and there was little time to dwell on the idea that my body and lifestyle were about to change permanently.
On the Friday before the surgery, I read through everything again, including the long consent form that sets out the known risks. I had long been aware of certain postings created by a few disgruntled patients intent on destroying the high street chains (ultralaseruinedmylife, optimaxruinedmylife, opticalexpressruinedmylife and so on). I noted that my surgeon was mentioned in a YouTube video by one of these people with a grudge. I also noted that the consumer group Which (where I once worked) had recently done a survey of the main UK laser eye surgery centres, and had raised concerns that some outlets were not making patients fully aware of the risks. However, there were no major concerns over the standards of treatment at the high street chains, and I concluded that I had been given more than adequate risk information personally. I also concluded that if the surgeons were really as bad as the vocal grudge-bearing contingent were saying, then they would have been struck off for medical negligence, which clearly was not the case. Indeed, my assigned surgeon, Dr Amir Abdul Hamid, had a vast amount of eye surgery experience in both private practice and the NHS.
I’m a level-headed person, so I am more persuaded by scientific facts and the opinions of people I know and trust than the rantings of people with an axe to grind. Even so, it would take a thick-skinned person not to feel nervous in the prelude to surgery, any surgery.
Saturday morning was grey, and the North Circular its usual dreary self as my husband drove me to the Optimax surgery centre on the Finchley Road. The clinic was much like any other large opticians in the UK. I was the first patient of the day. Mouth dry, I was tested with the same machine with concentric red lights that had been used in all the consultations. I was reassured that everything was fine, and the data was being fed directly to the laser equipment upstairs. There was little waiting around. I signed each point of the consent form, then I was introduced to Dr Amir Hamid, who spent some time making sure that I knew what type of surgery I was booked for and the reasons why I had decided to have it. A questionnaire also went through a number of points to make sure I fully understood the treatment I was about to have.
I was called into the treatment room, and prepped for surgery with a hairnet and anaesthetising eye drops. My spectacles were gently taken and put into a bag with eye drops that I was to use at home. It was in these few minutes that nervousness really set in. I had the most bizarre chain of thoughts as it occurred to me that the surgeon looked like he might be Malaysian, which brought to mind the Malaysia Airlines missing Flight MH370 mystery. What indeed had happened with that unfortunate flight – had the captain gone mad? And the last time I had been surrounded by surgical equipment and scrubbed-up doctors was for a forceps birth, not a pleasant memory. I was fighting to quell the negativity of these stupid random thoughts as the surgery began. Fortunately I managed to gain control of my mind by focusing on the image of my beautiful baby daughter’s face in the minutes after she had been born in a surgery room like this.
I lay down with my head between rests, and Dr Hamid brought the laser equipment into place. He reassuringly talked me through each step of the process: “the suctions are in place now, very good”, “everything is going to go black for a few seconds, that is normal”, “you will see lights, keep looking at them”, “ten more seconds like this”, “that one is successful, now on to the next”.
The creation of the flaps took a matter of moments; the reshaping of the lenses not much longer, with a slight odour as the lasers were at work (I had anticipated a much stronger burning smell). My eyes were clamped open, which was hardly very nice, and at a couple of points I felt a small quantity of cold liquid run out from the edge of the eyes to my ears, which was unexpected, but there was no pain at all. A few minutes later the suctions were being removed, it was over, and I was standing up and being led out of the room.
The first hours
As I walked from the surgery through the waiting area into a recovery room I could immediately see that my vision was completely different from ten minutes previously. The whole room was indistinct, but not in a distorted way as with astigmatism. The furniture and people in the room were actually in focus, but milky. I signalled to my husband to come into the recovery room, and I sat in the dim light with my eyes closed. After another quarter of an hour or so, the receptionist came back and I was led downstairs. The whole place was discernible through a haze of light. I sat and looked at a chair: a distinct object within the mist. The horizontal top of the chair was a clearly defined edge, my god it was absolutely a solid edge. I looked over at a TV on the wall. I could make out some though not all of the words on the screen. All colours were muted, yet distinct from each other. The light wasn’t right, but the shapes were becoming clear.
Presently an optometrist called me into another room to examine my eyes. I immediately recognised her as the optometrist from Chiswick. “That’s a good sign that you can recognise me!”, she said. A few minutes later, to our delight, she said I was fine to go home. We had been at the clinic for barely two hours.
Out on the Finchley Road, I put on non-prescription sunglasses, as advised, and stood gaping at the buildings opposite for a few moments, feeling a sense of excitement rising as I found I could read the shop names. We began the long drive home, my eyes beginning to water. I kept my eyes mainly closed for the next hour, as the anaesthetic wore off and they started to feel mildly irritated.
As we entered Richmond Park, I opened my eyes again and found that the mist had almost cleared. Every leaf on the trees, the deer in the distance, the car number plates were all shockingly in focus. The experience was extraordinary and exhilarating. We stopped for hotdogs at Pembroke Lodge; I could read the small writing on a packet of ketchup. Everything was glowing as the sun broke through the clouds. I had spherical power! I closed my eyes again behind the sunglasses.
Back at home I lay down resting with the Optimax eye shields taped over my eyes (to be worn at night for a week). A few hours later I got up, started the first applications of the week-long course of eye drops prescribed and marvelled at the view of the garden. I went on Facebook and conveyed my excitement to friends, few of whom knew I was having the surgery. Yes, I could read the text on the screen! By evening, the wateriness and mild irritation had largely disappeared. I could see a few red bloodshot patches in the white of my eyes, where the suctions had been, but no other obvious trace of the life-changing surgery that had happened that morning.
The next 48 hours
The next morning, Sunday 28th September, we drove back to Finchley Road for my first check up. On the journey, I was estimating the distance at which I could read car number plates and was fairly certain that I had reached driving standard without glasses – you need to be able to read number plates at 20 metres. I hoped this would soon be confirmed by the optometrist. Beaming as I entered Optimax, I sat before the letters chart on the opposite wall.
For years I had been unable to read beyond the top line of the letters chart without glasses – and even the top line had been fuzzy. A brief pause, then I said, “I’m going to have a go at the bottom line” and I read out the letters. 100% right. “That’s 20:20.” Wow.
I was then asked to look at the chart one eye at a time. The left eye couldn’t actually read the bottom line… Ahhh, dammit, I hadn’t realised the new eyes were different. The left eye had always been worse than the right. Nonetheless, the right eye was compensating to give me 20:20. I was advised that it was only 24 hours after the operation, and my eyesight would likely fluctuate for some time to come. The flaps were clean and already healing nicely, and there would be no more tests that day. I was elated.
The only thing I was still nervous about was of a sudden reversal – that I might close my eyes for a few minutes and reopen them to find the world fuzzy and distorted again. I felt that Dr Hamid’s lasers had given me wonderful new eyes, but my stupid body might squash them out of shape again.
Later that day, obsession over my eyesight was instantly swept to one side as my son accidentally scalded his hands on a bowl of noodle soup, leading to hospital A&E visits. His discomfort and recovery time were far more than I was needing.
Thoughts after three weeks
I was relieved to give up the course of anti-bacterial eye drops and night-time eye shields after 7 days. This was also the point at which I was allowed to start jogging and going to the gym again. I am finding it truly blissful to be able to do physical activities with good vision – one of the main reasons why I wanted to try laser eye surgery in the first place.
What to do with six pairs of old spectacles? I was curious to see that looking through my old prescription glasses gives a slightly fuzzy view but does not reverse the view to look like the astigmatic distortion I used to have. I know that I am likely to need reading glasses within a few years, and I still worry that the astigmatism might creep back, so I have kept two old favourite pairs to be reglazed when needed. I handed in the other four pairs at the Optimax Chiswick branch, as they send prescription glasses to people in developing countries. At that checkup, 10 days after surgery, I was further delighted to find that although the left eye is still weaker than the right, both had improved to give slightly better than 20:20 vision overall.
My eyes will still take a few months to fully heal and stabilise. It had taken my brain about six weeks to adapt to wearing varifocals last year, so I’m not too worried that sometimes my vision still seems a little disturbed. In particular, if I’ve been working a lot on the computer then go out for a walk, it can take a few minutes to see long views sharply, and vice versa. I put this down to my eye muscles having got lazy with varifocals. (With varifocals you move your head to bring things into view at long, middle and near distances because different areas of the lenses are doing the focusing for you.) The other disturbances are when I’m using moisturising eye drops – the drops themselves cause a slight disturbance for a few minutes. Occasionally I have a mild stinging in the corners of the eyes, which may be due to dust particles.
My night vision was rather poor before the surgery. One of the main possible side effects of laser eye surgery is a worsening of night vision. On the one hand, I am finding that there is slightly more glare and starburst effect from bright lights at night. On the other hand, I have a wider field of vision than when I used to wear glasses, so I have more peripheral vision for night-time driving – I can spot the cyclist riding without lights at the side of the road so long as the oncoming car’s headlights haven’t blinded me.
I look forward to the next milestone – being allowed to swim again one month after surgery. It might be worth taking up snorkelling!
Update September 2016: Two Years On
So, it’s the final month of my two-year plan for paying off the laser eye surgery with Optimax, and a good time to reflect. I’m delighted to say that my vision is still 20:20. The middle-aged presbyopia is creeping back – as anticipated – though I only occasionally need reading glasses when the text is tiny and the light is dim. In fact, my husband needs to wear his reading glasses far more than me. But going jogging, swimming, cycling, driving, socialising and so on are blissfully spectacle-free. In particular, I enjoyed swimming in the Mediterranean this summer, with the view of the coast and the underwater reefs all sharply in focus. I had never seen the coast like this before, as of course I never used to wear glasses or contacts whilst swimming, therefore swimming used to be the ultimate fuzzy experience.
I’ve been asked by friends if I am still happy that I had the surgery. Oh yes. And would I recommend Optimax to others? Hmm, well I’m going to be careful here, because I don’t want to give any sense that I’m endorsing Optimax or specific surgeons, or generally the industry surrounding laser eye surgery, which after all is not essential surgery. Anyone contemplating this procedure really needs to understand the statistical possibility of complications, and decide for themselves if they want to risk it. All I will say is that for me, personally, yes, it’s been worth it.
Update October 2018: Four Years On
I have recently been contacted by several people asking if this blog piece is an advertorial for Optimax. The answer is emphatically no. I have not been paid by Optimax, I was not asked to write this by Optimax or my surgeon or anybody else at all, and I have never been offered any incentive or reward for writing it. It is entirely my own honest experience and personal views.
With regard to my vision, the presbyopia of middle age still advances – as previously mentioned, this was fully anticipated – which means I now often wear glasses when reading printed books. But most importantly the astigmatism has not returned. Driving at night is not a problem. My regular checks with Specsavers confirm that my eyes are healthy. Thus I am still happy with the outcome of my surgery after four years.