Joel Hunter, MD Refractive Surgeon, Hunter Vision Updated 08/22/19 6:53 PM
So LASIK day has arrived. A 10-minute procedure will transform the blurry vision you woke up with into vision that is mostly clear by the time you go to bed. But between Point A and Point B—that period of time where you’re recovering from the procedure itself—what happens? One of the main questions we get during LASIK consultations is the level of care that will be required that day. Most people understand they’ll need a driver to get them home. There is often a lot more uncertainty about those first few hours at home.
To begin with, we should establish a timeline. It’s easiest to measure it in hours after the procedure because things improve pretty rapidly that day. Specifically, it’s a window of about six hours that we’d consider the “recovery” period from LASIK. I use quotes there because I think if I was saying this out loud to you, then I would use air quotes for the word recovery. To me, recovery carries a connotation of returning back to normal function after being disabled in some significant way. Recovery from LASIK is different. With that, on to our six-hour timeline.
Hours one and two after LASIK:
The greatest variability from person to person happens here. From sitting up after the procedure until about two hours later, the vision doesn’t change a ton. The variable part is how much better the vision looks when you walk out of the LASIK suite compared to when you walked into it. For some—most noticeably those patients who are legally blind without glasses—the vision already feels miraculous during this period. For others, they feel like it’s mostly just more foggy and hazy than normal. The feature that is consistent for both of these groups is that whatever the vision looks like—miraculous, hazy, or both—it won’t change very much for about two hours.
The other component of the immediate post-LASIK period is the sensitivity and light sensitivity of the eyes. Again, it’s widely variable. Some patients feel like nothing significant happened to their eyes, some patients feel like there is a piece of sand in their eye and that makes it hard to open their eyes without blinking like crazy. Most people are somewhere in between: they feel like there is a mildly annoying eyelash. And while it’ll be great when the eyelash feeling goes away, it isn’t too terrible in the meantime.
The care required during these two hours varies as much as these two symptoms of vision and eye sensitivity do. No one has vision in danger of walking into walls or trying to shake hands with a potted plant. But if the vision feels very hazy, or if the feeling of sand in the eye is so irritating that you’d prefer to leave your eyes closed, it is good to have a friend or family member there to help you out. Every person, even those feeling invincible during the first two hours, needs someone to drive them home.
Hours three and four after LASIK:
This is where it gets fun. Almost magically, and somewhat like clockwork, the sensitivity either vanishes or diminishes dramatically right around two hours after LASIK. The fogginess in the vision starts to clear at a rapid pace as well. Most people are 20/20 by hour four but, interestingly, they won’t feel like they’re quite 20/20 yet. That’s because contrast sensitivity isn’t quite there yet. Contrast sensitivity is the clinical term for what would most accurately be described as how sharp the vision looks. If you can read every word of the ticker moving across the bottom of your TV screen, but none of them look sharp and clear, that is poor contrast sensitivity.
At this point, because you don’t have very much—or maybe any—feeling of a foreign body sensation or light sensitivity, your caretaker is usually off the hook. If you’re looking to get a sandwich made for you, or if you chose a specific friend because you’re looking for an excuse to hold their hand, you’ll have to get that done in the first two hours. That’s because hours three and four have turned you into a person who doesn’t look like they need much help. What about driving? You still should have a driver. The big reason is there’s no way to legally say it’s okay to drive until the post-op the next day. It’s important to point that out because there is a nearly 100% chance you’ll feel okay to drive before then. That leads us to the final two hours of the six-hour recovery period.
Hours five and six after LASIK:
By this point, almost everyone feels pretty great and is pretty pleased with their vision. If it is nighttime, then there are still halos and starbursts coming off of lights. (It’s only been a few hours, so I wouldn’t worry about it very much.) But do you need a someone to care for you? No. I mean, emotionally in a metaphysical kind of way, sure—we all do. For your surgical recovery though, it is exceptionally rare for people to need help at this point. Except for one category. If you guessed “needing a driver,” you guessed right!
There’s a reason for including six hours in the recovery window, even though most people are pretty independent at hours three and four, and almost everyone is up and running at hours five and six. For six hours, there are these little vials of preservative-free artificial tears that become like tiny, close friends. Every 15 minutes for 6 hours, a tear must be placed in each eye. Why? Because it is sooo worth it. The lifelong polish and smoothness of your eye (and consequently, your vision) is worth a somewhat annoying, every-15-minute ritual.
For many people, it is a big help to have a person to help with artificial tears. That may mean they are an artificial tear cheerleader, or coach, or it may mean they actually do the drops for you because it’s easier for you that way. It’s a time to bond with that person. My hope is someday I meet a couple whose lifelong romance started this way after one of them had LASIK with us. What kind of care did they need after LASIK? Someone to give them so many artificial tears for those six hours that they vowed to never make them cry again. I’d watch that movie.
Author: Joel Hunter, MD is an Ophthalmologist, Refractive Surgeon, and the Founder of Hunter Vision, a LASIK Orlando Clinic in Florida. A recognized and respected specialist in vision correction who has performed a countless number of refractive surgeries, Joel gives lectures across the country and trains fellow doctors in the newest LASIK surgery techniques.