Are contact lenses really riskier than LASIK?

Contact lenses and LASIK are both very low risk, but contact lens use over the course of your life is a somewhat higher risk for vision loss than LASIK.

Joel Hunter, MD
Joel Hunter, MD
Refractive Surgeon, Hunter Vision Updated 10/31/18 10:52 AM

The difficulty in internalizing the risk associated with contacts compared to LASIK isn’t in listing statistics. For one, anyone who wants that info can easily find it with a Google search. It’s not interesting reading stats on infections and loss of vision, but the information is easily accessible. Yet despite all the percentages immediately being available to anyone, few people search for them. And I believe that has to do with the other reason statistics aren’t the roadblock to understanding the risk of contacts vs. LASIK.

Almost no one cares about statistics enough to type a few words into a Google search bar because lists of numbers don’t speak to the real question we are asking about risk. Am I being wise or impulsive on a decision about something as precious as my vision? We can’t picture tens of millions of contact lens wearers or LASIK patients. It’s super easy to imagine how amazing it would be to have perfect vision or how awful it would be to lose our vision. The best statistics can do is influence which of those two visions of the future becomes the more intrusive thought.

To be clear, the statistics influencing what you’re reading here show that contact lenses and LASIK are both very low risk. Painting with a broad brush, which is mostly what we accomplish using statistics, contact lens use over the course of your life is a somewhat higher risk for vision loss than LASIK. It makes sense if you think about it. A one-time procedure with rigorous safety standards is usually going to win out over an every-day-of-every-year situation. It doesn’t mean contacts are inherently hazardous to your eyes. It means if you pull the lever on a corneal ulcer slot machine (you don’t see them much; they’re very unpopular) every day for several decades, your odds for hitting the unlikely and horrendous jackpot will inexorably rise over time. The biggest risk factor for vision loss is shared by LASIK and contact lenses: if the operator isn’t following perfect protocol every time, opportunities for problems appear. For LASIK, that operator is your surgeon. For contacts, it’s you.

The “flying vs. driving” analogy

I’ve made the comparison enough times that I wish I could come up with a new one, but I can’t find an analogy to fit quite as perfectly. Flying in an airplane and driving in a car both get you where you want to go. The statistics are very clear on the risk associated with them. “You’re safer on an airplane than you are in the car on the way to the airport” is the undisputed champion of the award for Statistic Most Likely to be Presented as Surprising Information but Everyone Already Knows. But why do people like to say it? And why does it do so little to decrease the heart rate of the nervous flyer? It’s because the fear is driven by the same factor we encounter with the comparison of LASIK and contacts. It’s not statistics causing anxiety. It is unfamiliarity. Whether we’re driving down the road or wearing contacts, the daily immersion creates a familiarity. And familiarity is comfortable. Statistics seem insignificant or, more precisely, unrelated when they’re about stuff we deal with all the time. The statistic about deaths per year from vending machines falling on people? It might as well be about the average size of moon rocks.

When we venture into unknown territory, however, statistics feel a bit useless for a different reason. It’s exceptionally difficult to dispel anxiety with math. If you’re five miles above earth and sitting next to someone with a fear of flying, the explanation of why there’s no reason to worry will not lower their blood pressure. Facts and figures do almost nothing to help someone through the visceral fear of the unknown. You know what helps? Trust. It’s comforting when you’ve got someone you can trust who knows way more about the unknown than you to guide you through it to the other side. A kid isn’t scared of the dark when his parent is in the room. I once, and only once, saw a nervous flyer feel better because someone was telling them facts during turbulence. It was because the person talking them through it from across the aisle was an off-duty pilot for that airline taking the flight home. Even then the facts didn’t help as much as the pilot’s familiarity with flying.

So are contacts overall riskier than LASIK? All things considered, yes. But if you’re worried about LASIK despite the fact that you wish you could get it, it’s probably not statistics that’ll help you. It’s usually a person who can help make the idea of LASIK a little more familiar and a little less of an unknown. It’s not a coincidence we meet way more new patients at Hunter Vision because their friend or online reviews told them about us rather than because they researched statistics. A guide is more helpful than a map. At a LASIK consultation, you should feel like you can ask about any statistics you’d like. And the answers should make you feel comfortable that you’re making a wise choice, including when the wisest choice is to avoid LASIK because it isn’t right for you. The most comforting part will never be the statistics though; it’s finding people you can trust to guide you through it.

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