Refractive Eye Surgery

Surgery is a common treatment for vision problems. Procedures can help correct refractive errors. The purpose of refractive eye surgery is to reduce or even end your need for glasses or contact lenses.

What are refractive errors?

Good vision depends on how well your cornea and lens focus light rays on the retina. In order for light rays to focus on the retina, they must be bent (refracted). The retina is the light-sensitive nerve layer that lines the back of the eye. It generates impulses from light rays that are sent to the brain via the optic nerve.

Refractive errors are basically vision problems caused by a not perfectly formed cornea or an eye that is longer or shorter than normal. The cornea is the transparent part at the front of the eye. It bends and focuses light waves. Refraction errors cause light from an object not to focus on the retina. This causes a blurry image. Refraction defects can occur in healthy eyes.

There are 4 types of refractive errors:

Myopia (myopia). Nearby objects appear sharp. But things in the distance are blurry. The eye is longer than normal from front to back. Or the cornea is too curved. Images are focused in front of the retina, not on it.

Farsightedness (hyperopia). You can see distant objects clearly. But nearby objects are blurry. The eye is shorter than normal. Or the cornea is too flat. Images are focused behind the retina.

Astigmatism Objects are blurred at any distance. The cornea, lens, or both are shaped so that images are not sharply focused on the retina.

Presbyopia. This is also known as the aging eye. The eye loses its ability to change focus due to the natural aging process. This usually occurs between the ages of 40 and 50. Refractive surgery cannot correct this problem. Surgery can make far vision clearer. But it can make nearsightedness worse.

What to expect during and after surgery

Refractive eye surgery involves minimal discomfort. The eye is often numbed with eye drops before surgery. You may be awake during the surgery. Your eye may be kept open with an eye speculum. This is a spring-like device that is placed between the eyelids.

After surgery, you may take pain medicine and use eye drops to ease discomfort. Your eye surgeon will give you more information. The most common after-effects of surgery include:

  • Sensitivity to light
  • Blurry vision
  • Minor discomfort
  • Dry eyes
Recovery time from surgery varies depending on the surgery. Full recovery may take days, weeks, or months.

Choosing a procedure

LASIK is the most common type of refractive eye surgery. Benefits of LASIK include:

  • Less pain and faster recovery

  • It can correct a wide range of myopia

  • It can be repeated to correct vision further

  • The eye is not weakened, because only 1 flap is cut into the cornea

  • Little or no scarring of the cornea 

But other types of surgery may be more suitable for your needs. And refractive eye surgery is not an option for everyone. Talk with your eye care provider about your type of vision problem, and if surgery may be right for you. 

Medical Reviewers:

  • Chris Haupert MD
  • Stacey Wojcik MBA BSN RN
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