Refractive Errors & Surgeries

A refractive error is an eye disorder caused by irregularity in the eye shape making it difficult for the eyes to focus the image clearly which can cause blurry vision.

Types of Refractive Errors

Myopia (Nearsightedness) 

In myopia, the eyeball is too long for the normal focusing power of the eye. As a result, images of distant objects appear blurred¹.

Hyperopia (Farsightedness)

In this condition, the eyeball is too short for the normal focusing power of the eye. In children, the lens in the eye accommodates for this error and provides clear vision for distance and usually near viewing, but with considerable effort that often causes fatigue and sometimes crossed eyes (strabismus)¹.

Astigmatism

Astigmatism results primarily from an irregular shape of the front surface of the cornea, the transparent “window” at the front of the eye. Persons with astigmatism typically see vertical lines more clearly than horizontal ones, and sometimes the reverse¹.

Presbyopia

Presbyopia is a decreased elasticity of the lens due to advancing age which moves the near point of vision farther from the eye, making it difficult to focus on near objects¹.

Examination

The first appointment examination includes the following steps which may take about 1 – 2 hrs.

1

Schwind Sirius and Keratron Scout

Using modern equipment, this is done to have a detailed topographic map of the cornea, which is the transparent frontal layer of the eye.

2

Pachymetry Technique

For measuring the thickness of the cornea. Corneal thickness is a parameter as important as knowing your current prescriptions when choosing the most beneficial surgery method.

3

Pupillometer

For the measurement of the pupil's diameter. Pupils dilate and contract in response to the amount of light. Pupil diameter is wider with some people. Especially with these patients, it is important to plan and coordinate the operation according to this measurement. This precaution prevents occurrence of glare, haze night-vision problems and halos after the operation.

4

General Examination

You will go through a detailed eye examination that include measuring your refractive error and eye pressure. Full detailed history will be conducted that include age, occupation, working conditions (tailor, teacher, computer engineer, architect, pilot etc.), and any systematical disorders such as diabetes, thyroid disease and high blood pressure. 

5

Examination using dilating drops

After application of dilating drops and a 20 to 30 minutes waiting period, a comprehensive examination of the retina (the back of the eye) is carried through and in cases to gain accurate refraction. The data acquired is analyzed by our refractive surgeons and the most beneficial treatment method for your eyes is determined. 

Types of treatments

PRK

The surgeon removes the epithelium (the uppermost layer of the cornea) using surgical instrument or an alcohol solution without creating a flap, then an extremely precise computer controlled excimer laser is used to reshape the cornea, as needed, in order to sharpen vision. Bandage Contact lens is applied to allow new epithelial cells to grow onto the cornea more quickly for faster healing and are to be removed in 3-7 days.

TransPRK

The TransPRK is a touch free laser eye correction method , the Schwind Amaris laser machine first removes the epithelium without using any instruments and then provides extremely precise computer controlled excimer laser to reshape the cornea as needed to sharpen vision.Bandage Contact lenses are applied to allow new epithelial cells to grow onto the cornea more quickly for faster healing, and are to be removed in 3-7 days.

Standard LASIK

A very thin superficial corneal flap is created using a manual surgical tool called keratome to access the underlying cornea for the laser treatment. The Schwind Amaris laser machine is then used to correct the refractive error. After the laser procedure, the flap is laid back in place. The flap then seals to the underlying cornea during the healing process following surgery.

FEMTO LDV Z8 LASIK

This is a bladeless Lasik procedure in which a corneal flap is created with a unique femtosecond laser using low energy pulses to reduce postoperative complications. In addition, this procedure minimizes the risk of creating an incomplete cut of flap. Dr. Haifa eye Hospital is the only Hospital in Bahrain that provides this type of advanced technology.

EPI-LASIK

In this type of procedure, the flap that is created on the cornea is thinner than a lasik flap, making it safe for patients with thinner than normal corneas.

PRESBYMAX

This is a sophisticated laser eye surgery that is only available on the Schwind Amaris 1050RS laser platform. Presbymax treats presbyopia (reading vision problems). In addition to this, other conditions can be corrected at the same time such as myopia, hyperopia and astigmatism. Similar to PRK, the procedure is quick, as it only takes a few minutes, and is done without touching the eye. The treatment exclusively utilizes laser treatment to correct the complete range of focus to distance objects, intermediate range and close print reading.

ICL Lens implantation

In this procedure, an artificial lens is permanently implanted in the eye. This lens is used to treat Myopia, Hyperopia and Astigmatic cases. It is a good alternative for patients who don’t make a good candidate for laser eye surgery. This procedure can be suggested in cases with a thin cornea and a high refractive error.

FAQs

Can I have Lasik surgery with keratoconus?

Keratoconus is a contraindication to Lasik or PRK. However, keratoconus patients should undergo cross linking procedure to prevent the progression of keratoconus in the future. Once cross linking is done, it is then possible to consider refractive surgery in some cases.  

Will I experience pain post Lasik surgery?

There is minimal eye pain post Lasik surgery when comparing with PRK. However, it differs from person to person, where some are more sensitive than others and the pain level varies. 

Can I undergo refractive surgery while pregnant?

Lasik or PRK is not advisable for pregnant women because for some patients, refraction may change temporarily during pregnancy.

What are the treatment of dry eye post lasik surgery?

Firstly, a dry eye examination will be conducted by your consultant. This will determine the type of dry eye you have, and then the best treatment will be advised and offered, such as, artificial tears, punctal plugs, etc..

Will I be able to travel and engage is water activity after lasik surgery?

You are able to travel post-surgery but your doctor might recommend to increase lubrication during the flight. Swimming is advised to be stopped for at least two weeks after surgery.

Is refractive surgery possible for patients with amblyopia?

PRK or Lasik is possible for amblyopia patients but the surgery will not make the vision return to normal 6/6. It will only make the eyes see as well as it did with your glasses.