Refractive surgery has become a huge business all around the world, supported by a steady advertisement on the media. It promises to solve all problems related to vision at a reasonable cost in a fast, clean and painless way Is it really so?

Light and shadows

Light may be there, provided by lasers, but there are also shadows, and what shadows!
Let's state a few points based on ophthalmology and optometry literature:

- People expect that after operation their eyes will be HEALED from myopia And expect to see well, just like somebody who never needed lenses.
The reality is that only the cornea (i.e the surface of the eye) is affected by operations, just like when you apply contact lenses, while the rest of the eyeball remains myopic.
Therefore, at best people will be able to see like a myopic wearing contacts (which is not as good as a normal, natural vision), but ...

- the vast majority of people after operations can see (after six months or so) better than they could without lenses, but worse than they could with the help of lenses.

- As a direct consequence of the operation they can develop problems impossible to correct with lenses, like irregular astigmatism, That is irregular shape of the cornea, because ...

- the cornea is in all kind of operations, greatly weakened. Many problems, even highly dramatic ones, can develop out of this. Of course, according to surgeons, ...

- every new kind of operation solves all the previous problems, but in reality creates new ones: for example in LASIK (the last procedure developed) there are no scars at the edge of the cut, but that means that the superficial layer of the cornea, the stroma IS NOT FIXED to the eye and a strong blow, like a car accident with ABS, may displace it or make it fall from the eye!

- Night vision is generally definitely worse than before operations.

- A shortsighted operated person will develop presbyopia (old age farsightedness) before than he or she would normally do, and will require glasses for reading.

All the information available shows that

operations give a poorer vision than lenses. And they give a weakened structure, a lot of pain (no wonder: nerves are burnt), and many risks. And no deliverance from glasses...

Why people undergo them so enthusiastically, then?

Field research

At the end of last year I did my best to gather information by extensively interviewing people (westerners) who had suffered an eye operation or intended to undergo one in Poona, India.

What I found is:

- People inquired very little before the operation. They only asked few questions to some friend, read some nicely illustrated (but very reduced in information) brochure provided by surgeons, and painted for themselves a very inadequate and optimistic picture of what would happen during and after the operation. This was twice surprising to me, because shortsighted people normally tend to be very, very cautious people.

- On the other hand I had a great difficulty to collect feed backs. They didn't seem to be interested to talk about their eyes (but somebody did, of course). Even all the call for feed backs which I made in Italy and Germany, sending letters, E-mails etc. gave very little results.

- People declared to be generally happy of the results, even when they were much worse than they expected (some of them had to undergo a second and a third round).

- They strongly felt that they had been "cured", that they had solved the problem once and for all, and could therefore forget all about it; this even in the face of evidence of eye tensions and poor eyesight. Nobody took the point that refractive surgery is like implanting lenses in their eyes, lenses that cannot be taken away.

- They had discarded the possibility of training their eyes to a natural vision as "too tiring or too long"; or they "didn't trust their own consistency in doing exercises".

Since then I extensively researched in many directions, not only through literature, but also seeking personal contact with people professionally involved in operations.

- Surgeons: needless to say, they try to keep their data as secret as possible (but some you get in Internet). What came out by interviewing people working with them is that some of them are good at programming the computer who run the laser, and some are not. Some get acceptable results and some always get bad results. This is a very well kept secret, but it is so.

- Optometrists are very busy trying to correct operations' by-products such as irregular astigmatism They used to be very critical about operations in the past, but now they see operations as a new source of income. Still, from them you get a lot of interesting details in private.

- Natural vision therapists. American vision therapists tend not to accept in their groups people who underwent operations.

Archaic religion

It seems to me that there may be hidden emotional factors at work, so much so that we could talk of "religious" attitudes:

- People expect that operations will change everything: they will be cured (= saved), once and for all.

- The change seems to be happening through the grace of a superior authority, using (almost) supernatural means: is it not fitting? They are using light to bring light back to your eyes.

- The change is expected to be sudden, like enlightenment or redemption.

- There is fear and there is pain. When this is recognized, is accepted as the price you have to pay in order to be rewarded: just like in a tribal sacrifice.

- There is no responsibility asked on your side: you only have to be ....patient. For the same reason you don't need to enquire: just trust and surrender.

If you also see these patterns, you will recognize them as a new form of a very old, archaic, kind of religion.

Personally I consider eye operations an unnecessary cruelty against one's body, with very few and largely illusory advantages and many disadvantages.

From this point of view I advise people to inquire and collect data, for example on the Web sites in Internet (see below). I also would advise them to talk with many people who did them and not only with a few, who may have some sort of vested interests in the subject (look at their eyes!). My point is not that people should not do them , my point is that it is better to see what operations are and what they do, avoiding wishful thinking.

Is there any positive side to operations?

Let's see. People tend to expect that through operations they will be able to forget all about, to be unburdened of a problem with no effort and no emotional troubles.

What is happening is exactly the opposite: there is a lot of physical pain, a lot of shifting of visual acuity, and a lot of emotional discomfort: your vision shifts very easily between near blindness and unbearable clarity and you may experience exactly those painful feelings that triggered your shortsightedness in the very beginning. And all that goes on for a rather long time: months, at least. A Purgatory...
Now this, painful as it may be, IS an opportunity for awareness and healing. In other terms: is an opportunity to become responsible for your eyes and the way you use them. But you can also close the eyes to reality...

Many holistic vision therapists simply refuse to accept operated people in their groups. I can understand their point: operated people may be difficult cases, both on a physical and a psychological level. I can see their point.
The approach of Buena Vista is different. It needs courage, the courage of seeing oneself. Or, you may say, the choice to be aware: then operations can be turned into a beautiful opportunity, and we can help in seeing patterns, and hidden drives that prevent seeing clearly

In the same process, people can also correct or prevent negative by- products of operations, such as poor night vision, loss of coordination between the eyes, premature presbyopia, and the likes.

Useful links

http://www.surgicaleyes.org/ A good site, is now becoming the most importance reference point for post-op "casualties",

http://www.lasikdisaster.com - Is exactly what it says in its name: a report on what can, and did in facts go wrong in an impressive amount of lasik operations.

References. From Medline, some important articles on PRK

There is an interesting article from BBC : people who regained 20/20 through laser are NOT any more accepted in German police, due to poor night vision

A personal report on PRK: www.geocities.com/badprklaser

References  Working with people's eyes  article from BBC The birth of Buena Vista  Summer holidays in Italy  English links