What I learned from LASIK

My eyes tolerated soft contact lenses for almost 10 years. As many others have also experienced, I began to have infections after these years of wear. As far as I could tell, the infections were directly correlated with how much I wore my contacts. I was told by an eye specialist, that many people search around for new brands of lenses or solutions, but I had had enough. Despite the fact that it had been performed here for only 5 years and the risks were greater for my large pupils than for others, I went ahead with the costly surgery (I spent around $4000). To this day my eyes are overcorrected, and one now has a slight astigmatism, where neither eye did previously. I can deal with all this, since not wearing contacts makes up for the somewhat blurrier vision.

My first theory, directly inspired by my frustration at the blurry vision, was that I had been overcorrected on purpose. By “overcorrected”, I mean that I was myopic (nearsighted) before and I am hyperopic (farsighted) now. To explain my suspicion, first you have to understand the difference between the two conditions. Yes, myopic people are better at seeing close up rather than far away and hyperopic people are better at seeing far away than close up. This is due to the eye being either too short for the lens (in hyperopia) or too long for the lens (for myopia). When we look at an object, its image is projected somewhere in our eyes, and perfect clarity is acheived when the image is projected precisely on the back of the eyeball, the retina.

Contact lenses or glasses can correct for both conditions, but we are also able to correct naturally when an image is projected past the retina, as occurs in hyperopic eyes. This process is termed accomodation, but I always called it focusing. You are probably accomodating right now, reading this page. The effect of accomodation is that the image that the eye lens creates is moved toward the lens. When we want to view things closer to us, their images through a lens are projected back further than images from far away objects. So a normal eye must use accomodation to bring images of close objects (like small words on a page) to the retina. Also, if you are hyperopic, by accomodating you may bring an image which is projected past the retina forward toward the lens, until it is directly on the retina.

It turns out that my suspicion that I had been overcorrected on purpose was a result of my regular (not the surgeon) eye doctor giving me misinformation during a follow-up, but that is another story entirely.

While dealing with the outright effects of hyperopia (blurriness, more accomodation), I began to notice other, more subtle effects of the surgery. I was having trouble reading for long periods of time, and I would get fatigued fairly quickly compared to reading with no contacts in before the surgery. I soon realized that when I was myopic I required no additional accomodation to read something, as my eyes were the perfect shape to receive close images clearly when not wearing contacts or glasses. Now I was studying to get a PhD and I had capped my reading limits. Great timing as usual.

This was sort of unimportant compared to the possible implications. The condition this surgery put me in a unique position to directly understand the difficulties of reading for hyperopic people. I always loved to read as a child. What if I had been farsighted as a young child? Would I have enjoyed reading? Would I have finished my math homework every night? There is no way in hell. I contend that children who grow up hyperopic are biased from the start against reading due to the relatively high degree of accomodation they must do while reading. Myopic and normal children, who are required to do little accomodation to read, are thus more likely to enjoy reading than hyperopic children. This subtle effect is supported by the ease with which mildly hyperopic children can slip through simple vision screening at schools. I believe the result of this bias is a corresponding widespread bias against academic success for uncorrected hyperopics, rooted in their reading stress. This is directly opposite the common belief that reading causes your eyes to “go bad”. Instead of reading causing myopia, I think that myopia causes reading. If this was my field, I would spend many years attempting to reseach and counter popular beliefs and practices in order to raise awareness of this possibility. It is not my field, so instead I have a full discussion of this problem on a web page.

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