Many a problem of lasik eye surgery (1. vision loss 2. debilitating visual symptoms 3. undertreatment 4. overtreatment 5. dry eye 6. results changing with time and age 7. loss of depth perception in monovision surgery 8. accidental malfunction of equipment) along with its high price (in the range of $4500 - $5000 for wavefront lasik for both eyes) is a major deterrent rightly stopping people from going for lasik eye surgery.

Operating on an irregularly shaped cornea can also cause vision loss. So in preoperative tests, a surgeon uses a corneal topographer to map the cornea's contours. Conditions such as ectasia, a steepness in the lower part of the cornea, and keratoconus, a bulging cornea, should disqualify the patient from laser surgery. Patients with these irregularities may see so poorly after lasik that they need corneal transplants.

Oversize pupils are also a problem. They can lead to a group of complications known as GASH--ghosting, arching, starbursts, and halos in which objects seem fuzzy at the edges and light sources seem to burst like the sun. "Every light is like the Fourth of July for me, with fireworks shooting out of it," says Frank Boydston, a San Diego financial analyst who had lasik last year. The problem arises because lasik lasers are built to operate on eyes with pupil diameters of 6 to 8 millimeters. Boydston discovered after the fact that his pupils exceed that limit.

Dry eyes, which sting from a lack of tears, are tolerable for most, patients. But for those who already have dry eyes, the condition can become so debilitating after surgery that they can no longer be in a dry environment-such as on an airplane-without excruciating pain. The Schirmer tearing test detects dry eyes by using paper filters to measure tear production. A tear spot less than 8 millimeters in diameter is a sign that the patient has dry eyes and may want to avoid lasik.

Painful abrasions on the eye can become a recurring problem for lasik patients who have epithelial basement membrane dystrophy (EBMD), a disease of the cornea's membrane, which causes it to erode. "It's one of the most painful things I've ever experienced," says Thomas LaMark, a freelance musician in Andover, Mass., who has EBMD and had lasik. "The eye becomes extremely bloodshot, swells up, and almost closes." To test for EBMD, the surgeon should stain the eye with a chemical called fluorescein and examine it under a lamp. The stain will have a different color in regions of the eye with abrasions, an EBMD indicator.

A common condition known as presbyopia can present another problem after LASIK surgery: difficulty in reading. The eye's lens hardens with age, and adjustments in focus from near to faraway points are difficult. lasik simply reverses the problem, so the person can see distances better but not up close. The test for presbyopia is a basic visual-acuity exam to measure the level of impairment. Presbyopic patients will need reading glasses after lasik, though they should be able to drive their cars without glasses or contact lenses.

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