Glasses with progressive lenses, or LASIK?

In My Humble Opinion
1

I’m nearsighted, and I’ve worn glasses since I was 12 years old. I wore contact lenses when I was younger, but I ultimately decided they weren’t worth the trouble (my optometrist once told me that I have “oily tears”, whatever that means). I’m 49 years old now, and for the last few years, I’ve started to develop a certain amount of farsightedness as well, as is typical with people my age. I’ve reached the point where I have to take my glasses off to read a book or my phone - I can read without then, but not with them.

It’s getting kind of annoying, and my glasses are old and beat up anyway, so I’m considering progressive lenses for my next pair. My wife already has a pair, and she loves them. The thing is, they’re expensive. So expensive that I thought maybe I might as well take the next step and have LASIK surgery instead. I understand that LASIK can fix nearsightedness and farsightedness at the same time, and there’s a certain appeal to getting rid of glasses altogether.

Still, it’s surgery, and I’m not crazy about the concept. And what if it doesn’t work? So I’d like to hear your opinions and experiences.

2

LASIK’s main drawback is eye dryness, and the very-tiny chance that you may get corneal neuralgia, which causes long-lasting, severe, eye pain.

The advice I’d heard was that you shouldn’t do LASIK unless 1) you really, really hate glasses and/or 2) your eyesight is so bad that corrected vision is not a matter of comfort but of necessity (one lady, for instance, got LASIK because her eyesight was so bad that if she were in a burning house or something, she might not be able to get out the door without her glasses.)

Also…if I’m not mistaken, at your age, 49, you are kind of beyond the ideal time frame for LASIK - I think the ideal window is usually age 20-40.

3

I was told that at the time I got my LASIK, (because your eyes deteriorate after your 40s no matter what) but that was still in the early days, so maybe they have updated their opinion on it.

4

One of our older members recently had either LASIK or lens replacement cataract surgery; I forget which. Which went OK in one eye and disastrously in the other. I’ll PM them and perhaps they’ll choose to share their experience here. It being medical I’m not going to out them myself; let them do that if they so choose.

Contact lenses have advanced a lot since 20 or 30 years ago. As have surgery, so bewre of advice based on old experience.

I have worn progressive contacts (yes they exist!) for years. At age almost 65 I finally had to give them up because the compromises between my basic astigmatism prescription and the progressive far-sighted correction became too much as my need for far-sighted correction grew. With the result that my total corrected acuity was not as good as I wanted.

So I now wear non-progressive contacts for astigmatism, plus reading glasses for up close. I also have progressive spectacles that I wear when I don’t want to mess with contacts. The specs give a sharper correction at the hassle of wearing glasses all day. Right now I probably wear contacts 80% of my days, and specs 20%.

Some people find they simply cannot wear progressive spectacles. The way their peripheral vision “swims” as they move their head gives them vertigo. They are weird the first time you try them. But for me, and for many many people, the adaptation takes a couple days and isn’t bothersome after that. IMO/IME the only way to know for yourself is to try it out for yourself.

I know zippo about the the prices of glasses in Israel. I do know we in the USA can get adequate progressive glasses made by random Chinese websites for very little money. You might try that as a cheap experiment you can afford to throw out if you just can’t adapt to progressives. And if you can adapt, now spend real money to get well-made ones & keep the Chinese experiment as a spare.

Good luck however you go.

5

I’ve gone through it all.

  • Glasses in third grade. Nearsighted.
  • Contacts right after high school.
  • Then started needing reading glasses.
  • I said the heck with this and got LASIK. No complaints. I still needed reading glasses, but did not have to fool around with contacts.
  • Then I got cataracts. And got that fixed.

The cataracts where replaced with multi-focal lenses. It’s great. No glasses, no contacts no reading glasses for the first time since I was 9 years old.

Note: I always wear sun glasses, but that’s what you do in the Colorado high-country. Between the snow and thin atmosphere, it gets way, way bright. I got chided once visiting in-laws in Pittsburgh for wearing sunglasses on a not really sunny day. No, it’s not because I’m trying to look cool (would take a lot more than eyewear). I’m just very used to it, and often wear sunglasses on an overcast day.

I wear expensive sunglasses. They go where I go, I’ve been caught without them and it’s a problem.

6

I remember that thread, and I have a friend in real life that had the same experience with cataract surgery.
I personally had refractive lens exchange surgery back in May. It’s the same surgery, without the cataracts. I wasn’t a candidate for LASIK primarily because of my existing issues with dry eyes.

I’m not 100% happy yet, but I’ve been told that it takes a good 6 months to fully heal and adapt. I’m going on a vacation next month and will go diving, and I don’t need to worry about wearing contacts or being able to read my dive computer.

Pros of RLE (with the expensive multi focal lens upgrade, in my case): I’ll never get cataracts. My vision should never degrade. They fixed my astigmatism at the same time.
Cons: Expensive, both for the lens, and because the surgery is elective and not covered by insurance. I still see halos around lights at night. I’ve lost a little ability to read in low light.

I believe LASIK patients sometimes need glasses eventually, but it may be noticeably better than what you currently have.,

7

One thing I though of mentioning is the possibility for monovision correction. It’s not for everyone but for those who can adjust to it (or who always had it naturally), it can preserve near and far sightedness by having one eye for each. This is most likely not your case as you had vision correction from a young age, so I assume you are used to using both eyes fairly equally (though one will be always dominant). As I understand it it works well for someone who either had their eyes in this position naturally (different focus near/far for r/l) or had one eye so out of focus that the child developed to almost ignore one eye due to comparatively poor focus ability and use a single one most of the time, but not so far gone that there is a problem using it when needed. It’s not without its drawbacks as some depth perception ability is lost, but again for those who have always been like this it’s not a loss as they never had it.

8

I don’t think the two can live in the same eye simultaneously. They could correct a nearsighted eye and a farsighted eye.

But …

At your age, the overwhelming likelihood is that you’d still need reading glasses for near work post-LASIK.

Whether they tell you or not :wink:

And … yeah … a really thorough evaluation of your ocular surface, tear film layer, corneal thickness, etc., is of paramount importance to properly screen you for the procedure.

And if it were me? I’d have that exam done by somebody who does NOT do LASIK surgeries themselves.

[Raises hand]

My corneal neuralgia came by way of long-term use of prescription eye drops preserved with Benzalkonium Chloride --effectively, Drano for eyes.

You don’t want corneal neuralgia. Trust me.

9

I’m also shortsighted. I ttied contact lenses many years ago, but they were never comfortable.
That was in the days of hard lenses, and maybe they have gotten better since, but I couldn’t be bothered to revisit the issue; glasses are really not much trouble.

Progressive lenses are useful, they allow me to drive and work on a computer with the same glasses, though I usually read a book without glasses.

As for LASIK: I am not letting any kind of high power laser anywhere near my eyes, thank you!

10

My decision to use progressive glasses over LASIK was pretty simple. If I have an problem with my glasses, I can get another prescription. Even though the risk is minor, if I have a problem with LASIK, getting another pair of eyes would be more problematic.

11

That was me, no problem at all with summoning me for these threads. :slight_smile: My problem occurred during cataract surgery though, not Lasik.

As to the OPs question, count me among those warning of dry eye problems. I’ve had several eye procedures in my past, which increased dryness each time. Due to some complex issues, I was actually offered Lasik* many years ago which would be covered under insurance. I declined it, as I didn’t want the dryness to get worse. At that point, the docs had “plugged” my lower ducts to slow the tears being wicked away, and I occasionally was using drops as well. I didn’t want to push my luck and chose to stick with glasses instead.

Since I haven’t had Lasik, my experience is only hearsay. But the docs did warn of dryness problems from it. Like you, I cannot wear contacts very well, and have given up on them. I’ve tried a variety of progressive lenses and they made me almost dizzy. I can’t seem to get my vision in the right place to make use of them. I finally returned to the old standby - bifocals. I only get two focus options, but their fields are large enough to use easily.

Short version on the disaster @LSLGuy mentioned above.
In May I had cataract surgery, and during the second one, I had a violent movement/seizure of some type while the surgeon’s tools were “in” my eye. This caused some slight damage to my eye, and dislodged a lot of debris and torn tissue into the lens area. To his credit, the surgeon had a backup lens at the ready, inserted it, and did the best repair he could at the moment. Immediately after, I was blind in that eye – only perceiving light and dark. When I posted about it here, it did seem like a disaster to me.

But as the surgeons predicted, it has continually improved over time, and I can now focus quite well with the bad eye, but only a tiny field of view right in the center, which is swimming with large floaters. The outer area is hazy, as though looking through layers of Saran Wrap. I’m assured it can be completely fixed in the future, but we must wait a few more months for (lots of complicated reasons).

FTR: The other eye is nearly perfect. The astigmatism is corrected and my distance vision is so good I can drive without correction. The only problem is everything being too bright, and I can’t go outside at all without sunglasses. It’s like being dilated but with everything in sharp focus.

*Apparently Lasik can be repurposed to correct scar tissue. The docs said they’d correct my vision as a freebie, since they would be in there anyway.

12

Cataract surgery is quick and easy, but there is a real chance that you will develop Fuchs Corneal Dystrophy and have to have cornea transplants after a few years. I think there is enough risk in eye surgery to warrant avoiding it for cosmetic purposes like simply avoiding glasses. Get the graduated lenses and be safe.

13

Really?! A half decent pair of progressive glasses can be had online for around $60-70 (Zenni, Eyebuy Direct) but LASIK will run you multiple thousands in the US. If one were to go to the local retailer, then the price of glasses can rocket to 300 or 400. I have used the online guys with excellent results. I have progressives, single vision computer glasses and progressive sunglasses from them.

14

How does an optometrist test you online? Also, how can you buy glasses without trying them on first? How can you know they’ll look good on you?

As for prices, good glasses wth high-quality progressive lenses from a local retailer are about 4000-5000 shekels ($1,100-$1,400), while LASIK, which is partially covered by my medical insurance, costs around 6500 shekels ($1,800). That’s just what the prices are around here.

15

I had LASIK surgery about ten years ago and it’s one of the best decisions I ever made. On my ophthalmologist’s suggestion I traveled several hours and paid about twice what it would cost locally. The surgeon had several dozen of us lined up on a Friday afternoon and it ran like an assembly line. A quick eye exam and a Xanax followed by less than five minutes under the laser. Scratchy, dry eyes for a week and no complaints since. I was already practicing monocular reading vision with my contacts and the surgery corrected my eyes to exactly that prescription. The one weaker (nearsighted) eye that I use for reading has slowly become like my long distance eye and I’m just recently starting to rely on reading glasses for very small print.

16

I wear sunglasses outdoors all the time. My eyes are sensitive to light. It’s almost worse on overcast days than completely sunny ones.

I had LASIK about 24 years ago. It was really new then, and I’m normally not an early adopter of technology, but there was a financial incentive, and I was damned tired of wearing my glasses. I had no issues after at all. I did develop cataracts years later, but the replacement lens for one was like a permanent contact lens, and my vision is good enough now to pass the eye test at the DMV.

17

It took me about 5 seconds to adjust to the progressives and I love them.

I also ended up with only good eye after cataract surgery. The first eye went perfectly and corrected my nearsightedness, which was fairly mild anyway, but left me needing stronger reading glasses. In the second, the old lens tore and a piece was left in there in the vain hope I wouldn’t notice. A second surgeon fixed it (the first one having retired in the meantime–he was obviously past his best buy date), but then a few months later the retina detached. The operation required inserting a gas bubble in the eye to hold the retina down until it healed and I was supposed to lie face down much of the day. I guess I was too restless but it didn’t work. A second operation used an oil bubble instead. That worked, but the bubble is still there. It could be removed but there is an estimated 30% chance the retina would detach again. I still have some vision in that eye, so I’ve chosen not to have operation. Besides, the eyes are seriously out of alignment, so my brain basically ignores what I see out of that eye unless I close the other. In the meantime, the progressive lens works fine.

18

I will wear my sunglasses on an overcast snowy day. Know that I drive on very snow covered roads 50% of the time. They seem to help with contrast between snow, and that white car coming at you.

I don’t wear sunglasses at night. That’s it.

19

My mom had that before her cataract surgery and therefore I have the chance that I will inherit it. She has not had to have corneal transplants, so far, but this might be in her future. :frowning_face:

As I already have sensitive eyes, allergies, have had corneal bruises (due to wrong behavior with leave-in contacts in my 20s) and probably will have cataract surgery in my future, as both parents have had cataract surgery, I will not be getting LASIK. Ever.

Also because my parents’ friend, is a who was a professor of opthamology and also practiced, is not a fan of LASIK.

I have been wearing glasses since I was 9 or 10 and only wore contacts from 15 to 24. I have progressive lenses for daily use (driving, watching tv and walking around) and a different pair for working with a desktop. I also have prescription sunglasses. I adjusted well to the progressive lens and will probably get them again.

20

I go to an independent optometrist to get my eyes tested. Usually they are attached to a store selling glasses but I do not shop there, just get my prescription. The test is usually $60-80. I am an older fart so glasses are needed for seeing more than looking good. The glasses online have very detailed specs (:slight_smile: ) width, length, bridge size etc that you can compare with your current one. You should be able to see the basic measurement of your current glasses printed on the inside of the side arm

Online, nice frames run $25-30 and high index lenses will cost you less than $100. Compared to buying in store, it is not an expensive mistake. I have often bought glasses for family not living in the US.

Here is a data point for how much stores fleece you. The anti reflective coating is usually $30-40 extra in-store and it is $4 online. Most frames are manufactured in China by the Luxottica that owns almost all the big brands you think of. Hence the high prices