LASIK Eye Surgery and Night Blindness

A common topic for patients that are screened at 20/20 Institute prior to the LASIK procedure is night blindness. For these patients, there can be concern about what their night vision will be like after their LASIK procedure. To accurately assess the likely night vision outcome for each patient, it is necessary to determine the cause for each person’s difficulty on an individual basis. There are several causes for night blindness that can be separated into (3) main categories:

Natural Occurring Conditions: these conditions are a result of genetic and environmental factors that can often be treated to lessen symptoms. Examples of these conditions include nearsightedness, astigmatism, dry eyes, extended sunlight exposure, large pupils and Vitamin A deficiency

Aging Conditions: these conditions are a normal part of the aging process of the eye that may or may not be improved by surgical or medical intervention. Examples of these conditions include cataracts, and macular degeneration.

Genetic Conditions: these conditions are inherited and typically have a permanent impact on night vision. Examples of these conditions include retinitis pigmentosa, Usher Syndrome, Keratoconus and many rod/cone dystrophies.

Testing for these conditions include annual eye health exams, refractions for glasses and/or contacts, and special testing like an electroretinogram for genetic conditions.

If before LASIK, the night blindness is caused by genetic conditions, the underlying condition is most likely not able to be treated and it may be progressive. Unfortunately, the night blindness is often permanent and the recommendation is to not drive at night, whether the patient moves forward with the LASIK procedure or not. If aging changes are the cause of poor night vision LASIK is usually not recommended.

If it is determined by the doctor that aging changes or genetic conditions are not contributing to night blindness for the patient that leaves the naturally occurring conditions. Naturally occurring conditions like dry eye and Vitamin A deficiency can be addressed prior to LASIK. If night vision issues related to a patient’s eyeglass prescription are the cause of their night vision symptoms, that may be able to be corrected or improved by LASIK.

The key to understanding a patient’s potential satisfaction level with their night vison post LASIK has a tremendous amount to do with what laser technology that is being used to correct the patient’s vision. In fact, this is probably the single most important question patients ask when it comes to visual outcome related to their LASIK procedures, especially as it pertains to their night vision after LASIK.

The FDA approved the use of excimer lasers (the type of laser used in LASIK) in 1995. When these corneal-reshaping lasers were first introduced they used a reshaping method known today as standard or traditional LASIK.

Although this type of reshaping does an effective job treating low to moderate prescriptions, it has a higher incidence of night glare and haloes. It is also less effective in treating farsightedness and astigmatism.

Many LASIK providers still utilize this older technology on their patients’ eyes today. While this type of laser technology is less expensive for both the provider and sometimes the patient, the majority of doctors agree that the more advanced and effective forms of LASIK are based on Wavefront Technology (Wavefront Guided or Wavefront Optimized®) corneal reshaping. These more advanced forms of LASIK give the patient a greater probability of the best visual result and the best quality of night vision.

A patient should be sure as to what reshaping technology will be used for their treatment and what they are being charged for that technology. Of course, when it comes to the probability of your visual result, LASIK is a “you get what you pay for” scenario. 100% of LASIK Patients at 20/20 Institute now receive Wavefront-Optimized® corneal reshaping.

While there are varying reports regarding night vision after LASIK, most studies show that patients who are screened appropriately and have the more advanced forms of LASIK reshaping technology are most satisfied with their night vison. Reports indicate that 98% of patients are satisfied with their LASIK outcome including their resultant night vision. ASCRS Eye World article, November 2014.

If you have any additional questions regarding night blindness and LASIK eye surgery, feel free to contact our experienced staff at the 20/20 Institute.