If you wear prescription glasses or contacts, you may be a candidate for a fairly simple surgical procedure that can eliminate the need for glasses or contacts altogether.

Laser eye surgery, developed in the 1980s, has allowed millions of people to put away their glasses and see clearly. The procedure is performed by an ophthalmologist in a few minutes and recovery can take only a few days.

Refractive surgery, as it is known, is used to treat nearsightedness, farsightedness and astigmatism (an irregularly shaped eye), according to Femida Visnani, an optometrist with the Clearly LASIK clinic in Edmonton.

Patients for refractive surgery can be as young as 18: there is no age limit at the high end, although older people may experience a longer healing time. Visnani’s clinic recently performed refractive surgery for a 73-year-old pilot.

Refractive surgery essentially reshapes the front surface of the cornea — the transparent front surface of the eye. If you are farsighted, it is because the curvature of the cornea is too flat, making the eye too thin overall to focus properly on near objects. “In that case, the ophthalmologist uses the laser to reshape the peripheral surface of the cornea,” Visnani says. “That steepens it, making the eye, in effect, longer.”

In nearsighted patients, the cornea is too steep, making the eye too long to focus on faraway objects. The laser is used to ablate, or remove, the excess tissue.

There are two common methods for getting at the surface of the cornea. The first is PRK (photo-refractive keratectomy), in which the surgeon removes the outer layer of the cornea (epithelium) with a surgical blade or blunt instrument. A laser is then applied to reshape the surface of the eye. Healing takes about a week, while the surface tissue grows back.

The other, more recent technology is LASIK (laser-assisted in situ keratomileusis), in which the surgeon creates a flap in the cornea with a sharp blade or a laser. The doctor then lifts the flap and uses a computer-guided laser to remove tissue from the inside layers of the cornea. The flap is put back in place, and healing takes even less time. “We usually tell patients to take three days off,” Visnani says.

A number of factors, such as your age, the thickness of the cornea and your eyeglasses prescription will help determine which method is right for you. Occupation can even be a factor; until recently, certain military personnel were not allowed to have LASIK surgery because authorities feared the flap could become loose in a critical situation; that restriction has been lifted.

When considering refractive surgery, you should tell the doctor about any underlying diseases, says Dr. Allan Slomovic, an associate professor of ophthalmology at the University of Toronto. That includes systemic diseases such as rheumatoid arthritis and diabetes, as well as ocular conditions such as dry eye or thin cornea.

In most cases, the optometrist who works with the ophthalmologist will go over the treatment options with you. “The choice is up to the patient, whether they choose a conventional treatment, a customized treatment, a laser flap or a blade flap,” Visnani says. “All those are factors in the outcome.”

The time to complete the LASIK procedure is short — about two minutes per eye. Depending on the procedure and the clinic, the cost can range from $1,000 to $2,500 per eye. The procedures are not covered by provincial health plans.

Refractive surgery is not for everyone. “The surgery does not affect presbyopia, the need for reading glasses that comes with age onset, usually around age 40,” says Visnani.

But if you have a strong prescription for bifocals, the surgery can replace all but the reading portion of those glasses. “It is a huge advantage to go from wearing glasses 100% of the time to wearing them 25% of the time,” Visnani says.

If you are hoping to toss your reading glasses, researchers are developing refractive surgery to correct presbyopia. Those procedures are “not yet ready for prime time,” according to Slomovic, but there are options. One is a procedure called “clear-lens extraction,” recommended for people aged 40 to 55 with multifocal prescriptions that include a reading portion. The lens (the part of the eye that becomes clouded when cataracts occur) is surgically removed and replaced with a multifocal implant.

@page_break@“Clear-lens extraction has a tremendously high success rate,” Slomovic says. “It is not recommended for people who are nearsighted, but it can be a good alternative for people who are farsighted and presbyopic.” IE