After presbyopia surgery, your doctor will want you to rest a bit. Then you will be released to go home (you won’t be ready to drive yet, so someone should be with you). Your doctor may give you protective sunglasses or shields to wear to protect your eyes.

Most people feel fine after presbyopia treatment, and others feel nothing worse than mild discomfort. You may feel mild burning or itching, the eyes may water and the whites may look red or bloodshot. These are all normal and your doctor may prescribe a mild pain reliever.

Fill and take any needed prescriptions and continue to rest as recommended for a couple hours.

Avoid rubbing your eyes, though you may instinctively want to. While the corneal flap is healing, there is a slight risk of displacement with the friction and trauma of rubbing or itching.

The first day after laser eye surgery, your eyes may be sensitive to the touch and maybe even feel a little scratchy for a few days. Your eyes may water and the whites may look red or bloodshot. These are all normal and your doctor may prescribe a mild pain reliever. As your body adjusts, you will probably feel like resuming most of your normal activities.

Call your doctor immediately if you think there may be a problem or have questions. Only a doctor who has examined your eyes and has your complete medical history can say if your situation is within normal limits or requires additional care.

It is essential to follow all your eye surgeon’s instructions and keep all post-operative appointments.

Most people are able to return to work quickly, even as soon as the day after presbyopia laser eye surgery. Others take a couple days’ rest.

At your first follow-up appointment, your doctor will test your vision and examine your eyes. He or she may also give you eye drops to prevent infection and/or inflammation. And you may be advised to use artificial tears to help lubricate the eye as it heals.

If only one eye was treated initially, the second eye can usually be scheduled for surgery a week or so later.

Your doctor may advise you not to use lotions, creams or make-up near the eyes for a week or two after surgery. For several days, be careful not to get water in your eyes while bathing or washing your face. Strenuous exercise should also be avoided for up to a week and contact sports for a few weeks, as these can affect healing. Swimming, hot tubs and whirlpools are also to be avoided for a period of time.

As your vision continues to improve, there are things you can to do to strengthen and practice your near, intermediate and distance vision to help you adjust to monovision more quickly.

Exercising your near vision

The following activities are recommended to practice your near vision:

• Reading
• Writing
• Painting, needlework or other close work
• Shaving or putting on make-up
• Dialing the phone or working on a handheld device
• Ordering from a menu
• Eating

Challenging your intermediate vision

The following activities are recommended to practice your intermediate vision:

• Looking at the computer monitor
• Watching TV
• Cooking and reading recipes
• Reading tags and labels while shopping
• Gardening
• Sporting activities like focusing on an approaching ball or seeing an object in the road as you approach it on a bicycle

Practicing your distance vision

The following activities are recommended to challenge your distance vision:

• Sports, especially golf and tennis or other sports that require the ability to focus on an object in the distance
• Watching a movie in the theater or attending a play

Putting it all together

The following activities are recommended to exercise all ranges of vision at once:

• Playing with pets or children, or any activity that includes people or things approaching and receding from you.
• Sports that use balls require that you train your eye how to see over the entire visual range.
• Walking, especially hiking or any other kind of exploratory activity, in which you look at things near and far.

As your eye heals, your vision may take two to three months to reach its best focus. In some cases, vision continues to slightly improve even at six months after surgery.

Your surgery will be planned based on the average patient’s healing response. But every eye heals differently. If you are an aggressive or slow healer, you may develop an undercorrection or overcorrection of your refractive error.

Rarely, a patient may instead see visual improvement and then see it diminish again to some degree over time. This is called regression. It is most likely to occur for people with high levels of refractive error.

In any of these cases, once your vision has been stable for at least three months, a touch-up treatment-also called an enhancement-may be needed to gain the best vision possible.

Whether or not to have a touch-up is largely a matter of personal preference. Your doctor will advise you about which type of touch-up would be best in your case.

Some patients, especially those with high refractive errors, may still need glasses, reading glasses or contact lenses under some circumstances, even after obtaining their best corrected vision from laser vision correction. However, the prescription level will generally be much lower than before surgery.

Following any surgical procedure, it is normal to experience some side effects as your body heals. These are generally short-term symptoms and usually do not affect your daily activities. They are treatable and tend to get better by themselves in time.

The common side effects of laser vision correction include temporary night vision symptoms and dry eye. A slight undercorrection or overcorrection of refractive error is also possible.

As a temporary side effect, you may see glare, halos or starbursts around lights at nighttime while driving or doing other activities. Occasionally these symptoms can interfere with normal activities, but usually they are not significant and resolve within three to six months as your eyes heal.

A 10-year survey of scientific studies from around the world has shown that many people have some degree of night vision symptoms naturally and that laser vision correction more often reduces these symptoms than it increases them.

One way to reduce your incidence of night vision symptoms after treatment is by choosing Wavefront-guided or Wavefront-optimized LASIK. Because they are more customized to your eye, these advanced technologies result in fewer night vision symptoms.

If you have bothersome night vision symptoms, a touch-up Wavefront treatment following your initial LASIK treatment or wearing glasses may help. Treatment of dry eye symptoms with artificial tears may also help relieve night vision symptoms.

In some cases, night vision symptoms may be permanent, but many patients say symptoms are so mild that they prefer not to wear glasses or have a touch-up at all, because the symptoms do not significantly interfere with activities.

While your eye is healing, its normal system for producing moisture is temporarily disrupted. This often causes your eyes to be dry for a time after surgery and may cause fluctuating vision for some time. As the nerves in your eye heal, they become better able to send information to and from the tear gland again. This allows the eye to resume producing moisture as needed.

Artificial tears and other treatments can protect your eyes while they are healing. For most patients, dry eye symptoms are mild and temporary. Those who experience difficulties generally say symptoms go away within six months as the eyes heal.

The best way to avoid dry eye is to be carefully screened prior to surgery. A small number of patients may be prone to long-term symptoms. Treatment of mild to moderate dry eye ahead of surgery may also reduce your experience of dry eye afterward. And an all-laser flap has also been shown to produce fewer cases of dry eye. Your doctor can advise you of your specific level of risk.

As with any surgery, LASIK risks include certain complications. But today, such complications are rare, thanks to the latest technology and rigorous safety precautions, and almost all complications of laser vision correction are treatable.

Don’t forget that all of the complications mentioned below are all extremely rare-most people do not experience any of them.

"Flap" complications from laser eye surgery

During laser vision correction, a flap is created on the cornea. If it is made too small or too thin or if it is irregular or torn, it may be necessary to halt surgery. It may be possible to resume laser treatment after several months. Other flap complications can also cause the cornea to become irregularly shaped, leading to symptoms like blurry vision or nighttime glare. However, these symptoms can often be reversed with a laser touch-up treatment. Some flap complications can lead to serious visual impairments that may require additional treatment.

As your eye heals after surgery, it is also possible (though rare) for the flap to become dislocated, especially due to trauma like eyelid rubbing or squeezing or due to blunt trauma from flying objects. Should this happen, seek treatment immediately for the best outcome.

Occasionally, a flap may not heal evenly and smoothly. It may develop tiny wrinkles, the smallest of which (called micro striae) are so fine that they do not affect your vision or require treatment. Other wrinkles (called macro striae) are still very fine, but may need to be treated with a touch-up LASIK procedure if they are noticeable to you and visually significant.

A flap complication during surgery may make your eye more prone to epithelial defects (see below).

Studies show a lower incidence of flap complications with an all-laser flap.

Epithelial ingrowth

Epithelial cells cover the surface of the eye. After surgery, they may grow beneath the flap, called an "ingrowth." This condition is more common in patients who have had touch-up procedures compared to those who have only one procedure. Patients who have flap complications are also more prone to this condition. Epithelial ingrowth can appear one to two days after surgery and more often occurs one to three months later.

Most epithelial ingrowth is harmless-it does not affect vision or require treatment. If it occurs within the field of vision or affects a wide area, however, follow-up surgical treatment is needed to remove the epithelial cells from the flap.

Irregular astigmatism

This complication from laser eye surgery is now rare, thanks to developments in surgical technique and Wavefront-guided technology.

Irregular astigmatism is caused by an uneven corneal surface, which can occur during surgery or when the flap heals irregularly. This condition results in symptoms like blur and double vision and can be treated with a touch-up LASIK procedure.

Ectasia

This condition (also called keratectasia) is rare.

Ectasia is a bulging of the cornea and may occur if a flap is too deeply cut, if too much material is removed in reshaping the cornea or if the cornea was already weak or at risk prior to LASIK (which may or may not be seen in pre-operative topographic mapping). It also rarely occurs in the absence of risk factors.

Ectasia causes vision to be distorted. Gas permeable contact lenses or corneal implants (Intacs) may be required instead to obtain corrected vision. Rarely, a corneal transplant may be required. A new technique under investigation, called collagen cross-linking, may provide a new way to stabilize the cornea, as well.

Infection

A clean surgical environment and modern broad-spectrum antibiotics make infection rare today. In fact, studies suggest you may run a greater risk of infection while wearing contact lenses than following laser vision correction.

However, as with surgery on any part of the body, infection as your eyes heal is a possible LASIK risk. Most eye surgeons prescribe daily antibiotic and/or anti-inflammatory eye drops for a short time following laser vision correction to prevent infection. Some surgeons may prescribe lid-cleaning measures and antibiotics preoperatively, as well, in certain circumstances.

Inflammation

If you develop inflammation (swelling) under the LASIK flap, it may feel scratchy and uncomfortable. If left untreated, it can interfere with healing or even cause vision loss. Call your doctor immediately if you experience these symptoms.

Inflammation is treatable with antibiotics and topical steroids, which usually resolve the condition. If necessary, the flap can also be surgically rinsed to remove inflammatory cells and prevent tissue damage. Although rarely necessary, oral steroids may facilitate more rapid resolution of inflammation.

Transient light sensitivity

With this rare condition, the eyes become unusually sensitive to light between two to six weeks after surgery. It is more common with an all-laser flap and is usually treatable and short-lived.

Steroid treatment should be started promptly while the condition is mild-in the first three to four weeks of having symptoms. If left untreated for six to eight weeks, sensitivity may become severe. With treatment, however, most if not all symptoms typically go away within weeks. In rare instances, symptoms may persist indefinitely.

Lower your LASIK risks even further

There are steps you can take to keep your LASIK risks as low as possible:

• Choose an experienced, board-certified surgeon. Studies show that complications reduce dramatically after a surgeon treats more than 200 eyes with LASIK.
• Ask prospective surgeons what percentage of patients they refuse to treat and choose one that refuses at least 10% of patients or more. Why? Not all patients are good laser vision correction candidates. If you are one of these, you deserve to know.
• Share your full health history with your doctor, follow all instructions before and after surgery and notify your doctor promptly of any problems.
• Wavefront-guided or Wavefront-optimized LASIK and an all-laser flap may also reduce your chance of experiencing complications as well as side effects.
• Be sure to attend all follow-up appointments so that if rare complications develop, they can be treated promptly.

A thorough screening, regular follow-up appointments and realistic expectations are the most reliable predictors of success. Learn how to choose your doctor for optimal results.

You can resume most normal activities immediately after surgery. However, for at least two weeks you should avoid activities that would cause perspiration to run into the eyes. You should also avoid contact sports or swimming for several weeks. Your surgeon may recommend wearing safety glasses during contact sports for at least one month after LASIK (you should wear safety glasses during contact sports anyway).

If you participate in boxing, wrestling, martial arts or other activities in which blows to the face and eyes are a normal occurrence, LASIK may not be for you-talk with your eye doctor about other surgeries that might be more appropriate.

It depends on your occupation. Certain jobs that require intense clarity of vision (dentistry and surgery, for example) may be difficult to perform for one or two days after surgery. Most patients can return to work the next day, assuming their vision is adequate for their job. However, some people may feel fatigued for a day or so following surgery.