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Does Lasik Hurt?

Does Lasik Hurt?

How can it be that you can correct vision with a surgery on the eye and it be painless. But that's just the case with lasik. There is only one part of lasik which hurts. And it's NOT during the procedure itself.

Lasik does not hurt. You can have weird sensations during the procedure but it is technically painless. However, immediately after the surgery for the first 2-4 hours the eyes can hurt.

It is only this short window after lasik in which you can have some pain. Fortunately this heals over pretty quickly. But lasik isn't completely sensation free; you will feel things other than pain during lasik.

During the procedure

The cornea is one of the most sensitive structures in the body. Lasik involves applying laser energy to the cornea; if the cornea wasn't numb, lasik just wouldn't work. It would be way too painful. But the procedure itself is completely pain free. It's the only way lasik can actually work.

If you've ever tried to touch your cornea [note: I don't recommend trying], you would understand that it's very uncomfortable. Those that wear contact lenses know to be extra gentle when putting in and taking out the contacts. Most of the lasik procedure involves touching your eye. For lasik to work, you must not be able to feel those parts.

Numbing drops applied to the cornea are extremely effective. These drops completely block out all the pain on the cornea. These are the same eye drops you may have already gotten during an eye exam. They give the eye a “heavy” sensation.

The 20-30 minutes that these drops work is enough time for the whole duration of the lasik procedure. You don't have to worry about the drops not working or the drops not lasting (and plus you often get multiples sets of these drops to make sure that they are fully absorbed in the eye).

You can feel things during lasik

But lasik ISN'T sensation free. There are a few sensations which the numbing drops don't eliminate.

The first one you feel during lasik is a pressure sensation. During the step which creates the lasik flap, high amounts of pressure are used to secure the eye and ensure that the lasik flap is being created in the exact right position (see also How Does Lasik Work?). You WILL feel this pressure sensation. It will feel like a physics textbook is sitting on the eye.

After the lasik flap is created, sterile water and sponges are used to clean the surface of the eye. Numbing drops block out pain sensation but NOT temperature sensation. You can still feel a cool sensation on the surface from the water.

In addition, you can feel the sponges on the eyelids. While the numbing drops are excellent at preventing a lot of sensation on the cornea, the numbing drops don't really do much for the eyelids. Because of this, you will a tickling sensation on the eyelids from the sponges. This is the same reason you feel a stretching sensation from the eyelid protector. The eyelids just aren't numb.

If you focus real hard on these extra sensations, you can trick your mind into thinking you are feeling pain. If you squeeze down real hard on the eyelid protector, you will cause pressure pain. Best way to get through lasik is just to realize that all these weird sensations are normal and sit back and enjoy the show. Also, getting a Xanax or Valium before the surgery help.

Immediately after lasik

The real pain with lasik is within the first 2-4 hours following the procedure.

Because of the lasik flap created just below the surface of the cornea, you will have a semi-circular scratch on your cornea. Scratches are uncomfortable. But scratches also fortunately heal up quickly. Symptoms you may notice with this scratch include a stabbing sensation, the feeling like there is something in the eye or extra sensitivity to light. Some people actually get lucky and don't notice it a whole lot. Some people notice it a whole lot more and have a hard time opening their eyes.

This short window of pain is why many lasik surgeons tell their patients to go home and fall asleep. Best treatment is to completely sleep through the discomfort until the scratch heals up (which happens in the first 2-4 hours).

After the first day

Once the scratch heals up, there isn't anymore pain with lasik. But again, things may not feel completely normal.

Until the eye fully heals up, you can still notice a slight feeling like there is something in the eye. While the scratch has healed over and all the pain is gone, the healed scratch may not yet be perfectly smooth (similar to how if you get a cut on your skin, it takes time for the cut to completely disappear even after it's healed over). Your eye is very sensitive to picking up on any changes.

You can also have dry eye symptoms over the first few months as well. Everyone after lasik will have some short term dry eye. The lasik flap and treatment disrupt tiny corneal nerves that signal tear production. You will produce less tears after lasik until these nerves regenerate. With less tears, the eye is more prone to dry out and cause you symptoms of burning, irritation or again the feeling like there is something in the eye.

But these additional sensations are more of an annoyance rather than painful.

Summary

Rest assured that you'll be able to get through lasik. Other than the first 2-4 hours afterwards (which you may be asleep for anyway), you don't have to worry about any pain. The procedure is completely painless. Instead you can focus on being able to see without glasses or contact lenses afterwards.

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