Lasik works by creating a flap in the cornea. The cornea doesn't normally have a flap. So will these flap serve as a point of weakness for the eye in the future? What happens if you get punched or hit in the eye after lasik?
With the invention of femtosecond-laser created lasik flaps, lasik flaps have become more stable. It is very rare for the flap to dislocate in the future - even with trauma such as being hit or punched in the eye! Typically, any trauma that will cause any issues with the lasik flap will cause a lot more damage to the eye.
However, if you are punched in the eye and noticing symptoms, you should seek medical attention. Even if nothing is wrong with the lasik flap, you still can develop other issues with the eye that need to be treated. But does the data say about the lasik flap?
The Data
Whats a good group to study on trauma to the eyes? The US military...
Not only does the US military have large records on injuries including eye injuries, the US military also has many service members treated with lasik - the US military has always been proactive about laser vision correction.
In fact, between 2006 and 2011, the U.S. Navy had performed over 25,000 lasik procedures.
During that same time frame, there were only 3 service members who developed a traumatic dislocation of their lasik flap. This works out to a rate of 0.012%.
In addition, each of these 3 service members, when the lasik flap dislocation was repaired, they all ended up with 20/20 vision or better!
Not all 25,000 of those service members got punched in the eye. But still, with most trauma to the eye you are more likely to have other serious issues before you develop any issues with the lasik flap. This includes blunt force trauma such as being punched in the eye.
Laser Created Lasik Flaps Are Strong
One big reason why lasik flaps are so strong and secure on the eye is the invention of the femtosecond-laser created lasik flaps. These lasik flaps are just better.
Prior to the laser, flaps were created by a blade called a microkeratome. Lasik flaps created by a blade are much more likely to develop a flap dislocation. In fact, within the first few days after surgery, lasik flaps from a blade are 10 times more likely to dislocate! (but fortunately still only at a rate of 0.03%).
What makes laser created lasik flaps stronger?
- Using a laser to create a lasik flap actually creates a little more inflammation at the edge of the lasik flap. This inflammation will generate a little more scarring at the edge of the lasik flap. But don't worry, this is a good thing. The scarring will actually act like superglue to secure the lasik flap in place.
- Laser-created flaps also have a more refined geometry than flaps created with a blade. The laser allows us to create complex 3D shapes. Instead of having a single cut through the cornea, the laser can create a flap that actually has depth and a bevel. Both of these features allow the lasik flap to lock in place on the cornea.
Laser created lasik flaps have dramatically added to the safety and long-term stability of the lasik flap.
Our Natural Defenses From Eye Punches
Many punches to the eye won't actually affect the eye. Our body is actually designed to prevent injuries to our eyes as much as possible.
Ever see someone with a black eye from being hit in the eye? The skin all around the eye may be dark and bruised but the eye may look totally fine (or just slightly red). This is our body's defense mechanisms at work.
Black eye; Photo by clydeorama on Flickr (CC BY-NC 2.0)
If you run your fingers around your eyebrow and below your eye, you will find a bony ridge. This is called the orbital bone. If you make a fist, you will actually find that the fist is going to hit this orbital bone first before making any significant contact with the eye.
This orbital bone will absorb much of the energy from the punch. By the time the punch has hit the eye, it doesn’t have much force left over to cause significant damage to the eye (in most cases).
What To Do If Punched In Eye
First thing first, if you do have blurry vision, double vision or pain, go to the emergency room. If the eye is completely red, go to the emergency room. If you have any doubt...go to the emergency room.
Injuries to the eye can become a whole lot worse without any medical attention. If the punch was able to cause damage to the eye, you need to see a doctor to evaluate for any injuries.
What about the lasik flap? Any issues with the lasik flap will cause one of two things: pain / discomfort or blurry vision. If you don’t have any of these things, chances are that you didn’t create any new issues with the lasik flap. (also check out Everything You Need To Know About Flap Dislocation After Lasik)
- If the lasik flap gets displaced, the part of the cornea where the lasik flap was situated will suddenly become exposed. The cornea is very sensitive. And any exposed parts of the cornea will be very painful. You will notice pain or discomfort even if the lasik flap just gets slightly displaced.
- You can also have some blurred vision. Your vision is sharp when the lasik flap is flat and smooth. If the lasik flap becomes displaced, it can become wrinkled. This can cause your vision to become distorted and blurry.
If you are punched in the eye, whether an emergency or not, it is still a good idea to visit an eye doctor to do a full evaluation of your eyes and make sure everything looks as it should.
Summary
If you are punched in the eye, chances are very low that you will develop any issues as a result of lasik. The lasik flap is very secure on the eye. Our eyes are also decently protected by the bone surrounding our eyes. However, you still can have other issues with the eyes which can require emergent treatment to fix.
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