Refractive Surgery

Do you know that you may still be able to see more clearly even without experiencing blurry vision?

According to the National Eye Institute, many of the 150 million Americans who have some form of refractive error don’t know that their vision could be made sharper.

This is why it’s vital to have your eyes checked regularly by an eye doctor. At Focus Eye Care & Surgery, our board-certified eye surgeon, Dr. Neelofar Ghaznawi, specializes in general and specialized ophthalmic care. 

Dr. Ghaznawi is a member of the American Society of Cataract and Refractive Surgeons. With her extensive training and experience, you get accurate diagnosis and treatment that suits your needs. The result is better eyesight and a higher quality of life.

What Are Errors of Refraction?

At its most basic, refractive errors happen when the shape of your eyeball, cornea, or lens focuses light in front of or at the back of the retina, instead of on it.

The cornea is the clear covering at the front of your eyes. It takes up most of the eye’s light-focusing job. The crystalline lens, which hardens in old age, flexes so you can easily see far away or up close. 

The retina is the light-sensitive surface at the back of your eyes. Its photoreceptors convert light waves into electrical signals. These signals are sent to your brain via the optic nerve. The brain then interprets these signals to form images.

Causes of Errors of Refraction

Any problem in the structure of your eyes that disrupts the light-bending process reduces your eyes’ ability to see clearly. This means that refractive errors may be caused by any or two of the following:

  • When the eyeball is too long or too short instead of round
  • When the cornea is too steep or too flat instead of dome-shaped
  • When the crystalline lens is unable to flex due to old age
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Types of Refractive Error

When any one or two of the causes of refractive error happens, the following vision problems arise:

  • Nearsightedness (myopia) – far away objects look blurry but nearby objects appear sharp 
  • Farsightedness (hyperopia) – objects up close look blurry but objects at a distance appear sharp 
  • Astigmatism – objects up close or faraway look blurred or distorted
  • Presbyopia – objects far away appear sharp but close objects appear blurry due to aging natural lens

Refractive Surgery 

The type of refractive surgery you need depends on the type of refractive error you have. At Focus Eye Care & Surgery, our New York cornea surgeon, Dr. Ghaznawi, specializes in blade-less refractive surgery. She uses state-of-the-art technology and surgical techniques to restore her patients’ sharp and clear vision.

  • To correct myopia, refractive surgeons flatten the central part of the cornea or reduce the light-focusing power of the lens. For mild myopia, a surgical option is to implant “intacs” or intracorneal rings. These rings change the curve of the cornea so it focuses light better.
  • To correct hyperopia, eye surgeons make the central part of the cornea more curved. If the refractive error is caused by the lens, a multifocal intraocular lens (IOL) is implanted. This IOL enables the eyes to see at various focal points whether close up or far away.
  • To correct astigmatism, cornea surgeons change the irregular shape of the cornea, which causes light to scatter and images to look distorted. The result of surgical reshaping is a smooth and symmetrical cornea. This allows the cornea to focus clearly onto the retina. Advanced IOL optics also makes lens implants possible so people with astigmatism regain sharp distance vision.
  • To correct presbyopia, our refractive specialist in New York replaces your eye’s hardened crystalline lens with a cutting-edge IOL implant so you can see nearby objects more clearly.


How is refractive surgery done?

Refractive surgery is a surgical technique that uses lasers to correct nearsightedness. All refractive surgeries involve excimer laser delivery to the Bowman’s layer of the cornea that lies underneath the epithelium. Variations in refractive surgery are due to the technique used to assess the Bowman’s layer; some methods use a laser beam or blade to create a flap at the desired depth while some techniques completely remove the epithelial layer of the cornea. In nearsightedness, light rays fall in front of the retina, which diminishes visual clarity. Refractive surgery thins the cornea, which then allows light rays to fall on the retina.

What are the criteria to be a suitable candidate for refractive surgery?

In order to be a candidate for refractive surgery, your corneas must be of enough thickness to allow for safe thinning of the cornea via laser. Furthermore, you must be older than 18 years, your prescription glasses should have a stable refractive power for at least two years, and you should have no history of any corneal or other significant illness.

Are LASIK and refractive surgery the same?

Refractive surgery is a term used to broadly describe all surgical techniques used to correct refractive errors. It includes LASIK, PRK, RK, AK, LTK, ALK, and many more. LASIK differs from most of these procedures in how it uses a femtosecond laser to create a tiny flap on the corneal epithelial layer to allow the excimer laser to target the underlying Bowman’s layer.

Are there any age limits for refractive surgery?

Refractive surgery can be done in anyone older than 18 years of age. The reason for this age limit is that the eye continues to change in shape and size at least until 18 years of age. Some people even have continued changes in eyes beyond 18 years of age, which can increase prescription power of glasses. Therefore, another criteria for refractive surgery correlating to age is that the prescription power of glasses should have been stable for at least two years. There is no age limit for people older than 18 years, but factors such as comorbid conditions may limit a person from getting refractive surgery.

Does Medicare cover refractive surgery?

Unfortunately, refractive surgeries are not covered by Medicare as they are considered to be elective surgery. Medicare only covers eye procedures that are considered to be medically necessary such as cataract or glaucoma surgeries.

Call us today to see how we can make your vision sharper and clearer.

At Focus Eye Care & Surgery, our New York refractive surgeon will make a thorough eye evaluation to get the correct diagnosis. The result is a treatment plan developed with you so your vision and lifestyle needs are addressed.
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