Refractive error
By The Treatment Registry editors
Myopia (short-sightedness), hyperopia (long-sightedness), and astigmatism are very common refractive errors corrected by glasses, contact lenses, or surgical refractive procedures. Surgical correction is elective and depends on stable refraction, healthy corneas of adequate thickness, and absence of conditions like keratoconus that contraindicate laser surgery.
Treatment ladder
Conservative options are first-line where appropriate; surgical options are typically reserved for cases where lower-tier options are unsuitable or have failed. Decisions are individual and depend on clinical assessment.
Conservative
- Spectacles
Reversible, no surgical risk. The default option and the appropriate baseline before considering refractive surgery.
- Contact lenses
Daily disposable, monthly, or extended-wear options. Careful hygiene reduces but does not eliminate microbial keratitis risk.
Procedural
- LASIK · View procedure page
Laser-assisted in-situ keratomileusis. Femtosecond-laser flap creation followed by excimer-laser stromal ablation. Rapid visual recovery and minimal post-operative discomfort.
- PRK
Photorefractive keratectomy: surface ablation without flap. Slower visual recovery and more discomfort than LASIK but suitable for thin corneas and contact-sport athletes.
- SMILE
Small-incision lenticule extraction: a stromal lenticule is created by a femtosecond laser and removed through a small incision, without a flap. Promoted as having better biomechanics than LASIK; evidence for advantages over LASIK is mixed.
- Implantable collamer lens (ICL)
Phakic intraocular lens for high myopia or thin corneas where laser refractive surgery is contraindicated. Lens-based, reversible.
Surgical
- Refractive lens exchange (RLE)
Replacement of the natural lens with an intraocular lens, similar to cataract surgery but performed for refractive correction. Particularly considered in presbyopic-age patients with high refractive errors unsuitable for laser surgery.