Believe It When I See It

It’s been one year exactly since I had laser eye surgery, which is enough time for me to give my own account of the entire process.

If you want to skip this and just find out out who to go to and when, the answer is David Gartry at Moorfields. And right now. I’ve got him to thank for changing my life, and I’ve got India Knight to thank for her post convincing me to get it done. Hopefully I can do the same for you.

I’ve gone from a -7.50 prescription with astigmatism in each eye to having eyes fit for a fighter pilot. And it took one consultation, one surgical appointment and a few weeks of eye drops. Magic. Seriously, how futuristic is it to say ‘yeah, I had lasers fired into my eyeballs and now I can see better than ever before’?

Yes, make sure your surgeon is a big dog in teaching and does lots of NHS work.

No, you don’t want to go to a high street place unless you’ve got a really small, simple prescription and aren’t worried about aftercare.

Just go and see Professor Gartry, ok? I don’t even get commission – he’s just the best. He’s got lots of letters after his name, which are always a good sign, and he was the first person in the UK to perform the surgery. He trained the person who performed the surgery on his own eyes (although presumably not while he was doing it).

And the cost? IT’S YOUR EYES. YOUR ACTUAL SEEING EYES. You don’t get another pair. Ask yourself: what’s the most amount of money you’ve spent? What the most amount of money you’d be prepared to spend on something? I guarantee your eyes are worth more than that.

Plus, you can pay for it monthly by financing (I’m not sure what happens if you don’t keep up repayments – maybe you have to give your eyes back?) – anyway, it makes the expense much more manageable.

I’ve worn glasses since I was six years old. I’d been used to only seeing the world at certain times of day – everything else was fuzzy shapes. When I woke up, I needed glasses. Showering, swimming, getting into bed – they all required a transition to a world where someone’s gone a bit mad with the blur tool on Photoshop. Even sex (sorry mum) was sometimes a sort-of tactile piece of guesswork. Think I’m joking? Without glasses, I couldn’t see anything clearly that was more than about 20cm from my face. Oh and the slight astigmatism I had was weird – if I looked at my computer screen at any other angle than dead-on, the YouTube player bar would be wonky. Bit odd.

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Holidays were where it mattered most: prescription swimming goggles, no diving off diving boards, prescription sunglasses (they don’t make ANY nice designs for someone with that high a prescription) and finally getting over my fear of poking stuff in my eye to wear contact lenses at 19 years old. I couldn’t even wear them every day – I’ve got really big bug eyes (#sexy) and they dry out a lot. Moist contact lenses didn’t even get off my finger to stick to my eyeball. But I managed – and that was a leap in itself. If you have glasses and you start wearing contact lenses you’ll remember the feeling of freedom you felt. Well, getting laser eye surgery is one hundred times that.

Laser eye surgery has always been one of those ‘yeah, maybe, in the future’ ideas for me. Just short of buying a super yacht and a Ferrari. Plus, it’ll wear off, right? WRONG.

Sort of.

There’s a myth that at some predetermined point after your surgery (5, 10, 15 years, depending on who scares you) your eyesight will suddenly revert back to what it was before you had surgery. Not true at all. What will happen, as the inescapable march of time rumbles on, is that your eyesight will deteriorate. Just like every other human on earth. Sorry, those are the facts. It’s called ‘presbyopia’ and as Professor Gartry reminded me, even RAF pilots in their mid-to-late-40s start to need reading glasses. Laser eye surgery can’t fix that (yet).

What about the chance that laser eye surgery can’t actually correct ALL of your vision? That’s not really true either. When I told Professor Gartry I was a journalist, he spent a really long time telling me about how the machines worked, and how his unit audits them. Like, a really long time. Basically, there’s a really small error margin that they keep track of with hundreds of patients who either get under-corrected or over-corrected, and they adjust the machine accordingly. If you like data, my man Gartry’s got tonnes of it. But importantly, you get FREE RE-TREATMENTS AND ADJUSTMENTS within two years of your surgery. The chances of you needing that are super small, though, so don’t assume that because he offers this it’s a regular thing. It’s not.

I was 24. The way I saw it, I’d get at least twenty years of precision before I needed reading glasses. Also, even if it didn’t get me to hawk-eye level, my quality of life would be improved by even 4 points of improvement. That was my worst case scenario.

Once I’d decided (and er, convinced my family) that I wanted to GET MY EYES BURNED BY A LASER and that I could afford it, I had to have a consultation appointment to see if I was eligible. It’s an e-mail and £175.

You only need four stable prescriptions to qualify for the consultation appointment (to check that your eyes aren’t still changing). My main worry was actually being rejected from laser eye surgery – remember how bad my prescription was? Clearly, I wasn’t rejected.

I was after IntraLASIK surgery – that’s the easiest and most common process – you only need LASEK if you’re in the armed forces or play a lot of contact sports. I intend to go to ‘hostile environments’ as part of my job and yet I was still told I didn’t need LASEK. Which is good, because LASEK requires a LOT more after-care, involving wearing a medical contact lens for a bit.

What happens at the consultation? All the tests you get at the opticians but with snazzier equipment and Professor Gartry’s elite team. There is one test involving a needle – instead of puffing air in your eye it’s better for them to poke you. Don’t panic, you get local anaesthetic drops and you can’t feel a thing. I had to ask if they’d done it – they’d done it twice – and another time to demonstrate how I COULDN’T FEEL A THING. Then you get a chance to ask questions to Prof Gartry.

It all took less than an hour and a half – but I had to wear sunglasses to go home because the stuff they put in your eyes makes your pupils dilate. And they return to normal size at different times, you look like you’ve just dropped a bunch of pills from the sketchiest dealer alive.

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Before I left the consultation I asked when the next available appointment was for surgery, now I’d been approved. I thought it’d be months and months away – giving me time to panic over it. Two and a half weeks, was the receptionist’s reply. Christ, I can’t even get my leave requests approved in that time.

Six weeks later, I’d taken a week off work and had my surgery booked. Tip: take a week off, ok? It’ll make everything a lot more relaxing.

I went to Moorfields (the proper hospital bit, not the private bit over the road where the consultations take place) and was told I’d get a quick tutorial on how to put in eye drops before I waited for the surgery. Obviously there’s no point getting the tutorial immediately after the surgery because you’ll be a bit foggy. You chat to the nurse, she shows you what bits of your face to hold and what bits of the pipette to squeeze – it’s actually a bit of an art, but don’t worry, in 24 hours you’ll be an expert.

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So, I’m in the waiting room. Acting super nonchalant next to my mum, but a bit concerned because there’s only four people here. Two people return in the time I’m there with huge grins on their faces, so I know the machine is working today. I start to wonder if I should be nervous. Every person that accompanied a patient asks ‘can you see?!’ and the reply is ‘yeah – and it’ll get even better!’, which is quite possibly the best advert to have in a pre-surgery waiting room ever. Plus, I’d got seven days off – one guy was going on holiday in 36 hours. On an actual plane. Dry-eye central.

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Okay, it’s my go. I get led into doors with ‘WARNING: LASERS’ on them. Isn’t this the same machine that turned Hugh Jackman into Wolverine? I’ve got to put on a silly hairnet hat thing while I wait. Oh, it’s Professor Gartry. Hello! Remember me? Of course he does. Shut up. Stop talking about how his week’s been, the man needs to focus on firing a beam of incredibly focused light into your face. While you’re watching the whole thing.

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I put my glasses on the side. I won’t ever need them again. That’s…a really weird feeling.

I’m lying down on a chair a lot like the dentist’s. Professor Gartry gives me a running commentary of everything he’s doing. I’m not nervous. I’m not. Anaesthetic eye-drops go in. I’m now not going to blink for a really long time. Not that I can feel it. He says I’ll be out of here in twenty minutes. Don’t rush, pal. He asks me to look at the clock before I begin. I can’t see it – just a fuzzy shape.

Right, time for laser number one. Oh, yeah, didn’t I mention? There are TWO lasers. Laser number one makes a little cut on your cornea to create a flap. That’s your first laser experience. Everything’s supposed to go blurry, but to be honest, it’s no different from what I normally (can’t) see. The pain is no worse than pushing your thumb in your eye (closed, if you want to try it. Weirdo.) It takes about twenty seconds, and Gartry does a NASA-style countdown in the calmest voice I’ve ever heard.

He’s going to lift the flap up now, and put some other stuff in my eye. I’m watching him do this. It’s really odd. A bit like someone mixing a cocktail really close to your face. Or on your face. Or IN your face. Oh, hold on – what’s this? He’s told me it might go a bit dark now. It goes dark.

When you have a big migraine and your vision goes funny…this is a bit worse than that. It’s worse because your brain doesn’t really know what’s going on. Your other eye is covered while one eye gets all the attention. And when it goes dark, my brain went into overdrive. Full panic mode. “This is it, Nick. Game over. It’s black now. Black forever. You’ll never see again.” Lies. Time for the big laser.

Your eyelashes are taped up and a little rubber ring is pinged in your eye to hold it open. I assume I look like something out of A Clockwork Orange, now.

I’ve got to look at a red dot – which is quite difficult when it’s gone dark and blurry and at the best of times you can’t see. If you look away, the laser shuts off. If you blink (you can’t), the laser shuts off. Sneeze? Laser shuts off. You’re not accidentally going to think about a really funny joke you read on Twitter and accidentally end up carving half your face off.

This red dot flashes a bit, and I was told by other patients it’s only about thirty seconds. Not for me – I almost had a full minute of staring at that damn red blinking light. Or, in the case of my troublemaker of a brain, when you’re told to stare exactly at this one point, my mind thought it would try and make me stare everywhere except that spot. I didn’t realise I needed to have zen-like concentration…

Except, you don’t. Because no-one tells you about the noise. This laser is actually burning and reshaping your cornea, so it’s obviously not going to be silent. It sounds like…the world’s biggest hard drive failing. A tank-sized chain being dragged along gravel, accompanied by a methodical click. The ticking of a demonic clock accompanied by the hum of a huge building sight. I wish someone had told me about the noise. Professor Gartry is counting down ‘just thirty more seconds…halfway there…fifteen…five…’ and I don’t realise that my head is shaking a bit from how intensely I’m trying to stare at the light.

I’m not going to lie to you: there’s a smell. And it stings. The smell is just like burning your hair on hair straighteners (yeah, I had an emo phase). The sting is a bit like having a bit of grit pushed in your eye. It’s unpleasant, but it’s bearable. Neither of these are really upsetting, but it’s important you know.

Then we do it all again on the other eye.

I’m done. If you’ve ever been in a sauna or a steam room, that’s what my vision is right now. Foggy. Very foggy. Professor Gartry asks me what the time is – look at the clock – I can actually see the shape of the clock, but it’s still blurry. In 24 hours it’ll be clear. In 48 hours it’ll be sharper than a computer screen. In three months I’ll be a daytime hawk. In six months my night vision will have improved, too (it’s the last thing to heal, because you’ve just burned off half your rods and cones that help you see at night). Everything is so BRIGHT.

My eyes HURT. I want to put them in a fridge. Which is handy, because the cocktail of eye drops you have to administer every hour or so for the first week need to be refrigerated. Sleep is the best healer – even more so than staying awake to put eye drops in. But there’s a catch…you have to sleep like this, so you don’t rub your eyes accidentally:

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You have a follow-up appointment a minimum of 48 hours after the surgery. I had my surgery on a Saturday and the follow-up on Tuesday. On Monday I went out for coffee with my flatmate for the first time. I was reading out the number plates of all the parked cars on the way. No, not just the number plates – the small dealership text at the bottom of each number plate. “I get it, Nick, you can see. That was the point”. I know, but everything’s so…sharp. It’s like someone’s switched the world on.

I became obsessed with my vision as the fogginess post-surgery faded. I’ve got Reading Festival posters (and what?) – I’d stand at different distances away from them and in different lights to test myself. For three days. Before I was called into work. Oh.

It was the European & local elections. I had a job to do. But TV studios are bright. Really bright. All the lights had a bit of a halo around them. I nearly had a bloody panic attack. Professor Gartry said the halos would fade and everything was fine – he was right, of course, but holding a clear bag of pipettes makes you look a bit suspect, unless you work in a pharmacy or a crack den. Did I mention I had to drive to work? At night? Yeah, don’t do that. Oncoming traffic has a bit of a fuzzy glow. Everything has a fuzzy glow for the first week. I thought I was radioactive.

Six months later, I had my final follow-up appointment. Well, it wasn’t exactly six months…it was more like eight (I’m busy, OK?). But it doesn’t matter. I told Professor Gartry he’d changed my life. He asked about the halo-ing, the night vision – all the initial problems have worn off, to be expected. I had an eye-test. The final moment of truth. On my way in, I’d wondered what I’d do if I was offered a re-treatment. I was told not to watch any YouTube videos of surgery in case it put me off going through it again. Apparently it’s quite gruesome.

Could I do it again? It was unpleasant, but for a slight tweak, could I be bothered with the aftercare time again? Yeah, I probably could. I say probably because I didn’t need to make the decision. I had better than 20/20 vision. I could quit my job and become a fighter pilot. I just stared at Professor Gartry. I thought I’d got over the wonder of it all, but it hit me: my vision was better than the vision I was born with. Not better: perfect.

The only thing I struggled with was reaching for my glasses when I woke up, or when I got out of the shower. I allowed myself a little grin and a chuckle every single time. They weren’t there. They didn’t need to be. I packed them in a box when I moved flat and I don’t actually know where they are now. I went on a spending spree for cheap sunglasses. Rolling out of bed and into the pool on holidays felt like a luxury I’d never been afforded.

The self-esteem boost was instant – I could stay out all night and look how I finally wanted to look, without worrying that my contact lenses would be adhered to my eyeball by the time I ended up back home.

I could sleep wherever I wanted without worrying about the same problem – or finding a surface to put my glasses so they wouldn’t be trodden on. Floors at parties, sofas – the ‘guest bedroom’ (if you know what I mean)…

My biggest fear was that I couldn’t turn this off. It seems silly, but when you take off your glasses – or remove your contact lenses – the world retreats. The familiar fuzzy shapes coddle you to sleep. With my whole view now in focus, how would I manage? Wonderfully. I’d never want to turn this off.

Have I convinced you, yet?

UPDATE (September 2015): I’ve had a lot of questions about the financial nitty-gritty, so I thought I’d better say how much I spent.
It cost me £4,800 (both eyes) and this is due prior to treatment unless you apply for finance cover, which I did.
With interest-free financing (through the scarily-named V12 Retail Finance offered in-house) you have to stump up 10% yourself (which is £480), leaving you £360 a month to pay back over the following year. Apparently you can take out a payment plan over 36 months but it’s not interest-free.
You also have to pay for a consultation before you start treatment. That was £175.
Total cost for me in 2014: £4,975.