Refractive Surgery

What is refractive surgery?
Refractive surgery (also known as corrective eye surgery) is a laser procedure that involves reshaping the front part of your eye (the cornea) to correct your distance vision.

What types of refractive surgery does the Navy perform?

• PRK (Photorefractive Keratectomy): PRK is a laser procedure where the very top layer of the cornea is removed from the eye, and a laser then reshapes the cornea. The immediate tissue healing process usually takes 3-6 days, with vision continuing to improve over the first month. It may take several more months to reach true visual potential. This is the procedure of choice for those in the military.


• LASIK (Laser-Assisted in situ Keratomileusis): LASIK is a laser procedure where a “flap” is created on the front part of the eye. The flap is pulled back, the laser reshapes the cornea, and the flap is placed back down to heal. Vision is usually very good within 2 days to one week after surgery. A minimum corneal thickness is required for this procedure.

How do I know if I am eligible for PRK or LASIK? To determine eligibility, it is first necessary to undergo a comprehensive eye exam including dilation to determine if the eye is healthy enough to be operated on. Other testing and imaging studies must be obtained to see if the prescription and shape of your eye are conducive to surgery. The Navy typically requires a minimum age of 21 (although an exception is made for midshipmen). Other criteria include: stable refraction over 12 months; realistic expectations; no diseases that affect healing; healthy corneas (no history of herpetic eye disease or keratoconus); not pregnant; and no thyroid disease.

What should I expect from refractive surgery? It is important to have realistic expectations from surgery. It is considered an elective surgery, and it is not always easy to predict how someone’s eye will heal after the procedure. The goal is to give the patient functional vision without the need for glasses, and most patients achieve 20/20 vision or better. However, complications can occur (such as dry eyes, or glare and haloes at night), even with perfect distance vision.

What is the process for Midshipmen to be screened for refractive surgery? Midshipmen are automatically screened for refractive surgery during their pre-commissioning eye exams in the fall of their 2/c year. If they desire to have surgery and are deemed to be suitable candidates, they will be provided with forms to complete and for their company officers to sign granting permission for the procedure. Once all the paperwork is completed and returned to the Optometry clinic, the midshipmen will be assigned a tentative surgery date, and will be contacted directly by the Refractive Surgery Center at the Walter Reed National Military Medical Center (Bethesda) to schedule a pre-surgical evaluation. Once the Surgery Center provides final approval, the surgery date will be confirmed.

What about reading glasses after refractive surgery? LASIK and PRK generally correct your distance vision. After the age of 40 or 45, you will probably need glasses for reading.