What are the main benefits of having a pupil dilation test done before LASIK, and what are the risks of not having one?

Doctor's Answers 1

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Dr E-Shawn Goh

Ophthalmologist

Your pupil measurements in the light and the dark is one factor that affects your suitability for a LASIK procedure. It is measured with a special device called the infrared pupillometer. This test is important because if you have a generally larger pupil size, you are at a higher risk of night vision problems such as glares and haloes. Your surgeon may make some adjustment to the parameters of your surgery in order to minimise this risk.

A cycloplegic or dilated refraction is also performed during the Lasik assessment, so that your eye doctor can get the most accurate measure of your refractive error, with minimal interference from pupillary accommodation. During the test, you will be given eye drops to fully dilate your pupils. The medicine could take up to 6 hours to wear off and during this time, your eyes will be more sensitive to light. Do bring along a pair of shades to help with that. As part of the pupillary dilation, your surgeon will also be able to fully assess the state and health of your retina. If required, some patients with retinal pathology may need to have this brought to their attention, and even require treatment prior to Lasik surgery.

In addition to the pupil dilation test, there are also various other tests necessary to determine your suitability for a LASIK and other eye procedures. Do consult your eye doctor for more information!

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How can I prevent blood clots on the whites of my eyes after LASIK?

Hi Susanne In the first step of the LASIK procedure, a ‘flap’ is created using a femtosecond laser (or, in the past, a special blade called a microkeratome). During this step, the laser is ‘connected’/docked to the eye with a ring-like device that grips the white part of your eye. You can watch an animation here: There are many small blood vessels on this part of the eye, and sometimes the suction pressure providing the grip may cause some of the blood vessels to leak some blood, causing red patches after the LASIK.

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What factors should I consider in deciding whether Punctal Plugs are the right treatment for my dry eyes after LASIK?

Punctal plugs are very effective for treating dry eyes that occur during waking hours, whether or not the situation is associated with LASIK. They help to reduce the need for eyedrops, so are very useful for people who have to use artificial tears very frequently eg instead of having to use the eyedrops every 2-3 hourly, sometimes after the plugs are placed, the eyedrops might only be needed every 4-6 hourly. As long as there is no active eye inflammation (eg persistent eye redness/discharge), punctal plugs can help anyone with moderate dry eyes requiring frequent eyedrop instillation.

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