If they invented this for shortsightedness, which I have very slightly, I would pay a huge amount of money (in European medical cost terms) for it.
I mildly dislike wearing glasses but need them or I have a headache within an hour, I can’t overcome my blink reactions to put in contacts (after several hour long sessions with my optometrist) and my shortsightedness isn’t strong enough to convince myself to go for laser eye surgery.
I wouldn't say that cutting a hole in your eyeball and putting a foreign object inside is 'safe'. Perhaps safer than LASIK, but I have a hard time believing any surgeon that would claim there are no risks.
> LASIK/SMILE/etc were never and are not safe. At least ICL is fully reversible.
Citation needed.
All people I know and feedback I've heard that took LASIK or LASEK have said that it was a live-changing surgery. I myself underwent LASEK and have nothing bad to say.
I've never heard that it was unsafe. Quite the opposite, actually.
Then again, when I hear feedback from Americans it sounds like a different world. I live in a wealthy and medically-respected European country, though.
I've been wearing glasses for short sightedness for my whole life and also don't wear contacts because the idea of putting them in freaks me out.
I always think about it from the point of view of what would happen if I want to do extended travel. Which method minimizes risk around something going wrong.
For example:
If you put your contacts in luggage and that gets lost or stolen now you have a really big problem with your sight in a foreign country.
If you're dependent on drops, it's the same problem as contacts.
In both cases, even if you do things to minimize losing them they have a limited supply. What if you want to travel for a year, are you comfortable getting the same type you have at home sent to you in a foreign country?
If you're dependent on glasses, typically you wear them all the time so the risk is them getting broken somehow which is rare. I've been wearing glasses my whole life and have never once broke or damaged them. The biggest risk is falling asleep with them on and rolling over them so it's critically important to move them off to the side somewhere. That also means being extra careful if you're sleeping on a bus or outdoors, you need to be really mindful of where your glasses are at all times if you're not wearing them.
The downside to glasses is they can prevent you from experiences. Casual swimming is annoying, especially alone where you also want to watch your bag that could be hundreds of feet away. Also practicing martial arts with sparring is a problem. Showering without being able to see clear isn't too bad in practice but it's a daily thing.
Surgery has the highest potential upside since you effectively become "normal" but the surgery has to go well so there's a risk factor to think about now. I only know 3 people who have gotten lasik in the last ~15 years. 1 of them sees massive halos at night time with lights so they can't drive at night. 1 of them has to use eye drops for dryness even 2 years after surgery. 1 of them had it done about 10 years ago and has no negative side effects but the effects of the surgery are slowly wearing off to where they will need another surgery in the next few years since their eyes have changed.
Personally if I knew surgery had a 99.999% side effect free success rate and at worst I would only need to do it every 10-15 years I would do it but I just can't get past the risk factor. Sight is just too important. I look forward to a day where this is a fully solved problem in a non-invasive way.
The travel risks of contacts are manageable. Always travel with a fresh spare pair, a contacts case (to store the old pair), and a pair of glasses in a hard case. The glasses go in your personal bag, not your luggage.
If the risk management strategy of contacts involves having a pair of glasses on hand, why not jump straight to that (unless you don't like glasses in the first place and only use them if all else fails)?
Then again, my eyesight isn't bad enough for me breaking my glasses on a holiday to be a potential problem. I've never broken any of my pairs before, and even if they were lost, I'm still able to read and get around. It's just more unpleasant to do so. But I still prefer glasses and wear them pretty much at all times.
Before I got LASIK, I wore contacts but travelled with glasses. There are a huger variety of reasons that you might use contacts even if you have your glasses available. In fact, everyone I know with contacts also always has a pair of glasses that goes with them on travels.
In my case I worked onboard tall ships. Contacts let me be on deck in inclement weather without worrying about spray, fog, or losing a pair of glasses, let me use any pair of sunglasses instead of a ~$250+ pair of prescription glasses, as well as things like diving and snorkelling without needing a $150 prescription mask.
You can get cheap glasses from China. I found on reddit people swearing by zenottic on aliexpress and got some glasses for 20-30$. Nothing to scream about, plastic but they do the job really well.
I already lost one pair in the sea, which would have been bad if I had 200$+ glasses.
I wear contacts in water or if I lose my glasses, but try to use glasses most of the time to let my eyes breathe.
Contacts in water? A friend of mine did that and got sand in them. Really bad. It was a long time ago so I forgot details, i.e. why not just discard them?
Try having vision worse than 20/200 and getting around without glasses. When I traveled, pre-contacts, I always packed a spare and a repair kit. With contacts, I pack one pair of glasses, a repair kit and spare contacts, its essentially the same prep and experience. Except now I have peripheral vision and can wear whatever sunglasses I have on hand. They also don't fog up like glasses do, which makes the transition in and out of buildings in hot, humid climates where AC is prevalent less annoying.
I've used contacts for about 20 years and I prefer them to glasses doing anything active and generally traveling. I would be very worried about navigating the world without being able to read things 3 feet away with my prescription of -4 so I always travel with a pair of glasses.
> I always think about it from the point of view of what would happen if I want to do extended travel. Which method minimizes risk around something going wrong.
This actually happened to me. Spent two months on the other side of the planet. When I landed I realized I didn't pack my contacts. I just wore the same pair the whole time and was fine.
These were dailies. I was either wearing an Acuvue brand or I had already switched to Daysoft, I forget.
I talked to my optometrist and they told me that most contacts are the same material, and bi-weeklies/etc are just slightly thicker for durability.
I was diligent about cleaning them, while at the same time being gentle so I didn't tear them. I was also very cautious about swimming with them, touching them or otherwise doing anything that might promote eye infections. Comfort-wise, they were fine, but it felt like they shrank slightly over time, if that makes sense.
I wore glasses since I was maybe 10 and then contact lenses for decades.
I got sick of the daily ritual of having to clean my hands, put them in and then take them out at night.
My eyesight was pretty bad with a large prescription and keratoconus on top (that I did have C3R surgery for). I was dismayed when I found out I wasn't eligible for laser surgery so I just accepted that I'd have to deal with the inconvenience of glasses/lenses during the most active years of my life.
Then I found out that you can do Refractive Lens Exchange (same surgery that they do for people with cataracts) and went for that a few years ago. It isn't perfect but - for me at least - it was worth the risk. I do get issues with glares when it's dark but when it's bright there are no side effects. I also had to get a YAG laser treatment about a year later due to some 'clouding' but that not a big deal other than the expense.
When I last went for an eye test I was told I had 20/20 vision in one eye and I didn't believe the optician. I've long forgotten what 20/20 vision is like so maybe it's just overrated.
Basically, contact lenses you wear at night (which could perhaps be tolerable for you). Then, your vision stays fine during the day (mostly, it worsens gradually but it's manageable).
I don't use it myself but I have a relative that does and they love it.
The issue is getting the lenses in and out of my eyes. I simply can’t. I tried really hard for about 4 hours with a consultant and I think that I got it in successfully once, and she had to remove it for me while I held my eye open.
Not something that is recommended for ordinary bad vision - as it mostly works to treat eye pressure (one particular type of age related vision correction).
I had a similar issue with lenses. Those appointments are hell and counter-productive. Firstly, it's a difficult thing to do under pressure. Secondly the more you attempt it the more your eyes get irritated and the more difficult it becomes. Eventually I managed to sort of just shove it in when the optometrist wasn't looking. Then they gave me some to take home and I was able to practice in a less stressful environment and finally got the hang of it. Saying that, if I stop for a while and then go back to them it can take a couple of days to get the reflexes to slow down again. If you can order a pack online without a prescription I'd say it's relatively safe to do that and practice at home provided they've already explained the hygiene basics and you know how to put them in/out, you're just having issues with the blinking.
Pilocarpine has been already approved in the US since 2021 under the trade name Vuity (pilocarpine hydrochloride 1.25%), which was discussed on HN [1]. Another version, Qlosi (pilocarpine HC 0.4%), was approved in 2023.
It seems that this formulation differs by adding naproxen, an NSAID. I'm not sure why they believe this is needed.
> The drops contain pilocarpine, a drug that constricts the pupils and contracts the muscle that controls the shape of the eye’s lens to enable focus on objects at different distances...
I wonder if using that might be dangerous for people with people with conditions that could lead to macular damage ... (by adding pressure)
I'm nearsighted with simple myopia and most of my life I've used contacts for distance vision. I never had any problems reading close up with my contacts in. Then I turned 50, and within a year, I suddenly needed to use either reading glasses with my contacts or bifocal glasses in order to both see long distance and use a computer or my phone.
It wasn't a slow decline. One day my eyes worked like they had for my entire life, and the next my eyes went wonky. Getting older sucks! Without glasses, I can still read books and my phone just fine. I've just lost my "middle vision" of about an arm's length away.
Anyways, all my fifty-something peers are going through the same thing. It's a really inconvenient life change. I imagine something like this would be popular if it were more well known. My optometrist didn't say anything at all about it.
Side note: Laser surgery can only fix one type of vision problem. So if I were to go in to fix my myopia, I'd still have presbyopia (age related hyperopia), or vice versa. There doesn't seem to be a one-size-fits-all surgery for vision.
A similar thing happened to me in my mid-40s. I had been fortunate to have "perfect" vision until suddenly I was complaining about the tiny fonts on labels and started struggling doing small wiring tasks. It wasn't a surprise really, my mother had the best vision in my family and she eventually needed reading glasses. But how suddenly it came on surprised me, although maybe I had actually been compensating all along until I couldn't anymore.
Very nice, albeit I'm still waiting for Ocumetics (for 8+ years) to come up with a permanent solution for both shortsightedness and longsightedness. It's a replacement for your natural lense with an accomodating lens - but it should definitively give you great vision at any distance.
They just started human testing after years of doing and redoing their solution. I assume they're being somehow paid by the industry not to release too early, because even the first iteration had great results and it would have been life changing.
Hopefully this is not another RISUG and we see some innovation reach the market.
If they invented this for shortsightedness, which I have very slightly, I would pay a huge amount of money (in European medical cost terms) for it.
I mildly dislike wearing glasses but need them or I have a headache within an hour, I can’t overcome my blink reactions to put in contacts (after several hour long sessions with my optometrist) and my shortsightedness isn’t strong enough to convince myself to go for laser eye surgery.
EVO ICL. Or even pinned ICL. Just got it recently, would recommend.
LASIK/SMILE/etc were never and are not safe. At least ICL is fully reversible.
Note that is the current version (EVO) I’m referring to, not the older (Visian) which still involved irreversible steps.
Info: https://eyewiki.org/Implantable_Collamer_Lens
Patient info (simpler language): https://www.rcophth.ac.uk/wp-content/uploads/2020/05/Phakic-...
(I paid out of pocket for this and have no affiliation with any clinics)
I wouldn't say that cutting a hole in your eyeball and putting a foreign object inside is 'safe'. Perhaps safer than LASIK, but I have a hard time believing any surgeon that would claim there are no risks.
> LASIK/SMILE/etc were never and are not safe. At least ICL is fully reversible.
Citation needed.
All people I know and feedback I've heard that took LASIK or LASEK have said that it was a live-changing surgery. I myself underwent LASEK and have nothing bad to say.
I've never heard that it was unsafe. Quite the opposite, actually.
Then again, when I hear feedback from Americans it sounds like a different world. I live in a wealthy and medically-respected European country, though.
[dead]
I've been wearing glasses for short sightedness for my whole life and also don't wear contacts because the idea of putting them in freaks me out.
I always think about it from the point of view of what would happen if I want to do extended travel. Which method minimizes risk around something going wrong.
For example:
If you put your contacts in luggage and that gets lost or stolen now you have a really big problem with your sight in a foreign country.
If you're dependent on drops, it's the same problem as contacts.
In both cases, even if you do things to minimize losing them they have a limited supply. What if you want to travel for a year, are you comfortable getting the same type you have at home sent to you in a foreign country?
If you're dependent on glasses, typically you wear them all the time so the risk is them getting broken somehow which is rare. I've been wearing glasses my whole life and have never once broke or damaged them. The biggest risk is falling asleep with them on and rolling over them so it's critically important to move them off to the side somewhere. That also means being extra careful if you're sleeping on a bus or outdoors, you need to be really mindful of where your glasses are at all times if you're not wearing them.
The downside to glasses is they can prevent you from experiences. Casual swimming is annoying, especially alone where you also want to watch your bag that could be hundreds of feet away. Also practicing martial arts with sparring is a problem. Showering without being able to see clear isn't too bad in practice but it's a daily thing.
Surgery has the highest potential upside since you effectively become "normal" but the surgery has to go well so there's a risk factor to think about now. I only know 3 people who have gotten lasik in the last ~15 years. 1 of them sees massive halos at night time with lights so they can't drive at night. 1 of them has to use eye drops for dryness even 2 years after surgery. 1 of them had it done about 10 years ago and has no negative side effects but the effects of the surgery are slowly wearing off to where they will need another surgery in the next few years since their eyes have changed.
Personally if I knew surgery had a 99.999% side effect free success rate and at worst I would only need to do it every 10-15 years I would do it but I just can't get past the risk factor. Sight is just too important. I look forward to a day where this is a fully solved problem in a non-invasive way.
Until then I compromise with glasses.
The travel risks of contacts are manageable. Always travel with a fresh spare pair, a contacts case (to store the old pair), and a pair of glasses in a hard case. The glasses go in your personal bag, not your luggage.
If the risk management strategy of contacts involves having a pair of glasses on hand, why not jump straight to that (unless you don't like glasses in the first place and only use them if all else fails)?
Then again, my eyesight isn't bad enough for me breaking my glasses on a holiday to be a potential problem. I've never broken any of my pairs before, and even if they were lost, I'm still able to read and get around. It's just more unpleasant to do so. But I still prefer glasses and wear them pretty much at all times.
Before I got LASIK, I wore contacts but travelled with glasses. There are a huger variety of reasons that you might use contacts even if you have your glasses available. In fact, everyone I know with contacts also always has a pair of glasses that goes with them on travels.
In my case I worked onboard tall ships. Contacts let me be on deck in inclement weather without worrying about spray, fog, or losing a pair of glasses, let me use any pair of sunglasses instead of a ~$250+ pair of prescription glasses, as well as things like diving and snorkelling without needing a $150 prescription mask.
You can get cheap glasses from China. I found on reddit people swearing by zenottic on aliexpress and got some glasses for 20-30$. Nothing to scream about, plastic but they do the job really well. I already lost one pair in the sea, which would have been bad if I had 200$+ glasses.
I wear contacts in water or if I lose my glasses, but try to use glasses most of the time to let my eyes breathe.
Contacts in water? A friend of mine did that and got sand in them. Really bad. It was a long time ago so I forgot details, i.e. why not just discard them?
Try having vision worse than 20/200 and getting around without glasses. When I traveled, pre-contacts, I always packed a spare and a repair kit. With contacts, I pack one pair of glasses, a repair kit and spare contacts, its essentially the same prep and experience. Except now I have peripheral vision and can wear whatever sunglasses I have on hand. They also don't fog up like glasses do, which makes the transition in and out of buildings in hot, humid climates where AC is prevalent less annoying.
I've used contacts for about 20 years and I prefer them to glasses doing anything active and generally traveling. I would be very worried about navigating the world without being able to read things 3 feet away with my prescription of -4 so I always travel with a pair of glasses.
But then you need to make sure you have access to clean water in order to put in your lenses.
I don't use water to put in lenses. It might be troublesome to clean my hands without clean water, though...
I assumed GP meant for the handwashing part. General advice I've always seen is to wash your hands before touching contacts.
> I always think about it from the point of view of what would happen if I want to do extended travel. Which method minimizes risk around something going wrong.
This actually happened to me. Spent two months on the other side of the planet. When I landed I realized I didn't pack my contacts. I just wore the same pair the whole time and was fine.
Is there a comfort difference between daily contacts and monthly?
When you wore yours for 2 months, what type was it?
These were dailies. I was either wearing an Acuvue brand or I had already switched to Daysoft, I forget.
I talked to my optometrist and they told me that most contacts are the same material, and bi-weeklies/etc are just slightly thicker for durability.
I was diligent about cleaning them, while at the same time being gentle so I didn't tear them. I was also very cautious about swimming with them, touching them or otherwise doing anything that might promote eye infections. Comfort-wise, they were fine, but it felt like they shrank slightly over time, if that makes sense.
I wore glasses since I was maybe 10 and then contact lenses for decades.
I got sick of the daily ritual of having to clean my hands, put them in and then take them out at night.
My eyesight was pretty bad with a large prescription and keratoconus on top (that I did have C3R surgery for). I was dismayed when I found out I wasn't eligible for laser surgery so I just accepted that I'd have to deal with the inconvenience of glasses/lenses during the most active years of my life.
Then I found out that you can do Refractive Lens Exchange (same surgery that they do for people with cataracts) and went for that a few years ago. It isn't perfect but - for me at least - it was worth the risk. I do get issues with glares when it's dark but when it's bright there are no side effects. I also had to get a YAG laser treatment about a year later due to some 'clouding' but that not a big deal other than the expense.
When I last went for an eye test I was told I had 20/20 vision in one eye and I didn't believe the optician. I've long forgotten what 20/20 vision is like so maybe it's just overrated.
I can also never get cataracts!
Have you looked into orthokeratology?
Basically, contact lenses you wear at night (which could perhaps be tolerable for you). Then, your vision stays fine during the day (mostly, it worsens gradually but it's manageable).
I don't use it myself but I have a relative that does and they love it.
https://en.wikipedia.org/wiki/Orthokeratology
The issue is getting the lenses in and out of my eyes. I simply can’t. I tried really hard for about 4 hours with a consultant and I think that I got it in successfully once, and she had to remove it for me while I held my eye open.
There are new non laser surgeries either in the testing or just released stages. I only know about them because they were on HN in the past 6 months.
Easiest link I found: https://news.ycombinator.com/item?id=44938818
I suspect the issue is less the "laser" bit than the "eye surgery" bit.
US has a few look at Vuity - which is for age releated.
Vuity is just Pilocarpine -- https://en.wikipedia.org/wiki/Pilocarpine
Not something that is recommended for ordinary bad vision - as it mostly works to treat eye pressure (one particular type of age related vision correction).
I had a similar issue with lenses. Those appointments are hell and counter-productive. Firstly, it's a difficult thing to do under pressure. Secondly the more you attempt it the more your eyes get irritated and the more difficult it becomes. Eventually I managed to sort of just shove it in when the optometrist wasn't looking. Then they gave me some to take home and I was able to practice in a less stressful environment and finally got the hang of it. Saying that, if I stop for a while and then go back to them it can take a couple of days to get the reflexes to slow down again. If you can order a pack online without a prescription I'd say it's relatively safe to do that and practice at home provided they've already explained the hygiene basics and you know how to put them in/out, you're just having issues with the blinking.
Pilocarpine has been already approved in the US since 2021 under the trade name Vuity (pilocarpine hydrochloride 1.25%), which was discussed on HN [1]. Another version, Qlosi (pilocarpine HC 0.4%), was approved in 2023.
It seems that this formulation differs by adding naproxen, an NSAID. I'm not sure why they believe this is needed.
[1] https://news.ycombinator.com/item?id=29509163
TIL Brits say long and shortsighted instead of far and nearsighted. In my English "shortsighted" means poor planning
Dollars to doughnuts that "shortsighted" as poor planning would be from the "shortsighted" eye affliction.
since you can only see a short distance ahead.
> The drops contain pilocarpine, a drug that constricts the pupils and contracts the muscle that controls the shape of the eye’s lens to enable focus on objects at different distances...
I wonder if using that might be dangerous for people with people with conditions that could lead to macular damage ... (by adding pressure)
Is this different from QLOSI?
I'm nearsighted with simple myopia and most of my life I've used contacts for distance vision. I never had any problems reading close up with my contacts in. Then I turned 50, and within a year, I suddenly needed to use either reading glasses with my contacts or bifocal glasses in order to both see long distance and use a computer or my phone.
It wasn't a slow decline. One day my eyes worked like they had for my entire life, and the next my eyes went wonky. Getting older sucks! Without glasses, I can still read books and my phone just fine. I've just lost my "middle vision" of about an arm's length away.
Anyways, all my fifty-something peers are going through the same thing. It's a really inconvenient life change. I imagine something like this would be popular if it were more well known. My optometrist didn't say anything at all about it.
Side note: Laser surgery can only fix one type of vision problem. So if I were to go in to fix my myopia, I'd still have presbyopia (age related hyperopia), or vice versa. There doesn't seem to be a one-size-fits-all surgery for vision.
A similar thing happened to me in my mid-40s. I had been fortunate to have "perfect" vision until suddenly I was complaining about the tiny fonts on labels and started struggling doing small wiring tasks. It wasn't a surprise really, my mother had the best vision in my family and she eventually needed reading glasses. But how suddenly it came on surprised me, although maybe I had actually been compensating all along until I couldn't anymore.
Retinax 5!!!
Very nice, albeit I'm still waiting for Ocumetics (for 8+ years) to come up with a permanent solution for both shortsightedness and longsightedness. It's a replacement for your natural lense with an accomodating lens - but it should definitively give you great vision at any distance.
They just started human testing after years of doing and redoing their solution. I assume they're being somehow paid by the industry not to release too early, because even the first iteration had great results and it would have been life changing.
Hopefully this is not another RISUG and we see some innovation reach the market.