You are myopic

In France, myopia has been performed since 1982 only. And the laser has only been used since 1987 . But the technical progress is undeniable: the software that "controls" these lasers are more and more precise.

The problem: your eyeball is too long . As a result, images of distant objects are formed too far ahead of your retina and you see trouble from afar .

The solution: it is necessary to flatten the cornea in the middle , it is the technique now well at the point of Lasik . For this, it is first necessary to cut surgically or laser, the top of the cornea (as a kind of "hat"). The ophthalmologist sculpts the part thus stripped of the laser, then puts the hat back on top of the cornea. There is no suture and the suites are painless.

And after ? About an hour after the operation, it is possible to go home, but not to drive. The vision clears up the next day - driving is then possible - but plan two days of rest. You should also wear sunglasses , put artificial tears and, most importantly, do not rub your eyes. Your vision improves and stabilizes after two months.

The right indication: the operation is for nearsighted people who no longer support lenses or do not want glasses (sports are often demanding) but can not do without correction. Except that all myopes are not housed in the same sign. If the cornea is not thick, the surgeon does not cut a small pre-hat and sculpts the cornea directly. In this case, it is necessary to take analgesics because the consequences are painful. Note: in case of very high myopia (from -10 to -20 diopters), the technique is not always possible, but sometimes an intraocular implant is used. By a small incision, the ophthalmologist slides a soft lens over the iris. It's almost painless and you can see it in just a few hours.

At what price ? From € 1,000 to € 1,500 per eye, not reimbursed by Social Security, but by a growing number of mutuals. For the implant, count € 2,500 to € 3,500.

You are astigmatic

The problem: your cornea is abnormally oval and you see blur from near and far .

The solution: you have to "smooth" the cornea. The choice of the laser depends on its thickness and the association or not with another disorder of the sight.

And after ? Rest , sunglasses and artificial tears are enough. And you must not rub your eyes.

The right indication: as the sight is obstructed from near and far, operated astigmatists always appreciate the difference. But, in reality, it is mostly a question of context: if the astigmatism is light, it remains bearable. On the other hand, if the astigmatism is really troublesome and is associated with myopia, hyperopia or presbyopia, the operation becomes interesting.

At what price ? It costs from € 2,000 to € 3,000 for both eyes.

You are presbyopic

The problem: from 45 years, the lens contracts more and more badly and becomes rigid. This defect evolving rapidly, presbyopia worsens quickly at the beginning. After age 50, the loss of elasticity evolves more slowly because it has almost reached its maximum. Then, around age 60, presbyopia no longer evolves because the loss of elasticity is complete.

The solution: the ophthalmologist sculpts the equivalent of a progressive lens on the cornea . So it's close up if you look down and clear from afar if you look up. It takes a month of adaptation time and not hope for better vision with progressive glasses for presbyopia . Note: nearsighted myopes have other solutions, such as removing the lens and put a correct myopia implant instead. This avoids the wearing of glasses to see from afar, but not those to see up close. Another choice: imperfectly perform myopia to compensate for a beginner presbyopia. Finally, the last possibility: better correct myopia on one eye and presbyopia on the other (balance technique) by focusing on the fact that the brain will sort between sharp images and blurred images. Attention, everyone does not support this feeling.

And after ? The instructions are exactly the same as for an intervention of myopia, however, the discomfort to see from afar may persist for several days.

The right indication: presbyopic hyperopia make the best candidates. As presbyopia evolves between 45 and 60 years, the results are not definitive in this age group. A new intervention can however be programmed a few years later if one has been operated at that time. The ideal is to wait until the presbyopia is stabilized.

At what price ? It costs between € 3,000 and € 3,500 for both eyes

Myopia, hyperopia, astigmatism and presbyopia

The intervention is rapid : it is performed under local anesthesia and lasts between ten and twenty minutes per eye. We can operate both eyes in stride.

Intervention is not always possible: one does not operate an eye when there is an infection or a chronic disease of the cornea, an evolutionary glaucoma, a major dry eye, a lesion of the crystalline lens or the retina.

Zero risk does not exist : it is quite common, for a few weeks, to see halos (particularly annoying night driving), to have dry eyes. Exceptionally, within 3 days, the eye can become very painful and vision blurred . Emergency treatment, sometimes with hospitalization and a new procedure to clean the eye, is necessary.

The operation is programmed as in cosmetic surgery, only after the signing of an informed consent.

She did it!

Marielle, 32, commercial: at the moment, it's not pleasant.

"I was short-sighted and astigmatic, and I was less and less supportive of my lenses. My mutual reimbursed the intervention, so I jumped at the chance. D-day, I was tense and that's probably why I had a little pain when the ophthalmologist put the spacers to hold my eyelids open. This is my only bad memory. For the rest, I forgot everything to the point of not remembering being nearsighted one day! "

Frédérique, 57, anthropologist: an hour later, I was doing my shopping!

"I am short-sighted, astigmatic and presbyopic. I was anxious a lot before the intervention (scale technique). And then, it's been magical, totally radical: it's the only act that only takes a few minutes and is able to make you one of your five senses! "

You have glaucoma

The problem: the eyeball is an inextensible shell in which is permanently secreted a liquid (the aqueous humor). This liquid is normally discharged through a channel. In the event of an obstacle, it remains inside the eye and the pressure increases, compressing the fibers of the optic nerve. Chronic glaucoma , the most common, can evolve years without the slightest symptom, then a veil settles in front of the eyes .

The solution: the ophthalmologist prescribes eye drops . The treatment may be sufficient but sometimes (in about 10% of cases) the operation is essential. Under local anesthesia , the ophthalmologist creates, either laser or surgically, a small fistula in the eye at the trabecular meshwork, the tissue through which the mood normally flows, to derive the fluid. A new technique - pneumotrabeculoplasty or PNT - involves "sucking" around the eye to make this trabeculum permeable.

And after ? Nothing to report! It does not feel like a better, but the eye is preserved for the future. With the PNT, the eye is just a little red and the vision disturbed for a few hours. On the other hand, you must avoid any violent effort and take anti-inflammatory and antibiotic eye drops for several weeks. Finally, the ocular tension remains under surveillance for life.

The good indication: there is no choice. When it comes to the operation, that's it or the loss of vision!

At what price ? The intervention is supported by Social Security .

Acute glaucoma? An emergency !

Redness, pain and an eye suddenly hard as a marble? These are the signs of acute glaucoma . A real medical emergency that requires ultra-fast treatment (within 6 hours), otherwise the loss of the optic nerve is irreversible. Initially, the ophthalmologist gives drops and medications infusion to lower the eye pressure, then, within 24 to 48 hours, it makes a small hole in the iris of both eyes to evacuate the overflow of liquid.

You are hyperopic

The problem is that the eye is too short and the images of close objects form behind the retina, resulting in blurred vision , unless you make a permanent effort to accommodate it.

The solution: it is necessary to change the curvature of the cornea .

And after ? Two days of rest , sunglasses and artificial tears in the eyes. Rubbing your eyes is strictly forbidden. And for a month after the intervention, the near vision lacks precision.

The right indication: near vision is very much in demand on a daily basis, so most farsighted people make good candidates for surgery, especially in their forties, when presbyopia starts and adds to the poor vision.

At what price ? It takes between € 2,000 and € 3,000 for both eyes.

You have a cataract

The problem: with age (sometimes following ocular trauma), the lens becomes opaque , causing a drop in vision that gives an impression of fog in front of the eyes.

The solution: the procedure is to replace the opaque part of the lens with an implant that can, moreover, correct a bad vision near or far. To remove the lens that is no longer wanted, it is destroyed with ultrasound or vibrating oscillations. It is then extracted by a mini-incision and replaced by the implant. The procedure is usually performed under local anesthesia and lasts about 15 minutes.

And after ? Do not rub your eyes and do not do DIY to avoid any trauma. The ophthalmologist prescribes eye drops to dilate the pupil for a few days (the lens is thus put to rest) as well as antibiotic and anti-inflammatory eye drops for 3-4 weeks. The view clears up the next day, but it takes about a month to stabilize. Attention, if, after the operation, the eye is painful and the sight drops, it is necessary to consult in urgency because the intervention can be complicated by an infection (1 case per 1000). This is the reason why cataracts are never done with both eyes at the same time.

The good indication: the cataract having no chance to regress, we do not hesitate!

At what price ? The intervention is supported by Social Security.

Thanks to Dr. Laurent Benzacken , head of ophthalmology at the Robert-Ballanger University Hospital in Aulnay-sous-Bois (93).

She did it !

Maryline, 51, salesgirl: I saw myself differently

"I'm farsighted, used to glasses, but at the age of fifty, my vision suddenly worsened with presbyopia. So, I started. I also found other pleasures, that of makeup, to see me in another light. An unexpected benefit but nice. "

More information on www.snof.org the website of the National Union of Ophthalmologists of France.