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Comment by Void_ | Hacker News Reader

I'm so glad people are talking about this!

Here's a question for you:

If LASIK involved a 1/10,000 chance of losing ten thousand dollars, would you do it? How about hundred thousand? One million? I would probably stop here - would wan't to be in one million debt.

So what's functioning eyesight worth to you? Because to me it's more than $1m, more than billion, more than all the money in the world. I wouldn't risk it even if there was one failed case to millions.

Anyway, this is my setup:

1. Contacts for sports/social activities

2. Lightweight glasses for work (like Snowden in his iconic photo). Don't like to wear this in social setting. I would feel nerdy.

3. Fashionable round glasses with that spotted texture. Can't get used to the plastic glasses, so I don't wear them a whole lot, but no problem wearing them in social setting.

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You're assuming that losing a $10,000 bet is the same as experiencing some side affects years after having Lasik. It's not that clear-cut - you don't go blind. A fairer comparison might be a $10,000 bet only paying out $9,000, but while you play you get free drinks and a show, so maybe the trade-off is worth it.

I had Lasik about ten years ago. I just didn't like the inconvenience of glasses and contacts and taking them on/off all day when switching from a screen to driving/walking and back was straining.

I went in understanding that there was a risk night vision degradation in the future. But really, I'd likely have experienced that with age anyway.

To this day LASIK is the best money I've ever spent. I've got near-perfect vision and have since taken up many activities (flying, cycling, motorcycling) that, while they can be done with glasses, are much, much more convenient without them.

Agree... I did it about 2.5 years ago and is one of the single best things I have done, next to it is getting married and having the kid.

My vision is only slightly nearsighted, so I'm certainly not a candidate for LASIK (or PRK).

But I did try getting married; definitely one of the worst decisions I ever made in my life.

Luckily there weren't any kids involved.

According to statistics, you're significantly less than 50% likely to have a happy marriage, so it's not a very good gamble.

Contacts aren't risk-free either. By choosing to wear them over glasses for sports and social activities, you're making the same basic choice, perhaps with different numbers. (I say this as one who chose contacts over surgery, and I use them exclusively, no glasses.)

What's the risk of contacts in sports?

Nothing to do with sports, but contacts in general carry some risk due to things like eye infections.

I have similar setup. For contacts I use "Dailys". They are more expensive but lesser risk of infection. And these workout almost cheaper for those who use contacts occasionally.

Not with proper use. General recommendation is to wear contacts for 10, sometimes 12 hours in a 24 hour period and use supplemental glasses for the rest. Also clean them daily and well.

Sleeping in contacts is also a big no-no.

Wouldn't be surprised if there's a decent amount of anecdata that people don't really adhere to the guidelines.

Yes! Many people seem to miss this for whatever reason. There is no risk-free choice if you are unlucky enough to have poor eyesight.

Personal anecdote: I have a retinal scar from an eye infection that was a direct result of wearing contacts. The $2K I spent on LASIK in my early twenties was the best money I've ever spent.

I did a good amount of research and came to the conclusion that the expected value of LASIK outweighed that of contacts over a lifetime. To simplify things a bit, you are trading a one-time risk of a serious post-surgery complication for a risk of a contact-caused eye infection spread out over the remaining years of your life.

> There is no risk-free choice if you are unlucky enough to have poor eyesight.

What's the risk with glasses? Losing/breaking them?

I was evaluated for wavefront LASIK at the Stanford Eye Laser Center and I asked the doctor there specifically about this, because like you I wondered whether LASIK would be lower-risk than wearing contacts for the rest of my life. He said that conditioned on the fact that I had already worn contacts continually for several years without any problems, it probably wasn't true that continuing to wear contacts was a higher risk than LASIK. (I might have gotten LASIK anyway, but it turned out that I have unusually large pupils, which ups the likelihood of bad side effects.)

My dad is professor of ophthalmology and a practicing MD. I got LASIK done (by one of his partners) several years ago and it was the best health-related decision I've ever made.

I was on contacts before. The thing most people don't understand about contacts is that they also carry some risk and constant contact use can lead to major complications even if you follow all best practices regarding hygiene. That, to me, is much more scary than seeing halos around lights or slightly decreased night vision quality.

Contacts seem way more dangerous. Eyes are immune privileged, a dirty contact lens can lead to a rapidly growing infection with permanent loss of visual acuity in a matter of days. That is the short term; in the long term, the reduced oxygen supply to your eyes may lead to excessive ingrowth of blood vessels into the cornea. They are permanent and can obscure vision once you accrue enough of them.

Odds of dying in a car accident are 1/606 but I assume you don't avoid transportation. There's a 1/1,700 chance you'll die from dealing from steps. I assume you don't also avoid those.

http://www.iii.org/fact-statistic/mortality-risk

I had PRK done because the idea of LASIK freaked me out more and there were more side effects. The procedure feels pretty benign although there is a long healing time. I assume that most of the problems occur because people don't take proper post-surgery care.

First, I agree with your assessment of the risks and I do intend to consider surgery if my myopia worsens enough to justify it.

However, I don't think it works to compare the odds here. People accept the dangers of traveling by road vehicles because it's drastically superior to the alternatives. If there were an option that was less convenient/more annoying than a car, but just as fast, almost as flexible, and much safer (glasses/contacts vs surgery)... I think a lot of people would take it. (I realise this is not a perfect analogy.)

Secondly- and I realise this sounds a bit dramatic, and quite insensitive towards blind people- but I would not want to live my life without vision. If I get smashed by a truck and killed, that sucks but I'm probably not going to have to deal with it for long. If I go blind, that's something I have to deal with for the rest of my life and which prevents me from doing almost everything I enjoy doing.

I do accept that people don't tend to judge risk in a rational way. A plane crash is a much scarier concept than a car crash, even though it happens far less often, because

* plane crashes involve many people at once * they are far more likely to be fatal when they do occur * in some cases you will know you are doomed to crash many minutes before you actually do * a passenger has zero control over that situation

BUT, despite this, most of us happily accept air travel because it's vastly better than any alternative.

The benefits of eye surgery, in most cases and for many people, are far more marginal than the advantage a car or plane gives you. I would therefore say it's quite rational for someone to decide it's not worth the risk.

Those risk numbers aren't really valid for everyone, for all activities. The steps thing, for instance, is BS for most people; steps are a serious danger, of course, to elderly people, which is why the mortality number is so high for them. For healthy adults under retirement age, the risk isn't remotely as high.

Similarly, your risk of dying from getting hit by an asteroid are actually pretty significant according to some sources. Do you know how many people in history have actually died from an asteroid strike? Probably zero, at least in the last couple millenia, and almost certainly zero in the last century. But the risk is still pretty high because if a giant earth-killer asteroid hits the planet, we're all dead, or a city-killer asteroid could cause massive devastation. A small one hit a Russian city a few years ago and 1000 people were injured.

According to Wired, your risk of dying from an asteroid is higher than by lightning strike: https://www.wired.com/2013/02/asteroid-odds/

So you have to take some of these with a grain of salt. Car accidents, like the steps thing, probably also affect different places differently. Cars are much more deadly in some 3rd-world nations, for instance; does that 1/606 statistic include those? And death rates per mile traveled are probably higher in some places than others (rural vs. urban). And they're also probably higher for drunk drivers (though obviously the drunks do kill innocent people too), and possibly lower for small children (because they're better protected in car seats).

You can get one eye done at a time, which means what we're really talking about is a 1/10,000 chance of being a pirate.

Full disclosure: I've had LASIK three times[1].

[1]: https://news.ycombinator.com/item?id=13025716

I started doing a similar calculation http://kybernetikos.com/2007/06/08/plastic-surgery-to-make-o... while I was at waiting for surgery which just goes to show how irrational I am.

I think most people just hear the good things about it and don't properly evaluate the risks. I know I didn't.

You are lucky you can use contacts. I honestly don't know if I would have had a corrective surgery if I could use contacts. My eyes are, however, so dry that I never found a brand of contacts that would stay in my eye for more than 2 hours. After that, the eye would be so dry that I would blink them out.

The quality of eyesight isn't binary, though. The chance of total blindness from LASIK is, what?

The worth of generally improved eyesight will vary substantially person to person, as evidenced by these comments. Short term risk and long term risk according to patient outcomes seems to vary according to the article. A more holistic assessment of risk might include an answer to this question: what percent of doctors performing PRK or LASIK have undergone the procedure themselves?

That's an interesting question, but I don't know if it really applies. As an example, how much is it worth for you to get a cup of coffee? Depending on your mode of transportation, or the temperature of the coffee, there is risk. There's risk in everything, which is what you're getting at I think.

What brand of protective goggles do you wear over those 3 things 24/7?

You can probably buy an eye for much less than a billion dollars. So if I was given that offer, I would take it.

What good would someone's eye do to you? Is eye transplant a thing?

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