Glaucoma is an eye disease that results in loss of vision and total blindness if untreated. It is caused by an increased pressure inside the eye that gradually decreases blood flow to the optic nerve. In doing so, the optic nerve dies. Many systemic disorders increase the likelihood of contracting glaucoma, but there is usually a positive family history in many of these patients. The question that needs to be asked is, “are there procedures or factors that will increase the chances of getting glaucoma?”

The answer to this inquiry is maybe. LASIK is a surgical procedure that alters the shape of the cornea in order to reduce or eliminate its’ refractive power and thereby decrease a persons’ need for eye glasses. In doing so the cornea is made thinner because of the lasers’ ablation of the central corneal tissue. This decrease in corneal thickness also results in a more flexible or softer cornea.

Measuring intraocular pressure is best done by the use of a procedure called Goldmann applanation. It involves a tono tip that is gently applied to the anterior corneal surface creating mires or semi circles that ” read” the internal ocular pressure. A thick cornea will “push” back on the applanator resulting in a higher reading while a thinner cornea will give more ground thus resulting is a lower reading. Therefore, corneal thickness directly influences the results on this extremely important test.

Post LASIK patients, because of thinner corneas, will usually have what appear to be lower intraocular pressures. In patients with a predisposition toward contracting glaucoma this factor further complicates a usually difficult situation. Central Corneal Thickness ( CCT) measurements are done routinely and average corneas should be at least 500 microns thick. Post LASIK patients will be much thinner depending on how much cornea had to be ablated. The problem arises when trying to accurately measure the pressures. If one of these post surgical patients is a glaucoma suspect then attempting to determine an accurate IOP will be very difficult. Therefore, while LASIK does not increase the chances of contracting glaucoma, it does make diagnosing and treating much more complex.

The most important point to remember from this is that if an individual has a family predisposition for glaucoma, LASIK may not be a good procedure to have since it may result in a more difficult and complex situation later on when dealing with a dangerous condition.