Are You Awake During LASIK?

That's the answer people don't want, and it's the reason this gets searched so often at two in the morning a week before surgery.

Here's the thing though. Most of what makes it frightening is not knowing what's about to happen. So rather than telling you not to worry, I'm going to walk you through it properly including the two bits that surprise people, which the surgical clinics tend to skip.

Do they put you to sleep for LASIK?

No, and it isn't because they're being tough on you.

General anesthesia would make the procedure worse, not better. Under GA your eyes roll upward, which is precisely the opposite of what a surgeon needs. They need you to look at a fixed point, on command, for a couple of minutes.

There's also nothing to anaesthetise you against. Numbing drops block the corneal nerve endings completely, and the excimer laser works by breaking molecular bonds rather than burning a cold process, no heat sensation.

Add to that the fact that general anesthesia carries genuine risks of its own, and you're taking on a real danger to avoid an imaginary one. No reputable surgeon offers it for this.

What you do usually get is a low-dose oral sedative Valium or Xanax typically an hour beforehand. Enough to blunt the edges. You'll still be awake and able to follow instructions, just considerably less bothered about it.

Can you blink during LASIK?

No, and this ends up being the most reassuring part of the whole thing.

A lid speculum holds your eyelids apart. It sounds medieval and it's the single feature that alarms people most in advance but think about what it removes: the job of holding your own eye open. You couldn't blink if you tried, so you stop trying.

Your eye stays wet throughout because the team keeps applying lubricating solutions. You won't feel it drying out.

And the fear of "what if I flinch" mostly dissolves once you understand that your eyelids aren't part of the equation.

What happens, in order

Drops. Anesthetic goes in first, then more of it. Your eye is completely numb within a minute or two. Someone marks the eye, you lie back, the chair adjusts under the laser.

The speculum. Goes in, feels strange, doesn't hurt. The other eye is usually covered.

The suction ring. This is the one to know about. A ring is placed on the white of your eye to hold it perfectly while the flap is made, and it applies firm pressure people describe it as pressing a finger hard against a closed eyelid.

Then your vision dims and goes dark. Not blurry. Dark. For roughly fifteen to thirty seconds you can't see anything at all.

This is completely normal, it happens to everyone, and it is genuinely the most disorienting moment of the procedure. It's also painless. Knowing it's coming turns it from alarming into merely odd.

The flap. A femtosecond laser creates the flap while the suction holds you steady. You feel essentially nothing. Vision comes back foggy, like looking through a steamed window, which is expected.

The correction. The flap is lifted no sensation at all and you're asked to look at a blinking light. The excimer laser runs for something like twenty to forty seconds per eye depending on your prescription.

Two things happen here. There's a tapping or clicking sound. And there's a smell, faintly like burning hair. That's the laser plume, it's normal, and almost nobody warns people about it in advance.

The flap goes back. Smoothed into position. You might sense something touching the eye. It seals without stitches.

Other eye. Same again.

You're in the laser suite for about ten minutes total. The actual lasering is a couple of minutes of that.

What if I move, or lose the light?

You will move. Everyone does, and the system expects it.

Modern excimer lasers have eye tracking that follows your eye more than a thousand times a second and adjusts the beam accordingly. Move too far and it simply stops firing until you're back. The surgeon may also pause to realign or wet the eye, which is routine rather than a sign something went wrong.

The fixation light itself often looks like it's drifting around, partly because your cornea is being reshaped underneath you. Don't chase it. Keep looking in its general direction and that's enough.

Staying calm in the chair

A few things that actually help.

Take the sedative if it's offered. There's no medal for refusing.

Ask the surgeon to talk you through it as it happens. Most do this anyway, and a running commentary is far better than silence.

Breathe slowly and deliberately. Holding your breath makes you tense, and tension is what makes the pressure sensation worse.

And keep hold of the timeline. The uncomfortable part the suction is under thirty seconds per eye. That's the whole of it.

Right afterwards

Your vision comes back foggy and improves over hours. Once the numbing drops wear off, expect an hour or two of grittiness and stinging, like something is caught under the lid.

The best thing you can do is go home and sleep for three or four hours. Eyes closed means no blinking against the flap, and most people wake up dramatically more comfortable and seeing far better.

One more thing worth knowing in advance: you'll probably have red patches on the whites of your eyes where the suction ring sat. They look worse than they are and clear over a week or two.

Where we come in

We don't perform LASIK, which is exactly why we'll give you a straight answer about whether you should have it.

The consultation covers corneal mapping and thickness, whether your prescription is genuinely stable, a dry eye assessment dry eye being one of the more common reasons someone isn't a good candidate and screening for conditions that rule surgery out. If you're suited to it we'll refer you. If you're not, you'll hear that before you've paid a deposit anywhere.

Afterwards we handle your follow-up care.

If you're nervous about the procedure itself, bring that to the consultation. It's a reasonable thing to want talked through by someone who isn't selling you the operation.

Jersey City is on 201-420-7733. Florham Park on 973-994-1444.

FAQ

Are you awake during laser eye surgery for PRK too?

Yes, the same way. PRK has no flap and no suction ring, so you skip the vision-going-dark moment entirely. Recovery is longer and more uncomfortable, but the procedure itself is arguably easier to sit through.

Will I see the laser working on my eye?

Not in any meaningful sense. You'll see a blurry light and shifting shapes. Nobody watches their own cornea being reshaped.

Does LASIK hurt?

Not during. Pressure from the suction ring is the strongest sensation and it's brief. Afterwards, a few hours of gritty burning once the drops wear off is normal.

Can I have LASIK if I'm very anxious?

Usually, yes. Tell the surgical team beforehand rather than on the day. Sedation can be adjusted, and some surgeons will do one eye at a session for patients who need it.

What if I sneeze or cough?

Say so and the surgeon pauses. The eye tracker stops the laser anyway if you move beyond tolerance.

The nerves are about the unknown

So, are you awake during LASIK? Yes, for ten minutes, with numb eyes and your lids held open for you.

Almost everyone who's had it says the same thing afterwards that it was easier than the version they'd built in their head. That gap is mostly information, which is what this page is for.

Start with finding out whether you're a candidate at all. Plenty of people worry about themselves through weeks of this and then discover their corneas are too thin.

Book a laser eye surgery consultation