CASE STUDY: LASIK FOR A LONG DISTANCE SWIMMER
A 32-year-old long-distance recreational swimmer was referred to the Bochner Eye Institute for evaluation of laser vision correction. She reported intolerance to contact lenses and noted that glasses were incompatible with her swim goggles. Her primary concern was the inability to clearly see the shoreline while swimming, which affected both her confidence and safety in open water.
Her manifest refraction was:
- Right Eye: -4.50 -1.25 × 115, achieving 20/20 acuity
- Left Eye: -5.50 -0.75 × 80, also achieving 20/20 acuity
Slit-lamp examination revealed normal anterior segments. Computerized topography demonstrated regular corneal curvature with no evidence of irregular astigmatism or signs suggestive of corneal ectasia. Minimum pachymetry measured 540 microns in the right eye and 535 microns in the left eye.
After a comprehensive discussion of the risks and benefits of LASIK, the patient elected to proceed with surgery. The procedure was performed without complication, utilizing the IntraLase femtosecond laser to create a thin corneal flap, followed by excimer ablation with the Wavelight 500 kHz system to correct the refractive error.
POSTOPERATIVE RESULTS
Within several days postoperatively, she achieved 20/20 uncorrected visual acuity. More importantly, she expressed how thrilled she was to return to swimming with clear vision and without the encumbrances of corrective eyewear—enhancing both her enjoyment and safety in the water.
ADVANTAGES OF LASIK FOR SWIMMERS:
Swimmers face unique challenges when it comes to vision correction. LASIK offers several significant benefits that can enhance both performance and safety in the water:
1. FREEDOM FROM GLASSES
- Glasses are impractical in the pool and cannot be worn during training or competition.
- LASIK eliminates dependency on prescription swim goggles or post-swim corrective eyewear.
2. AVOIDS CONTACT LENS RISKS
- Wearing contact lenses while swimming increases the risk of serious infections (e.g., Acanthamoeba keratitis) from contaminated water.
- LASIK removes the need for lenses altogether, reducing the risk of waterborne microbial exposure.
3. IMPROVED SAFETY AND AWARENESS
- Clear, uncorrected vision improves spatial awareness, stroke alignment, flip turns, and awareness of competitors or lane boundaries.
- In open water swimming, it enhances orientation, sighting, and safety by allowing quick visual scans of the environment.
4. GOGGLE COMPATIBILITY
- Post-LASIK patients can use standard, non-prescription swim goggles, offering a better fit and improved comfort.
- No lens fogging or dislodging issues during dives or sprints.
5. LONG-TERM CONVENIENCE AND COST SAVINGS
- No ongoing expense for contact lenses, solutions, or special eyewear.
- Eliminates the logistical burden of maintaining visual aids during travel, training camps, or competitions.
FINAL THOUGHTS:
This case highlights the importance of incorporating lifestyle factors and recreational priorities into the refractive surgery decision-making process. While the patient met standard clinical criteria for LASIK—moderate myopia, mild astigmatism, normal corneal thickness, and topographic regularity—the motivation for surgery was primarily driven by her difficulties functioning as a long-distance swimmer.
Swimmers, particularly those who train or compete in open water, encounter unique visual challenges. Glasses are impractical, and contact lens use carries a well-documented risk of serious infection, particularly from waterborne organisms like Acanthamoeba. This patient’s inability to clearly see the shoreline during swims introduced not only frustration but legitimate safety concerns. These factors made laser vision correction both relevant and justifiable from a quality-of-life standpoint.
Anatomically, she was a strong candidate for LASIK. Her pachymetry readings were within safe limits, and topography showed a regular pattern without signs of ectasia risk. The combination of a femtosecond laser flap and high-frequency excimer ablation with the Wavelight platform enabled precise correction with a rapid visual recovery.
