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See And Ski

See And Ski

Fitness
By Edith Thys Morgan
posted: 11/18/1998

Look ahead, keep your eye on the ball, anticipate your next move. If you've sought instruction in any sport, you've heard this advice. Before you can hope to master these mantras, you need sharp vision, especially in a high-speed outdoor sport like skiing where changes in light, speed and terrain are part of every run. Seeing clearly in all types of weather is a safety factor as well, since losing your balance can send you into trees, lift towers or other people.

I learned all of this the hard way in ski racing. As my vision deteriorated, so did my confidence and my results, until my best performances were limited to sunny days. In poor light, I was skiing by Braille, on the defensive, and the experience was more about survival than speed. On cloudy or stormy days and in shadows, I couldn't decipher details-ice patches, bumps, compressions, take-offs and landings-that frequently sent me off-course and into the local clinic.

So I began my quest to find a solution and, in the process, discovered every sort of eyewear available to four-eyed skiers. Some were effective, but none were perfect. Prescription inserts and over-the-glasses goggles meant there was one more surface to reflect light and to accumulate fog. Prescription goggles offered excellent vision on the hill, but they aren't available in many frame shapes, and if you lose, scratch or break a lens, you're stranded.

Contact lenses delivered the best distortion-free vision, but we never got along. After much experimentation, I finally found a brand that was comfortable, but putting them in every morning was a finger-wrestling match. Once they were safely in, all it took was an eyelash or a piece of dust to ruin the moment. And I soon found out that contact lenses can be especially troublesome in dry mountain air, causing eye irritation or simply not staying in the eye. At higher speeds, the split second it takes to adjust to a moving contact lens can be all it takes to throw you off-line or cause you to misjudge terrain and lose your balance.

Until recently, surgery had seemed a radical alternative to the inconvenience and discomfort of contact lenses. But now, refractive surgery-Photo Refractive Keratectomy (PRK) and Laser Assisted In-Situ Keratomileusis (LASIK)-have won FDA approval and are becoming immensely popular, especially with athletes.

Though I'd been intrigued by the prospect of lens-free living, I first seriously considered refractive surgery when I was contacted last fall by Dr. Barry Seiler, director of medical and surgical services at three Eye Care Centers in Illinois. We had met briefly in 1992, when he was part of a visual screening program at the Albertville Olympics. (Surprisingly, visual acuity isn't usually part of the physical exams for athletic teams. So for many athletes, such screenings are the first indication that their vision is failing.)

Dr. Seiler had been so appalled by my vision (and others') that he worked with the U.S. Ski Team to institute an annual screening to evaluate vision and a training program to enhance it. Since I had quit competing before his program was in place, I didn't have the opportunity to participate. But Seiler didn't let me off the hook that easy: He wanted to know if I was finally ready to do something about my under-performing eyes.

After reading every bit of research I could, and asking enough questions to allay my fears about eye surgery, I decided to go for it. My first step was to decide which process was appropriate. Both PRK and LASIK use the Eximer Laser, which removes tissue to change the shape of the cornea and restore vision. Since LASIK involves a cutting of the cornea, it's viewed as a higher risk procedure and thus only recommended for patients with severely limited eyesight. Recovery is nearly immediate, however. In PRK, there is no cutting, but it can take months to achieve full visual correction.

Since I needed about two diopters of correction (not blind as a bat, but I couuldn't drive without glasses), PRK was the clear choice. Like my research had promised, the process itself was bloodless and pain-free. The next three days were uncomfortable at times. What the doctors had said was true: There were moments when the "gritty sensation" I was warned about felt like the Sahara Desert in my eye socket. But I was comfortable enough to be active the next day-and even skied the day after undergoing surgery on the second eye (though, because of increased light sensitivity, that's not the smartest thing to do). Within a week, my vision felt near-perfect-good enough for driving and other normal activity. And within three months, it was crisp and clear.

After years of struggling with deteriorating vision and trying to find the right corrective eyewear, it's a whole new experience to ski in flat light or shadows without going into a tailspin. Now I never quit early because my eyes are sore. And there are other, smaller benefits, like being able to wear any type of goggle or sunglass, never panicking about lost glasses and being able to recognize people in the lodge without putting on prescription goggles.

My experience is fairly typical. A Navy-sponsored study at the Vision Surgery and Laser Center found that 96 percent of patients who underwent refractive surgery were able to see 20/40 (driving standard in most states) or better, and 84 percent had their vision restored to 20/20. The process is so new in this country that long-term risks of PRK beyond three years have not been studied. And since it's elective surgery, not covered by most insurance policies, the cost can be prohibitive: about $1,500 per eye for PRK and $2,000 per eye for LASIK.

Considering those factors, is it worth it? If you've never had a problem with contact lenses, and don't mind the hassles associated with them, you may prefer to use the money for a new couch. But if sports-and performing them well in all conditions-are an important part of your life, and your vision has been getting in your way, refractive surgery is worth a look.

HealthHit!
Rays measured at Vail's summit in January were 50 percent stronger than those on a New York beach in June.

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