These are three of the questions we hear most at the free assessment: what happens if I blink, can both eyes be done together, and what about pregnancy? The short answers are below, followed by the detail and the evidence.

QuestionShort answer
Can I blink or move?A clip holds your eyelids open and the laser tracks your eye 1,050 times a second, pausing if you move too far. You can’t ruin it by moving.
Both eyes on the same day?Usually yes for LASIK, TransPRK and CLEAR. Same-day results match separate-day results in trials.
Pregnant or breastfeeding?Not until three to six months after you finish breastfeeding, when your prescription has settled.

Short answer: you can’t ruin the treatment by blinking or moving. Your eyelids are held open, you look at a target light, and the laser follows your eye and pauses if it moves too far.

This is the worry we hear most often, and it makes sense: most people can’t imagine holding their eye still. You don’t have to do it alone. Several things keep the eye steady and protect the treatment.

How your eye is kept still

  • An eyelid holder. After numbing drops, a small clip gently holds your eyelids open so you can’t blink during the treatment (AAO). The drops stop this from feeling uncomfortable, and the other eye is covered while it waits.
  • A target light. During the excimer laser step of LASIK and TransPRK you look at a small blinking light. Your eye naturally stays fixed on it.
  • A suction ring for the femtosecond step. In LASIK and CLEAR, a suction ring gently holds the eye still while the femtosecond laser works. You feel pressure, like a finger pressing on your eyelid, and your vision dims or goes dark for a short time (AAO).
  • An eye tracker. The Alcon WaveLight EX500, the laser we use for LASIK and TransPRK, tracks the position of your eye 1,050 times a second. Modern excimer laser trackers respond within a few thousandths of a second and follow up-and-down, side-to-side and rotational movements (El Bahrawy & Alió, 2015). If your eye moves outside the tracker’s range, the laser pauses and restarts when you are back in position.

What if I sneeze, cough or feel I’m going to move?

Tell your surgeon. They talk you through every step and will stop until you’re settled. The surgeon controls the laser throughout, and the tracker means small, sudden movements don’t land the treatment in the wrong place. If you have a cold, hay fever or a cough on the day, let the team know when you arrive.

What if I’m nervous?

Most people are, and it doesn’t stop the surgery going well. LASIK, TransPRK and PRK are done awake, with relaxing medication offered beforehand. The whole LASIK procedure takes around 10 minutes for both eyes. For CLEAR, you can choose to be asleep, with sedation from a specialist anaesthetist in our accredited day hospital, currently at no extra charge. Our guide to whether you can be asleep for laser eye surgery explains the options, and what happens on the day walks through each step.

Are both eyes done on the same day?

Short answer: for laser eye surgery, usually yes. Both eyes are treated one straight after the other, as two separate procedures. It means one recovery period and one block of time off work.

ProcedureBoth eyes on the same day?Typical time off desk work
LASIK and Ray Tracing LASIKUsually1 to 2 days
CLEARUsuallyA few days
TransPRKUsually7 to 10 days
ICLCan be, or on separate days2 to 4 days
Lens replacement (RLE)Can be, or on separate daysYour surgeon will advise

What the evidence shows

  • LASIK. In a randomised trial of 714 eyes treated by 14 surgeons, there was no significant difference between same-day and separate-day LASIK in complications during surgery, loss of best-corrected vision or accuracy of the result. The one exception was a slightly higher rate of epithelial ingrowth (cells growing under the flap) in the same-day group, 2.9% vs 0.6% (Waring et al., 1999).
  • PRK. In a randomised trial of 104 eyes, same-day PRK gave the same vision and accuracy as separate-day PRK. Pain scores were lower and satisfaction higher in the same-day group (Vetrugno et al., 2000).
  • Infection is rare. In a series of more than 645,000 laser eye surgery procedures, serious corneal infection occurred in 26 of 564,165 LASIK eyes and 11 of 81,792 PRK eyes (Schallhorn et al., 2017). Each eye is still prepared and treated as a separate sterile procedure.
  • ICL. In a multicentre study of 352 eyes, having both ICLs implanted on the same day was safe and effective (Russo et al., 2024), and a comparison of same-day and two-stage surgery found both approaches equally effective, predictable and safe (Lorger et al., 2024).
  • Lens replacement. Most of the evidence comes from cataract surgery, which is the same operation; our RLE cost guide sets it out. If you are having cataract surgery through a health fund, the eyes are generally done on separate days.

The trade-offs

Same-day treatment means one trip, one recovery and less time away from work. The downside is that both eyes are blurry and sensitive at the same time, which matters most after TransPRK, when the surface of both eyes heals over several days. You’ll need someone to drive you home and help for the first day or two. Your surgeon may suggest separate days if there is a reason to see how the first eye heals before treating the second.

The price is per eye either way, so treating both eyes on one day doesn’t change the cost; see our costs page.

Can I have laser eye surgery while pregnant or breastfeeding?

Short answer: no. Wait until you have finished breastfeeding. Focus Vision asks you to wait three to six months after you finish, so your prescription is stable when it is measured.

Why pregnancy and breastfeeding matter

  • Your prescription can change. The FDA lists pregnancy and nursing among the reasons not to have LASIK, because hormonal changes can alter your prescription (FDA).
  • Your cornea changes shape. In a study of 60 pregnant and 60 non-pregnant women, the front of the cornea was measurably steeper in pregnancy (Goldich et al., 2014). Treating a temporarily changed cornea risks a less accurate result.
  • Dry eye is more common. Pregnancy hormones affect the tear glands and the surface of the eye, and dry eye is already a common side effect of LASIK (Moshirfar et al., 2019).

A review of the evidence recommends waiting until breastfeeding has stopped, regular periods have returned and your prescription is back to its pre-pregnancy level (Moshirfar et al., 2019). At your assessment, your optometrist compares your measurements with your previous prescriptions to check they have settled.

Planning a pregnancy?

Laser eye surgery does not affect fertility or pregnancy, so having it before you start a family is a common choice. In a study of 64 women who had LASIK and later became pregnant, pregnancy did not change their vision, prescription or corneal shape (Kanellopoulos & Vingopoulos, 2020). Some experts still advise that the prescription can drift if pregnancy happens within a year of surgery (Moshirfar et al., 2019).

If you’re planning a pregnancy, tell your surgeon. You’ll use medicated eye drops for weeks after surgery, and longer after TransPRK, so it helps to plan the timing together. If you find out you’re pregnant soon after surgery, let your surgeon and GP know so they can review your drops.

Other questions people ask

Ask us at your free assessment

Every patient starts with a free assessment with our optometrist, including detailed scans of your eyes. If laser looks suitable, you then have a paid consultation with Dr Brendan Cronin or Dr David Gunn, who answer your questions and confirm the plan; the consultation fee comes off your surgery price.

Call (07) 3239 5005, email hello@focusvision.com.au or book online.

References

  1. American Academy of Ophthalmology. LASIK — Laser Eye Surgery. EyeSmart. aao.org/eye-health/treatments/lasik
  2. El Bahrawy M, Alió JL. Excimer laser 6th generation: state of the art and refractive surgical outcomes. Eye Vis (Lond). 2015;2:6. pubmed.ncbi.nlm.nih.gov/26605362
  3. Waring GO 3rd, Carr JD, Stulting RD, et al. Prospective randomized comparison of simultaneous and sequential bilateral laser in situ keratomileusis for the correction of myopia. Ophthalmology. 1999;106(4):732-738. pubmed.ncbi.nlm.nih.gov/10201594
  4. Vetrugno M, Maino A, Cardia L. Prospective randomized comparison of simultaneous and sequential bilateral photorefractive keratectomy for the correction of myopia. Ophthalmic Surg Lasers. 2000;31(5):400-410. pubmed.ncbi.nlm.nih.gov/11011709
  5. Schallhorn JM, Schallhorn SC, Hettinger K, et al. Infectious keratitis after laser vision correction: Incidence and risk factors. J Cataract Refract Surg. 2017;43(4):473-479. pubmed.ncbi.nlm.nih.gov/28532931
  6. Russo A, Filini O, Mertens E, et al. Immediate Sequential Bilateral Implantable Collamer Lens Surgery Is Safe and Effective. J Refract Surg. 2024;40(5):e313-e320. pubmed.ncbi.nlm.nih.gov/38717079
  7. Lorger A, Luft N, Mayer WJ, et al. One-stage versus two-stage bilateral implantable collamer lens implantation: a comparison of efficacy and safety. Sci Rep. 2024;14(1):5648. pubmed.ncbi.nlm.nih.gov/38453996
  8. U.S. Food and Drug Administration. When is LASIK not for me? fda.gov/medical-devices/lasik/when-lasik-not-me
  9. Goldich Y, Cooper M, Barkana Y, et al. Ocular anterior segment changes in pregnancy. J Cataract Refract Surg. 2014;40(11):1868-1871. pubmed.ncbi.nlm.nih.gov/25217070
  10. Moshirfar M, Rosen DB, Heiland MB, et al. Should I Get LASIK If I’m Breastfeeding? Ophthalmol Ther. 2019;8(3):349-352. pubmed.ncbi.nlm.nih.gov/31254257
  11. Kanellopoulos AJ, Vingopoulos F. Does Pregnancy Affect Refractive and Corneal Stability or Corneal Epithelial Remodeling After Myopic LASIK? J Refract Surg. 2020;36(2):118-122. pubmed.ncbi.nlm.nih.gov/32032433
B

Brendan Cronin

MBBS (Hons), DipOphthSci, B.Com, LLB, FRANZCO, FWCRS

Dr Brendan Cronin is a corneal, cataract and refractive surgeon and co-founder of Focus Vision in Brisbane. He is the Director of Education at the Queensland Eye Institute, completed his corneal fellowship at the Manchester Royal Eye Hospital in the UK, and teaches corneal and refractive surgery techniques to ophthalmologists internationally. He co-created the CAIRSPlan surgical planner and the free Focus Vision Refractive Outcomes Analyzer.

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