• Laser Eye Procedures Shared Consent

  • Because you are under the age of 18, your legal guardian must sign this consent form

  • Enter The Video Confirmation Code

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  • Question 2: Which of the following is not a common side effect of the procedure   *   0-3 months

  • Question 3: 95% of patients report being highly satisfied with their procedure*

  • That response was incorrect. Please review the explanation below carefully, then answer the question(s) again.

  • Question 1: What type of drops are administered to your eyes before the procedure begins?

     

    Before the laser eye surgery starts, the surgical team needs to make sure your eyes are completely comfortable and that you won't feel any pain. To do this, they apply local anesthetic drops—numbing drops—directly to your eyes.

  • Question 2: Which of the following is not a common side effect of the procedure

     

    In the first few months after laser eye surgery, your eyes are actively healing. During this 0–3 month recovery window, experiencing dry eyes and seeing halos or glare around lights (especially at night) are incredibly common, expected parts of the healing process. A runny nose, however, has nothing to do with the healing of your cornea and is not a side effect of the surgery.

  • Question 3: 95% of patients report being highly satisfied with their procedure

     

    This statement is completely true! Laser eye surgery (like LASIK or PRK) is widely recognized as one of the most successful elective surgical procedures available today. Decades of clinical data and patient tracking show that satisfaction rates consistently hover around 95% or higher, meaning the vast majority of patients achieve excellent vision and are incredibly happy with their results.

  • Question 2: Which of the following is not a common side effect of the procedure   *   0-3 months

  • Question 3: 95% of patients report being highly satisfied with their procedure*

  • Common F&Qs

  • 1. Does the procedure hurt?

     

    Answer: The surgery itself is virtually painless. Before the procedure begins, the surgeon will administer numbing (anesthetic) eye drops to completely desensitize the surface of your eye. You may feel a slight sensation of pressure for a few seconds when the laser is active or when the corneal flap is created, but no sharp pain.

    Post-op expectations: Once the numbing drops wear off, it is normal to experience a gritty, watery, or mild burning sensation (similar to having an eyelash in your eye). For LASIK, this typically lasts for just 3 to 6 hours. For PRK, the discomfort can be more pronounced and last for 3 to 5 days while the surface epithelium heals.

  • 2. What happens if I blink or accidentally move my eye during the surgery?

     

    Answer: This is a very common anxiety, but the technology is fully designed to handle it. You cannot accidentally ruin the procedure by blinking or moving.

    Blinking: Your eyelids are gently but securely held open throughout the procedure using a small, specialized medical device called a speculum.
    Movement: Modern corrective lasers utilize advanced, high-speed eye-tracking technology. The tracker measures the position of your eye hundreds of times per second. If your eye makes a microscopic movement, the laser shifts with it perfectly. If you make a sudden, large movement, the laser automatically shuts off instantly and safely restarts exactly where it left off once your eye is repositioned.
     

  • 3. How long is the recovery time, and when can I return to work and driving?

    Answer: Recovery timelines depend significantly on the specific type of surgery you have:

    LASIK/SMILE: Most patients experience a dramatic improvement in vision within 24 hours. You will generally have a post-operative checkup the next morning, after which most people are cleared to drive and return to non-strenuous work (though you may want to limit screen time initially to prevent dryness).
    PRK/Advanced Surface Ablation: Because the top layer of the cornea needs time to regrow, functional recovery takes about 3 to 7 days, and your vision may fluctuate for a few weeks before fully stabilizing. You may need to take a week off work.

  • 4. Are the results permanent, or will I need glasses again in the future?

    Answer: The physical reshaping of your cornea is permanent, and the vast majority of patients enjoy excellent distance vision for decades. However, the surgery cannot stop the natural aging process of your eyes.

    Presbyopia: Around age 40 to 45, the natural lens inside everyone's eye begins to stiffen. This causes difficulty focusing on close-up objects (presbyopia) and eventually requires reading glasses, regardless of whether you had laser eye surgery.
    Regression: In a very small percentage of cases, a patient's eyes may naturally regress slightly over time. If this occurs and your corneal thickness allows it, a minor enhancement procedure can often be performed to restore crisp vision.

  • 5. What are the most common side effects or risks?

    Answer: While serious complications that lead to permanent vision loss are extremely rare (affecting fewer than 1% of patients), temporary side effects are quite common during the healing phase:

    Dry Eyes: The laser temporarily disrupts the corneal nerves responsible for tear production. Most patients experience dry eyes for the first few weeks to months, which is managed with frequent use of preservative-free artificial tears.
    Night Vision Disturbances: You may notice glare, halos around headlights, or starbursts around light sources at night. These symptoms are typical during the first 1 to 3 months as the corneal tissue heals and usually subside completely.

  • Medical History and Risk Factors

  • Select any that apply

  • Important risk notification before you sign. Serious or activity-limiting complications are uncommon, less than 1%.

    Although most side effects are temporary, some may be long-lasting or permanent and could affect driving, reading, screen use, sport, performance work, or activities requiring sharp vision, night vision, or visual precision. This may be especially important for people whose work or hobbies involve night driving, aviation, emergency services, surgery or clinical work, photography, design, microscopy, screen-based work, or other high-vision-demand activities.

    Please discuss your individual risk with your surgeon before signing, especially if you have dry eyes, a high prescription, thin or irregular corneas, autoimmune conditions, previous eye disease, or high visual demands.

  • Please tick any of the boxes below if they are relevant to you

  • Section A: Clinical Understanding & Success

  • Section B: Specific Complication Disclosure

  • Section C: Legal Rights & GDPR (European Standard)

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  • Dr Y MB BCh BAO
    Member of RCSI MRCS 345689
    CSCST/CCST in Trauma & Orthopaedic Surgery

  • Dr X MB BCh BAO
    Member of RCSI MRCS 7214567
    CSCST/CCST in Trauma & Orthopaedic Surgery

  • Dr Z MB BCh BAO
    Member of RCSI MRCS 568902
    CSCST/CCST in Trauma & Orthopaedic Surgery

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