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Some link bouts with depression with failed LASIK
By Sabine Vollmer
McClatchy Newspapers
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RALEIGH, N.C. -- Patients who undergo vision-correcting laser eye surgery sign a release form with an extensive list of risks, but some researchers and former patients say a potential complication is not mentioned: depression that can lead to suicide.

In response to patient complaints, the Food and Drug Administration plans to convene a large, national study to examine the relationship of LASIK complications and quality of life, including psychological problems such as depression.

Malvina Eydelman, an ophthalmologist with the FDA’s Center for Devices and Radiological Health, wrote in an e-mail message that the scant clinical data available “failed to suggest significant problems following LASIK surgery,” but she said the FDA wants a broad and systematic review. She wrote, “We also noted that quality of life issues related to LASIK had not been evaluated consistently, and there were few reports of well-designed studies.”

Frustration and even sorrow can follow any unsuccessful surgery, but when the procedure leaves a patient with unremitting eye pain or permanently impaired vision, the emotional toll can be particularly severe.

One who could not endure it was Colin Dorrian, 28, a patent lawyer and aspiring medical student from suburban Philadelphia. He committed suicide last summer, six years after LASIK surgery left him with lasting visual distortions. The surgery was done at a LASIK center in Canada that has since closed.

“If I cannot get my eyes fixed, I’m going to kill myself,” he wrote in a note police found on his body. “I just cannot accept the fact that I’m supposed to live like this.”

In the note, Dorrian wrote that there had been other instances when he felt down. “I have other problems like most people do. But this is something else,” he wrote. “As soon as my eyes went bad, I fell into a deeper depression than I had ever experienced, and I never really came out of it.”

Laser eye surgeons who treat patients with complications say they do come across cases of depression, but they don’t think LASIK complications are the root cause. They say patients who exhibit depression after the procedure were likely depressed or psychologically troubled beforehand.

“There’s no cause and effect,” said Dr. Steven C. Schallhorn, the former head of the Navy Refractive Surgery Center in San Diego and an expert on permanent visual distortions from LASIK.

‘I was in so much pain’

Martha Walton of Raleigh postponed LASIK twice. She had had bouts of depression and anxiety attacks and wasn’t sure she was ready for the permanence of eye surgery. She still felt very anxious when she went ahead with it in August. Within a month, Walton, 41, a high school teacher, developed constant, severe pain from eye dryness. She couldn’t cope with it and spent six days on suicide watch in a mental health facility.

“I was in so much pain,” Walton said. “Twenty-four hours a day there was no escape. The only relief I could think of was to end my life. At least the pain would be over.”

An elaborate regimen of taking supplements, wearing special goggles and switching to preservative-free eye drops has drastically reduced her pain. But her eyes still do not produce enough tears and she continues to take daily anti-anxiety medication.

Christine Sindt, an optometrist and associate professor of clinical ophthalmology at the University of Iowa in Iowa City, Iowa, has encountered the psychological effects that patients experience when they have trouble seeing.

“Depression is a problem for any patient with a chronic vision problem,” she said. But in the case of post-LASIK patients, she said, the depression is compounded by remorse.

“It’s not just that they lose vision,” she said. “They paid somebody (who) took their vision away.”

Sindt specializes in treating ectasia, a bulging of the eye that is considered the most severe and rarest LASIK complication. She sees a few dozen patients with ectasia; all of them show signs of depression, she said.

Since the mid-1990s, numerous studies have shown that the surgery known as laser-assisted in-situ keratomileusis, or LASIK, is safe and successful in most cases and has become more so with the introduction of new technology. Most of the 1.3 million Americans who undergo the surgery every year are happy with the results. The American Society of Cataract and Refractive Surgery, which represents about 9,000 ophthalmologists specializing in laser eye surgery, suggests that only 2 percent to 3 percent of LASIK patients experience complications.

Dr. Alan Carlson, a laser eye surgeon at the Duke Eye Center in Durham, built his career on correcting the vision of patients at high risk of complications. He said people at risk of depression or anxiety are generally not good candidates for LASIK. He compared them to patients who become depressed after undergoing cosmetic surgery, another elective and medically unnecessary procedure.

“Their motivation and expectations may reflect something they’re missing in their life that they’re not telling you about,” he said.

But surgeons agree that LASIK is unlike a face-lift or even most necessary surgery because it affects a process — seeing — that is essentially a mental function. The eyes focus light, but what a person actually sees depends on how the brain decodes an image. That neurological difference in decoding explains why dyslexics reverse letters and why alcohol consumption can produce double vision.

Although laser eye surgery has been around for years, little research has been done to explore how the ability to see affects how people feel and act. In 2006, the FDA began to look into LASIK complications and quality-of-life issues and determined more research was needed. A task force that includes representatives of the National Eye Institute and the National Institutes of Health has since formed to design a large study that would be conducted by laser eye surgeons across the country.

The FDA is also planning an open public meeting this spring to discuss experiences with LASIK devices since their introduction to the U.S. market.

Filled with anger after LASIK

In Cleveland, Tenn., Kim Hybarger, 44, a nurse, developed debilitating visual distortions after LASIK surgery Dec.21, 2006. She tried to walk into traffic, cut her throat and starve herself.

“I was filled with anger,” she said. “I felt so hopeless and helpless. I just wanted to die. The way I saw was so frightening.”

Her vision was blurry. The moon had six to eight overlapping copies, a distortion called ghosting. Bright lights erupted into irregular star bursts the shape of chicken feet.

Hybarger compared her vision to looking through glass that is cracked and smeared with grease. She stopped driving, exercising, working and going to the grocery store. She couldn’t read a book or watch television.

Hybarger said she had never had problems with depression before her LASIK surgery. Afterward she felt so bad, she said, she told her husband to “load a gun with a bullet and give it to me. I’m not going to live the rest of my life like this.”

Hybarger’s mental state didn’t improve until Ed Boshnick, a Miami optometrist, offered to fit her with special contact lenses. Sales of the special lenses have increased with the rising number of Americans who had LASIK since 2000. The lenses can restore the cornea’s shape and correct visual distortions.

Boshnick is one of a handful of specialists who have had considerable success fitting the lenses. Hybarger is one of about 250 patients with complications from LASIK who regularly see Boshnick. About half of them suffer symptoms of depression, Boshnick said.

The new lenses can clear up more than vision.

Hybarger left Miami remembering the moment she first looked through them.

“It was indescribable,” Hybarger said. “It was like the first time I smiled in a year.”

Take a look
Martha Walton feeds her hens outside her home in Raleigh, N.C. Walton fell into a deep depression after LASIK in August left in her constant pain. For months after the surgery Walton couldn't feed her hens because of the pain and the dust outside. (Ethan Hyman/Raleigh News & Observer/MCT)
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Reader comments on this story - 26 total

Note: All views and opinions expressed in reader comments are solely those of the individual submitting the comment, and not those of the Pantagraph or its staff.

my 2cents worth... wrote on Feb 11, 2008 8:53 AM:

" I had LASIK also at Eye Surgical Associates by Dr. Pinter 5 years ago. Could not have had a better doctor or staff. My eyes are done in monovision, which means one eye is for distance and one is for closeup since I am over 45 yrs. ago. Worked great!! Highly recommend Dr. Pinter and his staff!! "

had it wrote on Feb 11, 2008 8:08 AM:

" done two years ago and i can honestly say it was the BEST investment I have ever made. My eyesight was so poor I couldn't even see the alarm clock in the morning without my glasses/contacts. My eyesight is 20/15 now and i experienced no problems afterwards. "

I had~ wrote on Feb 10, 2008 5:58 PM:

" it done in October. My left eye is a little fuzzy, and may have an enhancement. overall, I don't regret it. Thankfully if I did get the blues, no way would I ever resort to the thoughts and doings some of the people in this story did. "

did it wrote on Feb 10, 2008 2:30 PM:

" I got lasik in December at Eye Surgical. It's the investment I've ever made. The day after the procedure, I tested 20/20. The week after (and ever since), I've been near 20/15 or at 20/15 (like a previous reader mentioned, that's better than 20/20). That means for the things people with 20/20 can see, I can back up five feet and still see them. No worries about glasses or contacts. I actually didn't have many of the side effects immediately after surgery that others have - all I had was some mild dryness.

Sure, the idea of changing your eyesight forever is mind blowing and scary, but doing research and talking to the right people can alleviate any worries. It's not like everyone can get it - patients are thoroughly screened beforehand and only those that are great candidates will be able to get the procedure done. "

head in the sand wrote on Feb 10, 2008 1:22 PM:

" The doctor who said there is no "cause and effect" in these cases could not be more wrong. Our eyesight is probably the single most fundamental component that allows us to function. To become suddenly, permanently, blind (especially as the result of a botched operation) would push many if not most of us to the brink of desperation. In most cases it means the end of life as we have known it- loss of career, et al. I live with an elderly parent who can no longer see the tv set, and she is nearly out of her mind with what she calls "depression". I can certainly understand how someone might take his / her desperation too far. "

Concerning Dorrian 28 wrote on Feb 10, 2008 8:52 AM:

" I do believe that Colin Dorrian, mentioned in the article, had difficulty dealing with change firstly. He couldn't accept a disability, even if only temporary condition. He also wouldn't be too happy if he was diagnosed with skin cancer, or given a permanent limp due to an unfortunate car accident. Seems to me his vanity or perhaps "visions" (sorry bad choice of words) of becoming a Doctor are the real disappointments; which would've led to a financially comfortable lifestyle. Maybe this is what scared him to death. Literally. "

To Lasik pt also wrote on Feb 10, 2008 4:03 AM:

" How's your blood pressure? "

FYI wrote on Feb 10, 2008 1:36 AM:

" I'd be pretty depressed too, if I spent all that money for surgery that didn't work...and hurt. "

Lasik pt also wrote on Feb 9, 2008 8:42 PM:

" however, I do have "frequent" headaches which I had prior to the procedure, just thought it was from wearing my contacts so long, but not so sure anymore! Still don't regret yet having it done! "

to Miltone wrote on Feb 9, 2008 8:35 PM:

" The study hasn't been performed yet. Read the 2nd paragraph. "

WOW.. wrote on Feb 9, 2008 8:11 PM:

" I found a link between failed plastic surgery and suicide... Now, pay me a million dollars ! What a stupid article. "

Any Surgery! wrote on Feb 9, 2008 7:57 PM:

" Any surgery or procedure should be carefully researched by the patient! The old days of 'taking your doctors word for it' are gone! YOU have to decide if your willing to take the risks, etc. that go along with it. I held off on getting the eye surgery for 2 years because I wasn't willing to take the risks but I found Dr. Pinter and he was wonderful. He answered all my questions and was even great during the surgery. Plus they have the laser. I'm very fortunate because my surgery went great and I see wonderfully now and believe me, I had horrible eye sight! I'm sure these people had other 'underlying' problems before this; though I'm sure what they are going through now is horrible and would mess with your quality of life. I can't imagine and my heart goes out to them. It's hard to tell how you would be or act if you walked a mile in their shoes. Perhaps it just needs to get looked at more closely on who's allowed to do this surgery. "

Lasik patient wrote on Feb 9, 2008 6:50 PM:

" Just had mine done less then a month ago ..its TERRIFIC !
WTG Dr. Bond in Peoria :) "

To Eye Get It wrote on Feb 9, 2008 4:58 PM:

" Are your vision problems from LASIK or is there some other cause? You don't say in your comment. "

reader wrote on Feb 9, 2008 4:54 PM:

" It says little research has been down to see how the ability to see affects how people feel and act.This surely isn't a serious statement? "

Sooo... wrote on Feb 9, 2008 4:24 PM:

" People with a history of depression and anxiety are depressed after a failed surgery? Say it ain't so! What an ignorant, unscientific article. "

??? wrote on Feb 9, 2008 4:00 PM:

" why does everyone assume because a surgeon can operate on a human cornea that he/she is an expert on how the human visual system works? This should not be a surprise to anyone. Two separate, although related, issues. The average persons understanding of their own vision is extremely poor and those who "sell" lasik as a final solution are only taking advantage of the public's ignorance. "

LT wrote on Feb 9, 2008 3:46 PM:

" So.........Who fed the chickens? "

Eye Get It wrote on Feb 9, 2008 3:25 PM:

" I have problems with blurred/double vision on a daily basis. It is a very disabling feeling. I get disoriented, and am sure I look wierd when talking to people....the brain does wierd things ........I pretend like I am okay when in fact, I can't see/think straight. It can be depressing...but something just have to live with. "

20/15 wrote on Feb 9, 2008 3:02 PM:

" I had Lasik performed a few years ago. I've been 20/15 (better than 20/20) ever since. I've referred numerous friends and they all agree its the best thing.
glassesfree dot com Future Vision Laser Center Hinsdale Illinois.....by far the best in Illinois.
"

p.s. wrote on Feb 9, 2008 2:51 PM:

" cant those folks sue if the surgery is unsuccessful? (like other surgeries) that should cheer them up "

Miltone wrote on Feb 9, 2008 2:10 PM:

" Studies such as this are subject to peer review where there is an extensive process to root out factors such as the ones you suggest. I'm sure that when someone found years ago that smoking increases the risk of lung cancer there were derisive comments made about that study. "

lasik from streator wrote on Feb 9, 2008 1:55 PM:

" Lasik was the best thing i have ever done for myself. i would do it again with out thinking twice. research your dotor before going through with it. mine was done by Dr. Pinter and you will never find a better doctor. Eye Surgical Associates is the best and they also gave me a whole new life. "

Meh wrote on Feb 9, 2008 1:50 PM:

" This is like those scare articles about pain years after a vascetomy. They find a handful of people after millions of procedures and blow up their stories as if they were the norm. "

Duh! wrote on Feb 9, 2008 12:55 PM:

" Some articles are so dumb! If you go in to have something done especially surgery and it is not successful or leaves you worse off of course there is cause and effect! The stupidity of this is hilarious! Naturally you are going to be DEPRESSED and VERY ANGRY at yourself for doing it in the first place. And rightly so! But again that is why some people should think before they proceed which is not too common these days. My rule of thumb with surgery is that if it doesn't go well you won't be worse off than you started. Have you seen some of those old women with face lifts? A few or even a lot of wrinkles would look better than that. "

Love my Lasik wrote on Feb 9, 2008 12:53 PM:

" I hope this is not suppose to scare people. Life after Lasik has been outstanding!
Its like a new begining!
Dr Pinter was fantastic!
250 People with complications? Out of what?
Eye Surgical gave me a whole new life! "
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