Had my first eye exam with Dr. Callahan and it was the most thorough I’ve ever had in 60+ years. She explained things I’d never heard before. Efficient, pleasant staff. She’s my ophthalmologist for life!
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Are You Awake During LASIK Eye Surgery?
What You Will Feel and Experience During LASIK
Knowing what to expect during the procedure helps reduce anxiety and puts you in control. The sensations involved in LASIK are mild and temporary, and most patients describe the experience as far more manageable than they anticipated.
You may feel a sense of light pressure on your eye during parts of the procedure, but you should not feel sharp or intense pain. Some patients notice a slight heaviness or the feeling of something gently resting on the eye. These sensations are normal and pass quickly.
- Coolness from the numbing drops or saline rinse
- A mild tickling or watery feeling on the eye surface
- Awareness of the small device holding your eyelids open
- Light pressure when the laser is active
The first step of LASIK involves creating a thin protective flap in the outer layer of your cornea using a femtosecond laser (an extremely precise laser that works in a fraction of a second). During this step, a suction device is briefly applied to your eye, and you will feel firm pressure for roughly 10 to 20 seconds.
Some patients describe this pressure as similar to a finger resting gently on a closed eyelid. Your vision may dim or go dark for a brief moment, which is completely normal and expected. The pressure stops as soon as the flap is created.
Once the flap is gently lifted, your LASIK Surgeon will ask you to look at a small steady or blinking light. The excimer laser (the laser that reshapes the cornea to correct your vision) then does its work while you hold your gaze on that target. You may notice blurriness, haziness, or soft colored lights during this phase.
Your vision will be quite unclear during this part of the procedure, and that is entirely expected. The key is to keep looking in the general direction of the target light. The laser system continuously tracks your eye position and pauses or adjusts if movement is detected, so precision is maintained throughout.
You will likely hear a clicking or buzzing sound while the laser is active. These sounds are completely normal and simply indicate that the laser is working as it should. Some patients also notice a faint scent, often described as similar to a mild electrical smell, which comes from the laser interacting with corneal tissue.
The smell is harmless and fades within seconds after the laser stops. Knowing about these sensory details in advance helps many patients feel more prepared and less startled during the procedure.
Managing Anxiety About Being Awake for LASIK
It is very natural to feel nervous about undergoing eye surgery while you are conscious. Our team has guided many patients through this experience, and we have a range of tools and approaches to help you feel calm and supported from start to finish.
Many people worry about seeing instruments near their eyes or fear that they might move at the wrong moment. These concerns are among the most common we hear from patients considering LASIK. Talking through your worries during your consultation often reduces anxiety significantly, because understanding each step removes much of the uncertainty.
We encourage you to share any concerns with your LASIK Surgeon before surgery day. There are no questions too small or too worrying to bring up.
If you have significant anxiety about the procedure, we may recommend a mild oral sedative to help you relax beforehand. This medication does not put you to sleep. It simply takes the edge off your nerves so you can remain calm while still being awake and able to follow instructions.
- The sedative is typically taken about 30 to 60 minutes before your procedure begins
- Your LASIK Surgeon will review your medical history to confirm the sedative is appropriate for you
- You must arrange for a driver if you take a sedative, as you cannot drive afterward
- Avoid alcohol on the day of surgery, and inform us if you are pregnant, breastfeeding, or have sleep apnea
Simple breathing strategies can be surprisingly effective during surgery. Slow, steady breathing in through your nose and out through your mouth keeps your body relaxed and your focus steady. Some patients find it helpful to silently repeat a calming phrase or picture a peaceful place while the laser is working.
If our facility offers music during the procedure, that can also be a helpful distraction. The most important thing to remember is that the active laser treatment per eye lasts only seconds to about one minute, so even a few calming breaths can carry you through.
You will never be alone at any point during your LASIK procedure. Our LASIK Surgeon and surgical staff remain with you the entire time, explaining what is happening before each step so there are no surprises. If you need a moment or want to communicate anything, simply say so.
We take pride in creating an environment where patients feel informed, safe, and genuinely cared for. Many patients tell us afterward that the support and communication they received made the experience far easier than they expected.
Preparing for Your LASIK Procedure
Good preparation makes surgery day smoother and more comfortable. From your pre-surgery evaluation to what you do the night before, each step matters for your safety and your outcome.
Before any surgery is scheduled, we perform a thorough evaluation of your eyes. This includes detailed corneal mapping, corneal thickness measurement, pupil size assessment, tear film evaluation, and screening for conditions such as keratoconus (a thinning of the cornea that can affect candidacy for LASIK).
Your LASIK Surgeon will also review your medical history and current medications. This consultation is the right time to ask every question you have, including anything about being awake during the procedure. We will not proceed until you feel fully informed and comfortable.
Contact lenses can slightly alter the shape of your cornea, which affects the accuracy of your preoperative measurements. We will give you personalized instructions about when to stop wearing your lenses, and it is important to follow those instructions precisely.
- Soft contact lenses: stop at least one week before your final measurements
- Toric or extended-wear soft lenses: stop at least two weeks before
- Rigid gas permeable or scleral lenses: stop for at least two to four weeks and until measurements are stable
- Always follow the specific timeline your LASIK Surgeon provides based on your lens type and history
Certain medications and products can interfere with LASIK or with your healing afterward. We will give you a specific list for your situation, but some general guidelines apply to most patients. Eye makeup, face creams, and perfumes should be avoided on the day of surgery, as they can raise the risk of infection.
If you take prescription medications regularly, your LASIK Surgeon will advise whether to continue or temporarily pause them. Never stop a medication without guidance from our team or your prescribing physician.
Even though you are awake during LASIK, you will not be able to drive yourself home. Your vision will be blurry immediately after surgery, and if you have taken an oral sedative, operating a vehicle is not safe. Please arrange for a trusted friend or family member to drive you.
Your driver should plan to stay with you for a short time while we review your aftercare instructions and provide your eye shields and prescribed drops. Having support at home for the rest of the day allows you to rest comfortably and start your recovery on the right foot.
Risks, Side Effects, and Alternatives
Like all surgical procedures, LASIK carries some level of risk. Understanding possible side effects and alternatives before you decide helps you make the most informed choice for your vision and your lifestyle.
Most LASIK side effects are temporary and improve as your eyes heal over the first days to weeks. Knowing about them in advance means you will not be alarmed if they occur.
- Temporary dry eye symptoms and mildly fluctuating vision
- Glare, halos, and increased light sensitivity, especially at night
- Mild discomfort, tearing, or a gritty sensation in the first 24 to 48 hours
- Temporary haziness or blurriness while the cornea heals
Using preservative-free artificial tears as directed can help manage dryness and support vision stability during the healing period.
Although LASIK has a strong overall safety record, serious complications can occur in some cases. Your LASIK Surgeon will discuss your individual risk profile thoroughly during your consultation before any decision is made.
- Infection or significant inflammation, including a condition called diffuse lamellar keratitis
- Flap-related issues such as displacement or wrinkling
- Epithelial ingrowth, where surface cells grow under the flap
- Undercorrection, overcorrection, or vision regression that may require an enhancement procedure
- Corneal ectasia (progressive corneal thinning) in eyes that were predisposed prior to surgery
LASIK is not the right fit for every patient. Other procedures are also performed while you are awake using numbing drops, and each has its own advantages depending on your corneal thickness, prescription, and lifestyle.
- PRK (photorefractive keratectomy), a surface ablation procedure well suited for thinner corneas or certain corneal conditions
- EpiLase, our surface ablation option using a specialized instrument to gently remove the epithelium before laser treatment
- Phakic IOLs for patients with higher prescriptions or thinner corneas who may not be LASIK candidates
- Lens-based options for patients with early cataract changes or presbyopia
Our team will help you understand which option is the best match for your eyes and goals.
Recovery After LASIK: What to Expect
Recovery from LASIK is generally straightforward, but following your aftercare instructions carefully makes a meaningful difference in how well and how quickly your eyes heal. Here is what to expect in the days and weeks after your procedure.
In the first few hours after LASIK, your eyes may feel gritty, watery, or mildly irritated. Some patients experience a stinging sensation or a feeling similar to having an eyelash in the eye. These sensations are a normal part of early healing and typically fade within a few hours.
Your vision will likely be blurry or hazy right after surgery, and you may notice glare or halos around lights. Resting with your eyes closed for the remainder of the day helps reduce discomfort. Most patients notice significant improvement in their vision by the next morning.
We will prescribe antibiotic drops to prevent infection and anti-inflammatory drops to reduce swelling. Following the exact schedule we provide is important for proper healing and the best visual outcome.
- Wash your hands thoroughly before applying any eye drops
- Tilt your head back and pull your lower eyelid gently down to create a small pocket for the drop
- Avoid touching the tip of the bottle to your eye or eyelid
- If you use more than one type of prescribed drop, wait at least five minutes between each
- Use preservative-free artificial tears as often as recommended to keep your eyes moist and comfortable
During the first day after surgery, protect your eyes by limiting activity and avoiding anything that could cause irritation or injury. Do not rub your eyes under any circumstances, even if they feel itchy. Rubbing can dislodge the corneal flap and lead to serious complications.
Avoid screens, reading, and tasks that require intense visual focus, as these can contribute to eye strain during early healing. Resting with your eyes closed as much as possible is the best thing you can do on surgery day. Keep water, soap, and any other liquids away from your eyes.
As you move through the first week of recovery, you will need to continue protecting your healing eyes from potential irritants and injury. These guidelines are designed to reduce your risk of complications and support the best possible healing.
- Wear the provided protective eye shields while sleeping for at least the first week
- Avoid swimming, hot tubs, and saunas for at least one to two weeks
- Keep eye makeup, lotions, and creams away from your eyes for at least one week
- Avoid dusty or smoky environments during the healing period
- Light non-contact exercise may be resumed after 48 hours as comfort allows; avoid contact sports for about four weeks
- Wear sunglasses outdoors to reduce light sensitivity and protect healing tissue
You will return for a follow-up visit the day after your surgery so your LASIK Surgeon can check the corneal flap and evaluate your early healing. Additional appointments are typically scheduled at one week, one month, and three to six months after LASIK.
These visits allow us to monitor your progress, address any concerns, and confirm that your vision is developing as expected. Attending every scheduled appointment is an important part of getting the best long-term result from your procedure.
While complications after LASIK are uncommon, knowing what to watch for allows you to act quickly if something does not feel right. Contact our office right away if you notice any of the following after your procedure.
- Sudden or significant loss of vision
- Severe pain that does not improve with over-the-counter pain relief
- Increasing redness combined with worsening vision
- Yellow or green discharge from the eye
- Flashes of light or new floaters in your field of vision
- A shadow, curtain, or dark area moving across your vision
- A new white spot on the cornea or a noticeable change in the corneal surface after accidental rubbing
Frequently Asked Questions
These answers address some of the most specific questions patients bring to us before deciding on LASIK, with practical guidance to help you feel prepared.
General anesthesia is not used for LASIK because it would prevent you from following the instructions that make the procedure precise and safe. Being fully asleep means you cannot fixate on the target light, which is essential for accurate laser placement. For patients with significant anxiety, oral sedation is a practical alternative that reduces nervousness while keeping you conscious enough to cooperate.
Modern LASIK systems include real-time eye-tracking technology that monitors your eye position many times per second. If your eye moves, the laser pauses automatically and resumes once your eye is back in the correct position. A small sterile instrument called a lid speculum holds your eyelids open during the laser treatment so blinking is not possible while the laser is active. You can blink freely between procedural steps when the speculum is removed.
You should not feel pain during the procedure because of the numbing drops. After surgery, once those drops wear off within a short time, some patients notice mild irritation, a gritty sensation, or mild stinging. This is typically manageable with over-the-counter pain relief and preservative-free artificial tears. If discomfort worsens rather than improves after the first day, contact our office, as that can be a sign that something needs attention.
If you feel a cough or sneeze coming on, simply tell us. Your LASIK Surgeon can pause the procedure safely and resume once you are settled. The laser tracking system and the lid speculum both help protect your eye during any brief involuntary movement. There is no need to hold your breath or try to suppress natural reflexes, just communicate with our team and we will handle it.
Most patients notice a meaningful improvement in their vision by the morning after surgery, though clarity continues to improve over the following weeks as the cornea heals. Vision can fluctuate slightly during the early recovery period, which is normal. LASIK results are intended to be long-lasting, but natural changes to your eyes over time, such as those related to aging, can still occur and may require reading glasses or an enhancement procedure in the future.
Yes, being awake is not only safe for LASIK, it is the medically recommended approach. Staying conscious avoids the risks that come with general anesthesia and allows you to cooperate with your LASIK Surgeon in ways that directly improve the accuracy of the procedure. Numbing drops handle all pain prevention effectively, and our team is trained to manage anxiety and keep you comfortable throughout.
Schedule a LASIK Consultation at NewView Eye Center
If you have questions about being awake during LASIK or you are ready to explore whether this procedure is right for you, our team is here to help. NewView Eye Center has been providing personalized, expert eye care to patients across Northern Virginia since 1999, and we are committed to making sure every patient feels informed, comfortable, and confident before ever stepping into a procedure room. We invite you to schedule a consultation so we can evaluate your eyes and discuss the vision correction options that best fit your life.
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