Refractive Surgery & Laser Vision Correction

Over 20 years of eye care experience at Eye & Laser Surgeons Sydney
Experts in cataract, refractive and corneal treatments at Eye & Laser Surgeons Sydney.
Advanced diagnostic and surgical technology at Eye & Laser Surgeons Sydney

What is refractive surgery?

Refractive surgery describes procedures that change how light is focused by the eye. The aim is usually to reduce dependence on glasses or contact lenses.
Options may include LASIK, SMILE, PRK, implantable collamer lens surgery and lens replacement surgery.
A detailed refractive surgery assessment is needed to determine whether surgery may be appropriate and which option deserves consideration.

Start with the question that’s on your mind

Choosing the best vision correction for you isn’t about finding the latest procedure, but about understanding your eyes, your lifestyle and the options that may be appropriate for you. Start with the question that best matches your situation.

Before thinking about procedures, it’s important to understand whether your eyes are likely to be suitable for vision correction and what factors influence that decision.

Many people reach a point where they would like greater freedom from glasses or contact lenses. For some the trigger to investigate your options may be because they play sport, travel frequently or find contact lenses increasingly uncomfortable. Other people simply want the convenience of clearer vision in everyday life.

Today there are several ways to reduce dependence on glasses or contact lenses, but there is no single option that is right for everyone. Depending on your age, prescription, eye health and lifestyle, the most appropriate option may include continuing with glasses or contact lenses, laser vision correction, implantable contact lenses or lens replacement surgery.

Choosing the right treatment for you begins with understanding how your eyes work, what your visual goals are, and which options are most likely to provide a safe and lasting result.

Our role, at Eye and Laser Surgeons, is not to recommend the latest procedure, but to help you understand all of the appropriate options, explain the potential benefits, limitations and risks of each, and guide you towards the treatment—or sometimes the decision not to have treatment—that best supports your long-term eye health and quality of vision.

Understand the differences between LASIK, SMILE and PRK, including recovery, advantages, limitations and who each procedure may suit.

Page: LASIK vs SMILE vs PRK

As our eyes age, the most appropriate vision correction option often changes. Learn how presbyopia, early cataracts and lens changes influence treatment decisions.

Page: Vision Correction After 45

Being told you are not suitable for one procedure doesn’t necessarily mean you have no options. Learn why laser surgery may not be recommended, what other treatments may be available, and why protecting your long-term eye health always comes first.

Page: Why Have I Been Told I’m Not Suitable for Laser Eye Surgery?

I want the best possible vision for work, sport or an active lifestyle

Your vision needs are unique. A professionalathletes, pilots, surgeons, emergency services, tradies & office worker or someone who spends long hours on digital devices may all have different visual priorities.

Visual acuity is only one part of how your eyes perform. Depending on your work, hobbies and lifestyle, we may also consider night vision, contrast sensitivity, depth perception, dry eye, visual endurance, glare, occupational standards and the practical demands of your daily activities.

Our goal is not simply to improve how well you see on an eye chart. It is to help you achieve the best possible vision for the way you live, work and perform.

Read more →

Vision Correction for Work, Sport & Active Lifestyles

Understanding your vision before considering surgery

Before discussing treatment options, it helps to understand how the eye focuses light. Once you understand this process, it becomes much easier to see why different vision correction procedures suit different people.

Clear vision occurs when light passes through the cornea and natural lens before focusing precisely on the retina, the light-sensitive tissue at the back of the eye. When this process works correctly, images appear sharp and clear.

However, if the eye is slightly longer or shorter than average, or the cornea has an irregular shape, light no longer focuses accurately on the retina. As a result, vision becomes blurred. This is known as a refractive error.

The four most common refractive errors are:

  • Myopia (short-sightedness) – Light focuses in front of the retina, making distant objects appear blurry.
  • Hyperopia (long-sightedness) – Light focuses behind the retina, making close vision more difficult and, in some cases, affecting distance vision as well.
  • Astigmatism – Light focuses unevenly because the cornea or natural lens has an irregular shape, causing blurred or distorted vision at multiple distances.
  • Presbyopia – As we age, the natural lens gradually loses flexibility. Consequently, focusing on near objects becomes more difficult, typically from the age of 40 onwards.

By understanding how your eyes focus light, you can better appreciate why no single procedure is suitable for everyone. Instead, the most appropriate vision correction option depends on your eyes, your prescription, your lifestyle and your visual goals.

Read next: Understanding Refractive Errors →

Diagram showing how light focuses in a normal eye and how myopia, hyperopia and astigmatism change the focal point on or around the retina. This is what laser vision correction adjusts.

Refractive errors

Which vision problems may be treated?

Refractive surgery may be considered for several common focusing problems. The appropriate method depends on the type and amount of refractive error, the health of the eye, age and visual goals.

Myopia, also known as short-sightedness, occurs when the eye is slightly longer than average or the cornea is more curved than normal. As a result, light focuses in front of the retina rather than directly on it, making distant objects appear blurred while near vision often remains clear.

People with myopia may notice difficulty recognising faces across a room, reading road signs while driving or seeing clearly in the classroom or at sporting events. Myopia often develops during childhood and adolescence and may continue to progress as the eyes grow.

For some people, myopia remains relatively stable in adulthood. In others, particularly those with higher levels of myopia, there may be an increased risk of other eye conditions later in life. Regular eye examinations are therefore important to monitor both vision and long-term eye health.

Depending on your prescription, age, eye health and lifestyle, vision correction options may include glasses, contact lenses, laser vision correction or lens-based procedures following a comprehensive assessment.

Read more: Understanding Myopia and Vision Correction 

Hyperopia, also known as long-sightedness, occurs when the eye is slightly shorter than average or the cornea is flatter than normal. As a result, light focuses behind the retina rather than directly on it. Younger people can often compensate by increasing the focusing power of the natural lens, but this becomes more difficult with age.

People with hyperopia may experience blurred near vision, eye strain, headaches or tired eyes after reading or prolonged computer use. Some people with higher levels of hyperopia may also notice blurred distance vision.

Hyperopia can remain stable for many years, but as the natural lens gradually loses its ability to focus with age, symptoms often become more noticeable. This is one reason why many people first become aware of long-sightedness during their 40s or 50s.

Depending on your prescription, age, eye health and lifestyle, treatment options may include glasses, contact lenses, laser vision correction or lens-based procedures following a comprehensive assessment.

Astigmatism occurs when the cornea, or sometimes the natural lens, has an irregular curvature rather than a perfectly smooth, round shape. Instead of focusing light to a single point on the retina, light is focused at multiple points, causing blurred or distorted vision.

People with astigmatism often describe vision as being blurred or stretched at both near and distance. They may also notice glare, halos around lights, headaches or eye strain, particularly after prolonged visual tasks.

Astigmatism can occur on its own or together with myopia (astigmatic myopia) or hyperopia (astigmatic hyperopia). Most people have a small amount of astigmatism, but larger amounts may require correction to provide clear, comfortable vision.

Regular astigmatism can often be corrected with glasses, contact lenses, laser vision correction or lens-based procedures. However, irregular astigmatism may indicate an underlying corneal condition such as keratoconus, which requires careful assessment before any refractive procedure is considered.

Presbyopia is a natural age-related change in focusing that affects almost everyone, usually becoming noticeable from the mid-40s onwards. Unlike myopia or hyperopia, presbyopia is caused by the gradual loss of flexibility of the eye’s natural lens, making it more difficult to focus on nearby objects. This happens to everyone at the same rate all over the world.

People with presbyopia often notice that they need to hold reading material further away, require brighter lighting for close work or find it increasingly difficult to switch focus between distance and near tasks. Reading, using a smartphone or working on a computer may become more tiring.

Presbyopia continues to progress gradually over time and is a normal part of ageing. It does not mean there is anything wrong with the eyes, but it often changes the type of vision correction that may be most appropriate.

Management may include reading glasses, multifocal glasses or contact lenses, blended vision, laser vision correction in selected patients, or lens-based procedures such as refractive lens exchange following a comprehensive assessment.

Vision correction options

What vision correction options are available?

Vision correction can involve glasses, contact lenses, corneal laser procedures or lens-based surgery. Alternatively, choosing not to have surgery is also a valid option.

However, the purpose of a comprehensive assessment is not to fit every patient into a surgical category. Instead, it is to identify the option—or, in some cases, the decision not to proceed—that best balances your visual goals, safety and long-term eye health.

LASIK, SMILE and PRK reshape the cornea using different surgical approaches. They have different recovery profiles, limitations and suitability requirements.

ICL surgery adds a lens inside the eye. Lens replacement surgery removes the natural lens and replaces it with an intraocular lens.

LASIK, SMILE & PRK:

understanding the differences

All three procedures reshape the cornea, but they do so differently.

No procedure is universally better. The recommendation depends on your eye measurements, lifestyle and visual needs.

SMILE creates a small disc of tissue within the cornea. The surgeon removes it through a small incision without creating a flap.

Early recovery: Usually progressive.

Important considerations: Prescription range, recovery and enhancement planning.

Read the complete SMILE guide

LASIK creates a thin corneal flap before an excimer laser reshapes the underlying tissue.

Early recovery: Often relatively rapid.

Important considerations: Flap-related issues, dry eye and suitability for particular sports or occupations.

Read about LASIK and the blogs

LASIK– 6 professions that most benefit, LASIK for Tradies, LASIK for Surgeons, LASIK for Emergency Service, LASIK for Pilots, LASIk for Atheletes, Wavefront guided LASIK.

PRK reshapes the cornea from the surface without creating a flap.

Early recovery: Usually slower.

Important considerations: More early discomfort and a longer period before vision stabilises.

Read about PRK

Lens-based vision correction

However, not everyone is an ideal candidate for corneal laser surgery. For example, some people have higher prescriptions, presbyopia or early lens changes that make a lens-based procedure worth considering. In these situations, your surgeon will discuss whether an implantable lens or lens replacement surgery may be a more appropriate option.

Implantable Collamer Lens (ICL)

An implantable collamer lens (ICL) is positioned inside the eye while your natural lens remains in place.

As a result, an ICL may be suitable for selected patients, particularly those with higher prescriptions or corneas that are not well suited to laser reshaping.

Because ICL surgery is performed inside the eye, it carries different benefits and risks from corneal laser procedures. Therefore, a detailed assessment is essential before deciding whether it is the right option for you.

Learn about ICL surgery

Refractive Lens Exchange

Alternatively, refractive lens exchange involves removing the eye’s natural lens and replacing it with an artificial intraocular lens.

This procedure may be considered when presbyopia or early natural lens changes significantly affect vision. In addition, it can reduce dependence on glasses for many people, depending on the type of lens selected.

However, lens replacement surgery is not reversible. For this reason, retinal health, intraocular lens selection and your long-term visual goals should all be carefully discussed before proceeding.

Explore lens replacement surgery

 Suitability

How do we decide which option may be appropriate?

Suitability involves much more than checking your glasses prescription. Instead, we need to understand whether your eyes can safely support a procedure and whether the expected visual outcome aligns with your needs, lifestyle and long-term eye health.

To do this, your assessment may include:

  • Your current and previous glasses or contact lens prescriptions
  • Corneal shape, thickness and stability
  • Corneal topography and tomography
  • Tear film quality and dry eye assessment
  • Pupil size and night vision requirements
  • Examination of the natural lens, macula, retina and optic nerve
  • Medical history, medications and previous eye surgery
  • Your age, occupation, sporting activities and lifestyle
  • Your expectations and willingness to accept the limitations of different procedures

In some cases, more than one procedure may be suitable. However, each option has different benefits, limitations and long-term considerations, which will be discussed during your consultation.

Alternatively, your assessment may show that surgery is not the best option at this stage. For example, you may be advised to treat dry eye first, repeat measurements, monitor your cornea over time, continue with glasses or contact lenses, or avoid surgery altogether.

Ultimately, the goal is not simply to determine whether you can have surgery, but whether surgery is the safest and most appropriate choice for your eyes.

Read next: Refractive surgery assessment

A useful first step

The online quiz may help you decide whether vision correction is worth discussing.

It cannot determine suitability or replace a suitability eye examination. Or Book a free suitability assessment with Dr Daya Sharma’s team.

Technology

Technology Helps Us Understand Your Eyes

Modern diagnostic technology provides valuable information about your eyes. However, technology is only useful when it helps answer an important clinical question. Most importantly, it does not select a procedure on its own or replace clinical judgement. Instead, it provides information that helps Dr Daya Sharma recommend the safest and most appropriate treatment for your individual eyes.

Corneal Topography and Tomography

Corneal mapping measures the shape, curvature and thickness of the cornea. As a result, it can identify regular astigmatism, subtle corneal irregularities and patterns that may increase the risk of corneal instability.

Learn how corneal mapping supports treatment decisions

Wavefront Analysis

In addition to measuring your glasses prescription, wavefront analysis assesses subtle optical imperfections that cannot be detected during a standard eye examination. Consequently, it may help refine treatment planning for selected patients.

Understand wavefront-guided treatment →

Ocular Surface Assessment

The tear film forms the eye’s first focusing surface. Therefore, a healthy ocular surface is essential for accurate measurements, comfortable vision and optimal healing.

Because dry eye can affect both vision and surgical outcomes, it should be identified and treated before considering refractive surgery whenever possible.

Learn about dry eye and ocular surface disease →

Retinal and Optic Nerve Assessment

Finally, clear vision depends on much more than the cornea. For this reason, every comprehensive assessment includes examination of the retina and optic nerve.

In some cases, imaging may identify conditions that influence the choice of procedure or require treatment or ongoing monitoring before surgery is considered.

Benefits, limitations and risks

All three procedures reshape the cornea, but they do so differently.

No procedure is universally better. The recommendation depends on your eye measurements, lifestyle and visual needs.

For appropriately selected patients, refractive surgery may:

  • reduce dependence on glasses or contact lenses
  • make sport, travel and some daily activities more convenient
  • provide clearer unaided distance vision
  • reduce reliance on contact lenses
  • support selected occupational or lifestyle goals

The extent of benefit varies. Glasses may still be required for some distances or tasks.

  • Surgery cannot prevent normal ageing of the eye or development of Macular degeneration, glaucoma or other eye diseases.
  • Presbyopia may still affect reading vision.
  • A residual prescription may remain or develop.
  • Glasses may still be needed for night driving or fine detail.
  • Dryness, glare or halos may affect visual quality.
  • Enhancement surgery is not always possible or appropriate.
  • No procedure can guarantee a particular outcome.

All surgery carries risk.

Depending on the procedure and the individual eye, risks may include:

  • temporary or persistent dry eye
  • glare, halos, starbursts or night-vision symptoms
  • under-correction, over-correction or regression
  • fluctuating or reduced quality of vision
  • infection or inflammation
  • corneal haze after surface treatment
  • flap complications after LASIK
  • corneal weakening or ectasia in susceptible eyes
  • loss of lines of best-corrected vision, although uncommon
  • the need for further treatment or glasses
  • procedure-specific intraocular risks for ICL or lens replacement surgery

A careful assessment can reduce avoidable risk but cannot remove risk entirely. Dr Daya Sharma will discuss the specific risks related to your eyes and the procedure being considered for you during your consultation.

Alternatives

Alternatives to refractive surgery

Alternatives may include:

  • continuing with glasses
  • contact lenses where they remain comfortable and safe
  • different glasses for distance, reading or occupational tasks
  • treating dry eye or another condition before reconsidering surgery
  • monitoring a changing prescription, corneal pattern or lens change
  • choosing no active treatment

For some people, continued non-surgical correction is the safest and most appropriate recommendation.

RECOVERY

Recovery and follow-up

Recovery differs by procedure and patient.

LASIK often provides relatively rapid early visual recovery. SMILE vision generally improves progressively. PRK usually requires a longer healing period. Lens-based procedures have separate recovery requirements.

Follow-up allows us to:

  • check healing
  • monitor inflammation and pressure
  • manage dryness or discomfort
  • assess visual stability
  • to check for any sign of a complication

You will receive individual guidance about driving, work, exercise, swimming, eye rubbing, cosmetics and contact sport.

Vision correction for sport, work and active lifestyles

Different lifestyles place different demands on vision.

An office worker, professional athlete, pilot and surgeon may have very different priorities.

Assessment may consider:

  • risk of eye trauma
  • night vision and low-contrast performance
  • dry or windy environments
  • occupational visual standards
  • recovery and return-to-work requirements
  • distance, intermediate and near-vision needs
  • the practical consequences of any residual prescription

Our work in sports vision and vision correction for athletes reinforces an important principle:

Reading an eye chart is only one part of how vision performs in real life.

RECOVERY

Recovery and follow-up

Elite cricketer demonstrating high-performance visual skills including eye tracking, contrast sensitivity and reaction time after laser vision correction

High Performance Vision Assessment for Athletes | Eye & Laser Surgeons Sydney

High-performance vision involves much more than reading an eye chart. Careful assessment of visual function can help us understand the visual demands of sport, work and everyday life when discussing vision correction options.

Dr Daya Sharma

Refractive surgery with Dr Daya Sharma

Dr Daya Sharma is a cataract, corneal and refractive surgeon with subspecialty training from Moorfields Eye Hospital in London and Sydney Eye Hospital.

His approach is based on detailed assessment, careful procedure selection and open discussion of benefits, limitations, risks and alternatives.

We believe the right recommendation is the one we would make for a member of our own family.

Meet Dr Daya Sharma

Frequently asked questions

Laser eye surgery is one type of refractive surgery. Refractive surgery also includes lens-based procedures such as ICL and lens replacement surgery.

There is no procedure that is best for everyone. Suitability depends on prescription, corneal shape and thickness, tear-film quality, age, lifestyle, occupation and other findings.

Regular astigmatism can often be treated. Irregular astigmatism requires careful investigation because it may be associated with keratoconus, scarring or another corneal condition.

Age alone does not determine suitability. Presbyopia and natural-lens changes become increasingly important after the mid-40s.

Dry eye does not automatically exclude treatment, but it may affect measurements, comfort and visual quality.

Not necessarily—but it is important to understand why.

A thinner cornea does not automatically mean you cannot have vision correction. Some people with thinner corneas may still be suitable for another procedure, such as PRK or an implantable collamer lens (ICL), while others may be better served by continuing with glasses or contact lenses. The most appropriate option depends on detailed measurements of your corneal thickness, shape, stability and overall eye health.

Sometimes laser eye surgery is not recommended because an underlying eye condition needs attention first. For example, progressive myopia, keratoconus or corneal ectasia may require monitoring or treatment to help stabilise the eye and reduce the risk of further vision loss. In these situations, protecting your long-term eye health is more important than proceeding with refractive surgery. You may benefit from another medical treatment to help stabilise your eyes and prevent vision impairment.

Our role is not simply to determine whether you are suitable for laser eye surgery. It is to understand why a procedure may or may not be appropriate, explain the findings clearly, and discuss all reasonable options for improving your vision while protecting the long-term health of your eyes

Refractive surgery may reduce dependence on glasses, but it cannot guarantee complete freedom from them forever and it can’t prevent other causes of vision loss.

The intended surgical change is long-lasting, but ageing, presbyopia, cataract and prescription changes can still occur.

Procedures are generally performed with anaesthetic eye drops. Early discomfort varies. PRK usually causes more surface discomfort during the first few days than LASIK or SMILE.

We explain why and discuss appropriate alternatives. These may include another procedure, treatment of another condition, monitoring, glasses, contact lenses or no surgery.

Explore the Refractive Surgery & LASER Vision Correction Centre

Understanding your vision

Learn how myopia, hyperopia, astigmatism and presbyopia affect focus.

Read the refractive errors guide

Comprehensive assessment

See which measurements and clinical factors guide an individual recommendation.

Explore the assessment

Procedure guides

Understand your vision correction options in 3 EASY STEPS.

A comprehensive assessment can help determine whether refractive surgery may be appropriate and which options deserve consideration. We will explain the findings, expected benefits, limitations, risks and alternatives so you can make an informed decision.

STEP 1: GET IN TOUCH

Every eye is different. The first step is to find out which treatment could help you see more clearly and protect your long-term vision. Call our caring team or use our online calendar to book an appointment.

STEP 2: WE’LL MEET

During your appointment, we’ll examine your eyes and explain which treatment options may suit your condition and lifestyle. You’ll receive expert advice and a clear, personalised plan.

STEP 3: ENJOY FREEDOM

After treatment, many people feel relief knowing their eyes are healthier and their sight is clearer. With proper care, you can look forward to years of confident, comfortable vision.

Take the first step toward clearer, healthier vision

Book an appointment to learn more about your eyes and the treatment options that may suit you

Take the first step toward clearer, healthier vision

Book an appointment to learn more about your eyes and the treatment options that may suit you

Are your eyes making life harder than it should be?

Book an appointment to understand what’s going on and explore treatment options that may suit your eyes and lifestyle

Dry, gritty, or burning eyes?

Screens, air-conditioning, and wind can make eyes sore, watery, or light sensitive. An assessment can identify the cause and discuss treatment options to improve comfort.

Concerned about glaucoma?

Glaucoma often has no early symptoms. A pressure check and optic nerve scan can detect risk early. We will explain monitoring and treatments that may protect your sight.

Worried about AMD?

Words may blur or straight lines may look wavy, especially in low light. An appointment can confirm what is happening and outline care that may help you see more clearly.

Affiliations and memberships

We are proud to be a part of these professional bodies

Dr Shanel Sharma ophthalmologist in Sydney providing wet macular degeneration and anti-VEGF injection care

Hi, I’m Dr Shanel Sharma

I’m an ophthalmologist with subspecialty training in paediatric eye conditions, strabismus, medical retina and general ophthalmology from leading hospitals in Sydney and London, including Moorfields Eye Hospital. I hold a Fellowship with RANZCO and have published widely in peer-reviewed journals. My focus is providing careful, individualised care using evidence-based treatments. I’m accredited to treat a range of conditions and perform procedures including intravitreal injections, strabismus surgery and botulinum toxin treatments. I always aim to make the process clear, calm and supportive.

Hi, I’m Dr Daya Sharma

I’m a cataract, corneal and refractive surgeon with subspecialty training from Moorfields Eye Hospital in London and Sydney Eye Hospital. I perform laser vision correction procedures, refractive lens surgery, and advanced cataract surgery using the latest diagnostic and surgical technology. My work is focused on helping people reduce their dependence on glasses and improve their quality of vision at all distances. I’m actively involved in research, publication and surgical education, and I take pride in offering honest, thorough guidance to every patient. My approach is personal, careful and always tailored to individual needs and lifestyles.