Heather Cherry’s vision was fairly good, but the stay-at-home mom in rural Nevada was tired of reaching for her glasses when she wanted to see into the distance during a hike or fully enjoy the sight of wild horses grazing at the side of the road.

LASIK vision correction surgery offered the hope of 20-20 vision, and when she went to an eye-surgery centre in January, she was told she was an excellent candidate.

But then came the consent form, with warnings about possible side effects such as diminished night vision and eye irritation. Cherry went online, found the patient website Lasik Complications and saw complaints of chronic eye pain and severely impaired vision.

“I don’t feel good about this,” she said when she cancelled her surgery. “I don’t feel like this is the right choice for me.”

Potential patients are less likely to opt for LASIK than in the procedure’s heyday of 2000-07, when ads flooded the airwaves and more than a million of the outpatient surgeries were performed each year. The number of laser vision correction surgeries per year — a category including LASIK and the closely related PRK procedure — has dropped more than 50 per cent, from about 1.5 million surgeries in 2007 to 604,000 in 2015, according to the eye care data source Market Scope.

Explanations for the decline in volume vary widely, with eye surgeons blaming the economic downturn and noting that some practices have seen increases in the last few years.

“I can’t tell you exactly why LASIK volumes are down, but there are some ideas and theories” says Dr. Kerry Solomon, president of the American Society of Cataract and Refractive Surgery. “One is that the economy hasn’t fully recovered. Two, we’re dealing with a different generation, millennials, and millennials make decisions differently, maybe they have different priorities. Maybe the millennial generation won’t adopt LASIK to the same extent the baby boomers did. Maybe they will, and we have to reach out to them differently.”

There’s also less marketing going on than there was in 2006 and 2007, Solomon says, and not as many doctors are doing LASIK.

Anti-LASIK patient advocates say potential patients are finding websites such as Lasik Complications and reading sobering stories about patients who endure debilitating side effects.

Word-of-mouth may also be having an effect, says Paula Cofer, an administrator of the Lasik Complications Facebook Group.

Interest in LASIK, in which a surgeon uses a laser to reshape your cornea, exploded in the late ’90s.

“Back in the cowboy days, as I call them, people were doing this (surgery) in the mall, with people watching,” recalls Dr. Daniel Durrie, a clinical professor of ophthalmology at the University of Kansas Medical Center who says he’s very happy that’s no longer happening. “We used to have an entity that rolled a truck into the Hy-Vee (grocery) store, and people would walk in one area, and get their LASIK, and walk out the other, like they were at the state fair.”

Cofer, who had LASIK 15 years ago, says she began experiencing disturbing side effects within days.

At night, ordinary lights transformed into massive starbursts, with rays radiating outward from a bright centre. The visual distortions continue, she says, swallowing large portions of her field of vision and making night driving impossible.

“I can see eight moons in the sky at night — all smeared and overlapping,” says Cofer, who lives near Tampa, Fla.

She also experiences daily eye pain, which she describes as a burning sensation similar to having soap in your eyes.

There’s little question that LASIK complications occur, but the magnitude of the problem is a matter of debate, with anti-LASIK advocates saying serious complications are common and eye surgeons, who cite patient satisfaction rates of 95 per cent and higher, saying serious complications are rare.

The FDA is taking steps to address the complication-rate issue with its LASIK Quality of Life Collaboration Project, the results of which haven’t yet been published in a peer-reviewed journal. In a presentation of preliminary findings, available at the FDA website, the FDA’s director of the Division of Ophthalmic and Ear, Nose and Throat Devices, Malvina B. Eydelman, reported on more than 400 patients who had LASIK and filled out questionnaires at three months postsurgery.

Up to 4 per cent of LASIK patients in the study experienced “very” or “extremely” bothersome visual symptoms at three months post-LASIK (without visual correction), according to Eydelman’s presentation. Up to 45 per cent of patients who had no visual symptoms before LASIK had developed new visual symptoms at three months post-LASIK, she reported.

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Durrie, a clinical investigator for the FDA study, says that, according to his calculations presented at the American Society of Cataract and Refractive Surgery annual meeting earlier this month, only one out of 551 patients in the study reported visual symptoms that caused them difficulty in performing their usual activities at the three-month mark. That’s 0.2 per cent.

Durrie also says that only 1.4 per cent to 2.3 per cent of patients said they were dissatisfied with LASIK at the three-month mark and that 64 per cent of patients who had visual symptoms before LASIK had no visual symptoms at the three-month mark. By his calculations, 23 per cent of patients who reported no visual symptoms before LASIK had at least one visual symptom at three months post-LASIK.

Asked about the discrepancy between that figure and the FDA’s, Durrie says his figures are more up-to-date than Eydelman’s. An FDA spokesperson says Eydelman’s 45-per-cent figure is correct, but applied to only part of the study.