Interview with Dr. Kerry Assil, world-renowned LASIK and cataract surgeon

Dr. Thais Aliabadi and Mary Alice Haney sat down with Dr. Kerry Assil to cut through the noise about eye health: what actually damages vision over time, which everyday habits matter most, when modern surgery can help, and how to spot real emergencies versus the normal wear and tear of aging eyes. The conversation moves from practical prevention to the latest in refractive surgery technology and ends with simple, actionable routines we all can adopt.

Table of Contents

• About Dr. Assil
• How to read this interview
• Technology highlights: diffractive optics and the Odyssey lens
• Everyday habits that are damaging vision — and what to do about them
• Eye issues specific to women and life stages
• Eye safety: rubbing, sleeping position, and common acute problems
• Diseases that threaten sight and what to watch for
• When surgery is permanent and when vision can change again
• Eagle Eye LASIK and other advanced corneal techniques
• Practical daily rules to protect vision — what we recommend
• Realistic expectations: what modern eye care can and cannot do
• Short takeaways we always repeat to patients
• FAQ
• Final clinical perspective

About Dr. Assil

Dr. Kerry Assil is a board-certified refractive and cataract surgeon with decades of experience and tens of thousands of procedures performed. We focus on the intersection of practical eye care and the newest surgical advances that genuinely improve quality of life: LASIK, refractive lens exchange, custom lens implants with diffractive optics, and the management of dry eye disease, glaucoma, macular degeneration, and retinal emergencies.

How to read this interview

The following is a question-and-answer conversation. Questions are highlighted; answers are given from Dr. Assil’s perspective using plain language and clinical clarity. We end with a concise FAQ you can reference when a quick decision or action is needed.

What is the difference between LASIK and refractive lens exchange, and who should consider each?

Think of the eye like a two-lens camera. The cornea is the powerful front lens that provides most of our focusing power. LASIK reshapes the front lens. Behind it sits the natural crystalline lens — the zoom lens that changes shape to focus at different distances. With age, we lose the lens’s flexibility and clarity. LASIK is great for correcting corneal refractive errors for many people, particularly younger patients who want to be free of contacts and glasses for distance vision.

Refractive lens exchange, sometimes abbreviated RLE, replaces that internal lens — the zoom lens — with a synthetic intraocular lens, similar to the ones we use for cataract surgery. RLE is an excellent option for people over about age 50 who are beginning to notice the classic age-related drop in near vision and changing middle-distance vision. If the internal lens is stiff or starting to turn cloudy, removing and replacing it not only restores near and distance vision (with the right implant) but also eliminates the need for future cataract surgery.

We use tiny, minimally invasive probes to gently remove the core of the lens while leaving the outer capsule intact. The new foldable lens rolls through a small incision and unfolds inside that capsule. Modern implants can be monofocal, extended depth of focus, or multifocal — many now use diffractive optics to allow both near and far vision. For people who already had LASIK years ago and now need reading help, RLE can be a permanent solution.

How does the surgical experience feel — is it painful or scary?

Many people are nervous, especially about anyone touching the eye. We perform these procedures under local anesthesia with a sedative cocktail that keeps patients relaxed and often produces brief amnesia about the procedure itself. Patients are awake but comfortable. We place numbing drops, use a blink protector, and play calming music. The vast majority report seeing immediately afterward and are surprised by how quickly vision improves.

Some transient visual phenomena can occur, such as halos around lights, for a few months after certain intraocular lenses. These usually fade and are an acceptable trade-off for the freedom from glasses. Recovery is rapid: tiny incisions seal, and most people resume normal activities within a day or two.

Technology highlights: diffractive optics and the Odyssey lens

How do newer intraocular lenses allow us to see near and far?

Modern lenses use microscopic structures etched into their surface, called diffractive optics. These tiny concentric rings manage how light is directed, so both parallel rays from distant objects and divergent rays from near objects are focused onto the retina. The result is a clear vision across multiple distances without relying on the natural lens to change shape.

As the lens technology evolves, each generation refines how these rings distribute light and reduce side effects such as glare and halos. We match lens design to the specifics of each eye — corneal shape, pupil size in different lighting, and retinal health — so the implant is a tailored choice rather than a one-size-fits-all.

Who is not a candidate for these modern multifocal or diffractive lenses?

Patients with severe retinal disease, such as advanced macular degeneration or uncontrolled glaucoma, are poor candidates because the retina or optic nerve must be able to translate the incoming light into clear neural signals. If the underlying neurosensory system cannot interpret the high-resolution image, an advanced lens can actually create confusing visual inputs. In that case, we still remove cataracts but choose implants that prioritize contrast and clarity rather than multifocality.

The vast majority, however, are candidates if we match the right lens to the right eye. Advances mean we now narrow our selection to a few preferred lenses instead of choosing from a dozen, which simplifies patient choices while improving outcomes.

Everyday habits that are damaging vision — and what to do about them

Does screen time really harm our eyes, and how?

Yes, prolonged screen use causes digital eye strain and accelerates dry eye symptoms through simple mechanics. We normally blink about 12 times per minute. When we stare at screens, that number drops to roughly three blinks per minute. Each blink distributes water, oil, and mucus across the corneal surface. When blinks decline, the tear film evaporates, surfaces dry, and irritation follows. Paradoxically, people then experience reflex tearing because the eye reacts to surface irritation with watery tears that do not solve the underlying oil-deficit problem.

Over time, low blink rate and poor oil production can lead to persistent dry eye disease. Preventive steps are simple:

• Consciously blink while working; set a gentle reminder on screens with a sticky note that says “blink.”
• Follow the 20-20-20 rule: every 20 minutes, look at something 20 feet away for 20 seconds to relax accommodation and increase blink rate.
• Use preservative-free artificial tears if you rely on drops frequently.
• Consider environmental changes: humidifiers and reduced airflow from vents help tear film stability.

What are the best treatments for dry eye?

Dry eye is complex because the tear film is multilayered: a mucin layer adheres to the cornea, aqueous fluid floats on top, and a lipid oil layer prevents evaporation. If the lipid layer fails, no amount of water will stop rapid evaporation. We now have a toolbox of treatments:

• Warm compresses and lid hygiene to unclog meibomian glands.
• In-office gland rejuvenation using light or thermal therapies that stimulate oil production.
• Prescription topical medicines that address inflammation and tear production.
• Autologous blood-derived eye drops made from the patient’s own blood (PRP drops) for severe surface disease.
• Punctal occlusion with dissolvable collagen plugs to retain tears when the ducts drain too quickly.

If eyelid laxity is a component — common with aging — surgical tightening by an oculoplastic specialist may restore normal eyelid function and improve the tear film.

Do blue light glasses work?

Blue light blocking glasses reduce high-energy blue wavelengths that can contribute to glare and visual discomfort for some people. They are not a cure-all for digital eye strain. The most effective measures remain increased blinking, regular visual breaks, ergonomics, screen brightness matching ambient light, and proper corrective lenses for refractive error.

Eye issues specific to women and life stages

How does menopause affect the eyes?

Hormonal changes around menopause reduce tear production and quality for many women. The tear film becomes thinner, and oil production falls, increasing dry eye risk. Women who already have dry eye must be stabilized before surface-altering procedures such as LASIK. Refractive lens exchange tends to impact the surface less, but we still assess the surface carefully before any elective surgery.

What should pregnant or breastfeeding people watch for?

Pregnancy can cause transient changes in vision. Most of these resolve after delivery. However, sudden changes in vision, especially accompanied by high blood pressure or headaches, are red flags. They can indicate preeclampsia — a potentially life-threatening condition that can cause bleeding in the retinal circulation. If symptoms like new floaters, flashes, or severe blurring occur during pregnancy, immediate evaluation is critical.

Are cosmetic eye products safe? What about lash serums and extensions?

The desire for fuller lashes and thicker brows is understandable. Makeup and cosmetic procedures can be safe if used correctly, but some issues arise:

• Makeup contamination or allergic reactions can block glands and create chronic irritation or tearing.
• Lash extensions and adhesives can cause contact dermatitis and eyelid inflammation.
• Prescription lash-enhancing serums (for example, bimatoprost derivatives originally noted as glaucoma medications) can darken eyelids and even the iris over time. Rarely, long-term use has been associated with abnormal pigment changes.

If you notice darkening of the eyelid skin or new brown spots on a light-colored iris, stop the product and have an evaluation. For routine daily use, choose hypoallergenic makeup and practice strict hygiene: replace mascara every three months and avoid sharing products.

Eye safety: rubbing, sleeping position, and common acute problems

Is rubbing your eyes really that bad?

Yes. Rubbing transfers dirt and bacteria from the hands to the eye. Repeated forceful rubbing can change corneal shape, leading to conditions like keratoconus and, in extreme cases, make corneal pathology severe enough to require a transplant. We consider severe eye rubbing one of the leading avoidable causes of corneal damage.

Does how we sleep affect our eyes?

Sleeping face down or on the side with a pillow pressing against the eye can cause mechanical stress. Over many years, this can lead to eyelid laxity, corneal stretching, and dry irritation on waking. The safest position for spine health and minimizing ocular pressure is supine, flat on the back. If side sleeping is unavoidable, wearing a plastic shield at night can protect the eye from friction and exposure.

What to do for a scratched cornea or a stye?

A corneal scratch is painful and should be seen promptly. The cornea has no blood vessels; its defense relies on blinking and the tear film. Once the surface layer is breached, bacteria can invade quickly. We typically examine the eye, rule out infection, and begin antibiotic drops if needed.

Styes often start as plugged oil glands. Early treatment includes warm compresses, lid hygiene, and topical antibiotic ointment if infection is suspected. If a stye develops into a chalazion — a chronic, noninfectious lump — in-office drainage or surgical expression may be required.

Diseases that threaten sight and what to watch for

Glaucoma: why it is called the silent thief of sight and who gets it?

We are born with over a million nerve fibers dedicated to vision. Each year, we lose about 1 percent to normal aging. Glaucoma accelerates that loss, most commonly due to elevated intraocular pressure from impaired fluid drainage. It often progresses without symptoms because peripheral vision is lost first. By the time central vision suffers, significant and irreversible damage may already have occurred.

Treatments include topical medications to reduce fluid production or enhance outflow, laser procedures, and surgical options for cases not controlled by drops. Regular screening is essential because early detection is the only reliable way to preserve vision.

Macular degeneration: how it differs from glaucoma and why early detection matters

Macular degeneration affects the central retina, so the earliest symptom is distortion or blurring of central vision. Straight lines may look wavy, and recognizing faces becomes difficult. Unlike glaucoma, macular degeneration is noticeable early because the central detail we rely on is impaired first. Fortunately, we now have effective injectable medications that block abnormal blood vessel growth and can reverse or stabilize vision loss in many cases. Timely referral to a retina specialist is crucial.

Retinal detachment: red flags and immediate steps

Early signs of retinal tear or detachment include new floaters and flashes of light. If a small tear is found early, a quick laser barricade can often prevent progression. If you experience a sudden shadow or the sensation of a curtain falling over part of your vision, seek immediate retinal evaluation. Left untreated, detachment can progress to involve the macula, causing permanent vision loss despite later repair.

When surgery is permanent, and when vision can change again

Are intraocular lens replacements permanent?

The implants themselves are designed to last essentially forever; many manufacturers assert lifespans measured in thousands of years. If the eye remains healthy, vision should remain stable. In the unlikely scenario that the eye’s shape changes later in life, small surface laser touch-ups (like surface LASIK) can fine-tune residual error without removing the implanted lens.

If an intraocular lens no longer meets a patient’s visual needs or a rare complication arises, exchange of the lens is technically possible but less desirable than small surface adjustments. Our goal is to select the best implant initially, based on detailed imaging and measurements of corneal shape, pupil behavior, and retinal status.

Eagle Eye LASIK and other advanced corneal techniques

What is Eagle Eye LASIK, and how is it different?

Over two decades ago, we developed a technique originally called the temporal hinge or elliptical flap LASIK, marketed now as Eagle Eye LASIK. The approach personalizes flap placement and laser ablation based on detailed aberrometry — that is, measuring how light is distorted through a specific eye. Initially developed for elite athletes who need the quickest recovery and highest visual fidelity, we found the method benefits most patients by improving comfort and outcomes.

The principle remains: design the corneal flap and laser reshaping to the unique topography and higher-order aberrations of each eye rather than applying a standard template. The result is optimized visual quality, particularly in challenging lighting conditions and for tasks requiring fine visual discrimination.

Practical daily rules to protect vision — what we recommend

Small habits add up over decades. We distilled the conversation into clear, practical steps anyone can adopt today to protect and preserve eyesight.

• Blink more often while on screens: Place a small sticky note that says “blink” on your monitor; practice the 20-20-20 rule.
• Use preservative-free drops: If you use lubricants several times a day, choose preservative-free single-use vials to avoid chronic surface irritation.
• Control environment: Add humidity, reduce direct air on the face from vents, and adjust screen brightness to match ambient light.
• Prioritize sleep posture: When possible, sleep on your back to reduce mechanical stress on eyelids and corneas.
• Stop rubbing eyes: Use clean tissues or rub the area gently externally if necessary; severe rubbing can permanently alter the cornea.
• Use hypoallergenic cosmetics and good hygiene: Replace mascara every three months and thoroughly clean eyelids during daily showers.
• Get regular exams: Screening for glaucoma, macular degeneration, and retinal tears is the most reliable way to catch treatable problems early.
• Know the red flags: new flashes, sudden floaters, a curtain over part of vision, sudden blurred vision with headache or high blood pressure — seek immediate care.

Realistic expectations: what modern eye care can and cannot do

Medicine moves fast. We can correct refractive errors with corneal or lens-based surgery, treat many forms of macular degeneration with injections that stabilize or reverse disease, and manage glaucoma with drops, lasers, and minimally invasive surgical implants. But good outcomes depend on realistic expectations and appropriate patient selection.

Advanced multifocal lenses improve independence from glasses for most patients, but a small percentage will find trade-offs — night glare or decreased contrast — unacceptable. We counsel patients thoroughly and choose technology that aligns with lifestyle and retinal health.

Short takeaways we always repeat to patients.

• Many everyday habits — low blink rate, chronic rubbing, and environmental dryness — accelerate surface disease and visual discomfort.
• Refractive lens exchange can be a life-changing permanent solution for presbyopia and early cataract prevention when matched carefully to the eye.
• Not all advanced lens implants are right for everyone; retinal and optic nerve health matters most.
• Prompt evaluation for sudden visual changes saves sight. When in doubt, see a specialist.

“It is no wonder that we have evolved to be so dependent on our eyes and therefore are so protective of them.”

FAQs

How often should I get a comprehensive eye exam?

Baseline: every one to two years for most adults. If you wear corrective lenses, have diabetes, a family history of glaucoma, macular degeneration, or previous eye surgery, follow your eye doctor’s recommended schedule. If you experience new symptoms — flashes, floaters, sudden blurring, or a curtain-like shadow — seek immediate evaluation.

Can people who already have had LASIK get reading correction later?

Yes. Options include monovision LASIK touch-ups for some or refractive lens exchange, which replaces the internal lens and can restore both near and distance vision with the right implant. Patient-specific anatomy and ocular surface health determine the best path.

Are over-the-counter blue light glasses worth it?

They may reduce glare and perceived eye strain for some people, but they will not correct dry eye or refractive error. Prioritize blink rate, screen breaks, ergonomics, and proper refractive correction first.

Can dry eye be permanently cured?

Dry eye is a spectrum condition. Many people achieve sustained relief with a combination of in-office gland therapies, prescription drops, lifestyle changes, and, if appropriate, punctal occlusion. Severe autoimmune-related dry eye may require long-term management rather than a single cure.

What should I do if I think I scratched my eye?

Seek prompt evaluation. Corneal scratches are painful and can rapidly become infected. An exam confirms the injury and guides antibiotics or other treatment to prevent complications.

When is an emergency retinal evaluation necessary?

New flashes of light, a sudden increase in floaters, or a curtain or veil over vision warrant urgent retinal assessment. Early laser treatment can often prevent a small tear from progressing to a detachment.

Is it safe to use lash serums and extensions?

Many people safely use them, but monitor for eyelid darkening, irritation, or allergic reactions. Avoid products that cause pigment changes, and consult an eye specialist if you notice persistent color changes or irritation.

Can sleeping posture cause long-term eye changes?

Chronic side or face-down sleeping that places pressure on the eye can contribute to eyelid laxity, corneal shape changes, and morning irritation. Sleeping on one’s back is generally kinder to the eyes and face.

Final clinical perspective

Vision is central to how we interact with the world. Many daily habits are low-effort fixes: blink more, clean eyelids, avoid rubbing, and schedule regular eye exams. When surgery is appropriate, modern refractive options offer durable, life-changing improvements — but they should be chosen with careful testing and realistic expectations.

We emphasize prevention and early intervention. If something new or alarming appears, prompt assessment preserves options. When you combine simple daily care with smart use of technology and specialist guidance, you protect not only sight but the everyday freedom that comes with clear vision.

For a practical start: check your blink habits, switch to preservative-free drops if needed, and make an appointment for a comprehensive eye exam if it has been more than a year.

This article was created from the video The Daily Habits That Are Destroying Your Vision ft. Dr. Kerry Assil | She MD for Dr. Thais Aliabadi’s website.