After reviewing the main site, some employers may feel a need to educate their employees about the risks of refractive surgery. This assignment would normally be handled by the Human Resources department. To assist you, EyeKnowWhy has provided the following draft letter that you can customize based on your own policies.

You can access this document on your Web connected PC by copying this URL to your hard disk as a .txt file (all browsers provide this function). You can then import them into your selected word processor, strip the HTML tags and customize based on your policies. For more extensive detail, you can copy other URLs associated with the EyeKnowWhy site and incorporate them as well. Copies of this site should not be used for financial gain, and should identify the source as web site: http://members.aol.com/eyeknowwhy, title: I Know Why Refractive Surgeons Wear Glasses.

Model Employee Communications Letter Regarding Refractive Surgery

NOTE: Begin Model Letter

TO: Employees

Most of you are aware that there are surgical procedures advertised that are 'supposed' to correct nearsightedness (myopia).

Three surgical procedures are advertised:

1) Radial Keratotomy (RK)

In this procedure, a knife is used to cut radial incisions into the cornea. As the wounds heal, the resulting scars cause a flattening of the central cornea and a reduction in nearsigtedness.

2) Photorefractive Keratectomy (PRK)

This is a new procedure where a laser called the 'excimer laser' is used to vaporize tissue from the central part of the cornea causing 'flattening' and a reduction in nearsightedness.

3) Laser Assisted In-situ Keratomeulisis (LASIK)

This is a new procedure where a horizontal incision is made across the front of the cornea resulting in a 'flap' with a small hinge of tissue at one side. Tissue within the remaining cornea is vaporized and the hinged 'flap' is placed back over the cornea.

While it is true that some patients appear to have excellent results, there are negative aspects to these procedures. These procedures are all controversial for several reasons:

1) They are elective, medically unncessary, and considered 'cosmetic.'

2) Lasers, despite their 'technical awe', are just as invasive as a scalpel.

3) FDA approval does not guarantee absolute safety of any drug or medical device.

4) In rare cases, they may cause vision threating complications, including blindness.

5) They all compromise the integrity, and potentially compromise the long term viability and clarity of the cornea.

6) They are associated with persistent side effects such as glare, poor night driving vision, and optical aberrations such as starbursts and halos around bright lights.

7) A significant number of patients end up farsighted (or 'overcorrected') resulting in the need for glasses for both distance and near vision.

8) Long term refactive stability has been a problem. Some patients become progressively farsighted over time, while others regress becoming nearsighted over the years following surgery.

9) A significant number of patients experience a permanent reduction in the quality and sharpness of their vision. This is true even though they may be able to 'read' the 20/20 line on an eyechart (with or without eyeglasses) after surgery. A large number of patients attain good daytime vision, but night vision (especially when driving) has consistenly been a problem.

10) The long term effects are UNKNOWN. A small group of RK patients have been followed clinically for 10 years. PRK patients that participated in FDA clinical trials have been followed for only 3 years. LASIK patients have been followed for less than one year.

11) They all require you to sign an informed consent form restricting or eliminating your rights to compensation if you are rendered visually impaired or blind.

No one should consider these procedures without a thorough investigation, a thorough understanding of the risks involved and the possible underlying motivations of physicians marketing these procedures.

NOTE: Highly Recommended; Some companies may wish to contact Consumer Reports and request permission to copy and distribute their February 1994 article "Surgery Instead of Glasses". The following paragraph is an example referencing this article.

Attached is a copy of an article by Consumer Reports titled "Surgery Instead of Glasses." This article appeared in their February 1994 magazine and expresses significant concern regarding RK and contains reservations about PRK. The most important aspect is the discussion of 'informed consent' and the discussion of severe complications that may be cited by refractive surgery clinics as 'rare' but that the chances are '100% if it happens to you.'

Research on the Web

There are numerous sites on the Internet that market refractive surgery. You should be careful of these sites since they may be overly optimistic and less than truthful.

NOTE: Add and delete sites you believe appropriate.

The American Academy of Opthalmologists maintains a site, but provides little information about the risks of refractive surgery. Their site name is

http://www.aao.org/

Mayo Center maintains a site that provides a fairly good discussion regarding refractive surgery. Their site name is

http://www.mayo.org/

The organization EyeKnowWhy, a consumer health advocacy group, maintains a site that provides a sobering discussion of refractive surgery. Their site name is

http://members.aol.com/eyeknowwhy/

I would like to state our company's policy regarding these procedures:

NOTE: Choose the paragraphs you would like to customize. Delete others.

PARAGRAPH 1: ABSOLUTE BAN

Any employee after this letter's effective date of month, year who undergoes any refractive surgery may be subject to immediate dismissal or reassignment.

All applicants for employment will be screened for refractive surgery and be denied employment for some or all positions.

PARAGRAPH 2: LIMITED BAN - EMPLOYEES DRIVING COMPANY CARS, TRUCKS, AND AIRPLANES; EMPLOYEES WHO ARE GUARDS

Because of the concern with impaired vision (especially when driving at night), no employee who drives company cars, delivery vehicles, or any pilots operating company jets may undergo refractive surgery. The company plans to verify all employees who drive company vehicles have not undergone surgery previously. The company reserves the right to require verification from an employee's ophthalmologist or optometrist that he has not undergone any refractive surgery procedures.

PARAGRAPH 3: NO BAN BUT STRONG WARNING

I urge you to consider carefully the risks of having medically unnecessary surgery on your eyes regardless of statements made by refractive surgery clinics. Considering these are the only two eyes you will ever have, are the risks, however slight, worth it?

Over the next 3 months, x of y department will be evaluating the risks of refractive surgery and a revision of the company's policy may be made. We urge everyone to wait for at least a few years until longer term results of PRK and LASIK are known.

PARAGRAPH 4: INSURANCE - NO REIMBURSEMENT FOR THE SURGERY

The company's insurance plan does not reimburse for any refractive surgery procedures.

PARAGRAPH 5: INSURANCE - NO REIMBURSEMENT FOR MEDICAL TREATMENT FOR COMPLICATIONS

Employees who require medical services for complications AND had undergone a refractive surgery procedure prior to this communication may be eligible for insurance reimbursement. Employees who undergo refractive surgery after this communique will not be eligible for reimbursement.

PARAGRAPH 6: WORKMEN'S COMPENSATION

Employees who apply for disability benefits or workmen's compensation for reasons that are directly associated with complications of refractive surgery AND had undergone a refractive surgery procedure prior to this communique may be eligible for workmen's compensation and disability benefits. X will evaluate each case on an individual basis. Employees who undergo refractive surgery after this communique will not be eligible for workmen's compensation or disability benefits directly related to complications of refractive surgery.

PARAGRAPH 7: CURRENT INSURANCE REIMBURSEMENT POLICY FOR GLASSES AND CONTACTS

Our current insurance policy provides the following benefits for all employees.

a) Annual Eye Exams (free or x)

b) Reminbursement for Contacts and Glasses with an annual expenditure limit of $.

If you are bothered by your glasses, you should purchase new frames and the high index lenses now available. Great advances have been made in frame styling and thin lens technology in the last few years. Likewise, disposable contacts with high water content have made contact lens wear more accessible and convenient. Before purchasing contacts, you should be aware that contacts do carry some risks. Your ophthalmologist or optometrist can discuss them with you.

We are always concerned about our employees/associates health and well being and have offered health programs such as our stop smoking program and our health club discount programs to promote employee health. Considering that vision is your most important sense, and is your 'window to the world', I am sure you will agree with us that the risks outweigh any possible benefits.

If you have questions regarding this communique, please contact x.

NOTE: End of Model Letter

If you have any questions or comments, please contact eyeknowwhy@aol.com.