As an ophthalmologist, I advise all of my patients to avoid contact lenses if possible while in the water. I'm less concerned about loss of the lens than contamination and infection. However, the risk of infection is relatively low. With use of a disposable lens that can be discarded after a dive or swim, the risk of infection is probably almost as low as no lens at all. If my patients are comfortable with this level of risk, I have no objection to their use of lenses for recreational diving. I also ask my patients to consider whether loss of one or both lenses could seriously jeopardize their safety. The answer is usually no, not any more than loss of a mask would.
Disposable contact lenses are now available in a wide variety of powers, base curves and diameters, so it should be possible to obtain just as good a fit with one of these lenses as with reusable lenses in most patients.
A prescription mask is another alternative.
LASIK is a low-risk, but not a zero-risk, procedure. Some patients are at greater risk of complications than others. An individual's level of risk can only be estimated after a thorough evaluation. Those who are interested in hearing the negative side of the LASIK story should visit
SurgicalEyes.com, or check out this simulator of refractive surgery
visual side effects.
The LASIK flap heals extremely slowly, so that trauma to the eye could dislodge the flap even years after the surgery. LASEK avoids the flap issues, but may be more uncomfortable and require a little more time before stabilization of vision than LASIK. The main reason to delay diving after LASIK or LASEK surgery is to ensure that the surface epithelial cells, which provide a barrier to infectious organisms, have healed. This typically occurs within a few days after LASIK, but can take longer after LASEK and in patients with dry eye. And dry eye typically gets worse after LASIK surgery. The DAN recommendation cited above seems reasonably conservative, but I would recommend a specific clearance from the surgeon based on postop exams prior to resumption of diving. Compression and decompression shouldn't be an issue.
For those seeking LASIK or LASEK surgery, it is advisable to consult with an experienced practitioner. Someone who has done 500 or 1,000 cases is more likely to know how to deal with the uncommon but inevitable unexpected complication than someone who's done only 100 cases. However, the surgeon who's done 30,000 cases may or may not be seeing his own patients in follow-up. This may be the case in some of the $700/eye LASIK centers. I would ask about this. If I were having surgery, I wouldn't go to a surgeon who wasn't going to see me himself for all of the postop visits. FWIW, I stopped doing LASIK surgery a few years ago because of the commercialization of the procedure. I couldn't compete on price and still give the quality of care I felt necessary, and I wasn't willing to turn postop care over to someone else.
None of the above is offered as medical advice. It is not meant to be taken as advice for the treatment of any individual, nor does it establish a doctor/patient relationship with any individual. It is offered solely for general informational purposes. All readers are encouraged to contact their own eye doctors for specific recommendations.