Brits Are Going Abroad For Laser Eye Surgery

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The Law Of... getting laser eye surgery abroad

New Tan And New Vision? 21% Of Brits Surveyed Would Opt To Go Abroad To Have Laser Eye Surgery

With the summer upon us, many Britons will be looking forward to jetting off abroad but while the purpose was once to relax, get a tan and experience new places, some Brits could be looking to get even more out of their next vacation, and ditching the need to wear glasses or contact lenses for good.

The Law Of... getting laser eye surgery abroad

According to a new YouGov survey1 of prescription glasses and contact lens wearers, conducted by Simpson Millar, over 1 in 5 (21%) of those who would consider laser eye surgery would go overseas to have the procedure, with the top reason being that it would be cheaper than having laser eye surgery in the UK (62%).

Over 1 in 5 Brits who would consider laser eye surgery would go abroad for itSample: Prescription glasses or contact lens wearers who would consider laser eye surgery abroad in the future

Saving money seems to be a recurring theme, with 54% admitting that discounts and cut-price deals are one of the common reasons they would consider going overseas to have laser eye surgery.

Eastern European countries such as Poland and Hungary are the most popular destinations for UK patients seeking medical treatment, according to the 2015 Medical Travel Trends UK by MEDIGO, and when it comes to long-haul destinations, Thailand takes the top spot.

Most popular medical travel destinations - Poland is number 1

MEDIGO estimated that 200,000 UK patients would be heading abroad for treatment in 2015, with the main motivations being reduced waiting times for appointments, lower costs and having access to specialist care. While the majority (70%) of MEDIGO enquiries from the UK were from patients seeking dental treatments, 5% of enquiries were for ophthalmology procedures, which included LASIK (one of the most common types of laser eye surgery).

Although patients may end up saving money on the surgery itself, there is still travel and accommodation costs to account for. Perhaps this is why 45% of those who said they would consider going abroad to have laser eye surgery, said a reason for doing this would be so they could combine the procedure with a holiday.

Sandra McAngus, who works as the head of nursing and aftercare at Vistalaser Oftalmologia in Marbella explains that the surgery usually takes place within the space of a week. The client could have the consultation on a Monday or Tuesday, for example, and provided the results of the eye tests meet the requirements, the surgery can take place on the Thursday or Friday of the same week.

While each clinic will vary, it's easy to see how people can make a decision to undergo the procedure once they've arrived at a destination. However, this is where problems can occur, especially if the individual fails to do their research and is lured by cheap deals. In some countries there may not be a regulator such as the Advertising Standards Authority (ASA) that is responsible for monitoring misleading adverts.

Spain is another popular destination for UK travellers seeking medical appointments and as McAngus explains:

"We tend to get three or four patients a week from the UK. Clients often phone or email to tell us that they are flying out on vacation, so we will book them an appointment with the doctor, as well as an appointment for the surgery, in case they are suitable. Sometimes they will just walk into the clinic while on holiday but even though we are busy we try to keep some appointments free so they can be seen as soon as possible during their vacation."

"The procedure takes about 20 minutes and afterwards they are required to stay for a further ten minutes. They are then discharged so they can go home or return to their hotel. They need to apply eye drops every three hours and we also provide them with special glasses for the first two days."

"Patients can go back to normal life the next day, where they can enjoy sunbathing around the pool or beach, provided they wear sunglasses with UV protection, although they may be a bit uncomfortable to begin with. However they cannot go into the water and swimming is not permitted for 15 days."

You should wait 7 days before flying after eye surgery

The Civil Aviation Authority (CAA) recommends waiting at least seven days before flying following complicated eye surgery although each airline may have its own regulations.

30% of those that haven't yet had laser eye surgery would consider it in the future

According to YouGov, over half (57%) of the nation are glasses wearers, just 3% only wear contact lenses, and 10% wear both. Of those people who wear glasses or contact lenses, 3% have had laser eye surgery, while another 30% say they haven't yet had the procedure, but would consider it in the future, with those aged 25 to 34 the most likely (48%). Interestingly of those who would consider in the future, males are slightly more likely to consider undergoing the surgery abroad than their female counterparts (25% vs 16%).

Which gender is more likely to undergo surgery abroad? Males.Sample: Prescription glasses or contact lens wearers who would consider laser eye surgery abroad in the future

Although the long-term effects of laser eye surgery are relatively unknown, almost a third of those surveyed (31%) said they know someone who has had the procedure. Of these, almost 1 in 10 (9%) thought this person had a poor understanding of the potential risks involved with the surgery.

Interestingly, those aged 45 – 54 years old (3%) are twice as likely to think that they or someone they know had a "very poor" understanding of the risks involved with laser eye surgery.

Understanding how the industry is regulated

Geoffrey Simpson-Scott, Associate Solicitor of Medical Negligence at Simpson Millar explains:

"Hard sell sales techniques are known to be used to promote eye surgery and worryingly, these procedures involve complex medical treatment, which can have serious physical and psychiatric consequences when things go awry."

Geoffrey explains that while there is some protection for consumers in the UK, the standards may differ in other countries:

"In the UK, the Care Quality Commission (CQC) has regulatory authority to ensure that the premises and facilities where laser eye surgery is performed adhere to certain standards. This helps to guard against rogue practitioners offering cut-price surgery in hired venues, which can sometimes take place away from their respectable consulting rooms. In some cases, the room where the patient has their surgery may not be the place that was advertised or where their initial consultation took place."

Among those who would consider laser eye surgery overseas, the most common concern about undergoing the procedure abroad is that the doctors or surgeon may not be fully qualified (57%), closely followed by the possibility that it would not be properly regulated (56%).

Seeking compensation abroad

The third most common concern was the possibility that they may not be able to claim compensation or seek legal advice should anything go wrong (54%). This came above concerns over language barriers, which meant that they might not be fully aware of the side effects (47%) and the risk of lower standards of hygiene and competency (42%).

Medical Compensation Abroad

However, as Geoffrey explains: "A patient who has travelled from England to have laser surgery abroad may find that they cannot seek compensation when they return to the UK. Many people make the mistake of thinking the same rules will apply elsewhere. Patients may also find that there are certain restrictions in place, which would make it impossible to claim compensation should something go seriously wrong."

"It can also be hard to prove negligence, you need to prove that the treatment was below an acceptable standard and that the injury was not just a complication of the surgery. The clinic or surgeon does not have to prove that they acted reasonably but will often try to do so. Lawyers need to focus on the evidence of what happened and what the client was advised prior to and at the time of having the surgery. If evidence is not readily available, then this can prevent a patient from receiving the compensation they deserve."

With 66% of those who would consider laser eye surgery overseas saying they would be likely to claim if they suffered a side effect or any long-term damage to their eyes following laser eye surgery abroad, this may come as an unwelcome surprise.

66% would likely claim if they suffered side effects or long term damage following eye surgery abroadSample: Prescription glasses or contact lens wearers who would consider laser eye surgery abroad in the future

In the UK, the treatment must be consistent with a minimum national standard. If it doesn't meet this criteria then the patient can seek compensation. However, the standards and systems for claiming compensation can differ depending on the country, and in some places it may not be customary to seek remuneration.

A good example of this would be in the Baltic States, and as Ramune Mickeviciute, Paralegal - Medical Negligence at Simpson Millar, who herself originates from Lithuania explains:

"As far as I know from practice, doctors (especially dentists and other surgeons) might give you some sort of form to sign. However, it would not be like the typical consent form we are used to in the UK. Those forms are there for you to sign in order to say that you will not have any comments or complaints if something goes wrong. Even if people might have complaints, it is not common practice to sue public bodies or medical practitioners."

Check the surgeon's qualifications

What may come as a surprise is that legally any doctor can perform laser eye surgery in the UK, nor are they required by law to be on the specialist register of the General Medical Council (GMC). It's therefore even more vital that patients check the surgeon's qualifications.

Legally, any doctor can perform laser eye surgery in the UK

The Royal College of Ophthalmologists (RCOphth) recommends that they should be registered ophthalmologists and undergo additional specialist training in laser refractive surgery. The College introduced a Certificate in Laser Refractive Surgery in 2007 and recently brought together leading surgeons as well as college council officers to form part of the Refractive Surgery Standards Working Group (RSSWG), which reviews the guidance, advertising and marketing guidelines of refractive surgery. In light of this, the guidelines (Refractive Surgery Standards July 2011; Statement on Refractive Surgery Standards 2012) will be reviewed and the updated information will be published in September this year.

The GMC also recently published a patient guide which details some of the things that patients should consider when going overseas for cosmetic procedures. This includes the potential expense of returning to the clinic for follow-up care and deciphering who will pay if something goes wrong. The GMC states that 'questions as to what people should do if they're not happy with the outcome, and advice about any aftercare that might be required, are things they should discuss with the doctor before agreeing to go ahead with a procedure.'

Doctors who carry out cosmetic procedures in the UK have also been issued with new guidance by the GMC, which came into force in June, in an attempt to crackdown on cosmetic surgery cowboys.

Professor Sir Bruce Keogh, whose review of England's cosmetic industry initiated the guidance, explains: "The GMC's new guidance will play a pivotal role in raising standards and protecting people who choose to have a cosmetic procedure..."

"It will also help ensure doctors are seen to be open and honest, that they work within their competence and seek appropriate training and advice where necessary. This marks an important step forward for patient protection across a wide range of cosmetic and lifestyle procedures, including areas such as laser eye surgery."

However while this only applies to doctors carrying out cosmetic procedures in the UK, patients travelling abroad could still take heed of the GMC's latest advice as they urge patients to question doctors and surgeons carefully to ensure they get the right information and care using an easy to remember COSMETIC acrostic. The GMC's guidance puts a lot of emphasis on how procedures are marketed, to ensure that patients are not put under any undue pressure through tempting offers or prizes, without having adequate time to reflect.

Making an informed choice

While complications occur in less than 5% of cases, according to the NHS, it's important to find out how many times the surgeon has performed the procedure and what types of complications they have experienced. Although it's true that every form of surgery contains a degree of risk, it can be harder to assess the pros and cons while on holiday – throw in the mix some sun, sea, sand and Sangria, and can you really be certain that you are making an informed choice? Have you really had a proper cooling-off period?

Fewer than 5% of NHS laser eye surgeries incur complications

Another way not to get caught out is through insurance – a standard travel insurance policy will not cover medical or cosmetic treatments abroad, so it's important that you get the right policy, and one that covers you for medical tourism, as well as any complications that may arise.

Not only do you need to be adequately insured but you should also check whether the clinic has liability insurance. In certain countries, clinics may be able to operate without being insured or there might be some little known restrictions, such as the fact that medical tourists from overseas are excluded from the cover.

Case Study

Mr E* agreed to undergo LASIK eye surgery having seen advertisements promising to correct his mild short-sightedness. He paid for this privately following a consultation with someone that he later discovered had no formal medical qualifications – she was employed simply to get clients in to the clinic. He was not seen by a trained doctor until after he had agreed to undergo the treatment and made a part payment for the surgery. At the medical consultation, he was given a long form to sign but was assured that none of these risks would happen as LASIK was safe.

Unfortunately, Mr E had several conditions which meant that it was actually unsafe to perform laser refractive surgery without additional precautions being taken. Had his pre-operative examination been conducted to a reasonable standard, these would have been diagnosed and he would have been able to make an informed choice as to whether to take these risks.

After the LASIK treatment, Mr E was left with severely reduced vision in his left eye, as well as blurring and floaters in both eyes. He finds that the light upset his right eye and this led him to wear sunglasses more than normal. He lives at home with his wife in a ground floor apartment but when he visits friend's houses, offices or anywhere else with stairs, he can only manage these by taking a considerable amount of additional care by using handrails (if available).

He finds it much more difficult to judge depth and this makes it more likely that he spills drinks and food and risks burning himself more frequently. He can deal with his post and watch TV but the remaining blurring means he does not find this as easy to do as he did before the treatment. He also finds it more difficult to look at a computer screen for longer periods.

During daylight, he is able to go out without assistance but needs to take extra care when stepping up and down kerbs and walking on the cobblestone-streets of his local town. When the streets or shops are crowded, he finds that he is more likely to bump into people than he did before his treatment on his left hand side. During the dusk and at night, he does not feel safe to go out alone and requires someone to be with him. He also does not feel safe to drive at night.

He was a keen clay-pigeon shooter but his reduced vision now prevents him from participating in this activity and his ability to play snooker and pool is much reduced by the blurring and inability to properly judge depth. He no longer feels safe to drive a speedboat or take part in water-skiing or para-gliding which he also used to enjoy.

Mr E won his case and received a significant amount of compensation for his injuries. However, if he had the choice again, he would not have taken the chance of losing his eyesight.

*Mr E (not his real name)

1 These figures are from research conducted by YouGov Plc on behalf of Simpson Millar. Total sample size was 4209 adults. Fieldwork was undertaken between 3rd - 5th May 2016. The survey was carried out online. The figures have been weighted and are representative of all GB adults (aged 18+).

Price of laser eye surgery LASIK (laser in situ keratomileusis)

Country Hungary Lithuania Poland Spain Thailand
*Average Price From £700 Around £600 From £550 Around £1,500 From £850
**Travel Costs Flights from £149 Flights from £212 Flights from £145 From £188 From £723
Regulatory Body / National AssociationHungarian Society of OphthalmologyLithuanian Eye Doctors SocietyPolish Society of OphthalmologySpanish Society of OphthalmologyRoyal College of Ophthalmologists of Thailand

*Based on the prices advertised online. All prices are subject to change and fluctuation. Some countries also advertise installment plans and finance schemes.
**Prices are based on economy return flights in July for one person and are indicative only.

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