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For Jeri Goldstein everything was a blur. Without her contact lenses she couldn't distinguish people, the scenes on television, the stars at night, and, generally, the world at large. Then, in March 1998, the 49-year-old California resident had eye surgery, and all that changed.

"After wearing contact lenses for 35 years, you can't imagine the freedom I felt," says Goldstein.

Goldstein underwent refractive eye surgery, an elective procedure intended to correct common eye disorders, known as refractive errors, such as myopia (nearsightedness), hyperopia (farsightedness), and astigmatism (distorted vision). Although there are several types of surgical techniques being performed today to correct refractive errors, laser refractive correction is fast becoming the most technologically advanced method available, according to the American Academy of Ophthalmology in San Francisco. Doctors say it allows for an unparalleled degree of precision and predictability.

"Laser surgery is the most exciting advancement in ophthalmology," says James J. Salz, M.D., clinical professor of ophthalmology at the University of Southern California in Los Angeles and the doctor who performed Goldstein's surgery. But surprisingly, he says, despite its sudden popularity, "only 20 percent of ophthalmologists in the United States today are trained in its operation."

The Food and Drug Administration first approved the excimer laser in October 1995 for correcting mild to moderate nearsightedness. With that approval, the agency also restricted use of the laser to practitioners trained both in laser refractive surgery and in the calibration and operation of the laser. Currently, the excimer laser has been approved for use in a procedure called photorefractive keratectomy (PRK), and, as of November 1998, for a procedure called laser in situ Keratomileusis (LASIK).

In order to decide whether laser vision correction is a viable option for you, it is important to first understand how the eye works and why people need glasses or contact lenses to see well.

The eye works much like a camera; its primary function is to focus light. For the eye to see, light rays must be bent or "refracted" to meet at a single point through the cornea, the clear window at the front of the eye that provides most of the focusing power. Light then travels through the lens, where it is fine-tuned to focus properly on the retina, the nerve layer that lines the back of the eye and connects to the brain. The retina acts like the film in a camera, and clear vision is achieved only if light from an object is precisely focused onto it. If the light focuses either in front of or behind the retina, the image you see is blurred. A refractive error means that the shape of eye structures does not properly bend the light for focusing.

Having 20/20 vision means seeing at 20 feet what a normal person sees at 20 feet. However, if vision is measured at 20/40, it means a person has to walk up to 20 feet to see the same size letter that someone with 20/20 vision could see at 40 feet. And so on. People whose best-corrected visual acuity (what they see using glasses or contact lenses) is less than 20/200 in the better eye are considered legally blind, even though they still have enough vision to get around. Prior to laser surgery, Jeri Goldstein's visual acuity without her contact lenses was measured at 20/400 in her right eye and 20/200 in the left eye. Following surgery, her eyesight without contacts stands at 20/25 and 20/20, respectively.