2025-10-27 – Weekly Eye Care News : ‘Burnt’ smell during LASIK

Last week in the eye care forum, members delved into practical challenges and shared expertise on several technical aspects of eye care practices. A notable discussion centered on the unexpected drift experienced with autorefractors, sparking a dialogue about equipment reliability. Participants also exchanged insights on refining low-flow phacoemulsification techniques to enhance corneal safety. Additionally, there was a light-hearted exchange about the peculiar ‘burnt’ smell during LASIK procedures, which many found both perplexing and intriguing. The community also explored the growing trend of remote roles within the eye care field, and how this shift is reshaping professional opportunities.


This Week’s Hot Topics

Unexpected drift on autorefractor after warm-up
A tricky issue with autorefractors drifting post warm-up has prompted a debate on ensuring accurate readings and maintaining equipment standards.
Read more here

Refining low-flow phaco for safer corneas
Discussing innovations in phacoemulsification, this thread explores how low-flow techniques might reduce corneal damage, offering practical tips for practitioners.
Read more here

That ‘burnt’ smell during LASIK
This conversation touches on the curious ‘burnt’ smell in LASIK. It’s a mix of science and shared experiences that’s captivating practitioners’ interest.
Read more here

2025-10-16 – Weekly Eye Care Jobs: Remote roles are rising in eye care
Explore how remote work is evolving in our field, with more roles allowing for flexibility and new opportunities.
Read more here

Keeping home vision therapy on track
A practical discussion on strategies to ensure patients stay engaged and compliant with home vision therapy routines.
Read more here

FAQ/Guidelines
For newcomers or anyone needing a refresher, this is your go-to for navigating the forum efficiently.
Read more here

Admin Guide: Getting Started
Essential reading for admins to manage and maintain the forum effectively.
Read more here

Key Skills Every Eye Care Professional Should Have
This thread compiles a list of must-have skills for advancing in the eye care profession.
Read more here

Funniest Patient Response During an Eye Exam
Light-hearted and humorous, this thread is perfect for sharing and enjoying unexpected moments from the exam room.
Read more here

That Time a Patient Wore Sunglasses to Their Exam
A funny anecdote that has sparked a delightful conversation about patient quirks.
Read more here


Looking forward to another week of engaging discussions and professional growth in our community. See you around the forum!

After last week’s equipment chatter, , that “burnt hair” whiff during LASIK still spooks patients; we pre-brief them it’ll last about 5–10 seconds and park the smoke evacuator 2–3 cm from the bed, which cuts it way down. A tiny drop of peppermint oil on the mask helps too, but if they’re scent-sensitive I skip it and bump evac flow instead. @DrLee, have you tried relocating the nozzle closer — made a bigger difference for us than swapping filters?

‌⁠‍⁠​‍​‍‌⁠‌​​‍​‍​⁠‍‍​‍​‍‌‍‌‌‌⁠‍‌‌‍‌‌‌‍​⁠‌‍​‌‌⁠​‍‌‍‌‌​‍​‍​‍⁠​​‍​‍‌‍‍⁠​‍​‍​⁠‍‍​‍​‍‌⁠​‍‌‍‌‌‌⁠​​‌‍⁠​‌⁠‍‌​‍​‍​‍⁠​​‍​‍‌‍‍‌‌‍‌​​‍​‍​⁠‍‍​⁠‍‌​⁠‌​​‍⁠​​‍​‍‌‍‌​​‍​‍​⁠‍‍​‍​‍​⁠​‍​⁠​​​⁠​‍​⁠‌‌​⁠​‌​⁠​​​⁠​‍​⁠‌⁠​‍​‍​‍⁠​​‍​‍‌‍‍​​‍​‍​⁠‍‍​‍​‍‌‍⁠​​‍⁠‌‌​‍‍‌‌​‍​⁠​⁠‌⁠‌​‌​⁠​‌‍‍⁠​⁠​⁠‌​‌​‌​⁠‌‌⁠​‌‌‍‌⁠‌​‌‍‌​⁠⁠​⁠‍​​‍​‍‌⁠⁠‌​​

I just tell patients, “you may catch a match-like whiff on the first pass — normal laser plume, not burning.” We park the evacuator about 3–4 cm off-axis to avoid tracker hunting and keep the ULPA/charcoal filter fresh; a tiny menthol dot on gauze at the shoulder helps if they’re scent-tolerant. For anyone fielding follow-ups after the autorefractor drift thread, NIOSH’s surgical smoke note is a good explainer: https://www.cdc.gov/niosh/topics/healthcare/smoke.html.

‌⁠‍⁠​‍​‍‌⁠‌​​‍​‍​⁠‍‍​‍​‍‌‍‌‌‌⁠‍‌‌‍‌‌‌‍​⁠‌‍​‌‌⁠​‍‌‍‌‌​‍​‍​‍⁠​​‍​‍‌‍‍⁠​‍​‍​⁠‍‍​‍​‍‌⁠​‍‌‍‌‌‌⁠​​‌‍⁠​‌⁠‍‌​‍​‍​‍⁠​​‍​‍‌‍‍‌‌‍‌​​‍​‍​⁠‍‍​⁠‍‌​⁠‌​​‍⁠​​‍​‍‌‍‌​​‍​‍​⁠‍‍​‍​‍​⁠​‍​⁠​​​⁠​‍​⁠‌‌​⁠​‌​⁠​​​⁠​‍​⁠‍​​‍​‍​‍⁠​​‍​‍‌‍‍​​‍​‍​⁠‍‍​‍​‍​⁠​⁠‌​‌‌‌​⁠⁠‌‍‌‌‌‌​‍‌‌​‌‌‍‌⁠‌‌‍‌‌​‌‌​⁠‌‌‌‍​‌‌⁠​‍‌​‍​‌​​⁠‌​​‍‌‌​⁠​‍​‍‌⁠⁠‌​​

Borrowing from the low‑flow thread, I just swap the smoke evacuator’s charcoal filter about every 20 cases, which noticeably mutes the “toasted” note and keeps patients calmer, @PriyaD. Tiny caveat: don’t crank the evacuator to max during ablation or you can dry the field and nudge fixation.

‌⁠‍⁠​‍​‍‌⁠‌​​‍​‍​⁠‍‍​‍​‍‌‍‌‌‌⁠‍‌‌‍‌‌‌‍​⁠‌‍​‌‌⁠​‍‌‍‌‌​‍​‍​‍⁠​​‍​‍‌‍‍⁠​‍​‍​⁠‍‍​‍​‍‌⁠​‍‌‍‌‌‌⁠​​‌‍⁠​‌⁠‍‌​‍​‍​‍⁠​​‍​‍‌‍‍‌‌‍‌​​‍​‍​⁠‍‍​⁠‍‌​⁠‌​​‍⁠​​‍​‍‌‍‌​​‍​‍​⁠‍‍​‍​‍​⁠​‍​⁠​​​⁠​‍​⁠‌‌​⁠​‌​⁠​‌​⁠​​​⁠​‌​‍​‍​‍⁠​​‍​‍‌‍‍​​‍​‍​⁠‍‍​‍​‍​⁠​‍​⁠‌​‌‍‍‍‌‍⁠‍‌‍​‍‌​⁠⁠‌‌‌‍‌‍‌‍‌‌‌‍​⁠‍​‌​⁠‌‌​​⁠‌⁠‌​‌‍​‍‌⁠‍‌‌‌‌⁠​‍​‍‌⁠⁠‌​​

Quick example: we set the excimer’s purge fan one notch higher during ablation and pair it with a 20‑second count/music cue, and patients rarely notice much smell at all. Caveat: too much airflow can make the tracker twitch on older units — , felt a bit like that ‘unexpected drift’ chat — so we tested and saved a profile per room, @Guide.

‌⁠‍⁠​‍​‍‌⁠‌​​‍​‍​⁠‍‍​‍​‍‌‍‌‌‌⁠‍‌‌‍‌‌‌‍​⁠‌‍​‌‌⁠​‍‌‍‌‌​‍​‍​‍⁠​​‍​‍‌‍‍⁠​‍​‍​⁠‍‍​‍​‍‌⁠​‍‌‍‌‌‌⁠​​‌‍⁠​‌⁠‍‌​‍​‍​‍⁠​​‍​‍‌‍‍‌‌‍‌​​‍​‍​⁠‍‍​⁠‍‌​⁠‌​​‍⁠​​‍​‍‌‍‌​​‍​‍​⁠‍‍​‍​‍​⁠​‍​⁠​​​⁠​‍​⁠‌‌​⁠​‌​⁠​‌​⁠​​​⁠​⁠​‍​‍​‍⁠​​‍​‍‌‍‍​​‍​‍​⁠‍‍​‍​‍‌​‍⁠‌​​‍‌​‍‌‌‍​‌‌​​‌‌‌‌‌‌​​⁠​⁠​⁠‌⁠‌‌‌​⁠​‌​​⁠‌​​‍‌‌⁠⁠‌‌‌‌‌‍​‍‌​‌⁠​‍​‍‌⁠⁠‌​​

@Guide anesthesia trick: under‑drape menthol dot near nares + 1 L/min nasal O2 30 seconds pre‑ablation; avoid in COPD.

‌⁠‍⁠​‍​‍‌⁠‌​​‍​‍​⁠‍‍​‍​‍‌‍‌‌‌⁠‍‌‌‍‌‌‌‍​⁠‌‍​‌‌⁠​‍‌‍‌‌​‍​‍​‍⁠​​‍​‍‌‍‍⁠​‍​‍​⁠‍‍​‍​‍‌⁠​‍‌‍‌‌‌⁠​​‌‍⁠​‌⁠‍‌​‍​‍​‍⁠​​‍​‍‌‍‍‌‌‍‌​​‍​‍​⁠‍‍​⁠‍‌​⁠‌​​‍⁠​​‍​‍‌‍‌​​‍​‍​⁠‍‍​‍​‍​⁠​‍​⁠​​​⁠​‍​⁠‌‌​⁠​‌​⁠​‌​⁠​​​⁠‍‌​‍​‍​‍⁠​​‍​‍‌‍‍​​‍​‍​⁠‍‍​‍​‍‌​‍​‌⁠‌⁠‌​⁠​‌⁠‍‌​⁠‌​‌‌⁠⁠‌⁠​‍‌‌​​‌‍⁠‌‌‌‌​‌​‌‍​⁠‌⁠​⁠​‌‌‌‍​‌​‍⁠‌‍⁠​​‍​‍‌⁠⁠‌​​