“Health misinformation is a serious threat to public health. It can cause confusion, sow mistrust, harm people’s health, and undermine public health efforts.”

—Vivek H. Murthy, MD, MBA, Surgeon General of the United States

The prevalence of health misinformation has been rising steadily since 2016.¹ What began as misleading or false health headlines shared on social media has evolved into a serious public health threat. Ophthalmology—particularly LASIK—is not immune to this infodemic and is increasingly targeted by misinformation online (Figure 1).

“In the decade since the Refractive Surgery Council [RSC] began analyzing consumer mindset online around laser vision correction [LVC], we’ve seen a significant increase in the perpetuation of myths, misperceptions, and misinformation around LASIK—most of which is being posted by individuals without medical credentials or clinical research expertise,” said RSC Executive Director Liana Miller when contacted for this article (see About the RSC). “With the increase in social media channels and emerging AI technologies combined with Gen Z’s changing digital behavior, the refractive industry must collectively commit to aggressively combating the spread of misinformation.”

PROSPECTIVE PATIENTS ENCOUNTER BUMPS IN THE ROAD

Health misinformation has an overwhelmingly high prevalence on social media, with up to 40% of health-related posts—including topics such as vaccinations, eating disorders, treatment, and chronic diseases such as cancer—containing inaccurate or misleading information, according to recent studies.² A recent analysis of ophthalmic content on TikTok found that the majority of posts were created by individuals who are not health care providers.³ Although some content reflects personal experiences, much of it is inaccurate, ill informed, or misleading.

Since the early 2000s, individuals considering vision correction procedures have relied on online searches, often by typing directly into Google queries such as “What is LASIK?” “Is LASIK safe?” “How much does it cost?” and “Surgeon near me.” With the growth of social media, younger demographics now increasingly use platforms such as Instagram, TikTok, Reddit, and YouTube as their preferred search engines, with Google falling to last place.⁴

As prospective patients begin their vision correction journey online, they are highly likely to encounter misinformation, including from sources that appear credible at first glance. The burden is on the individual to separate fact from fiction. As they continue their research, they are likely to encounter more misleading information in forums, videos, and comment sections, which have become the new form of word of mouth.

“The reality is that LASIK prospects spend a significant amount of time online before they ever sit in a surgeon’s exam room,” said Ms. Miller. “Prospects are often deep into their research by the time they visit an office, and doctors and staff should anticipate questions informed by that research, which may include misinformation. Misinformation is difficult to correct because it creates doubt, even when accurate information is presented. The key is ensuring accurate information is what LASIK prospects find first. Doctors have an opportunity to increase their influence over prospective patients by actively supporting educational conversations online.”

PROBLEM AREAS

Health misinformation surrounding refractive surgery—specifically LASIK—originates from three primary sources:

• Google Search results (SERP);
• Misinformation amplifying damaging word of mouth; and
• Open access to ophthalmic meetings and trade publications.

In 2024, the monthly Google search volume in the RSC LASIK dataset was approximately 540,000. During the past 2 years, RSC’s consumer mindset analysis has identified a steady increase in fear-based search behavior related to LASIK, with 2024 volumes reaching the highest levels recorded since tracking began in 2016 (Figure 2).

During the past several years, Google has continuously fine-tuned its search experience to improve usability and retain users within its ecosystem. In response to these changes, the RSC expanded its tracking efforts to analyze not only traditional search results but also the content served within Google’s ecosystem.

RSC’s consumer mindset analysis in July 2024 revealed a 10% year-over-year increase in negative topic suggestions within Google SERP features such as the “People Also Ask” section, which included queries such as “going blind from LASIK.” This underscores the role of SERP features in amplifying misinformation about LASIK.

Economic factors are also contributing to declines in LVC procedural volumes. During periods of financial uncertainty, consumer search behaviors and psychological patterns often shift. Although prospective patients may be interested in vision correction procedures, fears about affordability and financial risk can emerge. This shift often leads to searches focused on reasons not to undergo the procedure as individuals seek information that validates their concerns. Unfortunately, this altered search behavior can increase their exposure to misinformation and negative content and amplify the damaging impact.

MISINFORMATION DAMAGING WORD OF MOUTH

Encouraging satisfied patients to share their positive experiences can be beneficial, but it also carries risks. Online trolling can quickly transform a positive patient post into a platform for rants against the procedure. Unfortunately, engaging with online trolls often becomes a no-win situation for surgeons and practices. Efforts to disprove negative claims can be futile and can lead to unfair characterizations of surgeons as uncaring, greedy, or hypocritical. A common misconception—that surgeons choose not to undergo vision correction procedures themselves—fuels this narrative. Once negative commentary is posted, it remains online indefinitely, where it can be discovered by prospective patients seeking authentic experiences and reliable information about vision correction procedures (Figure 3).

Increasing access to data and advanced tracking tools has revealed that misinformation affects the refractive market as a whole. The issue now extends beyond LVC to refractive surgery more broadly. Anecdotal reports from clinics indicate that prospective patients are increasingly expressing concerns about and referencing misinformation during consultations for a range of refractive procedures, including phakic IOLs, refractive lens exchange, premium IOLs, and other elective procedures.

OPEN ACCESS TO CLINICAL INFORMATION

“There are thousands of studies examining various aspects of ophthalmic procedures,” said Ms. Miller. “The intent of this research is to help doctors and surgeons better understand outcomes, complications, techniques, and technologies—all with the goal of improving procedures. You will not find a medical profession more dedicated to their patients than refractive surgeons.”

The internet has significantly increased public access to clinical data from journals, US FDA databases, and other sources. Although this is an important advance in information sharing, it also enables individuals without clinical credentials to present themselves as experts by offering clinical data without proper context. Self-described LASIK support groups often misquote, combine, or conflate data from clinical studies to emphasize concerns about complication rates. Once confined to a few niche websites, these inaccurate narratives now permeate search results and cover topics such as complication rates, safety data, US FDA findings, and even surgeons’ intent.

“It’s important for doctors to have many forums for sharing research, insights, techniques, and more—this drives innovation and improves the standard of care,” said Eric D. Donnenfeld, MD, RSC editorial advisory board member and advisor to the refractive surgery committee for the ASCRS, when contacted for this article. “However, many laypeople are unfamiliar with how knowledge is produced in science and medicine, so these concepts can feel abstract or even frightening. Research-backed health information must be available to patients conducting their own research, but it’s equally important that peer-to-peer clinical content is evaluated for appropriateness before being made publicly available.”

CONCLUSION

To combat the health infodemic effectively, it is critical to debunk false claims by providing accurate information and proper context to explain why the misinformation is incorrect. Refractive surgeons are the single best—and largely untapped—resource in this effort. As experts in the field, they hold a voice of authority that can refute erroneous claims by introducing relevant clinical information into the online narrative about LASIK and other refractive procedures.

1. Office of the Surgeon General. Health misinformation. US Department of Health and Human Services. Updated August 2, 2024. Accessed December 17, 2024. hhs.gov/surgeongeneral/priorities/health-misinformation/index.html

2. Fridman I, Johnson S, Elston Lafata J. Health information and misinformation: a framework to guide research and practice. JMIR Med Educ. 2023;9:e38687.

3. Sampige R, Rodgers EG, Huang A, Zhu D. Education and misinformation: exploring ophthalmology content on TikTok. Ophthalmol Ther. 2024;13:97-112.

4. Koetsier J. Gen Z dumping Google for TikTok, Instagram as social search wins. Forbes. March 11, 2024. Accessed December 17, 2024. forbes.com/sites/johnkoetsier/2024/03/11/genz-dumping-google-for-tiktok-instagram-as-social-search-wins