How young is too young for cataract surgery?
by Jessica White, COT
Cataracts are usually thought of as something that comes with age. In fact, when cataract surgery was first performed, it often took place when patients were well into their eighties. The risks were high and the benefits were not considered to be very great due to less sophisticated technology. Patients were left with the need for very thick glasses or hard contacts after surgery.
Today, the average age for cataract surgery is somewhere in the early seventies, and it is not uncommon to see patients much younger. Cataracts don’t just develop because of age, however; they can be brought on by injury, chronic steroid medication use, inflammation, or a number of other factors. Cataracts can be diagnosed with a dilated eye exam.
At first, when people realize they have cataracts they may feel this is a negative sign of aging. But, many soon discover that cataract surgery can be an opportunity to change dependency on glasses. Cataract surgery is now thought of as a refractive procedure, a surgery to become less dependent on glasses for most patients. There are different types of lenses that can be used to customize vision.
Many patients see well enough to be legal to drive without glasses following cataract surgery. Some even see better than they ever have before.
Due to great advances in technology and safety, cataract surgery can help improve vision for many patients regardless of age, and can help restore a more independent, active lifestyle. Here are some examples of cataract symptoms:Glare when driving at night or in bright sunlight
- Having to get closer to read street signs
- Difficulty reading fine print
- Needing more light to read by
- Trouble determining numbers (6’s look like 8’s)
- Difficulty seeing steps
If you would like more information regarding cataracts, follow the link below to a digital copy of our cataract patient workbook, or contact our office for a cataract consultation. You can schedule on-line through our website.
Jessica White, COT, works with the doctors and staff at The Harman Eye Clinic as a senior ophthalmic technician.
It doesn’t get much happier than this! A 23-year-old patient met up with eye surgeon, Dr. Wietharn. Her high degree of nearsightedness made it impossible to navigate without glasses or contacts. She hoped to explore options for iLASIK, (total-laser vision correction)
Casidhe is an optician’s apprentice and has a bit of background in eye care to say the least. She was careful about choosing her surgeon and made the rounds to several LASIK centers before choosing The Harman Eye Clinic staff and Dr. Wietharn.
Like every patient here, Casidhe was treated as an individual with her specific vision requirements, the health of her eyes beyond nearsightedness, farsightedness and astigmatism, her age and her lifestyle. And, like every patient, Dr. Wietharn and staff took the time to carefully weigh the risks and benefits and possible need for a refinement surgery in her case.
“I felt ready, and I felt like I knew what was going to happen. [Dr. Wietharn] was very straightforward and honest,” Casidhe told us after surgery.
At her 1-day post-op visit, Casidhe saw 20/30 with both eyes, and she was thrilled. She had achieved legal-to-drive without glasses or contacts at day one! Dr. Wietharn had prepared her with realistic expectations and she was a happy camper at day-one.
“Would you recommend iLASIK,” we asked. She answered, “Oh, yeah. Just do it, it’s amazing. Even if this vision only lasted 10 years, I would be happy with it.”
This positive spirit paid off. At her 1 week visit, Casidhe could read the 20/15 line without correction. And, as stated at the beginning, It doesn’t get much happier than this!
Congratulations, Casidhe. We never get tired of helping people achieve their vision goals.
Jessica White is a Senior Technician at The Harman Eye Clinic. Her observations may help you decide whether iLASIK is something that can benefit you.
I am one of those lucky people who sees well at all distances without glasses. For that reason, when I started working at The Harman Eye Clinic I had very little understanding of why someone would want LASIK. I thought it was a vanity thing; I assumed all people who had LASIK did so because they didn’t like how they looked in glasses and couldn’t wear contacts.
Boy, was I wrong!
Here are five of the most common reasons for wanting to have LASIK that I hear from patients.
Here in the northwest, we have the opportunity to enjoy snow and water sports without having to travel more than a couple of hours between. Unfortunately, neither of these genres mixes well with glasses or contacts. Patients frequently list things like snowboarding, skiing, swimming, and boating among the activities they hope to do without glasses after LASIK. Quite often I hear frustration about glasses fogging up under ski goggles, contacts drying out due to cold weather, or even just not being able to see when swimming because neither glasses nor contacts mix well with water.
I may not wear glasses or contacts, but I have traveled with people who do, and it is no surprise to me that this is among the more common reasons why people want to have LASIK. Packing contact lens supplies can be a hassle, especially if you are traveling far and will have to take them out to sleep en route. Also, there is always the possibility of breaking glasses or losing a contact, and I don’t know many people who feel comfortable having new glasses or contacts made in an unfamiliar place.
Although corrective lenses can usually make it possible for people to work almost any job, it does not mean that they make it easy. Patients who work construction or are mechanics often talk about how their glasses or contacts affect them when they are working in harsh weather or tight spaces. This is especially true for patients who wear Toric contacts or glasses to correct a fair amount of astigmatism, because their vision with lenses can change when they tilt their head. Anyone who works outdoors in the rain can attest to the problem that causes with glasses, and patients who work in kitchens often talk about their glasses getting steamed up or contact lenses making cutting onions much worse.
I was talking to one of my friends about LASIK shortly after she had her first child, and she exclaimed to me, “I just want to see what time it is when he wakes me up in the middle of the night!” Parenting while being glasses dependent can be really difficult, not only during late-night feedings. In my experience glasses are in the top 3 most desirable objects for infants and toddlers. Even just taking a few minutes to insert or remove contacts can feel like a huge inconvenience to a busy parent.
Even though I have learned that LASIK is not all about vanity, I do see that patients gain a lot of confidence by getting out of contacts and glasses. There is a certain amount of vulnerability that comes with knowing you can’t do all of the things you do without lenses. Not everyone likes wearing bold colored or extra-large frames, but some people feel the need to, because if they can’t see the blur of color, they can’t find their glasses when they are not on.
LASIK is so amazing because it gives patients the opportunity to wake up in the morning and just live.
The idea of having an elective surgery may be scary, but for so many patients, LASIK is liberating. We see patients every year for exams after LASIK, and it is amazing to ask how their vision has been and have them say “You know, I haven’t really thought about it because I can see everything I need to.”
When our surgeons offer LASIK to patients, it is because they truly feel that they can help that person get to a place where they don’t have to think about their vision throughout most of their day. If you are interested in having a complimentary evaluation with one of our LASIK surgeons to find out if you are a good candidate, please contact our refractive coordinator.
For more information, call our office at 360.435.8595 or visit our website, http://www.20Better.com.
The latest informational booklet has been released over the weekend. You may download it without any obligation and free of charge. It will introduce you to The Harman Eye Clinic Surgeons and numerous pieces of information that will help you decide whether LASIK can be in your future.
Recently, we received a comment on Facebook expressing disappointment for his sister who returned to glasses some two years later. I can imagine how he felt seeing his sister in glasses so soon after surgery.
The circumstances where a patient would need to return to glasses two years after surgery is very unusual. It is impossible to explore reasons without visiting an ophthalmologist’s office. The most obvious thought is that the patient was in her 40’s when she had surgery and hadn’t fully appreciated the onset of presbyopia.
Forty-something patients who are nearsighted usually have progressive lenses, bifocals or take off their glasses for best near vision. After surgery, they cannot take off their glasses and so now require reading glasses. It is unclear, however, that this is the situation with the commenter’s sister.
It makes us wonder how well people prepare for eye surgery. Eye procedures are certainly not on an equal plane as buying glasses or contacts. Refractive procedures are permanent changes to the eye. LASIK changes the shape of your cornea. We provide very precise, wavefront, computer-driven, customized laser vision correction. Even so, it is the preliminary discussions we have prior to LASIK that give a patient the best chance of successful surgery.
The VISX and IntraLase laser technology is considered the gold-standard of LASIK. We spend considerable time before surgery to screen patients to explore if there are any factors that will impact a successful outcome. We remind patients that we are working with each person’s individual health situation and ability to see, noting their specific lifestyle vision requirements. Patients who are seeking surgery in their 40’s are given special counseling, for they are heading for years when they will most likely need reading glasses. From the Patient Guide for Successful LASIK:
Not all people are candidates for LASIK. Here is one discussion we hold with all people before they make an appointment:
- Are you able to see close to 20/20 with glasses or contacts? If answer is yes, then you may be a good candidate so far! (If no, read the last paragraph).
- Do you consider your vision to be normal with the exception of glasses? If you answered yes you may be a good candidate so far! (If no, read the last paragraph)
- Do you have any history of serious eye disease: glaucoma, diabetic retinopathy, retina surgery? Yes, you are probably not a good candidate. (Read the last paragraph).
- Have you ever worn contact lenses? If yes, you will need to be out of your contact lenses for 2 weeks for soft lenses, and a minimum of 3 weeks for hard contacts plus additional weeks for each decade you have worn contacts, before you come in for a dilated evaluation appointment. You could come in for an initial evaluation to meet your surgeon and receive motivation to stay out of your lenses.
- Females: Are you pregnant? Yes, you are probably not a good candidate until nursing has stopped. Your vision may change during your pregnancy and the calculations for surgery will not be accurate for the long-term. It is far better to wait.
NOT A GOOD CANDIDATE? iLASIK and PRK are designed with a healthy eye in mind. This surgery will not improve poor vision in unhealthy eyes and could potentially make your present condition worse. It may help you to discuss with your eye doctor further to uncover reasons why iLASIK or PRK may not be for you. If you are unsure, you are welcome to come for a free LASIK evaluation.
After talking with a staff member, we will ask that you come for a free but comprehensive eye exam and plan to be here a minimum of 2 hours. During this time, our doctors will look for reasons why we should not advance toward LASIK. All surgeries contain risks and benefits. During this evaluation time, we will weigh risks and benefits in light of each patient’s situation. Realistic expectations are part of our discussion.
LASIK is a procedure designed to correct nearsightedness, farsightedness and astigmatism of patients who are over the age of 21, and have had stable vision for over a year. It will not correct presbyopia (the need for reading glasses), but there are other refractive options that can address this situation.
We hope these comments are helpful. For more information, please call 360.435.8595 Ext 1 or schedule a complimentary evaluation to see if any of the refractive surgery options are helpful for you and your vision needs.
Our Surgeons are always on the lookout for additional diagnostic equipment that will contribute to an individualized treatment plan for refractive surgery patients. The iTrace is especially helpful when patients with previous RK surgery are ready to seek cataract surgery with lifestyle lenses. The iTrace offers a better picture and helps open the conversation between surgeon and patient to achieve realistic expectations based on specific multifaceted data. This article may better describe the benefits of pre-surgical refractive diagnostic testing at The Harman Eye Clinic.
What is an iTrace exam?
The iTrace exam is a very quick reading taken with an imaging device. The iTrace’s breakthrough technology quickly provides technical information about your vision that is not available through other tests performed during a typical eye exam.
Our staff position you at the instrument and quickly acquires the data. It is painless, non-invasive and does not require your eyes to be dilated. Your doctor uses this unique information about your eyes to make clinical decisions.
How is the iTrace different?
The iTrace uses “Star Wars” technology that was first developed for space and military applications. The iTrace measures the eye differently than any other test available and gives information to your doctor that no other tests can. Your iTrace Exam can help your doctor better answer many questions you might have about your eyes, including:
- Am I a LASIK candidate?
- Do I suffer from Dysfunctional Lens Syndrome?
- Am I a candidate for a Premium Lifestyle Lens Implant?
- If I had RK in the past, can I still choose a Lifestyle Lens Implant with cataract surgery?
- Is my astigmatism correctable?
- Why can’t I see well at night?
- Why am I having vision problems even after cataract surgery?
- Is there anything that can be done to improve my vision?
How will your surgeon use the information from your iTrace Exam?
The iTrace analysis can be used for solving many vision problems. For example, if you are interested in refractive surgery or LASIK, your surgeon can determine if you are a good candidate. If you are in your 40s or 50s and not seeing as clearly as you did when you were younger, your doctor can know which vision component of your eye is causing the change. If you have a cataract, your doctor will use the iTrace information to help select the best intra-ocular lens (IOL) for your eye and to plan surgery. If you are having night vision difficulty, your doctor can analyze how your eyes see in light and dark conditions and possibly prescribe a different pair of glasses for nighttime. The iTrace gives your surgeon information that has not been available through other tests, and this will allow him to customize his treatment options to give you the best possible vision.
The iTrace measures quality of vision and visual function using a fundamental thin beam principle of optical ray tracing, a first in eye care diagnostics. The iTrace sequentially projects 256 near-infrared laser beams into the eye to measure forward aberrations, processing data point-by-point. This 5-in-1 system provides auto-refraction, corneal topography, ray tracing aberrometry, pupillometry and auto-keratometry. Our Surgeons compare these measurements with the more traditional measurements taken during your exam. What does this means for you? A higher chance of best vision after your surgical procedure or, even more important, saving you from having a surgery that cannot meet your vision expectations.
Challenges That Occur With Patient’s Time Versus Patient Care In a Specialized Medical Eye Surgery Clinic
When you come to our Clinic, you will meet a group of heart-centered team members with your eye surgeon They are trained to perform in the most efficient way to value your time.
There are numerous, behind-the-scene, staff members who are also relentless in keeping our standards high with checks and balances. From maintaining all of the specialized equipment, the secure network computer systems, the auditing of ICD-10 coding on your claim, sending and following up on claims sent to your insurance companies, the auditing of chart notes, education of possible surgical events, reminding patients of their appointments, tracking down patients with serious, sight-threatening eye diseases like glaucoma for timely follow-up appointments, maintaining your patient portal, responding to an average of 200 calls per day, and so much more. A staff of 25+ full and part-time people are diligently working together in our surgery center and clinic to make each patient’s visit meaningful, safe and enjoyable. All of this is taking place while you are sitting in the comfort of your chair in one of our lanes.
We support our medical doctors/eye surgeons who specialize in ophthalmology. Our comprehensive eye examinations and surgery consultation appointments will take from 1-1/2 to 2 hours. Patients sometimes find this time assessment unrealistic. Our doctors have invested in advanced technical equipment to make an effective, safe and appropriate diagnostic/treatment plan designed for your specific medical needs. To those new to ophthalmology, it may seem like an hour is enough for testing and meeting with your doctor. Your past experience of quick exams were from a time when medicine was less complicated leaving your opportunities for best corrected vision limited. It was a time when when government documentation regulations were less. Today, we are challenged by new strains of bacteria and viruses, we are challenged to be sure all medicines (yes even eye drops) interact well with each other, we have surgical options for your vision that we did not have before and we need to educate you on your options. We want to give you the best and the best takes time.
Insisting that an eye exam takes about an hour, you may feel you are ignored when you have not seen your doctor within that hour, or complain that we have over-booked appointments. A specialized ophthalmology medical facility deals with daily emergent and urgent work-ins and patients who require unexpected care while here. Even though there are several other patients working through doctor-ordered diagnostic tests, when it comes to your care we focus on you as the only patient of the day. You have all of our staff working to make this a reality. We love what we do and it shows!
From time to time people interested in an annual vision check, (getting a new prescription and a pair of glasses or contacts), with time restraints, would be better served to schedule with area optometrists who will refer you to an ophthalmology specialist if they were to see the need.
Our mission statement is this: We are an advanced eye surgery center where all people are treated with extraordinary care: Patient, Doctor and Co-Team Members. We hope these comments are helpful when you consider your time. Please let us know how we can make you more comfortable today.
The Harman Eye Clinic has been in existence for 32 years. We must remain vital, and not become complacent. We want to consistently redefine your needs. The Harman Eye Clinic has invested in new electronic medical records. We have chosen Modernizing Medicine and its EMA, Electronic Medical Assistant with the ability to utilize iPads during office visits. And, you can now view your entire medical chart from the comfort of your home through a secured Internet Patient Portal that is truly useful and secure. There is no more need to request and wait for medical records. Your chart is within your reach 24-hours a day. So are your glasses prescriptions, and much more.
When you call for an appointment you can receive a login and temporary password in order to enter your medicines, a past medical history, past surgeries, family medical history, and can even securely email a request or concern to our office. This can certainly help cut down the time spent with your technician. You and staff truly have a medical assistant who can be a great liaison between you and your doctor.
Excellence is never an accident. It is achieved by insisting on the highest standards of performance. These words have been with us over the years. When a company insists on excellence, a few staff will wish to retire from this fast-paced career. Others are inspired to ever refine our service. Toward the end of year, several staff members left to become homemakers or to take jobs that were less demanding. We have recruited and are currently training a very energetic, wide eyed, top-of-the-line group who will soon be ready to work at full speed.
In the meantime we appreciate your patience as you participate in reminding them and all of us of the great responsibility we have to patient safety, patient comfort and extraordinary care. Thank you for being with us in the past, in these special present moments, and in the future. We love what we do, and we thank you for allowing us to continue in providing extraordinary service. Growing pains? Reaching for excellence? You decide.
Bruce J Ballon, MD, Bruce E Wietharn, MD, Natalia V Bajenova, and Barbara C Aliaga
When you struggle with vision difficulties, such as experiencing uneasiness with driving at night, it’s helpful to research the latest in technologies. We hope this booklet will help prepare you for a visit with your doctor.
Just tap here to download your free copy. If you feel it has helped you, feel free to share with your family and friends.
We are recruiting professional people who will train as ophthalmic assistants. These assistants complete diagnostic testing, gather medical history and review medical systems to help our doctors assess and recommend treatment plans in a timely manner.
The Harman Eye Clinic is specialized medicine. Those who are employed here are offered specialized training that exceeds what is taught in medical assistants courses. These trainees will study the anatomy and physiology of the eye, EHR and Practice Management Programs, diagnostic equipment. They will learn how to educate patients regarding vision defects, iLASIK, lifestyle lens implants for cataract surgery, Dropless cataract surgery. A home-study course will be provided each trainee in anticipation of sitting for JCAHPO Ophthalmic Assistant Certification.
Within the next couple of weeks, a few eligible candidates will be chosen to enroll in this home-study and work-study training. For more information, visit our Careers website.
Noelle recently had LASIK with Dr. Ballon. Watch a short interview about her experience here:
Life in 2015 is amazing with daily delights making our lives more productive and fun! Along these lines, The Harman Eye Clinic has unveiled our new website, www.20Better.com.
With the common use of iPhones, iPads, Smart Phones, Smart Pads, Laptops, computer tv and, oh yes, standalone computers, it’s time to offer a site that will translate sizes to all computer devices. We first learned about responsive site programming from wordpress.com where we house this blog, HarmanEyeClinic.com. The layout and content magically adjusts to any device used.
Glacial Multimedia and WordPress.org have completely overhauled our old site and we think you will love the ease of communication between you and our doctors. Let us know what you think.
Thank you for your continued confidence and willingness to let us participate in your eye care. We love what we