astigmatism

5 ways iLASIK can change your life.

Gold Standard iLASIKJessica White is a Senior Technician at The Harman Eye Clinic.  Her observations may help you decide whether iLASIK is something that can benefit you.  

Here’s Jessica:

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.

1. Recreation

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.

2. Travel

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.

3. Career

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.

4. Family

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.

5. Confidence

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 Harman Eye Clinic

903 Medical Center Drive, Arlington WA 98223

360-474-2561  360-435-8595  FAX 360-435-5233

http://www.20Better.com

iLASIK Booklet Helps Patients Navigate Through Refractive Eye Surgery

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.

LASIK 2014 Winter Magazine

LASIK 2014 Winter Magazine

Weighing The Risks and Benefits of LASIK

 

Weighing the Risks and Benefits of LASIKRecently, 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.

The Harman Eye Clinic

903 Medical Center Drive, Arlington WA 98223

360-474-2561  360-435-8595  FAX 360-435-5233

http://www.20Better.com

Advanced Technology Lifestyle Lenses

Advanced Technology Life Style Lenses

This link leads to a presentation, a way to think about the choices in lens implants when having cataract surgery.  We hope it is helpful for you also.  The presentation is interactive in that you may advance forward, backward or even zoom into whatever interests you.  Press play and the presentation will automatically advance … your choice.  Thanks, Prezi.com!

Advanced Technology Lifestyle Lenses

 

 

For more information, Quality Life Depends on Maintaining Good Vision

6 Diopters of Astigmatism Corrected By Lens Implant

Patients who have an astigmatism and are candidates for cataract surgery can request a Toric Lens Implant to help improve their vision. A Toric IOL can treat both the cataract and astigmatism in one surgical outpatient procedure.

Previously, surgeons tried to change the shape of the cornea through an incision during cataract surgery. Now with the creation of the Toric IOL, vision can be improved or repaired without the need for more surgery. The Toric IOL helps to refocus vision, and is designed with the same technology as contact lenses.

Here, Dr. Bajenova completes a postoperative visit with her patient before she returns to Alaska.  She had six diopters of astigmatism before surgery.

For more information, read an article about astigmatism, visit our website or call us at 800.755.3937.

Astigmatism

Correcting Astigmatism with Cataract Surgery

Astigmatism:  What is it?  How can it be corrected?

Most of us have probably been told we have some degree of astigmatism.  Symptoms can include blurred vision and monocular double vision, but what exactly is astigmatism?

The term astigmatism is used to describe a cornea that is not round. It is shaped more like a football instead of a basketball.  Like a football, the astigmatic cornea has two curves: a steeper one and a flatter one 90 degrees away. These two curves bend light entering the eye, causing two images to form in the back of the eye on the retina.

As a comparison:

  • A person with standard myopia or hyperopia (farsightedness) may see a dot as a blurred circle;
  • A person with astigmatism may see the same dot as a blurred oval or a frankfurter-shaped blur. The variation depends on the how much astigmatism is present.

What are the treatments for astigmatism for patients with cataracts?

Our doctors will determine if a visually significant cataract is present. Astigmatism will be corrected with the cataract surgery, if the astigmatism is in the lens.

However, if the astigmatism is in the cornea, the astigmatism remains when the cloudy opaque  lens is removed.  If good, uncorrected vision is desired, the astigmatism needs to be addressed in addition to the standard lens implant surgery.

How can Astigmatism be corrected?

Astigmatism can be corrected with eyeglasses, toric (astigmatic) soft contact lenses and gas permeable (rigid) contact lenses.  Surgically, astigmatism can be corrected with laser vision correction (99% accurate), or for small amounts (less than 1.5 diopters) of astigmatism, Limbal Relaxing Incisions LRI (80% accurate), and Toric Intraocular Lenses in conjunction with cataract surgery  (95% accurate).

Several intraocular lenses are approved by the FDA for the surgical correction of astigmatism during cataract surgery.  The most commonly recommended are:

Typically, a patient’s eye is marked while sitting upright as the eye may rotate (cyclotorsion) when they lay supine for surgery.   Surgery is painless and takes about 15 to 20 minutes.  If the lens rotates more than 5 degrees it may be necessary to return to the operating room weeks later to rotate the lens to the desired axis.

If no cataract is present, LASER vision correction is an excellent modality to treat astigmatism.

Special Cases:

The usual type of astigmatism is symmetric regular astigmatism.  In case of asymmetric or irregular astigmatism other treatments are necessary.

Keratoconus is a progressive non-inflammatory (usually) bilateral thinning of the cornea associated with asymmetric or irregular astigmatism.

It typically is a contraindication for LASIK as well as any of the advanced technology lenses used in cataract surgery such as Crystalalens AO, Tecnis Multifocal or ReSTOR lenses which treat presbyopia (inability to read up close after age 40).

Sometimes keratoconus can be treated with a toric intraocular lens (Off-label) if the astigmatism is stable and the patient is not expected to ever wear gas permeable contact lenses.  Collagen cross linking is a new treatment worldwide for keratoconus, but it is not yet approved by the FDA.  It uses ultraviolet light to cure or harden the cornea after it has been pre-treated with riboflavin.

Pterygium is an abnormal growth from the conjunctiva (white part of the eye) onto the cornea (clear windshield-like dome in the front of the eye).  It can cause asymmetric astigmatism and can be cured surgically.  Small pterygia may be safely observed, whereas larger pterygia are best cured by surgical excision, typically with a conjunctival auto-graft secured with tissue glue (Tisseel) instead of stitches.

Tags: astigmatism, LASIK, PRK, cataract surgery, pterygium

 

LASIK: Nearsighted? Farsighted? Astigmatism?

The first step to understanding what LASIK can do for you is to understand vision disorders.  Eyes are amazing. There are mechanical, biological, anatomical aspects of vision. And, we continue to appreciate how specifically different we each interpret what we see. It is true there are people who have surgery and see explicitly clear by the end of their surgery day, yet we know that patients realize their new surgical vision each within their own time frame.  Much depends on overall health of body and emotions. With this knowledge, the Surgeons and Staff act as “training wheels” during the early postoperative days, and are available until support is no longer needed. It is our honor to work with patients at The Harman Eye Clinic.

To review the differences in vision disorders read more.  Be sure to take advantage of the graphic videos that will help demonstrate each vision condition.