I had both my Cataract Surgeries in October last year, a short five months ago. My vision was so amazing after surgery I felt like I was on cloud nine!
But over the last 4-6 weeks, I started noticing I was needing my drugstore readers more and more often because I couldn’t focus on the smaller print again, or the light was too dim. Now I have the Symfony lenses, so super fine print and low light required the readers on occasion, but this was beginning to be an increasing necessity. I was scheduled for a dilated followup, so I waited until that visit to discuss with my surgeon.
I work here at The Harman Eye Clinic, so I knew what was happening… I had Posterior Capsular Opacity (PCO) and was going to need a YAG Laser* treatment. I’ve been here long enough to know that 20-30% of cataract patients develop significant PCO and require this treatment to clear up their vision. I also know it can be anywhere from 2 weeks to 20+ years before it’s needed! Some people refer to it as an “after cataract” because it’s something that develops after cataract surgery. It’s also referred to as a “secondary cataract” which also means after cataract. It isn’t the cataract coming back. It’s not something that went wrong with your surgery. It’s just that some people can develop a thickening of the back (posterior) of the lens capsule which holds the artificial lens in place. This thickening of the capsule causes your vision to become cloudy (opaque).
Sure enough, my exam showed that glare was back and my vision was decreased. Time to schedule the YAG appointments.
While the procedure name sounds pretty unusual, the procedure itself is fairly simple. There weren’t any restrictions… in fact it’s a lot like going for an eye exam! Vitals, drops to dilate the eye that was going to be treated, sit down in front of the laser with your chin in a chin rest, focus on a little green light for a few minutes and you’re done. The surgeon uses the laser to create a small opening in the capsule to allow what you see to get to your retina without having to pass through that opaque tissue. My surgeon explained that I might notice some floaters afterwards (which I didn’t) and to call if I had problems.
I used some artificial tears after I got home because my eye felt dry, and I was dilated for a couple of hours. I drove myself, went shopping on my way home and resumed normal activities… except I couldn’t read through that blurry eye!
Day one after surgery. I was so excited, I didn’t sleep well. Realizing how dim my vision had become without me even realizing it blew me away! Colors are so much more…colorful! I couldn’t wait to go to work and see my quilts on display. Even washing my hands, the water seemed clearer. I got in the car to drive to work and when I turned on the headlights, the windshield looked clearer!
I was told to expect halos around lights for awhile. Yep, have those. But they don’t bother me. The floaters are just on the edge of my vision and not hard to ignore. Decided to see if I could go through the day without my glasses. I read the Bible without glasses (and not a large print version, either!). I worked all day in the office.
Saw my surgeon for the one day checkup. My best corrected vision before surgery was 20/25 with a fair amount of astigmatism. Now I can see 20/20 and a negligible amount of astigmatism. No glasses. I can see to read, work on the computer and drive. It’s like “normal” vision but so much clearer! If it continues to get better in the next few weeks as my vision stabilizes, well I can’t imagine.
I’m excited about life! Did the dim vision cause a bit of depression? Well, today I tried to give a hug to everyone I work with to thank them for the part they play in helping people like me see better. What a gift and a blessing.
Surgery Day. Must admit, I’m a bit anxious. Tossed and turned all night.
No coffee or breakfast this morning. Just a couple meds with a sip of water. Brushed my teeth and rinsed my mouth out, being careful to not swallow any of that tasty toothpaste!
My co-workers learned I’m not as perky when I am caffeine deprived! But I took a couple Tylenol with my meds to keep the headache minimized and made it through to admission time.
The staff are fantastic! I don’t think I was ever alone. Super supportive, keeping me informed of what was happening along the way. There were a bunch of eye drops that got easier each batch because there was always a numbing drop first. IV, monitors placed for heart rhythm, SAT and a blood pressure cuff. You know, surgery stuff! I was a bit chilly and a hand warmer and the heated chair were perfect. Even got a bit of a massage from the chair.
Seemed like no time at all and I was fitted with O2 tubing and being escorted into the Operating Room. Normally there are 4 folks in the OR with a patient: the Surgeon, Anesthesia, Scrub Tech and Circulator. As I said, never alone.
There was a little shuffling around to get comfortable in the chair and after that I really don’t remember much! I do remember seeing a really cool pattern (like a beautiful wallpaper), some colored lights, the surgeon saying we were going to do a final test, doing that and then being told the lens was in. Then the slight sensation of the medication being placed in my eye and we’re done!
Out to the post op area with another great staff member who recorded vitals while I had a cup of coffee and a “continental breakfast.” With strong vitals and me feeling good, time to disconnect the IV and head home.
Now this dropless medicine manifests differently for everyone. For me it’s like oil on top of a bowl of water being swirled around. At first it looked like mountain ranges, later it was bubbles, and even later just a patch of black dots! I was told to go home and rest in an upright position for a couple hours so that the medicine could settle to the bottom of the eye.
Headed home, noticing my eye felt a bit scratchy as the numbing wore off. Laid down with a bunch of pillows to keep my head elevated and took a short nap, woke up feeling great. My husband and I picked up our grandson and went to Taekwondo; back to normal except no driving today.
What a great experience! From checking in to checking out, the staff are very caring, friendly and professional. Yes, I work with them every day, and from a patient perspective, I’m proud to say GREAT JOB!
Tomorrow, back to work and I’ll see the doctor for my first follow up visit and I’ll keep you posted as I continue this journey and the second surgery next week.
My biggest WOW right now it how bright white is with my new eye! The old eye looks like someone turned the dimmer switch down. This is exciting!
An extended depth of focus lens is an integral part of the Lifestyle Premium lens implant menu at The Harman Eye Clinic in Arlington WA.
“The Symfony® intraocular lens is the option of choice that I can offer my patients to improve their vision following cataract surgery, especially those who have difficulty focusing on objects at near distances because of presbyopia,” said Dr. Bajenova.
The Symfony® lens improves intermediate (and in many cases near vision), thereby treating presbyopia. The Symfony® toric lens not only corrects presbyopia, but also astigmatism.
“Many of my patients live very active lifestyles and want to see clearly at all distances, and without glasses if possible,” said Dr. Ballon. “With the Symfony® lens, I can give patients the freedom to enjoy the activities that matter to them, while wearing glasses less.”
Traditional Cataract Surgery compared to an Extended Depth of Focus lens
During cataract surgery, the natural lens of the eye is removed, and an artificial lens, called an intraocular lens, or IOL, is inserted into the eye. Many patients still believe the only IOL available to them is a traditional monofocal lens, which only allows the person to see at a distance, with closer objects being out of focus.
“We take extra time during a patient visit to explore IOL options,” said Dr. Wietharn. It takes more time with staff and myself to introduce new concepts but we think every patient should be aware before surgery, whether or not they wish to take advantage of state-of-the-art technology.”
In contrast to the traditional, standard IOL, the Symfony® lens was specifically developed with features to improve both the range and quality of vision.
The Importance of Pre-Surgical Discussions with your Surgeon
“There is nothing as good as the original equipment from the manufacturer when you are a teenager,” says Dr. Ballon. “That said, the Symfony® lens is the best addition to our lens inventory to date.”
Symfony® lens is successful because it provides a continuous range of focus for both distance and intermediate (computer) vision. Patients who continually require absolute fine detailed vision, such as accountants or those who like to read paper, small-print books in bed without glasses may appreciate a comparison discussion over Technis multifocal lens and Symfony®. These patients who have the Symfony® lens may choose over the counter reading glasses (+1.50 cheaters) for fine print. Others who require fine-print access leave behind need for reading glasses by using their computers, smart phones and pads, to do their reading in bed and fine print projects. It is important to discuss comparison options before surgery by sharing your lifestyle and vision expectations.
The Symfony® lens also offers excellent quality of vision without loss of contrast sensitivity. Some patients who may not be a candidate for the Tecnis Multifocal lens due to, say, an epiretinal membrane (wrinkle in the macula) which may decrease contrast sensitivity, for example, may still be a candidate for the Symfony® lens. Presently, it is the only lens on the market that corrects chromatic aberrations, a feature that improves reading ability. The rings are larger than the Tecnis Multifocal lens, so that halos at night are much less prominent. Patients under the age of 60 tend to tolerate the Symfony® lens much better than multifocal lenses. Although the Symfony® lens is designed for bilateral implantation, patients with a cataract in just one eye seem to tolerate the Symfony® lens well, but the full benefits of reading are best when it is implanted bilaterally.
A LifeStyle Worksheet is available for our patients so that they can prepare. Many patients come for cataract surgery consultations with little or no information about what we call LifeStyle lens implants. The Symfony® is one such lens. Much of the senior population have come to accept that glasses are a part of their life. Some will even say that they like wearing glasses. That is fine, if true. Patients who were eligible and chose to have a LifeStyle lens implant continue to tell us how grateful they are to get up in the morning, look out the window, read the time on their smart phone, and remember how good it is to see with little or no dependence on glasses.
TAKE AWAY POINTS:
- Extended depth of vision was approved by the FDA in 2016
- Symfony® and Symfony® toric lenses can extend depth of vision: far, intermediate, and near
- Symfony® and Symfony® toric lenses can offer quality of vision without loss of contrast sensitivity.
- The traditional lens implant for cataract surgery is a monofocal lens (vision for one point of vision). Reading glasses and glasses for intermediate vision is expected after surgery.
- To proceed with confidence, prepare by listing your lifestyle vision requirements and expectations before meeting your cataract surgeon.
Download our latest, comprehensive Patient’s Guide to Successful Cataract Surgery, or request an appointment for a cataract evaluation and your surgeon will be able to address your questions on an individual manner after your eyes have been examined with an overall evaluation of your health, life-style and vision potential. Call The Harman Eye Clinic in Arlington today, the first step to life without cataracts.
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.
The Harman Eye Clinic
903 Medical Center Drive, Arlington WA 98223
360-474-2561 360-435-8595 FAX 360-435-5233
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
903 Medical Center Drive, Arlington WA 98223
360-474-2561 360-435-8595 FAX 360-435-5233
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.
Jessica White, COA, is the technician supervisor at The Harman Eye Clinic. She has successfully completed the COT exam and is awaiting instructions for completing this level. Jessica took the time to share her passion for gentle service.
I began working at The Harman Eye Clinic when I was 20 years old. I had never worked in a medical practice before, and to be honest, I didn’t even know what a cataract was. I suppose I felt a little bit overwhelmed once I realized the amount of information I was expected to learn, but the emotion I remember feeling most was amazement.
I had been an avid watcher of “ER” and “Grey’s Anatomy,” and so my view of medical staff was that they barked orders at each other, gossiped, and called patients by their medical condition. Looking back on those misconceptions, it’s a wonder I even agreed to take the job!
The reality that I saw at The Harman Eye Clinic was that people respected others. I shadowed a patient through cataract surgery on my first day of work, and the patient and I both were treated with extraordinary kindness. While the patient was being cared for by the nurse, the surgery coordinators were taking care of me. They told me what to expect and where to stand. They even taught me a few key medical terms while we waited. From my first hour at The Harman Eye Clinic, my co-workers were doing everything they could to set me up for success.
Later that day, I observed exams in clinic. Again, I immediately felt welcomed by the staff and saw that patients were feeling the same way. I had never felt so much warmth in a medical office, especially from the staff!
My journey to becoming an experienced technician was a long one, but I was never alone. There were always people making themselves available to answer my questions and teach me something new.
Looking back now I see that I was very much like a patient when I began my training. I had so many fears and doubts, and there was so much information presented to me at once! It was overwhelming at times, but my co-workers worked hard to help me. Their encouragement gave me the confidence I needed to continue.
Time after time I see our staff investing in our patients like they invested in me when I first came here. They look beyond the data and see who the patient is and what they need in order to feel secure. I am so proud to be a part of this place, but that isn’t really because of the medical side of things.
Yes, what our surgeons do is incredible and I love seeing patients regain their independence by having cataract surgery or iLASIK. But, the best part is knowing that the way we treated those patients made a difference in their experience.
Too often, the mood in a medical office matches the surfaces: It is sterile. The problem with sterility is that nothing can grow in that environment. The beauty of The Harman Eye Clinic is that we are constantly growing and changing to meet our patients needs in a better fashion.
Our surgeons and staff understand that when our patients trust us with their vision, they are really trusting us with their livelihood, their quality of life, and their independence. That trust deserves a great deal of respect and care, and it needs to be on a personal level. We strive to make connections with our patients because we know that it is important to treat the person, not the condition.
Any ophthalmology practice you go to will have similar medical equipment. There will probably be front desk staff, technicians, and clinic managers. Of course, there will be doctors, too. I feel that there is a difference here at The Harman Eye Clinic and I feel patients agree…
…At The Harman Eye Clinic, we do not only have skills, we have heart!
— Jessica White, COA