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.

Artist Robert Ruth to Display His Work at The Harman Eye Clinic

Robert Ruth

Robert Ruth

This September and October we are excited to welcome back artist Robert Ruth.

Robert Ruth’s pen and ink drawings are primarily a style called pointillism.  Combining this style with a few delicate lines, Robert renders his subjects with precision and loving care.

Once an original is completed, Robert creates black and white limited edition prints on 100% rag, neutral PH balanced paper.  The quality of this stock is meant to give a lifetime of viewing enjoyment with no worries of the life expectancy of the  print.

To make a black and white print come alive with color, Robert then hand colors it with watercolor.  The print then becomes a unique piece of art, an “ORIGINAL PRINT” that is signed and numbered – a valuable addition to any art collection.

Family and friends are welcome from Monday through Friday, 8 a.m. to 4:30 p.m. at the entrance to The Harman Eye Clinic.


For more information, please visit

What’s the latest in testing for dry eye?

Red, stinging, irritated eyes are often endured rather than treated.  It’s hard to realize that the condition of your tear film directly affects the clarity of your vision.

When you decide to have LASIK, PRK, or  a mutlifocal lens implant,  your Dry Eye Condition can get in the way of achieving the wonderful, clear outcome you desire.

If you wish to learn more about our TearLab read on.  Choosing  LASIK this year is a life-changing decision.  Taking care of your dry eye disease beforehand can be one of the most important things you do for yourself to assure the visual outcome you desire.  Let us know how we can help!


Congratulations Inna!

Congratulations!  Approved  by JCAPHO as an certified ophthalmic assistant.

Congratulations! Approved by JCAPHO as an certified ophthalmic assistant.

Whenever we interview potential candidates as ophthalmic assistants, we place as much importance on the ability to relate to our patients as if each patient were their family members as we do to their technical skills.  We call it extraordinary care.  We say, “champion the patient and never go wrong.”   We say, “every patient, every time.”  And when we find people who understand our culture, we snatch them up and train them in the fine art of ophthalmic assisting.  Such was the case with Inna.

Our technician supervisor, under the direction of our doctors, is responsible for training the skills needed to become a technician.  However, the candidate will spend time in every department: billing and medical coding, infection control, surgery center, patient coordination, and with the compliance officer, to establish a firm foundation for a most rewarding future for both the candidate and our patients.  Our technician supervisor, permits the candidate to perform a portion of our patient’s exam only when they have been “signed-off” by the supervisor as proficient.

There’s more.  Our practice enrolls the candidate into Ophthalmic Medical Assisting: An Independent Study Course  This course is published by the American Academy of Ophthalmology (AAO). Enhancements in this revision include two new chapters: Refractive Surgery Concepts & Procedures, and Understanding Practice Management; revised chapters and glossary incorporating new evidence-based information and groundbreaking technologies; and 37 procedures explained in detail. The 368-page textbook is in full color, and the examination booklet contains 200 multiple-choice questions.

The candidate receives assistance from the doctors and staff, but the hands-on exposure creates invaluable training towards success.  Candidates are expected to study, ask questions, share and most of all, listen to our patient needs and, most important, act as liaisons to our doctors.

JCAHPO Certification is earned through testing.  An ophthalmic assistant must have graduated from high school or equivalent; successfully completed an approved independent study course (e.g., JCAHPO Independent Study Course (JCAT) or the American Academy of Ophthalmology Independent Study Course) within the 36 months prior to submitting an exam application. and been employed at least 1,000 hours (six months full-time equivalent) under ophthalmologic supervision within 12 months prior to submitting your application.

THIS LONG INTRODUCTION is to give you a little history about how much goes on before a technician receives his or her certification.  Like those who have gone before them, we salute and hold in high esteem our newest JCAHPO Certified Ophthalmic Assistant!  Your updated name tag is on the way with well-earned initials, C.O.A. after your name!

Congratulations and continued success!

IntraLase method, a 100% blade-free approach.

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Topic: What is the IntraLase Method?  The IntraLase Method is a 100% blade-free approach to creating the corneal flap, the thin layer of tissue that the surgeon folds back in order to perform your LASIK procedure. The IntraLase Method can only be performed using the IntraLase FS Laser. Millions of procedures have been performed safely and effectively using the IntraLase Method.

Topic: How is the IntraLase Method different from other methods of creating a corneal flap?  The IntraLase Method is the most advanced technology available—and the first blade-free way to create a corneal flap.

Prior to the IntraLase Method, doctors relied on an instrument called a microkeratome for the creation of corneal flaps. The microkeratome is a hand-held steel blade that creates a cut as it travels across the cornea. While LASIK complications are rare, when they do occur they are primarily related to the use of the microkeratome. With the IntraLase Method, a blade never touches your eye.

Topic: How does the IntraLase Method work? How does it create a corneal flap without making a cut?  Instead of using a blade, the IntraLase Method uses tiny, rapid pulses of laser light to create your corneal flap.

Each pulse of light passes harmlessly through your cornea and forms a microscopic bubble at a specific depth and position within your eye that is determined by the doctor. The IntraLase laser moves back and forth across your eye, creating a uniform layer of bubbles just beneath your corneal surface.

Just prior to LASIK surgery, the doctor creates your corneal flap by gently separating the tissue where these bubbles have formed. The corneal flap is then folded back so the doctor can perform your LASIK treatment.

Topic: What is the difference between a corneal flap created with the IntraLase Method and one created with a microkeratome?  The IntraLase Method is 100% blade-free, exceptionally advanced, and has been shown to improve outcomes for more patients.1 And patients report better quality of vision overall, particularly in terms their ability to see well in low light such as at dusk or at night.2

The reason for this lies in the way the IntraLase Method works.

A microkeratome is only capable of making a single, one-dimensional cut across the cornea. As it cuts, the blade creates “drag,” which can leave a rough surface after the flap is lifted. This can affect the quality of your postoperative vision.

Because of the unique way in which the IntraLase Method creates a precisely positioned layer of bubbles just beneath the surface of your eye, it creates a smooth surface after your flap is lifted. This may translate to better vision.

Topic: Is the IntraLase Method better for the eye?  Unlike the one-dimensional cut made by a blade, the IntraLase Method gives your doctor the ability to tailor the dimensions of your corneal flap based on what’s best for your eye. Everything from the circumference of your flap to the angle of its edges can be precisely determined. This is important because everyone’s eyes are shaped a little differently. Having a corneal flap that’s individualized to the patient contributes to excellent postoperative vision. A corneal flap created with the IntraLase Method also “locks” back into position after the LASIK procedure is performed and rapidly begins to heal.

Topic: Is the IntraLase Method proven, or is it still being tested out? IntraLase technology has been in existence since 2001. To date, it has been used in over millions of LASIK procedures around the world.

Topic: How long does it take to create a flap using the IntraLase Method? The creation of the flap itself takes only 15 to 20 seconds per eye.  Including preparation time, it takes about 10 minutes total.

Topic: Is it painful?  Prior to creating the flap, the doctor applies drops to numb the eye, then applies a special ring and an instrument that gently flattens your cornea in preparation for the IntraLase Method. This part of the process takes about 10 minutes and is not painful—patients report feeling only slight pressure.

Topic: What’s the reaction of patients who have experienced the IntraLase Method?  In a clinical survey, the vision in the IntraLase-treated eye was preferred by LASIK patients 3-to-1 over the vision in the microkeratome-treated eye (among those who stated a preference).3

REFERENCES: 1. Tanzer DJ, Schallhorn SC, Brown MC, et al. Data on file, IntraLase Corp. 2005. 2. Durrie D. Data on file, IntraLase Corp. 2005. 3. Durrie DS. Randomized prospective clinical study of LASIK: IntraLase versus mechanical keratome. Subsets presented at: Meeting of the International Society of Refractive Surgery of the American Academy of Ophthalmology; November 14-15, 2003; Anaheim, Calif; American Society of Cataract and Refractive Surgery Symposium; May 1-5, 2004; San Diego, Calif; Refractive Surgery 2004: International Refractive Surgery: Science and Practice; October 22-23, 2004; New Orleans, La; American Society of Cataract and Refractive Surgery Symposium, April 15-20, 2005; Washington, DC.

©2009 Abbott Medical Optics Inc. INTRALASE AND FOR A BLADE-FREE LASIK EXPERIENCE are trademarks owned by or licensed to Abbott Laboratories, its subsidiaries or affiliates. Mkt Doc 373 Rev. C

Is Cataract Surgery Considered Successful If You Have To Wear Glasses Afterwards

A 70-year-old friend recently asked me why I thought her friend needed glasses after cataract surgery.  She asked me, did something go wrong?  This is a great question and one that will be the subject of this day’s blog.

First of all, let’s review what the term ‘cataract’ means.  From my desktop dictionary:  cataract |ˈkatəˌrakt|noun1 a large waterfall.• a sudden rush of water; a downpour: the rain enveloped us in a deafening cataract.   2 a medical condition in which the lens of the eye becomes progressively opaque, resulting in blurred vision: she had cataracts in both eyes. ORIGIN late Middle English: from Latincataracta ‘waterfall, floodgate,’ also‘portcullis’ (medical sense 2 probably being a figurative use of this), from Greek kataraktēs‘down-rushing,’ from katarassein, from kata-‘down’ + arassein ‘strike, smash.’

So where is the lens?  There’s solid description on our website, along with videos that will show you where the lens sits in the eye.  Once the opaque lens is removed by your surgeon, there is now opportunity to replace it with a variety of lenses.  Before cataract surgery, an intraocular lens implant measurement is made to determine  the lens power.  This measurement will incorporate your glasses prescription.  Now to answer your question.

1) A standard lens is designed to give you vision at one focal point.  Most patients who choose a standard lens will have great vision for distance, but will require glasses for reading up close or even on a computer.

Monovision. A few patients ask their surgeon to choose a standard lens correction set in one eye for reading and the other for distance.  This is called “mono-vision”: One eye sees in the distance and one eye sees up close.  When both eyes work together the brain decides which eye to pay attention to.  This option is not for everyone.  So those who have used contact lenses successfully with mono vision might be a happy candidate for this option, and those who have never heard of mono-vision would probably pass on this plan.

Some patients have astigmatism, and they will require glasses after surgery to correct the astigmatism  and to be able to read up close.

2)  Toric lens implant. Some patients with astigmatism, ask their surgeon to consider implanting a toric lens implant .  This implant is designed to refocus vision so that a patient may see clearer after cataract surgery for distance.  This patient would still require reading glasses and might opt for glasses with no correction on the top of their glasses and only a correction on the bottom (reading portion).  Sometimes patients choose this because they do not like to take their glasses on and off.

3) Multifocal premium lens implant.  The happiest patients in our practice are those who opt for a multifocal lens implant.  There are several lenses available and your surgeon may match your lifestyle to the performance of each lens.  Patients expect be less dependent on any glasses, near, intermediate or far.  And, these are the people you may see spectacle-free after cataract surgery.  They have opted for a lens implant upgrade.  While most insurance companies will pay for the standard lens and will pay this portion for all patients no matter what lens is chosen, the multifocal patient will pay an additional fee for the presbyopia correcting function of the premium lens.

Cataract surgery’s purpose is to provide a clear lens.  The answer is, yes, cataract surgery is considered successful even if patients are dependent on some type of glasses after surgery.  It can be even more successful for those patients who are good candidates for multifocal premium lens implants.

Please feel free to comment with your questions.  We are a refractive cataract and iLASIK eye surgery where people are treated with extraordinary care.

Barbara Aliaga, Practice Administrator, The Harman Eye Clinic

Dr. Ballon Is Searching for Patients Who Are Highly Nearsighted for Visian ICL

Dear Friends and Neighbors

Doctor Bruce Ballon is searching for highly nearsighted patients who do not qualify for iLASIK but would like to be free from dependence on glasses or contact lenses just the same.  You can learn more about this amazing lens correction by going to

Made from Collamer, the Visian ICL (Implantable Collamer Lens) is one of the latest technological advancements in vision correction.  The Visian ICL is a long lasting solution for refractive error.  Through its myopia correction, the Visian ICL offers excellent quality of vision.  The Visian ICL and its unique Collamer composition offer numerous advantages including:

Quality of Vision – The Visian ICL produces not only improved visual acuity (20/20 vision is considered normal visual acuity), but also excellent visual quality. Many patients experience the “Wow” factor when they experience the immediate improvement in the quality of their vision.

Versatility – The Visian ICL offers a wider treatment range for myopia than LASIK and PRK procedures.

Simplicity – Unlike traditional contact lenses, once the Visian ICL is implanted in the eye, there is no additional maintenance needed.

Safety – After implantation in over 55,000 eyes worldwide, the Visian ICL has established a proven track record of safety.

Lens Placement – The placement of the Visian ICL makes the lens invisible to the patient and any observer.

Removable – The Visian ICL was designed to be permanently placed in the eye. However, the lens can be removed if a patient’s vision changes or if it otherwise needs to be removed or replaced.

Dr. Ballon was one of the first surgeons in the Pacific Northwest to perform a similar surgery using the Verisyse Phakic lens.  Pam Miller, billing specialist supervisor in our practice, was one of his first happy patients to take advantage, and that was five years ago. Dr. Ballon is pleased to bring the Visian ICL solution to our patients.  He is now searching for first patients.

If you think you are one of the first candidates (highly nearsighted) for this procedure, please call for a free, no obligation refractive evaluation.  If you are one of the first to qualify for a Visian ICL implant, you will receive an impressive discount.  Please call us at 360.435.8595.  I will be glad to personally facilitate your appointment.

Sincerely yours,

R. Lee Harman, MD, FACS, Bruce J. Ballon, MD, Bruce E. Wietharn, MD

Barbara Aliaga, Practice Administrator, THE HARMAN EYE CLINIC, 360.435.8595

Dr. Ballon is searching for patients who are highly nearsighted and wish Visian ICL