ophthalmology

Cataract Surgery Day – A Journal III

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.

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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.

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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!

Tap here to read A Journal IV

Imagine iLASIK working for you.

The Harman Eye Clinic, in Arlington, Washington, invites you to stop in for a free, brief screening and meet-up with one of our surgeons.  There is no pressure or obligation to have surgery.  We are here to help you decide what type of vision lifestyle is best for you and whether you want to research further.  No one is the same and we do not expect to treat you like everyone else.

When you are ready either stop in (903 Medical Center Drive, Arlington WA) or call us at 360-474-2561 or 800-755-3937 and ask for a free screening.  Make the most of your lifetime!

What is an extended depth of focus lens? TECNIS SYMFONY®

 

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.

In 2016 the Food and Drug Administration approved two new types of intraocular lenses for use in cataract surgery—the and TECNIS SYMFONY® toric lens implants.

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.

Symfony Lens Implant with Cataract Surgery

Our patients appreciate that we are leaders in cataract surgery technology.  With the recent FDA approval, the Symfony lifestyle lens implant provides an extended depth-of-focus at near, distance and intermediate.  Our surgeons are pleased to experience these wonderful results!   Gerald Balamucki shares his impression just one day after surgery.  Today he demonstrated the ability to read in the distance, intermediate and up close without glasses in the newly implanted eye.

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

Excellence is never an accident and often takes time.

Cataract Surgery1Challenges 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

http://www.20Better.com

 

Training Course for Ophthalmic Assistants Offered

Transform Your Thinking

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.

This Thank You Note Warms All Of Our Staff

It may seem self-serving to occasionally share Thank You Notes on-line. When care is completed, it is most satisfying to our doctors and staff to find we have accomplished extraordinary care.  As we say, excellence is never an accident.  This current note tells us we are still successful in our mission.

Thank you, Dr. Bruce Weitharn!

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