Helpful Articles

LASIK co-management is an integral part of vision correction surgery that often goes unnoticed. It involves a partnership between your primary eye care professional and your LASIK surgeon. This cooperative approach ensures that you're provided with the best possible care before, during, and after your procedure.

LASIK co-management is the collaborative effort of your eye care team to ensure your vision correction procedure is safe and successful. It's a team approach where everyone plays a significant role in your eye health journey.

The Evaluation Process

The evaluation process in LASIK co-management is thorough and meticulous. It begins with a comprehensive eye examination by your primary care optometrist. This examination is meant to ascertain your eye health status and determine if you're an appropriate candidate for the LASIK procedure.

The evaluation process underscores the collaborative nature of LASIK co-management. Every step is carefully coordinated to ensure your eye health is prioritized and that you're receiving the best possible care.

The Importance of Consultation in LASIK Co-management

Consultation is a crucial aspect of LASIK co-management. It allows for patient education, addressing concerns and questions, and establishing a clear understanding of the expected outcomes.

During the consultation phase, your optometrist will explain the results of your eye examination and how it relates to your suitability for LASIK surgery. They will also discuss the risks and benefits of the procedure, giving you a balanced perspective to make an informed decision.

The consultation with your LASIK surgeon will delve into the specifics of the operation, including the technology used, the surgical process, and the anticipated recovery timeline. Having the opportunity to consult with both your optometrist and your surgeon ensures that all your concerns are addressed, allowing you to proceed with confidence.

The Role of Communication

Effective communication is the backbone of successful LASIK co-management. It facilitates a seamless transition from your optometrist to your surgeon, creating a cohesive care plan that's centered around your specific needs.

This communication is not just between healthcare providers but also involves the patient. Regular updates on your progress, detailed explanations about each stage of the process, and addressing any concerns or questions you may have are all essential parts of the communication process.

If you are one of the thousands of people considering LASIK laser eye surgery, then you will probably be gathering as much information as possible about the treatment. By this point, you are probably aware of the benefits that LASIK offers, such as a reduced or eliminated need for glasses or contact lenses and greater convenience in your day to day life. However, for many patients, despite the advantages of LASIK, the thought of surgery on their eyes is still a cause of anxiety and fear. One of the best ways to alleviate this concern is to find out more about what the procedure entails.
 

Your consultation

Before you can be approved for any form of laser vision correction, including LASIK, you will need to attend a consultation appointment with your surgeon. During the consultation, he will perform an examination of your eyes and use your medical and ocular history to determine if you are a good candidate for the procedure. He will also speak to you about the expected outcome from your surgery, making you aware that while LASIK will dramatically improve your eyesight, there is no guarantee that you will not need to wear glasses in some situations, such as while driving in the dark. 
 

How LASIK Works

LASIK uses a cool, ultraviolet beam of light to reshape the patient’s cornea. Doing so will more accurately focus the light that enters the eye on to the retina, thus improving the patient’s vision. The way in which the cornea needs to be reshaped will depend on the visual needs of the patient. For example, a patient who is far-sighted will need their cornea reshaping to be steeper to experience better eyesight. Alternatively, a patient who is near-sighted will require their cornea to be flattened in order to improve their vision. LASIK can also smooth an irregular cornea into a more standard shape, meaning that the procedure can also be used to correct astigmatism.
 

The LASIK procedure

The LASIK procedure is very fast and straightforward. Although you will probably be in the surgical suite for around half an hour, the actual process only takes a couple of minutes per eye. The rest of the time will be spent preparing and ensuring that you are comfortable. Anesthetic eye drops are given to patients before their procedure so that the entire process is pain-free. If you are particularly anxious, it may also be possible for you to be slightly sedated – this should be discussed with your doctor at your consultation appointment.

Once you are in position, we will use a femtosecond laser to cut a thin, circular flap into the outer cornea. This can then be pulled back to reveal the underlying corneal tissue, known as the stroma so that it can be reshaped using the laser. The exact path that the laser needs to take, known as the topography, will have been pre-programmed ahead of the procedure and can be followed with complete precision and accuracy.

Once the reshaping is complete, the flap is replaced back over the eye and the surgery is complete. There is no need for sutures or bandages as the cornea will start to heal immediately and without any medical intervention.
 

If you already rely on wearing glasses or contact lenses to be able to see clearly, you may be frustrated with the effect that they have on your life. Regular vision tests, finding glasses to suit your face shape, having to remember to take eyeglasses with you wherever you go, prescription sunglasses, fiddly contact lenses… the list of inconveniences associated with conventional ocular solutions is extensive. 

LASIK is a modern, minimally-invasive procedure that can substantially reduce or eliminate your need to use eyeglasses or contact lenses, allowing you to enjoy life without limitations or inconvenience. The popularity and success of LASIK laser eye surgery have helped to make it the number one elective surgery across the globe. 
 

Candidacy for LASIK

LASIK has an extremely high success rate. According to the American Society of Cataract and Refractive Surgery, 96% of patients achieve 20/20 vision or better. However, it’s high success rate doesn’t make LASIK automatically the right solution for everyone.

Candidacy for LASIK is assessed by our doctors on a case by case basis so that you be certain that whatever treatment is recommended for you, it will give you the very best opportunity to improve your vision. During your consultation, our doctors will perform a thorough examination of your eyes and vision, ask you about your general health and talk you through both the procedure and aftercare.

The general guidelines for LASIK candidacy state that patients must:

• be at least 18 years of age

• have had stable vision with no prescription changes for a minimum of 12 months

• have a current prescription for eyeglasses or contact lenses that falls between specified parameters (Our doctors will be aware of what these parameters are)

• have no significant medical or eye-related problems such as glaucoma, macular degeneration or diabetic retinopathy

• have no history of corneal disease

• not be pregnant or nursing at the time of the procedure

If you thought that just laser eye surgery was impressive, then be prepared to be astounded by the arrival of iDesign custom Lasik. iDesign is the most advanced wavefront-guided laser treatment available. The system creates a uniquely accurate measurement of the entire optical system that can be relied upon completely without any guesswork. This is then used to create a highly detailed topography or map of your eye, making it easier for your surgeon to pinpoint the areas that need addressing with pinpoint precision. 
 

How accurate is iDesign?

iDesign is extremely accurate due to its diagnostic equipment that is able to determine 1,257 different micro eye prescriptions. Each one of these will measure the eye prescription to 0.01 of a dioptre strength – 25 times more than what a regular prescription for glasses or contact lens prescription is measured to. 
 

Who is iDesign suitable for?

While iDesign Custom Lasik can benefit almost any patient with refractive problems, it is particularly beneficial for people who have unusual corneas or have had eye surgery in the past. 
 

Is it painful?

Laser eye surgery is generally considered a pain-free procedure by the majority of patients. Anesthetic eye-drops are used to numb the outer area of the eye during the course of the surgery. Once these have worn off, some patients do experience some mild discomfort during the days following the procedure, but over the counter pain relief is usually sufficient to relieve this.
 

Astigmatism is a relatively common eye disorder that causes the vision to be blurred or distorted. It occurs when the lens part of the eye, known as the cornea, isn’t perfectly curved and instead resembles a football rather than a soccer ball. This means that the light entering the eye comes through at a distorted angle, making the object appear blurry and out of focus. There are several ways in which it is possible to treat astigmatism, including laser eye surgery and corrective lenses. However, another possibility is a solution referred to as limbal relaxing incisions.
 

What are limbal relaxing incisions?

Limbal relaxing incisions are microscopic cuts to an area in the eye known as the limbus. This helps to relax the curve in the cornea and improve its ability to focus light correctly. It can significantly improve your astigmatism and the overall quality of your vision.
 

Am I a good candidate for limbal relaxing incisions?

If you have astigmatism, are over 18, in good general health and have no major eye conditions, then chances are you are a good candidate for limbal relaxing incisions. Make an appointment with your eye doctor to discuss your candidacy further.

A refraction test, also called a vision test, is usually performed as a part of a routine eye examination. The purpose of this test is to determine if a person has a refractive error which would then mean the patient would need glasses or contact lenses.
 

What Is The Normal Value for Refraction Test?

A value of 20/20 is normal (optimum) vision. This means that individuals who have 20/20 vision are able to read letters that are 3/8-inch (1 centimeter) tall from 20 feet (6 meters) away. The normal uncorrected vision (without glasses or contact lenses) refractive error is zero (plano). Individuals who don’t have 20/20 vision, have what is called a refractive error. A refractive error means that the light is not bending properly when it passes through the lens of the eye. The refraction test will tell the doctor what prescription lens should be used in order to have 20/20 vision.

For people over age 40 who have normal distance vision but difficulty with near vision, a refraction test with a small type size is used to determine normal near vision and the correct power of reading glasses.
 

How Is The Refraction Test Performed?

The test is performed by having the patient seated in a chair that has a special device (called a phoropter or refractor) attached to it. The patient looks through the device and focuses on an eye chart 20 feet (6 meters) away. The device contains lenses of different strengths that can be moved into the patient’s view. The test is performed one eye at a time. If the patient is wearing contact lenses, they should be removed before the test.

In case the final vision is less than 20/20 even with lenses, then there is probably another non-optical problem with the eye. The vision level achieved during the refraction test is called the best-corrected visual acuity (BCVA).
 

What Are The Causes of Abnormal Refraction Test Results?

• Abnormal results may be due to:

• Astigmatism (abnormally curved cornea causing blurred vision)

• Hyperopia (farsightedness)

• Myopia (nearsightedness)

• Presbyopia (inability to focus on near objects that develop with age)
   

Other conditions under which the test may be performed:

• Corneal ulcers and infections

• Loss of sharp vision due to macular degeneration

• Retinal detachment (separation of the light-sensitive membrane (retina) in the back of the eye from its supporting layers)

• Retinal vessel occlusion (blockage in a small artery that carries blood to the retina)

• Retinitis pigmentosa (an inherited disorder of the retina)
   

There is an art to refraction and the optometrist will always answer the patient’s questions and as well as discuss their findings. Based on the results of the refraction test, they can determine the amount of myopia, hyperopia or astigmatism.
 

The parts of a comprehensive eye examination vary according to the patient's age, date of last exam, and other factors. Not all parts of the eye exam may be needed or performed, but the first part of the eye exam will include documenting medical history. Here are some eye and vision tests that are likely to be encountered during a comprehensive eye exam:
 

Visual Acuity Tests

Visual acuity tests measure the sharpness of vision and are usually performed using a projected eye chart to measure the distance visual acuity and a hand-held small acuity chart to measure the near vision (for reading).
 

Color Blindness Test

A screening test that checks the color vision is often performed early in a comprehensive eye exam to rule out color blindness.
 

Cover test to check eye alignment.

A test used to assess strabismus or a more subtle binocular vision problem that could cause eye strain or amblyopia (lazy eye).
 

Ocular Motility (Eye Movements) Testing

Ocular motility testing is performed to determine how well eyes can follow a moving object and/or quickly move between and accurately fixate on two separate targets.
 

Stereopsis (Depth Perception) Test

This is used to test perception of depth and 3-dimensional structure obtained on the basis of visual information deriving from two eyes by individuals with normally developed binocular vision.
 

Retinoscopy

This test is used to estimate which lens powers will best correct distance vision. Based on the way the light reflects from the eye, the doctor is able to obtain an approximation of the eyeglass prescription. This test is useful for children and patients who are unable to accurately answer the doctor's questions.
 

Manual refraction with a phoropter.

This is the test used to determine the exact eyeglass prescription.

Macular degeneration, commonly referred to as age-related macular degeneration (AMD), is the single largest cause of sight loss in the developed world and affects more than 10 million Americans. It usually affects people over the age of 60, but has been known to affect those who are younger. It is a painless condition that usually affects both eyes with the loss being experienced in the central vision. It does not affect the peripheral vision, meaning that it does not cause total blindness.
 

What is the macula?

The macula is the most sensitive part of the retina and is responsible for our central vision and what allows us to see fine details with clarity.
 

Varieties of AMD

Wet AMD

Wet AMD is one variety of the condition in which abnormal blood vessels grow into the macula, leaking blood or fluid which then causes scarring and a rapid loss of central vision. Wet AMD can develop suddenly and rapid referral to a specialist is essential as it can be treated if caught quickly.
 

Dry AMD

Dry AMD is the most common variety of age-related macular degeneration and is a gradual deterioration of the retina as the cells die off over time and are not regenerated. Up to 15% of people with dry AMD go on to develop wet AMD, and so any sudden changes in your vision should be followed up with your optometrist as soon as possible.
 

When you were a kid, did you experience your eyes become reddish and all of a sudden, someone close to you was also suffering from it? Your eyes, as well as those who contracted it, got itchy and swollen, right? Then it must have been that you were suffering from pink eye.

Pink eye is well known as conjunctivitis and it is the infection or inflammation of the conjunctiva or the transparent membrane that serves as a covering for the white part of the eye called the sclera that lines the eyelid. In addition to inflammation, there is usually tearing in the eyes that emits a sticky discharge which develops into a crust while one is sleeping, making it difficult for the patient to open their eyes in the morning.

One thing about the pink eye, which could affect one or both eyes, is that it is highly contagious. While it is more common in children, adults can also be victims of this eye condition. Here are the 3 major causes of pink eye:
 

Bacteria

Streptococci and staphylococci are bacteria types that are most responsible for pink eye. However, chlamydia and gonococci can also cause pink eye. It is accompanied by serious eye pain, itching, swelling, redness, and discharge. The spread of bacterial pink eye is usually as a result of using personal items of infected parties, such as makeup or makeup tools that have been infected with bacteria or putting dirty hands in the eyes. If not treated, it can last for more than 10 days, but if treated, it should resolve in less than 3 days.
 

Allergies

Pink eye caused by allergies is followed by serious itching and tearing of the eyes. Pain is minimal, but it typically comes with quite a bit of discomfort. Most of the time, pink eye is accompanied by sneezing or coughing. Allergens that trigger pink eyes include grass, dust, pollen, mold, and ragweed. Allergy based pink eye is not usually contagious.
 

Viruses

Viruses such as the adenoviruses and herpes virus are the most common causes of pink eye. When a virus is the cause, there is usually a lot of teary discharge accompanied by nasal congestion, puffy eyelids, runny nose, and sharp pain. It is usually contracted from cough and sneeze droplets from an infected individual. It can take as long as 2 weeks to treat depending on the seriousness of the infection.

General Symptoms of Pink Eye:

• Itchy eyes

• Redness of the sclera

• Pain

• Watery discharge

• Swollen eyelids

• Hazy or blurry vision

• Oversensitivity to light
   

Prevention

The best way to prevent pink eye is by practicing good hygiene which includes:

• Avoid putting dirty hands in your eyes

• Make it a habit to wash your hands often

• Avoid sharing towels and other personal items

• Do not use dirty items

• Changing your pillow cover regularly

• Do not leave a makeup item open for too long

• Avoid sharing makeup items like eyeliners, mascara, etc.
   

Treatment of Pink Eye

• The treatment of pink eye is dependant on its underlying cause. If it is caused by a virus, you just might have to wait for the virus to run its course which could last for about four to seven days. Virus caused pink eye could be easily contracted so it is imperative to try and prevent further spreading. Viruses cannot be cured by antibiotics, but some antiviral drugs could be helpful.

• Antibiotics are most effective against pink eye caused by bacteria as they reduce the lifespan of these bacteria and could come in the form of eye drops or pills. Based on the doctor’s prescription, an eye drop should be administered about four to six times daily. It is important you finish using your drugs even after the disappearance of symptoms.

• To deal with pink eyes caused by allergies, the allergy should be treated. Once treated, pink eye should disappear. It is also important to avoid allergens as much as possible so as to avoid pink eye.
   

Whenever the symptoms of pink eye emerge, the best preventive measure is to stay at home until the watery discharge ceases to avoid the spread of the bacteria or virus. You should also visit your doctor immediately to begin treatment. While mild pink eyes generally go away on its own, some of the more serious forms can cause a scar on the cornea.

What Is Demodex?

The Demodex mite is a type of parasite that lives on humans and can reside in hair follicles and sebaceous glands. These mites are arachnid (eight-legged) and invisible to the naked eye, varying in size from 0.1mm to 0.4 mm long. They typically live on the face and in the hair follicles of the eyebrows, eyelids, roots of the eyelashes, facial hair, and around the ears and are associated with various skin problems of the eyes and face, such as blepharitis and acne rosacea.

Demodex can affect humans at any age, but their presence increases in prevalence with increasing age. Immunity compromised patients such as diabetics, patients on long-term corticosteroids or chemotherapy, or patients who have HIV/AIDS also have increased risk and prevalence of Demodex infection. Usually, when the immune system is weakened and the parasitic population has colonized, this disease can badly damage the skin.
 

How Can Demodex be Transmitted?

For transmission of mites from one person to another, direct contact of hair and sebaceous glands on the nose, or dust containing eggs is required. Since the disease processes begin when there is an overpopulation of Demodex, the vast majority of cases of mites go unobserved and don't show any adverse symptoms. However, in certain cases, the mite populations migrate and multiply in the eyelashes.
 

What Are The Types of Demodex?

There are two existing types of Demodex mites: the longer kind, Demodex folliculorum, which live in the hair follicles and the short ones, Demodex brevis, which live in the sebaceous (oil) glands in the skin.
 

What Are The Symptoms of Demodex?

In the early stages, there are often no noticeable symptoms, but if left untreated Demodex can progress. Symptoms vary among patients and may include dry eye, red eyes, severe itching along the eyelid margin and eyebrow, especially in the morning, eyelid irritation, burning sensation, foreign body sensation that seems to originate beneath the eyelids, heavy lid, and blurry vision. One of the earliest signs of mite infestation is cylindrical dandruff (CD), which is the accumulation of fine, waxy, dry debris that collects at the base of the lash and extends up to 2 mm along the length of the lashes and is most noticeable on the upper lashes.