LASIK FAQ

We wanted to share with you the answers to questions our professionals are most often asked. It’s perfectly normal to have such questions and concerns. If ever you don’t find the answer you’re looking for here, please feel free to contact us. We’ll be happy to take your questions.

What does the procedure entail in terms of a) procedure b) time c) any down time

DOES BOTOX PREVENT WRINKLES?

Absolutely. Botox (and competitors like Dysport and Xeomin, which will be widely available next January) are highly purified toxins that can temporarily erase or reduce horizontal forehead lines, vertical frown lines, and crow’s-feet. “The injections slow muscles that contract hundreds of times a day, eventually etching lines in the skin,” says New York City plastic surgeon Michael Kane, author of The Botox Book (St. Martin’s Press). Botox can also lift the corners of the mouth that sag with age, smooth out the “pin cushion” look in some chins, soften smoker’s lines around the mouth, and soften vertical neck cords.

WILL BOTOX MAKE ME FEEL NUMB AND LOOK FROZEN?

It will not affect the nerves that cause sensation, or make you feel numb. When it is used correctly, it can lift the brow to give an appealing and sincere look. “But if too much is injected in the danger zone—the horizontal lines in the forehead—you can look Spocked, as in Spock from Star Trek,” says Jean Carruthers, a Vancouver eye surgeon who, with her husband, Alastair, coauthored the first paper on the cosmetic benefits of Botox in 1989. That’s why it’s important to be treated by an experienced doctor who can judge the size of your muscles and how much Botox you will need.

DOES BOTOX HURT?

Like most injections, Botox can be slightly painful, especially between the eyebrows. Some doctors offer topical anesthesia ten minutes before the procedure or ice the area to numb it.

DOES BOTOX HAVE SIDE EFFECTS?

Every drug has side effects, and Botox is no exception. Luckily, they tend to be minor and short-lived, according to Kane. In one to five percent of cases, there can be mild droopiness of the eyelid or eyebrow, which usually goes away within two weeks, and some patients experience slight bruising.

HOW MUCH DOES BOTOX COST?

Prices vary widely. At PVSC, we made it affordable at $10-12 per unit. Her is the treatment location at the pricing for the max units at $12/unit. The actual cost is probably less than that.
Botox Dose and price

WHAT’S THE IDEAL AGE TO START USING BOTOX?

You don’t need it before you have wrinkles to hide. Other than that, a patient can have Botox safely whenever they are bothered by their wrinkles. There is no issue with long term use: “I’ve had patients who have used it repeatedly for over 20 years without bad effects,” says Kane.

HOW LONG DOES BOTOX LAST?

It varies from patient to patient, but good results usually last three and a half to four months. The effect is completely gone in 6 months.

WILL MY FRIENDS KNOW I DID BOTOX?

Yes and no. A good result will leave you looking fresher, more cheerful, and perhaps younger. Telltale signs of Botox that has been badly done are a smooth and shiny forehead, or a forehead and crow’s-feet that don’t move when you laugh or cry.

WHAT CAN I EXPECT THE DAY AFTER MY BOTOX APPOINTMENT?

Not much. Results begin to show in a couple of days and develop gradually over the course of two weeks. “I tell anyone preparing for a big event to have shots two weeks ahead of time,. Patients taking medications that contain aspirin or NSAIDs can develop pinpoint blue bruising. Patients can wear makeup immediately but should avoid heavy workouts for 24 hours.

Is it dangerous to have an intraocular lens implantation?

Today, thanks to modern microsurgery techniques, the risk of serious complications of eye surgery is very small (less than 1 in a 5000 for infection for example). There is therefore little cause for concern, even though it’s quite normal to be anxious about the idea of such a procedure.

Must I prepare for this procedure? How to Prepare for Botox Injections?

The reason that treatments such as Botox® Cosmetic, Dysport®, and Xeomin® are so popular is because they have real, effective results that do not require surgery or any recovery time. That said, each of these is a prescription medication that should be administered by, or under the supervision of, a qualified physician. Be aware that unscrupulous individuals stating that they provide Botox® may not be qualified healthcare professionals and/or may not be providing an FDA-approved medication such as Botox® Cosmetic, Dysport®, and Xeomin®. Others may dilute their treatments, making the cosmetic treatment last for a shorter duration or provide inadequate results. Be wary of unbelievable pricing and always have your treatment done by a qualified healthcare professional.

Botox® Cosmetic, Dysport®, and Xeomin® may also be administered as part of the Liquid Facelift.

Before the Procedure

One of the wonderful aspects about Botox® is the fact that no true preparation is needed. Most of Dr. Youssef’s patients simply arrange an appointment that is most convenient for their busy schedules. That said, there are certain things that will improve your likely results and minimize any risk of bruising that can occasionally occur from injection.

One of the best things you can do to minimize the possibility of a small injection site bruise is to avoid any aspirin or aspirin containing products. This will include similar medications, including ibuprofen, Alleve®, Motrin®, and most over the counter analgesic pain medications other than acetominophen (Tylenol®). If you take prescription medications that thin your blood, including (but not limited to) Coumadin® (warfarin) and Plavix®, you should be aware that you are more likely to have bruising from your injections. If you smoke, your likelihood of bruising is also increased. If you bruise easily, you may choose to take a natural supplement called Arnica Montanna. This has been associated with a decreased incidence of bruising.

Naturally, before any treatment, Dr. Youssef will evaluate you in order to determine that you are a safe candidate for the procedure. If you have a pre-existing medical condition that leaves you with muscle weakness, swallowing difficulties, speaking difficulties, or breathing difficulties, you should definitely let Dr. Youssef know. Every new patient will undergo a full history and expert exam in order to determine if a treatment such as Botox® will be a safe way to achieve that person’s aesthetic goals.

If you wear makeup on a daily basis, you should plan to have some with you so that you can touch up any makeup that is wiped away from your face in order to clean that area for the procedure. If you exercise on a daily basis, you may choose to work out prior to your treatment at the PVSC, since Dr. Youssef recommends waiting at least four hours before physical exertion following your Botox treatment.

Where are the intraocular lenses inserted?

They are placed in place of the crystalline lens. The crystalline lens is the eye’s natural lens. It is what allows you to focus on objects close up.

What are payments requirements / process?

The cost of Botox is between $10-12/unit. Depending the amount of treatment that is required. We take cash or cards (debit or credit cards) after the procedure as we need to know how many units where needed.

Is cataract surgery painful?

Medicine has evolved a great deal, and nowadays cataract surgery is not painful. During the procedure, which lasts about 6 minutes, you will only feel pressure and the occasional prickling sensation. Patients can resume their everyday activities the very next day. The anesthesia is administered in the form of eye drops; no needles are required.

Any warning signs if something has gone wrong? Botox Side Effects

Botox Side Effects

Potential Botox side effects include pain at the injection site, infection, inflammation, swelling, redness, bleeding and bruising. Some of these symptoms may indicate an allergic reaction; other allergy symptoms are itching, wheezing, asthma, a rash, red welts, dizziness and faintness. Tell your doctor immediately if you have any breathing issues or a faint or dizzy feeling. Also, dry mouth, fatigue, headache and neck pain have been reported.

You may have heard of other side effects as well, such as numbness, droopy eyelids, muscle spasms or twitching, and migration of the substance.

Numbness as an absence of physical sensation is not really an issue with Botox, because Botox is not an anesthetic. Numbness as the result of the inability to move a muscle is an issue for some people.

Muscle spasms in the area of the Botox injections do not occur while the Botox is effective. After all, Botox is used to treat spasms related to benign essential blepharospasm, hemifacial spasm, cerebral palsy, fibromyalgia and temporomandibular joint disorder.

It is possible for the Botox to spread a little beyond the intended injection site and affect surrounding tissues. For example, if you receive injections into the forehead close to your eyebrows or your upper eyelids, they could be affected and may droop temporarily.

The best practitioners know the correct sites of injection to avoid side effects such as droopy eyelids. A small, highly concentrated dose of Botox dose is less likely to spread from the injection site than a large diluted dose.

This underscores the importance of finding a practitioner who has long experience with giving Botox injections.

What You Can Do To Avoid Botox Side Effects

The list of possible side effects mentioned in this article is a long one, but it would be extremely rare for anyone to experience all of them. And following these six tips will minimize or prevent most Botox side effects:

  1. Make sure your practitioner is very experienced at Botox injections and is a respected medical professional. A salon stylist, for example, is not an appropriate person to administer Botox, because he or she would not have emergency equipment or sufficient medical knowledge if something went wrong. Some disreputable people have reportedly administered injections that were over- or under-diluted with saline, as well as counterfeit solutions that didn’t contain Botox at all.
  2. Before having injections, tell your practitioner about any health problems you have.
  3. Also tell your practitioner about medications, vitamins, herbal preparations or other supplements you take, since some combinations of these supplements with Botox could cause serious side effects. It’s especially important to mention having taken injected antibiotics, muscle relaxants, allergy or cold medicines and sleep medicines.
  4. Follow your practitioner’s pre- and post-injection instructions very carefully.
  5. Report all side effects — especially those that are bothering you or won’t go away.
  6. Beware of Botox injections at a “Botox party” at someone’s house. You need to be in a medical setting, where any side effects can be treated immediately. You may not see the final effects of the injections during the party anyway, as they usually take a few days. A Botox party isn’t such a bad idea if it’s held by a doctor in a medical setting, but even then there’s a risk of the doctor’s attention being divided between you and the other attendees.

How long will it take for my vision to improve after cataract surgery?

Patients usually notice an improvement in their vision one day after surgery. Vision continues to improve over the course of one month after surgery, until healing is completed.

The Botox Procedure?

The Procedure

Most people find that talking about Botox® takes far longer than the procedure itself. Most patients choose to have topic anesthetic ointment applied to the areas which will be treated in order to dull sensation in the area. At PVSC Dr. Youssef uses ice packs to numb the skin and decrease bruising. Others prefer nothing at all. You will have the opportunity to choose before your treatment.

Just prior to injection, any topical anesthetic ointment that has been applied will be gently removed and an ice pack applied to the area. After a short time, typically measured in seconds, the ice pack will be removed, the treatment area will cleaned with alcohol or an antiseptic such as betadine, and Botox® (or other neuromodulator) injections will be performed. All injections are performed by Dr. Youssef.

Botox® (Dysport®, Xeomin®) to the Brow

This is the most common treatment for Botox® Cosmetic, Dysport®, or Xeomin®, and is used to treat those vertical lines and can form between the eyebrows. As the years pass, frowning, squinting, or even simply concentrating while reading can lead to contraction of the corrugator muscle and result in unsightly lines that make us look tired, angry, stressed, or sad. For many folks who spend hours every day working in front of the computer, lines in the brow can form simply from the constant need to concentrate while looking at a bright screen.

The treatment takes less than five minutes to perform. Results are usually seen a few days later, and usually last three to four months.

Botox® to the Forehead

Age, sun exposure, and a host of other environmental factors can lead to horizontal lines on the forehead caused by chronic muscle contractions. Over time, these lines deepen and become permanent.

By administering Botox®, Dysport®, or Xeomin® to the forehead alone or together with treatments to the brow and crows feet, the forehead, brow, and eyes can be rejuvenated. For younger individuals getting these lines for the first time, Botox® treatments can be preventative and retain a youthful appearance much longer. Deep, permanent lines are less likely to form if the lighter temporary creases are never made!

Botox® to the Crow’s Feet (Around the Eyes)

Concentrating at work and while reading can also cause constant squinting, which eventually can become a habit that creates lines (commonly known as “crow’s feet”) outside each eye. Unfortunately, constantly making these wrinkles by squinting eventually makes them permanent over time.

By treating these lines with Botox®, Dysport®, or Xeomin®, you can soften the appearance of these lines and even completely eliminate them in some cases. Depending on the technique and your personal cosmetic concerns, Dr. Youssef may even be able to make your eye appear larger because the muscle around it is no longer squeezing the eye shut (as it does when you squint).

 

Botox® to the Lip(s)

Vertical wrinkles that appear around the lips as we age may have any number of causes. One prominent etiology is the overuse of the muscle around the lips responsible for causing them to purse together. We use this muscle (the obicularis oris muscle) to keep our mouths closed when eating and drinking, to express ourselves, and even unconsciously as part of a habit.

Some prominent and unnecessary reasons for overuse of this muscle, leading over the years to wrinkles around the mouth include:

  • Chewing gum
  • Drinking through a straw regularly
  • Smoking
  • Pursing the lips frequently as a facial expression or nervous habit

At the PVSC, Dr. Youssef can administer Botox® to gently relax this muscle, reducing the amount of wrinkling it causes in the lines around the lips. This procedure takes less than a minute in most patients and has no recovery time. Make up can be applied before leaving the office.

Are cataracts treatable?

YES for sure. There is only one treatment for cataracts: replace the crystalline lens. This is done by microsurgery. The surgeon first makes a tiny incision in the eye, then removes the crystalline lens and replaces it with a flexible intraocular lens. This surgical procedure generally yields excellent results.

When may I go back to wearing makeup?

You may resume wearing makeup about one week after your surgery. However, throw out your old makeup and buy new to decrease your risk of infection.

What should I do immediately after the surgery?

  • DO NOT RUB YOUR EYE(S). Rubbing them after cataract surgery may result in SERIOUS post operative complications. Do not rub your eye(s) for at least a month.
  •  Patients need to keep their eyes closed for the first two hours after surgery (with the exception of getting around).
  • At the end of the two hours the tape should be removed and the drops started. Patient will start to use the drops two hours after surgery.
  • NOT two hours after hospital discharge. This is without exception unless you are told specifically by the doctor himself.
  • At the hospital you will be given a schedule of when the drops are to be used. Patients are not required to get up during the night to use the drops. They will be used during waking hours only.
  • Always follow the instructions given to you on the day of surgery as that will be that most current schedule.
  • Your first appointment will be done the afternoon of your surgery, ON THE SAME DAY OF THE SURGERY. You’ll receive your appointment time for the same day when you are at the hospital.
  • Once at the office, you’ll be given an appointment for approximately one week later.
  • Patients having Bilateral Cataract surgery will receive a prescription for two sets of each drop. One set for the left eye and one for the right. This is done for your own safety; in keeping one set for each eye you reduce the risk of infection due to cross contamination.
  • You will also be given cards for your records with the name and power of the lenses you’ve had implanted. Please be sure you have them when you leave the hospital, as they are produced there and we do not have copies of the cards in the office.

Botox post-injection instruction: Any special measures that are needed after the procedure, ie. keep out of sun, etc…or any such measures ..

Not much. You do not need to keep out of sun. I normally tell my patients to:
1)  Avoid alcohol for a day
2)  Avoid strenuous activity for a day
3)  Avoid blood thinning medications if possible for a day

If you do bruise, I would continue to avoid the above until you no longer feel the bruise is getting worse.

I also tell my patients to avoid blood thinning medications if possible for a week before the treatment.

After the Procedure

Generally, you will be able to leave the office within minutes of your treatment. Many patients choose to return to work, go shopping, have lunch, attend social engagements (dinners, lunches, parties, etc.), or are on the way home. If you wear makeup, you can reapply or touch up make up before you leave the PVSC.

Dr. Youssef does not recommend exercising or lying down (flat on a bed) for four hours after a Botox® treatment. In addition, if you have Botox®, Dysport®, and Xeomin® around the eyes, you should avoid vigorously rubbing towards your eyes for a few days after your treatment.

In order to maintain your results, be sure to schedule your next treatment session before you leave the office.

Which is the better technique, PRK or LASIK?

Recent scientific studies have shown that, when performed using the new models of laser equipment and Wavefront technology, intracorneal surgery (LASIK and All-LASIK) and superficial surgery (PRK) yield similar long-term results. LASIK is currently the most commonly used technique in Canada and the US.

Can I go back to work right away?

Most people who have LASIK return to work the next day. With PRK, we recommend two or three days of rest instead.

How do you know what lens power to implant?

On the day of the assessment, you will undergo an eye measurement, to calculate the strength of your lens implant. The most accurate IOL Master is the preferred method to get the best results. If you wear contact lenses, please remove them at least one (1) week prior to your measurement. The longer you have them out, the better your measurement.

You will be given artificial tears to use, four (4) times a day in both eyes, starting one week before your measurement or right away. You will have to buy a bottle from the pharmacy, but you will use it for at least two months after your surgery, so it will not be wasted.

Please make sure you have read over this booklet before this appointment. Any questions you have will be answered this day. Please bring along a friend or family member, if you feel it might be necessary. A prescription for the surgery drops will be given at this appointment. You will also be given a calendar to follow (for the eye drops).

IOL-MASTER

The ZEISS IOLMaster® 500 is the gold standard in optical biometry with more than 100 million successful IOL power calculations to date. With the new version of the ZEISS IOLMaster 500 you get a piece of cutting-edge technology that points the way to the future of optical biometry.

  • Improving refractive outcomes: Any intraocular lens calculation is only as reliable as the lens constant it is based on. More than 40,000 sets of patient data created with the ZEISS IOLMaster are the basis of more than 200 optimized lens constants in the User Group for Laser Interference Biometry (ULIB) website – absolutely unique in the industry. Together with its one-of-a-kind distance independent telecentric keratometry (watch video) and the exclusively integrated Holladay 2 formula, the gold standard in optical biometry helps you improve your refractive outcomes.
  • Advanced measurement of challenging eyes: The true test of a biometer is its performance with challenging eyes. In denser cataracts the ZEISS IOLMaster 500 achieves a measurement success ratio that is up to 20% higher than that of other optical biometry devices. Even with staphyloma, pseudophakic and silicone-filled eyes the ZEISS IOLMaster 500 measures along the visual axis, yielding the relevant axial distance. And with its Haigis-L formula on board the ZEISS IOLMaster 500 is dedicated to myopic and hyperopic post-LVC cases.
  • Proven toric outcomes: The results of a meta-analysis of 28 published clinical papers covering more than 1900 cases show that the reported clinical outcomes for the ZEISS IOLMaster with regard to residual astigmatism “[…] exceed, or are at least as good as those using manual or automated keratometry

Where does it go in my body?

BOTOX Cosmetic® stays local to the muscle where it was injected.
After the injection, BOTOX Cosmetic® is simply metabolised & broken down into natural byproducts within a few hours.

What happens if my vision starts to deteriorate after laser vision correction?

If your vision weakens during the first year following your treatment, we will perform any necessary touch-ups free of charge. LVC does not wear off. People over the age of 40, start to loose their focusing ability with time, that why would need reading glasses. Even that can be corrected by monovision/blended vision.

When may I resume driving?

You may begin driving as soon as you see well enough, excluding the day you had LASIK or PRK performed. Usually second day after the surgery.

What if I blink or move during the procedure?

Although everyone shares these concerns, we take measures to ensure that moving or blinking is not a problem. Your eye will be held open with a holder supporting your lid so that you can’t blink. The holder is placed immediately before the treatment and removed immediately afterward. Lying still during the treatment is another common concern. The bed of the laser has a contoured headrest with an indent, which allows the back of your head to rest securely, but comfortably in place. During the treatment itself, Dr. Youssef will gently hold your head in position to help keep you steady. He also uses a focusing mechanism to assure that the treatment is precisely centered. Your job is simply to watch a blinking target light. While you are doing this, the laser’s computer will also be using its tracking system to monitor the position of your eye. The eye tracker adjusts the laser treatment to follow the small movements everyone’s eyes make during the procedure.

I have heard that you can get a drooping eyelid – is this true?

Side effects are rare and are not permanent and this can include a drooping eyelid.
The incidence of these side effects in Dr Rouzati’s experienced hands are extremely low and in the rare event that they happen they would not be permanet and would last a few days to a few weeks before resolving.

Will my vision be stable after laser correction?

Much like glasses or contact lenses, laser correction does not prevent the progression of vision problems, such as myopia or hyperopia. That is why laser vision correction is recommended only for individuals 18 years or older and once their vision has been stable for one year. If the myopia worsens after laser surgery, this situation can be treated with a slight touch-up.

What happens afterward?

Dr. Youssef will place eye drops or ointment in your eye. You may relax for a little while then go home and rest. You’ll probably notice clearer vision immediately, and typically it will improve even more as the weeks go by.

How accurate is LASIK?

Based on clinical data from the FDA and our personal experience from Dr. Youssef’s Results, LASIK is very accurate. Careful consideration of your needs and a complete preoperative evaluation help PVSC achieve excellent results with the vast majority of our patients. Even with our advanced technology and experience, approximately 1 in 10 patients may need to have a retreatment in one eye to achieve their best uncorrected vision. This is because we are treating human tissue and there is always some variability in how each individual’s eye will heal.

What are the side effects?

Side effects are RARE and are NOT PERMANENT.
Rarely, there can be some minor bruising (which is easily covered up with makeup) or a slight short term headache. Most patients do not experience any side effects at all

Are there any long-term risks associated with laser vision correction?

To date, no damage to the eyes has ever been observed as a result of a laser treatment. Most experts would agree that there is no concern for long-term complications.

What happens on the day of treatment?

LASIK and PRK are outpatient procedures, which means you’ll spend around an hour at the centre and walk out afterward. Someone else must drive you home, because your vision will be a little blurry right after surgery.

You’ll lie down in a reclining chair. Dr. Youssef will place anesthetic drops in your eye, position your head under the laser and place an eyelid speculum (retainer) under your lids to hold your eye wide open.

In LASIK, Dr. Youssef creates a thin flap in the top of the cornea, folds it back out of the way, uses the laser to remove some corneal tissue and then puts the flap back in place. If you’re having PRK, no flap is created: The laser simply removes the outer layer of the cornea (epithelium), which grows back after surgery.

What is Dysfunctional Lens Syndrome?

DLS is the progressive loss of function of the natural lenses inside your eye.  The lens is clear and flexible when you are born.  The clarity of this vital part of your eye allows light to pass cleanly through without light scatter, glare, or blurry vision.  It’s flexibility allows it to change shape and focus so you can see both far and near objects. From the day you were born, your lens started to lose both its clarity and its flexibility.  The early losses go largely unnoticed.  The good news about DLS is that there is a cure: dysfunctional lens replacement.  This involves removing the dysfunctioning lens and replacing it with a plastic intraocular lens implant.  The new intraocular lens is clear, restoring clarity of light transmission.  Advanced technology intraocular lens implants can be toric (astigmatism correcting) or they can be a multifocal or accommodating implants to restore some focusing ability.  Many patients with mulifocus  or accommodating implants do not need glasses for near or far vision after the surgery.  While these implants are not perfect, they are spectacular.  The ability to correct many of the ravages of DLS dysfunctional lens replacement is one of the marvels of modern medicine.

I don’t want to look like a mask without expression – will that happen?

No. We ensure you get the look you want – as natural as you want.
Most people simply want to look NATURAL, RELAXED and REFRESHED, without looking “done”.
In the experienced hands at our clinic – patients typically say that no one knows that they had anything done. Friends simply say that they look well rested and great!

Is laser vision correction painful?

During the surgery, the eye is completely numbed with the help of anesthetic eyedrops. After laser eye surgery, patients may experience some discomfort, much like if they had a grain of sand in their eye. This sensation is temporary. It can last 3 to 5 hours after a LASIK treatment or 24 to 72 hours after a PRK treatment.

What happens before laser eye surgery?

Dr. Youssef will give you a thorough eye exam to make sure your eyes are healthy and you’re a suitable candidate for laser vision correction. He or she will test for glaucoma, cataracts and other disqualifying conditions. He also will use a machine called a corneal topographer to photograph and electronically map your eye. Dr. Youssef will use this map to plan your surgery for the most precise results possible.

Am I too old to have LASIK?

Although there’s no real “maximum age” for laser vision correction, we would first need to determine that the overall health of your eyes is good, and that your vision difficulties are not being caused by cataracts or some other eye disease. Before the decision is made to proceed with laser vision correction, your vision needs to be stable. Depending on your age, you may need reading glasses after treatment. Nearly everyone needs reading glasses by their mid-40s. This is known as presbyopia. Presbyopia is a natural change in the lens inside of the eye and is not influenced by refractive surgery. If you are wearing bifocals or readings glasses now, you will still need reading glasses after LASIK. A treatment option with refractive surgery is known as monovision. In a monovision treatment, the patient’s dominant eye is corrected for distance vision with their non-dominant eye being left slightly nearsighted. Although not a replacement for reading glasses, this preserves a degree of near vision clarity. If you have a early changes in the crystalline lens (Dysfunctional Lens Syndrome) you might benefit from a lens exchange rather LASIK.

What is Dysfunctional Lens Syndrome?

DLS is the progressive loss of function of the natural lenses inside your eye.  The lens is clear and flexible when you are born.  The clarity of this vital part of your eye allows light to pass cleanly through without light scatter, glare, or blurry vision.  It’s flexibility allows it to change shape and focus so you can see both far and near objects. From the day you were born, your lens started to lose both its clarity and its flexibility.  The early losses go largely unnoticed.  The good news about DLS is that there is a cure: dysfunctional lens replacement.  This involves removing the dysfunctioning lens and replacing it with a plastic intraocular lens implant.  The new intraocular lens is clear, restoring clarity of light transmission.  Advanced technology intraocular lens implants can be toric (astigmatism correcting) or they can be a multifocal or accommodating implants to restore some focusing ability.  Many patients with mulifocus  or accommodating implants do not need glasses for near or far vision after the surgery.  While these implants are not perfect, they are spectacular.  The ability to correct many of the ravages of DLS dysfunctional lens replacement is one of the marvels of modern medicine.

How is it done?

It is injected with a very tiny needle (it only feels like a little pinch). Done directly into the muscles that need to be relaxed.

What factors might disqualify me for laser treatment?

Certain general health conditions, eye diseases, and immune system deficiencies can hinder recovery.  Pregnant women must wait until after their first trimester to have this procedure. Patients must also be 18 years or older.

How do I know if I’m eligible for laser vision correction?

Your eye care practitioner can help you decide, but here are some general guidelines:

  • You must have healthy eyes — no glaucoma, infection, cataracts, severe dry eye or any other condition that would affect postoperative healing.
  • You must be an adult: age 18 or older (with some exceptions).
  • Your vision must be stable for at least a year before surgery.
  • If you’re pregnant or nursing, your hormonal levels can affect the shape of your eye. You’ll need to wait until your hormones are back to normal levels.
  • You cannot have a degenerative or autoimmune disease, since this would affect healing.

Do you offer financing?

At PVSC, we understand that laser vision correction is an investment. We offer various financing options—ranging from short-term, no interest to long-term plans through a patient financing company, Medicard. Feel free to contact our patient education staff to learn more.  You can visit their website at https://www.medicard.com/

Canada’s Patient Financing Company

 

How long does the procedure take?

Generally, after the consultation, the procedure only takes up to 15 minutes.
Since there is no downtime – you can do it on your lunchtime – and no one would know you have had it done!

Am I a candidate for laser vision correction?

Thanks to our specialized teams and cutting-edge diagnostics equipment like iDesign, we can rapidly determine whether you are a good candidate for laser vision correction. A vast number of people qualify for this treatment, even those with more severe vision problems. Your eligibility for laser eye surgery is confirmed by Dr. Youssef during the consultation.

How long does LASIK take?

The laser treatment itself usually takes less than a minute, while the entire procedure takes approximately 6 minutes per eye.

Can you work with my regular eye doctor/Optometrist?

In order to make the process of care as comfortable as possible for you, we offer to co-manage with your current ophthalmologist or optometrist. You may choose to have your pre-operative evaluation, treatment and one day post-op visit at PVSC with the balance of your post-op care provided by your personal eye doctor. We believe that it is very important for you to continue seeing your personal eye doctor starting one year after your surgery. We will keep your doctor fully updated about the care you receive while with PVSC.

I have high blood pressure (hypertension). Is Botox safe for me?

When injected appropriately, Botox should not have a direct effect on blood pressure. Always consult with your physician prior to considering Botox injections. If the pressure is not will controlled, the probability of bruising with the botox would be increased.

Does laser vision correction hurt?

You won’t feel pain during LASIK or PRK, because your surgeon will place anesthetic eye drops in your eye first. Afterward, he or she may prescribe pain medication if necessary. Many LASIK patients report no more than mild discomfort for a day or so after surgery. There is more discomfort after PRK because the procedure exposes the deeper layers of the cornea. For clear and comfortable vision after PRK, protective surface cells have to grow back over the treated area. This process can take a week or two, sometimes longer.

Can I wear my contacts before my surgery?

Because contact lenses can alter the shape of your cornea, you will need to remove your contacts prior to your pre-operative exam. If you wear soft lenses, they should be removed a minimum of one week before your exam. If you wear rigid/gas permeable lenses, remove them at least 6-8 weeks prior to your exam. By removing the lenses, the cornea will be restored to a more natural shape before measurements are taken. Following your pre-operative exam, if you are a soft lens wearer, you will be able to wear your lenses up to 24 hours before your surgery. If you wear rigid/gas permeable lenses, you may be asked to leave your lenses off until your day of surgery.

What is Cataract?

CATARACT: AGING LENS

A cataract is a clouding of the lens inside the eye which leads to a decrease in vision. It is the most common cause of blindness and is conventionally treated with surgery. Visual loss occurs because opacification of the lens obstructs light from passing and being focused on to the retina at the back of the eye. It is most commonly due to biological aging but there are a wide variety of other causes. Over time, yellow-brown pigment is deposited within the lens and this, together with disruption of the normal architecture of the lens fibers, leads to reduced transmission of light, which in turn leads to visual problems.

cataracts

Those with cataracts commonly experience difficulty in appreciating colors and changes in contrast, driving, reading, recognizing faces, and coping with glare from bright lights. Signs and symptoms vary depending on the type of cataract, though there is considerable overlap. People with nuclear sclerotic or brunescent cataracts often notice a reduction of vision. Those with posterior supcapsular cataracts usually complain of glare as their major symptom. The severity of cataract formation, assuming that no other eye disease is present, is judged primarily by a visual acuity test. The appropriateness of surgery depends on a patient’s particular functional and visual needs and other risk factors, all of which may vary widely.

Cataracts may be partial or complete, stationary or progressive, or hard or soft. The main types of age-related cataracts are nuclear sclerosis, cortical, and posterior subcapsular.

Is it considered safe to have Botox around your eyes shortly before or after LASIK surgery?

The decision to have Botox injections before or after LASIK surgery should be left up to your LASIK surgeon. The injections should be safe. However, the effect of Botox around the eyes can reduce the strength of the blink reflex, which might create a sense of dryness of the eye. This might affect the healing process of the LASIK surgery. LASIK surgery is known to create temporary dry eyes immediately after the procedure.

How is eye laser surgery different from previous types of refractive eye surgery?

Current FDA-approved laser vision correction methods, such as LASIK (laser-assisted in situ keratomileusis), have a higher predictability of the final result with a lower incidence of complications. Additionally, older techniques typically involved manually performed incisions rather than automated lasers for correction.

How much does laser vision correction cost?

For All-Laser Femto LASIK it is $2300 and for PRK is $1800 per eye. For Refractive Lens Exchange it is variable starting from $2500.

How often will I see the doctor following my surgery?

Your postoperative appointments will be scheduled:

  • One day
  • One week
  • One month
  • Three months
  • And six months (optional)

More frequent appointments may be scheduled as needed. The doctors at PVSC will be available to see you whenever they or you feel that it is necessary.

What happens if I discontinue Botox after the first time or after several times? Will my forehead look worse than before I started treatment? Some people tell me once you start using it, you can never stop.

The wrinkles of your forehead should return to their original appearance when the Botox wears off. Discontinuing the Botox will not worsen your wrinkles.

The reason “you can never stop” using the Botox is because after seeing the disappearance of your wrinkles, you “never want to see the wrinkles” again. You can stop anytime you want without consequences (other than the return of the wrinkles).

What are my options for INTRA-OCULAR LENSES (IOLs)?

INTRA-OCULAR LENSES (IOLs)

Before intra-ocular lenses (IOLs) were developed, people had to wear very thick eyeglasses or special contact lenses to be able to see after cataract surgery. Now, with cataract lens replacement, several types of IOL implants are available to help people enjoy improved vision. Discuss these options with your eye doctor to determine the IOL that best suits your vision needs and lifestyle.

 

CATARACT LENS REPLACEMENT: HOW IOLs WORK?

Like your eye’s natural lens, an IOL focuses light that comes into your eye through the cornea and pupil onto the retina, the sensitive tissue at the back of the eye that relays images through the optic nerve to the brain. Most IOLs are made of a flexible, foldable material and are about one-third of the size of a dime.  Like the lenses of prescription eyeglasses, your IOL will contain the appropriate prescription to give you the best vision possible. Read below to learn about how IOL types correct specific vision problems.

Which lens option is right for you?

 

Before surgery your eyes are measured to determine your IOL prescription, and you and your eye doctor will compare options to decide which IOL type is best for you, depending in part on how you feel about wearing glasses for reading and near vision.The type of IOL implanted will affect how you see when not wearing eyeglasses. Glasses may still be needed by some people for some activities.If you have astigmatism, your Eye M.D. will discuss toric IOLs and related treatment options with you.In certain cases, cost may be a deciding factor for you if you have the option of selecting special premium lOLs that may reduce your need for glasses.

Monofocal lens

 

 

This common IOL type has been used for several decades. Monofocals are set to provide best corrected vision at near, intermediate or far distances. Most people who choose monofocals have their IOLs set for distance vision and use reading glasses for near activities. On the other hand, a person whose IOLs were set to correct near vision would need glasses to see distant objects clearly.Some who choose monofocals decide to have the IOL for one eye set for distance vision, and the other set for near vision, a strategy called “monovision.” The brain adapts and synthesizes the information from both eyes to provide vision at intermediate distances. Often this reduces the need for reading glasses. People who regularly use computers, PDAs or other digital devices may find this especially useful. Individuals considering monovision may be able to try this technique with contact lenses first to see how well they can adapt to monovision. Those who require crisp, detailed vision may decide monovision is not for them. People with appropriate vision prescriptions may find that monovision allows them see well at most distances with little or no need for eyeglasses. Presbyopia is a condition that affects everyone at some point after age 40, when the eye’s lens becomes less flexible and makes near vision more difficult, especially in low light. Since presbyopia makes it difficult to see near objects clearly, even people without cataracts need reading glasses or an equivalent form of vision correction.

 

Multifocal or accommodative lenses

These newer IOL types reduce or eliminate the need for glasses or contact lenses. In the multifocal type, a series of focal zones or rings is designed into the IOL. Depending on where incoming light focuses through the zones, the person may be able to see both near and distant objects clearly. The design of the accommodative lens allows certain eye muscles to move the IOL forward and backward, changing the focus much as it would with a natural lens, allowing near and distance vision. The ability to read and perform other tasks without glasses varies from person to person but is generally best when multifocal or accommodative IOLs are placed in both eyes. It usually takes 6 to 12 weeks after surgery on the second eye for the brain to adapt and vision improvement to be complete with either of these IOL types.

 

 

 

Considerations with multifocal or accommodative IOLs

 

For many people, these IOL types reduce but do not eliminate the need for glasses or contact lenses. For example, a person can read without glasses, but the words appear less clear than with glasses. Each person’s success with these IOLs may depend on the size of his/her pupils and other eye health factors. People with astigmatism can ask their eye doctor about toric IOLs and related treatments. Side effects such as glare or halos around lights, or decreased sharpness of vision (contrast sensitivity) may occur, especially at night or in dim light. Most people adapt to and are not bothered by these effects, but those who frequently drive at night or need to focus on close-up work may be more satisfied with monofocal IOLs.

Halos/Glare

 

 

TECNIS® IOL

The latest addition to the TECNIS® Family of IOLs offers new optical technology for providing an Extended Range of Vision.

Traditional IOL solutions for treating presbyopia include Multifocals and Trifocals, which work on the principle of simultaneous vision by splitting light into multiple distinct foci, and Accommodative IOLs, which change in shape and power when the ciliary muscle contracts.

Traditionally with these technologies, the correction of presbyopia is commonly thought of in terms of the distinct distance for which functional vision is provided.

Key Needs for Presbyopia-Correcting IOLs

  • High patient satisfaction by providing reliable outcomes
  • Low number of complaints (on refractive outcomes or halos and glare)
  • No significant additional chair time

 

I’m getting married and want to have Botox to “freshen” my face. How far out do I need to have it? I don’t want to be bruised or swollen on my wedding day!

Botox takes about two to four days to take effect. Its maximum effect occurs around 10 to 14 days and lasts up to three months. A bruise from a needlestick usually lasts five to seven days. With an impending event, such as a wedding, I usually suggest that my patients get their Botox injections one month before the event.

Are there any side effects?

Some people experience dry eye after LASIK, which usually is relieved with eye drops and disappears over time. Others may experience starbursts or halos around lights, especially at night. Usually this effect lessens or disappears over time, too. In a small number of people (probably fewer than 1 percent), their vision worsens rather than improves.

Is intraocular lens implantation a safe and effective procedure?

Yes. The insertion of intraocular lenses is a procedure that has been performed for decades to treat cataracts. Millions of people have undergone this type of surgery with great success. Moreover, the quality and precision of intraocular lenses has vastly improved, and they are now an effective treatment for a variety of other vision problems.

Does the LASIK effect wear off? How long will the effect of LASIK last?

In most cases, the treatment effect of laser vision correction is permanent, especially if your eyeglass prescription was stable before treatment. If there is something in your genetics that says your prescription will change in the future, having surgery now will not prevent that from occurring. In our experience, a change like this is very uncommon If necessary though, you may be able to be re-treated many years later should that occur.

Can I have both eyes done at the same time?

Most surgeons perform a LASIK procedure on both eyes at the same time. Because it takes longer for clear, comfortable vision after PRK, many surgeons will wait a week or two between eyes for PRK. At PVSC, we do at the same time.

What if time passes and I’m not seeing better?

A small number of patients see well after surgery then experience regression, a gradual worsening of vision. If this happens, consult Dr. Youssef to determine the cause and to see if retreatment (enhancement) is appropriate.

Is anesthesia used for the procedure? I’m a bit of a chicken when it comes to needles!

Some doctors will anesthetize the surface of the skin with a topical anesthetic cream. This makes the stick of the needle much more tolerable. At PVSC we use freezing packs to decrease pain and prevent bruising.

Are LASIK and PRK safe?

The FDA recognizes LASIK and PRK as proven, safe and effective. Laser vision correction uses a cool (non-thermal) beam of light that is computer controlled. The surgeon turns the laser on and is able to turn it off at any moment. Many safeguards are in place to reduce the risk of error. However, risks are associated with any surgical procedure.

Although no one knows the exact number of complications, studies suggest that the incidence of minor difficulties such as dry eyes and nighttime glare is around 3 percent to 5 percent, while the risk of serious incidents such as lost vision is thought to be less than 1 percent. There are no known cases of blindness from LASIK or PRK. Again, outcomes generally are very good.

Does the laser causes night vision problems?

Starbursts, glare and halos at night can be caused by several things. The first is when an inadequate diameter area of the cornea is treated. The treated area must approximate your pupil size under dim light. We analyze pupil size to make certain that your treatment area is large enough. The second cause of night vision problems is the use of older generation lasers and poor treatment designs. Dr. Youssef custom designs each patient’s treatment so that the optimal optics can be obtained. The new “flying spot” lasers, such as our STAR S4 IR® Excimer Laser – Abbott Medical Optics Inc, apply a much smoother treatment and blend the region between treated and untreated cornea better. The third potential cause of night vision problems after LASIK is the presence of subtle optical imperfections known as Higher Order Aberrations in the visual system. All patients seen at PVSC are tested with the iDesign Wavefront Sensor to detect any pre-existing higher order aberrations. When present, a form of LASIK known as iDesign Customized Vision Correction might be recommended for you. Actually we do that customized treatment for almost all the patients except if there is contraindications. This treatment pattern reduces the incidence of starbursting. Very few of our patients report any night vision problems after their first month post-op. Actually, most of the patients say that their night vision is better after LASIK than what it was before with their glasses and contracts.

What are the possible LASIK complications?

It’s perfectly normal to be concerned about the “worst case scenario”. With an experienced surgeon, the procedure itself is relatively safe. The excimer laser is computer controlled, pre-programmed with your treatment data. Statistically, there is a remote possibility of the loss of vision due to corneal infection or inflammation which we address by maintaining sterile conditions in the laser suite and by instructing you to use medicated drops for the first week after the procedure. Fortunately, we have never had a patient lose vision from these problems. That being said, refractive surgery has its risks and we will explain them to you at the end of your evaluation. Potential complications include: Under or over correction, corneal flap healing problems, pain or discomfort, dry eye, hazy vision, sensitivity to light, glare at night, loss of best corrected visual acuity, or infection. The majority of patients who are safe candidates for treatment have a trouble-free experience. Before considering surgery, we carefully evaluate each patient to understand whether or not you are a good candidate. The doctors will be happy to discuss any concerns that you may have. Our goal is for you to understand as much about this treatment as possible before surgery so that you can be comfortable with your treatment options.

Is it true that the more I have Botox, the less I need to use it?

This has been a topic of discussion among many physicians. Muscles that are not used tend to atrophy and weaken over time. Muscles that have been continually injected with Botox may actually fall into this category and produce a similar effect. This might result in using less Botox.

What is laser vision correction?

It is a surgical procedure that uses a cool (non-thermal) beam of light to gently reshape the cornea — the surface of the eye — to improve vision. The laser removes microscopic bits of tissue to flatten the cornea (to correct nearsightedness), steepen the cornea (to correct farsightedness) and/or smooth out corneal irregularities (to correct astigmatism).

The goal of laser eye surgery is to change the shape the cornea so it does a better job of focusing images onto the retina for sharper vision. LASIK and PRK are two types of laser vision correction.

What is Femto-Laser Cataract Surgery?

CATALYS® Precision Laser System

The CATALYS® Precision Laser System is indicated for use in patients undergoing cataract surgery for removal of the crystalline lens.  Intended uses in cataract surgery include anterior capsulotomy, phacofragmentation, and the creation of single plane and multi-plane arc cuts/incisions in the cornea, each of which may be performed either individually or consecutively during the same procedure.

Femtosecond laser assisted cataract surgery offers a reproducible, noninvasive technique to replace the least predictable and most technically demanding steps of conventional cataract procedures.

Catalys-702x336

 

Designed for Laser Cataract Surgery

Designed specifically for laser cataract surgery, the CATALYS® System offers:

  • LIQUID OPTICS Interface, gentle docking with minimal intraocular pressure rise and clear optics for excellent imaging and laser delivery
  • INTEGRAL GUIDANCE System – proprietary 3D Full Volume Optical Coherence Tomography (OCT) and automated surface mapping algorithms that guide laser delivery
  • Precise capsulotomies within 30µm
  • Complete segmentation and softening of the cataract with adjustable grid sizing
  • Multiple corneal incision centration options that are based on anatomical landmarks

The CATALYS® Precision Laser System combines a <600 femtosecond laser, gentle LIQUID OPTICS Interface, and integrated 3D Full Volume Optical Coherence Tomography (OCT) image-guidance system to create precise incisions in the lens and cornea. The CATALYS® System was developed in close collaboration with a medical advisory board of cataract experts from around the world. In 2012, the CATALYS® System was recognized as one of the top 100 technological innovations in the world.

Throughout the development of the CATALYS® System, numerous technology choices were made aimed at delivering excellent precision. Two of the most critical components are the patient docking interface and the image-guidance system. The LIQUID OPTICS Interface is designed to provide a stable, gentle dock and a clear optical path for the OCT and laser.

In addition, the CATALYS® System is equipped with INTEGRAL GUIDANCE System, an image-guidance system which maps ocular surfaces, establishes safety zones allowing the physician to select and customize the treatment, ensuring that the femtosecond laser pulses are delivered precisely to the intended location.

Understanding the user experience is another critical area focus for the CATALYS® System development team. The system’s intuitive and ergonomically designed user controls were developed with the needs of the patient, surgeon, technician and nurse in mind. A Medical Advisory Board of cataract experts and Medical Staff Advisory Board of dedicated technicians and nurses have had extensive input in system design and usability.

 

 The CATALYS® System procedure consists of four steps:

catalys_4steps

The CATALYS® System includes design features that optimize the precision, safety and control of all four steps of the procedure. Two of the key features that were developed to help surgeons deliver predictability and quality of outcomes are:

LIQUID OPTICS Interface

The novel two-piece liquid interface docks the patient to the system and is designed to provide:

  • A clear optical path for real-time video, OCT imaging, and laser treatment by:
  • Filling in corneal surface irregularities with liquid
    Creating a wide field of view, enabling all cuts to be performed in a single dock

A gentle dock for the patient by:

  • Minimizing the rise in intraocular pressure, which is particularly important for older cataract patients and those with glaucoma
  • Minimizing scleral contact of the interface with minimal redness of the eye after surgery

catalys_liquid_optics

INTEGRAL GUIDANCE System

During the CATALYS® System procedure, the ocular surfaces are visualized by a proprietary, integrated Optical Coherence Tomography (OCT) system. The OCT is enhanced by sophisticated algorithms designed to ensure that the femtosecond laser pulses are delivered precisely to the intended location.

 

Steps in the INTEGRAL GUIDANCE System process:

Proprietary, 3D spectral-domain OCT imaging system visualizes the ocular surfaces
Algorithms process the image, automatically and accurately maps surfaces and create safety zones
The surgeon’s treatment plan is then customized, based on the patient’s ocular anatomy and the precise orientation of the eye
After the surgeon confirms the customized treatment plan, the femtosecond laser pulses are delivered precisely to the intended location, maintaining the safety zones

Information on this page is taken from AMO website, http://www.abbottmedicaloptics.com/products/cataract/laser-cataract-surgery/catalys-laser-system

Wiki Femto Cataract

Astigmatism Correction at the Time of Cataract Surgery

Especially with advanced intraocular lenses that provide good vision without glasses after cataract surgery, it is important that the surgery results in minimal astigmatism. Examples of these advanced lenses are presbyopia-correcting multifocal IOLs and accommodating IOLs.

Basic-Information-about-Astigmatism1

Because astigmatism involves the cornea being more curved in one axis than the other (like a football shape), incisions can be used in the more curved axis to reduce the astigmatism so the cornea has a rounder shape (like a basketball). The procedure is called astigmatic keratotomy or AK.

 

Surgeons perform AK free-hand with a diamond blade, and it is quite effective in reducing astigmatism.

During refractive laser-assisted cataract surgery, the OCT image can be used to plan the AK incisions in a very precise location, length and depth, and then the laser accurately creates them. Since the laser minimizes the variables involved, the AK procedure becomes more accurate and reproducible.

A New Era in Cataract Surgery

An exciting aspect of laser cataract surgery is the concept of optimization — the continuous improvement of a technique or technology.

One example is the incision. When it is made with a human hand guiding a blade, there are limitations. But a laser can make a perfect zigzag incision that interlocks precisely and improves the chance of self-sealing, and this is an advancement over traditional manual technology.

Once a laser enters the surgical arena the opportunities to optimize are endless. We are just in the beginning of this refractive laser-assisted cataract surgery journey, and precision improvements will arrive quickly.

Conclusion

It is important to put this new technology into proper perspective. Traditional cataract surgery is very effective and successful. People who do not want to invest out-of-pocket money in laser cataract surgery can still feel confident about the traditional approach.

But for those who want the best possible vision, the laser approach is appealing. A more accurate incision, capsulotomy and astigmatic correction will help to achieve their goal of less dependence on glasses after cataract surgery.

Keep in mind that even though the early results of laser cataract surgery are promising, this is newer technology that deserves in-depth research and discussion with your doctor so that you can make the best possible decision for your situation

 

Source: http://www.allaboutvision.com/conditions/laser-cataract-surgery.htm

Where to get the best LASIK?

Tough question. There are a few things you should look for when trying to find the best place to have LASIK surgery.

  1.  Don’t think about price. Price is important but if you are pursuing inexpensive LASIK then you are not pursuing the best LASIK.
  2.  Word of mouth is very important but don’t forget to do your homework. You need to research. Find out about all of the LASIK centers in your area, before you make your decision.
  3. Find a surgeon that is a refractive or preferably a refractive cataract specialist. Someone with a long history and thousands of procedures.
  4.  Only have all laser LASIK, performed by a surgeon with at least 4-5 years of surgical experience. The more experience the better. Dr. Youssef started in refractive surgery at the beginning of this millennium, in year 2000 and done thousands of refractive procedures with excellent results.
  5.  Go to a center where they offer other options than LASIK because many people are not good candidates for LASIK.
  6. Do not have your surgery on the first visit to the center.
  7.  They must perform a cycloplegic refractive examination and a dilated fundus examination. Do not have your surgery for at least 3 days after this exam.
  8.  Insist on a full conversation with the surgeon, on a day prior to surgery. Never on the day of surgery. This might not happen in a discount centre.
  9. If the surgeon cannot answer your questions or seems too busy, then perhaps you should go elsewhere.
  10. Ask about the technology that is used at the centre, so discount centers buy used and older equipment to keep the price low.
  11. Be careful with word manipulations. For example, customized treatment actually measures your eyes and treat these aberrations that was measured. On the other hand, optimized treatment is not the same. It applies a general average aspheric treatment rather than measured one.

How many checkups will I need after LASIK?

We will see you the same day of the surgery then will probably return the next day, then one week or one month later and then three months later. Dr. Youssef will let you know if more visits are necessary.

How many Botox treatments are needed before you see results, does it hurt, and what is the healing period and aftercare?

When injected appropriately, the results will be seen after the first treatment. Botox takes two to four days before the muscle weakening effect takes place. The maximum effect occurs at about 10 to 14 days. The effect then lasts up to three months.

Pain and discomfort depends on one’s tolerance for needle injections around the face. There is typically no “healing period and aftercare.” Most physicians suggest that the areas of injection should not be rubbed or manipulated for a few hours after the injections.

How much does cataract surgery cost?

The cost of the procedure varies according to the nature of the vision problem and its severity, the type of treatment needed and the type of intraocular lens selected. If you come for a consultation at one of our clinics, we will be able to give you an exact quote for the cost of your procedure.

What Is Presbyopia and How Is It Treated?

Why Do I Need Reading Glasses as I Get Older?Have you ever noticed that nearly everyone who is in their mid- to late 40s or older uses reading glasses or bifocals? Here, the team at King LASIK explains why that is — and what your treatment options are for the age-related vision condition called presbyopia.

Presbyopia is an age-related form of farsightedness that makes it difficult to see objects up close. It typically develops during one’s mid- to late 40s and beyond. Even if you have never had vision problems before, you will very likely develop presbyopia as you get older.

To understand the possible causes of presbyopia, it is important to recognize that the eye lens normally changes shape in order to adjust its focus. In other words, the lens is one shape when looking at objects in the distance and adjusts to a different shape when looking at objects close up.

Most professionals believe that presbyopia develops as a result of the eye lens hardening with age. As the lens becomes more rigid and less flexible, it is unable to change shape — and is therefore unable to focus on close-up objects — like it is able to do during the earlier stages of life.

There are a few possible treatment options for presbyopia. The first is to wear bifocals or reading glasses when looking at objects close up. The second option is to use multifocal contact lenses that work like bifocals: They feature two different prescriptions to accommodate both distance and near vision.

Yet another possible treatment option is to undergo LASIK surgery to achieve monovision. Monovision is when the laser eye surgeon corrects one eye for near vision and the other eye for distance vision. With practice, many patients are able to adjust to monovision over time. However, some individuals cannot accommodate monovision, so it is important for anyone considering the procedure to visit King LASIK for a complimentary consultation. During this time, patients can try monovision to determine whether it might be right for them.

One more option is to have a lens exchange with a multifocal lens, like we do during cataract surgery.

Is there a rebound effect when Botox wears off and one does not go for repeat injections?

No, the muscle activity should return to its original state when the Botox wears off.

What should I do the weeks after the surgery?

The week after the surgery

  • THE CLEAR SHIELDS TAPED OVER YOUR EYES AT THE HOSPITAL MUST BE WORN TO SLEEP FOR THE FIRST WEEK AFTER SURGERY.

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  • Once you have had your cataract surgery, please contact your optometrist’s office and arrange an appointment for their office to see you 6 weeks after your surgery date.
  • Eyes should also remain covered with regular sunglasses when outside to prevent anything getting into the eyes.

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The month after the surgery

  • Patients must also cover the eyes with swimmers goggles to shower for the first three weeks after surgery.
  •  Swimming Goggle
  • Glasses (if still needed) should not be purchased until after the five to six weeks appointment.
  • Most people will find that they require reading glasses after surgery. We recommend dollar store reading glasses during the healing process.
  • After cataract surgery, patients will often report seeing what resembles quarter moons or black blinders in the peripheral (corner or side) vision. This is perfectly normal. The swelling of your eye is causing you to pick up extra light that creates the flickering quarter moons. These flickers of light will most likely be present when you go from a dark to light area or vice versa. These flickers should not be present when your eyes are closed. If they are present with the eyes closed, our office should be contacted as soon as possible. The dark blinders are caused by the inflammation and what you’re seeing is the wound, which gets better with time. If this is caused by the lens edge, it would last longer but finally most of the patients would adapt and stop seeing it.
  • Patients will often report the sensation of grit or sand in the eyes like the feeling of an eyelash or stitch. There are no stitches in your eyes. The sensation is dryness caused by the surgery. Using the Artificial Tears four times a day should avoid/correct this feeling.
  • A common misconception is that one should not bend forward after having cataract surgery. We now feel that simple bending is acceptable. Acts like bending to pick something up, tie your shoes, etc. are harmless.
  • You should avoid very heavy lifting or strenuous activity for a period of two weeks after cataract surgery.

How does Botox work?

Botox works by weakening the muscles into which it is injected. As facial muscles contract, the loose skin above those muscles wrinkles. By weakening the muscles, the wrinkles are reduced.

How long will it take to notice an improvement in my vision?

Vision is generally much better just one day after surgery. It continues to improve over the course of one month after surgery, until the eye has healed completely.

 
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