While bidding adeu you may say Good riddance to contact lenses too.
Imagine getting up in the morning and looking at the alarm clock with your naked eyes. You then grab your smart phone to check on your email and the latest from your friends on face book. While eating breakfast you skim through the newspaper. Continuing the trend, you drive with no glasses to work and then go on to play golf. After playing the best golf of your life, you get a quick swim in which is a pleasure without glasses or contact. On way home you pick up groceries without squinting. Then you cut some organic veggies for a nice dinner. Catching up on bedtime reading, you wonder why you did not get this unbelievable rejuvenating therapy before.
How is that possible? But first why not talk about why you even need glasses for reading. or I think I may have presbyopia.
Presbyopia is medical jargon for ageing eyes.
What causes presbyopia?
There is increasing stiffening of natural lens and decreasing strength of eye muscles. The zoom mechanism of the natural lens undergoes deterioration.
Old is difficult to define. This condition is present in mid forties. It may appear a little earlier in farsighted people. People with smaller pupils may display a delay in onset of presbyopia.
We have a few choices to overcome this natural malady.
Pie is the creme de le creme of methods to rejuvenate ageing eyes. Let us explore how it is superior to other methods which combat effects of taking too many revolutions around the sun.
PIE is more advantageous than Glasses
Heck yeah. You agree with this or you would not be reading this page.
It’s safe to say PIE overcomes all these nuisances.
Pie gives binoucularity which is better than Monovision
This is a process of setting the focus of one eye on close-up objects and the focus for your other eye on far-away objects. In doing this, your brain combines the two images to create a clear picture. This is a relic from the twentieth century. Primary disadvantage is one looses binocular vision.
PIE allows you to preserve binocular depth of field vision.
Brain prefers PIE to multifocal contact lenses
Multifocal contacts move with every blink. The image presented to the brain fluctuates confusing it. That is why many people are not able to adapt to multifocal contact lenses.
PIE are stable and do not move. Brain neuroadapts improving vision.
Contact can lead to sight threatening cornea infections for as long as you wear them.
PIE is not exposed to the elements or bugs.
Types of PIE
Multifocal PIE let you see far and near
These include the ReZoom, ReSTOR, Symfony and Tecnis lenses. Multifocal IOLs are lenses that have concentric rings of varying focal power, like a bullseye. Some rings provide focus for near objects, others for mid-range objects, and some for seeing objects at a distance.
The Tecnis Multifocal Foldable IOL also has concentric rings for different distances. It received FDA approval in January, 2009 for use in cataract surgery, where the natural lens is replaced. In the clinical trials most participants achieved 20/25 distance vision or better and 20/32 or better for near vision. It is designed using Wavefront data – the same precise level of information that is gathered when you are having Wavefront LASIK.
Accommodating PIE implants mimic natural lens
These lenses are designed to change focus. An accommodating IOL allows you to see distant objects, and then is can change focus and allow you to see objects that are close up. The only accommodating IOL approved in the United States is the Crystalens. This was true in 2005 and is still true in 2014. We even have toric crystalens called trulign.
Wherever you live you will want to enjoy good vision. If you want to see near and far , please contact our
office today. Los Angeles ophthalmologist Dr. Khanna and his staff can help you find the new technology PIE that is best for your lifestyle and needs. Please call today to schedule your free vision screening so that you can see far and near and your computer too.
By Rajesh Khanna MD
Good Morning, Dr Khanna here, with some very interesting questions on Lasik eye surgery, looking at it from a different angle. Some things I hadn’t thought people think and that’s how we learn more.
The first question is, “where to buy Lasik goggles” initially I got confused, like what do they mean by Lasik goggles? Then I understood. When we do Lasik surgery, we provide you postoperative kits, special glasses to wear, both during night, which are clear and wrapped around your face, so that you don’t accidentally touch or rub your eyes, and then during day time, so that no dust, sun or wind goes in and irritates your eye. I understand that some people are not able to get the same from their own Lasik providers and they’re looking to get good quality ones. So if you do online search, you can find like MHI Care, (INAUDIBLE – 1:08), solar glasses, cheapertender.com, funny name but it’s true, it is very cheap. But these have some good quality, both sun glasses, driving glasses, antiglare glasses which are very affordable.
“Can Lasik cause flutters?” No, Lasik does not cause flutters and Lasik does not treat flutters.
Which leads us to the next question, “can Lasik cause dry eyes?” Yes, Lasik can cause dry eyes, but usually it’s not permanent. When we did some studies, going back 20years ago, we used an instrument called the Osteometer, which checks the corneal sensation. We found that most of the corneal sensation returned back to normal between 3-6 months, and by 6 months people will adapt. That’s why when we are preempting dry eyes, that means we don’t want people to get dry eyes from Lasik, we start artificial tears, even insert punctual occluders in the corners of the lids to preserve the natural tears to prevent dryness from occurring. It is also very important to make sure that people don’t have severe dry eyes and that would become a contraindication. Like people with (INAUDIBLE – 2:27) syndrome who cannot produce any tears at all.
Another way we help people pre-avoid dry eyes, is that cyclosporine drops like Restasis or Zydra in indicated (INAUDIBLE – 2:41)
Our next question is, “can Lasik cure blindness?” I think that is a very general question. If the blindness legally is resulting from nearsightedness or astigmatism, yes, it can cure that. But if the blindness is from retinal detachment, (INAUDIBLE – 3:02) generation, optic nerve atrophy, then Lasik cannot help.
“Can Lasik correct double vision?” This is very important, because just yesterday, we got referred to a 24 year old young man but his neurologist, to find out the cause of his double vision. Now double vision is known as diplopia. We had to separate diplopia from monocular diplopia, where in each eye, when the other eye is closed you see double, to binocular diplopia you see double only when both eyes are open. When it is binocular diplopia, then more nerve related issues or muscle related issues are the cause. Because both eyes have to work in sync, so if the muscle is weak on one eye, one eye will move and the other eye will not and then you can have double vision. But this boy has a very clear history, that even when the left eye was closed, the right eye saw double. And the other way, when his right eye was closed, his left eye could see double too. Such things point more towards astigmatism, and that was my first impression, and we checked it his numbers, found astigmatism, put it in the trial frame and he said yes the diplopia disappeared. So that will be cured by Lasik.
“Can Lasik be done twice?” Yes, Lasik can be done twice. And when we do it the second time, we don’t even have to lift the flap. If we do Lasik today, and patient need to be enhanced to fine-tune in six months, we can just lift the old flap. But if the flap was done 10 – 15 years ago, with older instruments, it might not be wise to lift it up, and then the option becomes doing a surface treatment.
Thank you so much, keep your questions coming and watch out for answers.
So, you have gone ahead and had Lasik Eye Surgery. You may be wondering what to expect next. Are there any side effects or precautions you need to look out for or be careful of? We are here to answer all of your questions.
After having Lasik Eye Surgery it is common to have some temporary side effects. One side effect is that you might experience some tearing from either one or both of your eyes, and it might switch between the eyes. Your eyes may feel irritated and/or you might feel like there is something in your eye. There might be the occasional appearance of small red spots on the whites of your eyes. You also may experience sensitivity to light and your vision may be a bit hazy on the day of your treatment. These are all common side effects and should not alarm you. If you are experiencing any other side effect or are concerned about any part of your recovery contact your surgeon immediately.
Now that your Lasik Eye Surgery is over, there are some precautions we would like to go over with you. As with any surgery, or procedure, there are some steps you need to take to avoid injury or infection. First up, you are going to want to avoid showering or washing your hair until at least the next day. If you do decide to shower the next day you must be careful not to get any water, shampoo, or soap in your eyes for at least a week after surgery. Not that you would normally want any products in your eyes anyway! This just means you have to be extra careful. You will also want to avoid going swimming or using a sauna for at least three weeks after surgery. If you are thinking about getting your hair colored or permed, you must wait at least 10 days after your surgery. You should also avoid wearing any eye makeup for at least a week, and make sure it is clean so you can avoid any bacterial contamination or infection. You have to try not to rub your eyes for at least a month and you must sleep with your eye goggles for at least a week. You can exercise again two days after surgery but make sure to wear eye protection for up to a month after your Lasik Eye Surgery. Keep away from dirty or dusty surroundings for at least a week, and lastly make sure to wear sunglasses when you are outside in the bright sun.
By following these precautions, you will help to ensure a fast and safe recovery from your Lasik Eye Surgery.
If you have any questions or would like to set up a consultation call today 310 482 1240
Hi, Dr Khanna here and today we’re going to do a lot of comparisons, because there are different questions asked.
“Which Lasik Laser is best?” So there are multiple kind of lasers, the top three are: the VISX from Johnson-Johnson, Aligrator from Alcon, and shuwen (? 0:21), but out of the three, only the first two are FTA approved.
“Which Lasik clinic is the best?” Now that’s a very tough question, but they have to look at three elements. They should have: the best lasers, surgeons who are the best and experienced, and they being able to give you the best personalized care. So you have to look at these factors in whichever city you are, and select the best.
“Which is better Lasik or PRK?” Both are good surgeries, the surgeon had to decide which is safer for you. So in general, PRK or variations like Lasek and epi-Lasik are safer for you because they don’t cut into corneal. But they can also have their own side effects like haze. Lasik is more popular, because it’s faster healing because you can get back to work sooner, and you don’t want to be struggling to get your vision improved. So Lasik is faster, but PRK is safer.
“Which is better Lasik or Lasek?” Lasek is that form of PRK, where we remove the top layer by chemical instead of by hand, and I think Lasek is safe, in fact we can even do Lasek with in patients with (INAUDIBLE – 1:50), whereas that’s an absolute contraindication in Lasik. For 75% of the people, Lasek would be a better option.
“Which is better Lasik or ICL?” Lasik is less intrusive, it’s more on the surface, but ICL is indicated when there is a mismatch in the amount of corrections to be delivered in the amount of corneal available for safety. So in general I’d say if you have 520micro corneal and then the fraction is minus 12, ICL, but if you have a 460micro corneal and minus 6, ICL. But like for other scenarios like 520 corneal with minus 3 diopter refraction, Lasik would be a better choice, because it is less invasive, less side effects and you don’t penetrate inside the eye.
“Which is better, smile versus Lasik?” I think we did a whole video on this, but just to summarize what’s available in the US, Lasik, like I design Lasik and treat astigmatism, hyperopia, and myopia, whereas smile can only treat myopia and Lasik heals much faster than smile.
“Why does Lasik cause dryness?” Because it cuts the nerves, but that is not supposed to be permanent.
“Are we awake during Lasik?” Yes, it’s important to remain awake. We do you and anxiolytic or Sedative to keep the edge off, nut you need to be looking at the laser light, and the laser light has to focus on you so that the position of the delivery of laser is maintained.
And here is another question which is a big mis-normal , “Why do Lasik Doctor wear glasses?” Few doctors do wear, because it’s everybody’s individual, but there was a recent general study in (INAUDIBLE – 4:05) surgery, and 70% of refractive surgeons have had Lasik eye surgery, so because you see one or two people who wearing and then that gets spread, that’s not true. So most of the refractive surgeons have had Lasik.
“Which is cheaper, Lasik or Lasek?” I think pricing is dependent on how the business is run, because the cost to do both surgeries, Lasik, Lasek, or epi-Lasik, super-Lasik is similar. But there might be more follow ups required with Lasek and epi-Lasik, and in epi-Lasik, another special instrument is used. So some practices have the same price, so that price does not affect the best choice, and other practices grade it. They have different packages, but just to summarize, the pricing should be relatively same.
“Are Lasik prices negotiable?” That again becomes a business question, and I’m sure all Lasik centers usually have some discounts running, and you should specifically ask. There are a lot of centers like us, and where we learnt from, our mentors… we give special discounts to the armed forces, and to cops and firefighters, teachers, so you should always try to get some discounts and ask based on your profession. And if discounts are not available, the next thing is to try to get interest free payment plans.
And I think that comes to the end, apart from one more interesting question, “Can I pay for Lasik eye surgery with bit coins?” And I think that is also getting more popular ad that your answer might be yes right now.
Thank you for listening, have a wonderful day, use your money for investment, not for burning and throwing it away.
Best Laser Lasik Eye Surgery is being offered at Khanna Vison Institute located at Westlake Village and Beverly Hills. Idesign Lasik surgery is one of the best things to happen in the advance of lasik eye surgery. Why are we calling it Best Laser Lasik Eye Surgery? Lets look at the facts.Continue reading
Hi, Dr Khanna here and today we are going to do some challenging questions on Lasik. They’re especially challenging for a physician like me because they deal with pricing.
And the first question is… and this might relate more to United States, but we’ll try to cover it for around the globe too.
First question is “Why is Lasik surgery considered as cosmetic?” Now this is a very tricky thing, because this was conceived 20 or 25 years ago, and it’s actually a misnomer. Lasik is not a cosmetic, it’s a visual surgery. Cosmetic is the way the world looks at us, so if you want the eyelids lifted, or face lift done, etc, then that’s cosmetic surgery. But visual is the way we look at the world, because when we go from glasses to Lasik, we can see more of the world. So it’s about vision, the colours are brighter, everything is more in focus.
But the insurance industry in the United States did not want to cover Lasik eye surgery, because it is more expensive than, let me say cataract, and also, there will be lot more people with the myopic, epidemic in the whole world right now, so it was conceived as cosmetic. So it’s a visual surgery, not cosmetic.
That leads us to the second question “Why isn’t Lasik covered by insurance?” And that’s the answer, because the insurance companies don’t want to spend money, they’d rather keep that money for themselves.
Then the third question becomes… also leads in… “Which are the insurances that do cover Lasik surgery?” Now the most commonly seen, are for like firefighters, their union benefits are there, then a get a portion towards Lasik eye surgery. There are some other insurances which do not cover, but negotiate a discount with the providers, like: VSP, like (INAUDIBLE – 2:27) does it through Blue cross, Blue Shield. They give discount price to the patient.
“Why is Lasik surgery so expensive?” If you look at it, and I quote Warren Buffet here, “There’s a difference between an investment and expense” When you go but a set of new clothes, that’s an expense. But when you go buy stock like Warren Buffet did, that’s an investment. So Lasik eye surgery is an investment. And when you invest in the best, you get the best outcomes. But let’s look behind what all of this required for that 10 seconds, or 2 minutes when the laser is reshaping your corneal, what expenses go in?
So first, we want to make sure you’re the best candidate. So for that, we’ll need a lot of expensive equipment which was not even existing 10 years ago. We need OCT Pachymetry Maps, we need colour corneal topography, we need eye designs via scan studio. These combined come to quarter million dollars, and I didn’t even add lensometer, and auto refractor, and tonometer, slit lamps. So that diagnostic part is very expensive itself. But now when we come to the actual laser, you will be surprised why it’s nearly costing half a million dollars.
When we first started 25years ago, the common thing was that Lasik would become so popular, that instead of the 8-10% penetration that we have right now, it would be 80% penetration and there’s half million dollars, machines would come down to price for $50,000. That never happened, so the machines are still expensive and it’s expensive to run them. Even if we have the state of the art laser, every time we use it, we have to put a debit card in, which debts the cost for each eye surgery. This is again coming from something called (INAUDIBLE – 4:41) going to the manufactures, and there are other expenses like gasses used. And if this was not enough, the companies also charged an exorbitant maintenance price to maintain it monthly. You don’t want to go to someone who’s using the local engineer to maintain the laser.
So when… let’s say Johnson-Johnson or Alcon… they charge a fair amount of money to make sure the laser runs precisely every monthly. And that’s your guarantee to good Lasik outcomes. Now what about the old lasers we had also taught that the technology will advance, the older lasers will become cheaper, and that has become. But you don’t want to trust your eyes to 15year old technology, just like you don’t go buy a computer which is 15years old, or a car which is 20years old. Because the more we progress, we want the best.
And there are also costs involved with the equipment sterilization and follow up. So when you take this, and let’s say you do financing over the 3years,( 36months), it just comes to a Starbucks coffee per day. So it’s how you look at it, if you’re just spending $5 per day on Starbucks coffee or on your eyes, you tell me which one is more expensive in the long run. Because Starbucks coffee is not an investment, but your vision is.
So keep using your vision to watch me, and send me more questions, and I’ll be happy to pick up tricky ones like these too. Have a wonderful day.
We all know that price is important! But think about it, is that all that is important? We get these phone calls that come in from all over Ojai, Santa Monica, Santa Maria, Santa Barbara, Fillmore, Santa Paula wherever it may be and the first thing that comes out a lot of peoples mouth is how much is it?
Well that’s a great question. But aren’t you also concerned about who the doctor is, how long has he been practicing, how is the facility, the equipment we use, what’s the quality of our machine, what’s the staff like, what’s the environment like in the office. Well the great thing about our office is we offer FREE consultations. In that FREE consultation you get to come into the office meet the staff, meet Dr. Khanna, most important of all find out if you are a candidate whether it be for Lasik, or Super Lasik!
You may even need a different procedure done such as intacs, or cataract surgery who knows until you come in and see us for your FREE consultation. We are also more than happy to go over the procedure with you, the cost and answer any questions you may have!
Hi, Dr Khanna here, and today’s questions are related to our workforce, because people are interested to know ‘when can they go back to work?’
So the first question, “When can I return to work?” So it depends on the kind of work you do. So most people can go bat to work the next day, I know some people in the financial industry who go back to work the same day in the night because they save it on the laptop. But it’s best to keep the eyes closed on the first day, so the earliest you should return to work the next day. But for Nurses and Doctors who are exposed to bugs in the hospitals, it’s better to wait 48 -72 hours, so the epithelium is fully healed, so bugs don’t find a way to enter into your Lasik flaps. At the same time, same thing applies to people who may be in the in the agricultural industry working with animals like (INAUDIBLE – 1:00) or taking care of horses, so in those instances, it’s better to wait 2-3 days before going to work .
But here’s a question women ask more often. “When can I wear makeup, because I don’t want to go to work without makeup?” So within 48 – 72 hours again, you can start wearing makeup. We just want the flap to heal completely, so nothing is able to penetrate inside.
“How young can I be to have Lasik?” The FTA approved range is from 18 onwards, but off FTA, we can do it even younger, and there has to be certain indications for that. For most common indication for doing Lasik, and I’ve done laser vision correction on as young as 13, is when one eye is amblyopic or lazy, and then you are worried because of contact lenses intolerance, the eye should not become totally lazy. So you to stimulate that nerve pathway, so in those instances you can do. Another time you can do, is when kids are going to college and they’re more (INAUDIBLE – 2:17) some kids cannot handle contact lenses by themselves, or more prone to infections since Lasik eye surgery is safer than contact lenses. If the refraction has stabilized, usually in girls, it stabilizes by 15years, whereas in boys, 17 – 18, but if you have done serial exams and found that refraction is stable, then it can be done.
“How does Lasik work?” Lasik works by reshaping the front part of the corneal, so that the incoming light gets focused on the retina on a single point. So that means astigmatism, nearsightedness and farsightedness can all be treated.
“How long does Lasik take to heal?” So there are three steps in the healing of Lasik eye surgery. The first one is like immediately I finish doing the eye surgery, within 1-2 minutes, negative suction created by the endothelium makes the flap attach to the bed. Just like a (INAUDIBLE – 3:27) it sticks back, so this is the first stage of healing.
The second stage is within 48-72 hours when the epithelium which has been cut grows back over the cart and spreads to all the sides. This is the second stage, and this is what we want to wait for before sending you work or apply makeup etc.
But the third stage is the long term. Over the next few months fibrosis occurs. So the flap is stuck down even more tightly.
So initially, two minutes, then 48-72 hours and finally many months.
Hope all these questions and answers are continuing to help educate you about Lasik eye surgery. Have a good day.
See a testimonial from a Lasik patient who has 20/20 after Lasik surgery with Dr. Khanna from the Khanna Institute of Lasik and Refractive Surgery: http://youtu.be/p8Zzm8b2II4
Lasik eye surgery proves to give a person a permanent corrected vision and this is why more people want to try this recent advancement. It is also known as the painless and safest procedure. However, there are some limitations as to what you can do right after having the treatment.
· Staring at Bright Lights
The patients of Lasik eye surgery will be given dark sunglasses just to dim the light he or she can see. This is because you should have a gentle view of the surroundings and this is also to prevent you from scratching your eyes.
One is not allowed to drive since the patient still needs to depend on other people after a few days or weeks or as long as the healing process is happening. Not being permitted to drive also prevents your eyes from having tiny debris such as dust.
· Applying Cosmetics
Cosmetics may infect the eyes so it must thoroughly be avoided. Otherwise, the healing process will not be completed successfully. Cosmetics include false eyelashes. The only allowed cosmetic is the eye drops since it helps in keeping your eyes moisturized.
Though exercising has no direct effect to the eyes of a patient having Lasik eye surgery treatment, physicians still prohibit doing routines as a precautionary measure. It is recommended that physical fitness must only be done after a month of having the treatment. The patient must rest most of the time and must not take long in front of the television and computers.
· Drinking Alcohol
Alcohol can halt the effects of any type of medication taken by a person so it must be avoided as well after having Lasik eye surgery.
· Taking a Bath in a Shower
It is advisable that no water shall enter the eyes for the first few days after the treatment so taking a bath with a shower must be avoided. However, one can wear goggles as an eye protection.
All types of surgery surely have do’s and dont’s and knowing the things above Things to Avoid After Lasik Eye Surgery can help you make your treatment successful.
By Rajesh Khanna, MD
Lasik Vision Expert and Host of Hangout with Laserman
Hi, today’s questions are more directed for women, because they are related to pregnancy childbirth. But also men need to be understanding, so they can know when it’s the best time for doing Lasik.
“Can Lasik be done when a woman is pregnant?” Lasik can be done, but it’s best avoided in the first trimester, and later on it depends more on “why are we doing it?” Because we have to be aware of two things, 1, can Lasik affect the baby in the tommy? Number 2 are the eyes stable? So we have preoperative history of the curvature of the eye, the numbers of the eye and the other similar of when the person presents to us, Lasik can be done. But in the first trimester, we don’t want to avoid any trauma to the eye because we don’t want to be putting drops, because it can affect the fetus. So the first trimester, we totally avoid, it’s almost contraindicated. In the second and third trimester, if somebody really wants… because you know a lot of times, what really happens very busy women procrastinate and put off Lasik eye surgery because of not having leave from work, and when the time comes, of pregnancy and they’re thinking of child birth that they will have to carry their glasses, or they may not have contact lenses, or contact lens intolerance has set in, they might want to do in the third trimester, when the baby is already developed would be a good time to do.
“Can Lasik be done when breastfeeding?” Again this is a relative contraindication, because you don’t want to be doing surgery and then if you put drops it could go into the milk into the baby’s mouth. But the amount of the drop we put is very minimal, and the Paediatricians will tell you that does not have any much effect on the baby. And we can even avoid putting many drops by reaching down, by occluding the eye with punctual occluders, so the drops stay in the eye. And we can put long acting drops, but again, we have to make sure that the eyes are stable. And usually as a rule of thumb, we like to wait six months, sometimes it’s not possible very long because, like I can give you an example of an editor, she came in and she was in her mid-30’s, she said, “I’m starting my family really late and I want to have my kids quick before I turn 40, so I may not get time like I (INAUDIBLE – 2:48)stop breastfeeding for a year or more, because I want to be breastfeeding for up to a year, and I want to have another baby.” So around six months would be a good time, but in special situations, we can even do earlier.
“When to get enhancement for Lasik” That bar keeps shifting. 20years ago, when we started doing Lasik, we wouldn’t even enhance anybody above 20 – 40, but today we enhance even people who are 20 – 20. The difference in our technology is more accurate with better outcomes, and we even go after minimal astigmatism like .75 diopters. Why? If you feel that it’s still residual diplopia like we discussed in the previous video because of the astigmatism, or there is not sharpness to see distance, and if that bothers you, even with (INAUDIBLE – 3:52), and even if you’re a lie short of 20-20, we can do that. So it’s more dependent on you, if it’s really bothering you and if the surgeon feels it’s something going after. Sometimes it’s more like a number, if is a quarter and the person just likes it when glasses are put, that might have more to do with cutting off some hydroboration’s (? – 4:13) glare something, and that time antiglare glasses like we mentioned she put in that (INAUDIBLE – 4:20) might be more helpful.
“When can I watch TV after Lasik?” Only good shows should be watched on TV, I’m just kidding. So on the same day of Lasik, it’s better to avoid being on laptop or TV because the light emanating from (INAUDIBLE – 4:36) can dry out your eyes, and when you’re watching something interesting, you might not remember to blink. Normally, a person blinks 16times a minute, but when you are reading a very interesting book or watching a show, you don’t, then eyes can dry out. So best avoid 24 – 48 hours, you can start listening to music and just occasionally open your eyes and watch.
Hope these questions are helpful, stay tuned for our next set.
LASIK eye surgery is capable of treating a wide range of candidates with excellent results. However, not everyone is an ideal candidate for LASIK. Certain medical conditions and unique anatomical factors can put patients at an increased risk of an unsatisfactory outcome, or simply limit the success of your results.
Some of the risk factors for LASIK eye surgery include:
These factors are also known as “contraindications” – meaning they are reasons to withhold medical treatment. However, if you have one of these contraindications, you may qualify for a different type of laser vision correction. For example, people with thin or irregular corneas often qualify for LASEK or SUPERLASIK.
If you have further questions about LASIK eye surgery, please contact The Khanna Institute today to schedule your free LASIK screening. We serve patients throughout the Los Angeles area, with offices in Beverly Hills and Westlake Village, California.
Hi, it’s Dr Khanna – we are tackling questions relating to Presbyopia.
Our first question is, “Can Presbyopia be corrected?” The answer is yes, Presbyopia can be corrected. We can use glasses, contact lens to overcome the effects of presbyopia, but if you want to totally correct it, we have to do a surgical procedure.
“Can presbyopia be reversed?” Yes we can reverse the ageing eyes, by putting in presbyopia by putting in presbyopia implant inside the eye. And that’s why it answers the next question.
“Can presbyopia be cured?” Yes, presbyopia can be cured and ageing eyes can be reversed with ‘PIE’ which is acronym for ‘Presbyopia Implant in Eye’
“Can presbyopia correct myopia?” No, presbyopia cannot correct myopia, but myopia helps in deferring the onset of presbyopia. Because myopia means that a person is nearsighted, they can see near but not far, so they wear glasses to see far. But when they take the glasses off, they can see near. So when they become presbyopic, the nearsightedness helps them, but after some point in time, the help vanishes.
“Can presbyopia cause headaches? Can presbyopia cause dizziness?” The answer is yes, and I’ll give you examples of this engineer, who is working on small microchips, and because of presbyopia, he tries to be very focused, he developed so much headaches and dizziness… that he had already been referred to orthopedics, neck surgeons, neurologists, and the only thing that cured him was PIE, when we did Presbyopia implant in his eyes, then he was able to get natural vision, and his awkward sitting posture was eliminated.
“Can presbyopia cause blindness?” Blindness in the sense of you not being able to see near. So it will be blindness for near, if you don’t use glasses or contact lens. And that must have been the case in smaller villages, and third-world countries where they can’t afford glasses, they’re not able to see near. And it’s also a manifestation of more of the industrialized world. Because as farmers, you may not need a lot of near vision, you don’t read, you plough, you milk cows and you may not notice the loss of near vision as you would notice when you’re on the computers or reading all the time.
Can presbyopia improve? With some exercises you can get improvement in presbyopia, especially during the early part when the presbyopia first starts. Doing some exercises like closing one eye and forcing your eye to read, and then doing the same on both, and then opening and trying to focus in and trying to bring it in gradually, that can help. So I think that’s one of the advantages you can get, but if you are 60 years old and already wearing, there’s unlikely to be a dramatic improvement. But some people get improvement when they develop cataracts, and that’s on their second sight. Because when nuclear sclerotic cataracts do a lot, it acts like a magnifying lens and makes you near sighted, so a person can then read, which they were not able to read before.
“Will Lasic make presbyopia worse? Presbyopia has got no sighted around its fixed stage, Lasic is not going to make it worse, it can mask the presbyopia. So in a farsighted person, doing Lasic can improve your reading and defer presbyopia. Whereas in a myopic person, if you correct for a near sighted parson, next they might have a need for reading glasses.
“Will everybody get presbyopia? Yes, everybody sooner or later gets presbyopia.
“Will surgery help presbyopia?” Yes, surgery does help presbyopia, and we are going to get into the details of presbyopia implants in our next set of questions. After this one which says
“Will Lasic correct presbyopia?” Lasic cannot correct presbyopia it can counteract the effect of presbyopia. What I’m trying to say here is, Lasic works on the static corneal, whereas presbyopia is a problem of the dynamic lens. So Lasic cannot cure or reverse presbyopia, it can help mask the effect. So if somebody is farsighted and we do Lasic, then your vision can improve. Or if somebody is planar and we make we make one eye for reading called blendo mono-vision , then they can be free of readers. But it does not cure presbyopia. The only thing that cures presbyopia and reverses ageing eyes is ‘PIE’ or ‘Presbyopia Implant in Eye’
In our next set of questions and answers will be related to presbyopia implant procedures. Thank you and stay tuned.
Hi, it’s Dr Rajesh Khanna, and if you were born before 1965, you should not miss this episode, because now we’re going to discuss about presbyopia with a flurry of questions. Oh my God, I didn’t even realize that a lot of people would be interested. But the number of questions are even more than what came for lasik. We’ll start with the first question and it is actually related to the same word “start”.
“When does presbyopia start, or when does presbyopia occur?” So presbyopia means ageing eyes in simple terms. Around 40 to 50, between that age group, our lens has hardened, the muscles… they’re called ‘Zonules’ , they’re very thin fibrous but they act like muscles that pull against the shape of the lens, they begin to weaken. So in that age group, it’s almost mathematical how the weakness occurs. Usually at age 40, you need zero diopters of reading add, but by the time you hit sixty, you need plus three reading add. In between for every four – five years, it increases by half a diopter. “When does presbyopia stabilize?” So it begins to stabilize towards the end of 50’s and early 60’s, because the maximum limit is reached, which is 3 diopters.
“Who gets presbyopia?” Everybody gets presbyopia. Whether you are a man, woman, whichever ethnicity, but not 100%, so you know that everything that is a bell-shaped curve, some people will get it in their 30’s, and some people will not get it until 70’s, but the rule of thumb, everybody gets presbyopia around 45 years of age, which affects the near end reading activities.
“Who discovered presbyopia?” I think even as early as Benjamin Franklin, or even if you go back to the 13th century, there are pictures where people have invented some sort of glasses to be able to read. So I think presbyopia had been there for a long time with us. And it might have started when men and women started living longer. Because as you know, people who follow the Paleolithic diet etc, in those times, human age was around 30-32 years, so people did not live long to experience presbyopia. But I think that around the time of our millennia, about 2000 years ago, when human life began to increase, we experienced presbyopia.
“What does it mean presbyopia?” Presbyopia means ageing eyes. “What age does presbyopia start?” We again discussed that, around 40 to 45. “What to do when you get presbyopia?” There are a couple of things you can do. You can push your hands a bit further and try to read. You can get glasses, or you can put a contact lens in one eye and not the other and make it for reading, or there are surgical procedures which we will discuss in following questions and answer.
“What is presbyopia contact lens?” So I was just hinting at that. So if you wear contact lens in one eye, that will help you read with one eye, whereas the other eye will see far. There are also multifocal contact lenses, but they don’t work very well because with each blink, the lenses move. And most of the people are not able to tolerate that fluctuation in image. “What does presbyopia mean in medical terms?” So in medical terms, it’s the failure of the lens to change its power, by changing its shape.
“What is presbyopia and myopia?” So that’s important because presbyopia occurs in everybody. Whether you are farsighted, you’re plano, or myopic. So in farsighted people, it occurs maturely in their 30’s, myopia people who are nearsighted can read fairly longer into their 40’s and sometimes 50’s until it begins to affect them too.
“Why is presbyopia not a refractory error?” This is a very good question, because the refractory errors we say are myopia, hyperopia and astigmatism because they are static. Presbyopia is a failure of the dynamic part. So just to repeat that, nearsightedness, farsightedness and astigmatism are static problems, so they occur under 40, whereas presbyopia is a dynamic problem.
“Are hyperopia and presbyopia the same?” No, hyperopia just now as we mentioned, is a static problem with the eye being small or the cornea being flat, whereas presbyopia is an ageing issue.
And now, we are going to come to some questions which will be tackled in our next episode, ‘How to kill or treat presbyopia’, so stay tuned for the next episode. Thank you and have a wonderful day.
Everyone will experience presbyopia as they grow older. If you are currently using reading glasses or bifocals, you may be interested in some of the more permanent presbyopia treatment options that are now available. Our experienced Beverly Hills ophthalmologist Rajesh Khanna, MD offers three main forms of presbyopia treatment:
There is no reason you should resign yourself to using reading glasses or bifocals for the rest of your life. Today’s presbyopia treatment options make it possible to enjoy clear vision at all distances again, freeing you to do and enjoy more on a daily basis.
To discuss presbyopia treatment in more detail, please contact The Khanna Institute today or call (888) 339-8143 to schedule a consultation with our experienced Beverly Hills eye doctor. We serve patients in Beverly Hills, Westlake Village, and surrounding areas of Los Angeles, California.
Hi. This is Dr. Khanna, and today we are going to talk about iDesign LASIK eye surgery and why it’s one of the best LASIK vision corrections available today.
We have come a long way from the early ‘90s, when lasers were first invented to correct or reshape the human cornea. The precision and accuracy and safety has increased in the culmination of iDesign. It’s better than SMILE. It’s better than conventional, Wavefront Optimized, and even Wavefront LASIK, because it can not only correct astigmatism and other aberrations, it can do it very precisely. Let me just focus then on a little iDesign picture to show you what all it measures, and then it can treat that. If you look at this picture, it identifies the outer iris boundary. It identifies the inner iris boundary.
It identifies the hills and valleys, and also, the center of the cornea, the fixation, reflects, and the pupil, center of the pupil. These become very important when you’re dealing with esotropia or exotropia or angle alpha and kappa. Without getting you confused, all the three things I mentioned, the center of the pupil, center of the cornea, and the side reflects should be well opposed or as close to each other. The fun begins when they are separated, and that’s where we get into angle alpha and kappa. It becomes very important that the computer which is generating the treatment profile takes those into consideration and the algorithm is based on previous studies and seen where the outcomes would be the best.
iDesign Lasik does that. We don’t have that facility in conventional and other forms. Now we’re going to turn to some more interesting pictures here. If you look on this, I’ll move onto this side. These are 3-D images of the higher order aberrations, all aberrations, and the refractive map, and the point spread function of the higher. If you want to focus on in here, you’ll see it looks fairly uniform, though even from here to here versus from here to here, you see the shape is different. If you’re using SMILE or conventional, they’ll not be able to match, correct the shape, because for -5, it’ll be just making it like a sphere. Whereas in iDesign Lasik, the treatment is matched to the exact shape.
This gets even more interesting when we look at the higher order aberrations. What are the higher order aberrations? They’re called coma, etc., trefoil patterns. The lower order is what we are used to. The sphere, cylinder. But in the higher order of aberrations, if you look, how do they generate this? If you want to do SMILE or conventional, how is going to be possible to match the shape to correct this? What it means is, here on the hill and here, it needs more spots and here it needs less spots. The same thing we can see in the point spread function, that the cornea is not uniform when you compare superiorly and inferiorly, and even temporally and nasally.
If you were to put a mirror here, this spot and this spot wouldn’t match. That means the treatment profile is unique for each eye, and that can only be achieved by a really fast computer processor and special cameras which can pick up and then transmit all that information to a laser which can use that by variable spot scanning to reshape the cornea to give us the most precise vision possible.
I hope this is helpful. If you have any questions, feel free to comment or reach us at 805-230-2126. Have a wonderful day.
Symfony toric is a new premium intraocular lens to correct astigmatism. It is manufactured by Johnson and Johnson, the same company which also makes Band Aids.
There are about 4 million cataracts surgeries that are performed every year and more than half of Americans have undergone cataracts surgery by the time that they are 80 years old. It is not only a condition that treats older people, but it can occur in the eyes of any human being. Similar surgeries are done in people who suffer from presbyopia, astigmatism, and other problems people may experience with their vision. These surgeries are not necessarily painful, but they do cause some discomfort. However, there is a new way in which patients can look forward to crisp vision after the surgery.
The Symfony Toric contact lens has been approved by the FDA recently and shows that it can help with any of the above problems. Doctors have recommended it to their patients following their cataract surgery in order to help them enhance their recovery and vision. It is especially helpful for those who suffer from presbyopia. The lens returns the sense of freedom and independence to the patients and allows them to continue with an active lifestyle without having to wear glasses.
During a cataract or presbyopia surgery, the lens of the eye is removed and an artificial lens, or IOL, is inserted into the eye. The IOL is usually a monofocal lens which only allows patients to see objects at a distance. The result is then that objects that are closer are out of focus. The Symfony lens is developed in such a way that both the objects at a far distance and those at a closer distance can be seen perfectly. It improves the range as well as the quality of vision in patients. Those who have had the Symfony implanted in their eyes have proven to have more successful results than those who have the IOL implanted in their eyes.
The Symfony lens has been approved by over 50 different countries worldwide and is also available in the United States of America. It has been clinically tested on over 2,000 eyes and these are the results that have been returned:
Would you like tolerant more about symfony toric or presbyopic implants. You should read this informative book on Presbyopic Implants.