Wednesday, February 03, 2010

Dr. Arun Gulani
 ARTICLES BY DR. GULANI:
About LASIK Eye Surgery
LASIK Raises Vision Surgery To An Art
Understanding Your Eyes
Lens Based Vision Surgeries
After 40 Reading Glasses  
 

• Doctors who may be new and inexperienced themselves but use the established name recognition of their more experienced, senior partners (who may have actually even retired from the practice).
• Eye surgery “Mills” that advertise the joint number of cases done by all chain centers across the nation (ie. 500,000 cases done) while their surgeon may be a novice with a high chance of causing bad outcomes.
• Doctors using celebrity testimonials (NFL sportsmen/movie stars etc). In many such cases, the doctors actually pay a hefty sum to be known as official surgeons of such celebrities. Also, they most often will do surgery for free to get an endorsement.

• Patients are not educated about other available options since the surgeon may themselves not be capable of performing those options.
• Patients feel intimidated to ask questions about surgeon qualifications, vision expectations, side effects etc.

• Lasik may be all that the surgeon performs. They be ignorant or incapable of performing the entire range of Laser Vision Surgeries
• Lack of knowledge, initiative or expertise in offering and performing vision surgery options if Lasik is not ideal for the patient (ie. New generation ICL surgery for Thin cornea patients who are not ideal Lasik candidates)

• Lack of understanding on surgeon’s part regarding interaction between, anatomy, physiology and optics of the eye to get a great vision outcome.
• Lack of technological finesse to detect early abnormalities and avoid Lasik in improper candidates
• Inability to deliver the best outcomes due to lack of modern, cutting edge equipment.

• Besides visiting the surgeon’s website; do use a search engine (ie. Google/MSN/Yahoo etc) and type in the doctor’s name and see what comes up. “Do you find only a website and other paid advertising claims? Or do you find interviews, published articles and third party confirmations of the doctor’s status?”
• If your surgeon says that they are the First or that they teach other Lasik surgeons, ask for evidence. Are they first in the world, country, state or just on their street (decreasing order of importance). Do they teach at local dinner meetings that they host or are they invited to teach nationally at prestigious podiums.
• Meet with the surgeon, get a feel for the integrity and involvement of the surgeon in educating you and answering every question. Also make sure that your surgeon is contactable and that they do indeed respond when you call.
• Make sure that your surgeon will see you before surgery, perform your surgery and also see you and be available after your surgery.
•  Find out if your surgeon performs the full spectrum of Laser Vision Surgery (remember Lasik is just one of many Laser Vision techniques) so they can offer what is truly best for you rather than suggesting the only surgery they know how to perform.
• Do not fall for flashy computer screens and equipment in the office; make sure that you understand all that is going on and insist on asking the surgeon to explain in layman terms.
• When meeting your surgeon, do ask about possible side-effects and complications. Ask if in the rare event that you do end up having a complication can they handle it? If the answer is yes, then ask for evidence.

Dr. Gulani: Understanding Your Eyes

POSTED: Thursday, January 7, 2010
 
One of a continuing series of articles by Dr. Arun Gulani, who founded Gulani Vision Institute in Jacksonville, and is one of the leading laser eye surgeons in the United States.

He will be in Channel 4's studios Jan. 21 for a live, interactive Webcast to talk about the possibilities of corrective vision.

Normal Vision

Just like a camera, the eye has a viewfinder (called the cornea) a shutter (called the iris) and a lens. Normal, clear vision occurs when light rays pass through them and the image focuses directly on the film (called the retina). When light rays don’t converge and focus directly on the retina, this results in “refractive errors” and blurry vision. Video explaining these concepts are available at this link: GulaniVision.com/eyecare-understanding-your-eyes.html.

Nearsightedness (myopia)

This occurs when the cornea is curved too steep in relation to the length (front to back) of the eye. This bends the light more sharply and makes the image focus in front of the retina, as opposed to directly on it. When this occurs, near objects can be seen clearly, but objects in the distance are blurry. Advanced Myopic Lasik surgery treats this refractive problem by slightly flattening the corneal curvature, so the focal point of the image is moved back and directly on the retina.

Farsightedness (hyperopia)

This is the reverse problem from myopia. In farsightedness, the corneal curvature is too flat, or the eyeball is too short, and the focal point of the image is behind the retina. With farsighted vision, objects in the distance appear clear, while objects close up are blurry. Advanced Hyperopic Lasik surgery corrects this problem by slightly steepening the corneal curvature and increasing the refractive power of your cornea so that the focal point of the image is closer and directly on the retina.

Astigmatism

In normal vision, the cornea is more spherical or round, like a basketball. An eye with astigmatism has a cornea that is irregularly shaped, like a football. This prevents images from converging or focusing directly on the retina. Although some parts of the image may focus on the retina, others focus in front of or behind it. Astigmatism causes images to appear blurry or distorted. Astigmatism can occur along with either myopia or hyperopia, or it can occur alone. Advanced Astigmatic Lasik surgery can correct it by modifying the corneal curvature so that images can converge and focus directly on the retina.

Presbyopia

Presbyopia is most commonly associated with the need for reading glasses as we age, usually after age 40. It is caused by changes in the lens. As we age, the lens hardens and becomes less flexible, losing the ability to change shape. Like a camera, this causes the eye to lose its power to “ Zoom”. Presbyopia can also exist with any of the above vision problems and can be treated with unique approaches like Multifocal Lasik laser vision surgery or MonoVision Lasik.

Higher Order Aberrations

The above three refractive errors are called lower order aberrations. They account for about 80% of refractive error and affect how much you can see – that is, how clear your visual field is at all distances.

Our eyes also have small defects called higher order aberrations and these affect how well you see. If you imagine the eyes as being a pair of glasses, they could have smears or bits of dust on them which interfere with otherwise clear vision. This would be analogous to your higher order aberrations.

Examples of higher order aberrations are halos around lights, starbursts, and glare, which cause night vision problems. Until recently these more subtle vision problems have not been treatable by Lasik. But since the advent of Wavefront technology, they can be diagnosed in detail and treated by Corrective Lasik, PRK, Advanced Surface Ablation (ASA), LASEK, epi-Lasik, Intralase, and iLasik.

Corneal Surgery

Since the cornea has the most refractive properties to focus images clearly on your retina, the most common treatment for the above refractive errors is corneal surgery. Nearly all cornea-based refractive surgeries (including all variations of laser vision surgery, such as Lasik, Wavefront Lasik, Custom Lasik, Epi-Lasik, Lasek, PRK, Advanced Surface Ablation (ASA)) focus on re-shaping your cornea to modify how light passes through it to improve your vision.

Dr. Gulani believes that it is essential for Lasik surgeon to be an elegant corneal surgeon because this experience will give their patients added confidence and assurance that they have been allotted the right surgery for their specific needs. A thorough examination of your eyes is essential for a surgeon to then recommend the best procedure for your particular vision problems to achieve the desired visual outcome.

Copyright 2010 by News4Jax.com. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
 

• Phakic Implants (VISIAN ICL): A miniature contact lens like implant is gently tucked into place inside the eye to add to the focusing power of your natural lens in correcting your vision. Video demonstrating this technology at : GulaniVision.com/implantable-lenses-icl-phakic-iols.html
• Clear Lens Exchange / Refractive Lens Exchange - Your eye’s natural lens is replaced with an artificial lens implant of the appropriate power to correct your vision.

Dr. Gulani: Presbyopia (After 40 Reading Glasses)

POSTED: Thursday, January 7, 2010

 JACKSONVILLE, Fla. -- One of a continuing series of articles by Dr. Arun Gulani, who founded Gulani Vision Institute in Jacksonville, and is one of the leading laser eye surgeons in the United States.

He will be in Channel 4's studios Jan. 21 for a live, interactive Webcast to talk about the possibilities of corrective vision.

For this article, Dr. Gulani discusses the need for reading glasses as people age:

During middle age, usually beginning in the early 40s, people experience blurred vision at near points, such as when reading, sewing or working at the computer.

Dr. Gulani likes to describe this as an age-related loss of the “zooming power” (tele & wide like a camera) of your natural lens inside your eye.

When your natural lens is Clear: Monovision (the non-dominant eye is focused for near), very much like that with contact lenses can be achieved with Laser Vision Surgery to assist this condition.

When your natural lens has become a Cataract: Cataract surgery with multifocal lens implant can be performed.

More information at GulaniVision.com/presbyopia-treatment.html.

Copyright 2010 by News4Jax.com. All rights reserved. This material may not be published, broadcast, rewritten or redistributed. 

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