Refractive Surgery and Age Consideration

People usually ask me if they're a candidate for refractive surgery.  Most surgeons usually want the patient to be at least 21 years old although I have seen some surgeons perform surgery with the patient at 18 years old.

A prime consideration for performing surgery at any age is if the eyes are changing.  If they are, usually the surgeon will not perform surgery no matter what the age is.

A third and very important consideration are the ages between 35 and 42.  This is a critical age because around this time the focusing system of the eyes is changing.  Let's say you perform a surgery at 39 years of age.  The patient should be able to see both distance and near.  However, as the patient gets into the early 40's, the patient will not be able to see as well close up and will probably need reading glasses.

If the patient is in their mid 40's or older, they already know they can't focus through the distance prescription .  In this case they'll either have surgery where one eye's for reading and one eye's for distance or they'll need reading glasses for up close if both eyes are corrected for distance.

The above surgeries only pertains to corneal surgery.  If the older patient elects, they can have surgery where a multifocal lens is implanted into the eye and they can see far and near.

Keen Observation By Teacher

A seven-year- old patient came into my office.  Her complaints included headaches.  The mom remarked that the teacher indicated that the patient had trouble focusing from the book to the board.  The patient had 20/20 vision in each eye without any distant prescription. 

The patient held everything close up within 4 inches to read.  When I put the reading prescription in front of her, she was able to see it more easily and she was able to hold the book around 10--12 inches away.

The reading prescription would blur the distance so we gave her a bifocal with no prescritpion on top and the reading prescription on the bottom.  I have done this often for kids who just need correction for reading and it has made a real positive difference.

Those Mobile Devices

I was doing an examination on a five year old boy yesterday.  Not only was the mom looking at her device, but her two year old son was also. 

Over the last several decades, increased near work has attributed to the increase of near-sightedness in the population.  When I went to optometry school over 30 years ago, the average population was far-sighted while the average population in the optometry school was near-sighted.

It's hard to predict how the tremendous amount of close up work everyone is doing, especially very young children, will haveon one's vision.  There definitely won't be a shortage of patients.

A Little Prescription Goes A Long Way

I had a nine-year-old boy come in last week for an examination.  The mom related he was going to be tested for educational deficiencies.  The child basically couldn't see any of the letters on the distant chart and had to hold print exceedingly close to read it. 

When I examined the boy, I found he had a very low prescription.  With this he was able to see the distant chart.  More importantly, when I put the lenses in front of the boy while reading, the mom marveled at how he had never read this fluidly before.  He was also reading at a normal distance.

In rare circumstances, a youngster's focusing system will spasm, both causing headaches and blurred vision at distance and near.  A mild prescription in some of these cases makes all the difference in the world.  It certainly did with this individual.

"Hopeless" Case

A few days ago, a patient who suffered a stroke came in.  Even though the patient was capable of 20/20 sight in each eye, he almost functioned like a blind person.  This was because he lost the right side of his vision in each eye as a result of the stroke.  He actually used a cane to help guide him in his walking.

The patient's eyes were healthy.  He was told there was nothing further that could be done for him.  The patient was similar to others whom I've seen who have a visual field defect.  I prescribed prisms which help shift the image up, down, left or right, depending how they're placed in the glasses.  This appeared to have a dramatic effect on the patient.  His walking was a lot better.  His confidence exuded.  He was also way less sensitive to light.

I love these type of cases.  The change seen in these patients is priceless.

Community

It's really neat to live and work within the same community.  I have now been practicing in Rancho Cucamonga, CA for over 23 years.  I live 1/2 mile from my office.  I see many of my patients in the stores, the gym and other local hangouts.  It's really great.  I also belong to four chambers of commerce:  Rancho Cucamonga, Fontana, Upland and Ontario.  In addition to business, these organizations have been a great source of friendships.  I feel really fortunate in being in this situation.

Understading Your Visual Condition

One of the factors I most enjoy about optometry is being able to demonstrate to a patient what their problem is and in most cases, what it's going to take to remedy it.  It's easy to show a patient what you're prescribing in the form of glasses and contact lenses before they receive them.  It's really good to show a patient how they've changed from their old prescritpion.

As far as disease or injury to the eye, it's easy to go online and show a patient what their condition looks like.  Patients could get an appreciation of what's going  on with their own condition.

Also, when we do talks to audiences, it's very interesting to demonstrate to an audience member what effects certain visual conditions have on performance, especially at school, work or play.

If you, your organization, or business would like to have a seminar, please let us know.  We could be reached at (909) 980-3535 or e-mail us at ranchooptometric@verizon.net.