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Archive 2012 · possibly OT, but LASIK warning

  
 
Tri Tran
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p.4 #1 · p.4 #1 · possibly OT, but LASIK warning


Sorry to hear that Chris. I hope you could still enjoy photography.
Really, claritin causes memory loss? This is the first. The problem is everyone thinks they're a doctor when they do research on the internet. Check the information you're reading.



Dec 04, 2012 at 08:04 PM
cputeq
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p.4 #2 · p.4 #2 · possibly OT, but LASIK warning


Re: the "other procedure"

I have had this done through the USAF, and though I had to go through my PCM to schedule it, a local urology clinic did the procedure. It is very simple.

Advise: buy some damn good underwear afterwards. I use Underarmour. Expensive at $20/pair but well worth it.

Also realize this can have some side effects also. Possible testicular atrophy and even the induction of epididymitus (which can be caught from trauma, not just STDs).

If you get chronic epididymitus, a tip from a lady working for the USAF and was in charge of interviewing us during our PHAs. -- oranges or orange juice. She told me that (a doc had told her husband) and it works like a charm
Just a tip to remember just in case!




Dec 04, 2012 at 08:16 PM
StevenPA
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p.4 #3 · p.4 #3 · possibly OT, but LASIK warning


Jman13 wrote:
Plus, I don't mind wearing glasses.


I went to a family function far away from home (and my optician/optometrist), and one day the arm of my glasses fell off, broken at the hinge. I walked around for two days with no glasses - through the airport too - that was fun - couldn't see a damn thing. But then when the pictures of the family event came out, I was like, whoa, who's this guy with no glasses? I didn't like the way I looked! I thought even if I do get LASIK, I'll probably keep the frames because glasses have just become an integral part of my face and the way I look, and I like the way I look with glasses on much better than without. But for sports... I wish my vision was better.



Dec 04, 2012 at 08:27 PM
ISO1600
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p.4 #4 · p.4 #4 · possibly OT, but LASIK warning


Steven, that is too funny!


Dec 04, 2012 at 08:46 PM
Keith B.
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p.4 #5 · p.4 #5 · possibly OT, but LASIK warning


I have heard---but have not done the actual research myself---that it is very difficult, if not impossible, to find an ophthalmologist who has had LASIK.


Dec 04, 2012 at 11:24 PM
RustyBug
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p.4 #6 · p.4 #6 · possibly OT, but LASIK warning


Something to consider ... coming from "inside" the industry.
It's a bit "dated", but the full article is worth a read for some perspective / primer "behind the scenes".

The thing that gets me most is where they think that patients achieving 20/25 have unrealistic expectations of "super" vision desiring 20/20. That's the equivalent of missing focus by 5 feet when you're only 20 feet away. Sure some people get 20/20 or better, but this article infers that 20/20 is something you should prepare the patient to not expect, otherwise you'll have unsatisfied customers.

For me, it was like "pulling teeth" to get them to finally admit that I might have to "be okay with" 20/25 ... even though my glasses already give me better than 20/20 ... but they sure want you to think your life will be different after LASIK.

http://www.ophthalmologymanagement.com/articleviewer.aspx?articleid=86324

When wavefront-guided LASIK was first introduced, some doctors saw their enhancement rate skyrocket. The results were quite good, but patients expected "super" vision. If the patient had 20/25 visual acuity after surgery, they would be upset. They expected 20/20 or better for the extra money they paid, and now they want an enhancement to fine-tune their eyes for added clarity.

How many doctors would have performed an enhancement on a patient with 20/25 visual acuity after a standard LASIK procedure? But the added pressure from unrealistic patient expectations has influenced some doctors. This can be eliminated by giving patients realistic expectations.








Dec 05, 2012 at 12:53 AM
douglasf13
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p.4 #7 · p.4 #7 · possibly OT, but LASIK warning


Yikes, I'm really starting to feel fortunate in how good of a LASIK experience that I had a few years ago. My doctor, located in Korea Town in Los Angeles, was a pleasure to work with. He explained how all of the procedures work in quite a bit of detail, made sure that my expectations weren't too high, and performed quite a few tests to make sure that I qualified for the procedure. He was really passionate and nerdy about the whole thing, explaining to me how other doctors make mistakes in certain areas, and, in retrospect, he kind of reminded me of the type of "nerd" that would frequent photography forums, like me. I actually talked a lot about optics with him and enjoyed going back for checkups.

To top it all of, his service was one of the least expensive in town. It was cheaper to use him without insurance than it would have been to go to any of the places that my insurance covered. I'm realizing now that I got pretty lucky. It's scary to take chances with your eyes.

p.s. I ended up with 20/20 in one eye and 20/25 in the other, which was what he predicted, and I'm happy with it. I've basically had zero side effects like flare, luckily, and it's been great for photography. I'm sorry to hear about your story, Chris.



Dec 05, 2012 at 01:18 AM
RustyBug
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p.4 #8 · p.4 #8 · possibly OT, but LASIK warning


http://www.abramslaw.com/Articles/LASIK-Malpractice.shtml

OMIC STATISTICS

OMIC is a nationwide malpractice carrier that is associated with the American Academy of Ophthalmology. Their web site posts a large amount of information about LASIK malpractice. OMIC breaks down LASIK malpractice lawsuits into four categories: Clinical Issues, Systems Issues, Provider Issues, and Patient Issues.
CLINICAL ISSUES

Clinical issues were present in 42% of all the claims. Of the clinical issues, 79% involved preoperative issues. These consisted mostly of contraindications to surgery, including, form fruste keratoconus, pellucid corneal degeneration, other corneal problems dry eyes and pupil size. [4]

In fact, according to OMIC 50% of the LASIK settlements in 2006-2007 involved ectasia. This is caused by forme fruste keratoconus, pellucid degeneration or leaving too thin a posterior corneal bed.



From OMIC
http://www.omic.com/risk-management/ophthalmology/

Article: Twenty Years of Insuring Refractive Surgery
LASIK makes up 85% of all open and closed refractive claims (i.e. malpractice claims)


http://www.omic.com/risk-management/ophthalmology/refractive/
Article: Refractive Claims Up, Payouts Remain Low
Far from being the “risk free” procedure that some claim, laser refractive surgery can have an adverse outcome even in the hands of the most conservative and experienced practitioner. (This is from one of their defense attorneys advising them to be careful. )

Just a snippet ... plenty of other articles to review ... remember, this is coming from the insurance company who has to pay for all the things that go wrong.

Edited on Dec 05, 2012 at 02:05 AM · View previous versions



Dec 05, 2012 at 01:48 AM
asbalyan
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p.4 #9 · p.4 #9 · possibly OT, but LASIK warning


Sorry to hear this.. I sometimes think of LASIK for myself...
LASIK or eye correction surgeries have really interesting history.... I found this text while reading one book (the ref was: "incentive"),

"In the 1990s, the ophthalmologists were building careers on performing cataract procedures. They’d take half an hour or less, and yet Medicare would reimburse them $1,700 a pop. In the late 1990s, Medicare slashed reimbursement levels to around $450 per procedure, and the incomes of the surgically minded ophthalmologists fell. Across America, ophthalmologists rediscovered an obscure and risky procedure called radial keratotomy, and there was a boom in surgery to correct small impairments of vision. The inadequately studied procedure was marketed as a cure for the suffering of contact lens wearers. “In reality,” says Burry, “the incentive was to maintain their high, often one-to two-million-dollar incomes, and the justification followed. The industry rushed to come up with something less dangerous than radial keratotomy, and Lasik was eventually born."

Just like any other technology adaption, incentive and demand played key role. But high incentives sometimes keep the negatives hidden...



Dec 05, 2012 at 01:50 AM
carstenw
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p.4 #10 · p.4 #10 · possibly OT, but LASIK warning


StevenPA wrote:
I went to a family function far away from home (and my optician/optometrist), and one day the arm of my glasses fell off, broken at the hinge. I walked around for two days with no glasses - through the airport too - that was fun - couldn't see a damn thing. But then when the pictures of the family event came out, I was like, whoa, who's this guy with no glasses? I didn't like the way I looked! I thought even if I do get LASIK, I'll probably keep the frames because glasses have just become an integral part
...Show more

You should post with/without photos and make a poll of what we think!



Dec 05, 2012 at 07:36 AM
ISO1600
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p.4 #11 · p.4 #11 · possibly OT, but LASIK warning


I have chilled out a little since the OP, that was only a few hours after I got the awesome news.
I am fully aware that things could be tremendously worse, and I am still better off than plenty of people in this world.
I've been paying extra close attention to my vision these past two days, and I think a mix of emotions had been making me feel that this was much worse than it really is.
I'm still able to drive in bad light, it just isn't as easy or comfortable as it used to be.
I still have 20/15 in daylight.

My wife and son had been out of town for about a week when I got the news, and I was just a bit overwhelmed at the time.
Now they are back, and how could anybody stay upset when they've got this fella at home?


Wyatt by Chris.jpg, on Flickr

Thank you all for your kind words!

Edited on Dec 05, 2012 at 08:03 AM · View previous versions



Dec 05, 2012 at 07:48 AM
carstenw
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p.4 #12 · p.4 #12 · possibly OT, but LASIK warning


Well, that is good news in itself, glad to see you look at the bright side of it.

Since my eyes are so different anyway, I might take the risk one day on my worse eye, and see how that goes. If that turns out well, I might after a few years try the (currently) better eye. I would probably try PRK rather than Lasik. I would rather have more days of pain and a longer stabilisation period than later complications.



Dec 05, 2012 at 08:03 AM
ISO1600
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p.4 #13 · p.4 #13 · possibly OT, but LASIK warning


They way LASIK/PRK healing/stability was explained to me:

LASIK (with modern procedures)-
immediately (1-5 days) after surgery, you should see about as good as you will possibly expect to. No pain and just MINOR discomfort after the first day.
Slight dip over the first month as your eye goes through some small changes.
3-6 months you should be stabilizing towards your final vision.
6-12 months- any remaining fluids/oils under your flap should be absorbed back into your eyes, everything should be kosher.
The flap never heals, but the way it's constructed with the excising Laser, they only way it should come dislodged is with some serious trauma- like a motorcycle accident. I was told less than 1% of flap problems over the course of my life.
The fix if something happens to my flap(s)? PRK. haha!

PRK-
Quite a bit of pain and bad eyesight the first two weeks after surgery.
LOTS of vision changes over the first 6 months.
Should be stable vision by 1yr.
Honestly, far less long-term complications seem possible with PRK, but the way it was explained to me was the risk factor on both was so low, why not go with the "easier" procedure to deal with?

My wife was 6mo pregnant when i was getting this done, and i did not want crappy vision when our son was born. Didn't want to have to worry about that.



Dec 05, 2012 at 08:10 AM
Bifurcator
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p.4 #14 · p.4 #14 · possibly OT, but LASIK warning


The people on YouTube all seem to agree that PRK is stable vision by 3 to 6 months and completely painless - about like opening your eyes under water for 10s. (I personally have no idea but that's the claim of 5 or 6 folks on youtube anyway)



Here's something:

http://www.independent.co.uk/life-style/health-and-families/health-news/the-truth-about-pinhole-glasses-1253113.html#disqus_thread
http://upload.wikimedia.org/wikipedia/commons/thumb/d/d0/Rasterbrille.jpg/333px-Rasterbrille.jpg

http://www.ebay.com/itm/Eyes-Exercise-Eyesight-Vision-Improve-Pinhole-Glasses-Natural-Healing-/280939198650?pt=LH_DefaultDomain_0&hash=item416947f8ba

$1.99 with free shipping. Can't hurt to try. And even cheaper too:

http://www.ebay.com/sch/i.html?_sacat=0&_from=R40&_nkw=pinhole+glasses&_pgn=2&_skc=200&rt=nc







Dec 05, 2012 at 09:05 AM
RCicala
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p.4 #15 · p.4 #15 · possibly OT, but LASIK warning


asbalyan wrote:
Sorry to hear this.. I sometimes think of LASIK for myself...
LASIK or eye correction surgeries have really interesting history.... I found this text while reading one book (the ref was: "incentive"),

"In the 1990s, the ophthalmologists were building careers on performing cataract procedures. They’d take half an hour or less, and yet Medicare would reimburse them $1,700 a pop. In the late 1990s, Medicare slashed reimbursement levels to around $450 per procedure, and the incomes of the surgically minded ophthalmologists fell. Across America, ophthalmologists rediscovered an obscure and risky procedure called radial keratotomy, and there was a boom in surgery

Just like any other technology adaption, incentive and demand played key role. But high incentives sometimes keep the negatives hidden...
...Show more

It's a bit off topic, so I apologize, but this reminds me a lot of why I left medicine. Although I will mention articles do tend to confuse an M. D.s 'gross revenue' with income. My income was about 20% of my gross revenue. Still a good living, don't mean to say otherwise.

But the overall point is correct. For 20 years I would go to medical meetings in my specialty and we'd have lectures all day about new treatments, new methods of diagnosis, stuff like that. In the evening we'd meet for dinner and talk about interesting and difficult cases.

The last 5 years I was in practice, meetings were largely about 'how to code for better reimbursement', 'managing practice costs', etc. I would sit in a meeting where the expert said "don't diagnose this, diagnose that, you'll get payed 25% more". Don't do this procedure, do that procedure, it pays 30% more.

Obviously, I'm one of the ones who left, so maybe I'm looking back through unrose colored glasses, or maybe I was just old and didn't want to change with the times.

The most interesting thing to me is a couple of years ago, a company called me that puts on seminars for doctors all over the country. They offered me a hefty 6 figure salary if I would give lectures full time on 'how to get out of medicine'. Said it was the most in-demand topic they had. So apparently I wasn't the only one who got sick of it.

Rant off now, thank you for letting me vent. We now return you to your regularly scheduled topic.


Dec 05, 2012 at 09:13 AM
ISO1600
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p.4 #16 · p.4 #16 · possibly OT, but LASIK warning


Bif,

When i had my procedure done, we had a large group (~30 military members) go through that day. That clinic probably does thousands of Mil members every year.
We had 5 or 6 (myself included) do LASIK, everybody else either didn't qualify for it, or wanted PRK.
The LASIK guys, myself included, came in the following day for our first checkup. We were all smiling, happy, could see, no problems.
The PRK guys came in the next day, moaning, covering their eyes, medicated. They were all perscribed Percoset or Vicodin.
A week later, some or most of the PRK crowd was still experiencing pain/discomfort. I was driving 250 miles home at that point.



Dec 05, 2012 at 09:30 AM
RustyBug
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p.4 #17 · p.4 #17 · possibly OT, but LASIK warning


If I understand your dilemma correctly, most of your issues are related to the optics incurred with your pupils @ their largest size. Is there a means (medication, specialty glasses, etc.) that could refrain your pupils from opening to their largest aperture.

I had a time when I was having trouble with my pupils adjusting to rapid light changes (i.e. night driving). The strategy was to wear darker driving glasses (custom colored) to require my pupil to be more fully open in differing conditions, thus the adjustment was less intense.

000 is the darkest sunglasses lens that you can have without a prescription ... I literally had a sunglasses script that read "as dark as humanly possible" to help me during this time. They were somewhere between cutting glasses and welding hood lens for light transmission.

Yours is obviously different / opposite, but wondering if while I wanted to keep my pupils wide open more often, and found a strategy for doing so ... if there might be a strategy for preventing yours from becoming wide open. I've got no real suggestion / answer, just a question that you might ask your docs.



Dec 05, 2012 at 10:16 AM
ISO1600
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p.4 #18 · p.4 #18 · possibly OT, but LASIK warning


that would probably work. I think i read of somebody else in my situation being given drops to do that, but it had some other side effect that was not worth it IIRC.


Dec 05, 2012 at 11:07 AM
khphoto
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p.4 #19 · p.4 #19 · possibly OT, but LASIK warning


So, in normal every day light you have perfect vision, but at night you need a small correction? But prior to your surgery you basically had to wear glasses all the time and couldn't see anything without them?

As Sheen would probably still say <winning/>



Dec 05, 2012 at 11:18 AM
RustyBug
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p.4 #20 · p.4 #20 · possibly OT, but LASIK warning


ISO1600 wrote:
that would probably work. I think i read of somebody else in my situation being given drops to do that, but it had some other side effect that was not worth it IIRC.


Gotcha ...





Dec 05, 2012 at 11:20 AM
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