Patient Resources

Reach our team, get access to your health record, find patient education forms and resources.

Patient experience: Glaucoma and cataract

Background: Some patients have the diagnosis of both cataracts and glaucoma. These patients may be candidates for a combined cataract and glaucoma surgery. Below is an example of a patient who presented with these two conditions and was treated with a combination surgery.

Patient experience: The patient presented with poor vision due to cataracts and uncontrolled glaucoma. The patient has a difficult time taking eye drops for glaucoma. On presentation, his eye pressures were in the mid thirties. After discussion of management options, we decided to start a pressure lowering eye drop and schedule the patient for a combined cataract and glaucoma surgery.

Results: Eye pressure was in the thirties the first day after surgery but after a week the eye pressure had dropped to the mid teens. His vision was also much improved.

Conclusions: Patients with both glaucoma and cataract surgery may benefit from a combined surgery. Cataract surgery by itself can lower eye pressures but the glaucoma procedure has an added effect.

Resources:

Dry eyes and Sjogren's syndrome

Background: Sjogren’s syndrome is an autoimmune disorder targeting the salivary and lacrimal glands. As a result, patients diagnosed with this syndrome experience dry mouths as well as dry eyes. Dry eyes can cause significant discomfort to patients.

Signs and symptoms:

red eyes worse in the mornings, winter months, after prolonged reading or watching TV
Foreign body sensation, stinging, irritation, burning, tearing
Vision changes including glare and fluctuating blurriness

Diagnosis and treatment:

Autoimmune markers and slit lamp examinations with fluorescein to check for tear breakup time and corneal erosions
Treatment approach is stepwise and depends on severity of the condition. Treatments include artificial tears for mild disease, immunomodulators for moderate disease, punctal plugs for moderate to severe disease.
Patients may also require systemic immunosuppression if they have severe symptoms with joint involvement.

Resources:

Astigmatism and cataract surgery

Background: Astigmatism can be corrected with glasses and contact lenses. But for patient undergoing cataract surgery, astigmatism can be corrected with a Toric intraocular lens. If patients are interested in becoming less dependent on prescription glasses after surgery, a Toric lens is a great option.

Pros:

High safety profile. There are no additional steps to the surgery that would increase the complication rate.
Patients will be less dependent on prescription glasses after surgery

Cons:

The Toric lenses are not covered by insurances. Average costs can range between $1,000 to $2,000 per eye

Resources:

Medication implant for glaucoma patients

Background: medications for glaucoma have always been in the form of eye drops until recent developments. Now patients have the option to get a sustained release medication implanted instead of using drops daily.

Pros:

Patients do not have to worry about taking their drops
The implants can last 4-6 months
The implant is biodegradable, preservative free and can be safely implanted in the clinic

Cons:

There’s only one FDA approved medication at this time.
The implantable medication replaces only one eye drop medication. If patients are on multiple eye pressure lowering drops, they would only stop taking the drop that was replaced by the implant

Resources:

New artificial lens implant for cataract surgery

Background: there are many choices for lens implants in cataract surgery. These options are discussed with the surgeon and the most appropriate lens is selected for the patient. This new lens called Vivity by Alcon offers advantages for select patients.

Pros:

Non-diffractive technology which means it has less glare and halos compared to other multifocal lenses on the market
Gives patients an extended range of vision. Patients will be less dependent on prescription glasses for distance (road signs, TV) and intermediate (computer, cell phones, dashboard) vision.
Patients who are not candidates for a diffractive multifocal lens such as patients with macular degeneration and severe glaucoma may be candidates for this lens

Cons:

Near vision will likely still be limited and patients may end up needing readers for near vision
Cost: this lens is not covered by insurance
New lens on the market

Resources:

Botox for facial wrinkles

Background: Botox injections are used to decrease the appearance of wrinkles. Botox treatment has become the most commonly performed cosmetic procedure in the world.

Pros:

Excellent safety profile since its introduction approximately 2 decades ago
Improvement in skin quality and progressive reduction in wrinkle severity has been observed with repeated treatments
In case of unwanted results, the effect of Botox on muscles is temporary

Cons:

Treatments are not cheap. The cost is generally calculated on per unit basis. The average cost is approximately $15/unit. Depending on wrinkle severity, most patients will get 30-40 units.
Botox needs to be administered every 3-4 months when the effect wears off

Resources:

Laser vs. drops for glaucoma treatment

Background: there are several good options to lower intraocular pressure for patients with glaucoma. In recent years, laser treatment (selective laser trabeculoplasty) has emerged as one of the more economical and effective methods.

Pros:

Approximately 75% of laser treated patient will not need to use eye drops to lower eye pressures
The procedure can be repeated if successful
Highly safe procedure

Cons:

May not work for some patients; in which case, the patients will remain or start pressure lowering eye drops

Resources:

Multifocal lens implants

Background: a multifocal lens is an implant placed after the removal of a cataract during cataract surgery.

Pros: a multifocal lens allows patients to be able to have functional vision at distance, intermediate and near without the need for glasses

Cons:

slightly more glare and halos than a standard lens
Cost: these lenses are not covered by insurance and have an out-of-pocket cost
Patients may still need to sometimes wear glasses to sharpen vision

Resources:

Patient Communication

We want you to have an easy access to your health information and we want you to be able to contact us regarding your health without difficulty. Please use the patient portal to send us a message and to view your health information. To be able to use the secure patient portal, you must receive an invitation from your doctor. You can also email us with the email address provided below for any questions.