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Tricare Eye Exam

Presented by Dr. Antoine Garabet, Ophthalmologist



LASIK, also known as laser in-situ assisted keratomileusis, is an elective clinic based procedure performed on individuals with need for glasses to provide them with frrdom from glasses. A laser is used to reshape the cornea and provide better focus without the use of glasses or contact lenses.

2. The benefits of LASIK?

Over the past 20 years millions of people worldwide have benefited from LASIK. This state of the art technology has the ability to provide clearer vision with the use of glasses or contact lenses.Studies have shown that the majority of individuals undergoing LASIK have vision thatenables them to drive legally. The degree of success has improved over the years where many have 20/20 vision following treatment.

3. Who is a candidate for LASIK?

Most people over the age of 18 with dependence on glasses are good candidates.The degree correction needed has to be sufficient to warrant the trouble and expense of going through surger. A small percentage of patients cannot have surgery primarily bea=cause their eyes are not healthy enough to undergoe the procedure. Some have a weak cornea, some have pressure in the eye, or problems in the retina, etc…All of these conditions are normally investigated during the initial evaluation for LASIK by the surgeon.

4. What isAll-Laser LASIK?

LASIK involves the formation of a flap followed by the laser reshaping of the cornea. Traditionally the flap is formed using a blade, however in the recent past laserswere developed to form the flap using a laser as well. Hence the term All Laser lASIK

5. How is the cornea reshaped?

The cornea is reshaped ustilizing a specialized laser (193 nm) to remove or evaporate microscopically thin layers of cornea. Depending on where the removal of tissue with respect to the center of the cornea, the effect of removal can either steepen or flatten the cornea. For nearsightedness, the cornea is flattened; for farsightedness the cornea is steepened and for Astigmatis, the cornea is treated more in one axis than the opposite axis.

6. Which is safer All-Laser or traditional LASIK?

Many of the risks encountered when traditional LASIK is performed are less freequent with theAll Laser LASIK. In good experienced hands, the difference maybe minimal. Under all circumstances risk is always to be factored in regardless of the type of procedure used.

7. Is the visual outcome the same in All-Laser as in traditional LASIK?

Although it is argued that ALl Laser LASIK is safer than traditional LASIK, the visual outcome is about the same.

8. What is CustomVue All-Laser LASIK?

CustomVue All-Laser LASIK is a laser vision correction procedure that is tailored for your specific vision care needsNit is a customized approach to LASIK using the revolutionary WaveFront mapping diagnostic system, and the IntraLase laser to create the corneal flap.

9. What is WaveFront mapping?

WaveFront mapping is a diagnostic tool that allows the surgeon to obtain a detailed three-dimensional map of your entire optical system. WaveFront mapping measures the curve of the cornea, how light is distorted as it reaches the retina, and both lower- and higher-order aberrations or vision errors.

10. Can you explain lower- and higher-order aberrations?

Glasses, contacts and traditional LASIK correct lower-order aberrations-nearsightedness, farsightedness and astigmatism. However, they do not correct higher-order aberrations, which are irregularities unique to your particular eye, just as your fingerprint. Higher-order aberrations could not be detected and mapped prior to WaveFront technology, so they remained uncorrected. Now, correcting these irregularities enhances patient satisfaction, reduces the potential for problems with night vision and provides even sharper visual acuity.

11. What is Custom LASIK?

Custom LASIK is the technology used to deliver a treatment based on the unique shape of each individual patient. Whereas two individuals with the same prescription will get the same shape glasses and the same traditional LASIK treatment, They would receive two different Custom LASIK treatments. The treatments are tailored to the unique geometry of their eyes.

12. What is the expected visual outcome?

The expected outcome of LASIK is improvement of vision without the use of glasses. With today's lasers most people are achieving 20/20. In general most people becom independent from glasses. LASIK does not correct for age related weak near vision. There are newer techniques that can correct for this problem.

13. How are LASIK and PRK different?

During PRK treatment the laser beam is applied to the surface of the cornea. This leaves a abrasion following the procedure causing discomfort for a few days with delay in visual recovery. With LASIK, the treatment is delivered under the flap and the patient is only uncomfortable for one day. The eliminating of the risk of forming the flap in PRK is the reasn hy some people chose the discomfort of having PRK. The long term visual outcome is the same for both procedures.

14. How much pain is involved in LASIK?

Doctors use topical anesthesia prior to the LASIK treatment. Therefore there is no pain during the rocedure, just discomfort. About 20 minutes following the procedure the pain/discomfort begins and persists for the remainder of the day. In general there is no discomfort the morning after the procedure.

15. How long does LASIK take?

Generally LASIK takes less than 10 minutes.

16. How long is the visual recovery?

Immediately following the procedure, the vision is blurred and patients are advised to stay home and rest. The morning after, most people have vision that is sufficient to perform most daily tasks. The vision can go through fluctuations over the subsequent few weeks. Within one month the vision stabilizes.

17. What are the risks of LASIK?

Risk is classified as side effects or complications. The most common side effects are dry eyes, glare, and incomplete correction. With ore recent lasers, these side effects are less freequent and less severe. Complications can be infection or ectasia (thinning of the central cornea). Both of these complications can lead to visual loss. Although possible, these complications are rare; the vast majority of the millions that underwent surgery over the last 20 years are satisfied with LASIK. Advances in medical knowledge, technology and surgical skills and experience have led to the decline in the incidence of all side effects and complicaitons.

18. Is a repeat treatment ncessary?

Enhancement are possible following LASIK treatment. The possibility is about 5%. Most enhancements are performed within one year of the initial operation. Although possible, enhancement are seldom performed past the one year mark

19. Can LASIK be performed on both eyes at the same time?

In the early days of LASIK most surgeons performed LASIK one eye at a time. With the advancement of the technology and increased experience of the surgeon, the standard of care shifted to performing botheyes at the same time.

20. How long will the results last?

Short of any eye disease that may develop as a result from age or injury, the LASIK treatment is fairly permanent. Individuals are still subject to minor changes in their vision over the years, however these changes in vision are seldom significant to warrant going under the laser again.

21. Is monovision good for everyone?

Since LASIK does not correct for age related weakness in near visioin, many doctors recommend their patients over 40 to undergoe treatment where one eye is focused at the distance and the other at near. This ability to see both near and distance in separate eyes is not possible in every patient. This is tested during the initial evaluation, and recommendations are made accordingly.

22. Can LASIK cause cataracts or glaucoma?

LASIKDoes not cause cataract or glaucoma, however individuals with inherent tendency to develop these conditions are still subject to these age related diseases.

23. How much does LASIK cost?

LASIK cost vary amongst doctors and centers. It is most important when chosing a doctor to make a decision based on experience rather than cost. Most centers provide their patients with financing options to make the decision to have surgery easy.

24. What are my payment options?

LASIK centers provide various financial plans. Some are interest free for a defined period such as 12 or 24 months, and others provide payment plans with low monthly payment. This is best handled at the center once the medical decision is made.

25. Is LASIK covered by insurance?

Most insurance companies do not cover LASIAK. Some have benefits for their members for discounted pricing. Check with your insurance company if they have a list of providers that offer preferential pricing.

26. Do Flex Plans cover LASIK?

Flex plans do cover LASIK for payment using pre-tax dollars. It is best to check with your employer about the option to open a Flex spending account.

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