Frequently Asked Questions
About Your Exam: What are Refraction and Dilation?
Refraction is performing a series of measurements, both with a computer and/or using trial lenses in front of the eye,in order to determine your best possible vision. This is important in ensuring that any decrease in vision is not due to a medical problem which may require treatment. It is also used to determine the prescription necessary for glasses or contact lenses.
Dilation usually lasts 3-4 hours, sometimes longer for people with light colored eyes. When the use of stronger drops is necessary, as in children, the effect may last for a day or longer.
Is your staff experienced and up-to-date on current medical and technical information?
We are fortunate in retaining an excellent, dedicated staff, many of whom have been with us for as long as 25 years! These well-trained people are comfortable in providing the highest level of up-to- date care, and always enjoy welcoming you back when it is time for you to return for a visit.
We provide in-practice continuing medical education for our technical staff, along the guidelines of the Joint Commission of Allied Health Personnel in Ophthalmology. Many of our staff have been certified by that organization for higher levels of patient care. The National Board of Certified Ophthalmic Executives of the American Society of Ophthalmic Administrators has named our Practice Administrator, Ms. Catherine Brennan, a "Certified Ophthalmic Executive." She also is qualified as an "Ophthalmic Coding Specialist", which assures that your insurance claims will be processed accurately.
Can cataract surgery be done with lasers?
Although experimental laser technology is being developed to aid in cataract surgery, traditional surgical techniques are still required when using these devices. Lasers alone cannot be used to remove a cataract. Typically, a form of ultrasonic technology, called phacoemulsification, is used to perform today's high-tech cataract surgery with intraocular lens implantation. We routinely do use lasers in our office for treatment of glaucoma, retinal diseases and laser vision correction.
LASIK, which stands for Laser-Assisted In-situ Keratomileusis, is a type of refractive surgery used to correct myopia, hyperopia and astigmatism and is used as an alternative to contact lenses and glasses. The procedure involves creating a thin flap on the surface of the eye and folding it back to allow for the remodeling of the corneal tissue by the laser. The flap is then repositioned and the eye heals after the surgery is completed.
LASIK has significantly advanced over the past ten years. Today, safety, accuracy and precision of the procedure has been greatly enhanced due to the use of 3-D Eye Tracking, Wavefront CustomVue technology, IRIS Registration and the Pentacam HR system.
Who is a prime candidate for LASIK?
Prime candidates for LASIK are:
- Individuals over 21 years of age.
- Those who maintain the same eye prescription for at least a year.
- Those who possess no pre-existing corneal abnormalities or other medical conditions.
- Those with realistic expectations regarding the results of laser vision correction.
- Those who are not pregnant.
Only by having a complete eye evaluation can an ophthalmologist tell you if LASIK is an appropriate, safe procedure for you.
What is PRK?
PRK is also performed using the excimer beam. Rather than creating a flap on the cornea, the cornea is gently brushed to remove the very superficial corneal cells. The laser is then applied to the underlying tissue. Over the next week or so the superficial cells that were removed grow back to cover the surface. Many surgeons prefer PRK for patients with larger pupils or thin corneas, enabling us to treat patients who would not be good candidates for LASIK. At Hudson Valley Eye Surgeons, PC, we are able to custom design the correct procedure for each patient, rather than a "one size fits all" philosophy.
Is there pain associated with LASIK?
Pain, if any, is minimal with LASIK. Numbing eye drops are applied to the eye prior to the procedure. Some mild pressure is felt on the eye while creating the corneal flap, however, the actual cutting of the flap as well as the laser treatment is pain-free. Some patients may experience mild to moderate irritation for a few hours after the procedure.
Will I be able to see clearly immediately after LASIK?
While you may be able to see with sharper focus immediately after LASIK, eye drops used during and after your surgery are necessary to heal the cornea. While a dramatic change in vision is experienced as soon as the following day, the eye continues to heal over the coming weeks and the vision continues to become even more crisp during this time.
Will I have 20/20 vision after LASIK?
Because everyone’s eyes are different and may heal differently, not all patients will experience 20/20 vision after LASIK surgery.
How long will the effect of the Laser last?
Once the healing process has finished, the effect usually remains for life. In some instances, however, a retreatment may be required.
Do some patients need glasses after surgery?
Patients with very strong prescriptions may not achieve their full correction with laser alone, and glasses or contact lenses may be necessary in certain situations. For patients close to (or over) 40 years of age, reading glasses may be necessary.
Which laser do you use and should I wait until a newer generation of lasers comes out?
We use the VISX Star S4. This laser is a variable spot-scanning laser, which means that it optimizes the balance between speed and precision that all lasers attempt to achieve. It is fitted with an eye tracker, which corrects for any fluctuations in eye movements. The S4, with 3-D Eye Tracker and Iris Registration, is the latest in the VISX Star laser series, which is the most widely-tested and used laser system in the U.S. We have a laser technician and a laser engineer present during every procedure to assure perfect functioning of the laser, with standard re-calibrations between procedures.
Our current laser is a 4th-generation laser. The S4 is fully wavefront-compatible, allowing us not only to free patients from glasses and contact lenses, but also to correct even minor abnormalities in the optical systems of selected patients.
Does insurance cover laser vision correction? Do Employers Cover It? How much does it cost?
Most health insurance plans will not cover the cost of laser vision correction, although a few are now beginning to do so. However, employers will often help patients to cover the cost of this surgery through pre-tax salary deductions using Flexible Spending Accounts and Cafeteria Plans. When compared to the cost of glasses or contact lenses over several years, laser vision correction can actually end up saving you money. Laser Vision Correction does qualify as a medical deduction if you can take a medical deduction. (See IRS Publication 502 for more information.)
Unless you have a "Vision Care Rider" on your health insurance, the cost of a refraction is specifically excluded from payment by the insurance company, much as cosmetic surgery is excluded.
Because Medicare does not cover preventative medical care, in general, it also does not cover for "routine eye exams," or "screening visual field" testing. If, however, you are found to have a medical problem during your "routine eye exam" or on your visual field test, they will cover for treatment of that problem on future exams. Many other insurance carriers follow Medicare's lead.