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Does the Doctor peform narrow angle glaucoma surgery? What is the procedure and does he provide something for nervous patients? |
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Ruthe, Tallahassee, Florida 5/28/08
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Yes Mam, I do provide this service. Narrow angle glaucoma surgery typically consists of a short, and yes, painless laser procedure performed in the office. It is relatively risk-free and is used to prevent serious complications which may arise from angle closure glaucoma. Preoperative sedation is available, but rarely required. We would be happy to evaluate your eye for the necessity of this. Please call us at 850-877-7337 at your convenience.
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Richard
Palmer, M.D. 5/28/08
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Do custom interlase Lasik create brain injuries? |
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Anonymous 5/07/08
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Let me guess… you have had IntraLase?
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Richard
Palmer, M.D. 5/07/08
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Dr Palmer,
I teach wilderness medicine & search and rescue classes and with the increasing numbers of people who have undergone laser vision correction feel it is important for my students to know what is appropriate first aid for traumatic avulsion of a LASIK flap. Most of my students are EMT-basic & paramedic trained. Especially important are time limits for getting to an Ophthalmologist. It is important to help with the decision to call a helicopter to evacuate a patient or to arrange a lower risk ground evacuation which might take hours or days.
Any references to published info would be greatly appreciated.
Thank you sir for you time & service |
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Jamie Butler RN , Albuquerque, NM 5/05/08
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Traumatic avulsion of a LASIK flap is extremely rare. The mechanism of injury would first require an unlikely separation of the corneal lamellae which are tightly bound together. Certainly an injury of this magnitude would produce other significant ocular manifestations and diagnosing a flap complication would be difficult with out proper magnification. If the flap is completely lost, and the globe remains intact – there is no time urgency. If the flap can be identified, it should be repositioned the best as possible with an attempt made at “smoothing” out the surface with a clean finger tip. A general rule is to place a fox shield over the globe and nothing more. The time frame for ophthalmological intervention would be urgent, rather than emergent. Delaying the consultation by hours would be reasonable - days may be too long for a serious eye injury. However, injured veterans from Iraq are doing well after having retained intaocular foreign bodies left in side the globe for days. To be honest, with an injury significant enough to avulse a flap – a ruptured globe would be more likely.
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Richard
Palmer, M.D. 5/05/08
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Q. |
I had very successful Lasik surgery six years ago. Shortly thereafter, a tree twig went directly into my right eye and actually removed the flap from the surgery, reducing my vision to 20/80. Back then, I was told that further surgery wasn't an option, but I've heard that new technology since may have changed that. I do know I have very thick corneas. What do you think? |
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David, Tallahassee, FL 4/19/08
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Traumatic avulsion of a LASIK flap is extremely rare. I am sorry that such a severe eye injury has decreased your vision following successful LASIK surgery. Modern microkeratomes are capable of creating a new flap from donor tissue which can then be implanted on your cornea – in effect, replacing your flap. This approach may be able to improve your vision without entertaining the option of a more invasive corneal transplant.
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Richard
Palmer, M.D. 4/22/08
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I am a 64 year old male and have worn glasses since age 18. I am nearsighted and have a high level of astigmatism in my left eye. I have hypertension which is controlled by medication and I have Type II diabetes, controled by insulin, medication, and diet. I realize there are still more factors you would have to consider before making a decision regarding lasik surgery, but would the conditions mentioned above alone disqualify me for the surgery? |
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Anonymous, Tallahassee 4/19/08
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The issues you have mentioned do not automatically disqualify you as a LASIK candidate. However, as the human eye ages, cataract formation is inevitable. Refractive errors can now be safely eliminated with modern cataract implant techniques. In fact, we have “toric” implants that can remove astigmatism. Because of your age and micro vascular issues, cataract surgery may well be the best option to afford you terrific vision without the need for glasses.
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Richard
Palmer, M.D. 4/22/08
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I have a blood clot in my leg. Thet put me on Comidan 5 Mg. 1 X a day. Can I still go ahead with my catarac surguries? |
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Mark, Tallahassee,Fl 4/19/08
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Blood thinners are no longer a contradiction to cataract surgery as needles are not routinely used. Because the incision is made through avascular tissue of the eye (cornea), the risk of hemorrhage is negligible.
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Richard
Palmer, M.D. 4/22/08
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Great Question and Great Answers. My question..I have had 2 eye surgeries for stopped up tear ducts and neither took. I am really miserable. I never had this problem until I got an eye infection after using Renuew contact cleanser. From their it has gone down hill. I was first told it was allergies, before surgery. Now I am experiencing white, stickey gooey in my eyes that interfere with vision until removed. I would like to know would lasik surgery help me. I do wear contacts. The surgeon I have been seeing rushes you in and out..No Help! |
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Lynn, Sneads, Florida 4/08/08
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Ocular discharge present upon awaking is a common finding with insufficient tear drainage. Surgery for a blocked tear duct begins with silicone tube stints. When these fail, a more invasive and reliable Dacryocystorhinostomy (DCR) is recommended. These are now being performed endoscopically, through the nose, with excellent results. A LASIK procedure will certainly resolve your contact lens issues but would not, of course, open your tear duct. I am sorry your surgeon does not afford you the time and attention you deserve.
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Richard
Palmer, M.D. 4/14/08
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I had an eyelash stuck in my left eye 4 months ago and I shined a blue LED flashlight into my left eye for 1-2 minutes to try to locate the eyelash. Since then, my vision became blurry, especially when reading words from a distance or just reading a newspaper. Shortly thereafter, my left eye started producing tears at the corner of my eye, a sign that I had dry eyes. Could shining an LED flashlight cause substantial damage to my eyes? Is it possible that my vision became unclear due to this? I will entertain any professional insight. thanks. |
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Anonymous, New York, NY 4/11/08
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Although photopic damage to the retina is not uncommon from sungazzing (solar retinopathy) and a welder’s torch (radiaton keratopathy), the human cornea will absorb and filter most harmful ultraviolet and natural sources of light - including light from an LED source. It is therefore unlikely that you produced any substantial damage to your photoreceptors. Your visual complaints may be related to a simple and correctable refractive error. A visit to your local eye care professional should provide a solution to your problem.
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Richard
Palmer, M.D. 4/14/08
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Do you know of any hospital's or financial institutions that can help with my friend's son (Matt 20 years old) that is on the verge of going completely blind in the next 2-3 years. |
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Jean, Atlanta, GA 4/10/08
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I see that you live in Atlanta which is home to Emory University. Emory has a world class eye center – this would be an excellent place to start. You can contact them @ 404-778-2020 or www.eyecenter.emory.edu
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Richard
Palmer, M.D. 4/14/08
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I had Lasik @ Dr. Shugar's Office in Perry. I feel that my vision is not as good as it could be, but Dr. Shugar says that it is 20/20. I seem to get eye strain alot. My eyes seem to be always irritated and red. I never had any problems like this before. I am not scheduled to see him until Novemeber 08. Any thoughts or suggestions? |
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Anonymous, TLH FL 3/26/08
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It is not uncommon for a patient’s perception of their subjective vision to feel different from what is measured in the examination lane. I suggest you contact your surgeon and explain the problems you are having. I am sure he would be happy to see you before your regularly scheduled appointment in November.
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Richard
Palmer, M.D. 3/26/08
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About Ask the
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