LASIK and Cataract Consultations

If you're thinking about LASIK, or you've been told you have cataracts, the surgery is only part of the process. Most of the care that determines how well things go happens before and after it — and that part you can do here, with doctors who already know your eyes.

We co-manage LASIK and cataract surgery with surgeons we've worked alongside for years. You get the surgeon's expertise in the operating room and your own optometrist for everything else.

What co-management means

It's simpler than it sounds.

We evaluate you first. Before any referral, we do a thorough workup: your prescription and how stable it's been, corneal measurements, the health of your tear film and eye surface, and a full look at the back of your eye. This is where we determine whether surgery makes sense for you at all, and which procedure fits.

We refer you to the right surgeon. Not the one running the biggest ad campaign. The one whose approach fits your eyes and your situation. You have surgery at their center. You come back to us for follow-up. Post-operative visits
happen here, close to home, with doctors who have your history. Both cataract surgery and LASIK require a series of checks over the first few months.

The practical advantage is that you're not driving to a surgical center every time something needs looking at, and the person checking your healing is the person who examined your eyes before anything changed.

Our surgeons
We refer to and co-manage with:

• Dr. Thomas Tooma of NVISION Eye Centers

• Dr. Younger of Orange Coast Eye Center

Which surgeon we recommend depends on your eyes, the procedure, your insurance, and sometimes just where you'd rather drive. We'll explain the reasoning rather than simply handing you a name.

Lasik and Refractive Surgery

Are you a candidate?

This is the question worth answering honestly before you spend an afternoon at a consultation.

Good candidates generally have a stable prescription, healthy corneas of adequate thickness, no significant eye surface disease, and realistic expectations. Things that complicate it include a prescription still changing year to year, thin or irregular corneas, keratoconus or a family history of it, significant dry eye, and certain autoimmune conditions.

Age matters too. LASIK corrects distance vision, but it doesn't stop the normal loss of near focus that starts in the forties. A 45−year-old who has LASIK will still need reading glasses. We'll tell you if you're not a candidate. We don't perform the surgery and we don't have a financial stake in whether you have it, which means we can give you a straight answer. A meaningful number of people who ask us about LASIK are better served by something else, and we'd rather say so.

Dry eye comes first

This is the part most consultations skip.

LASIK temporarily reduces tear production, so a patient who's already borderline for dry eye can be genuinely miserable for months afterward. Surface disease also distorts the measurements the surgeon uses to plan the procedure, which affects the result.

We evaluate your tear film and image your meibomian glands as part of the workup. If there's a problem, we treat it before you go to surgery. See our Dry Eye Treatment page for what that involves.

Alternatives worth knowing about
LASIK isn't the only option. PRK works for corneas too thin for LASIK. SMILE is available for some prescriptions. For higher prescriptions outside the range of corneal surgery, implantable lenses like the ICL are an option. And for patients in their fifties and sixties, refractive lens exchange sometimes makes more sense than LASIK. We'll go through which of these apply to you before you sit down with a surgeon.

Cataract Surgery

What is a cataract?

The lens inside your eye gradually becomes cloudy with age. Vision dims, colors wash out, night driving gets harder, and headlights develop halos. The only treatment is replacing it. Cataract surgery is among the most commonly performed and most successful operations in medicine. The cloudy lens is removed and an artificial lens is placed in its position.

When it's time
There's no threshold you have to reach. The right time is when the cataract is interfering with things you want to do: reading, driving at night, recognizing faces, working. We'll track your cataracts over time and tell you honestly where you are. Some patients wait years. Some are ready the first time we bring it up. Neither is wrong.

Choosing your lens implant — and why we're useful here

This is the decision that matters most, and it's the one patients find most confusing.

• Standard monofocal lenses give excellent vision at one distance, usually far, with reading glasses for close work

• Toric lenses correct astigmatism

• Extended-depth-of-focus and multifocal lenses offer a range of vision with less dependence on glasses, at a higher out-of-pocket cost and with trade-offs — halos at night, or contrast that isn't quite as crisp

• Monovision isn't a special implant but a strategy: one eye is set for distance and the other for near, using standard lenses, so there's usually no premium cost. The trade-off is slightly reduced depth perception and less crisp night vision, and some people never adapt. We can simulate it with contact lenses beforehand so you know how it feels before it's permanent.

There's no universally best choice. It depends on your eyes, your astigmatism, the health of your retina and cornea, and honestly, on your personality. Some people adapt easily to multifocal optics and some are bothered by them.

We'll talk this through with you before your surgical consultation, so you walk in understanding the options rather than deciding under pressure with a price sheet in front of you. We don't sell the implants and we don't earn anything on which one you choose.

Insurance

Cataract surgery is medically necessary and covered by medical insurance, including Medicare, when it meets the criteria. Premium lens implants and astigmatism correction are typically an out-of-pocket upgrade. Your pre- and post-operative visits with us are billed to your medical insurance, not your vision plan.

LASIK and refractive surgery are elective and generally not covered. Many patients use HSA or FSA funds, and surgical centers usually offer financing. Some vision plans include a
discount.

See our insurance and payment information [Insert Insurance & Payment] for how we handle billing.