EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/78788
August 2012 Refractive challenges and innovations February 2011 EW FEATURE 41 to tell me what it is, but you're not going to tell me that you have blurred vision.'" Usually he finds he is able to drill down on the major complaint such as the patient needs to read better, wants to enhance poor intermediate vision, or reduce glare at night. With the complex patients who have been referred, he stressed prac- titioners have to tell them what they're going to do better or differ- ent from what the other doctor did. He will outline for the patient steps that he will take such as treating the ocular surface disease, higher order aberrations, or topographic abnor- mality. Often the timing of the patient's return can have an impact. Dr. Lindstrom finds that early problems such as DLK, flap slips, striae, mi- crostriae, abnormal flaps, epithelial defects, and epithelial ingrowth can be straightforward to treat. "For DLK it's steroids and irrigation if it pro- gresses, and for flap slips, striae, and epithelial ingrowth, we fix them," he said. Epithelial defects he finds are often related to missed cases of epithelial membrane dystrophy. Dr. Lindstrom usually treats this with superficial keratectomy or some- times PTK. Dr. Lindstrom is always careful in these cases to write in the pa- tient's chart that risks, benefits, and alternatives have been discussed, as well as making sure that the proper informed consent documents are filled out. Late focus For the long late post-op cases, Dr. Lindstrom finds that patients are un- happy about one of a small number of things. Many patients have com- plaints of residual or recurrent re- fractive error. "Now they've become worried because they've developed myopia again, hyperopia, astigma- tism, or in some cases they've be- come presbyopic," Dr. Lindstrom said. "Those patients are fairly straightforward, except for the pres- byopia patients, because we can eas- ily treat those problems." For the presbyopia patients, Dr. Lindstrom carefully explains the condition and offers them the option of monovi- sion. In the U.S., he pointed out, there are limited choices. "We don't have advanced technology that is Whether you're just beginning or experienced in cataract and refractive surgery, ASCRS is the professional society that's right for every stage of your career. Mentors and Innovators As an experienced anterior segment ophthalmologist, you've come to understand the importance of innovation and collaboration. It's through collaboration that ophthalmology improves and expands—at times in great leaps and at times through subtle change. Through its many educational and networking services, ASCRS provides an effective forum for the debate of new ideas and the incremental improvement of technique and outcomes. ASCRS offers the means and the unrestricted opportunity to advance the profession and yourself. Join ASCRS today! The Society for Surgeons AMERICAN SOCIETY OF CATARACT AND REFRACTIVE SURGERY 4000 Legato Road, Suite 700, Fairfax, VA 22033 • 703-591-2220 • www.ASCRS.org becoming available elsewhere in the world to treat those patients in the U.S.," he said. With age, Dr. Lindstrom pointed out, patients are more apt to develop ocular surface disease. "Both aque- ous deficient and evaporative dry eye become more prevalent, and sometimes patients who were well tolerating of the situation early on develop some dry eye symptoms," Dr. Lindstrom said. "We explain dry eye to those patients, as we do for other patients, and treat the dry eye." continued on page 42 An ASCRS Membership For every stage of your career