Western Laser Eye Associates | Dr. Anderson Penno

What is Co-management for LASIK, Epi-LASIK, PRK, and Intra-LASIK?

2009-07-12T11:52:00.000-07:00

In cases where the surgery center is located far away, some surgeons are agreeable to co-managing with another ophthalmologist or optometrist. For this type of arrangement to work there must be good communication between providers.

Both the surgeon the eye care provider who will be doing follow up care must agree in advance in order for co-management to be effective. If there is a late complication the follow-up provider must be able to communicate with the surgeon and arrange additional visits or treatments with the surgeon if necessary. This arrangement works well for those who may live in more rural areas where they may have to travel into a metropolitan center to access laser vision correction.

Co-management

Co-management: describes an arrangement between the surgery center
and another eye care provider such as an optometrist.
Communication: for co-management arrangements to work there must
be excellent communication between the surgeon and the co-manager.
Benefit: for some people co-management is a great option due to
geographic reasons, if their usual provider has better hours, or if they
wish to continue care with a trusted provider

If you are interested in considering a co-management arrangement ask your current eye care provider if this is an option or speak to your laser vision correction surgeon. If you need more information about this topic or about laser vision correction, contact Western Laser Eye associate staff at www.westernlasereye.com or call 403-547-9775.

PRK, Epi-LASIK, LASIK, and Intra-LASIK in Calgary: how to they compare?

2009-07-12T10:17:00.001-07:00

There are a variety of options available to anyone considering laser vision correction in Calgary. In order to make a good choice it is important to understand the similarities and differences between procedures.

Similarities Between PRK, Epi-LASIK, LASIK, and Intra-LASIK

The following things are the same regardless of the type of laser vision correction procedure you choose:

- You will have to undergo an assessment to determine if you qualify for laser vision correction.
- There is some risk to any of the laser vision correction procedures – no technique is risk free.
- The most common side effects of all of the laser vision correction techniques are dry eye and rarely glare or halo with night vision
- The goal of all laser vision correction procedures is to reduce your dependence on glasses – none of the techniques will result in better vision than you have with your most up to date glasses or contact lenses.
- If you are 40 to 45 years old or older you will need reading glasses for close work unless you choose monovision.
- PRK, Epi-LASIK, LASIK, and Intra-LASIK all have excellent long term results. To date there have been no large scale studies to prove that the visual outcomes are better with any one of these laser vision correction techniques.
- Custom Wavefront or other types of customized laser vision correction can be done with any of these techniques.

Differences: Flap (LASIK and Intra-LASIK) Versus No-FLAP (PRK and Epi-LASIK)

As mentioned above, the long term outcomes of any of these procedures are equally good. The main difference between a flap based procedure and a no-flap surface treatment is that creating a flap carries a higher level of risk and gives more rapid recovery of vision in the first few days following surgery.

The risk of complications with flap creation is low, but it is possible that irregularities in the flap such as a buttonhole or partial flap may occur at the time of surgery. With no-flap techniques there is no flap to become involved in that type of intra-operative complication so the risk is lower. The flap may also be damaged or shifted months or years after surgery. This is very uncommon and in most cases the flap can be replaced and smoothed back into position with additional surgery.

There are a number of additional possible complications that are uncommon but can occur following a flap based procedure. I have co-authored the book “LASIK Complications” which has been translated into Spanish and Japanese and has gone into three editions – there is not a book called PRK Complications. While the risk of the no-flap procedures is not zero, it is lower because there is no flap that can become involved in these types of complications.

The reason the flap based procedures are so much more popular is due to the more rapid recovery of vision and earlier return to work. Most people are back to work within one to two days, although the night vision may take longer to recover. With no-flap procedures approximately one week is required to recover useful vision and the vision may sharpen up over a few weeks to a month following surgery. Most people undergoing laser vision correction with a no-flap technique will plan to take about a week off of work and may need assistance with young children or other duties for the first 3 days following surgery.

The other reason that flap based procedures became quickly popular when introduced in the 1990’s has to do with the older excimer laser technology and the past tendency for the formation of scarring and haze with PRK. Due to advancements in laser technology, medications, and surgical techniques the risk of visually significant haze is very low now.

The most feared complication of the flap based procedures is corneal instability called ectasia. Ectasia has been reported following PRK but is much more common with LASIK. Intra-LASIK and newer SBK (sub-Bowmans keratomeleusis) microkeratomes create very thin flaps which are thought to reduce the risk of ectasia. Thin flap techniques are very new and the prevalence of ectasia with thin flaps may not be known for several years as this condition can develop any time from immediately post-operatively to several years following surgery.

There is a significant amount of discussion recently about the risk factors for ectasia and the corneal biomechanics of creating a corneal flap. Some risk factors have been identified but there are some cases of ectasia in which no risk factors were apparent. Risk factors may include corneal mapping abnormalities, thin corneas, and family history of keratoconus.

Ectasia can not be corrected by further laser vision correction and requires treatment with customized contact lenses or in severe cases with corneal transplant. There are some surgeons who will only perform no-flap procedures due to this risk of ectasia, some are turning to thin flap procedures to reduce the risk, and others feel the risk of ectasia is so low that it is reasonable to give people a choice of procedures.

Differences Between Surgeries

PRK & Epi-LASIK: no flap treatment with laser applied to corneal
surface after surface epithelial cells are removed
LASIK & Intra-LASIK: flap is created and the laser is applied to
the interior corneal bed under the flap
PRK: surface epithelial cells are removed using a brush or by using
a dilute alcohol solution to soften the cells followed by manual removal
Epi-LASIK: surface cells are removed using an epi-keratome device
with an epithelial separator which uses a suction ring to stabilize the eye
LASIK: the flap is made using a microkeratome device with an oscillating
blade; a suction ring is used to stabilize the eye.
Intra-LASIK: a femtosecond laser is used to create a corneal flap; a
suction ring is used to stabilize the eye
Qualifying: some people may not qualify for flap procedures due to thin
corneas or other factors
Risk: PRK is the lowest risk followed by Epi-LASIK; flap procedures
have a mildly higher risk with Intra-LASIK felt to be safer than LASIK
Outcomes: depending on the study there have been some differences
discussed between procedures but there are no large scale studies to
show that one type of surgery is better than another over the long term
LASER: each center will have a particular type of laser which may
have the capacity to do customized treatments; the laser application will
be essentially the same regardless of the procedure type.

When given a choice between a low risk flap based procedure with a return to work within a few days and a lower risk no-flap procedure many people will choose the more rapid return to work and others will choose the lower risk treatment and accept the longer recovery. What it comes down to is each individual’s choice. If you would like more information or to book a free assessment contact Western Laser Eye associate staff at http://www.westernlasereye.com/ or call 403-547-9775.

Why is the price of LASIK, Epi-LASIK, and PRK different at different Calgary laser vision correction centers?

2009-07-09T21:30:00.000-07:00

Laser vision correction centers are businesses. Just as different retail chains offer different levels of service and products, laser vision correction centers vary on their business models. Some do higher volumes and have many centers and so can benefit from volume pricing on surgical supplies and pass that savings to their clients. Some centers offer more individual care with the surgeon before and after surgery such that lower volumes of patients are being treated but at a higher price.

Pricing can also be difficult to judge at first glance. Sometimes the advertised low price may only apply to very simple corrections and may not include enhancements. When searching for the right center to have vision correction surgery, it is wise to shop around to find the combination of price and service that fits you best. Be sure to find out what is included in the base price and who will be providing your pre- and post-procedure care.

Pricing not only will vary between centers, and it will also likely vary between procedures. For example, a standard laser treatment may be less expensive than a custom wavefront treatment due to the costs of providing the custom treatment. Some centers may have different prices for PRK, LASIK, and Intra-LASIK due to the costs associated with providing each of the different procedures. Some centers may price according to the strength of your prescription and some prices may not include retreatments or enhancements.

Price is an important factor but should not overshadow safety, effectiveness, and the level of service that you may need as an individual. As in all other consumer services you can not judge on price alone – each individual needs to weigh the price and levels of service offered by the various centers and decide which one is right for them.

Questions you may wish to ask about pricing include:

1. What are the prices for the surgeries you are considering for your individual case (some centers use a price scale based on your level of correction)?

2. Does the price include enhancements (touch up surgery) and for how long?

3. Who provides the pre- and post- operative care and when will you meet your surgeon?

4. Are all the pre-operative and post-operative visits included in the price?

5. Are there payment plans available?

6. Can the center provide documentation for spending accounts or insurance if needed?

You may be able to have some of the questions answered by speaking to staff at the laser vision correction center, but you may need to have a full assessment to get an accurate price for your individual case. Laser vision correction assessments can be time consuming, typically taking about 2 hours or longer and you will be asked to have a driver or alternate transportation due to the use of dilating eye drops; however it can be a good investment to have an assessment at the centers that you might be considering. This way you can learn what services you will get for the price. Price is one of many factors you will need to consider if you are thinking about having laser vision correction.

Which Calgary Laser Eye Centre has the best excimer laser?

2009-05-15T20:24:00.000-07:00

Whether you are considering LASIK, PRK, Intralasik, or Epi-LASIK in Calgary, you may be wondering which excimer laser is going to give the best results. Keep in mind that the laser while important is only one factor to consider when choosing a surgeon and center for laser vision correction.

There are 3 types of excimer lasers which are categorized by the laser beam profile. Broad beam lasers are able to ultilize a variable diameter pulse by using shutters. Scanning slit excimer lasers use a rectangular shaped beam which also can be varied by the use of shutters. The flying spot uses a fixed small diameter spot size.

Lasers will also vary according the eye tracking technologies. Eye tracking uses an infrared beam which to track the pupil in the vertical and horizontal meridians. The tracker follows small eye movements also known as saccades occur during laser treatment. If the pupil moves too far out of position then the tracker will stop the laser treatment. In many cases the surgeon will stop the treatment and realign the pupil even before the tracker automatically stops the treatment.

Some lasers also have a rotational tracker called cyclotorsion control. This rotational control is important for astigmatism corrections (astigmatism means your eye has 2 difference curvatures at 90 degrees to each other like a football or barrel). Cyclotorsion control is also important for wavefront treatments in which the higher order aberrations or more complex individual irregularities are corrected along with the nearsightedness, farsightedness, and astigmatism. Since the wavefront treatments are highly complex and individual a rotation of the eye will lessen the accuracy of the correction. Studies have shown that in some people the eye will cyclorotate up to several degrees between the upright and supine (laying down) position.

While the most commonly used lasers available today have a long and well established record of safety and effective results, the Visx Star S4 IR is the only laser available in Canada today which offers both a wavefront CustomVue treatment with iris recognition and cyclotorsion control.

The Visx Star S4 IR is a well established excimer laser platform with proven excellent results and is the laser which is most commonly chosen laser among North American surgeons. The Visx Star S4 IR also offers variable spot size and variable repetition rate which provides exceptional smoothness and lessens the possibility of haze.

When comparing excimer laser technology consider all the factors including whether or not a true wavefront correction can be performed and whether cyclotorsion control is available. Your surgeon will inform you if you qualify for laser vision correction and should be available to answer any questions you may have about the laser technology.

You should also consider carefully the options available at each center as these may vary. At Western Laser Eye associates Dr. Anderson Penno offers surface treatments PRK and Epi-LASIK which offer excellent long term results and carry less risk than flap based procedures such as LASIK and Intralasik.

Also consider surgeon availability for pre- and post- procedure consultations, cost, and retreatment options. The decision to undergo laser vision correction can be complex. Our staff is available to answer any questions you may have about our center, our technology, and our surgeon. Call 403-547-9775 or contact our staff at contact@westernlasereye.com to book your complimentary consultation with Dr. Anderson Penno.

Calgary: LASIK, Epi-LASIK, Intralase, PRK - How do you decide?

2009-05-02T19:36:00.000-07:00

Calgary: LASIK, Epi-LASIK, PRK, Intrase - how do you decide? Most people will shop around and compare prices when considering a large purchase. It's no different if you are considering laser vision correction. It makes sense to compare prices but how do you know what you are comparing?There are several differences to keep in mind.

First consider what procedure you may wish to undertake. There are differences in risks and benefits between the different treatments. Procedures which create a corneal flap such as LASIK and Intralase may offer more rapid recovery of vision with less discomfort but at a higher risk compared to surface treatments. Surface treatments like Epi-LASIK and PRK take longer to recover but are safer. Some centers have different pricing for the type of treatment and for the amount of correction. More information can be found on http://www.westernlasereye.com/ .

Another difference to consider is the type of laser treatment that is available at different centers. A standard laser treatment will correct nearsightedness, farsightedness, and astigmatism. Customized treatments such as the wavefront treatments available at Western Laser Eye Associates also correct individual irregularities in the visual system. Studies have shown that true wavefront treatment gives better results. Some centers have different pricing for standard or wavefront treatments.

Finally, the availability of the surgeon may vary between centers. In some centers such as Western Laser Eye Associates the surgeon will see you before, during, and after treatment. At other centers the surgeon may only see you on the day of surgery.It is important to make an informed choice. Be aware of what you will receive for the price. At Western Laser Eye Associates the pricing is simple, the care is exceptional, and Dr. Anderson Penno will see you before, during, and after surgery.For more information about the services provided by Western Laser Eye Associates contact us at http://www.westernlasereyeassociates.com/ or by calling 403-547-9775.

Calgary LASIK, Epi-LASIK, PRK: Patient Satisfaction

2009-04-22T21:27:00.000-07:00

April 1, 2009 Ophthalmology Times reported on a study by Dr. Kerry Solomon on LASIK satisfaction. Dr. Solomon was asked by the American Society of Cataract and Refractive Surgery (www.ASCRS.org) to review the world literature in response to a US FDA inquiry into complaints by LASIK patients. It is estimated that over 16 million people have had laser vision correction worldwide. In 2006 the FDA initiated an inquiry based on concerns raised by a group of LASIK patients.

Dr. Solomon's study identified 2,915 articles of which 309 were judged to be well designed. From these studies the data was pooled and analyzed. Satisfaction following LASIK was found to be 95% up to 6 months after surgery and 98.6% for questionnaires completed more than 6 months following LASIK. The most common reason for dissatisfaction was residual refractive error (a need for corrective lenses due to under correction, over correction, or regression). Some of these people may have been candidates for enhancement, and in studies that included people who had enhancements the satisfaction rate was higher. Other factors that lead to dissatisfaction after LASIK included dry eye and night vision symptoms.

LASIK involves cutting a corneal flap, lifting the flap, and performing the laser application on the underlying bed. Epi-LASIK and PRK are no-cut surface laser vision correction treatments that avoid the risks of creating a corneal flap and have been shown in many studies to have equally good or better results than LASIK. These surface treatments are safer than LASIK but do take longer to heal in the first days to weeks. Surface treatments like Epi-LASIK and PRK do not disrupt the corneal nerves as deeply and may be less likely to trigger a worsening of dry eye. With the use of CustomVue Wavefront treatment which corrects the individual higher order aberrations there may be less risk of significant permanent worsening of night vision.

For more information about laser vision correction or to book your complimentary evaluation call 403-547-9775 or go to www.westernlasereye.com.

April is Sports Eye Safety Awareness Month

2009-04-19T21:37:00.000-07:00

LASIK is still the most common laser vision correction procedure performed in Calgary and around the world, but surface treatment with PRK (photorefractive keratectomy) is becoming popular again along with a new surface treatment called Epi-LASIK. One of the reasons some surgeons in Calgary and elsewhere favor surface treatments over LASIK is the risk of flap dislocation following LASIK.

For many sports activities specialized eye wear is recommended. Unfortunately for some higher risk sports such as basketball safety glasses may not be routinely recommended. Other sports such as mountain biking or hunting may pose a risk when traveling through wooded areas. Recreational activities such as paint ball are also a risk for eye injury. More information about eye injuries can be found at www.geteyesmart.org .

Following LASIK the corneal flap heals around the superficial edge. It can be lifted surgically or shifted following an eye injury even years later. Although only a few people per year require treatment for shifted LASIK flaps, it can lead to a loss of vision if not properly treated within a short time. Epi-LASIK and PRK do not require the creation of a corneal flap. Instead just the very outer layer of cells called the epithelium is removed and the treatment is applied to the corneal surface. The long term results of Epi-LASIK and PRK equal to LASIK. The healing following surface laser treatments takes longer in the first few days to weeks, but there is no flap that could be damaged or shifted due to sports related or other eye injuries.

Whether you choose to undergo laser vision correction or not, always wear safety glasses for any activities where they are ordinarily recommended. For hockey a visor is recommended. When working in the yard with mowers or weed trimmers safety glasses will guard against stones that may be launched by these machines. Table saws, grinders, and other shop equipment also pose a risk for eye injuries. The few extra seconds it takes to put on a pair of safetly glasses can save you from a lifetime of poor vision.

For more information about your laser vision correction options contact us at www.westernlasereye.com or call 403-547- 9775 to book a complimentary assessment.

Calgary LASIK: What is Epi-LASIK?

2009-04-11T13:26:00.000-07:00

Western Laser Eye Associates is pleased to announce the acquisition of the Moria Epi-LASIK epikeratome. Epi-LASIK is the latest advancement in laser vision correction. Epi-LASIK combines the keratome technology of LASIK with the safety of surface PRK.

In Calgary as well as around the world LASIK has become very popular in the past decade due to the fact that there is more rapid recovery of vision and less discomfort in the first few days following surgery as compared to PRK. For LASIK corneal flap is made with a keratome blade or femtosecond laser in order to lift the flap and apply the laser energy to the deeper bed underneath the LASIK flap. Within the past few years some surgeons in Calgary have followed the worldwide trend to move back to surface treatments such as PRK due to the superior level of safety with equally good long term vision results.

Surface treatments like PRK and Epi-LASIK are safer because the surgery is simpler and avoids the possible flap related complications such as a buttonhole or partial flap that can occur with LASIK. Epi-LASIK and PRK are also safer than LASIK due to the fact that the treatment is not as deep and preserves more of the natural cornea to maintain the corneal strength and avoid the rare but serious complication called ectasia in which the cornea becomes unstable which results in poor vision within months or years following LASIK. This condition is uncommon following surface laser vision correction. Surface treatments such as PRK and Epi-LASIK also avoid the possible future risk of flap shifting which can occur even years after LASIK if there is an eye injury.

Surface laser vision correction eliminates the need to cut a LASIK flap. The surface cells are removed in order to apply the laser energy to the smooth membrane which is just underneath. For PRK these surface cells are either removed with a special brush or with a dilute alcohol solution (sometimes this technique is called alcohol assisted PRK). Both of these methods have been in use for many years and may be recommended for certain people with corneal scars or other conditions. Epi-LASIK uses an epikeratome with a blunt separator which can remove these surface cells more cleanly and without the use of chemicals.

For both Epi-LASIK and PRK a contact lens is placed for approximately 3 days. There is some discomfort with either of these treatments for those first few days until the contact lens is removed. The amount of discomfort varies from person to person with some people who need nothing more than frequent artificial tears and others who will need additional drops or oral medication such as Tylenol #3. It is important to rest and keep the eyes closed as much as possible for these first few days.

The difference between PRK and Epi-LASIK is most obvious after 3 days. There are more people who will be able to read the 20/20 line within 3 to 4 days following Epi-LASIK as compared to PRK where it may take 7 to 10 days to be within this range of vision. It is important to understand that surface laser vision correction involves a healing phase of up to 6 months over which time the vision continues to sharpen. Many people who have Epi-LASIK will be able to return to usual activities within 3 to 5 days, but it is important to keep in mind that while the vision may be in the legal range for driving it may still be somewhat blurred. Some people will limit their night time driving or have to take more frequent breaks from computer or other visually demanding work for a few weeks to a few months following Epi-LASIK.

Several studies have shown that the long term results are equally good for surface treatments like Epi-LASIK and PRK as they are for LASIK. Some studies have shown better results with surface laser vision correction than for LASIK for people having custom wavefront treatments such as CustomVue which is done at Western Laser Eye Associates.

Epi-LASIK offers excellent safety, more rapid recovery of vision compared to PRK, and outstanding long term results. For more information or to book a complimentary assessment call Western Laser Eye Associates at 403-547-9775.

What is Epi-LASIK?

2009-03-10T13:59:00.000-07:00

Epi-LASIK is an alternative to LASIK – another way to have laser vision correction. It is very similar to LASIK except for one important difference. It creates a thinner corneal flap. This makes it a good option for people with thin corneas.

LASIK and Epi-LASIK are both ways to reshape the cornea, the clear front part of the eye. By reshaping its curvature, they cause it to bend light differently so that it focuses clearly on the retina. When the light-sensitive retinal cells (at the back of the eye) receive a clear image, they send it to the brain for interpretation and naming, and the brain can give you a confident translation of what you are looking at. This is 20/20 vision.

When a person has thin corneas LASIK may not be safe. Corneal reshaping is done by removing tiny pieces of tissue from the right places. This is not done from the top level of the cornea, but from the middle layer, the stroma. A flap of surface tissue is folded back to give the laser access to the stroma.

In eyes with thin corneas the flap needs to be thinner. The epi-LASIK flap is only as thin as the top layer, the epithelium – hence the name “epi”-LASIK. None of the stromal tissue is included in an epi-LASIK flap.

Results from this way of doing laser vision correction are every bit as good as those from LASIK or from PRK. You can read more on Choosing Between PRK and LASIK, as this page also discusses Epi-LASIK.

LASIK, PRK and epi-LASIK can all be done using Wavefront Technology for the diagnosis. This will give you better night vision.

To determine which method of laser vision correction would be best for you, please call or email our LASIK office today for a free consultation.

LASIK and dry eye

2009-03-09T09:24:00.000-07:00

Dry eye is a common side effect of LASIK eye surgery. Moisturizing eye drops are always prescribed after surgery to encourage tear production and help the eyes stabilize. Even with these drops, however, some patients experience dry eye symptoms such as:
• Itchiness
• Blurred vision
• Burning
• Redness
• Pain

The good news is that these symptoms are generally temporary and will subside in the weeks and months following surgery.

Why does LASIK produce dry eye?
During LASIK eye surgery, Dr. Penno cuts a thin flap on the cornea so she can use a laser to reshape the cornea underneath the flap. When the corneal flap is created, small nerves in the cornea are cut which supply impulses to the lacrimal, or tear-producing, gland.

As a result, the patient’s eyes are not able to produce the proper amount of lubrication. This is usually a temporary condition that corrects itself in the weeks following surgery as the nerves regrow.

Can I have LASIK surgery if I have dry eye?
If you already have symptoms of dry eye you may be able to undergo LASIK. During a thorough examination, Dr. Penno may determine that in your case it would be safe.

It may also be prudent to insert collagen or silicone punctal plugs into the openings where tears drain out of the eyes (called puncta, singular is punctum). These plugs can remain in the eyes for weeks or months and keep better lubrication on the eyes prior to surgery.

If you suffer from severe dry eye you may not be a good candidate for LASIK.

It is important to share your medical history with Dr. Penno during the consultation, including dry eye symptoms and all medications you are taking. This will help us to give you the best treatment options possible.

For a free evaluation, please contact our LASIK office today to see if you are a good candidate for this popular surgery.

LASIK and the military

2009-02-06T15:09:00.000-08:00

Imagine being on an intense battlefield, fighting for your life and the lives of your troops. The last thing a soldier would want to think about is dropping or breaking eye glasses in a combat situation.

But many who are nearsighted or farsighted or who have astigmatism are forced to wear eye glasses or special goggles to correct their vision problems, even in combat. The ability to effectively complete missions under these circumstances can lead to injuries and lives lost. In addition, contact lenses in dusty landscapes can be hazardous to a soldier’s eyes, even when not in combat.

As a result of these hazards and to help protect the lives of military personnel, the U.S. Army, Navy, Air Force and Marine Corps now permit Wavefront LASIK eye surgery for most military personnel. One exception is that LASIK is not approved for military pilots at this time. The U.S. Navy did allow four of its aviators to undergo LASIK surgery in November of 2006, so this rule may change in the future. In addition, some Special Forces units are not permitted to undergo LASIK surgery.

Millions of people have had LASIK eye surgery since it was approved by the U.S. Food and Drug Administration (FDA) in 1995. The fact that the military now accepts WaveFront LASIK eye surgery for its military personnel is a testament to the success of the procedure and how LASIK can help save lives on the warfront.

If you would like to learn more, please contact our LASIK office today to arrange a free evaluation.

LASIK for pilots

2009-01-09T09:00:00.000-08:00

Airline pilots rely on their sense of sight more than any other sense to safely transport people from location to location. The burden of wearing eye glasses or contact lenses to help correct nearsightedness, farsightedness, or astigmatism leads many pilots today to look into LASIK eye surgery.

While most people can resume work in a few days after LASIK eye surgery, it is recommended that pilots be especially cautious about their recovery time. In fact, many airlines require a six-week waiting period after LASIK surgery before piloting to ensure they meet Federal Aviation Administration vision standards.

As with any elective surgery, LASIK eye surgery does have potential risks and complications that could hinder a pilot’s ability to properly do his or her job. Those possibilities can include:

Visual aberrations (double vision, glare, starbursts, etc.)
Dry eye
Blurring
Haze
Irregular flap healing
Corneal scarring
Infection

These risks are greatly reduced when your eye surgery is performed by a qualified, experienced surgeon like Dr. Anderson Penno. Dr. Penno has performed several thousand refractive surgeries since 1996 and personally takes time to ensure each patient is a good candidate for LASIK.

The possibility of a pilot losing or breaking glasses or contacts prior to a flight can have a potentially disastrous effect on the outcome of the flight. If you are a pilot and would like to learn if you are a candidate for LASIK, please contact our eye surgery office today to arrange a free LASIK evaluation.

LASIK for athletes

2008-12-29T15:35:00.000-08:00

If you are an athlete and do not have perfect vision, you are probably all too familiar with the hassles of wearing eye glasses or contacts while playing sports. LASIK laser refractive eye surgery is a way for you to shed those burdens and let a 20/20 vision take your game to a new level.

At Western Laser Eye Associates, we are committed to helping patients gain the best eyesight possible. And for athletes this is especially important. The ability to play a sport without being hindered by eye glasses or contacts can not only improve your game, it can also help save you from possible harm.

Consider these situations:

Eye injury: caused by shattered eye glasses, torn contact lenses, sweat or dirt underneath contacts, dry eyes due to contact lenses
Lessened playing ability: caused by eye glasses limiting peripheral vision, contact lenses that fall out during play, rain or snow limiting vision in eye glasses

LASIK can help patients who have lived for years with eye conditions such as:

Nearsightedness
Farsightedness
Astigmatism

Not every athlete is a good candidate for LASIK eye surgery. Those who play aggressive contact sports may be at a higher risk for infection or damage to the cornea. We will fully evaluate your eyes, medical history and lifestyle to determine if you are a good LASIK candidate. If you are not, there may well be another procedure that would work.

Please contact our LASIK office today to arrange a free evaluation.

What is 20/20 Vision?

2008-12-17T13:25:00.000-08:00

If you have been told you have 20/20 vision, you have what has been defined as humanity’s “normal” eyesight. You can see clearly at all distances. Those numbers refer to feet from an eye chart.

The typical eye chart has a large “E” at the top and lines of smaller letters underneath. When your eye doctor tests your vision for glasses or contact lenses, you look into a device called a phoropter. You are asked to read the smallest row of letters you can clearly see, and the doctor flips from lens to lens asking you to compare: “Which is clearer, this … or this?”

The phoropter is simulating your distance from the eye chart. In the expression “20/20”, the first number refers to the tested eye’s distance in feet from the chart. The second number changes according to your visual acuity.

If you have 20/40 eyes, you must be only 20 feet from the chart to see what “normal” eyes can see clearly from 40 feet away. You are mildly nearsighted.
If you have 20/100 vision, you are more nearsighted, and normal eyes can see at 100 feet what you can only see from 20 feet away
Legal blindness is defined as 20/200, where the eyes being tested must peer at the letters from 20 feet way to see what “normal” eyes can see from 200 feet away.

“Better Than Normal” Vision
After having a Custom LASIK procedure, some people achieve 20/16 vision. That means their visual clarity is better than what is considered normal. In terms of the eye chart, they can see from 20 feet away what a “normal” person must be only 16 feet away to see clearly. These superior results are possible because Wavefront technology is used for diagnosis instead of a phoropter. It gives a more microscopically precise picture of your eye contours, which means your LASIK treatment can be more precise.

Please see our page on How the Eye Works for more detail on eye anatomy and how an eye can be nearsighted, farsighted or astigmatic.

To learn more about what LASIK could do for your vision, and to learn more about your eyes, please contact our office for a personal consultation with Dr. Penno.

LASIK and Pregnancy

2008-11-03T11:49:00.000-08:00

Are you pregnant or planning to become pregnant? Are you breastfeeding? If so, you are not a good LASIK candidate until after these activities are finished. Dr. Penno does thorough screening of potential LASIK patients and two of the questions always asked of women is whether they are pregnant or lactating.

To have excellent LASIK results, you have to be as good a LASIK candidate as possible, within the parameters of safety and effectiveness. During pregnancy certain hormones are produced which make many changes in the body, and one of them is increased fluid retention. Most pregnant women experience some degree of fluid retention but may not realize that it occurs in the eye’s lens as well as in the ankles and other areas.

Reasons to Wait for Your LASIK

Swelling in the lens causes increased myopia (nearsightedness) and sometimes also astigmatism. In some cases it can cause hyperopia (farsightedness). A vision correction done while swelling is present would not be accurate after the swelling subsided.
Drugs used during LASIK are antibiotic eyedrops to prevent infection and cortisone eyedrops to reduce inflammation. A mild sedative may also be used to help you relax. These will all enter the bloodstream and could therefore affect the baby. It is not known whether they enter the milk also, but why take the risk?
Pregnancy causes some dryness in the eyes. LASIK also causes dryness during recovery. If you went into your LASIK procedure already having dry eyes and then compounded that with the post-surgical dryness you could develop Dry Eye Syndrome which is chronic.

If you are pregnant or lactating, and would like to learn more about LASIK and whether it would be a good option for you later, by all means contact us. We will be happy to explain things, answer your questions and examine your eyes. Then when you are ready for LASIK we can continue the candidate screening and choose the best procedure for your individual eyes.

LASIK for Astigmatism

2008-09-30T10:02:00.000-07:00

A common form of astigmatism results when the cornea is elliptical or irregularly shaped rather than spherical. In people with this condition, light that enters the eye is focused on more than one point at the back of the retina. That’s the reason people with astigmatism experience blurred vision. LASIK or Laser-Assisted In Situ Keratomileusis can be used to treat astigmatism since it provides a way to reshape the cornea.

LASIK procedures approved by the FDA for treatment of corneal astigmatism include traditional LASIK or wavefront-guided LASIK (also known as custom LASIK). Traditional LASIK basically involves making a small circular incision in the cornea to create a flap, and using a laser to reshape the underlying corneal tissue. Wavefront-guided LASIK uses a computerized device that shines light in the eye and creates a 3D model of the cornea based on the wavefront of light that bounces back. The computer takes this information uses it to guide the path of the laser during the cornea-reshaping process. Wavefront-guided LASIK is more likely to result in 20/20 vision or better than traditional LASIK. At Western Laser Eye Associates, Dr. Elizabeth Anderson Penno, a board certified ophthalmologist can tell you which procedure is right for you.

While you may not have perfect vision after LASIK astigmatism correction, many people who’ve had LASIK astigmatism correction find that they don’t need glasses anymore. Vision improvement can increase over time, but some report improvement as early as a day or two after a LASIK procedure.

Dr.Ellen Anderson Penno, serving Calgary, Alberta, combines ten years of LASIK and PRK experience, today's most advanced technology, and customized care to give you your best possible vision. Please call or email our office to schedule your free LASIK/PRK evaluation today.

Does age matter for LASIK or PRK?

2008-09-19T21:10:00.000-07:00

If you are considering LASIK or PRK in Calgary you won't be considered a good candidate for laser vision correction unless you are at least 18 years old with a stable prescription for at least one year. There may be rare cases where LASIK or PRK might be recommended for people younger than 18. There are also many people at that age that may not be good candidates due to increasing prescriptions. Some people with higher corrections may not stabilize until they are in their mid to late twenties. It is not uncommon for people with stable prescriptions to need a second treatment (enhancement) following LASIK or PRK, but repeated enhancements are not recommended due to the risk of corneal thinning which can result in corneal instability. For this reason it is wise to wait until your prescription stabilizes for at least one year whether you are 18 or 28 years old.

Once the prescription stabilizes, most people will experience only small changes in their contact lens or glasses correction until they reach their 40's. Sometime between age 40 and 48 most people will experience a change in their focusing power. This change is called presbyopia and means that a bifocal or progressive correction or reading glasses over contact lenses will be needed for near vision including reading. LASIK or PRK may still be a good choice for people in this age range but reading glasses may be needed after treatment. If you are over the age of 40 you may want to ask your surgeon about monovision. Monovision means that one eye is corrected for distance vision and one eye is targeted for near vision.

For people over 50 years old LASIK and PRK can be an excellent choice for vision correction. In this decade cataracts may begin to form. Cataracts involve age related changes that result in clouding of the lenses inside the eyes. Early cataracts may cause a change in prescription. If your correction is changing and your surgeon has identified cataracts then LASIK and PRK may not be a good choice for you. If your prescription is stable and your surgeon does not see any cataracts or other age related changes then laser vision correction is an option to consider. If both eyes are targeted for distance then reading glasses will be needed for near vision unless a monovision correction is done.

For people who are in their late fifties or older most surgeons will begin to recommend an intraocular treatment called a refractive lensectomy for vision correction. Refractive lensectomy uses the same techniques to remove and replace the lens inside the eye with an intraocular lens implant. Cataracts become more common in this age range and if a refractive lensectomy is done then cataracts will not develop later since the lens inside the eye will have already been removed. If you are in this age group there are some exciting developments in implantable lens technology including the Tetraflex lens which may restore some ability to focus at near.

No matter how old or young you are, your prescription should be stable for at least one year before considering PRK or LASIK. If your prescription was stable and then begins to change it can be a sign of diabetes, cataracts, or other eye conditions and you should contact your ophthalmologist or optometrist for an eye health check.

For more information on eye conditions check out the American Academy of Ophthamology site http://www.aao.org/ or http://www.mayoclinic.com/. To book a complimentary evaluation for PRK or LASIK contact Dr. Anderson Penno in Calgary, AB at 403.547.9774 or http://www.westernlasereye.com/.

Do you know who’s taking care of your eyes before and after LASIK?

2008-09-07T21:33:00.000-07:00

Many people don’t know the difference between an optometrist and an ophthalmologist. Most don’t understand the role that certified ophthalmic personnel play as part of your eye care team.

If you are considering LASIK or PRK in Calgary, come and meet the Western Laser Eye Associate team which includes:

Ophthalmologist
An ophthalmologist or ophthalmic surgeon is an Eye M.D. – a medical doctor trained in eye care and eye surgery. Ophthalmologists can provide all types of care from diagnosis of eye disease to eye surgery. At Western Laser Eye Associates, Dr. Anderson Penno is a board certified ophthalmologist. Dr. Anderson Penno will see each LASIK and PRK candidate to determine the best procedure for each person. Dr. Anderson Penno will provide ongoing care including LASIK or PRK and follow up visits.

Certified Ophthalmic Personnel
The Joint Commission on Allied Heath Personnel in Ophthalmology (JCAHPO) certifies technical eye care personnel at four levels – certified ophthalmic assistant, certified ophthalmic technician, certified ophthalmic medical technologist, and corporate certified ophthalmic assistant. Certification requires that personnel complete training and testing. Certified ophthalmic personnel assist ophthalmologists and optometrists with vision testing, visual field testing, and a variety of other technical duties including corneal mapping and surgical assisting. Most offices will also have ophthalmic personnel who are gaining experience in advance of testing for certification.

Optometrist
A Doctor of Optometry (OD) degree and a license to practice optometry (not medicine) is required for optometrists. Optometrists prescribe glasses and contacts and diagnose and treat common eye diseases. Optometrists often work closely with ophthalmologists and may refer to ophthalmologists for eye surgeries including LASIK and PRK.

Optician
Opticians are trained to fill prescriptions for contacts and glasses. Opticians are not trained to diagnose or treat eye diseases or to write prescriptions. They can provide excellent advice regarding lens and frame choice.

More information about eye care professionals can be found at www.AAO.org , www.JCAHPO.org , www.opto.ca , and www.geteyesmart.com.

If you are interested in booking a complimentary laser vision correction evaluation please call Western Laser Eye Associates at 403.547.9775 or contact us online at www.westernlasereye.com.

Laser Eye Surgery Technology

2008-08-25T12:54:00.000-07:00

The newest advance in laser eye surgery technology is Wavefront technology. It offers the patient better vision than traditional LASIK and also offers iris registration. Traditional lasers track the movements of your eye. In other words, if you move your eye left, right, up or down the laser will follow it.

The problem with older LASIK technology is that if you move your eye closer or farther from the laser, the technology wasn't sophisticated enough to track this movement. Iris registration technology is advanced enough to match these movements in order to match the eye tracking points perfectly with the laser during the surgical procedure.

The new Wavefront technology can also track eye rotations. When the patient lies down, the eyes can slightly rotate clockwise or counter clockwise. It is now technologically possible to track that additional eye movement.

The use of Wavefront technology in laser eye surgeries has offered surgeons the ability to perform nearly perfect surgeries on their patients. This provides even better results and less room for error and complication.

It is important to consult with an experienced and skilled eye surgeon before undergoing any procedures. Discuss all of your options with your eye doctor to determine which procedure will best suit your individual needs. To schedule a complimentary appointment with a skilled and caring eye surgeon, please contact Dr. Ellen Anderson Penno today.

Calgary LASIK: Preventing Eye Injuries Before and After Laser Vision Correction

2008-08-19T21:01:00.000-07:00

The 2008 Eye Injury Snapshot shows that half of the 2.5 million eye injuries reported annually in the United States occurred in and around the home and yard. For the past five years members of the American Academy of Ophthalmology (www.aao.org) have participated in this study which reports injuries occurring within a one week period.

The majority (76%) of injuries occurred in men, and over half of those suffering injuries were between the ages of 10 and 45. Common household tools including bungee cords and chemicals were reported to cause injuries. The majority of injuries took place in the yard, workshop, and garage.

Results from this study can be found at www.geteyesmart.org.

The best option for reducing the number of eye injuries is prevention. In many cases common sense and safety glasses will prevent these types of injuries. For any work involving power tools, lawn mowers, weed trimmers, and household chemicals, safety glasses may prevent serious injury. The study highlights the need for safety glasses for common activities that do not involve power tools such as using a hammer and nail.

The risk for injury may be increased following LASIK due to the possibility of flap shift. Following LASIK, the eye should be considered to be more fragile as the flap can be shifted or damaged even years later. While there is no flap with PRK, safety glasses are still recommended for any activities including home repair where they would be ordinarily worn.

Whether or not you have had LASIK or PRK you should seek prompt treatment with your optometrist, ophthalmologist, or emergency physician following any eye injury. Serious vision loss occurred in 50,000 cases reported in the 2008 Eye Injury Snapshot study.

More information about Calgary LASIK and PRK can be found at www.westernlasereye.com or by calling 403-547-9775 to book a complimentary assessment with Dr. Anderson Penno.

How do I decide between PRK and LASIK?

2008-08-11T22:43:00.000-07:00

For some people the choice is easy. There are certain conditions which may be present which mean you only qualify for PRK. For others who qualify for both LASIK and PRK the choice can be more challenging.

In order to make a good decision it is important to gather as much infomation you can about PRK and LASIK. You must understand the basics of these two methods of laser vision correction before you can begin to make a well informed choice.

With both procedures numbing drops are used to freeze the surface of the eye. For PRK the surface cells are removed and the laser energy is applied to the corneal surface. For LASIK a flap is created with a device called a microkeratome. The flap is lifted and the laser energy is applied to the corneal tissue underneath the flap. More detailed information about the two types of laser vision correction can be found at http://www.westernlasereye.com/ . Other websites which have reliable information include http://www.aao.org/ (American Academy of Ophthalmology) and http://www.mayoclinic.com/ .

You should watch the DVD or video provided at the pre-operative evaluation, read all information provided to you by your surgeon (including consent forms), and ask a lot of questions. There are many basic questions that can be answered by qualified staff, but if you are feeling unsure about your choice you should request to speak to your surgeon. It may help to make a list of all your questions to bring to the appointment or to guide you during a telephone conversation with staff.

There may be individual factors which make you a better candidate for LASIK or PRK. For example, extremely farsighted (hyperopic) people may have a better result with LASIK due to a tendency to heal back towards farsightedness following PRK. For nearsighted (myopic) people this is not an important factor with the newer PRK techniques. Another example is thin corneas. If a cornea is too thin for a given correction then PRK may be recommended since it is not as deep a treatment and does not weaken the cornea as much.

As a general rule the following would be true for people who qualify for both LASIK and PRK:

These results will be the same with PRK or LASIK

- the longterm results are equally good for most prescriptions
- if you are over 40 you are likely to need glasses for reading and other close work

- the night vision may take longer to improve (up to 12 months in some cases)

- most people feel their night vision is similar to pre-operative night vision

- glare or halo present with corrective lenses may be present permanently after surgery

- dry eye is a common side effect of laser vision correction, usually improving over months

- the overall sharpness of vision can improve up to a full year

- there is a chance a second treatment (enhancement) may be needed for best vision

- safety glasses for sports or activities such as using power tools is always recommended

These results may be different with PRK or LASIK

- LASIK is more complex and a deeper treatment and carries a slightly higher risk

- risks of LASIK include flap problems during an after surgery

- the LASIK flap can be shifted even years later with trauma to the cornea

- PRK is a simpler procedure with less risk for most people

- PRK does not create a flap so there is less risk with future injury

- PRK is not as deep a treatment so there is less risk of weakening the cornea (ectasia)

- for thin corneas or irregular corneas PRK may be preferred

- for high farsighted or high astigmatism corrections LASIK may reduce enhancements

- there is a very slight chance of haze or scarring with PRK

- the chance of haze or scarring with PRK is greatly reduced with newer lasers

- PRK takes longer to recover with 7-10 days before return to activities like driving

- with PRK the vision may be blurry for up to a month or more

- LASIK has less discomfort in the first few days compared to PRK

- LASIK has more rapid visual recovery with return to usual activities in 1 or 2 days

Overall if you qualify for both PRK and LASIK the bottom line is that you trade a higher risk with LASIK for more rapid recovery. With PRK you are choosing a lower risk with the understanding that the recovery of vision is more gradual and there may be more discomfort in the first few days following surgery.

There may be factors individual to your own eye health, your correction, your overall health or medications, or lifestyle requirements that may make you a better candidate for one procedure or the other. It is important to listen carefully to the recommendations of your surgeon. If you have any questions be sure to ask. You can get more information by scheduling a complimentary assessment with Dr. Anderson Penno by calling 403-547-9775 or fill out the online form at www.westernlasereye.com.

How Will My Eyes Feel After LASIK?

2008-07-11T08:49:00.000-07:00

After undergoing LASIK surgery, most patients experience the following symptoms:
Burning

Scratchy feeling
A feeling like something is in the eye
General eye irritation
Some blurring of vision for the first day and on occasion for a few months
Some night vision effects like glare of halo, which usually improve ove six to twelve months

Experiencing dry eyes depends on the individual patient. A mild dryness is normal for the up to three to six months and occurs after first waking or reading for long periods. These symptoms are typical and can generally be relieved through the use of artificial tears in the form of eye drops. If you work on a computer the majority of the time, you may experience dry eyes more than the average person. Artificial tears and more frequent breaks should help you manage these symptoms.

Continual blurred vision may occur for the first few months after surgery as your eyes begin to stabilize. During this period, you should not feel any pain or discomfort and can continue with your regular activities as soon as the day after surgery.

Your vision may take up to six months to stabilize. Some patients find that it takes several months for the night vision to improve. Your doctor should advise you what to expect in the first few days and months following surgery.

Most patients never experience any complications after undergoing LASIK eye surgery, although it is possible. The key to a quick and healthy recovery is to follow all of your eye surgeon’s directions completely before, during and after your procedure. You should be sure to ask your surgeon any questions you may have before and after LASIK.

You will be monitored regularly by your doctor to be sure no complications are developing in your eyes as a result of your LASIK surgery. To learn more about LASIK and other eye surgery procedures, please contact Dr. Ellen Anderson Penno's office today to schedule an appointment.

LASIK Recovery

2008-06-19T07:39:00.000-07:00

LASIK surgery generally takes less than 15 minutes to complete. The majority of patients experience immediate improvement in vision, although complete LASIK recovery can take as long as six months. In some cases, the patient's vision takes this long to become completely stabilized.

Recovery from LASIK surgery is generally considered to be short lived. Dr. Anderson Penno may require that you wear some form of protective eye wear for the first day or two following the procedure. You may also be prescribed antibiotics, anti-inflammatories, eye drops or a combination of these.

Finally, dark glasses may be required if you experience any sensitivity to bright lights immediately following your LASIK surgery. Your doctor will likely recommend that you go to sleep immediately after surgery to avoid any post-operative pain that may occur. When you awake, your vision will already be markedly improved.

Complications from LASIK surgery are possible, although very rare. Most patients are able to return to work and regular daily activities the following day after the procedure. Nearsighted patients may experience some initial difficulty reading in the first few days.

Post-operative discomfort is generally very little, if any and follow-up exams are regularly scheduled to be sure you do not experience any unexpected complications.

Typical outcomes from LASIK eye surgery are:

Nearsighted patients usually return to functional vision one day after the surgery.
Farsighted patients usually experience dramatic results one day after surgery. Distance vision may be blurry at first, but this will improve.
Astigmatism conditions are harder to treat, but most patients still experience dramatic improvements.

In general, do everything you can to rest your eyes and do not rub them for the first 24 hours after receiving LASIK eye surgery. Aside from any unforeseen complications, this will be the largest part of your LASIK recovery. To schedule an appointment, please contact Dr. Ellen Anderson Penno today.

Tough Questions You Should Ask Your LASIK or PRK Surgeon

2008-05-27T22:12:00.000-07:00

If you are considering laser vision correction in Calgary Alberta or elsewhere, don't be afraid to ask your refractive surgeon tough questions. LASIK or PRK may take only a few minutes to perform but you need your good vision for years to come. Here are some questions you may wish to ask your surgeon:

1 How long have you been doing laser vision correction surgery?
2 How many laser vision procedures have you performed total?
3 How many refractive procedures have you performed in the last 12 months?
4 How have your results been with the surgeries you perform?
5 What kinds of complications have you seen, and am I at a higher risk for any specific complications?
6 How many laser vision surgery candidates do you decline?
7 Do you use wavefront technology in your evaluation and treatments?
8 What is the chance I will need an enhancement or second treatment to achieve good vision?
9 What is the worst complication of laser vision correction you have had and what was the final result?
10 If you intend to use an excimer laser, is it broadbeam, variable spot, or flying spot? What are the benefits and possible side effects of this type of laser?
11 Have you ever had malpractice insurance problems, malpractice claims, or license revoked?
12 If another doctor will be comanaging pre- and/or postoperative care, can I see you at any time without my comanaging doctor’s authorization?
13 What should I expect my vision to be like for the first few weeks after surgery?
14 Will you perform a complete refractive examination including evaluating the medical health of my eyes both before and after surgery?
15 If you recommend LASIK, how will you make the flap?
16 Do you measure tear production prior to surgery?
17 Will you measure the size of my pupils when naturally dilated in a dimly lit room prior to making a recommendation about surgery?
18 Do I have to stay out of contact lenses before evaluation and surgery?
19 How often and when will you perform postoperative examinations?
20 How will my occupation, leisure activities, and hobbies influence my candidacy and results or PRK or LASIK surgery?
21 Is there anything in my medical history that would make a difference in my candidacy or result of laser vision correction surgery?
22 Does being pregnant or contemplating pregnancy make a difference for laser vision correction surgery?
23 What are your qualifications to perform this surgery? Do you have any board certification or other specific certifications?

You may wish to discuss some or all of these points with your laser vision correction surgeon. There may be other questions you may wish to ask. A qualified and experienced surgeon should be willing to take the time to answer all your questions before recommending laser vision correction.

Questions about outcomes or complications from LASIK or PRK surgeries should be easily answered by your surgeon - any experienced laser vision correction surgeon will have had a few complications over their career. It is not possible to have a complication rate of zero with any type of surgery including LASIK or PRK.

Some of these questions might be answered by the technical staff, by reading written materials provided by your surgery center, or by viewing the laser vision correction centre's website. Be sure you ask your surgeon any additional questions that you may have before surgery.

For your complimentary laser vision correction assessment in Calgary Alberta with Dr. Anderson Penno call 547-9775 or contact us on www.westernlasereye.com.

Beautiful Eyes Before and After LASIK

2008-05-26T21:17:00.000-07:00

Healthy eyes are beautiful. Whether or not you have had LASIK or PRK the following tips will help you keep your eyes healthy and beautiful:

1. Replace your eye make-up about every 3 months. If you ever have an eye infection it is advisable to discontinue make-up until the infection has cleared and replace all products used around the eyes. If you have laser eye surgery, your surgeon may recommend you avoid make-up for a period of time following PRK or LASIK.

2. Never use testers at cosmetic counters as they may harbor infectious agents.

3. Practice good eyelid hygiene. Remove all eye make-up before going to sleep. Avoid waterproof products as they are more difficult to remove. Eye make-up removers often contain products which may contribute to plugging of the oil glands which line the eyelids. It may be helpful to soak the lids with a warm wet cloth for 3 to 5 minutes once or twice per day (only use warm water and a face cloth - never use heating pads or microwave as it may burn the lids).

4. To avoid allergy or sensitivities introduce one product at a time. Wait at least 2 weeks between introducing new products.

5. Apply make-up to clean lids. Do not apply make-up along the eye side of the lashes as this area contains oil glands that may be prone to plugging in some people. This may be particularly important for people who suffer from dry eyes or seasonal allergies.

Keep your eyes healthy and beautiful. More information can be found at http://aao.org/newsroom/release/20080501b.cfm.

At Western Laser Eye Associates, Dr. Anderson Penno and staff are committed to the health of your eyes before and after LASIK or PRK. For more information call 403.547.9775 or check out www.westernlasereye.com.