T a b l e o f C o n t e n t s Changingthe way you see Life Page One.. A Letter To My Patients Page Two. Meet Mark Schneider, M.D. Page Three.. Are You A Good Candidate? Page Four. Common Vision Problems Page Five.. Advanced CustomVue LASIK Page Six. The LASIK Consultation Page Seven.. State Of The Art Technology Page Eight What To Expect The Day Of Your Procedure Page Nine. Follow-Up Care Page Ten... Look What Our Patients Are Saying About Us Page Eleven. Great Vision Is Affordable
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Meet Mark Schneider, M.D. R e p u t a t i o n He was awarded: E x p e r i e n c e Dr. Schneider is a board-certified Ophthalmologist. He has been a vision correction specialist since 1988. He was trained at Loma Linda University, USC-Doheny, and was involved in neuroretinal research at UCLA. Dr. Schneider has practiced in the Inland Empire for over 20 years, has over 15 years LASIK experience, and is well known for his quality of care and caring attitude toward his patients. Physician Recognition Award 1990 and 1996-1999 by the American Medical Association Businessman of the Year 2002 by the Wall Street Journal America s Top Ophthalmologist 2002-2003 and 2007-2011 by Consumer s Research Council Pioneer Award by IntraLase for bladeless technology development 2003 Luminaries Award of IntraLase technology 2005 Changingthe way you see Life Dr. Schneider participated in the FDA clinical trials for the Excimer laser and was on the teaching staff for INTACS corneal rings in 1999. He has had numerous publications and trained hundreds of eye doctors in the field of refractive surgery. Some of Dr. Schneider s professional affiliations include: Fellow of the American Academy of Ophthalmology, Member of American Society of Cataract and Refractive Surgeons, International Society of Refractive Surgeons, American College of Eye Surgeons, California Association of Ophthalmology, and California Medical Association. C o m m i t m e n t T o S a f e t y As a specialist in vision correction procedures, Dr. Schneider is able to offer vision corrections other than LASIK, and will offer the option that is best suited for each individual patient. Patients are evaluated with the most advanced technologies. Highly trained, experienced staff will perform initial diagnostic pre-testing and preparation for the procedure. This includes pre-operative instructions, what to expect in the laser suite, and proper care of the eyes after surgery. Dr. Schneider personally meets with each patient at the time of the initial consultation in order to completely understand individual visual needs and concerns. He personally checks the eye measurements, and double checks the measurements before the procedure. This personal attention provided by Dr. Schneider is one of the many demonstrations of his commitment to every patient s successful visual outcome. With the latest technology, Dr. Schneider offers more safety and precision. His laser suite is a complete state-of-the-art facility with the most advanced laser software available. From the moment you step into the plush and luxurious office you will feel a sense of comfort and confidence. The highly trained and experienced staff is there to help and guide you through this life changing experience. This combination of experience, reputation, technology, safety and integrity is the TriCounty Eye Institute difference. This is the difference you can trust. Two
A re Yo u A G o o d C a n d i d a t e? Changingthe way you see Are You A Candidate? Life In most cases, the IntraLASIK procedure can treat nearsightedness (myopia), farsightedness (hyperopia) and astigmatism. The patients who fall out of the range of the IntraLASIK procedure can often times be treated with several of our other vision restoration procedures. The two most important determining factors in the candidate evaluation process are eye health and realistic expectations. IntraLASIK is not for everyone. To be a potential candidate you must be at least 18 years old, in good general health and have good eye health. During the consultation process a thorough in-depth examination of your eye health will be performed and we will discuss your visual needs, goals, and expectations. Lifestyle Changes Before having their vision corrected, our patients couldn t imagine waking up in the morning seeing the alarm clock without glasses. The simple things like making breakfast, shaving, and driving a car were always a process. Where are my glasses? I can t find the contact lens solution. Now, these same patients have simplified their lives and are pursuing life with more confidence, thanks to their vision correction procedure. These remarkable procedures, which take only a few minutes to perform, are truly Changing the way you see Life. Three
C o m m o n V i s i o n P r o b l e m s Myopia M y o p i a (nearsightedness) Myopia occurs when the eye is too long in relation to the curvature of the cornea. It causes the light rays entering the eye to focus in front of the retina. The term nearsightedness means that you can see objects that are near to you more clearly than distant objects. Hyperopia H y p e r o p i a (farsightedness) Hyperopia occurs when your eye is too short in relation to the curvature of the cornea. Light rays entering your eye focus behind the retina, producing a blurred image. Some farsighted patients can use their focusing muscles to pull the image forward into focus. But others who cannot, need glasses for distance as well as reading glasses. Astigmatism A s t i g m a t i s m Many patients with myopia and hyperopia have some degree of astigmatism, or an oval shape to their cornea. The cornea is shaped more like a football than a basketball. This causes light entering the eye to focus at multiple points within the eye, causing blurred and sometimes double vision. Presbyopia P r e s b y o p i a Presbyopia is part of the normal aging process. This occurs when the lens of the eye loses the flexibility that allowed it to change shape and bring near objects into focus. Everyone will experience the effects of presbyopia, usually between the ages of 40 and 50. Mild myopia will counteract presbyopia for a period of time. This is why a patient in this age group may remove their glasses and be able to read. When laser vision correction eliminates the myopia, glasses are needed for fine print and small objects to correct the presbyopia. This is usually in the form of single vision reading glasses, bifocals, or progressive addition lenses. An option for some presbyopic patients is monovision. Monovision has been used for years among contact lens wearers and is adaptable for some people choosing laser vision correction. With this technique, the dominant eye (the one in which one would focus a camera) is generally corrected for distance vision and the non-dominant eye is focused primarily for close vision. The brain learns how to integrate the different visual information and soon learns which image to select for a given visual distance. It doesn t necessarily mean eliminating glasses forever. Patients may still chose to fine-tune their vision for fine print or night vision following surgery. New surgical options to treat presbyopia are being researched. Four
Advanced CustomVue LASIK Wavefront Technology Not All 20/20 Is The Same Just like a fingerprint, each person s vision is 100% unique to their eyes. Several types of visual imperfections exist within the eye and may affect the clarity of the vision and how well you see at night or in dim light. Unless these imperfections are addressed, the quality of the visual result you achieve with LASIK may not be ideal, even if you have measurable vision of 20/20. Until now, conventional LASIK could only correct the visual distortions caused by nearsightedness, farsightedness, and astigmatism. Doctors were only able to use standard measurements to correct vision. These were the same type of measurements used to prescribe glasses and contact lenses, meaning that prescriptions could only provide a certain level of correction regardless of an individual s needs. CustomVue LASIK is a procedure that enables Dr. Schneider to customize the conventional LASIK procedure to your individual eyes, providing the potential to experience better vision than possible with glasses or contact lenses. It enables Dr. Schneider to measure and correct the imperfections that are unique to each individual s eye 25 times more precisely than standard methods used for glasses and contact lenses. The WaveScan WaveFront system uses a wavefront analyzer to measure the way light travels through your eye. The wavefront analyzer creates a customized 3-D map of your eye that looks at your entire optical system. This map provides information about the unique visual characteristics of your eye which adds an additional level of data about your vision. This data is saved on a computer disk and transferred to the excimer laser where it is guided by eye tracking technology. The eye tracker follows the eye s tiniest movements and automatically repositions the laser beam to focus exactly where Dr. Schneider wants it. The cornea is reshaped to each individual s unique custom correction. Five
The LASIK Consultation Contact Lenses Contact lenses need to be removed for a period of time prior to the procedure because they can distort the shape of the cornea. Soft contact lens These are made of soft, water-absorbing plastic that creates minimal distortion in the cornea because of the soft material and spherical shape. Soft lenses should be discontinued for one week prior to LASIK to allow the cornea to return to a natural shape. Soft toric These lenses are made of the same material as spherical soft contact lenses, but due to a difference in design, have two powers in them and are able to correct astigmatism in addition to nearsightedness or farsightedness. There is also a mechanism that keeps the lens from rotating on the eye. Because of this mechanism, there may be more distortion in the shape of the cornea and these lenses should be discontinued for 2 weeks prior to LASIK. Gas permeable These are rigid lenses. However, silicone was incorporated in the lens to make them more flexible and allow oxygen to pass through the lens resulting in better eye health and more comfort. These lenses should be discontinued for at least 2 to 4 weeks prior to LASIK because of the amount of distortion they create in the cornea. The time period may vary from patient to patient depending on wearing time and the number of years worn. PMMA/hard These rigid lenses are made of hard PMMA plastic that does not allow oxygen to pass through the lens. They are also difficult to get used to and somewhat uncomfortable. Because of the increased amount of corneal distortion these lenses must be discontinued at least 4 to 6 weeks prior to LASIK and sometimes longer. For the most part these lenses are obsolete today. The complimentary consultation is one of the most complete examinations you will ever have. A series of tests will be performed that will help determine if you are a good candidate for a vision correction procedure. Your consultation will include: Visual acuity a measurement of your vision with and without correction at distance and near. Autorefraction an automatic measurement of the amount of refractive error. Topography a multi-dimensional study of the surfaces and layers of the cornea. Wavefront Custom WaveScan a measurement that identifies and measures imperfections that are unique to an individual, 25 times more precisely than standard methods used for glasses and contacts. Pachymetry a measurement of the thickness of the cornea. Tonometry a measurement of the intra-ocular pressure, commonly referred to as a glaucoma test. Biomicroscopy a microscopic examination of the front segment of the eye. Eye dominance determination of the tendency to use one eye more than the other when looking at distant objects. Ophthalmoscopy an examination of the retina. Pupil exam determination of the size, shape, and reaction of the pupil. One of the procedures performed during the consultation is a corneal mapping called topography. This gives important information about the shape of the cornea. A stable and normal topography is essential prior to your vision correction procedure. TOPOGRAPHY MAP Six
S t a te - O f - T h e - A r t Te c h n o l o g y Other Options Implantable Contact Lens An artificial lens that is implanted inside of the eye without removing the natural lens of the eye. INTACS An acrylic, corneal insert implanted between layers of the cornea most commonly used to treat keratoconus. ReSTOR A multifocal intraocular lens implant that replaces the natural lens of the eye. Clear Lens Extraction The removal of the clear, non-cataractous lens of the eye as a refractive procedure, with or without an intraocular lens implant. PRK Reshaping the cornea to eliminate refractive error by superficial surface ablation. CK The controlled release of radio frequency energy to reshape the cornea for treatment of presbyopia. IntraLASIK Dr. Mark Schneider is proud to have been one of the first surgeons in the United States to offer this next generation, advanced laser technology to create the corneal flap, the important first step in the LASIK procedure. LASIK involves two steps. The first is the creation of a hinged flap of thin corneal tissue. IntraLASIK (derived from the combined use of the IntraLase laser and excimer laser in the LASIK procedure) has elevated the first step of the procedure to a new level of safety and precision. The flap is created with a femtosecond laser rather than a mechanical microkeratome with a metal blade. The advantages that the IntraLASIK, all-laser approach provide include more safety and predictability, more accurate flap thickness, more precise positioning of the flap, and much lower probability of flap complications. Next, the flap is lifted and the underlying corneal tissue is reshaped with conventional excimer laser ablation or wave-front guided custom technology. The surgeon then replaces the corneal flap over the treated area where it bonds securely without the need for stitches. Most patients experience very little, if any, discomfort during or after the procedure. Functional vision returns very rapidly. Most patients are able to see well enough to drive without glasses the day after surgery. Most patients elect to have IntraLASIK performed on both eyes the same day. Recent studies have shown IntraLASIK to be more favorable than LASIK with a mechanical microkeratome in providing vision with better contrast sensitivity. THE 4TH GENER ATION INTR AL ASE FS L ASER T O T A L T I M E : 1 5-3 0 S E C O N D S The ultra-fast laser uses an infrared light beam, generating up to 60,000 pulses per second, to prepare an optimal corneal architecture below the flap. Using an inside-out process, the IntraLase laser is precisely focused to a point within the cornea where thousands of microscopic bubbles are formed to define the architecture of the intracorneal surface and the resulting flap. The surgeon controls the flap diameter depth, hinge location and width, and side-cut architecture factors that can be varied per patient. Bubbles are then stacked along the edge up to the corneal surface to complete step one. The physician then exposes the prepared corneal bed for excimer laser treatment by lifting the flap. The LASIK procedure is complete when the flap is securely repositioned on its beveled edge. L ASIK WITH THE INTR AL ASE METHOD EMERGING AS THE GOLD STANDARD Seven
W h a t T o E x p e c t The Day Of Your Procedure Arrival On the day of your procedure, you should arrive as rested and relaxed as possible. There are no restrictions on eating or drinking with the exception of caffeine or alcohol consumption. These should be avoided as they can interfere with the pre and post-op medications. Wear comfortable clothing and bring a light sweater or sweatshirt as the laser suite may feel cool to some people. On your procedure day do not wear facial cream or make-up. Prior to the procedure, you will be given an oral sedative, and anesthetic eye drops will be placed in the eyes. Dr. Schneider will re-examine your eyes, review your corneal and WaveScan maps and make any necessary final adjustments to your treatment plan. The Laser Suite You will be escorted to the laser suite and be asked to lie down on our procedure bed. Additional anesthetic drops will be placed in your eyes. There is a comfortable family viewing room adjacent to the laser suite where your family can see your procedure being performed on our video monitors. The first step in the reshaping of the eye is the creation of the corneal flap. This is accomplished with the IntraLase laser. This is the only true blade free technique. Dr. Schneider uses it exclusively because of the superior results and safety it provides. You will feel a slight pressure sensation as the special focusing device positions the eye. This portion of the procedure lasts 20 seconds. The pressure is usually described as slightly uncomfortable. At the end of the 20 second period, the focusing device is removed and the corneal flap is created. Reshaping The Cornea Dr. Schneider will carefully position the bed so that your eye is precisely aligned under the microscope and aiming beam of the laser. In order to prevent blinking, a simple device is used to keep the eyelids open. There will be no discomfort during this second step. You will be directed to look at a red focusing light. The laser s eye tracking system will follow any tiny movements of the eye. As the laser reshapes your eye, you will hear a snapping sound generated by the laser, but you will feel nothing. Most laser applications last less than 30 seconds. At the end of the treatment, the corneal flap will be carefully replaced in perfect position. Eight
TRICOUNT Y EYE INSTITUTE Follow-Up Care After LASIK When you leave the office, you should go home and rest. It is unlikely that you will have much discomfort after surgery, but there may be mild irritation or a scratchy feeling that can last 3 to 4 hours. The relaxing medication given to you at the office will help you to relax in order to sleep through this phase. You will be given prescription eye drops to use. It is important that you follow the eye drop instructions exactly as directed. Visual Recovery LASIK surgery affords rapid visual recovery. It is likely that you will be able to drive the day after the procedure. Most patients return to work the next day. The vision will be clear, and will continue to improve over the next few weeks. Everyone heals at a different rate. Complete recovery of vision and stability typically occurs after about 3 months. The final outcome may be achieved sooner for some than others, longer in high levels of myopia and hyperopia. Follow-Up Care Proper follow-up care is just as important to your results as the actual procedure. For this reason, all of your post-op visits will be performed at one of our facilities. Only then can we be assured that the highest standard of care will be provided. At the post-op visits, the vision will be checked and an examination of the corneal healing will be performed with the biomicroscope. The office visit is generally 5 to 10 minutes. The normal schedule of visits are: 1 day 1 week 1 month 3 months 6 months If for any reason a different schedule is necessary you will be advised by one of our doctors. Changingthe way you see Nine Life
L o o k W h at O u r Pat i e nt s Are Saying About Us It s so wonderful to be able to see the alarm clock every morning, exercise without glasses, and do so many other things glasses free!! It s so amazing that the procedure takes 10 minutes or so. Thank you for your expertise, patience, and dedication to your profession. Thank you for the blessing of sight! Mary Fabulous, Fabulous, Fabulous. Life should be as easy as this surgery and people as friendly and warm as all Dr. Schneider s staff. It was a great experience. Julie The service was fantastic. I had gone to 2 other laser offices and then met two people who had come to Dr. Schneider and loved it! I am so glad I came to TriCounty Eye Institute. I can t believe that I am writing this without glasses and that I can actually read it. It is so clear! Dr. Schneider is the greatest. He took care of me himself from start to finish. I didn t have to see other doctors. The staff is the best. They made me feel so comfortable and special. Thanks again. Sue Thank you for the wonderful gift! I can see without glasses! My experience has been so positive. The procedure is relatively painless and the staff is so very nice. They are the best! Thanks for making this such a positive experience. I am thankful every day when I wake up and don t need glasses after wearing them for 30 years. Agnes I want to express my sincere appreciation for the excellent treatment and service I received as your patient. The expertise, compassion, and professionalism of your center is superb. Never have I imagined that a medical experience would be such a pleasure or have such awesome results. The staff here is first rate and the results are fabulous. I look forward to referring friends and family to you in the future. Brian My experience here has been a great one! It s wonderful to see long distances in such fine detail. The surgery was painless and the healing process has been easy and maintenance free. I would recommend the surgery to all that desire new vision. The staff here is kind and caring from start to finish, and they give you great cookies! Karen It s been a year since my LASIK surgery. I still can t believe that my vision is 20/15. It was worth every penny I spent to have this procedure. Joe You have surpassed Disneyland for the Happiest Place on Earth position. Thank you ALL so much for your smiles, your touch and your caring. Seeing all the details of your beautiful faces is such a gift. Dena Ten
G r e a t V i s i o n I s A f f o r d a b l e TriCounty Eye Institute makes vision correction affordable for any budget by offering options to assist you in paying for your LASIK procedure. Insurance Vision benefits vary from one insurance plan to the next. TriCounty Eye Institute has contracted with several vision insurance companies that could reduce your cost for surgery. Some of the larger companies include: VSP, Eyemed, Spectera, and United Health Care. Our LASIK counselor will be happy to work with you to determine how your plan works and how it may help you save. Flex Spending Accounts Many employers offer flexible spending accounts (also called Flexible Benefits programs or Cafeteria Plans) to help offset the cost of medical expenses. These accounts allow you to set aside pre-tax dollars for certain medical costs, including LASIK. Ask your employer about flex spending accounts to realize savings on your laser vision correction. Tax Benefits LASIK may also be tax deductible, depending on your filing status. Your accountant will be able to tell you if this applies to you. Many people also use their tax refunds to cover the cost of LASIK. This is a refund that can last a lifetime. Credit Cards Many patients choose to pay for LASIK with a personal credit card. This can be a good option, especially if you have a credit card with a rebate or rewards program. You may also have an interest rate that is lower than most conventional financing. TriCounty Eye Institute accepts all major credit cards. Financing TriCounty Eye Institute offers a variety of paymet plans which allow you to begin your procedure immediately, and then pay for it over time with monthly payments that will fit into any budget. Go to www.tricountyeyeinstitute.com and check our links. No Down, No Interest Plans 6, 12, 18 and 24 -month options No interest if the balance is paid within the specified time period Low minimum monthly payments as low as $65.00 per eye Extended Payment Plans 24, 36, 48 and 60-month options Monthly payments as low as $50.00 per eye for 60 months No penalty for prepayment Eleven