Timothy D. McGarity, M.D. Dr. McGarity received his B.S. in Microbiology, honors, at the University of Arkansas, Fayetteville, and his M.D. at the University of Arkansas for Medical Sciences, Little Rock. After his internship at St. Vincent s Hospital and the University Medical Center in Little Rock, Dr. McGarity completed his medical and surgical residency in ophthalmology at the University of Missouri, Columbia. He joined the medical faculty of the University of Missouri, Columbia in 2006 and served as an Assistant Professor of Clinical Ophthalmology. Dr. McGarity routinely lectures and trains other physicians in the practice of ophthalmology. He is a board certified ophthalmologist with the American Board of Ophthalmology and he holds an active state license to practice medicine and surgery in the state of Missouri. Dr. McGarity joined Dr. H. Kell Yang, M.D. in 2011. Dr. McGarity and his family moved to Columbia in 2003. Tim, his wife, and two young children enjoy outdoor activities, reading books, and traveling. They love Columbia because of its size, strong sense of community, and for all that the surrounding areas have to offer. For many great reasons they have made Columbia their home. As a cataract surgery patient, you should feel confident that Dr. McGarity and his extremely professional staff will deliver a high level of care for you or your loved one. The most important job is to help take the best care of your vision and your eyes. Dr. McGarity has performed thousands of surgeries. He will be able to guide you through every step of the process. Here are a few things that patients have said about Dr. McGarity and his staff: I was nervous about cataract surgery, but Dr. McGarity and his staff took care of everything! I would highly recommend Dr. McGarity, his staff and clinic to everyone. Thanks so much. -Stephen 73, Fayette, MO. He s the best. The doctor and his staff explained everything. I felt that all my questions were answered. Also, I didn t have a long wait. Now, I can see great! Rachael 62, Columbia, MO.
What is a Cataract? We all have a natural lens inside of our eyes. This lens helps to focus our vision. Glasses, contacts or LASIK surgery will help to further focus our vision. As our eyes age or other diseases affect the eyes, then the natural lens of the eye becomes cloudy and disturbs good vision. When this occurs, you now have a cataract or a cataractous lens. What is performed during the preoperative evaluation? A full eye exam is performed including dilation. This evaluation is performed to determine if your cataract is visually significant and can be safely removed. The surgery is not done on the same day as the evaluation. Your medical insurance allows us to perform the standard evaluation and testing for your cataract surgery. Cataract Surgery If cataracts are interfering with your ability to enjoy life to its fullest and heavy prescription lenses do not provide the clear vision you desire, cataract surgery may be an appropriate solution. At our vision correction center, Dr. McGarity performs surgery using phacoemulsification. Using ultrasound technology, phacoemulsification breaks apart the damaged natural lens (cataract). After these pieces are aspirated from the eye, a biocompatible replacement lens, known as an intraocular lens (IOL), is inserted.
Vision after Cataract Surgery Opportunities With cataract surgery and implantable IOLs, you have some wonderful opportunities. These are broken down into standard options which most insurance companies will reimburse and Advanced Technology Cataract Surgery options which come at a value and provide you with the best vision possible using advanced technology IOLs, testing, and laser vision correction if needed. Dr. McGarity and his staff will discuss all these options with you. Standard Opportunities A standard, single focus (monofocal) IOL is used to replace the cataractous lens. While this surgical option will help provide you with clearer distance vision, you will still be dependent on prescription glasses or contacts to see well, especially for near vision. Advanced Technology Cataract Surgery Options Eye surgery has experienced so many revolutionary breakthroughs. Many patients are familiar with the value in LASIK surgery and vision correction. Now, patients are becoming increasingly aware of the value in Advanced Technology Cataract Surgery. Advanced Technology Cataract Surgery includes advanced preoperative testing, astigmatism correction (AcrySof Toric IQ IOL), presbyopia correction (AcrySof ReSTOR IOL bifocals ), monovision correction ( Blended Vision ), extended postoperative care, and, if needed, Laser Vision Correction. Can you imagine seeing well without needing to wear glasses or contact lenses most of the time? Thank you for allowing us to take excellent care of you and your eyes. We are confident that you will be thrilled with our clinic, staff, skills and your new vision. Timothy D. McGarity, M.D.
Preoperative Refractive Evaluation What is included in the Preoperative Refractive Evaluation This evaluation includes all the advanced testing and counseling Dr. McGarity employs to achieve the best results possible for your cataract surgery. This helps to rule out other causes of visual problems not related to cataract. The evaluation is done on a separate day shortly after the initial cataract evaluation. Here is a short list of the advanced technology Dr. McGarity uses: Optical Coherence Tomography: uses laser-like light waves to form a CAT scan-like image of the fine structures inside your eyes to ensure your eyes are healthy. WaveScan: this device forms a high definition analysis of your optical system and gives Dr. McGarity vital information on how your pupil, cornea and lens interact. Corneal Topography: uses placido disc technology and advanced triangulation to form a high definition topographic map to ensure that you have a healthy cornea. Detailed counseling: Dr. McGarity wants you to feel that all of your questions and concerns have been answered. The details of the testing will be reviewed with you during this time, too. Why does Dr. McGarity recommend this extra evaluation? Dr. McGarity is a firm believer in advanced technology. Please take a good look around his clinic-it is very up to date and technologically advanced. He wants all patients undergoing cataract surgery to benefit from the use of advanced technology. Dr. McGarity truly believes that the information gathered in the Preoperative Refractive Evaluation will provide you with the best results possible after your cataract surgery. Even though Dr. McGarity has uncovered many eye problems using this evaluation, the evaluation is not covered by medical insurance or Medicare because it is deemed to be not medically necessary. We recommend that all patients undergoing standard cataract surgery schedule the Preoperative Refractive Evaluation. We highly recommend this evaluation for all patients who have had LASIK, RK or Keratorefractive surgery (cornea surgery for vision correction). The Preoperative Refractive Evaluation is included for those patients who elect to have Advanced Technology Cataract Surgery (see Advanced Technology Cataract Surgery handout).
Is the Preoperative Refractive Evaluation mandatory? Absolutely not. It is completely your decision. We want all of our patients (former or future) to know that we have advanced technology which may be used if they so desire. Dr. McGarity and his staff will explain this in further detail, but if you desire to have the standard or regular preoperative evaluation, then you should feel under no obligation or extra pressure to change your mind. Please be assured that we have the utmost respect for your decisions. Thank you for allowing us to take care of you and your eyes. Timothy D. McGarity, M.D. Blank space for writing questions for yourself or the doctor and staff:
Advanced Technology Cataract Surgery All ATCS packages include the Preoperative Refractive Evaluation and the Extended Postoperative Period (days 91-365). Standard cataract surgery is included, too (standard preoperative appointment and standard postoperative period up to day 90). ATCS options: Multifocal IOL for Presbyopia Correction Astigmatism Correction by Toric IOL or Limbal Relaxing Incision or Monovision for Presbyopia Correction How Multifocal IOLs Work Multifocal IOL The AcrySof IQ ReSTOR multifocal IOL (MFIOL) simultaneously corrects distance, intermediate distance, and near vision. During Advanced Technology Cataract Surgery your eye's natural lens is removed and replaced with a MFIOL. Why do I need this? Presbyopia Presbyopia is the loss of near focusing ability associated with the aging eye. People who are nearsighted may still be able to see up close without glasses, but when they wear their glasses or contacts (in both eyes) they will need either a bifocal or reading glasses to see up close. Those who are farsighted need glasses for distance and then bifocals or reading glasses for close objects. Are you chained to your readers or bifocals? What You Should Know Before Considering a Multifocal IOL MFIOLs are advanced IOLs which are designed to not only replace the cataractous lens of your eye, but simultaneously relieve the symptoms of presbyopia. The goal is to provide you with good distance, intermediate and near vision without needing to wear glasses or contacts most of the time. Studies performed have shown that 80% of patients never needed to wear glasses again! A very small percentage of patients only needed to wear glasses sometimes.
Good candidates for MFIOLs have an easy-going and positive personality. They have relatively low amounts of astigmatism and an otherwise healthy eye. Poor candidates for MFIOLs have a perfectionist or Type A personality. They also might have too much astigmatism or display signs of glaucoma or macular degeneration. Commercial pilots and professional night drivers (truck drivers) also may not be good candidates. Dr. McGarity will make the best recommendation for you. Side Effects of MFIOLs and Single Focus (monofocal) IOLs Side effects specific to the MFIOL are common, but are usually not too bothersome. These include rings around lights or glare which improves over time. Blurry vision during the adaptation period; your brain needs some time to adapt to the new vision in your eyes. MFIOLs provide great vision at all distances, but Monofocal IOLs provide even crisper distance vision. MFIOLs provide great vision at all distances usually without glasses, whereas Monofocal IOLs usually require prescription eye glasses to provide great vision at distance only. Monofocal IOLs will not provide near vision and you will be totally reliable on needing readers or bifocals. Reading vision in low light conditions such as a dimly lit restaurant may be somewhat difficult with MFIOLs. Adjusting the light will improve this side effect. Good candidates for the MFIOLs include those who understand these potential side effects, but are motivated to accept these potential side effects to become much less dependent on needing bifocals or reading glasses. Astigmatism Astigmatism Correction Astigmatism is a defect in the optical system of the eye. Typically it is related to the curvature of the cornea. Where one curve of the cornea is normal, the curvature ninety degrees away is too steep. Since the shape of cornea is not typically changed much during the cataract surgery, you would be left with a defect in your optical system even after cataract surgery. Fortunately, the AcrySof IQ Toric IOL optically corrects most corneal astigmatism. With the astigmatism corrected and the new AcrySof IQ Toric IOL aspheric optics in place, you should see so much better. How the AcrySof IQ Toric IOL works The AcrySof IQ Toric IOL has astigmatism correcting properties. Furthermore, it contains aspheric optics. These two properties combine to provide you with the best vision possible.
Side Effects Side effects of the Toric IOL compared to the standard Monofocal IOL are very similar. During the preparation and procedure for Advanced Technology Cataract Surgery, extreme care is taken to properly align the AcrySof IQ Toric IOL with the steep corneal axis to neutralize the astigmatism. Very rarely, under or overcorrection of Astigmatism may occur. This is rarely significant, but can quickly be corrected if needed. Limbal Relaxing Incisions If you have a lower amount of astigmatism, you may not be a candidate for the Toric IOL. In this case, a Limbal Relaxing Incision (LRI) will be performed. Even the lower amount of astigmatism will interfere with the optics after cataract surgery. The LRI will be performed near the edge of the cornea (Limbus) along the steep corneal axis to relieve (Relax) the astigmatism. This procedure works well for lower amounts of astigmatism. How it Works Monovision With monovision, you have an IOL implanted in one eye to correct your distance vision and a IOL on your other eye to correct your near vision. The IOL for distance vision is usually implanted on your dominant eye. The eye that sees well for distance vision will be slightly blurred up close and the eye that sees well up close will be slightly blurred when looking at distant objects, but with both eyes open, typically the result is acceptably clear and comfortable vision at all distances. Therefore, the term "monovision" is somewhat misleading. The two eyes still work together as a team to see clearly at all distances; it's just that one eye is clearer than the other, and the "stronger eye" will depend on whether you are looking at something far away or up close. Though monovision might sound difficult to adjust to, most people adapt very well and eventually don't even notice which eye is their "distance eye" and which is their "near eye." Variations of Monovision Depending on your daily visual demands, we may recommend a variation of monovision to best suits your needs. These variations include:
Mini-monovision. In this variation, a less-than-typical IOL magnifying power is implanted in the near vision eye. Mini-monovision often is an excellent solution for people who don't need to do much close-up work (or they don't mind wearing reading glasses on occasion). A good example is someone who spends much of their day driving and little time working on a computer or reading, but wants to be able to read a menu without prescription glasses. Though a person with mini-monovision may need reading glasses more than someone who has standard monovision, he or she will be less dependent on readers than a person who has had distance correction IOLs implanted in both eyes. Toric monovision for Astigmatism. In this variation, a distance correction IOL is implanted in the distance eye and near correction IOL is implanted in the near eye. This type of monovision simultaneously corrects for astigmatism. If the distance eye needs astigmatism correction, then a distance focused toric IOL is implanted. If the near eye needs astigmatism correction, then a near focused toric IOL is implanted. Sometimes both the distance and near eye need toric or astigmatism correction. The Limitations of Monovision Timothy D. McGarity, M.D., P.C. A small percentage of people find it compromises the clarity of their distance vision too much, making distant objects appear slightly blurred. Others find monovision doesn't provide adequate near vision to give them the freedom from reading glasses they were hoping for. In this case, Advanced Technology Cataract Surgery by Toric or Multifocal IOL may be a better option for you. Also, although the two eyes still work together as a team in monovision, binocular vision is slightly compromised, which can cause a slight decrease in depth perception. Recommendations Dr. McGarity and his team will make the best recommendation for you and your eyes. During the Advanced Technology Cataract Surgery evaluation, you and your eyes will be tested extensively to determine which opportunity is right for you. After the Advanced Technology Cataract Surgery, your eyes will be tested and treated for any needed enhancements during the one year following the surgery at no additional cost to you. Thank you for allowing us to take care of you and your eyes. Timothy D. McGarity, M.D.