– Hi, everyone, and welcome
to our Michigan Medicine live event. I’m Ed Bottomley with
the Michigan Medicine Department of Communication,
and today’s topic is LASIK. I’m joined by our three guests. In the middle, we have
Dr. Christopher Hood, a cornea specialist at Kellogg Eye Center where he performs refractive surgery and evaluates and treats
cataracts, dry eye, and corneal infections, and
other conditions of the cornea. We also have next to me Erin
Manno, the Lead Technician in the Cornea Refractive
Surgery Department at Kellogg Eye Center, and on the far end, we have a patient. Welcome, Andrea. Andrea, you had LASIK
surgery and you’ll be able to speak more about the
actual patient experience too. So before we jump in with the questions, just a quick reminder for
everybody watching today, you can submit questions
at any time, even now, for our panelists to answer during the Q&A portion of today’s chat. Questions can be submitted
in a couple of ways. You can comment on this
video, but please note that your name or your
profile name will be visible to others participating. Now, if you prefer a
more anonymous option, you can also send a private
message to us via Facebook. If you can’t stay for
the entirety of the chat, or if you want to share this
recording with a friend, a video of the chat will be available on the Facebook page soon
after, and we’ll also be posting to the Michigan Medicine
YouTube channel too. So, let’s move on to our questions. We want to answer questions
today about refractive surgery. What are we describing when
we say refractive surgery? – Yeah, I can take that one. So refractive surgery, Ed, basically means correcting some need for glasses, and there’s different
types of refractive surgery that we do, so that encompasses LASIK, which is what most people think of when they think of refractive surgery, and then also PRK or LASEK is another name that it can go by, a
very similar procedure, PRK and LASEK which we can get
into later if it’s important. And so basically, correcting
the eye’s need for glasses is what we mean by refractive surgery. – Excellent. Who performs LASIK at Kellogg? – I can let Erin…
(laughing) – So only our cornea specialists
do refractive surgery at Kellogg, so we have Dr. Hood, who sees patients at Anne Arbor site, and he also will see
patients at Grand Link. One of our other physicians
will go to Brighton at our Brighton office, and we have one in Northville as well, but only our cornea specialist, which is, we emphasize for our patients. – And these are board-certified? – They are cornea fellowship-trained. – Excellent, excellent. Well, let’s talk about
the evaluation process before someone goes into this. What happens during
that evaluation process to determine if someone’s
a good candidate for LASIK? What do you guys look for? – Well, I’ll let Erin answer that again, because she, as our lead technician, really has a lot of these
screening evaluations as we call them. – So on our end, what we do is, we tell our patients
they’re gonna be with us technician-wise for at least an hour before they see the physician. We do their history, we
check them for any type of prescription change, we
also do special topographies that the physician will review in the room with the patients, to
see if there’s anything that would eliminate them
from being a candidate for surgery. We tell them it’s one of
the most thorough eye exams they will every have. – That is a common response is that it is. Most patients will say that it
is the most thorough eye exam they’ve had, they’re oftentimes
with us for several hours, between the testing and
speaking with the physician, and we’re looking at a
number of different factors to see if someone’s a candidate. Stability of prescription
is obviously very important, but then discussing other risk
factors that they may have for refractive surgery, such
as any evidence of dry eye, or other corneal conditions,
and then making sure that the cornea shape is very normal, that we expect a good response, and then talking about expectations, in terms of the vision
need and the recovery. So that’s all the things we
do in our screening visit with patients. – Okay, and Andrea, that’s
presumably something that you would’ve been through. – I did, I did go through it, it was fine. A lot of tests, obviously,
I wasn’t familiar with, but it was, I would
say, about an hour long, and pretty easy, pretty simple,
look here, look that way, look into this, so pretty straightforward. – Excellent, excellent. How long does the procedure
itself take place? And is it done in an operating room? – Yeah, great question, so
we actually have a LASIK procedure room, refractive surgery room, that we basically have
in our cornea clinic, so it’s a sterile room
where we do the procedure, so it’s not a separate operating room, in a separate building, we do it right at the Kellogg Eye Center. The actual procedure, I tell
people they’ll be back there for about half an hour, ballpark, but the actual lasering for most patients is only a brief portion of that, and again, Andrea could
probably speak to that, but most of the experience
is getting set up, is basically getting the eye clean, getting the patient ready for surgery, positioned properly in
the actual procedure room. The lasering is usually
a very brief part of it, typically under a minute
of total laser time for most patients. – Interesting, Andrea, I
see you nodding over there. – Yeah, I was shocked by how quickly the actual procedure was,
like being in and out. Going back there, yeah, it took moments. My dad took me, and I came
back out shortly after. He was like, shocked, he was like, “I thought this was gonna
take way longer,” so, yeah. – Their initial screening evaluation is longer than the surgery itself. – Interesting, very interesting. So, let’s talk about what do you consider a successful surgery? – Yeah, so from the
physician’s perspective, I’m really wanting to make patients happy, and so my definition of success would be is the patient with the outcome? And I think that’s where
it’s very important during that screening
visit with the patient, to really establish
appropriate expectations. Patients that have a much,
much higher prescription may not have the same expectations and we may not expect the same result as someone who has a small prescription that may be more
successfully treated by LASIK or refractive surgery. But ultimately it’s gonna come down to is the patient happy with their outcome? And so I think it’s a
matter of asking the patient what they expect to get from the surgery and making sure we can
sort of meet that need. And if we can, then that’s the goal. – Great, great. And then this kind of ties into that one in terms of the flip side of that. Can you comment on what
complications may occur. – So there’s any number of complications. It’s a real surgery and there’s certainly
risk to every surgery, which again is I think why it’s important to speak with the patient and have the physician go over
some of the specific risks that a patient may have
over another patient, whether they have a very high prescription or they have maybe some dry eye that may make them more prone
to having symptoms of dry eye after the procedure. So there are many things. Luckily, all of them are
pretty much very uncommon. When you add them all up, they still are very small
percentage of patients. But some things like,
for example, dry eye, which I’ve mentioned several times, is something that happens to many people. In fact, it’s almost expected
to happen in the short-term for most patients after
refractive surgery. Now almost for all patients it will go away within a few months, and so we counseled them beforehand that dry eyes is very common and you will likely need to
use some artificial tears to lubricate the eye. But then, after a few
months for most patients that aren’t at high
risk, it should resolve and go back to how it was
before they had surgery. But there’s a number of
other risks that could occur, and we go over those
specifically with patients. – And Andrea, I saw you
nodding again with the. – Yeah, the dry eye for me
was definitely a few months after the procedure, something I just wasn’t
really familiar with, but definitely was given the heads-up that that could be a side effect. And after a few months went away, it started going away in
the wintertime sometimes if it’s really dry. I also sleep with a fan on. There are certain things that
in the morning can be dry, but for the most part I don’t have anywhere near the kind of dry eyes that maybe I might have
had the first month or two. – Okay, great. We have a little bit of
a long question here. Is it true that if you
wear contact lenses, you must not wear them one
week prior to an evaluation? Is that true? Also, if you’re a candidate what is the appointment wait time before a procedure can be done? So a couple of questions in there. – I’ll let Erin take that.
– So it is true. You need to be out of contact lenses prior to the initial evaluation. We ask patients when we’re
screening them on the phone if they wear rigid gas perms
or hard lenses versus soft. At Kellogg, we have them
be out of contact lenses if they’re soft for a week. Rigid gas perms, three weeks before. The other part, I’m
sorry what does it say? – And the second part,
if you’re candidate, what is the appointment wait time before a procedure can be done? – Typically, we can
once we see the patient, we can get them within the few weeks from their initial evaluation. And we do our screenings
Monday through Friday, with all of our physicians. (mumbles) – Sure.
– The reason we want patients out of contact lenses is contact lenses can warp
the shape of the cornea, and we want to basically get
the cornea in its natural state when we’re planning surgery. We want to be able to treat the eye not as it’s in a warped statement but in normal, back to its baseline state. So that’s why we want patients out. There are times when we actually will see some irregularities
in the cornea shape and actually request patients to stay up for even longer periods of time and come back for some re-measurements to make sure things
have returned to normal. We just want to get
patients the best outcome and we think that’s one
of the ways to do that. – Thank you for clarifying that. What are some of the reasons somebody would be
considered a poor candidate? – Yeah, there’s a number of reasons. So one reason is people
could have prescriptions that are just too high to treat. The lasers do have limits and there’s a safe limit of
what can safely be treated ’cause we’re basically
reshaping the cornea in these refractive surgery procedures. And so the lasers really have
limits of what they can do. So that’s one reason people
may not be a candidate. Another reason is that people
could have other eye diseases that make them not a good candidate. They could have cataracts
or other eye disease that would make them not
suitable for refractive surgery. Another one is that they
have an irregular shape of their cornea. And so that’s again,
what we’re looking for largely with the screening testing are there a regular shape of the cornea that could lead to a
potentially very bad outcome? Is that we really want to make sure we don’t miss people that would have that, ’cause again, we want to get patients the best outcome we can. – Sure absolutely, absolutely. So one of the beautiful things
about the Facebook Live is, we can take live questions and when you have people
watching right now, what would you say to them? What is the first step, timeline included, if you’re interested
in having a procedure? – Again, I’ll tap to Erin on that. – So you’ll need to have
an initial evaluation with one of our physicians
at Kellogg and again, it depends if you wear contact lenses. There are certain things
when they call in. We ask them, an example
is women, we ask them if they’re nursing or pregnant, because we will not do an
initial evaluation on them. And so they are at a certain time point. But it’s actually once we get
them in it’s not long at all if they are a candidate
that we can schedule them. And our evaluations are
good up to six months. So they’ll have their evaluation and then up to six months
they can call and schedule. Outside of that, our physicians
require them to come back and have another screen. – Sure, sure.
– I’d also emphasize that on the day of the screening evaluation, you will actually meet your surgeon if you come to the Kellogg Center, the one would be
performing surgery on you, so we make sure all your
questions are answered. That again, expectations are quite clear of what the goals are of surgery. And then typically the
next time you see any of us would be for the return for the surgery, which again was usually within
a few weeks, at the most, of the initial screening visit. But it’s patient preference, some prefer to wait
based on their schedule and it’s no problem with waiting but many people come in
when they’re ready to go and they want to have
it as soon as they can. – Sure, sure.
– We have great continuity in which we tell them on the phone when they call into our office. So the physician if that they
see, if they’re a candidate, will be the one in most
cases during their surgery and their follow-up care. So that way, the patient knows that they see the same surgeon. – That’s good to know. We mentioned pregnant women
in the previous question. I’ve heard speculation that
women should opt for LASIK after their childbearing years, as vision can worsen during pregnancies. Is this true or false? – So it can change during pregnancy, likely do the hormonal influences that are occurring during pregnancy and breastfeeding as well. And so we don’t have to
necessarily defer all surgery until after childbearing years, but we don’t want to have
someone who’s actively pregnant or breastfeeding to undergo
a screening evaluation and then surgery, because that could be a slightly
different state of the eye. So there are many young
women who have surgery and they get great outcomes. The vision could fluctuate if they later get pregnant or breastfeed, but it should return back
to how it was in most cases before that state. – So next question
athletes like LeBron James, like skier Lindsey Vonn,
they’ve opted for LASIK. What advantages can it
provide for athletes? – Well, maybe we can ask Andrea. I don’t know if you’re involved
in any athletic things, but. – I mean, I used to. I used to play tennis and I think well, I wore contacts
more than I did glasses, so I’d say for anyone that wore glasses, that’s obviously huge, but as far as contacts
go there’s so many issues that can happen. Dust, you get hit, anything
it can, jumping in the water, sometimes can like flood
it and push it back. So I think just being
able to see with the eyes that you’re given is a
pretty big advantage. – Yeah, I’m interested, beyond
the the athletic advantages just your day-to-day must have
changed quite dramatically. – It did, and what I was most surprised is how quickly I got used to it from wearing contacts sticking
them every single morning or putting him in every morning, taking out every night every single day, it’s just such a routine
that I was just so used to. And then after the surgery
I woke up and you can see, and I just got so used to
like oh I don’t have to. I don’t have to pack my glasses
some solution, my contacts, like it literally just
went right out my head that I can wake up and see and I don’t the routine
was gone completely so. – That’s great.
– I can say we get a lot of patients who say I still do reach for my glasses right, when I wake up the nightstand like I’m so used to doing that and now they say it’s just amazing they don’t have to do that anymore. They can just wake up and
be able to see right away. – And then back to the question
itself, I’m sure it does, there are obvious advantages if you’re talking about
someone like LeBron James or Lindsey Vonn or anyone
in that professional sphere for having LASIK, the
advantages must be obvious. So I’m a soccer fan. I know it couple of
goalkeepers who’ve had it done and that too, right? – Yeah, I think as long as
the expectations are clear, then I think that it
can be a great surgery for athletes as well.
– So on to the next question, how many years of stable
prescription do you recommend prior to proceeding with LASIK? – Do we ask them that
earlier in the screening, when they come in? – Yes, and most of the time they’ll say at least two to three
years, it’s been stable. If it’s fluctuating a lot, then obviously they’ll have the discussion with the physician but
if it’s still continuing to fluctuate that’s when they step in and have the conversation of whether they’re a candidate or not. But we do like them to be stable. – Yeah, they do need to be ’cause we’re treating one prescription and we don’t want to have to go back and keep doing enhancement
or touch-up procedures. And so we look for stability
and most of the time, patients will have an
old glasses prescription, often times from several years ago. We compare that to the current
prescription that we check, which we do take multiple ways actually when they come in through
the screening visit with the eyes undiluted and then dilated, which gives us actually
some more information about the natural state of the eye. And then we oftentimes look back at their glasses prescription
or contact lenses and make sure that’s stable. But by and large, most
people over the age of 21, which is our minimum cutoff for surgery, do have relative stability
in their prescription. And so age alone, for most people that have
an otherwise normal eye, will lead to stability for the most part. – Excellent and Dr. Hood, you kind of anticipated my next question with regards to age. Is there an ideal age to
have the procedure done? Did you say that the youngest ages is 21? – 21 is our minimum age. There are some practices that will treat patients younger than that if they’ve got proven stability
in their prescription, but in terms of the ideal age, it really it’s gonna be about the patient. We get patients and they’re
in their 30s commonly, often times when people
have start to have problems with contact lenses because of just contact
lens wear every day. It starts to wear out people and they start to say they have symptoms, with their contacts and they want to get rid of them if possible. But whenever we see
patients that are young, to me, I think it’s great when
people that are young come in because they have potentially much longer to enjoy their glasses-free
vision in many cases. – Sure that’s an excellent point. Is there an upper limit
or maximum age for LASIK? – Do we ask them under. – Patients will call in and ask them that, and we tell them there
is not a cut-off age, but that’s where their previous
history or eye history, or health comes into play
if they have cataracts, all of those things, but we do not tell them
they cannot have a screen at any age. – There really isn’t an age limit in terms of what we can do it on. In fact, Erin mentions cataracts. Cataracts are very common
when people get older in their 60s and 70s, and
sometimes younger than that. But people that have even
had cataract surgeries and still have a need for glasses can still be candidates for
LASIK or refractive surgery. So we can actually do refractive surgery on patients who have already
had cataract surgery, typically for small errors of glasses, small need for glasses in most cases. But we can do it up till upper ages. I’m not sure what the
oldest we’ve treated is but–
– I think in 70s. – Yeah, we may have treated
people in their 70s. – Okay, so here’s a question, a great follow-up question
about aging and vision. Will all adults eventually
need reading glasses, as they age?
(Erin laughs) Can LASIK help me get
rid of reading glasses? – Yeah, so we’re laughing ’cause
it’s a very common question and actually, unfortunately,
not a very simple answer when you start to get into
the nuts and bolts of it. So this the simple answer is yes, everyone will need reading glasses that has a good distance vision once they get into their
typically early to mid 40s. And that’s because of a
different process in the eye where the lens of the eye
becomes less flexible, less able to sort of zoom
in which we take for granted when we’re in our younger years. And so a stiffening of the lens of the eye basically prevents the eye from giving you really good near vision and it’s a progressive process that is symptomatic for
most people in their 40s, but continues to decline
until you’re in your 60s. Again, people that have
good distance vision. Now some people are naturally nearsighted and they already can see
up close without glasses. And so this is where it becomes
a little bit more confusing, and it’s often times best
to have a conversation with the patient about
their specific situation, it’d be impossible here to get into all the
details of every situation. LASIK does not affect
the status of the lens, which again is what’s
losing its flexibility to give you the zooming power. So LASIK itself cannot directly treat the need for reading glasses. Now the most common
workaround we have for that is what we call mono vision or basically one eye would be targeted to be a near vision eye. The other eye typically would
be a distance vision eye. And in that situation some people can be very functionally
free of glasses at distance as well as near as long as
the expectations are clear, because it’s a different situation to only have one eye for each distance. – So the next question, how
do if mono vision will work? Is it a problem to have
one eye for distance and one for reading? – I’ll let Erin answer. – Sure. We actually, and when we do the
evaluation for the physician, we typically will have this conversation and we demonstrate it for them in the room in what we call a trial frame,
but we also tell patients that our physicians will, if that’s something they’re interested in, have them trial it in
contact lenses first. We want them to, and we tell them, we want them to do their
work, their everyday living, their hobbies, to see if
they can in fact adjust. With mono vision, some of
the feedback from patients that we get the near eye
sometimes they will feel that it cuts their peripheral vision off, or they feel like they’re
swimming a little bit. So they may want it but
they just can’t adjust and that’s why they will
have them trial at first, because it’s not something that the physicians will do automatically without getting further into detail. – Sure.
– Yeah, I would just emphasize that. For the right patient, it
can be a great solution. We have many patients that are
very happy with mono vision, but many patients don’t
tolerate it and never would. And so we don’t want to ever
do that treatment surgically, because we it’s very difficult
to reverse these things, and so we really wanna make
sure they’re comfortable and that’s the right choice for them. And so it’s very individualized, and so the best thing is to try it, which again, we recommend
contact lenses as a trial. And so we work with our
contact lens colleagues and they can basically
fit patience for that. And it’s an investment a little
bit more effort and time, but it’s worth it before you do something
permanent to your eyes. – Now, I appreciate these
answers, you’re doing a great job, we’re jumping all over the place here. The next question I had
LASIK eye surgery in 2002 and had great results. However, my night vision isn’t
as clear as it should be. I’ve since gotten glasses
with a very low prescription, and my vision is much clearer with them. So my question is, would
I need to get LASIK again to correct for my night vision,
or is this even correctable? – So based on that information, I would recommend that
that person be evaluated. It’s too hard to know
based on that information what the best treatment for that patient but it sounds like if they do
have a small need for glasses and that in treatment with glasses, improves their night vision. they may benefit from a small treatment which can occur in many
cases if it’s safe. But again, an evaluation
would be necessary to know for sure. Again, if the patient had
surgery that long ago, there can be a slight drift
of prescription over time, especially into small
amounts in some patients. And so that may be why they’ve had a small need
for glasses at this point. But certainly can give
night vision symptoms if it’s untreated if you don’t have the
glasses prescription. – Sure, sure. The next question is about doing
both eyes at the same time. Is it possible to do both
eyes at the same time, and how long is the recovery process? – Maybe we can ask Andrea
– Mm-hmm. – About that. – I got both eyes done at the same time and told me go home, get some rest. Yeah, obviously you want
to let your eyes heal. And, I want to say I think by the next day, you have to wear these
protective like shielders over your eyes just make sure
you don’t hit it in your sleep or anything. And the next day I remember
kind of like lifting up one just to like I could
see, and it was crazy. I thought it was awesome. And then after that, it was mostly just be
careful of your eyes. Don’t rub them, don’t do anything, but the recovery time
was super, super fast. – That must have been so exciting. – It was awesome.
– Peeking that out. – (laughing) Yeah, yeah, it’s
really cool to just wake up and see how you’re meant to
see not reach for your glasses or put your contacts in just to see. – Did you have a high
prescription (mumbles)? – I don’t have anything too high, but I think I got so used to
my contacts and my glasses then then taking it off, seeing clear and then taking them off, to me it seemed completely
dramatic how poor my vision was, but I don’t think I had a
terrible, terrible prescription. – I think we secretly get just
as excited as the patients do on their follow-ups to see how they are. – I’m sure, I’m sure.
– We do, it’s very exciting. It never gets old to see patients really
happy with their outcomes. – Yeah, absolutely.
– I do want emphasize Ed that LASIK recovery, the
question was about recovery or healing time is quite
different between LASIK and the PRK surgery
which we could get into if you think it’s a good idea, but they’re different surgeries in terms of the recovery largely. The outcomes are usually
very much the same, but the recovery for PRK
surgery is different. It takes longer and there’s
definite can be some pain and discomfort after PRK. – Thank you. I think that’s an important
clarification there. We’re gonna move on to PRK. Can you offer advice about
choosing between LASIK and PRK? What’s the difference in the
vision-correcting procedures? – So, simply to answer your question that the difference is sort
of how we reshape the cornea, where we sort of put the treatment. So with LASIK, which is
what most people think of when they think of refractive surgery, we use a laser to make
a flap in the cornea. We then actually can lift up the flap and reshape the cornea
with a different laser, and then we put the flap back down. And the benefit of that is the eye doesn’t really know what
whole lot of what’s going on believe it or not, even
though a flap has been cut . When it’s laid down, the eye
actually recovers very quickly, typically within just a couple of days the vision is markedly improved. With PRK, we actually remove
the surface layer of cells. We loosen them typically
with an alcohol solution or we could have been brush them away, and then we treat directly
on the corneal surface with the reshaping laser. Now it’s the same
reshaping laser as LASIK. It’s just that we’re putting it directly
on the cornea surface, as opposed to sort of
hiding it under a flap. And the recovery of
PRK is quite different, because the eye has to heal
the surface layer of cells. We’re basically causing
a big corneal scratch which, at the time of the procedure, patients will be numbed, they do just fine during the
procedure, but afterwards that’s when it can be slightly painful. Now, in terms of the choice, that’s gonna be a largely
individualized thing again, with the discussion
with the physician. There are some patients
who are only candidates for one or the other, based on certain properties or
characteristics of their eye. Other patients are
candidates for either type, and maybe Andrea could answer,
were you offered PRK surgery? – I honestly I don’t think I was. – So you may have only
been a candidate for LASIK. There are certain things that happen that we could guide people
help with that decision and then it’s a matter of
talking about the potential risks and benefits of each type of surgery. – Okay, thank you for that. How long does it take
after the laser procedure before your vision is as
good as it’s gonna get? You may have touched on this. I understand that there will
be immediate improvement, but does this continue to
improve over several weeks or is my vision going to remain
stable right from the start? – Well, I think, as far as a couple side
effects like halos and stuff, I think my vision
immediately after was great. For about a month, I had
some halos, mostly at night, with street lights and whatnot, and that completely improved, and I don’t have that issue anymore. – Yeah, that’s basically what
we tell patients with LASIK, let’s just talk about LASIK recovery is that a lot of vision
is improved the next day and the quality of the vision
is what I tell patients, will improve for several weeks, even up to a month or two after LASIK. And that’s what Andrea was referring to with like the halos that some people will see you around like that will almost largely go away for most patients within
about a month or so. – Okay, okay. The next question, if
after having the surgery, your vision is either over-corrected or under-corrected, can you have it done again
to fix it and how soon after? – Yeah, good question. So the simple answer is yes,
but the complex answer is it depends a lot on the
patient’s situation. Again, it depends on sort of
how large the treatment was, what the prescription was
at the first treatment and how close they are to
their zero prescription need. But we can do enhancements or
touch-up procedures if needed, if we think it’s a safe
procedure for the patient. Now, typically the soonest we
will do that is three months. We want to make sure things are stable for at least three months
before we would offer that, ’cause things can change again, depending on whether
it’s LASIK or PRK surgery. So we want to see stability
with that need for glasses before we would even consider
an enhancement procedure. – The next question that
we have is for you Andrea. What did you experience during
your process or recovery that you found surprising or
perhaps weren’t expecting? – I guess I wasn’t expecting, I personally experienced a little pressure during the procedure because I believe you
have to stabilize the eye so it doesn’t move around and
it was a lot more pressure than I had expected from other
people, everyone’s different. Other people go in and are completely fine and have a pain-free experience
and mine wasn’t painful, I just wasn’t expecting that to happen. That was all surprising. And I was also surprised by
how quick it was, honestly. – Yeah, I was gonna say
you mentioned earlier your dad was probably just
settling in for the long haul and then you came straight out. – Yeah, mm-hmm.
– Okay. – Super fast. And then also how quickly I could see. I mean you’re supposed to go home rest, which I did definitely, but of course you want
to test out your new eyes so that was pretty cool. – Must’ve been, must’ve been. Are annual exams necessary after LASIK? – That’s a good question. So it depends on the age of the patient. So a young patient that
has no other eye disease, and gets a great outcome after LASIK, then I typically just recommend
every three to five years to get an eye check. Once you don’t have any
need four glasses anymore, you’ll notice if your vision changes and you could always be
seen if that’s the case. So really those eye exams, those annual exams are not needed. Basically we’re just
gonna have an eye doctor, basically just checking
for any eye diseases that you wouldn’t have symptoms of. And usually for a young
person with healthy eyes, every three to five years, I
think it’s sufficient for that. Now, older patients, because we can do LASIK on older patients, they may need to still have annual exams if they have any other eye diseases unrelated to those.
– Sure, sure. And let’s move on to a financing question. What’s the cost of the procedure and are there available
discounts or financing? – You want to defer
(all laughing) that out to me. There is a financing option
through UofM Credit Union. We let patients know that we as Kellogg don’t have any say on
who qualifies for that and the UofM Credit Union has
their own link on our website that we have patients go through and it’s typically from
what patients have told us a quick turnaround. They said they know more in like 24 hours, whether they qualify for that financing. There are discounts available
if you are UofM student, if you’re a UofM employee, if you or your significant
other or spouse, if they carry you on their insurance and they’re an employee, they
can also get that discount. And UofM employees can actually payroll the
debt for up to two years. – Okay.
– So we do tell everybody that when they call in. And because we are a teaching institution, we do have the ability to have resident or fellow do surgery staffed by one of the faculty
members for a discounted cost, and we let patients know that
it’s our third-year resident and then we have fellows. – Great, great. That’s a good answer, thank you for that. Next question, similar topic. There can be such a difference in costs. Can you explain the wild
cost variations in pricing that you see in TV that
you hear on radio ads? – Yeah, I think some of
that is just a promotional, sort of get people in
the door sort of pricing in many situations. Like we find patients that get multiple evaluations
at different practices and it almost ends up
being very much the same for all practices when you
get down to the actual cost that patients are asked to
pay for their procedure. We don’t offer any sales. We don’t offer any discounts
for low prescriptions, because what we have to do is the same. The cost of using the laser is the same, and so our cost is the
same for all prescriptions, whether it be low or high. Other places that you may see advertised sometimes they’ll offer very low cost for very low prescriptions
that are treated. I think maybe that’s part of what they do to get you in the door,
but we have the same cost for all patients for any prescription. – And our LASIK is a little more expensive than the surface PRK or LASEK, because we actually use, or
they use two different lasers. One laser will create the flap and then the second laser will reshape. – Thank you for that too. And then what would you, I’d like to hear you
speak on the difference between going to a place like Kellogg versus a more retail type of outlet that perhaps you might hear
advertised on TV or radio. – Yeah, well, I can just tell you that part of what we offer
is you meet the physician the day you come in for your evaluation and we’ll spend as much time
as necessary with the patients answering all questions, making sure that expectations
are clear for the surgery and the surgery outcome. And so I think that’s
part of what we offer and then you see the same surgeon throughout the whole process
for all your post-op visits. So I think that’s really what we offer. We’re also, as an academic institution, very into publishing our results and looking into our outcomes. And we’re also quite conservative, I would say in terms of what we offer, we’re not going to push
surgery on anybody. We’re only going to offer it to people that we think will get a good outcome, because we have a vested
interest in people doing well. – Absolutely, that’s the
bottom line there really. So we’re rolling towards
the end of our questions and I always like to ask, do you think there’s
anything that I’ve missed? Are there any questions that perhaps you think
I’ve missed, haven’t asked? – Well, I would just emphasize that LASIK can be a great
procedure, refractive surgery, for the right patient. I think a lot of that
needs to be determined with an individual evaluation. So I think it’s hard to tell anybody that they are or not a candidate based on some brief information. So I will say that if
people are interested, the best thing is to
sit down with a surgeon and talk out their specific
situation, what their goals are and whether they can be reached. And I think that’s the best
way to sort of approach this if people have interests
in refractive surgery. – When I’m with a patient
that’s in for their evaluation, I will, when I’m wrapping up
my portion, I will tell them that one of the many things
about working at Kellogg, I work with all of our cornea specialist is they’re very, very ethical. If there’s anything that they see that they’re not comfortable with, they will tell the patients and sorry I just don’t
feel you’re a candidate. They’re very ethical, which
is, I find very heartwarming – Absolutely.
– For our patients. – Absolutely. Andrea moving on to you,
what are the key takeaways that you’d like someone who
perhaps is watching this? What would you like to say to them about your experience overall? – That if you’re considering getting LASIK to go in and get an evaluation, because it is definitely worth it. Not a day goes by where I wouldn’t do the
procedure over again, if given the choice. I’m so happy with the results. And yeah, if you’re ever considering it and you’re tired of your
glasses and contacts like I was, it was a great solution for me. – Excellent. And then how about you two, what would you say the key takeaways, if someone’s just unfortunately tuned in as we’re wrapping this up, what would you say the key takeaways are? I know I know Dr. Hood you mentioned that perhaps you
definitely want to sit down for a consultation. Everybody’s eyes are different
and things like that, but is there anything else? – No, I would just emphasize that again. I think it’s worth getting a consultation if you have any additional questions because that’s when we
can really spend time answering specific concerns or questions that patients have. – I agree.
– Great, fantastic. So that’s the close of this chat. This chat will be available on Facebook and we’ll also be loading
it up to YouTube as well. And any questions on there
beyond the live factor will also be moderated and we’ll be sending them to you guys. So, thank you all of you
for sharing your time, sharing your expertise, sharing your experiences with us today. And have a wonderful
morning and afternoon.


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