The Initial Evaluation
Here at Mandel Vision, we pride ourselves in our attention to detail. Therefore, we perform the most thorough screening measurements during the evaluation for laser vision correction for all our patients. In this, our second video blog of the series, we take you through this process, step-by-step.
Nori’s screening process began with an advanced topographical analysis of her corneas followed by the most state of the art Wavefront imaging. The topography is an indirect representation of a patient’s cornea. The Wavefront analysis measures the speed of photons reflecting from the patient’s retina. Nori’s pupil size was then tested using infrared technology. This was followed by an advanced corneal analysis system called the Pentacam. The Pentacam analyzes 25,000 spots on the cornea, in 2 seconds, with the aid of 2 rotating Scheimpflug cameras. Minute corneal elevations and corneal thickness are analyzed to help determinelaser vision correction candidacy. Lastly, the prescription in her glasses was measured using a lensmeter.
In this next video, Nori’s eyes are measured using the Oculus Pentacam, one of the most advanced laser vision screening technologies available today.
The Preliminary Examination:
As some irregularities were noted by Dr. Mandel on the results of Nori’s corneal measurements, the preliminary exam was not performed. This will be completed once the above tests normalize, and Nori is accepted as a candidate for laser vision correction.
The Medical Eye Exam and Laser Vision Correction Consultation with Dr. Mandel
Dr. Mandel then performed a very thorough medical eye examination, which included an examination of Nori’s eyes under a slit-lamp microscope to evaluate the front part of her eye. Dr. Mandel then personally reviewed Nori’s diagnostic test results with her.
Watch the next video to see Dr. Mandel’s medical eye exam and laser vision correction consultation described above.
Due to possible corneal warpage from contact lens wear, Dr. Mandel was not able to accept Nori as a candidate for laser vision correction at the time of this initial evaluation. Soft contact lenses can warp and distort the cornea, as the cornea can mold to the shape of the contact lens. Even regular soft lenses can do this, although with toric soft lenses, it takes even longer for the cornea to regain its natural shape. The cornea is the front surface (window) of the eye that needs an extensive evaluation by Dr. Mandel to determine candidacy for LASIK or PRK laser vision correction. It’s important that the natural shape of the eye be evaluated, and not one that is molded to a contact lens. Warpage from contact lenses can also be difficult to differentiate from an actual corneal pathology or disease. This is precisely why we require patients to discontinue their contact lenses prior to the evaluation for laser vision correction, as well as prior to the procedure when many of these tests are repeated.
Since Nori was not a candidate, her evaluation was not completed, which would normally include dilating drops. Instead, Dr. Mandel recommended that Nori discontinue the use of her soft toric contact lenses, 100%, for 2 weeks, and then return for a second evaluation. At that time, all of the same preliminary diagnostic tests will be repeated. If her corneal shape has normalized, and she passes the screening tests, she will be dilated so that the evaluation can be completed.
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