Bird’s Eye View

Experience, equipment and technique key to success in complex cases.

Most transplanted northerners end up in Florida as part of some grand plan to escape the frigid winter cold back home. Deborah Lavery’s plan was to escape the frigid winter cold all right. But how she wound up in Palm Coast was more or less an accident.

Photo by Nerissa Johnson.

Deborah Lavery

“It was a fluke,” Deborah confirms. “I just wanted to be in a warmer place, and my husband and I were traveling south, looking around at different places along I-95, and at one point, I said, I’m tired of looking; let’s just get off here. That was in Palm Coast.”

Deborah made that decision in 2014, not long after she was forced to retire from her job as a certified nursing assistant – a position she held for more than 20 years – because of a rare autoimmune disease called birdshot chorioretinopathy.

Caused by an inflammation of the uvea, which is the part of the eye that supplies most of the blood to the retina, birdshot chorioretinopathy is largely hereditary and most often occurs in Caucasian people between the ages of 45 and 50.

In its early stages, it results in blurred vision and eye floaters, but over time, pain in the eyes, sensitivity to light, a loss of depth perception and a loss of peripheral vision can occur. In Deborah’s case, it led to all that and also contributed to the development of cataracts.

“It wasn’t from old age that I got the cataracts,” Deborah, 65, says. “It was from the steroid injections I had to get to correct the effects of the birdshot. But it was either that or go blind. That’s what the doctors told me.

“I got my first cataract in 2006. It was in my left eye, and because of the birdshot, I was more or less a guinea pig because the doctors really weren’t sure if the surgery was going to work.”

The surgery did work, but 11 years later, another cataract developed, this time in Deborah’s right eye. And this time, the effects were far worse, this second cataract causing such an impairment in Deborah’s vision that she wound up injuring herself.

“I had to give up driving, and there was one time where I walked into a wall,” Deborah says. “I thought I was walking through the doorway, but I wasn’t paying close enough attention and walked into the wall instead. It left a big bruise on my face.”

That incident prompted a search for a new eye surgeon in the Palm Coast area. With the help of her insurance company, Deborah soon found board-certified ophthalmologist Alexandra Kostick, MD, of Atlantic Eye Center.

A Challenging Case

“Deborah proved to be quite a challenging case because performing cataract surgery on someone with birdshot disease can actually make the disease worse,” Dr. Kostick informs. “The concern stems from the fact that there’s chronic inflammation in the eyes already.

“Now factor in that cataract surgery in and of itself causes inflammation, and you get the added concern that by doing a procedure that naturally causes inflammation in somebody who is already inflamed, you’re only going to exacerbate the problem.

“If that happens, if we make the birdshot worse and exacerbate the inflammation in the back of the eye, postoperative complications can develop that could leave the patient with retinal swelling and possibly even permanent vision loss.”

The increased risks associated with Deborah’s case meant she needed a specialist who is experienced, adept in advanced surgical techniques and has access to the most technologically advanced equipment available today.

She found just that in Dr. Kostick.

Recognized throughout the ophthalmologic field as one of its most accomplished surgeons, Dr. Kostick has been successfully treating complex cases such as Deborah’s for 23 years. She put that experience and much more to work in treating Deborah.

“She’s a great doctor, and I thank God every day that I met her. I recommend her to everyone I meet who has an eye problem. I literally hand her cards out like they’re candy. She’s a true specialist, and she treats you like family.” – Stephanie

To begin with, she worked in tandem with Deborah’s retinal specialist to ensure that for more than a month prior to surgery, Deborah’s birdshot condition was stable and under control. Then, during the surgery itself, she made use of a special device called the ORA.

ORA stands for Optiwave Refractive Analysis. It is a diagnostic device that provides accurate measurements of the shape of the eye during procedures such as cataract surgery after the cataract has been removed.

“The ORA fine-tunes the power and therefore narrows down the selection of the intraocular lens implant that is implanted in the patient’s eye after the natural lens has been removed,” Dr. Kostick educates. “And it’s done while I’m performing the surgery.

“There’s no way that our pre-op measurements can compete with that, because it helps to make the patient’s end result much, much better. A good end result, of course, includes the patient seeing extremely well, and that’s what we got with Deborah.

“She turned out perfectly, and that’s quite a success because with all of her inflammation, the implant power could have been completely wrong. But we were able to avoid all complications, in part because of the state-of-the-art equipment we have.”

Family-Like Atmosphere

Deborah was fit with a standard intraocular lens, or IOL, that corrected her distance vision to 20/20. She still wears glasses for reading but says her overall vision is better than it has been in years.

“I really can’t believe how well I’m seeing,” Deborah enthuses. “I can see birds and trees again. I can literally see all the way to the top of the trees. And I’m not walking into walls anymore. I really couldn’t be happier, and I’m extremely pleased with Dr. Kostick.

“She’s a great doctor, and I thank God every day that I met her. I recommend her to everyone I meet who has an eye problem. I literally hand her cards out like they’re candy. She’s a true specialist, and she treats you like family.”

A family-like atmosphere is a big part of what Dr. Kostick strives for at Atlantic Eye Center. She is proud to be treating the sons, daughters and grandchildren of patients she has been treating for years.

“Our patients become part of our extended family,” Dr. Kostick asserts. “We strive to make them comfortable by creating a very caring environment. They know they are going to be treated with a personal touch whenever they come here.”

A strong reputation in the community is also something the staff at Atlantic Eye Center strives to maintain.

“I think word of mouth is very important for doctors, and we pride ourselves on the referrals we get,” Dr. Kostick adds. “I can honestly say that my staff members go out of their way to ensure that people are cared for to our utmost capability.”

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    • Atlantic Eye Center

      Flagler County’s leading female board-certified ophthalmologist, serving the county since 1996, is at Atlantic Eye Center. Benefits the center offers you include: A multi-trained and highly regarded doctor Unparalleled eye care experi... Read More

    • Alexandra Kostick, MD, FACS, FRCSC

      Alexandra Kostick, MD, FACS, FRCSC, is board certified by the American Board of Ophthalmology. After earning her medical degree at the University of Manitoba in Winnipeg, Dr. Kostick served a mixed surgery internship at St. Boniface Hospital at... Read More