The Eyes Have It

Optical solutions deliver clear, comfortable vision.

Barbara “Barbie” DiMatteo, 44, has dedicated her life to the Maddie’s Fight Foundation, named for her daughter Madison who passed away at the age of ten from a form of bone cancer known as osteosarcoma.

Barbie DiMatteo’s nearsightedness is treated with laser vision correction, and Eileen Hoffman’s dry eye disease is treated with LipiFlow® by Dr. Clifford Salinger at The Dry Eye Spa® & V.I.P Laser Eye Center in Palm Beach Gardens.

Barbie’s successful laser vision surgery has made play-time with her dog
Anika more enjoyable

The foundation supports children and their families battling that and other types of cancer. Keenly aware of her own health, Barbie recently engaged in a fight to correct the vision problems she has had since her childhood.

“I was probably in sixth grade when I started having eye issues,” the New Jersey native recalls. “I was nearsighted. I couldn’t see far away. It was so bad, I couldn’t go without glasses or contacts. Over time, my eyes got worse, and it looked like there was a haze over everything; even the TV was fuzzy.

“A few years ago, I got an eye infection. It was really bad, and I couldn’t wear my contacts. I had to wear glasses. I realized when I went to read something on my phone or the computer, I put my glasses up on top of my head. Then to see far away, I put them back down. It got so annoying that I eventually decided to look into getting corrective surgery on my eyes so I wouldn’t have to wear glasses or contacts.”

The procedure Barbie had in mind to correct her vision is LASIK® laser surgery. LASIK corrects vision by reshaping the cornea, which is the clear layer that forms the front of the eye. Reshaping the cornea changes its focusing power. During LASIK, surgeons use a laser to create a thin flap on the cornea surface. Then, the laser removes some of the tissue underneath to reshape.

While conducting an internet search for a physician who performs LASIK surgery, Barbie found The Dry Eye Spa & V.I.P. Laser Eye Center in Palm Beach Gardens. At her consultation appointment, she was given a thorough eye evaluation by the center’s founder, Clifford L. Salinger, MD, a cornea specialist.

“Dr. Salinger was very personable,” Barbie describes. “He talked to me like we were friends for years and explained everything. We went over the results of my eye exam, discussed the things that were wrong with my eyes and ways they could be fixed.

“He didn’t want to do the LASIK procedure so as to prevent other issues with my eyes. He said another laser surgery with a slower healing process was better for me. He went over the pros and cons of that, and I agreed with his recommendation.”

“Barbie came to us with nearsightedness and a little astigmatism in both eyes,”
Dr. Salinger notes. “She was looking to become less dependent on glasses and contact lenses. Because she had some pre-existing dry eye disease, we determined a procedure without a flap called LASEK, also known as PRK, was the better option for her.

“While LASEK heals a little more slowly compared to LASIK, it has less chance of dry eye complications over time, both short-term and long-term.”

During LASEK, surgeons remove the cornea’s surface layer, then apply the laser to reshape the cornea. A bandage contact lens is placed on the eye for better comfort and to assist healing. Typically, the eye surface heals within a week after surgery, and the bandage contact is removed. Vision continues to improve for weeks to months following the procedure.

Perfect Eyes

“I didn’t have surgery right away,” Barbie relates. “Dr. Salinger wanted to get my eyes perfect first. Because I wore contacts for so long, I had changes like indentations in my eyes. I had to go without contacts for several months before my eyes were ready for surgery.”

Over-wearing or sleeping in contacts can cause the cornea to develop an unnatural contour in its shape, Dr. Salinger informs. To achieve the best results, laser vision surgeons must wait until the
cornea relaxes to its natural contour before attempting corrective surgery.

“If we move forward with surgery while the cornea has an unnatural contour, we won’t get the results we want or the patients want,” Dr. Salinger explains. “We would be aiming at a moving target.

“That was what we were looking at with Barbie, so before we could proceed with her surgery, we needed her to be out of her contacts for an extended period of time to allow her corneas to find their natural contours.”

Prior to surgery, Dr. Salinger also explained how it becomes more difficult for people as they age to see close up, a condition called presbyopia. Barbie doesn’t have presbyopia yet, but she worried about getting it in the future.

“That’s why we decided to correct my eyes for monovision,” Barbie reports. “Dr. Salinger corrected my left eye for near vision, so I can see clearly for reading phones, computers, anything close-up. My right eye is corrected for distance vision.”

“Barbie wanted to leave one eye a little under-corrected for near-vision purposes,” Dr. Salinger verifies. “She would need to wear readers if we corrected both eyes for perfect distance vision.

“Not everyone can handle monovision or mini-monovision, where there’s just a little bit of help up close, so we test very carefully ahead of time to make sure the patient is a candidate. Because Barbie was only in her early forties, mini-monovision was sufficient for her.”

Oil Shortage

Eileen Hoffman, 55, had poor vision since her youth as well. Because she wore glasses most of her life, she maintained her vision with annual exams by an eye doctor. At one appointment, the Jamaica native couldn’t achieve clear vision, and her doctor offered a possible explanation that sounded serious.

“At my eye exams, my glasses prescription kept going up each year,” Eileen recounts. “One year, no matter what prescription we tried, it wasn’t improving my vision. My doctor also tried a few different approaches, including using a series of soft contact lenses. When that didn’t help, he suggested I might have a condition called keratoconus. He told me I needed to see a specialist.”

With keratoconus, the cornea thins out and bulges forward. It cannot maintain its round shape and instead becomes shaped like a cone. Treatments for keratoconus include special contact lenses, corneal inserts, collagen cross-linking and, in severe cases, corneal transplants.

Eileen began looking for a cornea specialist and was given Dr. Salinger’s name. She was told he was one of the top cornea specialists in the area. He became her doctor in 2000, and he confirmed the keratoconus. Eileen eventually had corneal transplants in both eyes.

“After the surgery, I began suffering with severe dry eye disease,” Eileen states. “My eyes were irritated, and because of the corneal transplants, they became painful. My eyes were itchy, and I had blurred vision. I was also having difficulty with sensitivity to light. I’m an avid reader and news watcher, and my dry eye symptoms made doing those things uncomfortable.”

Dr. Salinger explained to Eileen that the oil glands in her eyelids had become clogged with debris. They weren’t releasing enough of the oils necessary to keep a good, consistent tear film on her eyes’ surfaces, which keeps the eyes moist. The lack of a consistent tear film was causing Eileen’s eyes to be dry and irritated.

The Surgery Factor

One of the causes of Eileen’s dry eye symptoms may have been the surgery.
Dr. Salinger notes that many factors contribute to dry eye disease, including previous eye surgeries such as cataract surgery and LASIK. Surgery does this by interrupting the corneal nerves. This plays an important role in the development of dry eye disease.

“Any surgery, even perfect surgery, can upset the delicate balance of the eye’s tear layer,” Dr. Salinger educates. “As a result, the tear layer is more unstable and has the potential to evaporate more quickly, which leads to dry eye symptoms.

“And Eileen obviously had a history of eye surgery. She had the corneal transplants in both eyes – first in her right eye in 2004 and then in her left eye in 2006 – and those surgeries, along with her age and perimenopausal status, contributed to her dry eye issues.”

Initially, Dr. Salinger treated Eileen’s dry eye symptoms with a regimen that included preservative-free, over-the-counter, sterile artificial tears; hot compresses, lid cleansings, vitamin supplements specifically for dry eye and anti-inflammatory eye drops to reduce the inflammation that contributes to the evaporation of tears.

“That treatment improved her symptoms some, but only incrementally,” Dr. Salinger observes. “She was still having difficulty wearing her contacts, and continued to have discomfort, itching and irritation. We finally recommended treatment with the LipiFlow® and went ahead and performed it in April 2018.”

Eileen Hoffman is treated for dry eye disease with the LipiFlow® system by Dr. Clifford Salinger at The Dry Eye Spa® & V.I.P Laser Eye Center in Palm Beach Gardens.

“The LipiFlow was the best thing I ever did,” says Eileen

The LipiFlow Thermal Pulsation System from TearScience® combines the controlled application of therapeutic heat with a gentle, pulsating massage. These two functions work to liquefy then remove clogging debris from the glands in the eyelids, enabling them to function efficiently.

“LipiFlow is a revolutionary breakthrough for treating chronic dry eye disease,” Dr. Salinger asserts. “It relieves dry eye symptoms by removing blockages of the eyelid’s oil glands. Opening and clearing the blocked glands enhances the natural production of the oils needed to restore a healthier tear layer on the surface of the eye.”

Amazing Results

“LipiFlow can be performed in different ways,” Dr. Salinger describes. “Many doctors perform LipiFlow only. We perform a three-step process that includes treatment with the LipiFlow. Step one in the process is a very thorough deep cleaning of the eyelids. Step two is treatment with the LipiFlow itself.”

The third step is an expression of the oil glands by the doctor immediately after the LipiFlow while the gland material is still warm and relatively viscous. This step is done to remove any clogging material the LipiFlow may have left behind.

During the actual LipiFlow procedure, an eyepiece that contains a soft, flexible bladder that intermittently inflates to provide controlled pressure and massage contacts the outer eyelid. Heat is also applied to the inner surface of the lid because of its proximity to the glands. These two applications work together to release any debris clogging the glands.

“We believe that by doing step one and step three in combination with the LipiFlow treatment, individuals get more benefit sooner than if we didn’t do all three steps,” Dr. Salinger declares. “The benefits also last significantly longer when the three-step process is used.”

The results are astounding. Dr. Salinger reports that 90 percent of people experience measurable improvement after one LipiFlow treatment at The Dry Eye Spa and V.I.P. Laser Eye Center. About half of those patients notice improvement within one month. For the other half, it may take two to three months. For a very small percentage, it may take longer.

Two Good Decisions

Once Eileen had the LipiFlow procedure, her vision improved appreciably, and her symptoms of irritation, itching and sensitivity to light disappeared. She can now read and watch the news in comfort. She’s thrilled with the outcome of her treatment.

“The LipiFlow was the best thing I ever did,” Eileen raves. “Since I had it done, I haven’t had any issues with dry eye.

“I told Dr. Salinger that sometimes things are going on in my life, and I forget to do my daily drops and cleansing routine. When that happens, I can go four or five days without suffering any ill effects. I attribute that to the LipiFlow because prior to that, if I skipped my drops or cleansing, I’d get severe irritation and discomfort.”

Laser vision correction changed Barbie’s life as well.

“Since my laser vision surgery, I notice how bright life is,” she marvels. “When I walk outside, the sky’s so blue and the trees are so green. I see perfectly at night, and I had problems with that before. Now, it’s like I never had any eye issues.

“My vision now is amazing. Dr. Salinger said it’s 20/15. I see perfectly both at night and during the day, and I wake up feeling great. I have eye drops to use so my eyes don’t get dry, but I don’t need them that often.”

Barbie and Eileen are so happy with the results of their treatments, they can’t stop telling people about them. They’re also pleased with the care they received from
Dr. Salinger and his staff.

“My surgery was fantastic, definitely a success,” Barbie enthuses. “I’ve recommended it to so many people, and about five of the people I’ve told have gone to Dr. Salinger to have the procedure done.

“Everyone at The Dry Eye Spa and V.I.P. Laser Eye Center is knowledgeable. They definitely know what they’re doing, and they’re really personable. They know my name and always ask how my day’s going when they check my eyes. Dr. Salinger and his staff are amazing.”

“I love The Dry Eye Spa and V.I.P. Laser Eye Center,” Eileen adds. “It’s top-notch. And I love Dr. Salinger. I’ve been with Dr. Salinger for eighteen years, which is a testament to the confidence I have in him and his team. I trust him implicitly.

“I recommend Dr. Salinger and The Dry Eye Spa and V.I.P Laser Eye Center wholeheartedly to anyone who has corneal or dry eye issues.”

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