Treatment Trifecta

Clear vision follows surgery to lift brows, remove cataracts, ease glaucoma.

Lawrence Podschelne

During two military tours totaling 19 months and 21 days, Lawrence Podschelne roamed the dense jungles of Vietnam in search of enemy combatants. But his dedicated service during the Vietnam War left him combatting physical and emotional enemies.

“I’m one of those veterans with Agent Orange problems,” Lawrence shares. “I developed Type 2 diabetes and extreme nerve damage in my feet, hands, knees, low back and neck.

The troughs we drank water out of were contaminated, and it messed up my kidneys. While my kidney function isn’t dangerous, it’s lower than normal. I also suffer with PTSD [post-traumatic stress disorder].

“But at 75 years old, my brain is still good and my heart is fairly strong.”

Lawrence’s doctors attribute most of his health problems to a delayed response to his Agent Orange exposure. But before his health began to deteriorate significantly, Lawrence enjoyed a career with the US Postal Service.

“After the military, I worked for the post office for 28 years and retired from there,” he elaborates. “Of course, I first retired from the Marine Corps.”

Lawrence deals daily with multiple issues affecting his body, so he was not particularly alarmed when another condition evolved: drooping eyebrows. He lived with the annoying condition for some time, but when it became too bothersome, he finally sought care.

“My eyebrows were sagging and I couldn’t open my eyes all the way,” Lawrence describes. “I have long eyelashes, which are the envy of my wife, but I was having to look through my eyelashes to see.

“Then, when I went to a regular eye place to get new glasses, they told me I had cataracts forming. My wife had cataract surgery a few years earlier, and she said, Lets go to Dr. Ge.

Q. Jocelyn Ge, MD, PhD, is a board-certified ophthalmologist at Premier Eye Clinic, a medical and surgical practice reputable for high quality eye care. New patients at her practice receive a complete eye examination and evaluation. The exam she gave Lawrence revealed a number of issues.

“My vision couldn’t be better.”–Lawrence

“Lawrence came to us in the beginning of 2020,” Dr. Ge recalls. “His main concern at that time was droopy eyebrow, and it was severe. He had to either hold his eyebrows up with his hand or tape them up to see. That’s a condition called brow ptosis, and the procedure to correct it is called brow lift. He also had some droopy eyelids, but it was not as severe compared to the brow ptosis.

“We learned additionally he had significant cataracts affecting his vision. Furthermore, his optic nerve appeared abnormal. We conducted glaucoma testing and discovered he had open-angle glaucoma, a condition associated with abnormal intraocular pressure that can damage the optic nerve over time and, if not treated, can cause blindness.”

As an initial step in the treatment of Lawrence’s glaucoma, Dr. Ge prescribed eye drops to lower the fluid pressure in his eyes. Then, she performed the brow lift procedure to correct his droopy eyebrow and to open up his field of vision.

Prior to Dr. Ge beginning that work, Lawrence expressed some concern.

“With my PTSD, if someone comes up to me and puts their hand on my face, I’m going to punch them.” Lawrence asserts. “I was worried about that because they don’t put you totally asleep for eyebrow surgery or cataract surgery, and they talk to you during the procedure. But they did a good job of relaxing me. I know Dr. Ge is good because she performed successful cataract surgery on my wife.”

As it turned out, Lawrence’s brow lift surgery was uneventful and his recovery was fast, Dr. Ge recalls.

“We raised his eyebrows, which widened his field of vision,” the doctor states. “His entire appearance also looked more upbeat and refreshed.

Combination Technique

The next phase was a combined surgery to remove the cataracts and more effectively control the glaucoma.

“After a successful first surgery to lift the eyebrows, we swiftly moved on to the next surgery, and the same outcome held true for his cataract surgery,” Dr. Ge reports. “In fact, because Lawrence had the dual diagnosis of open-angle glaucoma and cataracts, we were able to tackle both at the same time through combined cataract surgery and minimally invasive glaucoma surgery, or MIGS.”

MIGS is a brief add-on procedure performed at the same time as cataract surgery, with minimal added risk. During Lawrence’s surgery, Dr. Ge implanted two tiny titanium tubes called iStent inject® stents, which assist with fluid drainage and lower the eye pressure.

The procedures were done on Lawrence’s right eye at the end of June, and the left eye two weeks later. Once his eyes were stable and his eye pressure decreased to a safe level, Dr. Ge took him off the glaucoma drops.

During the cataract procedures, Lawrence’s clouded natural lenses were replaced with artificial intraocular lens implants, or IOLs. Like contact lenses, IOLs are available in different focusing powers to clarify vision.

“Lawrence has natural monovision, where one eye sees distance and the other eye sees near,” Dr. Ge details. “That made him a perfect candidate to keep what Mother Nature gave him, so during cataract surgery we corrected one eye for sharp distance vision and the other for near vision. Now his overall vision is crystal clear and he does not need to wear glasses.”

“The second eye cataract surgery was even easier because I knew what to expect,” Lawrence declares. “The anesthesiologist gave me something to relax me, but I could hear
Dr. Ge working. I knew she was doing something but I couldn’t feel anything. The cataract surgery was not a problem for me.”

“Following his brow lift, Lawrence felt much more at ease with having eye surgery even with his PTSD,” Dr. Ge confirms. “As it turned out, the experience and results of each surgery made him feel more comfortable and confident with the next one.”

Goodbye to Glasses

Since being fit with iStent injects, Lawrence’s eye pressure has been perfect. It currently measures 9 in one eye and 11 in the other without any glaucoma drops. Normal eye pressure ranges from 10 to 21. Dr. Ge is also pleased with how the brow lift turned out.

“Lawrence’s treatment went very well, and he’s more confident without the droopy eyebrows,” the ophthalmologist remarks. “His life is easier as well because he no longer has to hold up his eyebrows or tape them up to see well enough to perform his daily tasks.”

Lawrence raves that his vision could not be better.

“My eyelashes are out of my vision,” he explains. “Dr. Ge left me with monovision after my cataract surgery. I don’t need to wear glasses anymore, and I’ve worn them since I was in sixth grade.”

Lawrence adds that he was extremely impressed with the staff at Premier Eye Clinic.

“They treat me really nice,” he acclaims. “They’re all very polite and well-trained. I told Dr. Ge, You did a wonderful job. What you’re doing is very professional. And Dr. Ge is safe. I recommend that place to anybody!”

© FHCN article by Patti DiPanfilo. Photo by Jordan Pysz. Before and after images courtesy of Premier Eye Clinic. js
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    • Premier Eye Clinic

      Premier Eye Clinic provides comprehensive eye examinations and treatment for patients of all ages. Their board-certified ophthalmologist is highly experienced in advanced cataract surgery using a "no injection, no stitch, no patch" tech... Read More

    • Q. Jocelyn Ge, MD, PhD

      Q. Jocelyn Ge, MD, PhD, received her medical degree from the Vanderbilt University School of Medicine and her PhD from the University of California. She completed her internship at the University of Tennessee Medical Center and her o... Read More