Triple Play

Revolutionary replacement lens provides clear vision at all distances.

Of the seven species of sea turtles, six are classified as vulnerable, threatened or endangered. Denise Testa is among those working hard to keep the six species in peril from becoming extinct.

The PanOptix lens has given Denise “crystal clear” vision.

From April through October, Denise begins and ends two or three days each week by walking the beaches of Pinellas County in search of nesting sea turtles, which play a critical role in maintaining the marine ecosystem.

Without sea turtles, many of the ocean’s other species would also soon die out. In time, that could affect the existence of humans. So Denise, a University of Florida graduate who worked 35 years for the Social Security Administration, happily devotes a slice of her free time to protecting the environment.

“It’s a great volunteer organization that I work with,” Denise says of Sea Turtle Trackers. “We spend about six months doing the actual tracking, and the rest of the year is devoted to education and training. I really love being a part of it.”

The job of volunteers such as Denise is to search for the tracks of mother sea turtles or their nests just before dawn and after sunset. It’s a job that requires a well-trained eye, but Denise’s vision began to fail her two years ago.

“The first thing I noticed was that I wasn’t seeing as clearly at night as I used to, and because of that I was having a hard time driving at night,” Denise says. “And then my distance vision, which had always been my strong suit, started to diminish.”

Denise brought her fading vision to the attention of her eye doctor, David E. Hall, MD, of Pasadena Eye Center, in October 2018.

After conducting a thorough examination, Dr. Hall informed Denise that her problem was being caused by cataracts, which is a clouding of the normally clear natural lens of the eye that occurs as part of the aging process.

Lens Factors

As they did with Denise, cataracts typically develop because of a breakdown of the eye’s lens fibers, a clumping of the eye’s proteins or both. They usually result in blurred vision, an increase in the eye’s sensitivity to light or a reduction in the vibrancy of colors.

There is no known way to prevent or slow the development of cataracts, which mostly affect people 55 and older but can develop earlier. Thankfully, surgery to remove cataracts has become one of the most common procedures in all of medicine.

More than 4 million cataract surgeries are performed each year in the United States. In October 2019, a year after she was diagnosed, Denise learned that she was ready to become a part of that statistic.

“It was during my annual visit with Dr. Hall that he told me my cataracts were ready to come out,” Denise reports. “He then explained in great detail everything that happens during the surgery, including how he removes the cataracts and what happens after that.”

“The nicest thing is that I can see short distances, long distance and everything in between without glasses now.” – Denise

Cataract surgery is typically performed one eye at a time, with a week or two in between. During the procedure, the clouded natural lens is broken up and removed with an ultrasonic device. It is then replaced with an artificial intraocular lens, or IOL.

IOLs are made of acrylic or silicone and coated with special material to protect the eyes from the sun’s ultraviolet rays. During surgery, the IOL is rolled up and placed in the eye. Once in place, the IOL unfolds and side structures called haptics hold it in place.

Like contact lenses, IOLs are available in different focusing powers. Standard IOLs correct vision primarily for distance, but patients can have one eye fixed for distance and the other fixed for reading, an option called monovision.

A third option is multifocal IOLs. One acts like a bifocal lens to correct distance and either reading or intermediate vision. A more advanced multifocal lens acts like a trifocal lens and corrects distance, reading and intermediate vision.

The trifocal variety, which was not available when Denise was first diagnosed with cataracts, is called the PanOptix® lens. For people who want to be truly glasses-free following cataract surgery, it is fast becoming the IOL most often recommended by doctors.

The PanOptix is “one of the most exciting things that’s happened in cataract surgery in years,” Dr. Hall says. “I’m so happy with the results we’re getting from it that I’ve made it my lens of choice for all my patients who want multifocal IOLs.”

Dr. Hall warns that the PanOptix lens may not work well for every patient. He notes that patients with a corneal condition, macular degeneration or diplopia (double vision) are not good candidates.

But for patients such as Denise, or anyone who may be nearsighted but does not have another lingering vision issue, the PanOptix is now considered the gold standard for replacement lenses during cataract surgery.

“I believe it’s the best option we can offer a patient who wants to be rid of glasses,” Dr. Hall concludes. “There’s no other lens like it, so for patients who are active or no longer want the inconvenience of glasses, I highly recommend the PanOptix.”

Glasses-Free

Dr. Hall did exactly that in recommending an IOL for Denise, who considers herself fortunate that she didn’t have her cataracts removed when they were first diagnosed. Had she done that, she says, she might not be seeing as clearly now.

“I only started wearing glasses about 12 or 15 years ago, but they were always an annoyance,” Denise laments. “And then you have to get sunglasses and switch them all the time, so it was quite a bother really.

“But now I don’t need glasses at all. I don’t need them to read, to see off in the distance or even to look at something on a computer. I can’t tell you how happy I am with the results of my cataract surgery. I’m literally seeing better than I’ve ever seen before.

“And it’s not just at all distances that I see better. Everything is so much crisper, clearer and brighter. And colors are so much more vibrant. That’s something I didn’t realize until after I had the surgery was how much colors had faded for me.

“But the nicest thing is that I can see short distances, long distance and everything in between without glasses. I really didn’t understand how that worked until I got these new lenses, but it’s awesome to see everything crystal clear again.”

Order Up

Since March, when the coronavirus began to spread across the country, online ordering has become the primary source of revenue for many restaurants large and small. David Gallagher plays a critical role in the fulfillment of those online orders.

Denise’s photo by Jordan Pysz.

A two-minute procedure,
performed during cataract surgery, provided David with a long-term fix for his glaucoma.

“I manage an application support team for a software development company in the restaurant industry,” David says. “We’re the integration piece between the restaurant and the application or online service that brings them their customers.”

David’s business has been booming for a while now, but it received an unexpected boost from the fallout associated with the coronavirus. David’s company now serves as “the integration piece” between more than 50 applications and 22,000 restaurants.

That makes David, 53, a busy man. He’s so busy, in fact, that he wears a Fitbit to remind him to occasionally get up, stretch his legs and get his heart pumping a bit. Not long ago, David began taking those breaks for reasons other than his heart health.

“I probably spend 90 percent of my day staring at computer screens, so you get to a point every once in a while where you can no longer read what’s on the screen or the eye strain is just so bad that you have to take a break,” David says.

“Well, that started to happen more frequently. I could feel it in the back of my eye and the back of my head. There was a lot of tension there, so I was having to take breaks more often to relieve the tension and just defocus.”

A glasses wearer since the third grade who “graduated” to bifocals in his 20s, David also began to experience rapid changes in his distance vision. At first, those changes were occurring about once a year, but they soon increased to once every six months.

Concerned about the eye strain and the changes in his glasses’ prescription, David visited his eye doctor, who recommended that he see a specialist. After doing some research, David opted to see Dr. Hall.

Sharp Curve Ahead

Dr. Hall first saw David this past May. During that initial visit, Dr. Hall learned that David was diagnosed two years earlier with cataracts and treated for glaucoma, a condition where increased eye pressure causes damage to the optic nerve.

“In examining David, I found that his eye pressure was normal but in the upper range of normal,” Dr. Hall relates. “I also found that he had very significant cataracts and that he had a very large amount of astigmatism in both eyes.”

An astigmatism is an imperfect curvature of the lens that can cause blurred vision. In David’s case, the astigmatism combined with cataracts to create a nearsighted situation in which David could only see clearly if objects were very close to him.

Dr. Hall suggested removing the cataracts and correcting the astigmatism through the insertion of a toric IOL. He also recommended performing a laser treatment to further correct David’s glaucoma.

“I used to see just a blur of color, but now I can make out each flower and leaf because everything is more defined and in focus.” – David

“When you have glaucoma, the pressure in the eye goes up because there’s an imbalance of the fluid flowing inside the eye and out,” Dr. Hall educates. “So all glaucoma treatments are designed to either slow the flow of fluid coming in or speed up the flow going out.

“Eye drops are one such treatment, but David had previously undergone what is known as an SLT (selective laser trabeculoplasty) laser treatment that increased the drainage in his eyes and allowed him to get off the drops.

“What I suggested doing is an ECP (endoscopic cyclophotocoagulation) laser treatment, where you aim the laser right at the ciliary body that makes the saline that fills the eye. The laser turns off those cells so that there’s about 35 percent less fluid coming in.”

The difference between the SLT and ECP treatment is that the SLT can be done in a doctor’s office, where the eyes are treated externally. An ECP must be performed from inside the eye, much like cataract surgery.

“It takes less than two minutes, and since I would be in the eye already to remove his cataracts, I recommended the ECP procedure as a way to lower David’s eye pressure long term,” Dr. Hall reports. “Thankfully, David agreed to the treatment.”

As expected, Dr. Hall performed the ECP while completing David’s cataract removal. During that surgery, Dr. Hall followed David’s request and replaced his natural lenses with toric IOLs that only corrected David’s distance vision.

“I elected to have both eyes corrected for distance because I felt that was the better choice for me,” David says. “I still need to wear glasses to read, but that’s fine. I’ve been wearing them since I was a kid and actually feel naked without them.

“But I don’t need glasses to drive any more or to go out fishing, and that’s great, because for the previous couple of years, glasses couldn’t even get me to 20/20 vision.

“Now, my distance vision is 20/20, and it’s like night and day. I used to get a lot of glare when I was outside, especially if I was on the water, but I don’t have that anymore. Now, I can see the fish when I’m fishing and pick out all the flowers in a garden.

“I used to see just a blur of color, but now I can make out each flower and leaf because everything is more defined and in focus. It’s really remarkable what Dr. Hall and everyone at Pasadena Eye Center did for me.”

Pressure Relief

In addition to giving him clearer vision, Dr. Hall’s work also reduced David’s eye pressure. David sees Dr. Hall for an eye pressure checkup every four months, but if his pressure stays low he’ll soon be able to reduce those visits to every six months.

“I feel fortunate that I was able to find Dr. Hall, and I’ve already recommended him to others,” David says. “He’s a wonderful guy and a very pleasant man. He’s very patient with you, and he explains everything and answers every question you have.

“I appreciate that because when you do the same thing every day, your approach can become a bit mechanical. But Dr. Hall isn’t like that. You can tell that he really cares about you and how you’re doing, and I felt that from everyone on his staff as well.”

Denise is also a fan of Dr. Hall. She, too, has recommended the doctor and Pasadena Eye Center to friends, including 10 that she went to lunch with not long after her surgery.

“We were all looking at the menu, and one of my friends said, Denise, I can’t read this menu; can I borrow your glasses for a minute?” I told her, I don’t have glasses anymore because I don’t need them,” Denise remembers.

“They all heard that and said, Wait, what? And I told them all about my surgery and the PanOptix lens and said, You guys just wait; when you get your cataracts out, you’ll see this well, too. You won’t need glasses anymore to read fine print or anything, and you’re going to love it.”

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    • Pasadena Eye Center

      The doctors and staff of Pasadena Eye Center are dedicated to providing you with the highest quality eye care, and they offer the latest advancements in ophthalmology.... Read More

    • David E. Hall, MD

      David E. Hall, MD, is a board-certified ophthalmologist. He graduated from the University of Mississippi and received his medical degree from the University of Tennessee College of Medicine. He completed his internship at Erlanger Hospital and... Read More

    • Nathan R. Emery, MD

      Nathan R. Emery, MD, is a board-certified ophthalmologist. He completed his undergraduate studies at Brigham Young University, Provo, UT, before serving a two-year mission in England. Upon his return to the United States, he completed his medi... Read More

    • Dennis C. Ryczek, OD

      Dennis C. Ryczek, OD, is a Florida-certified optometrist. He attended St. Petersburg Junior College and the University of South Florida. He graduated summa cum laude with a doctorate in optometry from the University of Houston, TX, and c... Read More