Personalized Vision

Lens implants provide clear, glasses-free vision after cataract surgery.

Bill Terry working in his garage workshop

Bill likes being a fixer and makes furniture in his spare time.

Bill Terry’s family owned Ralph’s Electric in Yonkers, New York, for more than 50 years. The family also constructed homes in the Westchester County area. Bill, now 70, was introduced to the family business at a young age.

“I vividly remember sweeping out some of the new houses my uncle built in 1959, when I was 9 years old,” Bill recounts. “I thought my father and uncles were the smartest people in the world. I always wanted to be involved in the business.”

When Bill’s time finally came and he became a licensed electrician, he gravitated toward the repair side of the profession rather than installation.

“I enjoy the challenge of solving problems,” he shares. “I prefer diagnosing issues and fixing what’s wrong, which is a little more involved than installation.
That’s what really attracted me to the occupation.

“I like being a fixer. I fix plumbing, perform heating and air-conditioning repairs and other similar jobs. I retired a couple of years ago, but I still do repair work for people I know.”

After retiring, Bill relocated to Florida to escape the severe New York winters. His affinity for fixing things came in handy at his new home in the Sunshine State.

“I initially came down to Florida for the winter,” Bill confirms. “I loved the weather and the Jupiter area. I decided I didn’t want to live in New York anymore. I wanted to be in Florida, so I became a permanent resident. I found a home in a gated community that needed a lot of work. I bought it and renovated it.”

Renovation was on Bill’s mind earlier this year when his vision, which had been deteriorating for years, reached a point of significant impairment.

“My vision was blurry, and I was having trouble seeing at night,” Bill remembers. “There were halos around lights, and I couldn’t drive at night without my glasses. I couldn’t read without my glasses either. My nighttime and daytime vision was poor.

“But wearing glasses was a hassle, too. I’ve worn glasses since I was about 40 years old, and whether I was working or just engaging in activities like reading and exercising, I was always having to adjust them. Not only that, but they were constantly fogging up and getting scratched, and that annoyed me.

I’m seeing the way I did when I was younger, before my eyes began to deteriorate.” – Bill

“My wife had laser vision correction surgery 20 years ago, so I decided to look into that. I discovered that the procedures have advanced and that you can have procedures done where you no longer need to wear glasses at all. That really attracted my attention.”

Bill’s search for an eye surgeon to do the job led him to Helayna Brown, MD, at The Dry Eye Spa & V.I.P. Laser Eye Center in Palm Beach Gardens. Upon examining Bill, Dr. Brown discovered the cause of his deteriorating vision: cataracts.

Cataracts are the clouding of the normally clear natural lens of the eye. They can cause blurry vision, difficulty with night vision, sensitivity to light and glare, and fading of colors. Bill was experiencing several of those symptoms, Dr. Brown reports.

“Mr. Terry’s symptoms included trouble with reading and distance vision,” the doctor confirms. “He was also seeing glare, especially when driving. We recommended cataract surgery during which we remove the cataracts and replace the cloudy natural lens with a clear intraocular lens implant, or IOL.”

Multifocal IOLs

Dr. Brown has many IOL options. She makes recommendations based on the patient’s visual needs, desires and lifestyle.

“The choice of IOL depends on whether the patient wants to be glasses-free for distance vision and wear reading glasses or vice versa, or be completely glasses-free after surgery,” Dr. Brown enlightens. “We also ask patients what they do for a living and what their hobbies and activities are. We measure how far away those activities are from their eyes, which is how we choose the correct lens power for that activity.

“Most of Mr. Terry’s activities involve good distance and up-close vision. He was very interested in getting out of glasses for all of his activities.”

Cataract surgery is typically performed on one eye at a time, with the patient taking a break of a week or two before having the other eye corrected. During Bill’s first cataract surgery, which was performed on his left eye on January 6, Dr. Brown implanted a TECNIS® multifocal IOL, which corrects for distance and near vision.

“The TECNIS has concentric rings of different power that split light entering the eye,” Dr. Brown explains. “Most of the light supports distance vision and the remaining light accommodates reading.”

Following surgery on his left eye, Bill was happy with his distance and up-close vision. But he noticed the dashboard in his car was blurry. Dr. Brown explained that the TECNIS lens corrects for distance and near vision only. Intermediate vision is not corrected.

“We planned for that deficiency with his second eye,” Dr. Brown informs. “Instead of using the TECNIS lens in his right eye, we used a Symfony multifocal IOL that corrects for distance and intermediate vision. Now, when he has both eyes open, he gets the best of both lenses. He has clear vision at all three distances.

“We call this approach personalized vision. We don’t provide a one-size-fits-all implant process. We take into account the patients’ visual needs following their first cataract surgery. If anything is missing, we account for that with the second surgery and personalize the treatment. We give patients what they need for the best vision for everyday life.”

“Dr. Brown told me the cataract surgery would take maybe 15 minutes,” Bill relates. “It took less than that. There was no pain and little to no discomfort afterward. I noticed improvement in my vision within two or three days following surgery.”

Dry Eye Determination

Pamela McGregor poses in her chef jacket in her kitchen.

Pamela loves to cook. It’s one of her passions in life.

The tale of Pamela McGregor’s career begins when she left her native Chicago at age 21 to be a flight attendant. Pamela was initially based in San Juan, Puerto Rico, but was transferred to Miami in 1980. Shortly after, the airline went out of business.

“At that time, I met my first husband, got married and had babies pretty quickly,” Pamela shares. “When my children were around kindergarten age, I decided to go back to work. That’s when I started my career in real estate. It gave me the opportunity to both work and take care of my kids.”

After earning her real estate license, Pamela established a goal of becoming a broker. She achieved that in 1998. Now 62, Pamela still dabbles in real estate but she considers herself semi-retired.

A year ago, while making the transition to semi-retirement, Pamela developed a painful stye, a small bump that forms when the tiny glands lining the eyelids become infected. At that time, the COVID-19 pandemic had forced most physicians to close their offices to all but the most emergent cases. Pamela’s ophthalmologist agreed to see her.

The doctor prescribed antibiotics and anti-inflammatory eyedrops to combat the stye. The doctor also noticed Pamela was showing early signs of dry eye disease. He recommended Pamela use over-the-counter artificial tears to keep her eyes moistened.

Those medications worked for a while, but not for long.

“My dry eye symptoms really flared up after the infection cleared,” Pamela discloses. “There was a gritty feeling in my eyes, and there was burning, itching, watering and general irritation. It felt like an eyelash was in my eye when, in fact, nothing was there.

“My eye doctor wasn’t an expert on dry eye disease, so I started searching the internet for someone who was. That’s how I found Dr. Salinger.”

Clifford L. Salinger, MD, is a cornea specialist and the founder of The Dry Eye Spa & V.I.P. Laser Eye Center. Upon first seeing Pamela, Dr. Salinger evaluated her eyes using a digital imaging device called the LipiView interferometer.

“The LipiView provides an image of the structure of the Meibomian glands, the tiny oil glands located in the eyelid margins, as well as an assessment of their function,” Dr. Salinger educates. “It measures the output of oil into the eye’s tear layer. The LipiView of Ms. McGregor’s oil glands revealed their structure and function were significantly compromised.”

Gland Expression

After identifying Pamela’s issues with the LipiView, Dr. Salinger prescribed several treatments. These included hot compresses, lid cleaning, vitamin supplements containing omega-3 and omega-6, tear supplements, steroid eyedrops to reduce inflammation and an antibiotic drop to help improve the flow of the oil glands.

“We also prescribed an eyedrop called CEQUA, which is a new and improved form of RESTASIS®,” Dr. Salinger details. “The chemical ingredient in both medications is cyclosporine, which decreases inflammation in the eyes and increases tear production.

“After following this treatment regimen for several weeks, Ms. McGregor showed some improvement, but only a little. We then discussed the LipiFlow® treatment and decided to move forward with it. We performed that procedure on June 5.”

The LipiFlow Thermal Pulsation System from TearScience® combines the controlled application of therapeutic heat with a gentle, pulsating massage. These functions work to liquefy, then remove clogging debris from the eyelid glands, enabling them to function efficiently. At the Dry Eye Spa & V.I.P. Laser Eye Center, LipiFlow is a three-step process.

“Right now, I have zero dry eye symptoms.” – Pamela

“We begin with a thorough deep cleaning of the eyelids and follow that with the LipiFlow treatment itself,” Dr. Salinger describes. “After that, we perform a manual expression of the Meibomian glands to remove any remaining clogging material. This makes room for healthier oil material to populate the glands and flow normally so the tear layer is more stable and uniform, which improves the dryness.

“We maintain the patient on the previous treatment regimen, which helps to amplify and extend the benefits of the LipiFlow. We believe that continuing with the other treatments encourages the oil glands to continue producing healthier oil material that flows more smoothly. Our goal is to find the least amount of treatment that can maintain the benefits patients realize with the LipiFlow.”

“Zero Symptoms”

“The LipiFlow treatment doesn’t take very long, and it doesn’t hurt,” Pamela maintains. “Some of the people in Dr. Salinger’s office have had the procedure and told me how it feels, which helped. I was fully open about it and prepared, so I was comfortable.”

Some people notice a difference in their dry eye symptoms right away following their LipiFlow treatment. For others, it takes several weeks or even months to experience a change. Pamela was one of those people.

“It took a few months, but then I really started feeling relief,” Pamela enthuses. “I noticed I wasn’t reaching for eyedrops all the time. That was happening less and less often, which I found amazing. Right now, I have zero dry eye symptoms, and my eyes feel great. I’m very happy with how my treatment turned out.”

“Perfect Experience”

Bill reports that his vision is better than ever since he had his surgery. During his last follow-up with Dr. Brown on March 9, his vision tested 20/20 and he was able to read the fine print on the eye chart, both at distance and up close.

“I can read the number on the mailbox across the street while sitting in my driveway 45 feet away,” Bill discloses. “I can see everything clearly, including the detail on license plates. I’m seeing the way I did when I was younger, before my eyes began to deteriorate with age.

Best of all, Bill is glasses-free following his cataract surgery.

“That’s what I wanted,” he raves. “I can see perfectly. I don’t have to worry about close-up work. I can read without glasses. Having the surgery is one of the best things I’ve ever done for myself. It was 100 percent successful. I’m very pleased with it and I recommend it to anybody.”

Bill also has kind words for Dr. Brown and the staff at The Dry Eye Spa & V.I.P. Laser Eye Center.

“I love Dr. Brown. She’s a very nice, wonderful woman,” he reports. “And the staff is very helpful and informative. They answer all my questions. On a scale of one to 10, I give them a 10. Overall, I had a perfect experience.”

© FHCN article by Patti DiPanfilo. Photos by Jordan Pysz. Lipiflow photo courtesy of The Dry Eye Spa & V.I.P. Laser Eye Center. mkb
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