The Preoperative Eye Examination
The Preoperative Physical
Illness Before Surgery
The Day of Surgery
Prep-op Area
Anesthesia
Recovery Area
Eye Patches
Postoperative Pain and Nausea
Postoperative Examination
Return Appointments
Care at Home
Bills
Please fill out the Consent Form, if you are having refractive or lens surgery.
EYE SURGERY PROGRAM
Outpatient Surgery
Eye surgery has been recommended to you or your loved one. We hope to enhance your quality of life with this procedure and we endeavor to make your surgical experience a pleasant one. Check-in prior to the scheduled surgery time is one (1) hour. Although eye surgery takes 5-10 minutes to perform, your stay at the surgery center may be 1 1/2 hours after which time you may go home. Arrangements for a ride home from the surgery center must be made in advance. You are allowed to drive the next day. Although use your judgment; your vision may take a few days to weeks to clear.
ONE WEEK BEFORE SURGERY
The Preoperative Eye Examination
You will be mailed a list of all your appointments necessary for your surgery. You must attend every appointment listed in order to proceed with surgery. These appointment times are subject to change on short notice. We will see you within two (2) weeks before surgery for preoperative examination and consultation. We will confirm your surgery schedule at this visit. You will also be given a written set of instructions regarding what to do and what not to do before and after your procedure. Our technician will review these in detail with you and answer your questions. Any other questions will be answered by Dr. Davidson while the eye examination is being performed. The informed consent document will detail the risks, benefits, alternatives and possible complications related to the surgery and should be read and signed by you prior to surgery as well.
The Preoperative Physical
A medical evaluation (History & Physical exam, "H&P") by your Primary Care Provider (PCP) performed within thirty (30) days of your procedure is required by all outpatient surgery facilities. Any additional preoperative tests such as complete blood count (CBC), urinalysis, EKG and/or a chest X-ray may be required depending upon your age and medical history. All pre-surgical requirements must be met at least seven (7) days prior to the date of surgery. This includes history and physical, signed consent form, lab work and medical clearance where appropriate. If the H&P is not on your chart the morning of surgery, your case will be cancelled. We make every effort to obtain all the necessary paperwork and send it to the surgery center ahead of your surgery date. Ultimately, it is your responsibility to insure that your preoperative paperwork is complete.
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Illness Before Surgery
If you become sick soon before the day of surgery, please let us know immediately so that we may reschedule your surgery as well as use the surgery time for someone else. Surgery may need to be postponed because anesthesia cannot be safely administered to anyone with an active cold, productive cough, chest congestion or moderate fever. It is usually safe to proceed with anesthesia several weeks after the symptoms of a cold have subsided.
THE DAY OF SURGERY
No food or drink (including coffee) should be taken by mouth for eight (8) hours prior to surgery. All essential medications may be taken with small sips of water. If you have any questions regarding a specific medication, ask your PCP. For cataract, or corneal surgery you DO NOT STOP taking aspirin-containing products or Coumadin (warfarin). However, for strabismus surgery you STOP taking aspirin-containing products, ibuprofen-type products and Coumadin (warfarin) two (2) weeks prior to surgery. Diabetics who take insulin need to consult with their PCP for the modified dosage the day of surgery. On the morning of surgery please shower or at least wash your face and cleanse the eyelids with a warm, wet washcloth. Avoid wearing any fragrances, face or eye make-up, or hair gels/sprays. Wear loose comfortable clothing. Leave all valuables at home.
Prep-op Area
The surgery center personnel will prepare you for surgery, by giving you a hospital gown, taking your temperature and other "vital signs," administering any necessary eye drops, and giving any preoperative medication that may have been ordered by the anesthesiologist (usually minimal medication, if any). Family members can wait in the reception area. The time surgery actually begins may be earlier or later than your scheduled time depending on the day's schedule.
Anesthesia
You are given an intravenous (IV) line in the preoperative area so that intravenous medications similar to Valium can be used for relaxation about 20 minutes before surgery. Usually local eye drop anesthesia is used for cataract, corneal, pterygium and most glaucoma procedures.
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Recovery Area
Your relatives or friends will be notified in the reception area when surgery is finished. A light snack will be served. Your nurse will monitor your vital signs and review your postoperative medications, instructions and office appointment time. You will remain in the recovery area for about 30 minutes until ready for discharge home.
Eye Patches
We generally apply gauze eye pads after strabismus surgery cases only. Gauze eye pads are not required after cataract surgery. The hard clear shield from your postoperative kit is recommended to be worn at night for two (2) weeks to prevent rubbing the eye while asleep.
AFTER SURGERY
Postoperative Pain and Nausea
There is usually little discomfort from eye surgery. Tylenol (or Motrin) is recommended immediately after surgery in all cases. Continue taking Tylenol (or Motrin) four (4) times daily as needed for a few days. Some patients will experience a scratchy or gritty sensation especially while blinking. This is from irritation of the eye surface and should improve within 2-3 days. Use the artificial tears as often as needed for this kind of discomfort. The anesthesia may cause temporary nausea or fever, which will pass within 24 hours.
Postoperative Examination
Depending on the type of procedure the first postoperative visit is scheduled later that same day, the next day or sometime within one (1) week after the procedure. This brief examination is intended to rule-out infection, and obtain a preview of the final result which may become apparent only after several weeks to months. A common occurrence after cataract surgery is increased eye pressure. If your eye pressure is high, we will lower it in the office with a brief painless procedure and recommend an eye drop to be used three (3) times daily for three (3) days. This medication will be used in addition to all other eye drops. Bring all of your eye drops to this appointment so we can review their proper use.
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Return Appointments
At the first postoperative visit we will give you an appointment card for the next visit usually in one (1) week. For cataract surgery, an additional visit at four (4) weeks will be scheduled to determine the new glasses prescription. If you have any questions in the meantime please do not hesitate to call us. We are always "on call" for you and can be reached 24 hours a day, 7 days a week at one of the local phone numbers below.
Care at Home
We routinely use eye drops help the eye heal well and prevent infection. A prescription for these eye drops will be given to you at the preoperative visit. Please have it filled before the surgery date, and bring the bottles with you to each appointment. Apply one drop of each medication inside the lower lid as directed on the label, beginning two (2) hours after surgery.
Other drops may be prescribed as well. Use them as directed. If you take drops for glaucoma, continue using them after all types of surgeries except when specifically instructed to do change their usage. In those procedures where sutures are used, some patients temporarily may feel the sutures, which cause a slight itching, irritation or gritty feeling. Artificial tears are recommended to be used for rinsing the eyes of dried secretions or bloody tears, and to lubricate the eyes if any scratchy sensation is present. Try to avoid rubbing the eyes for two (2) weeks following surgery. Other general restrictions include staying out of swimming pools, and avoiding physical overexertion for two (2) weeks. Otherwise, resume normal activities as tolerated. Keep the eye(s) closed while hair washing, bathing and showering. Sunglasses can be worn at anytime, as the eyes may be a little sensitive to bright sunlight. The wearing of makeup and contact lenses can be resumed one (1) week after surgery. Blood thinning medications, if stopped prior to surgery, may be resumed after three (3) days.
Bills
There are generally four (4) bills that you or your insurance company will receive: one (1) from the surgeon, one (1) from the comanager, one (1) from the anesthesiologist, and one (1) from the surgery center covering all facility, equipment, medication and service charges. Please ask us if you have any questions about the bills or the billing procedures. Many insurance companies require a prior authorization for surgery. Although our staff will assist you in obtaining these, it is ultimately your responsibility to assure that you are eligible for coverage and that authorization for the surgery is obtained prior to the procedure. If you are not eligible for services or do not have authorization, your surgery may still be performed on a cash basis. We offer financing for which you may apply in advance. We are preferred providers for most private and group vision and health insurance plans and PPO's. As a courtesy to you, we will bill your insurance company. You will be responsible for your contracted percentage of the charges as well as all applicable copays, deductibles, and non-covered service expenses.
It is our intention to make your surgical experience as pleasant and comfortable as we can. If there is anything special you need, or any question at all, please do not hesitate to ask us!
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