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Isa Sayyeed Karim Mohammed, MD
- Assistant Professor of Ophthalmology
Expertise: Cornea and External Diseases
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Nakul Shekhawat, MD MPH
- Assistant Professor of Ophthalmology
Expertise: Cornea and External Diseases
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Ashley Behrens, MD
- Chief, Division of Comprehensive Ophthalmology
- Associate Professor of Ophthalmology
Expertise: Cornea and External Diseases, Comprehensive Ophthalmology
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Irene C. Kuo, MD
- Clinic Director, Wilmer Eye Institute - White Marsh
- Associate Professor of Ophthalmology
Expertise: Cornea and External Diseases
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Everardo Hernandez-Quintela, MD MSC
- Medical Director - Patient Access Center for the Eye
- Associate Professor of Ophthalmology
Expertise: Cornea and External Diseases, Comprehensive Ophthalmology
Refractive Surgery
Meeting with a Wilmer Eye Institute refractive surgeon is the next step to determine if you are an excellent candidate for refractive surgery. At your consultation the surgeon will meet with you and perform testing to determine which procedure is best and safest for you. You can then schedule your refractive surgery at the Green Spring Station. The refractive surgeon will then ensure that you are healing well post operatively and completely satisfied with your visual outcome. We look forward to taking care of you.
Please contact Rebecca Scarborough to schedule your consultation:
410-583-2843 or [email protected] and 410-583-2873 or [email protected]
Note: All refractive surgery is performed at Green Spring Station
Yassine Daoud, MD
- Chair of Ophthalmology. Johns Hopkins Howard County Medical Center
- Associate Professor of Ophthalmology
Expertise: Cornea and External Diseases
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Isa Sayyeed Karim Mohammed, MD
- Assistant Professor of Ophthalmology
Expertise: Cornea and External Diseases
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Ashley Behrens, MD
- Chief, Division of Comprehensive Ophthalmology
- Associate Professor of Ophthalmology
Expertise: Cornea and External Diseases, Comprehensive Ophthalmology
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Everardo Hernandez-Quintela, MD MSC
- Medical Director - Patient Access Center for the Eye
- Associate Professor of Ophthalmology
Expertise: Cornea and External Diseases, Comprehensive Ophthalmology
Irene C. Kuo, MD
- Clinic Director, Wilmer Eye Institute - White Marsh
- Associate Professor of Ophthalmology
Expertise: Cornea and External Diseases
Available Laser Vision Correction Surgeries
LASIK (Laser Assisted In Situ Keratomileusis) - a thin flap is created with a laser in the top layer of the cornea and the underlying tissue is reshaped by another laser. Visual recovery and healing is rapid.
PRK (Photorefractive Keratectomy) - Instead of creating and lifting a small flap for the treatment, the outer layer of the cornea is gently removed and the underlying tissue is reshaped by the laser. The outer layer naturally regrows in approximately three to five days. Visual outcomes are excellent, however visual recovery is slower.
KLEx (Keratorefractive Lenticule Extraction) - Coming Soon. The latest, least invasive procedure in laser vision correction. A thin, contact lens shaped layer just beneath the surface of the eye is created and removed through a small incision in the cornea. Visual recovery is quick, but typically slower than LASIK.
Available Intraocular Refractive Surgeries:
Some patients may not be a candidate for a laser vision correction procedure, however fortunately there are excellent alternatives.
ICL (Implantable Collamer Lens) - Insertion of a contact-like lens behind the colored part of the eye (iris). This can be used to correct high amount of nearsightedness and astigmatism with great visual outcomes. Visual recovery is quick, but typically slightly slower than LASIK.
RLE (Refractive Lens Exchange) - Replacement of the natural lens in the eye with an intraocular lens, similar to cataract surgery.
- Typically for people with presbyopia or hyperopia, for whom LASIK, PRK or ICL surgery generally are not suitable
- Lens replacement surgery can also correct myopia, but generally it is not recommended for high myopes under the age of 50 due to the loss of accommodation and when LASIK, PRK, SMILE or ICL surgery are recommended
Enhancements:
For all patients who undergo refractive surgery at the Wilmer Eye Institutes, enhancements are included for up to 1 year from the initial surgery.
Before & After Surgery:
Before Surgery:
Your consultation will begin with one of our refractive surgery technicians who will review your medical history, check your refraction, and attain measurements of your cornea. You will then meet your surgeon who will examine your eyes and discuss what options are best for you. The evaluation lasts 1-2 hours and includes a complete dilated eye exam. You can then meet with the refractive surgery coordinator to schedule your surgery. As a reminder, do not wear your contacts lens for at least three days prior to your consultation (2 weeks for toric or extended wear lenses, and 1 month for every decade worn for hard lenses).
On the day of surgery, eat a light meal before coming and bring all your prescribed medications. Do not wear eye makeup or have bulky accessories in your hair that will interfere with you lying flat.
After surgery:
The Wilmer Eye Institute refractive surgeon who performs your procedure will examine you at your post operative visit to ensure that you are healing well. To ensure that you have an excellent outcome, plan on attending three post-operative visits – one day or one week (depending on the procedure), one month, and three months after surgery. The cost of these visits is included in your surgical fee.
What can I expect after refractive surgery?
You can expect that your vision may be blurry or hazy for the first day. You may experience mild discomfort or light sensitivity for the first several hours after LASIK or KLEx, and for the first several days after PRK. Your vision may fluctuate between blurry and clear for the first few weeks. The eye drops prescribed by your doctor will help with healing and dryness, although they may burn or temporarily blur your vision.
What restrictions will I have after refractive surgery?
It takes a few weeks for your eye to stabilize after refractive surgery. It is important that you follow the following guidelines to allow for an excellent recovery:
- Do not rub your eyes. Wear the goggles provided while you sleep for the first week.
- Do not shower until the next morning after your surgery.
- Avoid eye makeup and tap water for the first week after surgery, and hair coloring, swimming pools, hot tubs, etc. for the first 2 weeks after surgery.
- Do not exercise for two days. When you resume sport activities, wear eye protection for one month. Wear sunglasses with UV protection when you go out in the sun for at least the first three months, especially if you had PRK.
Most importantly, enjoy your new vision and freedom from glasses and contact lenses! Enjoy waking up and seeing the clock, exercising without contact lenses, and living life to the fullest clearly and without limitation.
FAQs about Refractive Surgery at the Wilmer Eye Institute
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Refractive surgery very often involves the cornea, the clear outer surface of the eye. At Wilmer, our refractive surgeons are all corneal specialists, experts who routinely perform corneal transplants, treat corneal abrasions and infections, perform corneal research, teach other doctors about the cornea, and handle challenging cornea cases. A refractive surgeon who is a corneal specialist will:
- See refractive surgery as one of several ways to improve your vision-- not the only way.
- Detect subtle corneal conditions that may require caution when considering refractive surgery.
- Know how the cornea ages and recommend refractive surgery with your long-term vision health in mind.
- Manage your progress after surgery for the best results and satisfaction.
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At Wilmer, our refractive surgeons are board-certified ophthalmologists, fellowship-trained cornea specialists, and full-time faculty members of the Johns Hopkins Wilmer Eye Institute. They are highly trained experts who can help you understand refractive surgery and its impact on your long-term vision health; help you have a safe and successful procedure; and help you maintain good vision health throughout your life. Refractive surgery is not the best choice for every patient. Rely on your Wilmer surgeon for information and advice.
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To refract means to bend. When you have a refractive error, the light rays going into your eye are bent and focused by the cornea and lens in such a way that they are not focused on the retina and thus form a blurred image.
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The four major types of refractive error are myopia (nearsightedness), hyperopia (farsightedness), astigmatism, and presbyopia. The most common refractive error is myopia or nearsightedness, whereby the light rays are focused in front of the retina. In astigmatism, irregular curvature of the cornea and lens results in the image being focused on different planes not coinciding with the retina. Hyperopia or farsightedness occurs when the light rays are not bent enough and the image is focused behind the retina. You can also have a combination of myopic astigmatism or hyperopic astigmatism. Presbyopia is a loss of the elasticity of the naturally occurring crystalline lens whereby individuals cannot focus clearly at close distances and need reading aids. This becomes apparent around the fourth decade of life.
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When you read a prescription, a minus sign means nearsightedness and a plus sign means farsightedness. The first number in the prescription indicates the amount of myopia or hyperopia you have. If there are numbers written in the next two columns, these indicate the amount of astigmatism, if any, and the axis where it is present. The unit to measure a refractive error is called a diopter or D. For example, if your prescription says -2 or -2D or -2 sph or -2 sphere, it means that you are nearsighted and require 2 diopters of correction. A diopter is a unit of measurement related to the focal length of an optical system including the human eye. The larger the diopter the shorter the focal length.
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The standard method for correction of any refractive error is glasses or contact lenses. For those interested in reducing their dependency on glasses or contacts, there are several surgical options depending on the type of refractive error; some options use lasers, some do not.
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There are three laser-based refractive surgeries, which include LASIK (laser assisted in-situ keratomileusis), photorefractive keratectomy (PRK), and KLEx (Keratorefractive Lenticule Extraction). In addition, there are two intraocular refractive surgeries, which include ICL (Implantable Collamer Lens) Surgery and RLE (Refractive Lens Exchange). Your surgeon will discuss which options are best for you.
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No. Your vision may be blurry and hazy for a few days, which could make it difficult for you to drive safely. Some people can drive the next day to their follow-up appointment, however. Use your own judgment.
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You will have follow-up appointments one day or one week after surgery, one month after surgery, and three months after surgery. The cost of these visits is included in your surgical fee.
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The actual procedure takes less than 20 minutes. Depending on your prescription and the amount of correction your eyes require, the laser itself is only on each eye for less than a minute, but plan on being in the refractive suite for two to three hours.
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It is safe to fly after surgery, but your eyes may be more dry than normal and require frequent use of artificial tears.
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Your eye is numb during the procedure, so no pain is felt, only gentle pressure at most. Most people have only mild irritation for a few hours after the surgery. Some people compare it to wearing old contact lenses. The eyedrops your surgeon will recommend will help in reducing this irritation. We also suggest patients go home and relax with their eyes closed for a few hours after surgery. Taking a nap is a good way to do this. With PRK, patients will experience slightly more discomfort with healing.
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We can correct nearsightedness, farsightedness, and astigmatism in most patients.
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Yes, usually. When laser vision correction was new, many surgeons chose to treat your eyes on different days as a safety precaution. However, now the technology is so advanced that most patients prefer to minimize the time off work and reduce the amount of healing time they experience after laser vision correction, so they have both eyes done at the same visit. Also, many patients reported headaches, disorientation and other discomforts from having one eye corrected and the other one not. So, if there are no problems when we treat your first eye, we feel comfortable treating the second one right away. However, for ICL surgery and RLE surgery, we typically operate on one eye at a time, with a week between surgeries.
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Some patients notice a smell like burned hair while the laser treats the eye. It is normal and passes quickly.
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Observers are not allowed in the laser suite. They can wait in our waiting area.
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You can leave them in a basket in our office and we will donate them to a vision charity.