What Risks Should You Know Before Eye Surgery? | Knock Knock Eye

[@jeridoney7604]

I appreciate your approach to informed consent. It's a great reminder to both surgeon and patient to communicate with each other. While doctors may seem to have all of the power in these relationships, patients have the power to say yes or no and "I have questions." ⚘

[@tazochaiguy]

Thanks for sharing your opinion on this, Dr. G and I really like what you had to say LASIK as a cosmetic surgery that is being performed on otherwise healthy eyes. I got LASIK done a few weeks ago and I'm dealing with complications from a atypically persistent DLK and inflammation arising from that.... I'm also still dealing with blurry vision because of the dry eyes that have developed (I didn't use to have this issue before). So i think I'm in for the longer haul for my recovery. I had so many friends who had LASIK and spoke so highly of it, but i guess I'm one of those unfortunate few wjo struck out on the risks of having a surgery done to themselves (apparently 1 in 50 get DLK...), so right now i have no choice but to hope for the best and buy myself a lottery ticket... I'm definitely one of the voices who would emphasize the risks of this procedure to balance out all the hype and glowing reviews. I'm happy for those who didn't have complications, and it just highlights how every patient is different.

[@gracemiller3861]

One of the best advice I ever got from my parents (medical advice) is that when safe and possible to put off a surgery, to do so, because you never know what kind of medical advancements may exist in the future and your surgery may go better.

[@BentQuarter]

Great podcast! Please do an episode on essential first aid for the eyes!

[@travelsandbooks]

Really enjoyed that. I got LASIK in 2017 and I recovered very quickly and am so grateful for it. I have better than 20/20 vision. I read an article in the Guardian about people with those complications and it really breaks my heart. I've had a corneal abrasion and I know how much eye pain can hurt, but it sounds like another level. Keep doing what you're doing Dr G, I love these episodes!

[@OcaRebecca]

This episode brought back so many memories. I wrote a research paper in high school bio (mid 90s) on RK, though because our sources had to be recent, I never read about its history. Then, as a grad student, some of my time was using an excimer/exciplex laser at 193 nm (a good wavelength for bond breaking) and boss pointed out that that was where LASIK was done, with a tone of voice that implied WHY would anyone do that. (Given the age of our laser, I kind of had the same thought.)

[@Blackcrowcaw]

I appreciated your comments about surgical complications. I’m dealing with a situation at the moment where I feel like my mother wasn’t given enough information and was rushed into scheduling a surgery. It was supposed to be done tomorrow but we canceled it. She’s got a couple of tricky medical things going on and I wish the doctor would have spent more time with us at the initial consult, but it was maybe 10-15 minutes and we walked out with a prescription for oxycodone and a surgery date. We’re seeing another doctor tomorrow and hopefully they can spend some more time working through some of the issues. I also recently found out that we’ve had multiple family members have issues with general anesthesia and not wake up from procedures, so that’s another thing that’s added to my worry about this situation

[@lemonpeelangelfish]

Thank you Will! I absolutely agree that informed consent is essential. Also if there is a complication I applaud you on your approach - communication is so important - I wish every surgeon felt this way.

[@nicolebezeau1174]

Great episode Dr. G! Someone whom I'm close to underwent surgery to reduce their dependency on glasses (I think it was PRK or RFK, but definitely not LASIK) and they suffered horrific post op pain and it made their eyes even more dependent on glasses. They definitely regret it and they stress to me (fellow glasses wearer) and everyone else who use glasses/ contacts to just stick to using whatever corrective lenses they need for the rest of their life, just to avoid the pain that they went through. But regardless if the surgery you're undergoing is for your eyes or for any other body part. Informed consent is key. And just like you said, getting second or even third opinions are 100% ok so you can be completely sure if your procedure is right for you. You deserve an award to taking whatever extra time is needed to ensure your patients give informed consent before booking surgeries with you!

[@petej23]

I just wanted to take a moment for dad appreciation. We appreciate you, dad.

[@sandraodell610]

Would love an episode on syphilis.

[@krisprepolec5616]

As a supervisor at a Gastroenterology clinic in Canada that just went onto Epic 2 years ago, the idea of having a scribe is definitely not relatable. Even my 65 year old doc is 1 finger typing out his clinic note and orders :-) I had PRK in 2006 because my corneas were uneven and it was a better fit for me. It had a longer recovery (preservative-free drops every 5 minutes for the win), but I had a great result. I have started having an issue with distance again, so I went back to see if I could get a touch up. When they worked me up they found that I had cataracts starting that were not there at my eye health exam last year (I just turned 50). It seems that taking Advair since 1999 for my asthma has caused cataracts, so I am going to need surgery by the end of the year. I wonder if this is something you are seeing in asthmatics who have been on long-term low-dose steroids.

[@jonc4403]

I didn't. I considered it several times, but after conversations with my eye docs, I decided contacts were the better option. It was the right choice. I'm over 50 now, and my vision is getting better. I was over a -6, I'm now at a -3, and it's still going. At this rate I'll have 20/20 vision by the time I'm 70.

[@shaguftahaque]

Is there anything that you did to get that progress or did it occur naturally?

[@jonc4403]

@@shaguftahaque Absolutely nothing I've done, it's just happened naturally as I age. I just have to get weaker lenses occasionally.

[@shaguftahaque]

@jonc4403 wow that's good to hear! I hope your vision improves even more😀

[@joshgurll5999]

I'd love to see some more episodes on Retinal disessee like Retinitis Pigmentosa

[@Passionatpropagator]

Consider doing an episode with a patient. Andrew Leland, author of Country of the Blind; a Memoir at the End of Sight has been on lots of podcasts (and has hosted and produced podcasts) talking about his experience with RP. There is also Paul Castle of Matthew and Paul although Paul seems to be a bit of a goofball so if you can get him Andrew might be a better choice.

[@KittleKattle22]

I just recently learned of the condition Megalocornea. It would be cool if you could cover that a little bit in a future episode.

[@hasufinheltain1390]

Back when I volunteered at a clinic; sometimes they had me doing scribe work for the phlebotomist so they could focus on, you know, sticks. And this is for a medical situation super low-key. But it made things so much more productive just because the phleb wasn't having to stop every few moments to enter stuff in the computer.

[@jessamineprice5803]

Great timing! I’m booked for elective retina surgery in two weeks. A PPV for severe floaters that have made my life difficult for over a decade (and keep getting worse due to severe myopia). This surgery was considered too new and experimental when I first had vision problems 15 years ago. But there have been steady advances. I had to think about it for many months after my first meeting with the retina surgeon but I decided to go ahead with the surgery. I got a second opinion and both doctors were really honest about the risks. (Cataracts will be a side effect; risks of infection and blindness, as with all eye surgeries.) Honesty from doctors is really important. They were even honest about how this surgery seemed crazy and far out just a few years ago 😂 I’m excited about the huge advances in eye medicine during my lifetime (seventies baby here) and I love your show!

[@AznJsn82091]

Best of luck!!

[@judithlashbrook4684]

Question: link between eyes and disautonomic syndromes. I have POTS (and hEDS) and i have felt and read that there are links but unfortunately for me no medical practitioner near where I lives seems to know anything about this... Your thoughts would give people like me acces to information and resources that we could share! Thank you for all that you do and love, light and spoons to you and yours and all those who need them!

[@stevejohnson5565]

As a very recently retired Ped ID doc (practicing in Portland, OR!), I hope you are aware that for the past several years we are in a syphilis epidemic! I used to see a case of congenital syphilis once a decade, but in recent years, I was hearing about or seeing a case every week that I was on service. If anyone is having unprotected sex, they should be getting tested for syphilis. I don't understand why there are not billboards up warning about the risk of syphilis in folk having sex, like the posters they had during WWII (well, OK--probably due to a lack of public health funding)...Most people are unaware of the epidemic, which is fortunately still treatable with penicillin (of course, when we are not in a national shortage of this crucial antibiotic).

[@neffsnicker]

Yep. We (sexual health clinic) VERY recently changed our messaging from “you’re not at risk, why are you asking for syphilis testing?” to “You get syphilis, and you get syphilis, everybody gets syphilis!” So. Many. Positives. Even when people aren’t “at risk.”

[@nikkiewhite476]

I think I mentioned this before but my mom had laser cataract surgery. I forget how bad her eyes were but she told me before that she was legally blind without her glasses. The eye surgeon told her the procedure would also correct her myopia so it was amazing seeing her without glasses. The side effect for her? She lost her reading vision! She used to be able to read with the book 2 inches from her eyes without her glasses. After she had to adjust to holding the book about a foot away.

[@ryanc473]

Just wanted to add, when you do the syphilis episode, might be worth including gonorrhea as well!

[@dawnbarchett8026]

Hi, Dr. G! Doing primary care documentation at home after work while watching this! There is no money tree outside my office. My glasses keep sitting cat-a-corner on my face. They won't stay on straight. Please send your Jonathan my way!

[@kylekane5727]

This podcast was amazing eye bro!!, I completely agree with you and everything you said . I'm thinking about ortho surgery but idk yet . Anyway I digress, what you said was so on point! and it really does take courage, to own up to any mistakes that can happen during surgery. Yes it is difficult, but don't make it difficult for you and the patient, continue to help and correct the thing done wrong, so that at least the patient knows you care. And that you're someone willing to own up to mistakes and correct them if possible. Even if its something not correctable do what you can for that patient for as long as they need and want.

[@kylekane5727]

Congrats on the move podcast bro!

[@toddkelman6767]

The biggest problem about informed consent from the patient side is that we don't know what it really looks like for a given procedure, so we don't know if we've actually received enough information to grant it. Even after doing as much research on our own as is reasonably possible it still very difficult to know what we don't know, and it's also incredibly difficult to vet the quality of information we're receiving without the necessary background. I was hoping you would delve into a bit more detail about what proper informed consent for LASIK would look like, apart from the neuropathic pain complication.

[@hasufinheltain1390]

Heard you very nearly say "I've got a plan on having syphilis". I would suppose there's always a risk of surgical regret for a patient when you're talking these rapidly-advancing technologies. The idea of not needing glasses is appealing - but if I were to get RPK now, that's a commitment. And we might find out ten years from now that it causes a major issue for people and it was a bad idea; or in five years there could be a new procedure which is significantly better. But then, do you hold off a bit and let that mature, or do you bite the bullet and get it done now?

[@hollish196]

Could you talk about how shingles affect the eyes? (Sorry if I asked this before).

[@dcseain]

Having presbyopia with astigmatism, I'm not eligible for LASIK. I'd never heard of PRK. That all said, I'm cool with glasses, as I'm progressing like my mother, and am near likely max prescription.

[@kylekane5727]

Btw podcast bro, totally relatable, I can't wait to have a scribe bro or John bro of my own when I get to that point! What happened to your John bro? Was he not fully charged in the morning when you went to the office?

[@martharuiz3613]

Please cover Dacryocystitis. I have had it several times over the years, the last quite severe because my new ophthalmologist wouldn’t believe I knew what I had and take it seriously.

[@SockimusPrime]

You've dangled syphilis on the podcast a few times now. I think the episode is required sooner or later.

[@neffsnicker]

Wait you use nextgen? I’m so, so sorry and I feel your pain!

[@lisaatp]

DUUUUDDDDEEEE!!!! Pediatric NP here… how in the HECK do I get a scribe?!?!?!

[@mnight9251]

Question, for future podcast: I find myself increasingly sensitive to glare off objects whether that be car windshields, mirrors, bumpers. I seem more bothered than ever. I'm 41 years old. Is that just me getting older or me just becoming more aware of glaring things?

[@saltiestsiren]

COULD be astigmatism, which is frequently developed over time. Unless it's causing pain. I'm not a doctor though

[@preluderacer88]

My question is, why don't they just replace people's lenses like they do with cataract surgery instead of doing LASIK or PRK?

[@aaheemas]

because myopia isn't usually a problem with the lens, elongated eyeballs and thick domed corneas are more the issues here - person with certified elongated eyeballs with thick cornea (-4.50R and -6.25L)

[@Passionatpropagator]

Can neurogenic pain after Lasix ever be successfully treated by a cornea transplant? Might be nuclear option but if folks are suicidal.....