Ортокератология в Израиле

[Larix]

Я тут ходил по форумам по этой тематике и нашел:

"Ортокератологию в Израиле не одобрили. Там принципы безопасности граждан ценятся известно как. И как расценить пользователя ОК с точки зрения вождения автомобиля? службы в армии? допуска к определённому оборудованию? Это ещё и бюрократическая проблема, как оказалось."

Если есть кто-то в теме, то не мог бы он прокомментировать - почему? И если есть, кто пользуется этим - откомментить реальный эффект. И что вообще об этом говорят врачи. Направление то довольно молодое.

[Boris123]

Larix, посмотри Википедию и все станет ясно. Очень много но. Это Возраст, Временная коррекция и так далее. И еще надо это смотреть у японцев. Там по статистике самый большой процент близоруких.

[Larix]

Boris123,
Борь, спасибо за помощь, но я отключился от русскоязычных ресурсов - в них ничего (кроме рекламы по большому счету) нет; и просматриваю литературу, посвященную исключительно практическому применению этого метода. Разработки начались еще в 70х, но реально ход был дан в 2003 году в штатах. Но мне - мреди прочего - очень интересно, почему в Израиле врачи задробили этот метод.

[Larix]

я буду сюда потихоньку сбрасывать - то, что мне показалось важным или интересным по теме глаз и ортокератологии

[Larix]

Microbial keratitis is the most serious complication that can arise from contact lens wear. Fortunately contact lens related microbial keratitis is relatively rare affecting approximately 5 in 10,000 contact lens wearers annually. Amongst these cases approximately 10-15% of patients lose 2 or more lines of visual acuity. However, this is not the only measure of morbidity of this condition. Changes to a patient’s quality of life, distress during acute phases of the disease and treatment, costs to the patient in time off work and to the health care system for treatment should also be considered in describing the severity of this disease. Prevention of infection, early detection and effective treatment are key to reducing the impact of this condition.


Australia and New Zealand Studies:

A large-scale collaborative research project involving the Vision Cooperative Research Centre, the School of Optometry and Vision Science at the University of New South Wales, and the Institute for Eye Research has just concluded. These studies involved surveillance of all cases of lens-associated keratitis presenting to private and hospital based ophthalmic practitioners and a population based telephone survey of 30,000 households in Australia and 7500 in New Zealand to gather information on contact lens wearers in the community. This research has provided a unique opportunity to develop evidence-based guidelines on a rare but important complication of contact lens wear.
The microbial keratitis surveillance study commenced on October 1st 2003 and concluded on 30th September 2004. All practicing ophthalmologists (n=71 and optometrists (n=3697) in Australia and New Zealand were invited to participate in this research. Active surveillance techniques were used to prompt the response from practitioners. The response rates for ophthalmology (96%) and therapeutically licensed optometrists were high (91%). Supplementary case reporting was sought through other practicing optometrists and through medical records reviews at large hospital clinics yielding a dataset of 389 cases.

The data from the telephone survey forms the denominator in estimates of incidence. Results indicate that contact lenses are worn by 5.1% of the Australian population aged between 15 and 64 years and a higher proportion in New Zealand. Detailed information about contact lens care practices were collected via these surveys for comparison to the contact lens wearers who developed microbial keratitis from the surveillance study.

To ensure the highest quality research, an international steering committee was formed involving experts in the epidemiology of contact lens related microbial keratitis. They have advised on research methodology and reviewed the methods for interpretation of data. The current study findings are interpreted in the context of previous [1-4] and recent research [5] into contact lens related infections.


Importance of research:

In the past, similar studies of corneal infections secondary to contact lens wear have provided evidence, which has led to changes to health policy. In 1989, a surveillance study [2] of 5 states in the north of America found a five-fold increase risk of infection with overnight contact lens use. A case control study in the US [6] published in 1989 also found increased relative risk of infection with overnight contact lens use. It was this evidence which led to the Food and Drug Administration in the USA reducing their approval of disposable contact lens use from 30 nights continuous wear to 6 nights extended wear in 1990. In the UK, similar findings led to the Department of Health requirement of signed consent for extended wear of soft contact lenses. These changes in health policy were also reflected in prescribing behaviour; overnight contact lens use which was commonplace in the 1980’s was largely disbanded in the Australia, New Zealand, United Kingdom and many other markets prior to use of silicone hydrogel contact lenses [7].


Contact lens wear: high risk behaviour?

Many studies of microbial keratitis secondary to contact lens wear have shown increased risk with overnight contact lens use [2, 3, 6, 8-11]. An important finding of recent studies is that overnight wear persists as a risk factor no matter which soft lens type is worn [5, 12, 13].
Published case reports of infection with daily disposable and silicone hydrogel lenses have highlighted a number of potential risk factors of infection. While lens and case cleaning [9, 14, 15], smoking [6, 9] socioeconomic status [8] and male gender [15] have all been identified as specific risk factors for infection, no study to date has considered the effect of water exposure, climate from either swimming or showering on the risk of infection. A number of reports of infection with silicone hydrogel lenses have been associated with swimming prior to the event [16], and the link between domestic water supply and Acanthamoeba keratitis is well established [17, 18]. Also, studies have found that there is an increased number of infections during summer months [19]. However, due to most incidence studies being of 3-4 month duration [2-4], seasonal variances have not been considered.
The Australia and New Zealand studies found that contact lens hygiene was of vital importance in preventing infection. The study also found that those who developed infections were more likely to have purchased their contact lenses over the internet, highlighting the importance of professional advice and education on contact lens prescribing.


Severity:

Our analysis suggests that over 50% of cases of contact lens related microbial keratitis present to optometrists. Treatment delays after presentation to a health care provider affected visual outcome, associated costs and duration of disease and this is a modifiable factor. Better education of primary health care providers about timely diagnosis, treatment and appropriate referral are indicated. Previous hospital population studies of microbial keratitis have also shown that delays in initiation of appropriate therapy is related to eventual need for penetrating keratoplasty [20] and increased severity [21].


Dissemination of research results:

Disseminating research findings to the health care community allows practitioners to make informed decisions about the care of their patients. The Oxford Centre for Evidence Based Medicine defines evidence-based medicine as the ‘conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients’. The conclusions drawn from clinical research are of limited value unless they are made available to practitioners.

The Microbial Keratitis Study Group was recently awarded the British Contact Lens Association Dallos Award for the development and evaluation of evidence based clinical guidelines on contact lens associated microbial keratitis. It is planned to publish these clinical guidelines both as colour brochures and electronically via links on various websites, which offer practitioners information on contact lens practice. The Internet is a medium for obtaining technical information used by a growing number of practitioners.

As part of a public health campaign with Sydney Eye Hospital, Australia the ‘Take Care With Contacts’ website has been developed by the Vision CRC.

This research has involved optometrists as well as ophthalmologists for the first time in studies of contact lens related microbial keratitis. The involvement of contact lens practitioners in the development stages of these guidelines promotes ownership of the guidelines and will enhance the likelihood of implementation [22]. Optometrists are the target for implementation of these guidelines as they provide the majority of contact lens care in Australia and New Zealand and in many other countries.

It is hoped that this research will generate information, which is of relevance to contact lens prescribing, patient advice, differential diagnosis and referral. The goal of these guidelines will be to reduce the total incidence of contact lens related microbial keratitis and the severity of this condition in both costs of treatment and visual outcome.
Take home messages:

Recent studies have confirmed that microbial keratitis is a rare but serious complication associated with contact lens wear. Silicone hydrogel lenses have provided certain ocular health benefits, however increased risk of infection in overnight wear persists despite the advances in material technology. Patients should be informed of risks and benefits and discuss these with their eye care practitioner when considering continuous wear.

To reduce the risk of infection, wearers must comply with stringent lens care and cleaning regimens, particularly when travelling, and must remove their lenses and contact a practitioner at the first signs of red and painful eyes.

Источник с сылками

[Larix]

Post-LASIK Eye Surgery Care

You probably should read this before you go for your surgery, because after your LASIK Eye Surgery , you should rest your eyes and avoid heavy reading.
The healing process of LASIK Eye Surgery can be rather quick, usually without pain. Some may even return to work in less than a week, but you will need to protect your eyes. Let us look at a few changes in your lifestyle that will be good for your recovery.

Be careful when you are showering. You might wish to use a hand shower. Also, you will need to be careful about getting shampoo, soap or water into your eye. After surgery, your eyes are very vulnerable, and if any foreign substance, even water, enters the eyes, it might potentially cause infection or other complications like misplaced corneal flap. Yes, your corneal flap will still move if you are not careful.

In fact, you should avoid all eye make-up after surgery. It is common these days to attach fake eye lashes, apply mascara or eye shadows to enhance the beauty of your eyes, but it will be best to avoid using these for a while during your recovery period. Eye cream should also be avoided, since the chemicals may potentially enter your eye. You will not be able to rub your eye lids as freely as you could prior to LASIK eye surgery, so cleaning your eyes after applying these substance may become an almost impossible task. Just be patient for a while, until the doctor tells you that it is okay to put on your eye make up again.


Sleep early. Sleeping is the best activity for your eye recovery after LASIK Eye Surgery. Even if you are not able to fall asleep yet, just lie down on bed and close your eyes. Avoid reading, watching television or staring at the computer monitors for too long. All these activities tax your eyes very much, and your eyes will be tired very easily. Closing your eyes will let your eye muscles rest, and make the recovery process progress quicker.

Avoid some sports. Sports such as swimming and those that require rough physical contact should be avoided at all cost. If your sports is just walking or swinging the hula hoop, there is no problem. But if it is going to be something like running, jumping or any sports that are high risk in terms of physical injury, you probably will want to wait until your eyes recover and your doctor say ‘yes’ before you play again.

Remember your eye drops! You may blame it on a hectic schedule or being busy and forgetting your medicine, but you should never forget your eye drops. The doctors prescribe eye drops after surgery for good reasons, to keep your eyes moist and to ensure that you are not affected by dry eyes, infection or any other problems.

Always remember that your eyes are the most important organ without any spare parts. Other changes to your lifestyle after your lasik surgery period may be just common sense and logical thinking.
Источник

[Larix]

Lasik Eye Surgery



Lasik Eye Surgery – LasikEye.co is a website with full information resources about Lasik.

When we talk about Lasik Eye Surgery, different people have different thoughts and ideas. Some may think that it is a great idea to have the surgery, while other have doubts about it. So, what is Lasik exactly?



The definition for LASIK is Laser-Assisted in Situ Keratomileusis. This simply means a corrective surgery for myopia, hyperopia and astigmatism. An ophthalmologist may perform this surgery using laser technology.

1. Is it safe?

Before deciding whether Refractive Surgery is the right way to go, it is the right of a patient to know how safe the surgery is, especially because it involves a very important organ of our body. Is it worth the risk just to look better without glasses?

A 2003 study entitled “Incidence and associations of retreatment after LASIK” by Hersh, Fry and Bishop showed that almost 18 percent of treated patients and 12 percent of treated eyes needed retreatment. Meanwhile, an October WebMD report stated that contact lens wear infection risk is higher than infection risk from LASIK.

2. Potential complications

One of the most common complain from Lasik Eye Surgery is “dry eyes”. It was reported in the American Journal of Ophthalmology study of March 2006 that 36 percent of patients experience incidence of dry eyes from LASIK Surgery after 6 months from surgery. Meanwhile, the Food and Drugs Administration stated in their website that “dry eyes” may become permanent.

Even though “dry eyes” is common, it should not be ignored. The high percentage of incidences warrants the need for proper treatment, such as artificial tears, prescription tears and punctal occlusion, which puts a collagen plug in the natural drain of the eye. Untreated “dry eyes” will cause a regression of the effect of the LASIK treatment, and may result in “chronic dry eyes”. A permanent visual impairment may be the ultimate outcome in severe cases of “chronic dry eyes”.

Other risks of Lasik Eye Surgery include ghosting (double vision), seeing halos, foggy vision, light sensitivity, induced astigmatism, corneal ectasia and glare. These are dependent on the degree of ametropia before the eye surgery and other factors. Thus, it is important to access the individual risk potential of a patient instead of generalizing the average probability of all patients.

a. Dry Eyes

“Dry Eyes” is a general layman term for Keratoconjunctivitis sicca (KCS), sometimes also called keratitis sicca or sicca syndrome. It is an eye disease caused by decreased tear production, or sometimes increased tear film evaporation, which is common in humans and some animals.

Contrary to believe, dry eyes do cause eyes to water. The patient may identify symptoms such as dryness, burning sensation and an irritation that gets worse. Eyes may also feel itchy, scratchy, stingy or tired, pain, redness, a pulling sensation and pressure behind the eye. However, even if the eyes do water due to irritation, the type of watery tear does not have any lubricating qualities to help prevent dry eyes.

b. Ghosting (Double Vision)

The correct name for double vision is Diplopia, a simultaneous perception of two images of a single object. It looks like a transparent duplication of the original object and yes, there are treatments available for this condition.

c. Glare

Glare will cause much discomfort from reduced visibility, and very often sunglasses are worn to reduce glare. Meanwhile, polarized sunglasses may reduce glare as a result of reflection from non-metallic surfaces, including painted surfaces, gloss print matter and water. Some eyeglasses also have anti-reflective treatment to reduce glare at night, from inside lights and computer screens.

What else to be careful about?

The dynamics of our cornea is changed after Lasik Eye Surgery or any other forms of laser refractive surgery. As a result, it will be difficult for an optometrist and ophthalmologist to accurately measure a patient’s intraocular pressure and affect the calculations for the correct intraocular lens implant for a cataract surgery. Patients with a history of Lasik eye surgery will need to provide the ophthalmologist and optometrist the pre-operative, operative and post-operative eye measurements.

When you consider about whether you want to engage yourself with Lasik Eye Surgery, there are 3 categories of experience that you have to consider: Before, During and After.

[Larix]

s LASIK Worth It?

The Internet provides an opportunity to each of us to become an informed and knowledgeable consumer. We seize the ease of the Internet to find information about health and medications, so that we may be able to access the risks and prepare ourselves for the worse possible outcomes of a certain decision before taking the ultimate decision of whether to undertake a medical treatment or not, besides listening to the doctor’s advice. This is especially true for those who are looking for answers regarding medical treatment to enhance our aesthetic value, for example, having a LASIK Eye Surgery to correct our vision.

Problems such as myopia and hyperopia had always been there in our human history, just more apparent now when people are wearing glasses or contact lens. We also hear about children’s vision getting worse over the years, first due to exposure to too much television watching, and then now to too much activities on the computer. Ultimately, when children grow up, there will be more attention on the physical beauty. This is when there will be questions, asking whether there is any permanent vision correction method that will help eliminate the need for glasses and lenses.

There are many considerations before we decide to take on LASIK Eye Surgery or not. First of all, by ourselves, are we ready for the possible failures in the surgery which may potentially make our vision deteriorate? The psychological trauma will be a lot if we were not really ready for the worst possible scenario, such as total loss of vision. Secondly, are we prepared that it may probably not give us the ideal perfect vision we thought we would get after the surgery? Some people still need to wear eye glasses after getting a LASIK Eye Surgery, and it is not going to allow you to go back to contact lenses in case you misplace the LASIK flap as you place or remove your contact lens. Thirdly, there is always the risk of side effects, such as dry eyes or glares, which can really affect your daily life significantly.


After you have already decided to go for LASIK Eye Surgery through all that research that you got from the Internet, you will then be approaching the doctor for the initial test. At this stage, you will still probably need to reject the LASIK Eye Surgery procedure, depending on the outcome of your eye test. Some people are not suitable candidates for LASIK Eye Surgery, perhaps due to pre-existing dry eye condition, that the cornea is too thin or maybe the person is taking some medications which disqualifies the candidacy. It is important to accept the rejection, but of course you may then ask your doctor if there are other alternative surgery that you may get instead of LASIK Eye Surgery, if you are very serious about getting that vision correction due to some emotional or physical discomfort using glasses or contact lens.

The activities that you do frequently should also be taken into consideration if you opt for the surgery. Do realise that you are not able to do serious sports for a while after the surgery so that the corneal flap has time to heal itself. You may also be prohibited from swimming for a while, partly also to protect against the possibility of getting infected by bacteria besides fearing for a detachment of the corneal flap.

Before signing up for the LASIK Eye Surgery, do check yourself, whether you are ready physically and psychologically. The corneal flap and the alterations to your cornea is permanent, and you will not be able to reverse the decision. Think wisely.

[Larix]

LASIK Eye Surgery Risks You Should Know

LASIK Eye Surgery is a refractive surgery procedure done by qualified doctors, and many people think that it is a miracle surgery to help them get rid of the glasses and good vision once more. However, that is where the danger sets in.
The first risk is to have unrealistic expectations about the outcome of the LASIK Eye Surgery. Never expect a perfect vision of 20/20 after the surgery, because in reality, there is no guarantee at all. In fact, no doctor should give you a guarantee of a successful surgery, much less a perfect vision. The doctor is only over-promising so that you will sign up for the surgery.
Each of us are individuals, with different reactions to the surgery and very individualised recovery. A responsible doctor should always make a thorough check on your eye and base it on your medical history, and honestly tell you whether you are a good candidate for the surgery or not. Yes, some people are not supposed to have the LASIK eye surgery performed on them due to some conditions, such as a thin corneal layer or perhaps there are some serious dry eyes conditions.

Your doctor will also not tell you about the possibility of overcorrection or undercorrection. He may be too afraid to admit cases of under or over correction of the eyes, just in case you start doubting his skills. In reality, undercorrection is a common problem, as doctors will still have additional room for correction and a second corrective surgery if the first did not give a satisfactory result to the patient. Sometimes, over or under correction is just temporary, and the eyes will adjust themselves during the healing period. However, in some cases, the effect is permanent. Usually, this cannot be determined until about three months after the surgery.
A rare condition that can be induced by the LASIK Eye Surgery is astigmatism. However, it is not necessarily always a bad thing, because sometimes a small degree of astigmatism may actually enhance vision in some special conditions. It is likely that you already have an under or over correction problem with the first LASIK Eye Surgery to get astigmatism this way, but be assured that a second surgery will usually be helpful to correct the over or under correction together with the astigmatism.
Enhancement procedures, which means a second proceure, and your doctor probably will not be telling you first because an enhancement surgery will mean extra cost to you. The enhancement surgery is not under the decision of the patient, and should not be done just for the sake of achieving a perfect vision. The doctor should only perform an enhancement surgery if it is absolutely necessary such as if the condition affects the lifestyle and activities of the patient, not for the sake of trivial decisions.
Another condition that your doctor will never tell you is that there is a possibility of your vision getting worse after the LASIK Eye Surgery. There may be people who experience some loss of visual sharpness, probably due to the irregular corneal flap. However, this condition may improve over the course of a year.
In Part 1 of this article, we discussed several high expectations that may stem from the psychological expectations of excellent vision immediately after surgery and the milder post surgery conditions of LASIK eye surgery such as deterioration of night vision and dry eyes. However, there still other expectations and complications, some that are directly related to the surgery itself.

One of the things that may be expected is the overcorrection or undercorrection of a patient’s sight. For example, nearsighted patients with an overcorrection may become farsighted immediately after the surgery as they find themselves not able to see things near to them clearly. The reverse will also happen when there is an overcorrection of farsightedness.
In the case of undercorrection, patients will notice that the improvement of their sight is not as good as expected, still blurry and below the average. Whether it is overcorrection or undercorrection, the doctor will be there to discuss with the patient on the corrective measures for this, including an enhancement surgery which should be ideally six months later. When it comes to this level, the LASIK procedure will be performed just for the remaining residue, whatever amount that is still required for the correction to be complete.
The problem of overcorrection and undercorrection is probably no longer too often with the advance of technology, first through the full computerization of the process, including the laser control and secondly with the mapping of the corneal especially with techniques such as a wavefront guided LASIK eye surgery.

In fact, those are probably not the biggest concern of the doctors. The biggest concern of both patient and doctor is the possibility of a regression, if your sight would still deteriorate after the surgery. If the patient’s corneal layer is too thin even before surgery, doctors will often inform the patient that the first surgery is the only surgery that the patient can afford to do with the condition of the corneal layer, and no enhancement can be done anymore if the vision regresses in the near future. Regression may occur slowly over time, or it may be very soon, within the first few weeks of the surgery. The outcome of the patient cannot be easily predicted especially for regression, and the doctor will need to evaluate the situation very carefully before knowing what to prescribe to the patient as a follow-up step to correct the situation.
Another risk which is really unique and rarely happens is diffuse lamellar keratitis, or DLK. The DLK is a condition post-operative complicatioun of LASIK, when foreign cells are introduced into the interface between the corneal flap and the underlying stoma. The condition is often accompanied by pain, blurred vision, foreign body sensation and some sensitivity to lights, and is often present within the first week of surgery. Although the condition is rare with an average of only one in five thousand surgeries, the treatment may be very easy, or it may be very time consuming.
However, it must be noted that not all patients will experience the symptoms for DLK within the first seven days of the surgery. There may be some milder conditions that can only be known upon examination, hence the doctor’s post-operative visit is certainly important. DLK inflammation, when detected early, can be easily treated with 80% of the condition clearing up within 48 hours of the treatment. If it is detected later, the treatment might take several weeks for the inflammation to subside.
Early detection of the DLK will also prevent the deterioration that may result in serious visual impairment. Therefore, patient must always work very closely with the doctor to ensure that the doctor will be able to detect any problems that may result from the surgery, instead of allowing matters to get worse. It makes absolutely no sense to spend a significant amount of money on the surgery, only to let things slide with the follow up post-surgery and get visual problems.
There are also many other potential complications that will arise from the surgery, and the recovery of one patient is definitely different from another. It is absolutely necessary for your doctor to actually be there to follow up on the case from the preparations pre-surgery, during the surgery and post-surgery with your complete medical history. Then the doctor will be able to determine whether your post operative experience are normal or requires medical attention. There are some time when you cannot play doctor to monitor or cure yourself, and LASIK eye surgery is one of them. Let your doctor be your best friend during this period of time, or at least until your doctor gives you the ultimate good news that your eyes have fully recovered.

[Larix]

Orthokeratology An Alternative To Lasik Surgery

Orthokeratology is a non-surgical method which does not resemble Lasik Surgery technology, to eliminate myopia or nearsightedness. It uses a specially shaped contact lens to temporarily reshape the cornea with some precision. Doctors will prescribe these rigid gas permeable (RGP) contact lens to shape the cornea gradually and temporarily eliminate myopia.


Procedure

The procedure involves the doctor measuring first the prescription for your nearsightedness, farsightedness and astigmatism. When the doctor has checked your eyes for prescription, it is then necessary to map out the shape of the front surface of your eye using a corneal topographer. The doctor, with your prescription and the blueprint of your eyes, will develop an exact shape and parameters necessary to reverse your prescription by reshaping your cornea.

These contacts are custom made to the exact specifications of your eyes. You will need to wear it for 8 hours each day until your vision is improved. Sometimes, your doctor may actually require that you wear the lenses while you sleep, probably to speed up the process of reshaping your eye.

After that, you probably need to wear the lenses for only a couple of hours a day, or even a few days only each week to keep the cornea in shape. The change in scheduling will depend very much on the improvements of your eye, and determined by your doctor upon examination. When you remove these lenses, you should have improved vision without the need for corrective lens.

Candidates for Orthokeratology


Orthokeratology is suitable for candidates who are too young to have LASIK eye surgery. This group of younger patients will not have a stabilized prescription yet, or it may be teenagers who are active in sports, yet will be limited should they wear regular contact lenses.

However, the technology is suitable for any age group, with nearsightedness no more than -4.00 dipters and astigmatism less than -1.50 diopters. Yet, there are still some people who are not suitable for orthokeratology treatment, and it is still best to consult your doctor before you may decide on any reatment.

Pros and Cons

While Orthokeratology is a non-surgical method that can be available to almost everyone. However, the results from this treatment take time, and it is not a permanent solution to myopia. It is also more expensive than regular contacts or eyeglasses, which means a bigger financial burden on patients since it has to be based on precise prescriptions by your eye doctor.

Improvement: Paragon Corneal Refractive Therapy (CRT)

The CRT is almost similar to Orthokeratology, except that it uses “designed oxygen permeable therapeutic contact lens” as opposed to “rigid gas permeable” lenses. The technology uses computerized eye mapping, computerized lens manufacturing and the special lens material is the first material approved by FDA for night-time Corneal Refractive Therapy. They are worn at night, and when the patient wakes up, there will be visual improvements during the day. This method helps patients with myopia up to -6.0 diopters and astigmatism up to -1.75 diopters. Improvements can be seen within the first few days and may take an average of 14 days for full correction, depending on many factors of the patient.

Most risks of orthokeratology and CRT are similar to wearing contact lenses although there are more. Do consult your eye doctor if you would like a more precise recommendation on whether you are suitable as a candidate for this option. Maybe you could advise your little sister on this procedure the next time she insists that Lasik Eye Surgery is the only way to go.

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