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Richard A. Norden, MD (in memoriam)

Board Certified Ophthalmologist

1144 E Ridgewood Ave, Ridgewood, New Jersey

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14 Questions Answered

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QUESTIONS ANSWERED

Why don't LASIK doctors suggest PRK for thin corneas?

Asked By:AnonymousANSWERS (1)

A number of possibilities exist here.

The first is that the combination of your thin cornea and the size of your prescription may mean too much tissue removal so that you're turned down for both LASIK and PRK.

Many LASIK specialists feel that a cornea thinner than 500 microns should not have any procedure and turn down patients for both procedures without any evidence that LASIK shouldn't be performed on these patients.

I and a co-author, two years ago, have presented a series of several hundred patients that have undergone LASIK successfully with corneas thinner than 500 microns with some patients having over twelve years of successful follow-up.

My recommendation is to find a LASIK surgeon with this experience and, assuming there are no other contraindications, have LASIK performed.

Richard A Norden MD

Richard A. Norden, MD (in memoriam)

Board Certified Ophthalmologist

Is it normal to be over corrected post lasek enhancement to +1.5?

Asked By:AnonymousANSWERS (1)

Overcorrection with any refractive procedure, be it LASEK, PRK or LASIK, can occur in a small percentage of patients due to healing outside the Bell curve of normal. Overcorrection can and does frequently resolve with time; on occasion it does not. You seem to have a rather large overcorrection for the amount treated during the enhancement -- are you still on steroid eye drops and, if not, for how long after the procedure were you on them? Steroids can sometimes promote an overcorrection. If this doesn't resolve, your surgeon should do a "cycloplegic" refraction (put drops in to relax your focusing and measure your prescription after). You certainly can have another procedure as long as your cornea is thick enough. Your surgeon should easily be able to determine this.

Richard A Norden MD Ridgewood, NJ

Richard A. Norden, MD (in memoriam)

Board Certified Ophthalmologist

Why is Thermage rated so low, and why is there such a disparity in what different clinics charge?

Asked By:AnonymousANSWERS (1)

Thermage, even in its most advanced iteration, has very modest and subtle effects. There are many superior radiofrequency alternatives on the market such as Exilis Elite and TruSculpt. Prices vary depending on the center.

Richard A. Norden, MD (in memoriam)

Board Certified Ophthalmologist

What can be done if your lasik enhancement was over corrected?

Asked By:AnonymousANSWERS (1)

The best thing that you can do is wait. A LASIK surgeon may typically "overcorrect" you because you "undershot" the first procedure by treating more than the measured amount, anticipating that with time the "overcorrection" will return to normal. If not, another enhancement can be performed, in general.

Richard A. Norden, MD (in memoriam)

Board Certified Ophthalmologist

Can I ride a bike 1 week after lasik with sunglasses?

Asked By:AnonymousANSWERS (1)

You can ride a bike one DAY after LASIK. Exertion at 100% is allowed from the first day on. The most important thing to know is that you must protect your eyes from trauma in the early post-LASIK period (not a bad idea to protect them forever!).

Richard A. Norden, MD (in memoriam)

Board Certified Ophthalmologist

1 month after Lasik. Can vision still improve?

Asked By:AnonymousANSWERS (1)

The answer is yes. After LASIK the corneas may be dry for several months causing fluctuating vision or sub-optimal vision. Lubrication and time almost always corrects this. Higher prescriptions (like a -6.00 or higher) can also take longer to obtain final vision. Some eyes just take longer. That's why the standard to wait before doing an enhancement is four months-- eyes can continue to improve (or get worse) till that time.

Richard A. Norden, MD (in memoriam)

Board Certified Ophthalmologist

I had laser surgery about 3 years ago, and I am afraid I am losing vision again in my left eye. what should I do?

Asked By:AnonymousANSWERS (1)

There are a number of reasons that vision can regress after LASIK Some are easily correctable and others not so much. The most common correctable cause is regression, usually of a treatment for farsightedness, easily fixed with a "touch-up". Nearsightedness can "come back" if you were treated at a young age before your prescription stopped changing; that, too can be corrected with an enhancement. A very rare cause of worsening vision is 'ectasia', a condition in which the cornea starts thinning and bulging, causing blurry vision. There is a correction for this but there aren't many centers that have the capability to do this.

Richard A. Norden, MD (in memoriam)

Board Certified Ophthalmologist

IntraLase LASIK Vs Traditional LASIK

Asked By:AnonymousANSWERS (1)

Although many LASIK surgeons have switched to Femtosecond (Intralase) technology, the newest microkeratomes have reduced flap complications to equally low levels, the flaps are just as thick as predicted, and they achieve more than competitive visual results. I've had both in my practice , and I've returned my Intralase and now use exclusively the newest generation Moria OUP microkeratome.
One should remember that the flap is just the first step of the procedure, and far more important, the excimer laser used to reshape the cornea, is far more important. At the end of the day, shop for the surgeon who has the best reputation, experience and outcomes -- don't try to micromanage the details -- leave that to your LASIK surgeon.

Richard A. Norden, MD (in memoriam)

Board Certified Ophthalmologist

Will not using my prescribed eyedrops after LASIK affect the healing process and will my vision be unclear forever?

Asked By:AnonymousANSWERS (1)

Since you are two weeks past LASIK, it's highly unlikely that you have developed an infection or inflammation, so the most likely cause of decreased vision is dryness, which is normal in the early course after LASIK, however made much worse by not using lubricating drops and then compounded by spending a lot of time staring at a computer.

Fortunately, by re-starting your drops on a regular basis and by taking frequent breaks from computer use, your vision should return to normal. Moral: use your drops, as prescribed -- there's a reason for it!

Richard A. Norden, MD (in memoriam)

Board Certified Ophthalmologist

Im allergic to cortisone eye drops. Can I do LASIK?

Asked By:AnonymousANSWERS (1)

True allergy to cortisone is extremely rare. Some people that take steroid drops can get elevated eye pressure but there are some steroid drops that won't cause that elevation. Additionally, most people are only on steroid eye drops for four days, so.... go for it!

Richard A. Norden, MD (in memoriam)

Board Certified Ophthalmologist