Charles Bittel, O.D., Inc.

Charles Bittel, O.D., Inc., Newsletter 

The LASIK Issue

March, 2011


Charles Bittel, O.D., Inc.

Thanks to another patient suggestion we have decided to focus this month's newsletter on LASIK (Laser-Assisted In Situ Keratomileusis). We will discuss who may or may not be a good candidate as well as some recent advances in technology. We just received word of a new laser that our affiliate is using and will be attending a seminar to learn more about the new Zeimer laser in a few weeks.
And while we will continue to keep the main focus of the newsletters on educational topics, we decided that we might as well share some "news" about the practice while we're at it. We will try and keep you posted on any new technologies that we're incorporating into the practice, any new contact lens rebates that are being offered, and if you're lucky enough to actually be getting a tax refund this year take a look at the bottom of the newsletter for a discount towards our main topic, LASIK!
As always, we hope you enjoy and learn something along the way!


Charles Bittel, O.D.

Charles Bittel III, O.D.


In This Issue
Featured Article
Technology Update
LASIK Discount
LASIK - Am I a good candidate?
This is the first question comes to most patients' minds when contemplating refractive surgery. Here's a general guideline of what both doctor and patient will consider when making this decision.
1. Is your prescription stable?
While there is typically an age minimum of 18 years old for refractive surgery candidates, this does not mean that all 18 year olds become eligible for LASIK on their birthday. In fact, most 18 year olds with a significant prescription are still changing and needing updated glasses and contact lenses every year or two. Unfortunately while we can usually get a sense of when a patient should stop changing (based on their current prescription, rate of change in the past, school/job status, etc.) we cannot predict the exact age when the prescription will stabilize. We really only know when you're done changing after you've had a stable prescription for a few years.
2. How many birthdays do you have under your belt?
As previously stated, patients typically need to be at least 18 to undergo a LASIK procedure, so we'll use that as the minimum age. Assuming you have a stable prescription, 18 to about 37 is the first age range to consider. Patients in this range will typically benefit from great distance and near vision after the procedure. As people approach 40-43 years old, they will almost definitively begin to experience some sort of change in their near vision. This does not mean that patients will necessarily need reading glasses right away, but near vision becomes less comfortable and the near focusing becomes less efficient for nearly everyone at some point in this age range. So, going back to the age range of 18-37ish being ideal for LASIK. As you approach that 37 year old mark, and especially at 38 and 39 years old, you need to consider the near vision changes that will almost definitively take place in the next 3-5 years. And you need to be okay with the fact that you may need some sort of reading correction, and not be upset by the fact that your LASIK investment did not keep you out of glasses entirely. So for this 18-37 age range, the sooner you are able to get LASIK (again, a stable prescription being necessary) the longer you will be able to enjoy life without glasses before near vision changes begin to emerge.
Once you reach 45-50 years old we are again able to reconsider LASIK from a different perspective. Generally we will take the monovision approach for patients in this age range. Monovision basically means that one eye is focused for distance vision and the other eye is focused for near vision. The brain essentially pays attention to the eye with the better image for the task that is being performed. If you are driving, the brain favors the distance eye. If you are reading, the brain favors the near eye. The best candidates for LASIK in this age range are those that are already wearing monovision contact lenses. If you are not a monovision contact lens patient, we typically do a trial period with monovision contacts to make sure you will ultimately be happy with the vision after LASIK.
* Patients that I think are great for monovision LASIK are those that have never worn glasses or contact  lenses in their life because they have had perfect distance vision, but are beginning to have a lot of trouble with their near vision. Sometimes we can ultimately just treat one eye for near and leave the other eye alone for distance and they can once again enjoy life without glasses or contact lenses.



Monovision is generally the best option for patients in the 45-60 year old age range. As you approach 60 there may be better options for you such as a Refractive Lensectomy (something that we can delve into further in a future newsletter).



3. Are your eyes healthy / Do you have a prescription that the lasers can treat?


These are obviously questions that will have to be addressed by your doctor and the answers will vary from person to person. Most patients that we see fall within the guidelines for having a safe and effective LASIK procedure. But sometimes we don't even have all the answers, and that is why your consultation with NVision is necessary. At your consultation there are 2 crucial tests that are performed to help determine your candidacy. The first is pachymetry, or a measurement of your corneal thickness. Dr. Tooma, our primary LASIK surgeon, needs to make sure there is enough corneal tissue to work with. The second test is corneal topography. This test is an integral part in the Custom LASIK procedure, but it also helps in detecting different corneal diseases that if present would likely preclude you from being a candidate.


Most prescriptions fall within the parameters of what NVision's lasers are able to treat, but if a patient has a high amount of hyperopia, myopia, or astigmatism, there may be alternative refractive procedures that are preferred. This is another question that can be answered by a consultation if Dr. Bittel thinks you are on the borderline of the laser's parameters.


LASIK Technology Update

Another concern patients have is whether or not they should wait for any improvements in technology before they proceed with LASIK. At this time the technology is exceptional for most LASIK candidates.
There have been 2 major innovations since the advent of LASIK in the late 1990's. The first has been the introduction of the IntraLase laser to create the "flap". Without getting into too much detail, a thin section of the cornea must be lifted up in order to reshape the underlying cornea with the laser. Originally a blade was used to create the "flap" which inherently had some occasional complications. The IntraLase laser allows for the creation of a much more precise and predictable flap that heals beautifully.
The next major advancement in technology has been the development of the "Custom LASIK" procedure. The previously mentioned topographical map taken by the ORBSCAN is an extremely detailed picture of the cornea. The lasers then use that information to treat every little peak and valley so the result is a smooth and uniform corneal surface once the procedure is completed. 
There will always be advances in technology such as the new Zeimer laser that we will be learning more about in a few weeks, but the base technologies of using a laser to make the flap and the Custom LASIK procedure are extremely advanced and exciting.
And if you do not fall within the guidelines for LASIK, there are other amazing refractive surgery options that Dr. Tooma will discuss with you if they are a better fit. Remember, your eyes are unique. No two people have the same pair so the guidelines and technologies discussed here are very general. We can only know if LASIK is right for you after a thorough evaluation and detailed discussion about risks, benefits, and expectations.
Medical Insurance: Dr. Bittel now accepts most PPO plans as well as Medicare for medical office visits. If you have a red eye, allergies, or any other eye related medical concerns we are happy to help.
Contact Lens Rebates: Many contact lens companies are offering rebates with the purchase of an annual supply of contact lenses. This can significantly reduce the price paid per box of contacts, especially when used in conjunction with vision insurance. Please ask if your contact lens manufacturer is presently offering any rebates.
Glasses: Some vision insurance plans offer 20-30% off a second pair of glasses. If you need to update your primary care glasses but are interested in a second pair such as sunglasses or computer glasses, please ask if your insurance offers these discounts.
Transitions: Many of you may have seen recent commercials for Transitions lenses (the lenses that are clear indoors and turn dark outdoors). For patients with certain vision plans we are able to offer a no-risk trial of Transitions lenses. If you ultimately don't like your Transitions the insurance company will refund the cost of the Transitions and remake your lenses.
About Us

Dr. Chuck Bittel (Senior) has been practicing in Yorba Linda for over 25 years. His son, Dr. Charlie Bittel (Junior) has been practicing in Yorba Linda and Fullerton for the last 5 years and has just joined his father's practice full-time.


Learn more about Dr. Bittel Senior and Junior and about their practice on their website and Facebook page. Also visit the blog for Computer Vision Services to learn more about Computer Vision Syndrome.


For appointments call 714-779-8521


Charles Bittel, O.D., Inc.
20399 Yorba Linda Blvd.
Yorba Linda, California 92886
LASIK Discount