Media

Hi I’m Florence Henderson. When I had cataracts, it was like seeing everything through a hazy film. My doctor said cataract surgery would remove the haze but ordinary cataract replacement lenses wouldn’t fully correct my vision. So, I chose crystal lens. Crystal lens correcting my cataracts and gives my eyes their natural range of vision. Now I can see my phone street signs even the gaps in my car. Some crystalens patients may experience glare and other visual disturbances. All surgical procedures entail some risk and crystalline has the same potential risks as all other intraocular lenses. Many patients hardly if ever need glasses after surgery. Only your surgeon can determine if crystalens is right for you. If you want your vision to go from this, to this, talk to your eye doctor about crystalens find a specialist at crystalens.com crystalens by Bausch Lomb, don’t just see, see better.

I was having more and more difficulty seeing clearly especially street signs you have no idea how many U-turns I could make before I got to my destination if I was in an area that was unfamiliar. So, I consulted with Doctor Salib and he performed cataract surgery on both eyes. As you can see I’m not wearing glasses and I get to my destinations in a very short time. We are located in the saddleback memorial medical towers see well live well.

And welcome back Doctor George Salib is here today with the orange county eye institute and he brought along a pamphlet and we’re going to talk about some of these things. I care facts and myths and I think it’s pretty interesting I looked over your questions and I looked over this and there are a lot of myths, I guess some people might call it old wives tales or whatever it might be, whatever that term may be but you grow up learning about these things you’re hearing them. So, let’s go. You brought along six, six, myths that we’re going to talk about today and the first one is reading in dim lights and that’s something that I remember hearing about as a kid and we got a photo of I don’t know who that is Galileo or Columbus or somebody there reading by candlelight which of course for eons that’s how people read. Yeah exactly this is actually called the young man reading by candlelight by Matthias stone and as you can see yes for centuries people have been reading by candlelight and in dim light because we didn’t have electricity, right. Now that we have great lighting it’s a lot easier to read now of course that basically is a myth it does not harm your eyes to read in dim light. However, it does make it maybe a little more challenging because you have poor illumination which leads to decreased contrast in your paper, so you can’t see the print against the background, you see less, visual details it just makes it overall more difficult to see especially for the 4d and overcrowd, where people tend to lose their focusing ability they don’t have quite the focusing ability. They did when they were younger than that and that’s normal that as you get past the age of 40 your, your, focusing ability decreases because the lens itself becomes a little less pliable the lens that allows you to focus, so good lighting increases what we call your depth of focus, how like the range that you can see things so that’s another challenge. So it makes it more difficult to read but it doesn’t harm your eyes in any way. Okay that makes perfect sense to me because I wear reading glasses obviously and if I’m out in bright sunlight there are certain things I can now read without my reading glasses on right as simple as that I still may need them certain times but that the better light is it makes a little bit easier. Yeah certainly you don’t have to hold the paper quite as far. Yeah and what’s actually nice you know I I read a lot through the, the, kindle app or whatever and of course if you’ve ever seen those apps, you can have a white background with black text black with white there’s like four or five variations that fit your needs the best and it’s, it’s, kind of nice, yes, plus adjust the brightness on the screen. Well let’s look at the next one and this one is I need to wait until my cataract is ripe before it can be removed. I guess that means that it gets to a certain point. Exactly and, and, that is also a myth this is as you can see there’s a cataract on our screen and the cataract is basically the lens of the eye that gets cloudy with time and as the lens gets cloudy it prevents you from seeing well. Now in the past maybe 20 or 30 years ago, this used to be a true statement because we had to wait till the cataract was a certain density or a certain firmness in order to be able to remove it, because they used to make a larger incision, they had to go inside and either freeze the like a special tip called a cryoprobe onto the cataract to remove it or else they would remove the whole lens in one piece, through this large incision, but then again cataract surgery back then was a lot more primitive than it is now, right, you had to stay in the hospital for three days with sandbags around your head. They wouldn’t put a lens in your eye wow and you ended up with these big thick glasses in order to be able to see, versus nowadays it’s an outpatient procedure. It’s about 98 percent successful and done usually within a span of about 15 minutes and it’s done through these micro incisions about two to three millimetres long and you can break up the cataract even before it is ripe. Wow, in fact you can take out a lens of an eye before it develops into a cataract. Now in order for insurance to, to, be able to cover part of your surgery or all of your surgery it has to be a cataract that is visually significant, meaning it’s, it’s, dense enough that it’s causing you to have problems let’s say driving at night because of glare or trouble seeing the fine print but a lot of people even in their late 40s early 50s and on decide to take out the cataract or the lens of the eye before it turns into a cataract, in order to take advantage of the newer lenses now that are available, that allow you to see like far and near at the same time. So it’s, it’s, really changed quite a bit so yes it is a myth that you don’t you don’t you basically do not have to wait till the cataract is ripe. All right, very interesting. The next one we’ve definitely heard over the years and I think  even more so now everybody we got a photo here on a computer, using a computer or watching tv too much or too close, that was as a kid you know you I didn’t we didn’t have computers then but you know the kid was three feet in front of the tv watching their cartoons and sit back and get back it’s going to be bad for your eyes. Yes, I’ve heard that many a time myself and that is also a myth. It doesn’t harm you to sit too close or too long in front of a tv. Now of course there are other health issues we might talk about if you’re sedentary and not moving around because you’re watching tv too much, that can lead to obesity which can lead to problems with the eyes later on but there’s no direct bad effect from just watching tv too long or using a computer for too long or sitting too close. Now a lot of kids will sit closer to a tv because their focusing ability is so well so good that they can focus up close without any difficulty. However, if you see a child sitting close to a tv or computer all the time then you have to take them to the ophthalmologist in order to determine if they need glasses. They might be nearsighted and they just can’t express that to you. They might only be able to see up close and with glasses they’ll be able to see far away but generally it does not harm your eyes. A lot of people after looking at a computer for a while or a tv their eyes will feel gritty or tired and or even reading a book for a long time, right, and that’s because your blink rate decreases meaning you blink less often when you concentrate on something. So, it’s important to maybe every 20 minutes just take a break have your eyes look far away for about 20 seconds or use an artificial tear to lubricate your eyes and that’ll take care of the problem, but yeah, it’s it doesn’t harm your eyes to, to, watch tv or, or, see a computer for too long. All right well that we’ve heard about since I was a kid when it comes to tv here’s another one that I would hear when I was a kid. Wearing eyeglasses will make you dependent on them and as I, I, said to the doctor before we got on, we all remember his kids maybe a parent or an older sibling had their glasses and you would put them on saying oh look I’m wearing glasses you know and your, your, mom will go don’t do that you’re going to be dependent on those glasses. Right you’ll need those glasses forever and that’s not true. All it is, is, when a person wears a pair of glasses and they’ve never worn one before and if those glasses are fit for their eyes, it’s like going from a regular tv to a high definition tv. All of a sudden, you’re seeing things you’ve never seen before, people’s faces more clearly. Print is much more clear so you want to wear the glasses just to have that clarity of vision. Right, but it doesn’t make you dependent on them and that’s different than let’s say a young child who actually needs glasses to avoid having a lazy eye or to make that lazy eye better so some people really need those glasses in order to prevent that from being a permanent thing. So, kids don’t outgrow lazy eyes you really have to give them the glasses in order to prevent that and in adults it doesn’t make you dependent on glasses. Okay very good. Cataract surgery and we talked about you know the cataract getting ripe. But here we go here’s another one cataract surgery can be done with a laser myth or fact? And that’s true. Here’s your new machine yes this is a laser cataract surgery machine called the lensx laser. If you had asked me that question about three or four years ago I would have said yes that is a myth. Wow oh really that’s short of time, yes, it’s quite near quite recently, interesting, this has happened and now with an video guided precision, we can make laser guided cuts in your eye basically incisions that are tailor-made for your eyes and break up the cataract into smaller pieces allowing us to use less time and energy to remove the cataract. I’m one of few surgeons in this whole area that are able to do this kind of surgery and I was actually the first surgeon in the western US to use the latest software version of this laser. It has really made this surgery even more precise, Wow, and even better, it’s really working, that’s great, the advances are just tremendous. Okay the final one that if you would have asked me before I read this I would have said fact, eating carrots will improve my vision because we’ve always heard that, right or the beta carotene that’s of course in the carrot. Right, right, and I wish that were true but it’s actually a myth. Carrots are an important source of vitamin a and beta-carotene is the form of vitamin a in those carrots. Now vitamin a is, is, important in general because those that beta-carotene is something called carotenoids. It’s a it’s a class of medicate of medications called carotenoids which basically are antioxidants in your body and they’re found in higher concentrations in your eye. So if you eat carrots or if you eat things with beta-carotene such as spinach kale coloured greens then you’ll get more beta-carotene. Now that beta-carotene has been shown in in some studies to decrease the rate of advancement from wet from dry macular degeneration to wet macular degeneration. So, in that regard it is helpful. However, it’s also it also could be harmful for people who are smokers who take extra amounts of beta-carotene because that’s been shown to increase your chances of lung cancer. So you have to be careful in terms of what you do and, and, how much you do it how, how, much of something you’ll take. Carrots are good for you but they’re not going to improve your vision okay all right so well we’ll still eat them but we don’t we won’t go all bugs bunny on the carrots like we used to I guess but they’re all good for you and they, they, taste good so I like this this was a very fun segment. I hope we do this again yes thank you, yeah this was a lot of fun if you want to get hold of Doctor Salib, orange county eye institute there’s the number on the screen 380 eyes or 380-3937 ocinstitute.com nice to see you nice to see you too all right take care we’ll be back in just a moment this was a fun one I liked it

We welcome you back as we continue with our Monday program here on channel six. Our good vision always very important that we all keep our eyes working well and Doctor Salib back with us today to talk about that welcome to the show sir. Thank you. Good to have you with us today’s topic is a unique one. Face it over the years having been here a number of years I’ve had a lot of interviews with medical folks and one of the things that we talk about a lot with you ophthalmologists is cataracts. It just seems to be a reality of aging. For those that have never had that experience or have yet to have it to deal with it real briefly what is a cataract? Well every eye has a lens much like the lens of a camera that allows us to see clearly and focus on what we want to focus. So, with time there’s proteins that aggregate or clump together in the lens and causes clouding of the lens and so a cataract is basically a clouding of the lens that doesn’t allow us to see as clearly as possible and you can see a picture of that up on the screen here where you can see this clouding of the actual lens. And my understanding is it’s a natural occurrence and there’s not much we can do to prevent it correct? Exactly the most common reason people get cataracts is time or age so  if we live long enough we’re definitely going to get cataracts and in fact as we age the incidence of cataracts increases. So, by the time we’re in our 70s about 50 percent of us will have cataracts by the time we’re in our 80s about 70 percent of us will have cataracts that are visually significant. There are other causes as well such as diabetes can increase cataracts, oral steroids can cause cataracts such as prednisone trauma but the most common reason is birthdays. So, for some people it could be in their 40s but for most of us it’s going to be in our 70s or 80s almost for sure that we’re going to have to cope with it. Yes exactly. All right so how do we tell it sounds like it’s something that takes place over years and years and years that gradual change in our vision. Does it have to get to a certain point do the people come to you or do you find it in the in the exam room? Well usually if they haven’t felt anything or seen anything I’ll sometimes see it in my exam room and I’ll tell them well you have the beginnings of cataracts. When people come to me and tell me you know I can’t see as well please change my glasses, I’ll change their glasses and they come back a month later I still can’t see well out of my glasses that’s a common sign that you have a cataract, if you’re frequently changing glasses. Another thing people tell me is they have difficulty for instance doing things such as driving at night. Maybe it’s a little darker or they can’t see quite as well because of the lights flashing in their eyes. The lights cause scattering of, of, the light they see halos. So that’s often also a common reason people will come in or they sometimes just say they can’t see quite as clearly in general whether they want to read, if they can’t see the golf ball the tennis ball you can see here a picture of a normal eye on the left where you see a clear image because you have a clear lens through which you’re seeing. On the right you can see the cataract and the cataract eye scatters the light so that the retina which is the back of the eye doesn’t get a clear image and you see it blurry. I guess the problem is it takes years and years for this to develop so we sort of accommodate everyday activities whether it’s driving or playing with our grandkids or whatever might be sort of just over time and eventually but of course getting an annual eye exam you can spot this maybe before it becomes real problematic. Well we know that for years they’ve been dealing with it I understand that it’s actually in England I think after world war ii or around world war ii they found that some of the pilots had little, little, chips of Plexiglass where the bullets had hit the plexiglass and on the airplanes and little pieces that stayed in their eye, so that the eye will tolerate to some extent some foreign things in it on a permanent basis. That’s kind of how they developed the lens inside the eye is that correct? Yeah exactly they found that for the fighter pilots, they found that that that material didn’t really cause much damage so they decided to try and develop a lens that you could put in the eye for that for the person to see. They used to just take out the cataract and then you’d have to wear those big coke bottle glasses in order to be able to see. So they put the inner the lens in but I guess part of the procedure is getting the old fuzzy part out so to speak and my understanding is you’ve got some new techniques using a piece of equipment you’ve used for something else for years you’re now able to use that to help get that old lens out of there. Right exactly so in the traditional method of taking out a cataract we use blades and bent needles basically to do the incisions in the cataract itself in the cornea in order to get at the cataract and then we use something called phacoemulsification which is the machine that actually breaks up the cataract using ultrasonic energy and then we put in the new lens. So now we’ve been using a technology called femtosecond laser technology where we’ve been using that for all laser LASIK where we create the flap, but now we can use that same precision to do the incisions for the cataract surgery and the circular opening in the front of the cataract called the capsulotomy and we can even soften the cataract itself to lessen the amount of energy that we use during the cataract surgery. Why do you feel that’s better than the shall we say the standard way of removing that capsule? Right, well while you know a seasoned surgeon is very good and he has nice steady hands he can never be quite as precise as a laser. So, with this new laser technology we have video assisted technology where we can actually see the layers of this the eye on the screen through something called optical coherence tomography and then with that that, basically gives a good map of the eye. We can precisely tell the laser where it we want it to cut how big the incision we want it to make it to make and exactly how big the capsulotomy we want to make, which is that opening in the front of the capsule of the cataract and we can actually break up the cataract. They’ve done a study where they found that out of 250 patients 43 percent of the time they had a 43 decrease in the amount of energy used to break up the cataract, once they broke it up with a laser and actually were able to do it in 51 percent less time and also in terms of the capsulotomy, the manual way of doing it compared to the LASIK the laser method only about 10 percent of the time were we able to achieve the same  precision as with the laser. So even though the doctor is well trained and skilled the equipment can help and modern technology we’re seeing so much of that arthroscopic surgery these days lasers being used in lots of ways but obviously for the eye as well. Are all patients’ good candidates for this or are there some people that would do better than others in this particular procedure? Right well with every case in terms of surgery we have to look at the individual case but certainly this can benefit a lot of people. It especially helps those people who have astigmatism. So astigmatism just means that the front of your eye is not completely round it’s kind of like if you look at a spoon and you look at your image in a spoon you’ll see how your image is a little distorted. That’s astigmatism. So, this laser is great for that because we can actually plan the astigmatic incisions in the cornea with the laser instead of doing it by hand and on top of that this is especially good technology for those people who choose those lenses that are not the standard lens. For instance, the what we call the lifestyle change, the focus lenses focusable lenses, yes the multifocal lenses the torque lenses all those lenses achieve the best results when you have good astigmatism, astigmatism, correction. Good sounds like something you folks would want to ask about if your doctor was saying to you hey your cataracts are coming out you need to get those dealt with this might be the next technology and something that might be helpful to people that want to find out more, they can contact your office for if they want to get that exam taken care of, sure, and they also can of course get taken surgery as well 770-1322 they can give you a call and find out more. I understand also with 250 clubs here meeting all year long, they always are looking for guest speakers I understand you’d be available to speak some of our clubs. Yeah certainly I’d be happy to come out to your club and give you a talk about any eye topic you choose. I am always interested in educating and talking to the residents of this town. Sounds good so if you would like to find out more again you can give Doctor Salib’s office a call and his staff will get you scheduled in between laser surgeries and cataract removal he’ll try and come and speak to your Cleveland organization thanks for joining us today good to have you with us thanks for having me see you back here in a few weeks thanks for joining us today. Doctor George Saleem again topic today laser cataract surgery very interesting new technology. We’ll be coming back with more guests as our Monday program continues for you stay with us.

Well part of good health of course is good vision and our next guest is an expert in keeping everyone’s eyes working well. That’s Doctor Salib from the orange county eye institute welcome back to the show. Thank you thanks for having me. Good to have you with us today, you know pretty much anytime you visit almost any doctor these days one of the things they want to do is wrap this black thing around your arm and squeeze this little bulb and check your blood pressure, right,  and obviously that’s very important to have normal blood pressure but from an ophthalmologist standpoint you’re concerned about if you will high blood pressure, hypertension in the eye? That’s right yes hypertensive eye disease is what we call and basically it’s high blood pressure of the body affecting the eye and most of the time it affects the back of the eye called the retina, which is the inner lining of the eye that allows you to see and you could see on these on the screen that basically on the left is a normal retina which is how it normally would look with the, the, disc which is the white thing and the blood vessels there but in high blood pressure, you’ll start to have hardening of the arteries and thickening much as you would in the body and then you’ll start to get haemorrhages leakages in the in the back of the eye. You can get optic nerve swelling even retinal detachments and with that comes of course loss of vision and it can influence other types of diseases of the eye such as even macular degeneration, where people with high blood pressure tend to have a higher rate of the wet kind of macular degeneration compared to those that don’t. So, it’s quite a devastating disease if you let that blood pressure progress and is uncontrolled in the eye. So, when the doctor is checking that thing on your arm, it actually also can impact your vision because they’re concerned about your cardiovascular system but obviously your eyes are fed by that system as well so, exactly you can see how it relates I guess that the only way to tell if you have high blood pressure is to test for it is the, the, squeezing on your arm thing. Right, right, the blood pressure cuff is very important. So, it’s imperative that you visit your general doctor and see if you have high blood pressure and if you do then you should definitely go to your ophthalmologist to get checked. I have diagnosed a lot of people with high blood pressure even though they’ve never had it before just by looking inside their eye and looking at their retina. In fact, about 30 percent of the people that have high blood pressure don’t even know they have it until they come to the eye to their regular doctor and determine that. So, it’s very important to get regular check-ups to see that. How common is this? It’s extremely common in fact about a quarter of the population in this whole country has high blood pressure about 23 and as you age you have a higher percentage or higher risk of having high blood pressure so that by the time you’re about 60 about half the population has high blood pressure and by the time you’re 75 about three quarters of the population have high blood pressure. The scary thing is that once you know you have high blood pressure only about half the people who have high blood pressure are adequately controlled for it. So, and about 20 to 25 percent of people who have high blood pressure develop eye disease associated with that. So, it’s a huge number of people in this country that have these problems. The I guess the common treatment is they start off with exercise and diet control, salt I think is a big factor of what I’ve heard. Yes, so some of those dietary changes maybe weight loss exercise and then there’s medication I guess if those things aren’t as effective as they want them to be and there’s I guess a range of medications that they can prescribe as well. Right, right, it’s a multi kind of faceted approach to treating hypertension or high blood pressure. So, as you said leading a healthy lifestyle, decreasing your salt intake increasing you know the amounts of fruits and vegetables you eat, increasing the amounts of foods with let’s say calcium magnesium and potassium not smoking losing weight, all those things are very important and then once you have high blood pressure that affects the eyes, then you might need other treatments. For instance, if you have swelling in the back of the eye you might need injections or laser treatments into the eye and in rare cases you might need some surgeries depending on the complications you might have with that high blood pressure. So it’s obviously important that we see our family doctor on a regular basis as well as our ophthalmologist on a regular basis and I guess good communication from us as the patient to our doctor and to you as well would be to say hey by the way last time I was in my blood pressure was elevated and, and, you, you, would probably already have observed that if it’s serious enough you would have seen that in the eye exam. Yeah that’s exactly right we all we have to really work with the patient and work with the other doctors to just ensure that your overall health is good, just because we’re only examining the eyes doesn’t mean we can’t remember the rest of the body. So, if the patient has high blood pressure they should let us know and then I’ll be looking for that and looking for any changes in your eye. I’ll be looking for it anyways and as I said I’ve diagnosed some people with diabetes high blood pressure or other diseases just by looking in your eyes. They’re kind of the portal to the rest of your body what do they say the eyes of the window to the soul but also maybe the windows to the rest of your body for your, for your health concerns as well, yes, well it’s an important subject and again some of the things you need to share with your doctor. I would imagine probably if somebody is taking medication for example for high blood pressure, you probably want to know what medications they’re taking because those some of those could be interacting with some things you want to do with the eye as well. Sure, anytime a patient comes into our office we ask about all of their medications in general some medications have some effects on the eyes and we like to know just their general overall history. So certainly, systemic medications can have effects on the eyes that people might not realize but we definitely look for that. Some doctors I know that we’ve had on have said that there are vitamins you can take that assist in your eye is that something that you sometimes suggest? There are certain vitamins that are helpful especially with people who have moderate macular degeneration. Those that’s the most commonly prescribed reason the reason that we would prescribe a vitamin. It hasn’t really been proven to be helpful in other people for instance mild macular degeneration or just people who have no eye problems, but I always think that once we develop the technology to find out if it does help, we’ll eventually find out that these vitamins do help so I often will prescribe it even for people with mild degeneration. Right again good communication whether it’s your family doctor or your ophthalmologist that’s always very important. Well speaking of good communication, I understand that you’re willing to come and communicate to our over 200 clubs here in the community if they’re looking for a guest speaker you’d be interested in speaking to them at no charge? Yes that’s quite right I’m very happy to come by and speak to your group to just educate anyone about eye disease and be happy to answer any questions you might have, I’m always willing to do that. That’s great well if you want to find out more information we’ve got the doctor’s phone number there on your screen. You can give them a call at 770-1322 the orange county eye institute and as we say Doctor Salib interested in maybe coming to your club or your group and sharing some of this important information with you thanks for joining us today we’ll see you back in a few weeks thank you good to have you on the program today. Doctor George Salib again that’s the orange county eye institute and if you want to find out more give them a call 770-1322 we’ll continue on with more of what’s happening around your busy community.

Well today’s health topic is brought to you by the orange county eye institute and it’s very important that you’ve treat your diabetes but a lot of people probably don’t realize that it also affects your vision and Doctor George Salib is joining us today with the orange county eye institute. Thanks for joining us today. Thanks for having me. There’s a lot of talk about diabetes but I don’t think people realize that it actually affects your vision you know quite a bit. Yeah indeed in fact, a lot of people go by and they have diabetes and then they don’t realize that what’s affecting their vision then all of a sudden, they start to see blurred images and then they figure out well what’s going on. Right, so diabetic eye disease really affects people who have diabetes, right, and diabetes is basically a disease of blood sugar. So, the elevated blood sugars which are caused either by insulin lack of insulin or a resistance to insulin, starts to cause damage to the vessels inside your eye that line the retina and once you get damage to those vessels, they can start to have little out pouching’s little micro aneurysms they call it, haemorrhages. Similar to what we see here on the screen? Exactly you see on the left you’ll see a normal retina, what this is what I’m looking at when I’m looking inside your eye if your eye is dilated. So, you have the, the, nerve surrounded by all these blood vessels on the left and everything looks kind of clean there. On the right you could see that there’s a haemorrhage there so you can get large haemorrhages and bleeding inside the eye as well as even retinal detachments and even certain types of glaucoma and fluid leakage and that’s all as a result of that sugar affecting those blood vessels and making them weak. How can the person tell that diabetes is actually the effect of these things could it you know could it just be a coincidence or is it usually you can tell and narrow it down that diabetes has caused this effect to their vision? Right, well that’s a very good question you have to look at their overall history that’s why when we take a patient into our clinic we will ask them a bunch of questions to see what is their past medical history and if they have high blood pressure for instance or diabetes or kidney disease or high cholesterol, we take all those factors into consideration to look at what might be causing that disease in your eye and there’s certain patterns that are more familiar or more characteristic of certain diseases and we take that into consideration. Now a person with diabetes will have a vision that looks similar to this slide how gradual is that before something like that happens. Well it’s a great question because in fact in the beginning you might not notice anything. You might not notice that your vision is blurry if the blood spots for instance inside your retina are not exactly in the centre of your vision but once it starts to get into you’re the centre part of your vision called the macula and you start to get leakage of fluid there, that’s when you’ll start to get these blurred and distorted images and even blind spots and even blindness if you get a huge haemorrhage or detachment. How common is that for people that suffer from diabetes that they’ll actually have this effect on their vision? You know it’s, diabetes is the leading cause of new blindness in the united states in ages 25 to 74. So, it’s a huge problem. In fact the CDC estimated about 26 million people in this country alone have diabetes and about three times that have pre-diabetes. Worldwide you could see this graph basically  in the beginning like now we have about 177 million people in this country alone in the in the world, 171 million who have diabetes and that’s thought to more than double by the year 2030, Wow, so it’s a huge problem the scary thing is that half of the people that know they have diabetes, they never seek eye care or they don’t get the appropriate eye care and it becomes a huge burden not only for themselves but on society in terms of health care costs. Now this affects people of all ages because we talked just briefly during the break, right, it’s not for 50 plus you know people as you age you kind of go through this process you have children that actually can suffer from this as well. Exactly there’s a couple of types of diabetes type one in type two. So, kids they have a lack of insulin production and so they can get them you know in the early years, you know, five six seven eight years old.  However, and then type two diabetes is usually as a result of a lack of insulin receptors or a downgrading of those receptors so that you don’t have so much response to the insulin and that’s as a result of obesity or lack of leading a healthy lifestyle and that the length of time that you have diabetes affects whether you get diabetic retinopathy. So usually after about 15 years about half of the people will have some changes in their eyes as a result of diabetes. So what kind of treatments do you have available for someone like this that’s suffering from that? Well always the best treatment first is prevention. So, you have to lead a healthy lifestyle as much as you can eat right exercise don’t smoke all those things are important to try to minimize your chances of developing diabetes and the next step once you have diabetes if you get diagnosed with that is to have good access to health care going to your doctor regularly and to make sure that you get treatment for that if necessary. Now what can we do for treatment? You could see on the left there’s an eye that has lots of little white spots. So laser is a very good treatment. So all those little white spots is where the laser actually hits the eye if you have a lot of leakage in your eye. On the right you could see an image of an eye being injected with a medication that actually helps to decrease the amount of leakage by decreasing the amount of blood vessel growth in your eye, that comes as a result of diabetes. So basically, these remedies are trying to get that vessel to kind of constrict and get back to its normal shape and function compared to this haemorrhage that’s now developed in your eye? Right, the idea is to really try to get those blood vessels to not grow and proliferate as much and blood vessels tend to grow when you have a lack of oxygen and if you have blood vessel damage there’s a lack of oxygen which causes that blood vessel growth. So really strict blood sugar control is very important and it’s been shown in a study here in the united states and in the UK that strict control can actually decrease the rate of progression of diabetic changes in your eye by about half. So that haemorrhage is that when we saw that blurred vision slide is that the haemorrhage that’s actually causing that kind of block? It could be the haemorrhage itself blocking it, it, could also be a leakage of fluid into the actual retina and that cause it’s like looking through water, right, if you have that leakage and that’s all as a result of that sugar affecting that blood vessel making it weak. Very interesting. So obviously some very important information that for anybody that’s suffering from diabetes and if you’re not suffering from diabetes I, I, probably would guarantee that you either have a family or friend that has some kind of diabetic condition, right, so it’s important that they see you and you also speak to clubs and organizations as well regarding some of these topics. I do, I’m always available to speak to that. I love educating about these topics I’m always available to give any lectures if necessary about this and other topics, and the most important thing too for someone like this is, is, nutrition like we talked about and your lifestyle right, exactly, yeah nutrition is extremely important remember what goes into our body makes up our bodies. So we really should think twice about what we eat and try to decrease those complex carbohydrates and eat a healthy meal. Right, well if you’d ever like to have the doctor speak at one of your clubs especially even the vision impaired club that we have here in our community give them a call at 770-1322 or visit them on the web that’s the ociinstitute.com and they’ll get you any information you may have and of course very important information especially if you suffer from diabetes. Thanks for joining us this morning. Thanks for having me. That’s Doctor George Salib he’s with the orange county eye institute give them a call at 770-1322 for any more information regarding your vision or if you’d like to have them speak at one year organizations we’ll be back with more the channel 6 NewsHour right after this.

Helping you folks to retain your good vision is the goal of our next guest on the program back with us today Doctor George Salib from the local eye group and he’s with us today to talk a little bit about what’s going on out there some cutting edge no pun intended. Right, way to correct your vision we’re talking about something called LASIK today and I’m assuming those letters stand for something. Exactly LASIK stands for laser-assisted in-situ keratomileusis and it’s just a fancy name for saying that we create a flap of tissue in your cornea, we lift it and we do the laser treatment.  In fact, it’s one of the really the most exciting innovations in ophthalmology in the last you know 15 or so years. What we do for a patient is we have them come to your office to the surgery centre basically have them lie down. We put a few drops in their eyes. We create a flap of tissue in the cornea which is the very front part of the eye. We use a cool laser to shape the cornea in order for you to be able to see and then we replace the flap. I usually ask my patients to go home and relax and close their eyes maybe take a nap and then by the next morning, they have a whole new world in front of them. I’ve actually had LASIK in my own eyes. That was about 10 years ago and I thank god every day for having had it. Waking up in the morning being able to see the alarm clock without putting on glasses not having to worry about glasses and frames and contact lenses and the associated possible risk of infection. I’m so happy that I don’t have to worry about that. Well I might say I’ve had it as well I’ve had a little bit longer I had it almost 16 years ago now and obviously the techniques and technology has improved since then, but yeah that was the first thing that when I woke up in the middle of the night that first night actually early morning the next morning, turned over and could read the digital alarm clock without having to fiddle for glasses. So yeah, it’s, it’s, amazing and it is life-changing for many people as well. Certainly, is it something for everybody, can anybody have LASIK or is it not appropriate for some people? Well that’s a great question the main thing that you have to really take into consideration is you have to come to the office, so that we can do a full evaluation. We offer complimentary consultations for LASIK and what we do when you first come in is we first get a full medical history. We examine your eyes in detail. We take lots of measurements with a bunch of fancy machines to determine if your eyes are good candidates and if you are a good candidate. The first thing you have to be able to the first thing that’s important is you have to be at least 18 years of age preferably 21 because if you’re too young then your vision is still changing and if we do the laser you’ll just have to repeat it later on as your vision changes. Right, your, your, vision correction parameters have to fall within the parameters of the laser machine itself. We have to make sure that your corneas are suitable for it like you don’t have something called keratoconus where your eye is abnormally curvy and a little bit thin and then certain medical conditions preclude you from having LASIK as well. So, we have to look at that your medications that your whole medical history to determine your suitability. I know a lot of people know that their vision is down distance wise they’re having a hard time seeing the signs on the freeway. For a lot of people their distance vision may still be okay and acceptable at least good enough to, to, keep getting that driver’s license renewed every few years, but for a lot of people you know the, the, joke is their arm’s too short you see him doing this in church with a handbook or you see him doing you know with the with the newspaper getting out the magnifying glass, so they can read the newspaper. Right, if somebody has good or at least normal acceptable distance vision but is having that near vision, issue does LASIK work for them as well. Well it depends how old you are. So up until the age of about 40 to 45 if you have had LASIK before then you’ll be able to see well at all distances. Now whether you had LASIK or you didn’t usually by the age of 45 you need some reading glasses, unless you were very nearsighted before then. So, if you get LASIK in your 40s 50s or 60s for instance then what you have to consider is you want to be able to see up close as well to try to get rid of all glasses or do you would you mind wearing reading glasses. If you want to get rid of glasses then what I would suggest is having one eye corrected for distance and the other eye corrected for near. I believe that that that is something that gets done as well with people that have contact lenses and often the doctors don’t tell them that they’ve your left eye is the strong eye or whatever and I understand. You test for which is the stronger eye or which eyes better to be your distance eye and your close-up eye. Exactly that’s called your dominant eye there’s a special test we do to determine that we usually have you try it out with contact lenses first to make sure you like that and that’s called blended or monovision and if you like that then we can certainly do that with LASIK. Is there a I know as a kid I can always remember anytime I got a new pair of glasses because they were very strong I was very nearsighted as a kid, I’d always get a headache for a couple of days. Right, is that normal and LASIK because you’re seeing different now but you’re not wearing glasses does that headache situation become a reality?  Actually, no most people don’t experience a headache at all I had LASIK in my eyes as you know and I and I didn’t experience that at all. Okay, you’re saying that your procedure is all laser.  Which says to me that not everybody is all laser. Tell us the differences? Right there’s two main parts to having LASIK one is the creation of the flap and the other is using the cool laser to shape the cornea so that you can see. The first part which is the creation of a flap is either done with a laser or with a knife basically a blade and that’s called a microkeratome. I used to do it with a microkeratome and that’s how most people started out and now we have a femtosecond laser that can be used to actually create that flap in a very precise and easy way in order to re lift that flap and do the laser so that’s what all laser LASIK is. Let’s talk about success rate. Obviously, you’d like to be able to say its 100 percent all medical procedures have some perhaps small amount that that aren’t successful. How about LASIK how successful is it? You know LASIK is incredibly successful I’d say about 95 to 98 percent of people have great success with it at least nine out of 10 people can see 20 over 20. In fact, I’ve seen some studies up to 98 of people seeing 20 over 20 with this procedure. So, there it’s a very successful procedure and most people are extremely happy with it. What about length of lasting is is it going to change as somebody say somebody gets it done in their, in their 50s or 60s by the time they’re 75 or 80, is it going to have changed will they be back to glasses will they be back to contact lenses or do they need a laser tune-up? Well you know how early you get your LASIK depends on how long it lasts. So, when you get into your 60s 70s or 80s then you have to start worrying about cataracts and then that of course will change your vision and at that point we’ll have to remove the cataracts and we can put in all these new lenses that allow you to even see without glasses. So, at any stage of your life there’s always a good option so if you’ve had LASIK you are not precluded from getting your cataracts dealt with if that’s the case in the future? Oh, not at all I routinely consider cataract surgery and do it on patients who have had it. When you do an eye exam on somebody and you’re say a new patient and they haven’t given you a lot of information about their eye history can you tell if they’ve had LASIK? In most cases yes sometimes the laser scar is so faint it’s hard to tell. So, I usually ask and I’m pretty direct about that. Right and finally obviously like a lot of medical procedures there may be some insurance coverage but maybe not how about paying for this obviously this is a procedure that maybe not all insurance companies are ready for yet? Right some will cover that some don’t most don’t so there’s different ways of paying for it you can either have a sell like a health savings or flex account where you take that money out of your pay check  without interest, I mean without taxes and then you use that for the LASIK or you can use it you can do financing with the company such as care credit which allows you to pay overtime without interest we actually pay the interest by contracting with a company for you so there’s a lot of very good. Affordable options for that, and your staff is good at explaining all those options I’m sure. I’m very proud of my staff. Speaking of explaining if you have a club or organization here in the community and you’re looking for an interesting topic maybe you want to find out more information about LASIK or something else with eye care. Doctor Salib tells me he’s available to speak to your club or organization as well. I’d be happy to. That’s great the office number there on the screen give them a call 770-1322. You can find out more about well taking good care of your eyes but also maybe if you’re looking for a speaker for your club or organization as always thanks for joining us good to have you on the program today see you back here in a few weeks and we’ll see you folks in about two minutes with more news and more guests as our program continues for today.

We welcome you back to the program and we’re welcoming back as well Doctor George Salib, good to have you back on the program. Thanks, good to have you come by today. So, something to hear a lot about and I guess as we age more and more of us or our family and friends have to deal with something called cataracts. I know it’s a something that you’ve studied for years in medical school and now in your practice working on it, but for our people that maybe aren’t up on all the latest medical briefly what is a cataract. A cataract is basically a clouding of the natural lens of your eyes. So, as you age mainly the proteins within the lens kind of like the lens of a camera that allows you to focus the proteins within the lens start to clump together and form a clouding of the lens. So you could actually see on the  on this picture over here that on the left image you can see the eye in a side view with the lens focusing the light very clearly onto the back of the eye which is the red part of the eye called the retina, and so you have a very clear image, right, on the right side of the screen the cataract the cloudy lens scatters the light and doesn’t allow for a clear image and usually by the time we’re in our 70s about half of us will have significant cataracts and by the time we’re in our 80s about 70 to 75 percent of us will have cataracts and they can impact our life greatly by blurring your vision, it makes it difficult to drive at night for instance because of the glare from headlights, even during the day from the sunlight you might have trouble reading or seeing the television or the print on the television, right, so it’s a natural occurrence and you could have good health and healthy eyes otherwise but develop that strictly through the aging process. Yes exactly, but I would imagine there may be some rare cases where maybe something happens and it happens sooner at a younger age I guess you’ve had some cases younger than 75 or so oh yeah sure if you had for instance some trauma in your eye if you have diabetes or if you’ve taken oral steroids such as prednisone for another medical condition certainly you can develop cataracts earlier so you remove the, the, lens the cloudy lens and I guess back in the day in the ancient days that was all they did and they gave you the real thick glasses so you could, could, cope right exactly so we’re taking out the natural lens of the eye which has gotten cloudy and we have to replace it otherwise you won’t have a lens to focus and that’s when you get those big coke bottle glasses nowadays we have really exciting ways of taking out the cataract we have the standard method which is with something called fake emulsification where we break up the lens with this machine and then we suck it out and we put in a new lens inside your eye which is called an intraocular lens or IOL the other option now we have is laser cataract surgery with a laser machine and we’re always staying up on the latest of technologies I’m actually very proud to announce that last Friday I was the first surgeon in the western united states to use the latest software advancement for the latest lens x laser and the cases really went beautifully I know you’ve been using lasers for years for other types of procedures with the eye LASIK and some of those corrective procedures right so is this the same laser or a different diff different type of laser well there’s two types of laser for instance used to do LASIK there’s one that creates the flap and ones that does the correction this is the same type of laser that creates the flap okay so you’re using similar technology that you’re somewhat familiar with already with this new procedure yes I guess the lens you replace it with I think people that have worn contact lenses it’s is it a soft material is it a hard material what’s the actual replacement lens made of it’s usually a soft material made with a plastic called acrylic or it could be made with silicone it’s very small and it fits right into the eye not on the surface of the eye but inside so it goes behind where that lens where that cloudy lens was removed you replace it with a new type of lens and I guess again they went from the coke bottle glasses to a for those of you in photography a fixed lens a specific millimetres of lens and usually that was for normal vision and then you’d correct with glasses for reading and distance and all of that right well there’s several types of lenses there’s the standard monotonal lens which is actually shown here has a nice clear  central portion through which you see but you’ll need glasses to see the different distances because it only focuses at one distance there’s got some new technology now that’s focusable exactly there are many new technologies now  there’s one lens that here for instance called the torque lens which has some hash marks that allows us to dial it in exactly to correct for something called astigmatism now astigmatism the easy way to understand that is if you look at your image inside a spoon your face will be distorted that’s what astigmatism is if it’s not perfectly round it distorts it a little bit so this torque lens allows us to fix that problem and then there’s other lenses such as the multifocal lenses let’s like the restore lens or the teknis multifocal which have these little concentric rings in the centre of the of the lens which allows us to focus at different distances allowing us to see far intermediate and near those of us that are used to doing  tv lighting or stage lighting maybe with a Fresnel lens this looks similar to that with the rings yeah it’s a very similar concept right and it allows us to split light at different levels to allow us to see different distances and there’s also another lens called the crystal lens which is similar to that and it has hinges which allows that single optic to move back and forth also allowing us for a broader range of vision if somebody has been using glasses for years or contact lenses in a substitute for glasses they develop cataracts you say well the bad news is you have cataracts I have to take them out the good news is I can replace it with a lens that allows you to focus is there some training has our eye gotten lazy wearing contact lenses or glasses  well it depends if you for instance have the crystal lens your eye and depending on how old you are you might have to go through an adjustment period to be able to focus that lens back and forth the other one with the rings you don’t need that because it naturally splits the light with those rings so how do you make a decision to which one to recommend it looks like you’ve got four or five here that you like to use right how do you make that recommendation to the patient well that’s the thing you know I don’t want the patient to think you know that you’re the only one that has to research this and figure out which lens is best for you we take you throughout the whole process we examine your eye I determine what is the best lens for your eye depending on the anatomy of your eye and what you like to do and what your goals are after surgery well the good news is that you can do a lot of great things with the other side of that is obviously anything medical is going to cost some dollars let’s talk about the insurance aspect either private insurance Medicare or Medicare supplement is cataract surgery covered cataract surgery yes is covered by insurance as long as you have trouble seeing if you’re not having trouble seeing but you still wanted to take advantage of the lens then it might not cover it but for all people who have trouble seeing yes it would now the lenses themselves  the standard lens is covered the other lenses you might have to pay a little bit extra to get that extra technology and you’ll just pay the difference there I understand  that we all like to hang on to our money and not dump it all at once you have something called care credit which helps people maybe kind of finance that process if they need to yeah exactly you can take between a year and a year and a half to pay off these lenses without interest and it makes it much more affordable to get that best lens inside your eye all right sounds like some unique technology if you want to find out more if this is appropriate for you give their office a call 770-1322 and by the way if you are the program director for a club or organization I understand you’re available to come give them a free lecture and deal with some of these topics or anything that might be of interest as far as I care yeah I’d be happy to go over these topics in much more detail at your clubs all right again if you want to find out more give the doctor’s office a call 770-1322 Doctor Salib, thank you for coming by interesting topic thanks for having me good to have you on the show today we’ll be coming back with more as our Monday program continues here on channel 6 tv

I couldn’t see very good at all through my right eye it was very cloudy Smokey-like and I didn’t know where I was going to find a good doctor my eye was just fantastic this is one fabulous doctor I could never say enough about him truly I’d like to welcome Laguna woods to my office we help our patients maximize their vision and live their lives to the fullest the orange county eye institute is a comprehensive eye care centre see well live well, well, our medical topic today is brought to you by the orange county eye institute and today our topic is going to be glaucoma and Doctor George Salib is joining us today with the orange county eyes centre thanks for joining us today thanks for having me your topic today glaucoma that’s a very popular topic in our community and especially for the aging population what is glaucoma really well glaucoma is an eye disease where the pressure of the eye not the pressure of the body affects the nerve of the eye that allows us to see and that nerve gets damaged and therefore you have a loss of your side vision or your peripheral vision there’s actually a picture of the eye over here on the right and towards the right of the eye that’s the front of the eye and the back of the eyes depicted on the left and that tube on the back that yellowish part is the nerve of the eye and that is the part that gets damaged in glaucoma and that’s the nerve that connects our eye to the brain now when you say it was damaged is that just from age is it the elasticity that’s kind of just wearing on it or is it physical damage it’s physical damage from the pressure of the eye and affecting the nerve and that causes the loss of the side vision or your peripheral vision now is when people are viewing when they have this condition it’s somewhat like of a foggy looking through a tunnel kind of scenario yes exactly we call it tunnel vision and what happens is because you’re losing your side vision it kind of closes in on you until finally you have just a central portion where you’re looking through and it looks like you’re looking through a tunnel so you’re losing a lot of that side vision so for instance if you’re trying to make a lane change when you’re driving it’s dangerous that was first thing I was thinking of so when people have glaucoma and they go to get their drivers test right they probably can read the chart pretty well if they’re focusing on it but they won’t be able to see the peripheral which is so important when it comes to driving exactly in fact people who have moderate to severe loss of their vision have a four times higher rate of having a car accident because of glaucoma. Right so they actually ask us to test visual field testing in a lot of patients for the driving test. How common is glaucoma then? It’s actually quite common it’s one of the leading causes of blindness in the united states and in the world about 2 million people over the age of 50 have glaucoma and by the in the next 10 years, it’s estimated that another million or so people will be added to that. The funny thing is or the strange thing is, is, that about half the people who have glaucoma haven’t even been diagnosed with it. Wow either because they haven’t come in for an eye appointment or they just don’t know, right, so they’re these people are probably just slowly or maybe they don’t even realize it that they’re slowly losing their peripheral and eventually it leads to blindness? Exactly and that’s, that’s, the scary thing about glaucoma. Most people don’t know there they’re getting or developing glaucoma. In fact, you can lose half of the tissue in your nerve before you start to have any noticeable change in your visual field. You can see on the screen there’s a normal nerve on the left and then there’s a glaucomatous nerve on the right. The normal one has a healthy kind of tissue that’s that circle in there that pink circle with a white circle in the middle and that pink area is nice and thick and that’s for a normal nerve whereas on the right you could see there’s some thinning here which is the nerve damage that you see in glaucoma. And it looks like the blood flow isn’t nearly as good either obviously in the glaucoma eye? Well that’s quite possible because it’s been shown to for instance be associated with conditions such as diabetes or high blood pressure although those haven’t been shown to actually cause glaucoma, they are more commonly associated with it. So, blood flow is one of the possible causes of glaucoma although they’re looking into all the different causes, no one really knows what causes glaucoma. Does it affect a certain gender or race more so than others? Well it’s thought to affect women more commonly and also in terms of races it’s been found to affect African Americans and those of Hispanic descent more commonly and also those of Asian descent tend to have a certain type of glaucoma called narrow angle glaucoma but it affects everyone from kids to adults. So what kind of treatments are available for glaucoma? There’s lots of different ways that you can treat glaucoma for instance, we usually like to start off with some medications such as eye drops that either lower the pressure by decreasing the production of fluid or decreasing or increasing the amount of fluid that gets out of the eye. You can see here this is the basic structure of the eye the front of the eyes over here the cornea but fluid is produced on the left side here comes towards the front and through these arrows they you can see how they get out of the eye. So medications can be used to lower the pressure by decreasing the outflow by decreasing the inflow of the fluid that is made in the eye or increasing outflow out of the eye. Other treatments include laser treatments such as SLT or alt. SLT stands for selective laser trabeculoplasty and that’s a very effective method and that helps us to lower the pressure by attacking the area of the eye called the trabecular meshwork which is the area that lets the fluid out. Wow, now this example is what we were talking about where somebody that would be suffering from glaucoma that’s how they would see possibly their grandchildren. Yeah exactly and you can see here these are what we call visual field tests. On the upper left the circle represents what we’re able to see. The more white the better so the darker spots are where we’re starting to lose vision and then over here you’re losing more vision and down on the far left on the bottom there you could see how that’s where your tunnel vision comes out and that’s what you end up seeing. The kids their face is fine but everything else is dark. Now in the old days when you were treated with glaucoma at least like knowing some of the residents and volunteers we have they talked about sandbags and peas and the post-op was you know somewhat painful and took a long time with technology nowadays, I understand it’s pretty much it’s a lot easier than it used to be let’s just say it that way. Well certainly technology is always advancing and now with our treatments such as eye drops which are quite effective and they’re coming out with more and more drops that work, laser is quite effective in fact with that SLT lasers talking about, about, 87 percent of patients can minimize their use of drops just after having had that done. Other surgeries such as what we call trabeculectomies or other shunt type procedures, increase the fluid physically out of the eye by producing a channel that gets out of the eye and most of that is outpatient. Right, now you also are available to speak to clubs and organizations too because obviously this is a this is a topic we could go on for many hours, certainly, you do you speak at certain clubs as well? Yeah, I’d be happy to a lot of patients a lot of people have questions about eye diseases that we can’t cover in just a few minutes and so I’d be happy to go out and talk to places at no charge. I’m, I’m, happy to do that I like to get out in the community. I know we have a visually impaired club and they’re very involved in this community so that would be somebody obviously you, you, could speak to. Yeah that would be great. Tell us a little bit about your background you know what, what, did you do for school and you live in the area I know that? Yeah, I live in the area I went to UCLA undergraduate medical undergraduate. I went to my medical school at the university of Wisconsin medical school. I, I, had a master’s degree at Georgetown and I did my training here at the county, county, hospital where I had a lot of experience through a UCLA affiliated program and then I went on to do a fellowship in cornea at Tulane university and then I’ve been out in the area. I was working in the valley at a, a, huge clinic for about eight years and then I came down here for the last year or so. Oh, great sounds you’ve had a a an interesting you know travel to come to orange county? Yes, well I California is my home, yeah its beautiful, and it’s always been so I’m glad to be back yeah I love it and speaking of California we have such beautiful weather here the sun people don’t realize what the damages the sun can cause to our eyes. You and I have brown eyes people with fair eyes everybody needs to take care of their eyes especially when the sun and then we have springtime in the summer coming. So wearing a baseball hat those kind of things are still common sense things to do right? Exactly for the eyes as well as the skin right wearing sunglasses with uv protection is always very helpful as well. Very good well we thank you for joining us today on our program this is a story this is the, the, topic of glaucoma obviously it affects millions of people throughout the world and people in our community. The orange county eye institute give them a call at 770-1322 for all your eye care needs. Located real close to us or go to ociinstitute.com they’re on the internet as well so be sure and check out those two things. Thanks for joining us on the program. Thanks for having me. We appreciate that we’ll be back with more of the channel six news for this. Doctor Salib did the lens replacement in my right eye since seeing Doctor Salib and having this procedure I can now see my children’s faces my grandchildren’s faces and the clothes they’re wearing much more clearly. I wasn’t sure what to expect but I see perfectly now. We help our patients maximize their vision and live their lives to the fullest. The orange county eye institute is a comprehensive eye care centre. We are specialists in cataract surgery laser vision correction dry eyes glaucoma and multifocal lens implants see well live well.

I couldn’t see very good at all through my right eye it was very cloudy, Smokey-like and I didn’t know where I was going to find a good doctor. My eye was just fantastic. This is one fabulous doctor I could never say enough about it truly. I’d like to welcome Laguna woods to my office we help our patients maximize their vision and live their lives to the fullest. The orange county eye institute is a comprehensive eye care centre see well live well. Welcome back as we continue on with our program for today and Doctor Salib back with us today to talk a bit about our eyes and specifically something that seems to impact us maybe more so here in California and other places and that’s dry eye disease.  We all know what it feels like when our eyes are itchy and scratchy but is there a medical definition of dry eye as a disease? Sure dry disease is basically a disorder of the tear film that coats our eyes that is usually inadequate and that leads to drawing of the eyes as well as ocular surface damage or damage to the front of the eye. The tear film is very important for many hosts of functions including lubrication of the eyes obviously and that will help to improve the clarity of your vision and the sharpness of your vision but also to protect the eyes from any things that might get in the eyes like dust or dirt or even pollens and it also helps prevent scratches of the eyes if your eyes are nice and lubricated if something were to go inside your eye, it would better resist any types of scratches. Okay, you know classically like I say we sometimes just know our eyes are itchy and they feel bad but is there a medical definition of symptoms that actually allow you to say yes you have dry eye disease? Well the thing about drying disease is that there are a whole host of symptoms for instance people will complain that their eyes just feel tired or they might feel dry or they might burn a lot. One common symptom that people don’t even think to relate to dry eyes is watering eyes if an eye waters it means that the eye is dry because the eye gets irritated and will reflexively water to actually lubricate itself to prevent any further drying. So that’s actually a symptom that your eye is trying to compensate? Right, for the dryness out there. Yeah, exactly. How common is, is, dry eye disease. It’s actually very common in fact about 40 to 50 percent of all visits to the eye care doctor include symptoms for dry eye disease. One study in 2005 a Gallup poll suggested that almost 93 million people in this country alone suffer from dry eye disease, so it’s very common actually. Is there any demographics men versus women older versus younger ethnic situations or where people live are these factors at all? Certainly, all of those things can have an impact on whether you have dry eye disease or not. For instance, the older you are of course your glands don’t produce the tears quite as well things get blocked in terms of the oil production for your eyes to lubricate it. So, age does have a factor. Hormones have a factor including menopause. If you lose some of the hormones or have a decrease of some of those hormones’ certain aspects of the tear film won’t be produced environmental factors like the Santa Ana winds can often cause drawing of the eyes and even certain medications can do it, certain blood pressure medications antihistamines for allergies can do it. A whole host of different things can, can, do it even sometimes where we live the arid environment that we live in can impact whether we have dry eye disease or not. But I guess the factors being what they are you could have it in Minnesota or the great lakes? Yeah you sure can yes in fact most people do have dry eye disease wherever they live, you know because the medications they take their age some autoimmune diseases such as Sjogren’s disease which is a disease of dry eyes and dry mouth and arthritis can cause that like rheumatoid arthritis and other things like lupus or thyroid disease. So, we have all of those problems all over the country and certain medications we take. Right, right, so let’s talk about the treatment I mean we’ve you know there’s lots of things over the counter if you go into any pharmacy there’s a whole area of eye care products we’re seeing them advertised on television and they say, use this one no use this one it gets the red out it does this it does that some are prescriptions some are over the counter. What’s, what’s, the treatment somebody comes in to see you what do you recommend? Right well I usually first try to figure out what is causing the dry eye disease, if it’s an eyelid problem or if it’s an actual just drying problem or production problem. The most common treatment is lubricating the eye with some artificial tears and then for instance if the eyelids are a problem, if they’re not producing enough oils to lubricate the eyes, I’ll have them do some warm compresses of the eyelids, a prescription medication such as Restasis is also very effective in increasing the production of your tears. Omega-3 fatty acids such as the fish oils flaxseed oil can also be quite helpful or some just things that you can change around the house such as putting a humidifier in your room or wearing sunglasses when you’re outside or eyeglasses can block the wind and decrease sun damage, so. What about pets do sometimes people I know there’s allergies to pets can that lead to dry eye? Well certainly the more exposure to pollens and, and, dander that you might have from these animals or plants can cause allergies which will cause you to take some antihistamines which can cause quite a drying effect. So again, the medications can grow. Right so it sounds like good, good, common sense is one of the best preventatives you know a good diet you mentioned the omega-3 most doctors recommend that for those of us over 50. It helps with heart health and some of those things it also helps with eye health you said, right, and of course I guess is drinking enough water do people become dehydrated is that could that lead to it as well? Oh sure yes if you’re not drinking adequately you’re the amount of fluids you should per day and if the medications you’re taking are causing you for instance to lose water, then you certainly can become dry because of that yes it affects the whole body right and we’re coming up on the spring time of the year moving into the summer, spring all these nice new plants are growing up and all these flowers. So we’ll be having that assault from plant input and the warmer weather and the heat and you mentioned sunglasses. I know you recommend that for lots of good reasons for our eye health. Sure, but that’s very important as well. Oh of course yes sunglasses are important to prevent the sun damage sometimes you can get growths on your eye that will further cause a drying of the eyes, just because of the sun so that will definitely help you. When someone comes in for a regular eye exam. I’m assuming that’s one of the things you look for or ask about but you can probably almost tell by looking in the eye if dry eye is a problem as well. Oh, sure at the microscope when we, we, put a special dye in your eyes to see if they’re little sunspots actually that I can see on the corneas themselves. It’s kind of like having a dirty windshield or a splotchy windshield. So I’ll be able to see that I’ll be able to see how thick your tear film is and be able to advise you based on that. You mentioned something like Rostasis which is a prescription product what about the over-the-counter eye drops? Sure, there’s a lot of good lubricant drops out there the ones that I like say that they get the dry out of the eyes. Not the ones that say gets the red out of the eyes those red reliever drops tend to be quite irritating to the eyes after a lot of use. There’re many different products out there. refresh, optive, sustain, I like all of them they’re all pretty good you don’t have to get the brand name necessarily but as long as it’s just a lubricant and not gets the red out, I like that. Is there ever a risk of using too much of those products? Well if you get the ones in a bottle they have preservatives so I would suggest using them about four times or less per day. Usually I suggest two to four times a day. If you feel that you need it more often you should switch to something that’s preservative free which they have those products over the counter as well. So that the preservatives themselves don’t start to irritate your eyes. So that’s the one you have to put in the refrigerator? Not necessarily actually usually they’re coming little vials that you can break off that within 24 hours of use you can usually use them and then toss them. The preservatives keep them in the bottles and you can keep those all with outside of the fridge. Right, well whatever your eye situation might be Doctor Salib is there to take a look at your eyes and help you with your vision where would we find your office? Oh it’s at the saddleback memorial medical tower and the Laguna woods bus does drop off there all right on the third floor orange county eye institute and Doctor George Salib our guest today again dry eye something I guess we all have from time to time living here in the desert of southern California, that’s right, good prevention and some good cures on the way as well thanks for joining us thank you good day on the program today. We’ll continue on with more of what’s going on here in the village right after this. Doctor Salib did the lens replacement in my right eye. Since seeing Doctor Salib and having this procedure I can now see my children’s faces my grandchildren’s faces and the clothes they’re wearing much more clearly I wasn’t sure what to expect but I see perfectly now we help our patients maximize their vision and live their lives to the fullest. The orange county eye institute is a comprehensive eye care centre we are specialists in cataract surgery laser vision correction dry eyes glaucoma and multifocal lens implants see well live well.

We welcome you back to our program as we continue on today some good health information coming our way Doctor George Salib back with us welcome back to the show. Thank you good to have you with us today. You know obviously good vision very important as an ophthalmologist that’s what you do is help everybody to see well and see better but there’s a condition I know a lot of people have concerns about and as we age, I guess we should be more concerned about it and that’s something called cataracts. Can you give us kind of a maybe a not quite so medical definition of what cataracts really are? Right well cataracts are nothing dangerous it’s nothing urgent it’s basically the lens of the eye much like the lens of a camera that’s gotten a little cloudy with time and so it scatters light and makes vision blurry. Basically, the proteins in the eye clump together and then you have some condensing of the proteins in the lens which makes it harder to see through. Okay, so it’s something that people have that occurs. Who gets cataracts is it are we all eventually going to get them? Well basically it’s a natural process as long as you live long enough we’re going to have cataracts. Usually by the age of like in your 70s about 50 percent of people have cataracts by your 80s about 70 to 80 percent of people have cataracts, so that’s the most common reason birthdays there are other reasons for cataracts of course there’s congenital cataracts ones where babies are born with cataracts trauma any kind of trauma diabetes is a common cause of cataracts both smoking and uv light have been shown to increase the rates of cataract formation, as well as the lack of certain antioxidants like vitamin c and vitamin e. Previous inflammations can cause cataracts there’s lots of different reasons people do get cataracts but the most common reason is basically age. Okay obviously if we’re seeing our ophthalmologist on a fairly regular basis every year every other year on a regular check-up basis, you’re going to look that’s one of the things you test for eye guess but would there be symptoms that somebody might experience they might you know they might feel discomfort or whatever how would they know they’re having it? They won’t feel any discomfort from a cataract but they’ll notice they won’t be able to do some of the things they like to do on a normal basis. For instance if you play golf or you play tennis you might not be able to see the ball quite as well, makes it hard to play yes if you’re reading you might not be able to see the fine print driving especially at night time is a huge problem for people one because they say it is a little darker and two because of the light from the headlights tend to be especially those newer ones tend to be quite irritating and cause a lot of glare other things such as sewing or threading a needle might be more difficult and in general seeing people’s faces seeing street signs things just become a little harder to see. So it sounds like in most cases it’s gradual although you say trauma and other things can cause it to accelerate, sure, but it’s something that we probably won’t notice we just sort of accommodate to it and spend more time or a lot more time or whatever or just accommodate these things but eventually it’s going to get to the point where it really is I guess going to require some attention. That’s when you say here’s what I can do for you and what can you do for us. Well it’s not urgent. It’s not a matter that you have to take care of one the first option is you can observe it. You can take care of you through eye exams the other thing is you can change glasses but that’s actually one of the signs that you might have a cataract is frequent changes of glasses without any benefit because it’s like you’re looking through a dirty windshield even if you change the glasses the windshield you have to clean in order to see but then surgery is an option as well. If you need to have clear vision then you need to take out that cloudy cataract that is causing vision to be blurred and put in a new clear lens so. That sounds like kind of an interesting procedure you’re actually going to extract something from the eye, how is that done obviously the person is going to be hopefully knocked out to some extent for that? Right, you start poking around in our eyes it’s like pretty much people get uncomfortable with that. Sure well the good thing is it’s quite a a non-invasive type procedure in terms of we don’t have to put your whole body to sleep it’s not general anaesthesia. We tend to put you under just topical drops meaning just drops to numb up your eyes much like we do in the clinic. They do give you an iv to make you very happy and very sleepy if you need to be and then we just basically go through a very small incisions less than three millimetres, take out the cataract and we put a new lens inside your eye to replace that cloudy lens that you used to have. We’ve got a visual here on the screen and this maybe shows kind of a extreme perhaps example of what people might be might be experiencing. The picture on the left the normal vision and the eye below it showing the normal reactions there and then the upper right there we see the blurriness and below they see what’s actually going on inside the eye and you mentioned that glare issue from headlights especially we’re seeing, sure, some of the responses and some of the results of all of that. Right this is what you have with on the left is the clear vision on the right you have the cataract causing scattering of the light and therefore you don’t get as much light going to the central point in the back of the eye that gives the clear image and that’s why you have that cloudy image. All right so you’ve extracted the, the, cloudy part the natural lens, you’re going to replace it with something. I understand that there’s lots of somethings these days it used to be just one something. Right well this is a actually a very exciting time to have cataract surgery simply because of all the options we have available to us. We have still the basic standard lens which is a great lens that insurance usually covers and that allows you to see one distance basically, either far, or near. Some people will combine one far and one eye near and that gives you what we call monovision, but there are other options as well for instance there’s the restore lens which is a great lens it’s called a multi-focal lens and it allows you to see different distances far intermediate and near, of course they each have their advantages and disadvantages. For instance, the restore lens oh this is a picture of a cataract by the way. Okay that’s the pre-that’s pre-surgery yeah pre-surgery right, but the restore lens for instance might give you a few halos at night in the beginning and you need a little bit of light to be able to see up close. The there’s a crystal lens as well which is another type of lens which allows you to see great distance vision and intermediate vision near is pretty good but you still need a little help with glasses to see the finer things. You mentioned insurance coverage, these two that you mentioned  the, the, focusable lenses normally aren’t covered by insurance so the patient would have to pay the difference perhaps right. That’s correct yes the insurance covers the normal portion of the surgery, the normal allotment that you would get for the normal lens but then because the insurance doesn’t cover that extra benefit of the lens that allows you to see different distances, then you it allows you to pay extra in order to get that lens. Right and again my understanding is unlike most procedures or you want to get everything out of the way at once you do one eye at a time correct? That’s right and we do it mainly for safety reasons. They are doing some both eyes surgeries in I think Europe as kind of a an experimental type thing but we prefer to do one eye at a time. It’s safer in case anything should happen like an infection for instance. All right so people are getting regular eye exams obviously they’re going to be you’re going to be looking for that and that’s one of those things where you’re, you’re, you’re, peering in our eye with this with the big light is that is that part of that test? Yeah exactly what we do is we normally will dilate your eyes take a look at the lens of the eye and you can see here a picture of another cataract where it starts to look cloudy and so that’s what I’m seeing with the dilated eye. I see the lens material and then I look inside your eye at the retina and at your nerve in your eye to make sure that everything else is okay. It’s okay to have cataract surgery even if you have macular degeneration for instance. We just have to modify our lens choices to give you the best vision. All right and I understand you’re using lasers more these days as well. Yes that’s really an exciting thing is that nowadays I’m one of the first few surgeons to be offering what we call laser cataract surgery where we use the laser to actually do some of the incisions and break up some of the cataract and correct some astigmatism which really improves the  precision of the whole procedure. Sort of a combination of the LASIK procedure with cataract removal yeah exactly interesting, interesting. Doctor Salib, thank you so much appreciate you sharing with us again none of us want to get cataracts but when that happens  obviously you need to get some good care to get that taken care of and you can give doctor Salad’s office a call if you want to find out more about this or schedule for an appointment 770-1322 right here in the local area thanks for coming in thanks for having me and we’ll be seeing you folks in just a few seconds with more local news right after this. I couldn’t see very good at all through my right eye it was very cloudy Smokey-like and I didn’t know where I was going to find a good doctor. My eye was just fantastic this is one fabulous doctor I could never say enough about it truly I’d like to welcome Laguna woods to my office we help our patients maximize their vision and live their lives to the fullest the orange county eye institute is a comprehensive eye care centre see well live well.

I couldn’t see very good at all through my right eye was very cloudy, smoky, like and I didn’t know where I was going to find a good doctor. My I was just fantastic. This is one fabulous doctor. I could never say enough about him, truly. I’d like to welcome Laguna Woods to my office. We help our patients maximise their vision and live their lives to the fullest. The Orange County Eye Institute is a comprehensive eye care centre. See well live well. Welcome back to our programme you know, one of the areas of health that we’re all very concerned about from a variety of reasons is our eyesight keeping our eyes healthy and well and our next guest is an expert in that field. Doctor George Salib joins us today Doctor, welcome to the programme. Thank you, thanks for having me. Good to have you with us today. So, a little bit about your background. Where did you grow up? How did you get interested in in medicine and Ophthalmology? Right, well actually I I grew up mainly in Southern California. I, I, was actually born in Canada, in Montreal, Canada, Canada. So, I’m a Canadian, but I grew up mainly in Encino and in the South Bay area in the Palace Verdes area and I have been. In medicine have been in my life almost all my life my, my, dad is a, an, associate professor of psychiatry at Harbour, UCLA and so I was always kind of interested in medicine and I’m a local UCLA graduate, so I’m very happy about that and after that I. I went on to do a Master’s degree at Georgetown University and Physiology and Biophysics, Right, and went to medical school at the University of Wisconsin in Madison where I studied medicine and, and, then I went on to do my training in ophthalmology and a general surgery. I did a, a, year of general surgery at Hahnemann University at Medical College of Pennsylvania in Philadelphia and then I came out here to Los Angeles where I did my ophthalmology training at a very big trauma centre here associated with UCLA, called the King Drew Medical Centre, oh yeah and that afforded me a really great opportunity to do hands on surgery and, and, lots of medical checks ups and then I went on to do a fellowship at Tulane University in New Orleans, where I specialised in complex surgical treatments of the eye, including corneal and refractive surgery. Not only have you had a very interesting medical education, but you’ve had a chance to travel extensively from Canada to Louisiana, East Coast West Coast. So you’ve had a, a, good look across the country. I would imagine because of the differences in weather the differences in lifestyle I conditions and eye problems might be somewhat different in different parts of the country? Sure, yes of course. For instance, in Louisiana it tended to be a little more humid, so we would see things like actually, fungal infections sometimes of the eye, whereas out here in California tends to be a little more dry and I’ll see a lot more dry eye disease and depending on where you go, for instance, in the rural parts of the country, like in Wisconsin for instance, there were some rural clinics we had to go to, People would leave their I used to get like their cataracts, for instance to get very advanced before they came in for surgery. So yes, it does vary. Yeah, I would imagine very interesting, but you’re back here in California now dealing with the, the, eye conditions here locally. You mentioned dry eye, and I know you’ve written extensively about that and also done quite a bit of I guess testing as well for some of the various products and we were talking before the programme. We see a lot of these things advertised on television things to make our eyes less, dry things take the red out of   our eye and some of these things are available over the counter. Some of these things are actually prescription items. You were saying that some people maybe can benefit from some of these things. It’s not just advertising this basically. Oh yeah, sure, and I I generally only talk about things I have done extensive research on and believing in fact I will use one of those products myself orstasis, which I’m sure a lot of people have seen advertisements on, but it makes a big difference. I’ve had LASIK in my own eyes and so my eyes tend to be a little more dry than, than, others and so I and I had dry ice actually before I had this surgery, so I use that product and I really think it’s a very beneficial product. Right, you mentioned cataracts and I guess that’s something if we, if we all live long enough I guess well, I’ll have to deal with that eventually, right, Just part of the ageing process. I’ve heard in some cases it could be. Even in some young children with unusual situations up to people, maybe in there, maybe in their mid-80s before they get far, they have to deal with it so it doesn’t really depend on age. It’s more of a physiological situation I guess. That’s right, age is the most common reason that people get cataracts. So if we have enough birthdays, we’re going to get. Cataracts, but definitely there are other conditions that can cause cataract. Some kids are born with cataracts and you have to operate on them even within a couple of days of birth. Some people develop cataracts earlier from diabetes and other people can develop cataracts if they’ve had a previous trauma to their eye. So, there’s lots of different reasons people can get cataracts, but the most common reason birthdays. Right, so I, I, guess what this all says is that really what we need to do is get in for regular eye exams and I guess they say that about every 20 years our eyes go through some changes, so when we hit 20, 21 getting out of college maybe and again maybe 40 kind of midcareer and then maybe again at 60. Is there another change at 80? Do we see another 20-year change in that at that length of time? Well, I would say you know around the age of 60 people tend to start to get cataracts, usually around 80 is when people start to notice a significant decrease in their vision, right, Some people notice that decrease in their 60s, but I would say that most of the people around here, since they generally take good care of their health, they tend to have decreased vision around the age of 80 for cataracts and then we have to also worry about other things like macular degeneration, so and dry eyes, of course, is a huge problem. Yeah, yeah. Yeah, I know you’ve got an extensive background and you mentioned some of the work you’ve done previously. You’ve done a lot of cataract surgery. Not that’s especially necessarily because, as an ophthalmologist, you really treat you mentioned, you know fungal infections, to dry eye to laser surgery. All these various things are all part of the ophthalmologist bag of tools I guess these days. Right, Right, yeah, definitely a cataract surgery is are is my biggest forte in when I was in Los Angeles before I came out here. I was one of the top cataract surgeons in that city in terms of the numbers and in terms of the quality but definitely we, we treat all sorts of diseases. I look at glaucoma. I have one of the biggest records of glaucoma treatment, especially in in Los Angeles. That was one of the top prescriber’s dry eye disease of course macular degeneration. We do, I’m a corneal train specialist so I can do Cornell transplants, LASIK so there’s a variety of diseases we look at and also a lot of conditions we look at. Right, you took over Doctor McCarthy practice and are now enjoying working with our folks here in Laguna Woods Village. I would imagine with all the different places that you’ve studied and practised, again, you’ve had a wide variety of experiences of affluent communities not so affluent communities in the South, the West up and you know, I don’t know if did he work in Canada or not, but she’s really lived up there for a bit. So you’ve been all over and seeing a variety of things. You mentioned the people here take good care of their eyes. Give us some tips. You know we all hear about sunglasses. Should we all wear sunglasses in California? Yes, I I would definitely suggest that. The sun can have many different effects on the eyes. It can affect cataracts, it can affect macular degeneration. It can also cause little sunspots to come on your eyes, so wearing sunglasses would be helpful. If you do have uncomfortable eyes or irritated eyes, you might come in for an eye exam so I can see what is the problem. A lot of the time it’s just a simple problem like dry eye disease or something where the eyelids can get a little irritated and and of course drinking plenty of water and fluids is helpful in maintaining good eye health because of the dryness. Sometimes Omega threes can help, so there’s a lot of different things you can do. Good, but generally check-ups are important. Where is your office located? If people want to come By and see you? Yeah, at the Saddleback Memorial Medical tower that tower just attached to the hospital. So, we’re on the third floor and 3, 40. And I understand if clubs or organisations looking for interesting speaker you would. You’d come and share with them. Oh yeah, I’d be happy to. I’m, I’m, really excited about being here and if anyone wants us wants me to come by and just give a little talk about eye disease or cataracts or anything, I’d be happy to. Great, we thank you for joining us. Good to have you on the programme today if you want to contact the doctor there’s this number on the screen 7701322 and again nearby offices and he can give you a good eye exam and also maybe come and speak to your club or organisation. Thanks for joining us. Good to have you on the programme. Thanks, thanks a lot. I appreciate you being with us today and we’ll be coming back with more. More things to share with you As we continue on channel 6 for this Monday. My vision was getting increasingly poor. I had to use a magnifying glass on more things to read. I came to doctor Salib and Doctor Salib said that I did had cataracts, which wasn’t a surprise after the surgery. I was astonished at how much better I could see. It was like brand new vision. We help our patients maximise their vision and live their lives to the fullest. We are located in the Saddleback Memorial medical towers. See well live well. 

Well, obviously it was not as good as I’d like for it to be cataracts or progressive, and it was to the point where I was getting Halos at night, around street signs and not being able to read them as clearly as quickly as I would like. I think when you start to have a surgical procedure, there’s always a lot of anxiety and concern, especially if it’s your first one. Could not have been more pleased with the way that all of my questions were answered, what I could expect was explained to me in detail, and I got no surprises following the surgery. Amazingly well, in fact, on the 1st I I was chatting with the anaesthesiologist and thought it was probably time to go into the procedure, asked the nurse and she said Mr. Brown, you’ve been in and out and it’s all completed and I was not even aware we had been in. It did not go back to the office in the afternoon, but think I probably could have but to absolutely no discomfort, no problems whatsoever. Very, very professional. It’s, I think you tend to judge a lot of the experience by how the support personnel do, and I had all of my questions answered well. The appointments were handled properly. The wait time was minimal. I have absolutely nothing that didn’t please me completely. Well the, the, vision improvement is incredible. You know before as I mentioned, I really had a difficult time reading freeway science, especially at night in strange cities. That is completely gone. I now see 20/20 in each eye at distance, have to wear glasses to read small print closeup and but that was explained and to be expected so I could not be happier with the outcome. First of all, this is absolutely the right place to come. Secondly, I don’t do his idea to procrastinate and put it off, thinking that it’s going to be more complicated. It was a revolutionary change in vision. I wish I had done it six months earlier. When it became obvious in my own mind that I needed to have this done. I was obviously very concerned about who to go, I visited with a lot of doctors I I’m on a hospital board of directors and so I’m very careful about who I picked for medical services. Was very impressed with Doctor Salib in my original telephone conversation with him, became even more impressed as the examination period went through and we discussed the surgery and completely became a fan following the surgery, saw how well it went and what my vision is like now following his efforts, I cannot be more supported. 

I couldn’t drive at night. I couldn’t read during the day. I need an additional light and it was simply a challenge for me to be able to see it all. Doctor Salib was very thorough in explaining the procedure. He answered all questions that I had. My concerns were alleviated by his thoroughness and now I wish I had it done it soon. The surgery went extremely well. I was pleasantly surprised. My anxieties were alleviated and my vision was 100 percent improved as soon as I rolled out of the operating room, there was absolutely no discomfort. I was able to see immediately. The vision is so improved, no pain, no discomfort, no tearing, just a wonderful experience. The staff is professional, courteous, knowledgeable and I couldn’t ask for better service when I come here. My life is back to where it was 50 years ago. I see so well I’m back to 20/20 vision and I’m just able to enjoy it without any encumbrances without difficulties, without pain, it is just I have my life in my hands again, thank you. Don’t wait, have it done as soon as you, your, eyes have the need for the surgery. Do not postpone it because you will miss more days of pleasurable and good vision. It is, I wish I would have done it a year or so ago. One thing that was great when I said when should I have the surgery? His answer when you feel you are ready for it and that was my choice. He does not push. He did not push or pressure me. It was my need to get my vision corrected and repaired. The other night driving couple weeks ago was foggy and the light and the lights were going and the driving and, and, I’m going around the corner and I say thank you, Doctor Salib. That’s all I can keep saying is he’s a miracle worker. 

My vision was getting increasingly poor. I had to use a magnifying glass on more things to read. I couldn’t read numbers and I even had to put a magnifying glass on my computer at times. So, I came to doctor Salib and Doctor Salib said that I did have cataracts, which wasn’t a surprise but after the surgery, I was astonished at how much better I could see. It was like brand new vision. All I really wanted was to have improvement. I didn’t expect a huge transformation. So when I was able to have the distinct vision that I experienced, I was so joyful and so very pleasantly surprised. Doctor Salib explains everything very patiently and very thoroughly. He has answered all of my questions, even the ones that I considered be trivial or kind of stupid, but he was very patient with me with everything I wanted to know. I was very well taken care of. Doctor Salib explained everything to me as he went along. It didn’t take very long which was really nice. I didn’t have an acute awareness of what was going on around me. I knew that I was in safe hands. I trusted Doctor Salib. I knew that he knew what he was doing. He gave me a feeling of real confidence and professionalism. I had a little discomfort, which is normal. I didn’t have anything that required any medication. Anything as severe as that but my I felt a little irritated. I couldn’t really see out of it much the day of the surgery, but the following morning it was like somebody had pulled the shade up on my eye and I could see again. The staff is excellent. They’re very professional group of people. They always greet you very kindly. When you come into the office. One of my pet peeves is to go into a doctor’s office and be ignored and in Doctor Salib’s office they all greet you very nicely. They treat you in a very professional manner. If you have to wait, which I have not had to do hardly at all. They check often and regularly and reassure you that you will soon be seen. They’re just a really terrific staff. My life has really changed since the surgery, which I didn’t expect. I can read without my glasses, which is just stunning and I drive without my glasses because I can see better and I have been so dependent on glasses for so many years that it’s just been a new experience with everything that I’ve done. I watch TV without glasses. I couldn’t do that before. It’s just been a really tremendous experience for me. I would highly recommend this clinic and Doctor George Salib. He was recommended to me by a friend who has had a lot of vision problems since childhood and she told me that she really liked him and she felt he was very competent and I really trusted what she said. So, I came to this office expecting to have a good doctor. I’ve never had a bad eye doctor, but Doctor Salib has been the best eye doctor that I’d had as far as being kind and in answering questions very thoroughly, that’s important to me. I’ve had a really fantastic experience with Doctor Salib and his office, his staff is very competent, very compassionate. Plus, they get the patient to the doctor and a very timely manner which is important to all of us. After the surgery the following morning I had such a surprise because I had expected that my vision would be better. It would be improved, but I had no idea that it would be remarkable. It was like I’d had a shade over my eye and somebody pulled that shade up and I could see, I could see the leaves on the trees I could see across the lake, I could see my husband’s face better. I could see some of the parts of my house that needed to be cleaned, which maybe wasn’t the most pleasant thing, but it was really very delightful. 

Well, actually I had multiple retinal detachments in my right eye over the recent years and lens replacement surgery. My left eye, multiple other surgeries in both eyes, and so my case was a little more complicated and doctors Salib at the lens replacement in my right eye and I wasn’t sure what to expect, but I see perfectly now. While Doctor Salib took the time to show me how he had come up with the calculations for my lens, spent some time consulting me through the different lens options available to me and it may be comfortable all the way through the process. The surgery experience was actually very good. I was comfortable. There was very little pain. In fact, I can’t think of any brilliant pain associated with the procedure and doctor Salib checked with me after the procedure and followed with me closely in the weeks and months following. The staff in this office has always been wonderful. They seem to know when I mean when I call, and they’re very personable. They are very accommodating and I just I can’t think of another office with a better staff. Now I see I can be corrected to see 20/20. I see about 20/40 so I see very well. It’s a little bit like getting your life back and I don’t have the depth perception issues that I had before, and I see clearly, I can read. I can see stop signs stoplights and Drive normally without glasses. I think Doctor Salib is an excellent choice for anybody who’s considering a procedure like this, at at least as a second opinion, he’s delivered wonderful results for me when other doctors, I think, thought the outcome could be questionable. He was confident and that allowed me to be comfortable, so I recommend anybody to doctor Salib. As a result of the procedure Doctor Salib performed on me, I can now see my children faces and my grandchildren faces and the colours that that things are wearing more clearly and just overall my experience might is now much better on a daily basis and it’s been a blessing. 

I couldn’t see very good at all through my right eye. It was very cloudy, smoky, like and I didn’t know where I was going to find a good doctor and my sister is also a patient of the doctor here, so she suggested that I come to visit with him and I did. He checked my eyes very well. He was very gentle, very kind and took his sweet time. Everything that he told me I wanted to know and he was very kind in explaining it very nice. He wasn’t in a hurry to talk with me. Everything he said, I understood very well. Then it was up to me as to what I wanted to do and he said anything would be fine. Just make up my mind, which I did very quickly and I think within a couple of weeks later I came back. He set the time for the surgery. We did it and it took him practically no time at all, to remove the cataract and came back out the next day. He checked it again, put a plastic patch over my eye to keep the dirt in the dust and the glare out and said that I should wear my sunglasses, which I did. My I was just fantastic. This is one fabulous doctor. I could never say enough about him. It was wonderful. It was fast and I felt nothing. I didn’t feel a pain. I didn’t feel anything. It was so, which is great, Why I waited so long was beyond me, but he did a wonderful job. He was there to talk to me before the he did the procedure and after the procedure, he came in and spoke with me and you don’t find many doctors that will do that because they don’t have the time, but Doctor does believe me when I say that he was fabulous and I hope to have my other eye done within the next two or three weeks. No discomfort whatsoever. I guess I was in such a hurry to be able to get out and drive and go and do, that I everything was great, just fabulous. I’ve used eye drops for maybe a month, which was no problem and everything just was great. The girls that work here with the doctor or fabulous, they’re sweet, they’re kind, they’re gentle. They’re very obliging, and are there for you, and that’s another reason why I love this doctor. His staff compliments him to no end. You have no idea how it has changed. I go more. I get in my car. I drive all over the place. It’s just been wonderful and I’m just sorry that I waited so long, but I’m glad that I did find the doctor that knew what he was doing and he did. He made me feel comfortable. You won’t believe what I did. I took about a dozen cards with me when I left. The last time I was here for a check-up and I just handed them out to all my friends and since then I understand three of the girls or women have come to be examined by the doctor, which is great. One thing I can say for sure is that I’m so sorry I waited so long and finding this good doctor because you cannot put something like this off when you find somebody that can fix it for you and he did and I’m just happy for him and his staff and I’m just happy that I had it done when I did.

I couldn’t see very good at all through my right eye was very cloudy, smoky, like and I didn’t know where I was going to find a good doctor. My eye was just fantastic. This is one fabulous doctor. I could never say enough about him, truly. I’d like to welcome Laguna Woods to my office. We help our patients maximise their vision and live their lives to the fullest. The Orange County Eye Institute is a comprehensive eye care centre. See well live well. 

Doctor Salib at the lens replacement in my right eye since seeing doctor Salib and having this procedure I can now see my children faces my grandchildren, faces and the clothes are wearing much more clearly. I wasn’t sure what to expect, but I see perfectly now. We help our patients maximise their vision and live their lives to the fullest. The Orange County Eye Institute is a comprehensive eye care centre. We are specialists in cataract surgery, laser vision correction, dry eyes, glaucoma and multifocal lens implants. See well live well.