How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. Rick Your Own Question

Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7808
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
48069651
Type Your Eye Question Here...
Dr. Rick is online now
A new question is answered every 9 seconds

doctor in The United States, Dr Brian Wachler who has seen my pentcams

Resolved Question:

I have keratoconus and whilst treid to search for an alternative to a corneal graft i have found a doctor in The United States, Dr Brian Wachler who has seen my pentcams and says i am good candidiate for cross linking. I can send the pentcams over to you to see what you think?
Submitted: 3 years ago.
Category: Eye
Expert:  Dr. Rick replied 3 years ago.
Chat Conversation Started
Rick :

Hi. I'll be happy to help you with your question

Rick :

Are you online?

Rick :

You stated that you have worn contact lens for a long time. Is the reason you are considering a corneal transplant because you have a large amount of apical scars and CTLs aren't working for you anymore?

Customer :

Hi yes i am

Customer :

No the main reason is that my right contact lens no longer fits, i need a sceral lens which is cumbersome

Customer :

I emailed Dr Wachler in the States and he said i was a good candidate for cross linking procdeure but here in the UK doctors have brushed that aside saying i need a graft which i wanto avoid at all costs. I have pentcams but not sure how to send them to you

Rick :

I can understand that about the scleral lens. I do not know Dr. Wachler. A quick check of the American Academy of Ophthalmology does not show that he is a member. Not all US ophthalmologists are members, but most are.

Customer :

He is a famous refractive surgeon in Los Angeles i believe

Rick :

This site had not yet been set up to send large files or pictures, but I think I can give you some answers that may help you in your quest to learn more about your options. I assume you are outside the USA but that travel for treatment would not be a problem for you?

Customer :

No that would not be problem i can travel

Customer :

By the way i do have scarring to both corneas- years of contact lens wear

Rick :

He has a very famous looking web site, that is true. I'm kinda old fashioned and sometimes worry when someone blows their horn so loudly about a procedure that it not accepted/taught/used by other corneal experts.

Rick :

I'm sure that you know corneal transplants are very, very sucessful in keratoconus. In that light, however, it is a big surgery with all the risks of an invasive procedure

Customer :

Yes so if i have severe thinning of my cornea say 225 microns and lens are difficult to tolerate what would you suggest as an alternative to a graft?

Rick :

that is a very thin cornea indeed. I really think that, if you can't tolerate the scleral lenses, that corneal transplant is your best course. I don't want to blow off Dr. Wachler though without talking to another corneal expert. A very good friend of mine is the chairman at a ophthalmology program in Texas and has over 25 years experience as a teacher and a expert in diseases of the cornea. He taught me how to do corneal transplants over 15 years ago.

Rick :

if you don'

Rick :

If you don't mind, I like to call him and ask him about Dr.Wachler's treatment and what he would recommend. I trust this man 100%

Customer :

yes that would be good thats the reason i am making the enquiry

Customer :

greatly appreciated

Rick :

Ok. It may take me a few hours to get hold of him and get back to you. It's almost 5 pm here. Can you be back online in 2 hrs, or is that too late where you are at?

Customer :

I am sorry but its late here and would need to go to bed

Customer :

I am in the UK

Rick :

Ok. I understand. I can type the information I get in a question/answer format and you can read it when you get up. That should work. And if you have any other questions we can go through them too. You will have more information soon, I promise.

Customer :

Where will i able to read this information ,will you email me?

Rick :

Right here by logging onto your question.

Customer :

excellent with that i will say good bye for now and thank you for taking the time to chat to me

Customer :

Do i now click the accept button?

Rick :

Wait! I've got him on the phone....

Customer :

ok

Rick :

we're talking.......he say's hi.

Rick :

He knows about corneal cross linking. with and without taking off the epithelium

Customer :

say hello to him from me!

Customer :

yep thats right

Rick :

k

Customer :

epi on its called i think

Rick :

do you know the thickness of your corneas and where you cone is at?

Rick :

and do you have blood vessels growing into your cornea?

Customer :

Thats why i would have liked to have sent the pentcams to you

Customer :

No blood vessels

Rick :

me2

Rick :

I told him you thought your corneas were in the 225 micron range.....

Customer :

The right one is the left one is over 400 microns

Customer :

[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]128.75[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]

Rick :

So the left one is the most problematic right now....

Customer :

I tried to send it but it seems it does not work

Customer :

the right one is

Rick :

Here is what he has to say.......

Customer :

the left is the better of the two eyes

Rick :

nope, just got a lot of gobbleygook

Customer :

thought so

Rick :

oops....I ment right. Sorry. Must have something to do with the fact you drive on the other side of the street that got me all confused :)

Customer :

Lol yes very true

Rick :

Now remember. As an academic physician and a university professor and chairman of the department he tends to be very safe and conservative......

Customer :

ok i am ready ..shoot

Rick :

While he believes corneal crosslinking has it's place in the treatment of things he agrees with your Brittish doctors: Corneal transplant is the tried and true way to go and offers the best hope of good vision.

Rick :

And, I must admit, I agree....although my friend has forgotton more about the treatment of corneal diseases then I've ever known

Customer :

Ok thank you

Rick :

I know this is not the answer you were hoping for but I believe it is an honest one.

Customer :

indeed being honest is the right thing to do

Rick :

best of luck to you. If you would be so kind as to press accept when we are done I would appreciate it.

Rick :

Thank you for offering me a reason to call my friend in Texas.

Customer :

Greatly appreciated and thank you

Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7808
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
< Last | Next >
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
  • Wonderful service, prompt, efficient, and accurate. Couldn't have asked for more. I cannot thank you enough for your help. Mary C. Freshfield, Liverpool, UK
  • This expert is wonderful. They truly know what they are talking about, and they actually care about you. They really helped put my nerves at ease. Thank you so much!!!! Alex Los Angeles, CA
  • Thank you for all your help. It is nice to know that this service is here for people like myself, who need answers fast and are not sure who to consult. GP Hesperia, CA
  • I couldn't be more satisfied! This is the site I will always come to when I need a second opinion. Justin Kernersville, NC
  • Just let me say that this encounter has been entirely professional and most helpful. I liked that I could ask additional questions and get answered in a very short turn around. Esther Woodstock, NY
  • Thank you so much for taking your time and knowledge to support my concerns. Not only did you answer my questions, you even took it a step further with replying with more pertinent information I needed to know. Robin Elkton, Maryland
 
 
 

Meet The Experts:

 
 
 
  • Dr. Dan B.

    Board Certified Ophthalmologist

    Satisfied Customers:

    2903
    Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
< Last | Next >
  • http://ww2.justanswer.com/uploads/DoctorDanB/2010-6-7_6228_just_answer_profile_picture_60_pixels.jpg Dr. Dan B.'s Avatar

    Dr. Dan B.

    Board Certified Ophthalmologist

    Satisfied Customers:

    2903
    Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
  • http://ww2.justanswer.com/uploads/anupamadesai/2010-04-13_122313_Dr._A.S.Desai_new_photo.jpg Dr. A.S. Desai's Avatar

    Dr. A.S. Desai

    Ophthalmologist

    Satisfied Customers:

    1903
    MS Ophthalmology with 11 years of surgical expereince
  • http://ww2.justanswer.com/uploads/gsokoye/2009-10-28_181751_Dr._Stan.JPG Dr. Stan's Avatar

    Dr. Stan

    Ophthalmologist

    Satisfied Customers:

    895
    Johns Hopkins Fellowship Trained, Certified and Licensed Medical Physician and Surgeon
  • http://ww2.justanswer.com/uploads/eyemd/2009-04-07_180315_pic.jpg Dr. Stevens's Avatar

    Dr. Stevens

    Ophthalmologist

    Satisfied Customers:

    629
    Board Certified Ophthalmologist
  • http://ww2.justanswer.com/uploads/CO/CorneaDoc/2012-2-18_0390_photo6.64x64.jpg Dr. Susan's Avatar

    Dr. Susan

    Ophthalmologist

    Satisfied Customers:

    217
    Board Certified & Fellowship trained eye surgeon.
  • http://ww2.justanswer.com/uploads/neuph94/2009-10-11_164729_gif_pic.GIF Dr. JP's Avatar

    Dr. JP

    Ophthalmology, Oculoplastic Surgery

    Satisfied Customers:

    28
    Harvard Medical School, Massachussetts Eye and Ear
  • http://ww2.justanswer.com/uploads/JA/JACUSTOMERjcufyksv/2012-3-13_44825_crop3.64x64.jpg Dr-Trace's Avatar

    Dr-Trace

    Board Certified Ophthalmologist

    Satisfied Customers:

    26
    Board Certified in General Ophthalmology