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Dr. A.S. Desai
Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2055
Experience:  MS Ophthalmology with 11 years of surgical expereince
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Hi Dr. I was told by Dr. Rick that you may be able to help

Resolved Question:

Hi Dr.Desai~ I was told by Dr. Rick that you may be able to help me with a contact question ~I have had cataract surgery 30 years ago when they would not put an implant in a young person~ as they were new then~I thus have to wear a contact lens to replace the lens removed~they no longer make my brand and the closest I can find through my Optomitrist is a contact by Hydrasoft XW my old one was readings of +13~8:30 steep~ and 14.50~ I was able to get the 8:30~+13 and 14.20~ would that reading be okay~Martha

Submitted: 11 months ago.
Category: Eye
Expert:  Dr. A.S. Desai replied 11 months ago.

Dr. A.S. Desai :

Hello Martha, Thank you for the question.

Dr. A.S. Desai :

I guess it is alright for you to go ahead with the contact lens which is available.

Dr. A.S. Desai :

A slightly smaller diameter of 14.20 instead of 14.50 would not do much of problem. LArger diameter are given for those with larger pupils. However a 0.3 mm difference should not do much of an aletration.

Dr. A.S. Desai :

I hope you found this answer upto your satisfaction.

Dr. A.S. Desai :

If you need more help, please use the reply tab to continue our conversation. If you do not require further assistance, kindly rate my service.



Thank you and best wishes.



It was a pleasure to have answered this question.

Views expressed are for information purpose only and cannot substitute a visit to an ophthalmologist


Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2055
Experience: MS Ophthalmology with 11 years of surgical expereince
Dr. A.S. Desai and other Eye Specialists are ready to help you
Expert:  Dr. A.S. Desai replied 11 months ago.
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Customer: replied 11 months ago.

Thank you so much Doctor~I have moved to a new Province in Canada after the death of my husband~ to be near my son and only child~ I had eye pressure at 37 and saw a Specialist and it is now 12~ I take drops~Azopt and Combigan twice a day and Lumigan once a day~ they really brought the pressure down fast~I do not have glaucoma yet~ but am a Suspect~ anyway since I saw this new Optomatrist I am getting tired of running there~she gave me a disposiable one first with measurements of 8.6~ 14.20 and a + 12~ I could see okay but my eye felt very uncomfortable~ the measurements were very different from what I had~they do not make my brand anymore called Durasoft 2~and this Hydrasoft seemed closer to what I did have before and like mine was it is not disposable~the reading did not come as a 14.50 it seems on any she ordered in and a 14.20 was the closest~would a + 13 not be better than a + 12~ she now wants me back to measure this one ~my son just picked it up and that is what I did before for years~ to me I could not get any closer to my original from the numbers she has been bringing in~ she said that other one fit perfectly and I had good vision~ but it did not feel good as I said~I hope I can be done with it and that this one would be okay~I don't have much choice anyway~ as it seems you cannot get any in a 14.50 here~Thanks~you are very pretty~Martha~

Expert:  Dr. A.S. Desai replied 11 months ago.

I agree that a +13 would be better as it would take care of your near vision too. But as you have rightly pointed out a good fit is also important and you would have to choose the one which is available. I was just curious to know whether you have ever been suggested to go for secondary intraocular lens implantation so far by any ophthalmologist. If not then you can discuss about it at your next visit. However if you are comfortable wih the wear of extended wear contact lenses and are not willing for another eye surgery then I guess you can wear the prescribed contact lenses. Have a good weekend . Take care.

Customer: replied 11 months ago.

Hi Again Doctor~I would love to have the surgery now~ but for some reason unknown to me two Doctors have said it would be too risky~ do you have any idea to WHY~one saying that there would be too much trauma on the eye~ with the high pressure~ does this make sense to you~Martha PS I had to travel to another City a way back too to have Laser done ~ as that eye had a secondary contact~

Expert:  Dr. A.S. Desai replied 11 months ago.
Hello Martha,

Yes, it can be risky to do surgery with raised IOP as it can lead to surgical complications. But the IOP seems to be controlled with the antiglaucoma eye drops in your case. Laser for secondary or after cataract would nit come in the way of further eye surgery. I guess you can discuss again with your ophthalmologist at your next scheduled visit.

Regards
Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2055
Experience: MS Ophthalmology with 11 years of surgical expereince
Dr. A.S. Desai and other Eye Specialists are ready to help you
Customer: replied 11 months ago.


Hi Doctor~I feel sort of discouraged now if having the surgery would be probably the best option~do you have many Patients like me who instead wear a contact lens~ as I know it is not always comfortable and a nuisance to clean~I know a way back when I had my surgery the implants were not as good as today's are~they were not sure if they would last 20 years so thus did not give me one then~I remember my nervous system must have been different ~ as I ended up being put to sleep for my cataract surgery~it was called a juvenile one~what would ever cause that~the Optomitrist says I have a baby cataract in my right eye and yet the Specialist says it is not a cataract at all~also what would the 8:30 measurement mean~ as she had a 8:60~ the vision was good~ but not the feel of the contact~they were monthlies and this last one is not~I hope the difference in the 14.50 and the 14.20 will not affect me~ as that is what she had the monthlie as well~ would it affect my vision~funny how she had a + 12 and not as my original was at + 13~ I assume all contacts do not feel comfortable at times~ sometimes mine does and then other times it bothers me~I have 20-20 vision up close in my right eye ~ but wear glasses for distance when watching TV or driving~I seem to make out around the house with no glasses~ as my cataract eye is farsighted it seems~ does this make sense~thanks for your help~Martha

Expert:  Dr. A.S. Desai replied 11 months ago.
Sorry for the delay in replying. The 8.30 is the back curve of the lens. Back curve is required to know how steep or flat the contanct lens would fit over the eye. Your vision close to the eye is good because you have been corrected with +13. That is why you need glasses for distance. The other way of treating the same condition is to give a + 10 so that the distance vision is 20/20 and one would need a +3 reading glasses for near vision. However you can continue with +12/+13 for the contancts and wear glasses accordingly for distance vision. The overall diameter change of 0.3 mm should make much of a difference.

Regards
Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2055
Experience: MS Ophthalmology with 11 years of surgical expereince
Dr. A.S. Desai and other Eye Specialists are ready to help you
Customer: replied 11 months ago.

Hi Doctor~I am not sure if I know what you mean ~The contact I wear is only one and it is for my cataract left eye and I have 20- 20 vision up close in the other right one~ but need glasses for distance in that one~ the other side of the lens is just plain glass~as I guess the contact is supposed to take care of the near and far~??? as they never gave me glasses for that left eye~only a contact~ I told you the measurements of it in my first message and one was a bit off~the 14.20~ instead of 14.50~I am getting so discouraged~as the contacts this Optometrist is getting in are not the same as I had in my home Province~ there are disposables now too~ which is different for me after 30 years of having my surgery~funny she had an 8:60 in those and that is quite a difference from 8:30~ which I always had~ the contact had good vision~ but did not feel good in my eye after a short time~ do people with my problem wear a contact and glasses too~ as they never did this for me~I can wear a contact for distance in my right eye~but then I have to wear reader glasses~does all this make sense~Martha

Expert:  Dr. A.S. Desai replied 11 months ago.
I get it now. Your left eye was operated for juvenile cataract 30 years ago and you were given extended contact lens for that eye. Your right eye has good near vision but you need glasses for distance vision. You are rigyt that if you were contacts for distance vision in the right eye then you will have to wear reading gkasses for near. Yes people with similar problems would have to wear contacts for distance and glasses for near. Since the effective refractive power between the two eyes is large, glasses cannot be given for both eyes together. As for the fit of the contacts, it is better to go for a good fit which feels comfortable .
Customer: replied 11 months ago.


Thanks for understanding~ to me it did not seem to make sense to wear a contact in my right eye and see so well at a distance and then not up close as usual~is 20-20 vision up close good for my age~this is in my right eye~ the contact I have now is getting old~ for my cataract eye~ but it was comfortable~ now the closest I can seem to get for it was those measurements I told you~the ONLY difference was a 14.20 and a 14.50~ which they do not seem to come in~as I also said she had a disposable one at 8.60 and a 14.20 and a + 12~the vision seemed good~ but it bothered my eye~I just don't know what to do~ the one nearest to my original seems my only option~ as long as that little difference does not matter~does a person ever wear glasses also with such a thing as I have~I mean on top of the contact~it seems years ago older people had the contact for cataract surgery and yet also wore glasses~ the other side of my glasses is just a plain glass~am I supposed to see far and near I guess is what I mean with a contact for juvenile cataract surgery~thanks Martha~

Expert:  Dr. A.S. Desai replied 10 months ago.
Your left eye is called aphakic ( as no intraocular implant was put after the cataract surgery). Aphakia is a condition with very high hypermetropia requiring around +10 D for distance and an add of +3 D for near ( +13D). If only one eye is aphakic , as in your case, one has to wear contact lens in that eye as the same cannot be given in glasses ( a difference of +3 D between the two eyes is acceptable to the eyes and anything more causes aniseikonia and anisometropia).

"she had a disposable one at 8.60 and a 14.20 and a + 12~the vision seemed good~ but it bothered my eye~" The problem could be more so due the back curve of 8.60.You can review with the optometrist for a better fit.

Since you are presbyopic, apart from the distance correction, you would need near correction in the form of glasses in the right eye( your left eye has good near vision as per your information).
Customer: replied 10 months ago.


I hate to bother you again~ but in layman's terms what do those words mean~ the last two in the first paragraph~it is only if I wear a contact in the right eye~ which I don't bother with~ do I need reading glasses~otherwise the right eye has 20- 20- vision up close~I need the glasses however to watch TV for distance~is wearing just a contact in the cataract eye~aphakia~ enough or should glasses also be added~the second Lens that she got me is the same as my original ~ as I told you~ a 8:30~ but only a 14.20 instead of a 14.50~ which was not available~and a+13~the vision is pretty good~ but I felt not as good as the disposable~ but to me a + 13 should be better than a+ 12~ which she had the disposable in~I am back wearing my old one again~ as I don't know what to do~I hate running back and forth to her like this~ as I am new here and have to depend on my son to drive me~my husband passed a way and I feel stressed a lot~thanks for any help~Martha~I think that you said the difference of the 14.50 and the 14.20 should not make much difference~I hope not~ as this contact is one that you wear a year~

Expert:  Dr. A.S. Desai replied 10 months ago.
Hello once again Martha,

Please do not hesitate to ask follow up questions as it is always a pleasure to answer to your questions. I can understand the situation which you are in thoroughly.

Anisometropia is a difference in the power ( refraction) of the two eyes. For example a normal eye ideally has zero power . A difference of 3Dioptres between the two eyes is well tolerated. Anything more than that would cause suppression of vision in the worse eye. In your case the difference between the two eyes is more than 13 dioptres thus making it mandatory for you to wear contact lens in the left eye( aphakic eye). Aniseikonia is the difference in the size of the image between the two eyes. Again it is seen in case of anisometropia. To avoid both of these conditions you would need to wear contacts in your left eye.

Usually we say the vision up close( near vision) is N6 ( 20/20 is only used to describe the distance vision).If the vision is N6 in the right eye ( unaided) but requires glasses for distance vision then one of the possibilities for this is an early cataract in the right eye ( age related nuclear sclerosis) as it induces myopia or short sightedness. If not then the right eye could have been myopic since your childhood.

Yes, a small difference in the overall diameter should not make much of a difference. It is the base curve ( 8.30 in your case ) which is important for a good fit .

Regards
Customer: replied 10 months ago.


Thanks Doctor~I also felt that maybe it was because of this so called baby cataract that I have such good near vision~ but the Specialist~ as you are~ said it was not really a cataract at all in her opinion~ it seems she would know more than an Optomitrist~ if it is a baby cataract how long before it would need surgery~ and again do people who have my aphakic problem~ordinarily just wear a contact for vision and not also glasses~along with the contact~I guess I should give this new contact a try then ~the other one must have been the 8.60 size~ she said it was a perfect fit~ but to me it did not feel good~although the vision was good~I am getting so discouraged and as I said I am still wearing my old one~I see on line you can get my old one~ can one order a lens like that with no prescription~Martha

Expert:  Dr. A.S. Desai replied 10 months ago.
The decision to operate on an earky cataract would depend on the vision in that eye and the maturity of the cataract. If the visual requirement of an individual is less then one can wait till the cataract matures some more ( you would know that by the gradual decrease in the distance vision). Your aphakic eye has been corrected to give you N6 vision for near most probably. The glasses are for correcting the distance vision in both eyes. Though you cqn order contact lenses online it is better not to do so in your case as a good fit can only be detected with the trial lenses with the optometrist.
Customer: replied 10 months ago.

Hi Again~What I mean is the Lens I see on Line is exactly as my original from my other Province~and what I am back to wearing~they say that they cannot get it anymore here~perhaps that is just Canada and the USA may have it~anyway with my glasses there is just a plain glass on the cataract side~this is what I mean~ is this the way it normally works~whereas the other side is for distance in my right eye~ also would not an Ophthalogist like yourself be not better at saying if it is a cataract or nor~ more than an Optometrist~if the optometrist is right over the Specialist~I feel it can't be very much~ how fast do they progress~now I am scared~Maybe I do not make myself clear enough~Martha~

Expert:  Dr. A.S. Desai replied 10 months ago.
An ophthalmologist is definitely better qualified and trained to comment on the status of a cataract than an optometrist. If your ophthalmologist feels there is no cataract then she must be right. It so happens that there is age related sclerosis of the natural crystalline lens which is the beginning of one of the types of cataracts called as nuclear sclerosis(NS). It does not show any kind of opacity on eye examination initially. Probably your ophthalmologist would have felt that there is no significant nuclear sclerosis and she could be right. To summarize stick on to the ophthalmologist's opinion.

Treatment of aphakia can vary from individual to individual as a standard +10 for distance and +13 for near is not acceptable in all aphakics. In your case a + 13 has been given to give you a N6 for near . I do not know your best corrected vision ( with contact/glasses) for distance and near separately for each eye. What is the power of your glasses which you are using for dstance vision?
Customer: replied 10 months ago.

I never wore glasses for distance until a few months ago~ although no doubt I needed them in my right eye~ as I noticed I was not seeing the TV well unless I went up close~plus I also no doubt should have been using then for driving~I guess my cataract lens helped however~I seemed to make out until I was 68~I was really afraid that I lost vision to glaucoma~ as I was from a small place and neglected to go to the eye Specialist~ he was not a nice person either and when I got here my eye pressure was 37 in each eye~ but Thank God there was no damage to the optic nerves~is that a dangerous level~ it came down within four days on drops to a16 and17 and even moreso after three months to a 12~of course I have to keep up with the drops~what causes black spots in front of one's eyes~ I was told that they are nothing to worry about~ I have them once in a while in my cataract eye~if I do have a baby cataract~ one Doctor said it could be years or never before I needed surgery~I just could not handle that now~ as I am not well emotionally~ moving so fast and with the death of my husband~anyway I just called and the eye place said at first a -5 and then she said it was not the whole prescription~ I think she realized that she was not supposed to give it out~I just called my Doctor and she said a -5 and a -1.25 and an axis of110 ~I think that I got that right~now this is the eye that I see close with and need this prescription for distance~I have a contact for it and it works so well~but I have a hard time getting it in and out~ after being used to the larger cataract sizes and also then I cannot see close with it in~I have to wear reader glasses then~ guess I am fortunate to not have glaucoma~after neglecting myself for so long 11 years~I hate to admit this as it sounds stuipid~she said my vision in my cataract eye is a 20-25 and is even legal to drive and my other is 20- 30~ would that mean with corrected glasses~also why do some days I do not feel the contact in at all~ my cataract eye that is and other days it is bothersome~is it the air or tiredness or what~I am still wondering if I can wear that new measurement safely~with the difference of 3mm~


 


My sister has polypoidal~ how serious is that~is it curable~ she has been getting needles in the eye and they did not help~so now she needs a laser treatment from a Retina Specialist~I hope that this is not too long and confusing~Martha~I hope there is hope for me!!!!


 


Expert:  Dr. A.S. Desai replied 10 months ago.
Sorry, I was a bit busy with work hence the delay.

The reason why some days with the contacts are uncomfortable is that they induce a papillary conjuncivitis ( tiny papillae appear in the under surface of the conjunctiva after prolonged use for years). There could alsohave been associated dry eyes whih is very common with contact lens wear. I guess a regular use of preservative free lubricating eye drop such as refresh tears or systane, 1 drop 4 times a day, should help.

I guess your left eye has good vision with the contact lens( 20/25) whereas the right has 20/30 with the glasses. Does not look like any myopia induced by a cataract in the right eye( -5.0 D myopia with cylinder would not have been due to a catarct). So I guess you can stop worrying about a cataract in the right eye at present.

Occasional floaters are common and are most often caused by posterior vitreous detachment or PVD. Here is a brief note on PVD. .

In this condition the thick gel at the back of the eye( called vitreous) gets detached from its surrounding retina . This results in retinal traction which results in the symptom of flashes of light and includes color distortion. Flashes of light may not be prominent in some individuals. Once the vitreous gets detached completely , it may form clumps or strands and cause symptom of floaters such as dark spots, cobweb or thread like strands in the visual field. More often it is not a serious issue and does not require any specific treatment. A routine retina examination needs to be done by an ophthalmologist just to check for the intactness of the retina and to look for any peripheral retinal tears or holes, which if found, can be sealed by lasers. The only concern is that of a remote possibility of a retinal tear extending into a frank retinal detachment, which is characterised by symptoms of sudden increase of flashes or floaters and a curtain or veil falling in the field of vision. This requires urgent treatment by a retinal specialist. This is not a common feature and is more predisposed in myopic and diabetic individuals. You do not seem to be having any of these acute symptoms and you have already had an eye exam. PVD can occur suddenly at anytime and is a diagnosis of exclusion and does not show any signs as such on eye examination.If PVD is confirmed then there is nothing much to be done. It would be best to ignore the floaters after that. Some floaters tend to drift out of visual field too.

I guess all your queries have been addressed to.

If you need more help, please use the reply tab to continue our conversation. If you do not require further assistance, kindly rate my service.Thank you and best wishes.It was a pleasure to have answered this question.Views expressed are for information purpose only and cannot substitute a visit to an ophthalmologist
Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2055
Experience: MS Ophthalmology with 11 years of surgical expereince
Dr. A.S. Desai and other Eye Specialists are ready to help you
Customer: replied 10 months ago.

Hi Doctor~Thanks for all your information~ I am not sure about a couple of things~ like how you would know that I did not have a cataract for the reason of my near vision~ by what you called a cylinder~I guess I don't know many terms that you Specialists use and no doubt are very familiar to you~also would wearing this new contact be okay with that difference ~of 14.20 and 14.50~ I always wondered to why my contact felt so good some days and others not~ when I wear it I seem to manage around the house with no glasses~ does that sound normal~ since I can see near with my right eye I can use the computer without glasses as well~I use my glasses when I am out driving with my son or watching TV~ I feel the left eye must make up for the lack of vision for distance in the right??~ Does some people have much worse vision I wonder and yet see well??


 


I am back to wearing my old contact and I hate that~as I am not sure about the new one and yet she can't get it in the 14.50 size~I am getting so discouraged and it is hard for me to get to her office and have to keep running back~ with a problem such as I have with no lens ~aphakic eye~is it possible to see near and far with just a contact~ as my glasses has no lens in that side~ just a plain glass~I see well with distance with the lens for the right eye~or do people also wear glasses in such an eye as well~


 


I told you my sister has polypoidal~is that real serious~ as now I am afraid I will get that~ thanks again for your help ~Martha~

Expert:  Dr. A.S. Desai replied 10 months ago.
Hello Martha,

Myopia induced by cataract is usually between -1.0 to -3.0 D whereas your myopia in the right eye is -5.0D. Also a cylindrical power ( -1.25 D in the axis of 110 degrees ) is due to the shape of the cornea and would not have been caused by a cataract. This is what made me think that you probably did not have a cataract in the right eye. This confirms the findings of your ophthalmologist too.

As for the new contact lens , you can wear a 14.20.

I have explained why on some days your contacts felt uncomfortable ( dry eyes and probably an allergic reaction to the contacts due to prolonged wear). It has so happened that your left is being used for distance vision ( right also when glasses are worn) while the right eye gives a good near vision. This kind of vision is also called monovision. One eye for distance and the other for near.

It would have been better if you could have adjusted to the contacts in the right eye for distance vision and worn readers for near vision.But you do seem to have some discomfort with contacts in the right eye which is why you would atleast have to wear glasses for distance.

As for the polypoidal choroidal vasculopathy in your sister, it is a peculiar hemorrhagic disorder of the macula ( central part of the retina) . I do not have much information in this regard and would suggest that you ask this question to Dr. Rick, who is a retina specialist.

Best wishes and regards
Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2055
Experience: MS Ophthalmology with 11 years of surgical expereince
Dr. A.S. Desai and other Eye Specialists are ready to help you
Customer: replied 10 months ago.

HI Doctor again~I am glad that my Specialist must be right more than the Optomitrist~I wonder what she sees that would resemble a baby cataract and she did say it could be years before I have to have the operation~anyway you seem so smart I asked about my sister's problem~I have talked to Dr. Rick about it too and I just wondered if you ran into it very often~it seems more rare than say macular degeneration~I hope one day to wear a contact in my right eye for distance~it felt so good in the eye and my vision was also so good with no glasses~I even bought the reader glasses~BUT I was having a hard time to get it in or out~ so we thought we would get my left eye fixed first~but if I can wear that cataract contact then it may be okay~I would need to practice with the right one I guess~it is actually my left eye that the comfort is bad at times~ the cataract one and other days it is fine~the right one I could not even feel it in~I loved it~ why would my near vision be so good then if not caused by a cataract~you sure are smart to figure all that out~Martha

Expert:  Dr. A.S. Desai replied 10 months ago.
The near vision in your right eye is good because of the myopia ( -5.0 D). Myopia is short sightedness in which the near vision is good bu the distance is blurred. Near vision is good here because near objects form an image on the retina whereas distant objects form an image in front of the retina. It is likely that your myopia has been there for a long time but only got noticed in the recent past.
Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2055
Experience: MS Ophthalmology with 11 years of surgical expereince
Dr. A.S. Desai and other Eye Specialists are ready to help you
Customer: replied 10 months ago.


Hi Doctor~Thanks for explaining things so well~ in your opinion what strength should my cataract eye lens be~would + 13 be okay for distance as well as close ~since my right eye has good close vision and not far then to me it would be best to have the left one with good distance vision~to kind of off set one another~the last one she gave me is a + 13 and 8:30 and 14.20~ the old one as I said was a 14.50 ~ for some reason it seems hard to get that one now and most are the 14.20~the 8.60 she ordered I had good vision~but it was not comfortable~ maybe it was because of the 8.60~perhaps the 8:30 is better~you sure are smart to be able to figure all these things out~it sounds so complicated~Dr. Rick says he knows nothing about contacts~he said to wash my eye lids with baby shampoo~ sometimes there is a bit of white in the eye and I was not sure if it was the Azopt that I use for high pressure~the Lumigan I use actually grows eye lashes~is it possible for a person such as myself to never get glaucoma~ even though I have a problem with high eye pressure~my mother had glaucoma~

 

I know that it is not a good idea~ but when you order contacts on line~ do they send them to anybody~ or do you need a prescription~to me it does not sound safe~Martha

Expert:  Dr. A.S. Desai replied 10 months ago.
The aphakic eye ( left eye ) cannot possibly see well with +13 for both distance and near. Since you have mentioned that the distance vision in the left eye is 20/25, I guess the +13 contact lens is good enough for distance vision in the left eye . However it may not be giving you a N6 vision for near in the left eye. But the right eye being highly myopic (short sighted), it compensates for the near vision.

As I have explained earlier too, the base curve of the lens is very important for a good fit. So go ahead with the 8.30 since the 8.60 is uncomfortable for you. A diameter of 14.20 should be fine.

It looks like you might be having glaucoma ( the treating doctors must have seen eye signs suggestive of glaucoma including a rise in IOP, optic nerve head changes and perimetry visual field changes) as you have been put on two anti-glaucoma medicines. Lumigan is known to cause growth of eyelashes as a side effect.

Anyone can order for contact lenses online provided you have a prescription and know how to fill their questionare for ordering.But it is not advisable in your case as the correct fitting of the lens is to be checked for before ordering. So it would be better to proceed with your optometrist's opinion and prescription.

Thank and best wishes. Take care.
Customer: replied 10 months ago.


Hi and Many Thanks~I hope that the +13 is good enough for distance vision~ as you say this is what I need moreso~I thus seem to be able to go around the house and be comfortable with my contact in~and not have to wear glasses~ she may have ordered a +12 for the uncomfortable one~ but my vision was good~I guess this very last one she ordered would be okay~ as it is exactly the same as my original and what I am back to wearing~the original that is~ as I was not sure about the fit of a 14.20~ that does not sound as important as the say 8: 30 size I assume~ anyway I am actually on three drops ~Combigan as well~ the three dropped the 37 pressure down in four days~ but she kept me on the three~ she asked if I wanted Laser and when I asked if I could cut out the drops she said no~ NOW she claims that I do not yet have glaucoma~ she did all those tests and said I was considered just a person with IOP and no damage thus far anyway and was called a Glaucoma suspect~ did you ever hear of this~I only take Lumigan at bedtime~she said women love this one~is a 37 pressure dangerous~

 

I find that I have been running to the Optomitrist so many times and she says the contact is a perfect fit~like that one with the 8:60~ but I did not feel comfortable after a wore it a bit~so it Is hard to always trust what they say~I have been wearing my original sizes for 30 years~ so I felt ordering on line would be okay with me~ the optometrist says it is like having a comfortable pair of shoes~ and it might be the material in the lens~ but actually there are not too many companies who make this type of lens~my original one she says are not being made anymore~yet I saw them on line ~ Dura Soft~ and it came in all my measurements perfectly~thus I asked if that was okay~ this last one she got~ as I said~ the only difference is it is a 14.20 instead of a 14.50~it seemed to feel okay though~ this Optometrist just can't seem to get the right one for me~ that is why I hope this last one can work~Hydrosoft is what it is~ would the monthly ones maybe better~that was the kind she ordered for the uncomfortable one~ but surely she could get a good fit in them~it just is hard for me to keep going there and she only worked one day a week on Sundays~also in closing is the vision really bad in my right eye for distance~ I mean abnormally bad~ as I was going around driving and did not seem to notice~ although obviously it was probably not right~ Thanks again so much~I hope this time I have covered everything~Martha~PS~I know being able to master wearing a contact for my right eye would be perfect~ she actually had one there in stock~ but when I say go to my computer and need close up vision it was sort of a nuisance~ when I am used to seeing close so well~

 

 

Expert:  Dr. A.S. Desai replied 10 months ago.
Hello Martha,

Glaucoma suspect is an individual who has one of the signs of glaucoma but does not show all signs of glaucoma. An individual with raised IOP only is called an ocular hypertensive. There is no fixed IOP to be called as dangerous. Each individual's optic nerve has different tolerence to the IOP. Sometimes the IOP is within the normal range but on eye exam there are changes suggestive of glaucoma. This is called as normal tension glaucoma. So, a 37mm of Hg IOP is definitely high but it would depend on the optic nerve changes to know if it is serious or not.

If your contacts are available online in the same specifications which you have been wearing for 30 years, then I guess you can go for them.

The vision in your right eye is not very bad but is less than normal. If you do decide to go for contact lens in the right eye for distance vision then you will need reading glasses both for computer viewing and for reading up close.

Regards
Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2055
Experience: MS Ophthalmology with 11 years of surgical expereince
Dr. A.S. Desai and other Eye Specialists are ready to help you
Customer: replied 10 months ago.

Thanks again~I always think I do not have to bother you again and then I have yet another question~this is what I like about Just Answer~ when you are at the Doctor's office you sometimes forget to ask certain things~or you may be nervous~now I am wondering if the loss of far vision in my right eye may have been caused by glaucoma~ if you say sometimes there are certain signs~I sure hope not~ as I was neglectful~ yet as a young person I always remember the sight was different in both eyes~one for near and one for far and I did not think anything of it as being abnormal~the Ophthalmologist said there was no damage to my optic nerves and I was just considered a person with high IOP~ my one in my other Province said the same thing~ but for some reason they also add glaucoma suspect~maybe it is different here~maybe due to the fact I have high eye pressure~

 

I also wondered if the monthly contacts would be best IF I can find a good fit~ they may be more sterile~in my day these were not available in my high prescription~ the Doctor said that I sure looked after it well~ my old one~ as it still is in good shape~I always did the things I was supposed to do~sorry to be bothering you with so many questions~when you do order On Line do they check with your Doctor or do you have to give their name~ as she may be hurt if I go behind her back~would Laser benefit me in any way ~ just maybe it would only take one drop?? Martha~PS The Specialist in my old Province said my left optic nerve was a different shape than the right~ this one now says it is not~ can you answer this to why two different opinions~he asked me if I had an accident in the eye even~one has to be right or wrong~ yet they Both are real Doctors like you~

Expert:  Dr. A.S. Desai replied 10 months ago.
The reduced vision in the right eye may not be due to glaucoma ( your eye exam showed a normal optic nerve). Moreover you do remember about a slight difference in the vision in the two eyes since childhood. A long standing refractive error ( in your case myopia) can cause amblyopia , if not corrected in childhood.

It would not matter if the shape of the optic nerve head was different in both the eyes. The right eye is myopic and its size might be larger ( normally seen in myopia, could appear tilted too or could be oblique)whereas the left eye is aphakic and would have a small size.

When you order online you do not have to name your doctor, it is only the power and other details which you have to give.

Regards
Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2055
Experience: MS Ophthalmology with 11 years of surgical expereince
Dr. A.S. Desai and other Eye Specialists are ready to help you
Customer: replied 10 months ago.


Hi Doctor again~I have read over your answers quite often and in one place you mention myopic as much the same as a diabetic problem for certain issues happening~ is that the same as myopia ~ which you say I have~now I am afraid of this happening to me~ as my brother was a severe diabetic and he had a lot of eye problems~ yet he drove his car~legally I don't think he was supposed to~he did not tell his Doctor that he had a car~do Diabetics retain a certain amount of vision ~ as he seemed to~I am now afraid with myopia I am in the same clump so to speak and you may just have spelled myopic instead as an error~I worry a lot~ so this kind of scared me that this would happen to me~I am alone now~ so things tend to bother me moreso~

 

What is lazy eye~my sister -in- law has that and at first did not pass her drivers licence~now she drives with no glasses~you say my eyes are not normal~but is there people worse than me who drive~ as an example~I find if I wore a contact for distance in my right eye~ which maybe I should~it is a nuisance when I want to do up close work~ with my right eye I see things people can hardly see with glasses for close~when I wear my glasses for distance my sight seems very good~I don't wear them around the house as with my left eye contact I seem to manage~does a + 13 do good for distance~as this was my original prescription~ I asked this before~ maybe you did not notice it ~ but do people with my left eye problem usually wear glasses along with the contact~

 

I am sorry for so many questions~but I told you that my Optomitrist could not get my Dura Soft lens here~I noticed that they were on Line in the States~my son has a friend there and asked him to order it~he agreed ~ so it looks like I may get my original after all~it was the 8.30 and 14.50 and a + 13~if this can happen I would be so glad~ as that contact seemed to work~I hope lt helps for distance as well as close~mainly distance though~again many Thanks~Martha~PS~What would cause me right eye to have a 20- 30 vision if not glaucoma~ do some people have worse eyes than me~the optometrist made me feel better by saying many are a lot higher prescriptions~

Expert:  Dr. A.S. Desai replied 10 months ago.
Hello Martha,

Thanks for the reply and additional info request.

Myopic is an individual with myopia ( short sightedness). Vision in diabetic individuals would depend on the severity of diabetic retinopathy in their retina. With good control of diabetes the vision might remain 20/20 and not deteriorate at all.

If you have not been diagnosed with diabetes at all then there is no need to be scared about it occurring in future.

To know whether you need additional near glasses in the left eye after wearing a +13 contact lens would depend on the near vision test. Since your distance vision with the contact is 20/25 it could mean that you have been given the lens with the intention of improving some amount of near vision too, if not N6 then N8 probably.

Lazy eye is a condition of the eye in which the eye has reduced vision( but not loss of vision) which cannot be corrected at all with any kind of treatment after the age of 10 years. This occurs because the brain does not accept any further improvement of vision ( in the absence of any disease of the eye). It is called as amblyopia.

Reduced vision in your right eye could have been so due to amblyopia due to high myopia , age related macular degeneration ( but has not been observed by your ophthalmologist).

Lots of people all around the world have much worse vision than yours, so I guess you need not worry too much about having poor vision in your eyes.

Have a good weekend and take care.

Regards
Customer: replied 10 months ago.

Hi again Doctor~
I just had blood work done and I am not diabetic~I asked about age related macular degeneration~ as that is what at first I thought my sister had~they said I did not have that~will my good close vision stay like this and does too much computer use cause eye damage or loss of vision~I had good vision all my growing up years~unlike a cousin of mine~who always had to wear glasses~ so at age 68 maybe I am lucky or normal???I see very well with my right eye with my glasses~ I notice many people wear them and have for years~so hopefully I am not too abnormal~I tend to worry about things a lot~some have told me that 20- 25 and 20- 30 is good~I don't think everyone has perfect vision at 20-20~I remember my parents not wearing glasses until they were older and then they did~I sure hope that I don't have macular degeneration~that is very serious is it not~ my sisters' is sort of like that I think~ polypoidal~Martha~Thanks for your patience~I am just afraid~

Expert:  Dr. A.S. Desai replied 10 months ago.
Hello again Martha,

Computer use does mot reduce vision but it can cause dry eyes which can be controlled with regular use of lubricating eye drops.

I guess you do have fairly good vision in both theceyes and there are a whoke lot of people all around with drastically poor vision. I don't think uou could be having macular degeneration since your ophthalmologist has not observed it.Your bision in the right eye is unlikely to change much unless the eye developes a cataract.

Regards
Customer: replied 10 months ago.

Hi and hopefully one last thing~if that eye does develop a cataract then surely this time they would do the implant~would I see both near and far if it was done~ although the Doctor like you~ too hard to spell :-) says I don't have one~could she miss macular degeneration~as when I asked her she said I did not have it~Martha~

Expert:  Dr. A.S. Desai replied 10 months ago.
If the right eye does develop a cataract then they would do an IOL implant ( the left would continue to wear the contact). In order to see both far and near very well with an IOL implant , you would have to opt for a multifocal IOL.

NO, I don't think your ophthalmologist would have missed diagnosing a macular degeneration for sure.

Regards
Customer: replied 10 months ago.


Hi Again~I read over all our many messages~I am afraid now that I may have macular degeneration in the right eye~ as I told you when I said about my sister maybe having that ~they told me I did not have that~if I did would they not start treatment with needles~ real scary for me right now~my Ophthalmologist surely would spot it~ she worded it as though all I had was high eye pressure and would only see me again in 6 months~I think I told you that I might be able to get my left cataract eye lens through the USA~ from my son's friend~the original one~ I am so hopeful~would a + 13 be good for distance~ as I need that more so since my right eye is for near and not far~I wish I could master wearing a contact in that right eye~I just need practice ~ she had me try there and I was so awkward~ the first time I went home with it in and ended up at Out Patients to have it removed~ I am used to larger and thicker lens from my cataract eye~30 years of practice too~the vision was so good with it and also it was so comfortable~ she had me practice there and I was supposed to get it three tries and maybe I was nervous~as I did not even make it to one~Martha~

Expert:  Dr. A.S. Desai replied 10 months ago.
Hello Martha,

If the ophthalmologist has not seen any sign suggestive of macular degeneration then I guess there should not be any matter of concern here.Please do not worry about getting it just because your sister was diagnosed with it. A regular follow up as scheduled would definitely confirm this.

Yes, a +13 lens should be fine for distance.

As for the contact lens in the right eye, your reaction is justified. It can be difficult to adjust to very different types of contact in the two eyes. However do not leave it at one attempt alone. You can give it a few more tries and some more time to adjust too.

Regards
Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2055
Experience: MS Ophthalmology with 11 years of surgical expereince
Dr. A.S. Desai and other Eye Specialists are ready to help you
Customer: replied 10 months ago.

Hi Dr. I accidently got a tiny bit of nail glue on the outside edge of my old contact~the only one that really feels good in my eye after two attempts at the Optomitrist~I am the one who had cataract surgery and did not get an implant a way back then~there is a hole like a small pin point and my optometrists were all gone for the day yesterday~ so my son took me to a walk in Clinic~the Doctor said there it was safe to wear as it was far a way from my cornea and he drew a picture to show me~ would he be correct in saying to wear it and could I just clip that little piece off~ or will it hurt my eye or cause discomfort~I am so discouraged and am afraid to wear it~ even though he said it was okay~Martha~

Expert:  Dr. A.S. Desai replied 10 months ago.
Hello Martha,

It is indeed an unfortunate thing to have happened. But I guess it is better not to meddle with the contact lens and do not clip off any part of the lens. A tiny hole in the periphery of the contact lens would not cause a problem as long its rim is intact.

Regards

Dr.A.S.Desai
Customer: replied 10 months ago.


Would you thus say it is safe to ear it then Martha~

Expert:  Dr. A.S. Desai replied 10 months ago.
The best option would be wear a new lens as we are not sure about the extent of damage to the contact lens. Till you get a replacement lens, I guess it is alright to wear this one as long as your eye feels comfortable with it.
Customer: replied 10 months ago.


It is not a matter of getting a new lens~the Optomatrist is having a hard time to get the right one and I have to keep going back to my original~ which is quite old~would a small little pin point at the very edge~ not near my eye ~ but on the white part~the Medical Doctor said it was okay~ but I trust an eye Doctor better~would it be safe and would I feel discomfort~Martha

Expert:  Dr. A.S. Desai replied 10 months ago.
As long as it is not a tear at the edge of the lens, it should not cause any problem. A very tiny hole at the extreme periphery of the lens with an intact rim should not cause any discomfort either. So I guess you can try wearing it as long as it feels comfortable. But discontinue use just in case you develop any discomfort/ redness/watering.
Customer: replied 10 months ago.

Hi Again~The little hole is at the edge of the contact~ one could almost cut it off ~but I am afraid to do that~it sits on the white of my eye and far from the actual eye~I don't have many choices~ as I said~ they can't seem to get me one that is as good as my old one ~would this be safe~Martha

Expert:  Dr. A.S. Desai replied 10 months ago.
Hello Again Martha,

One should never make the mistake of cutting a part of the contact lens as this could alter the shape of the lens and affect its fitting over the eye. Since you have mentioned it to be a hole ( and not a cut)I guess it should not alter the shape of the lens. If it were to be a tear wherein a tiny bit of the lens would have been snipped off, then it would have been a straight away no to wearing it. I hope this answers your question .

Thank you. Have a good day and a great weekend too.
Customer: replied 10 months ago.

The only way I can explain it is it is a very small hole at the edge of the contact~the Doctor felt it was okay as it did not touch the cornea and was off on the white of my eye~ so it is a small little piece missing on the edge~a small hole type of thing and not really a rip per say~I don't want to wear anything that is not safe and yet I don't have many choices~ as the two she ordered me don't seem to fit right~ my old one is no longer available~and it was the best~ so without a lens in I can't see with that eye~ a Medical Doctor probably does not know as much as an Eye one however~ he drew a picture to show me how it would be safe and far from my cornea~if this makes sense~I took them all out for now~ as my eye is red and sore from trying the different three lens I have~Martha

Expert:  Dr. A.S. Desai replied 10 months ago.
I can understand your plight in the given circumstances. I agree that the tiny bit of the contact lens is in the extreme periphery and not on the part which covers the cornea, so you can wear the lenses in the present situation. But do watch out for any discomfort/redness/watering. The problem with a torn contact lens is that if it has ragged edge it can abrade the cornea while inserting and removing. The other problem is that it can alter the fitting of the lens. If you do not face any problem after wearing the lens and the lens sits in place properly, then it is alright to wear it.
Customer: replied 10 months ago.


I am going to see my Optomitrst this afternoon~I decided to wear the Hydrosoft one~instead of my damaged one~ where the measurements are almost the same as my old one~Only the 14.50 was not available~ so got a 14.20 and you said that it would not make much difference~I think that I would like to be able to get the monthlies from now on however and they come in a Pro- Clear name~she had also fitted me with one of them on one of my visits~the vision seemed better than any others and she said the fit was perfect and the vision was real good~but for some reason the lens did not feel comfortable after a while~ maybe I needed to get used to it~ although I loved the vision part~to me these would be more sanitary and also I would not be so stuck if one got lost or damaged as happened this time~in my day the lens that thick did not come in disposable~what would the 8.30 and 8.60 difference be~ Thanks for all your help~ I was a bit afraid to wear the damaged one~Martha~PS~Since I need this one more for distance~ as my right eye is so near sighted~ what would be a good size ~I have a + 13 now

Expert:  Dr. A.S. Desai replied 10 months ago.
Hello Martha,

I am glad that you are considering a change of lens and not planning to wear the damaged one. As for the difference between 8.30 and 8.60 is that the 8.30 has a steeper fit than 8.60 which has a flatter fit. The decision of choosing the right one would depend on the K reading ( it is the measure of the curvature of the cornea based on which a flat or steep fit lens is chosen). You said that the new monthly disposable lens gave you clear vision and good fit but felt uncomfortable after some time.From your previous posts it looks like the 8.30 fit is more suitable for you than the 8.60.

Regards
Customer: replied 10 months ago.

Thanks~I am having anxiety issues and going out is hard for me at this time~I was taking a mild anti~ depressant and it was making me feel better~ then on the fourth week I broke out in a bad rash and had to stop it~ the Doctor picked one that he felt would not affect my eye pressure~ Wellbutrin~is that true that anti- depressants affect eye pressure~my mother was Bipolar~ so they also do not like to give them out in case I would develop it~ I am only telling you this so you will understand it is not easy for me to just keep running to this Optomatrist~ my husband died and I am living in a strange City where I don't drive~I lived in the Country~ I moved near my son and only child~ so I depend on him to get me there~ I wish this Optometrist could get it right~my old one never had this issue and just went ahead and ordered one and I just had to pick it up~I wish I could still wear this old one~ I will have her look at it today and no doubt she will agree to not wear it anymore~ even with a tiny hole~this Hydrsoft one today is feeling not too bad~ so the difference in the 14.50 and 14.20 can't be much of a change~is the + 13 the better one for distance~ as this one is ~ but I think the Disposable one was a + 12~MarthaPS~Apparently 30 years ago the implants were not as good as today's version~do you have any idea to why two Doctors would say having the surgery now would be too risky~whereas everyone is telling me I should have it done~ do you have many patients that just wear a contact like me??

Expert:  Dr. A.S. Desai replied 10 months ago.
The +13 D lens would give you a vision of 20/25 which is good enough for an eye with aphakia. However a +12 D lens can be worn if it is able to give a similar visual acuity if not the same.

Those who have advised you to go for a secondary IOL implantation have been experts who have not examined your eyes. So it is more like a textbook information. I am not sure what exactly prompted the two ophthalmologists who examined your eyes to advise against surgery. Frankly speaking most of the aphakia patients whom I have seen , either wear glasses or have undergone secondary IOL implantation.

Regards
Customer: replied 10 months ago.

Do any wear a contact and would not the glasses be very thick~ like coke bottles~Martha~Can you think of any reason why it would be too risky~

Expert:  Dr. A.S. Desai replied 10 months ago.
We cannot give glasses for uniocular aphakia. My patients have been bilateral aphakia. Yes, the glasses are very thick and very poorly tolerated due to too many drawbacks such as magnification, limited field of vision, heavy glasses and so on.

Secondary IOL could be risky if there is poor control of IOP or cornea shows signs of decompensation or poor endothelial cell count. I don't see any other reason for a contraindication here.
Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2055
Experience: MS Ophthalmology with 11 years of surgical expereince
Dr. A.S. Desai and other Eye Specialists are ready to help you
Customer: replied 10 months ago.


Hi Doctor~I went to my Optomatrist yesterday and she found the original one she had tried I had a better vision and she said it fit well~ like the first time I went~I left there and it did feel good in my eye~ but later that night it again bothered me~I was on my computer A LOT~ I got drops even~I am getting discouraged~ as people say one should not even feel the contact at all~I did not with my right eye ~BUT I have to admit with the cataract one at times I always felt discomfort at times ~ no matter even if it was the older now damaged one~other times I did not~ I don't know what to do and I am tired of running there~the Hydrosoft one did not feel good in either when I was there and the vision was not as good as this Pro Clear one~the distance vision is real good and they are monthlies~ so to me this is more sanitary~then having just one and I had my old one I am sure for a few years now~ if you lose one or tear it these would be better as well and not make one so nervous~but today I am feeling it in again~ although the vision is good~ she is ordering a few different kinds from different companies she said for me to try~I got good drops she recommended~would it hurt my eye by feeling it in there~she has a + 12 in this time I notice~I hope that is okay~Martha~

Expert:  Dr. A.S. Desai replied 10 months ago.
I guess you can give these new lenses some more time so that your eye can adjust to it. It may take 2 to 3 weeks before your begins to accept the lens and not cause you any further discomfort. Yes, it does make sense to go for the monthly disposable ones for the sake of hygiene and accessibility. Since the discomfort was not there at the time of fitting and only appeared after a few hours, it looks like there could have been tear film issues from dry eyes. To get rid of the discomfort use the lubricating eye drops , 1 drop 4 to 6 times a day for a month.
Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2055
Experience: MS Ophthalmology with 11 years of surgical expereince
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