Q: How should I prepare for my first exam with doctor Stevens?
Dr. Stevens will perform a complete dilated eye exam at your first visit. Come in with your glasses and contact lenses. Bring the labels or boxes from your contact lenses so the information may be recorded. Bring in your health insurance card and your list of current medications. Dr. Stevens will dilate the eyes. Dilation usually lasts for about 4 hours during which you will be sensitive to light and may have difficulty reading. Bring in dark glasses for comfort and protection. If you forget your sunglasses, Dr. Stevens will provide temporary ones. Most patients are safe to drive with dilated eyes, but if you do not feel comfortable, please have someone drive you or wait until the dilation wears off. Dr. Stevens does not use “reversing drops” after dilation since they cause as many problems as they solve. However Dr. Stevens strives to dose the dilating drops for every patient so that dilation is as comfortable as possible.

Q: Do I need a yearly complete examination?
A: Dr. Stevens will perform a complete dilated examination at your first visit to assess the eyes for health and any risk factors to vision. Many patients do not need a complete eye examination nor updated glasses yearly. Dr. Stevens will let you know when it is safe and appropriate to come in for your next visit according to your personal needs.

Q: If I wear glasses will it make my vision worse?
A: Vision changes throughout life. As children grow taller, the eyes grow longer, and vision may require correction for myopia (nearsightedness). Girls continue to grow into their early 20's and boys into their mid 20's. Glasses will need to be updated every couple of years to account for this normal growth. Growth is mostly determined by hereditary factors. Wearing glasses, or not wearing glasses, will not change vision. With aging, the ability to focus up close slowly weakens. Patients who have normal relaxed vision for distance often experience trouble seeing up close for comfortable reading around the age of 40. Loss of this focusing ability is called presbyopia. Reading glasses are needed to correct presbyopia, and the power of the glasses will need to be increased every so often until about age 65. Hopefully we all grow up, grow older, and need to have our vision appropriately corrected along the way.

Q: Will using my computer damage my eyes?
A: Many studies have shown that computer use is not a hazard to health or vision. However, computer use poses a special challenge for vision correction. Dr. Stevens likes to give prescriptions for “computer glasses” specifically designed for computer use. His patients find the glasses work exceedingly well and are a major comfort for computer use.

Q: Are there things I need to know to wear my contact lenses safely?
A: Although it is not commonly known, contact lenses are medical devices that can cause severe complications and blindness, usually due to infection. Fortunately with a few precautions, contact lenses can generally be worn safely. If pain ever develops in an eye while wearing a contact lens, remove the lens immediately. If pain doesn't go away within 12 hours, come in for emergency eye exam. Do not wait for Monday to roll around or for a routine appointment. Wearing contact lenses for sleep is a major risk for infection, and they should be taken out. In fact, it is a good idea to take the lenses out 1-2 hours prior to going to sleep to allow the eyes to get a good breath of fresh air once a day. Also do not wear the lenses for swimming. If dirty water splashes on an eye while wearing a contact lens, there is an increased risk for infection. This is particularly true for swimming in fresh water such as pools, ponds, and hot tubs.

Q: What is the best way to protect my eyes from the sun?
A: Sun exposure is not only a risk factor for pterygium but it is also a major cause of cataract. Wearing a hat with a brim protects the eyes 50%. The best protection comes from wrap-around high-quality sunglasses. These should be worn particularly in the middle of the day from 10:00AM to 3:00PM and especially when on a reflective surface such as sand, water or snow.

Q: If I have my pterygium removed, will it grow back?
A: With standard pterygium surgery there is a high incidence of pterygium re-growth or recurrence. On average, 40% recur after standard pterygium surgery. Dr. Stevens has developed a special technique of radical pterygium excision with conjunctival graft. He completely removes the pterygium, including the roots. This leaves a big raw spot on the surface of the eye. A very thin layer of conjunctival tissue is then taken, usually from the upper part of the same eye, to cover over the large pterygium defect. In over 21 years of surgery and hundreds of cases, Dr. Stevens has had no pterygium recurrence.

Q: If I wear sunglasses will my pterygium stop growing?
A: Pterygium is the result of lifelong accumulated sunburn. Statistics show that 80% of chronic sun damage occurs before age 18. Although it is wise to protect your eyes from sunburn, this will not necessarily guarantee that a pterygium will not grow or stop growing. Dr. Stevens has seen pterygium grow in patients in their 70's, many, many years after significant sun exposure. If pterygium is to be prevented, sun protection must start in childhood.

Q: Does my cataract need to be removed right away?
A: There is normally a clear lens within the eye located behind the iris, the colored part of the eye. A cataract occurs if that lens turns cloudy, even to a small degree. Cataracts are due to multiple factors such as age, lifelong sun exposure, family predisposition, smoking, diabetes, injury, and others. Immediate removal of the cataract is almost never necessary. If the cataract progresses to the point whereby the vision is blurred, affecting normal daily activities, then it is time for cataract surgery. If you are not certain that you are ready for cataract surgery, then waiting might be a good option since there is no harm in it. However, the natural history is that cataracts stay the same or slowly get worse with time. There is no effective medical treatment for cataract such as pills, eye drops, or glasses. The only way to eliminate cataract is with cataract surgery. On average, cataract surgery is highly successful, producing improved vision over 95% of the time.

Q: Will my cataract be removed by laser?
A: This is probably the most common myth in America . Cataracts have never been removed by laser. Dr. Stevens removes cataracts with the phacoemulsification unit. It uses ultrasound energy to fragment the cataract into tiny pieces that can be removed through a small incision. Once the cataract is entirely removed a clear plastic lens implant is folded and placed into the eye through the small incision. So, the cataract is removed with ultrasound energy, not laser.

Q: I need a corneal transplant. Will I have to go on a waiting list for donor cornea availability?
A: Corneas are provided by the Hawaii Lions Eye Bank and Makana Foundation for which Dr. Stevens is the Medical Director. Our eye bank is a certified member of the Eye Bank Association of America. We cooperate with other eye banks across the country to provide corneal tissue for transplantation in an expeditious manner. Almost all corneal transplant surgeries are scheduled, and the eye bank provides tissue as needed. On rare occasion, when tissue is not available, surgery must be cancelled and rescheduled. However, corneal transplant recipients on average no longer go onto a waiting list.

Copyright © 2007 Rhoads Elliott Stevens, M.D.  All Rights Reserved.