Rory A. Myer, M.D.
Dr. Myer is the only cornea specialist in the area who performs laser refractive surgery. He loves helping other people get out of glasses, he even had the procedure himself and would be happy to talk about his experience with you. Because of his training as a Cornea Specialist, Dr. Myer is often consulted by other physicians for help with complicated cases.
What qualifications should I look for in a laser eye surgeon?
Laser eye surgery treats the cornea, the clear outer surface of the eye. So at Tomoka Eye, we think a laser surgeon should be a corneal specialist, an expert who routinely performs corneal transplants, treats corneal abrasions and infections, performs corneal healing research, teaches other doctors about the cornea, and handles challenging cornea cases. A laser surgeon who is a corneal specialist will:
See laser eye surgery as one of several ways to improve your vision– not the only way.
Detect subtle corneal conditions that may require caution when considering laser eye surgery. Know how the cornea ages and recommend laser eye surgery with your long-term vision health in mind. Manage your progress after surgery for best results while continuing to provide data.
What is a corneal fellowship?
A corneal fellowship is a course of advanced study and practice in all aspects of corneal disease and care. Typically, a physician who is interested in eye care first enrolls in a residency program in ophthalmology. The residency program provides training in all areas of the eye, eye diseases, and eye care, and may enable the physician to become a board-certified ophthalmologist. For ophthalmologists who have a strong interest in one area of the eye, fellowship programs provide a mechanism for advanced specialization in that area, and should involve not only medical and surgical care but also research in advanced topics and the teaching of other doctors. A fellowship is considered the ultimate in training for an eye doctor.
What types of research are important in improving laser eye surgery?
The cornea is the outer surface of the eye and thus is easily subject to a range of problems such as abrasion and other trauma, infection, and inflammation. Of course, corneal surgery may open the cornea to these same challenges. Thus, a major area of corneal research is corneal healing: how to bring the cornea back to full function after a problem occurs or after surgery. A laser surgeon who performs corneal healing research is not only likely to know the latest advances in the field, but also to be highly aware of potential post-operative problems and how to prevent or solve them.
What is a refractive error?
To refract means to bend. When you have a refractive error, the light rays going into your eye are bent and focused by the cornea and lens in such a way that they are not focused on the retina and thus form a blurred image.
What are the four main types of refractive errors?
The four major types of refractive error are myopia (nearsightedness), hyperopia (farsightedness), astigmatism, and presbyopia.
The most common refractive error is myopia or nearsightedness, whereby the light rays are focused in front of the retina. In astigmatism, irregular curvature of the cornea and lens results in the image being focused on different planes not coinciding with the retina. Hyperopia or farsightedness occurs when the light rays are not bent enough and the image is focused behind the retina. You can also have a combination of myopic astigmatism or hyperopic astigmatism. Presbyopia is a loss of the elasticity of the naturally occurring crystalline lens whereby individuals cannot focus clearly at close distances and need reading aids. This becomes apparent around the fourth decade of life.
How is a refractive error measured and what is a diopter?
When you read a prescription, a minus sign means nearsightedness and a plus sign means farsightedness. The first number in the prescription indicates the amount of myopia or hyperopia you have. If there are numbers written in the next two columns, these indicate the amount of astigmatism, if any, and the axis where it is present. The unit to measure a refractive error is called a diopter or D. For example, if your prescription says -2 or -2D or -2 sph or -2 sphere, it means that you are nearsighted and require 2 diopters of correction. A diopter is a unit of measurement related to the focal length of an optical system including the human eye. The larger the diopter the shorter the focal length.
How can a refractive error be corrected?
The standard method for correction of any refractive error is glasses or contact lenses.
What are surgical options for correction of myopia (nearsightedness)?
The most common surgical procedures are the excimer-laser-based procedures called LASIK (laser assisted in-situ keratomileusis) and photorefractive keratectomy (PRK); in addition our surgeons perform corneal rings and intraocular lense implants.
What are surgical options for correction of astigmatism?
If the astigmatism is combined with myopia or hyperopia, the surgeon can correct astigmatism using LASIK or PRK. If the astigmatism is not combined with myopia or hyperopia, non-laser incisional methods such as astigmatic keratotomy (AK) may be used.
What are surgical options for correction of hyperopia (farsightedness)?
Wavefront-guided LASIK and LASEK are approved for correction of farsightedness.
How does laser vision correction work?
Laser vision correction changes the curvature of the cornea, one of the structures of the eye that focuses light on the retina. If the eye is too large or the cornea’s curvature too great, light focuses improperly and distant objects appear blurred. This is called nearsightedness or myopia. If the cornea’s curvature is too flat, close objects appear blurred. This is called farsightedness or hyperopia. With the laser we can reshape the contour of the cornea by sculpting extremely small amounts of corneal tissue. The four types of laser treatment we use are called Wavefront-guided LASIK, LASIK, PRK and LASEK.
Am I a good candidate for laser surgery?
You should be at least be 21 years of age to ensure stable vision, and should not have scars in the cornea or any autoimmune diseases. A complete evaluation by a specially trained Tomoka Eye optometrist, together with a Tomoka Eye laser surgeon, is required to determine if you are a candidate. The evaluation lasts 1 – 2 hours and includes a complete dilated eye exam, refraction, and corneal topography exam.
Are there contraindications?
There are certain medications that should be discontinued prior to surgery. Persons who are pregnant or nursing should postpone their surgery until their hormonal status is back to normal. People with certain corneal conditions such as keratoconus should be excluded prior to surgery.
Is there a problem if I wear contact lenses?
You should discontinue contact lens wear prior to your evaluation. Long-term contact lens wear can cause reversible surface changes in the cornea also known as corneal warpage. Soft contact lenses should therefore be removed at least two weeks prior and hard or rigid gas-permeable lenses at least three weeks prior to the evaluation.