General Procedure Instructions

ON THE DAY YOU BOOK YOUR PROCEDURE

• Arrange for a family member or friend to be with you on the day of your procedure and drive you home. Email [email protected] or text 314-375-2020 with their name, relationship, and mobile number. We may send them a short text message prior to the procedure and on the day of the procedure and will call them to give them notice when you are finishing up with your procedure.
• Read these five pages of General Procedure Instructions and the additional Specific Procedure Instructions thoroughly. This is for your safety and to ensure the best possible outcome! Initial and sign where indicated, then email or text us a scan/picture of each page by 5pm today to avoid having to reschedule your surgical appointment.
• Read your informed consent document. You will sign this on your day of procedure, so it is not necessary to email/text us any pictures of this document.
• For any surgery or preoperative measurement appointments, being out of contacts for seven full days is required. Contact lenses can alter the shape of your eyes, which affects the accuracy of our measurements and therefore your visual outcome after your procedure. Patients who wear contacts at all in the seven days prior to surgery or preoperative measurements will have their appointment rescheduled. Just imagine never putting contact lenses in your eyes again!
• If you do wear contact lenses, email or text us today with a picture of the side of your contact lens boxes including the prescription if we didn’t already get this picture at your BVOA. Include your name in the message and indicate which contact lens prescription is used for which eye.
• You may plan to fly as an airline passenger after your postop day #1 visit. Out of town patients should not book their flights from STL airport until after 12:00pm on postop day #1.

BEFORE PROCEDURE DAY

• We will send prescriptions for your post-operative drops to Juniper Pharmacy (please see Juniper letter for details). Proper usage of these drops is detailed in your specific treatment instructions. You are responsible for obtaining these drops from Juniper pharmacy prior to your surgery day. They will contact you for insurance and payment information. Please leave your medications sealed in the package as you receive them. It is very important you bring these with you on your day of surgery. We will open the package for you, confirm the medications are correct and all accounted for, and go through instructions with you. If you do not have your medicated drops with you when you arrive for surgery, we will have to reschedule your procedure to a different day to allow you time to pick up medications. This is for your safety as it is important to have each prescribed medication for you to heal well. This will not include your valium medication for during the surgery itself, that will be provided by our staff when you are in our office.
• Inform a Brinton Vision doctor if at any point between your initial consultation and procedure you have a change in medication, substance, or supplement use; if you have a new medical condition or change in health status; or (for women) if you are nursing or there is a chance you may be pregnant.
• Keep your phone nearby with sound on the night before your procedure and the day of your procedure. Surgery arrival times are commonly adjusted to decrease wait times in our office. You will only receive a call from our office if your surgery time will be changed.
• On procedure days we frequently take before and/or after photos with our patients, doctors, and/or the procedure staff for our Facebook page and other digital properties only. Email us if you would like a copy of your photo or if you would like to opt out of or restrict this.

ON PROCEDURE DAY

• No colognes, perfumes, scented lotions, or essential oils should be worn on the day of your procedure. Unscented lotions, body wash, and deodorant are fine. Completely remove all eye and face makeup prior to arrival.
• Leave valuables at home as you will not be able to keep your possessions with you during surgery.
• Eat a light but full meal. A spicy or heavy meal can make you uncomfortable when lying down.
• Take your regular medications on your procedure day as you would on any other day. If you are due to take a medication during the time you are scheduled to be in our office, you may bring the medication with you and take it while here.
• Before entering the laser room, use the restroom.

AFTER YOUR PROCEDURE

• Your vision may be blurry on your procedure day. It is normal to experience light sensitivity, halos/glare around lights, dryness, fluctuation in vision, and the sensation that something is in your eye. These symptoms typically improve as you heal. While many of our patients see well as soon as the next day, full healing for our procedures can take 3-6 months.
• We recommend keeping your eyes closed while sitting or lying down for the rest of the day. Listen to an audiobook or podcast, or just take a nap.
• Use the eye drops specific to your procedure as instructed (see specific treatment instructions). You do not need to start these drops until your procedure is complete, unless otherwise indicated in your specific treatment instructions. Our doctors may modify your medicated drop instructions or other instructions based on individual health circumstances or exam findings. In that case, what our doctor says supersedes what is written in your specific treatment instructions.
• You can expect to have some crusting on your eyelashes for a few days after surgery, as well as after instilling the prednisolone drop.
• Make sure to wash your hands prior to instilling any drops. After opening the top of the drop bottle or twist top vial, avoid touching the inside of the cap or the tip of the dropper so these can remain sterile. Use your fingers on one hand to pull down your lower lid slightly and create a “pocket.” With your other hand, place one drop in the “pocket.” Close both eyes gently as if you are sleeping. Dab the excess drop from your cheek with a tissue. Avoid squeezing, opening your eyes, or blinking for 3-5 minutes. This will maximize absorption of the drop and minimize the taste of the drop in the back of your throat.
• If you have difficulty placing drops, you may lie down so you are looking towards the ceiling. Close your eyes gently and place a drop in the inside (near the nose) corner of your eyelids. Blink several times to allow the drop to work its way into your eye.
• Separate eye drops by 5 minutes, so that the second drop doesn’t wash the first one away.
• When you administer an eye drop, one drop is sufficient as long as the drop makes contact with your inner eye. Using multiple drops does not increase the efficacy; additional drops will just run out of your eye and down your face. Using two or more drops is only necessary if you are flushing something out of your eye.
• During the healing phase after your procedure only use preservative-free artificial tears that come in a twist-top vial. We recommend that all patients use them frequently on the day of their procedure. Artificial tears in a bottle should not be used, even if the bottle is labeled “preservative-free.” The preservative-free vials multiple usages, and as long as you do not touch the tip, you may re-cap these vials and use them for several applications within 24 hours. It is impossible to over-use preservative free artificial tears – think of them more like a lotion for dry hands. For added comfort you may chill the vials in a refrigerator.
• Bring your eye drops to your postop visits so our staff can verify what you are taking.
• Patients may not drive until the next day following their procedure, and only once they are comfortable behind the wheel. Patients having the PRK procedure require separate clearance from a Brinton Vision doctor – please see the PRK specific procedure instructions for details.
• SBK, EVO ICL and RLE patients may take Tylenol/acetaminophen or NSAID medications (Aleve/naproxen, Advil/Motrin/ibuprofen, Aspirin, Excedrin) as needed. PRK patients may NOT use Tylenol if taking Percocet but can use NSAIDs.
• There is one restriction for all surgeries at Brinton Vision: no submerging head in dirty water including pools, rivers, streams, lakes or oceans for 1 week, then gradually return to water activities. You may shower or bathe after your postop day #1 visit as normal. Avoid getting tap water, shampoo, or soap in your eye for one week. If you do, rinse it out with artificial tears. Goggles are recommended early on if the potential exists for a hard impact on water (e.g. with water skiing, wakeboarding, jet skiing).
• Additional restrictions for lens-based procedures i.e. ICL/CLR include avoiding any strenuous physical activity for 1 week. This means no bending over at the waist where your head is below your heart, or lifting heavy weight that causes your face to turn red and neck veins to bulge.
• If you would like to wear eye makeup the day after your procedure, speak with a Brinton Vision doctor on how apply and remove this safely. We prefer you avoid eye makeup for one week.
• In some instances, your doctor will place a bandage contact lens in your eye at the conclusion of your procedure and will tell you if this is done. If your contact falls out, do not replace it. Keep your eyes closed as much as possible and use preservative-free artificial tears for comfort. Call the office and we can discuss whether to replace the contact lens.
• We recommend following these instructions if you have a history of dry eye or contact lens wear:
• Turn off all bedroom fans. These can cause dryness on the surface of your eyes even if they are small, off to the side, or pointed away from you because circulating air dries out your eyes while sleeping. Potential alternatives for your comfort while sleeping include a white noise machine/app for fan sounds, turning down your thermostat if you are too warm, or using a humidifier with distilled water for the sensation of a breeze or circulating air.
• Take omega-3 fish oil supplements. A common recommendation is to take two capsules twice a day for a total of 400 mg EPA and 200 mg DHA per day. If this leads to an unpleasant taste in your mouth you may freeze the pills. Discuss this with your primary care physician first if you have any medical conditions.
• Avoid over-the-counter medications for allergies or sinuses that dry the eyes, including Zyrtec, Allegra, Claritin, Sudafed, etc. For eye allergies we prefer you use a drop such as Zaditor or Pataday 2x/day.
• Take your preservative free artificial tears frequently in the early postoperative period.
• Our average blink rate is around 16x/min, however one study showed that if we focus on a book, phone, or computer screen our blink rate decreases to an average of 4x/min. This is a common cause of eyestrain when using a computer. To mitigate this issue, stay well hydrated, remind yourself to blink (picture your return key being the blink key), use artificial tears, and follow the 20/20/20 rule – every 20 minutes take a 20 second break and look at least 20 feet away into the distance.
• Strongly nearsighted patients may be used to holding objects very close to their face – e.g. for reading fine print, doing nails, makeup – because they are unable to see anywhere else. With your vision corrected you may lose very close up vision. Patients typically adapt from doing these activities very close in front of their face to a more typical mid-arm’s length distance just like anyone else who doesn’t need a glasses prescription. Special considerations apply for patients in their 40s and beyond who have presbyopia; make sure to discuss these with one of our doctors.
• It is our standard practice to update your primary care and eye doctors on the results of your exams and procedure.
• For your convenience, postoperative visits between 1 and 10 months after your procedure should be scheduled online at brintonvision.com/postop. Patients have the responsibility of ensuring that all required follow-up appointments are completed as specified in your Specific Procedure Instructions. These follow-up visits are scheduled on Tuesdays and Thursdays from 8am-3pm. Our schedule is subject to change.
• The eye is a delicate structure, so we recommend to all patients that they protect their eyes, whether or not they have had an eye procedure. We recommend general strategies to maintain the health of your eyes including wearing dark sunglasses with UV protection when outside and wearing protective eyewear when operating power tools, hammering metal on metal, repairing machinery, and even when doing yard work (mowing the lawn, using an edger, trimmer, or weed eater). The same applies for sports that present a risk to the eye such as racquetball, squash, and badminton. Never rub an eye (if you are curious why, ask one of our staff members to see the MRI video of what happens inside your eye while rubbing). Instead, if your eyes itch, use an artificial tear drop, stretch the skin over the bones around your eye (with clean hands), or place a clean, cool washcloth over your eyes for relief. Avoid bumping your eye.
• Even with your vision corrected, yearly eye exams are still required to maintain the health of your eye. Patients are to return to either Brinton Vision or your established eye care provider yearly for a thorough and comprehensive dilated health of eye exam. At Brinton Vision, we care about your eye health for life. Yearly dilated exams will have a charge of $240.
• Getting great vision isn’t just about your surgery day. Attending all follow-up appointments is essential to ensuring that you attain the best vision possible. If you live far from our office, please arrange for availability and transportation to any follow up appointments deemed necessary by our team of doctors. All care related to your procedure for the first year after surgery is included in the cost of your procedure. Health of eye visits for issues unrelated to your procedure, or yearly dilated exams will have a charge of $240.
• For clinic appointments at Brinton Vision, we request that you check in at our front desk on the third floor of the building fifteen (15) minutes prior to your appointment time. If you arrive after your scheduled appointment time we may reschedule your appointment. This is so that patients who arrive on time do not wait longer than necessary to see the doctor, and to allow proper time so that no one’s appointment is rushed. We may be able to schedule you for another appointment on the same day, however we cannot compromise on the quality and timely care we provide to our patients.
• Your follow up appointments are reserved especially for you. We value your business and ask that you respect our clinic’s scheduling policies. Our staff is scheduled a week in advance to be here and available for you, therefore we request that you arrive on time for your appointments, and should you need to reschedule that you do so at least a week in advance so we can adjust our staff schedule. We recognize everyone’s time is valuable, including patients and staff, and have implemented this policy for this reason. When you miss an appointment with us, we not only lose your business but also the potential business of other patients who could have scheduled an appointment for the same time. Additionally, in some cases, staff members work on an “on call” basis and may travel to the office or arrive at a time outside of their regular shift to accommodate your scheduled appointment.
• Follow-up performed at Brinton Vision that is directly related to your procedure and recommended by our doctors is included at no charge up until one year from your eye surgery date, including enhancement procedures. Our customary clinic, laser, and surgery fees apply thereafter, listed below. Complimentary follow-up services, including no-charge laser enhancements within the first year, are voided on the third instance that a patient is late for their appointment or reschedules without proper notice. At the third such visit our customary clinic, laser, and surgery fees will apply. When you book a surgery with us, you are agreeing to these policies.
• Customary clinic, laser, and surgery fees: Yearly dilated exams or non-surgery related health of eye visits have a charge of $240. Yag capsulotomy procedures for RLE patients, if recommended by a doctor, are $250/eye after one year. Permanent punctal plug placement by a doctor is $250/eye. If an enhancement or adjustment of vision is necessary over a year after your surgical procedure, we will not charge for our doctor’s time or surgical fees, however we do charge a facility fee of $1600/eye for a laser procedure.
• For logistical questions, contact Brinton Vision by email at [email protected] or text 314-375-2020 during office hours: M-F 8am-5pm. Questions received prior to 4pm will be answered the same day. Questions received after 4pm will be answered by the next business day. Medical questions need to be addressed in person by a doctor.

FAQS

“Why am I here for three hours on surgery day? Doesn’t my surgery take 15 minutes?”

Please remember to arrive in our front lobby 15 minutes prior to your appointment time.

You will have a significant amount of “down time” on your surgery day. This is intentionally added to the schedule so there is plenty of time for our topical eye drops and oral pill medications to take effect. For some surgeries, a wide and complete pupil dilation is required, not just the mild pupil dilation done at your BVOA, which can take 60-90 minutes. We also want to provide time for the Valium pill to take effect. Whether or not extra time is needed during your work up, it is built into our schedule for all patients so that when these steps are needed, we have adequate preparation time to provide a safe and comfortable surgery. While you wait, we ask that you not read or look at your cell phone, and rather keep your eyes closed as much as possible.

“Why should I keep my eyes closed while awaiting my surgery?”

We ask you to keep your eyes closed and not read on your cell phone more than necessary because the air filtration system in our office along with some of the drops we give can lead to your eyes becoming very dry prior to surgery. Cell phone use also decreases our blink rate so this compounds the problem. This can make your surgery more difficult, lead to poor surgery outcomes, and make your recovery process in the first 24 hours less comfortable. Plan to listen to a podcast or audiobook, talk to your companion, listen to music, or just relax with your eyes closed.

“I didn’t feel anything when drops were put in my eyes. Are you sure they went in?”

We use numbing eye drops on the day of surgery, so when we place eye drops in your eyes, you may not feel anything, or may even feel like we missed! Our staff are trained to carefully watch whether your eye receives the full drop given, and if not, will give another drop. If you don’t feel anything, this is a good sign!

“Why did my second eye surgery feel different than my first? Wasn’t it the same process”

Patients having surgery on both eyes should expect that the second eye surgery may feel significantly different than the first eye surgery, even if the surgeries are identical. It is the exception rather than the rule when a patient feels that both eye surgeries were similar.