In this episode, Dr. Mistry and Donna Lee are joined by ophthamologist Dr. Ravi Patel to discuss some of the most common age-related eye conditions and the cutting edge treatments he uses to help restore his patients' vision. Whether you have advanced cataracts and aren't sure what your options are, or have dry eyes and don't understand why eye drops aren't helping, this episode is for you! Dr. Patel explains which patients are good candidates for laser eye surgery, the difference between wet and dry macular degeneration, what to expect from a corneal transplant, and more! To contact Dr. Patel, call Eye Associates of Central Texas at 512-244-1991 or visit them online today.
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Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Speaker 2 (00:07):
Welcome to the Armor Men's Health Show with Dr.
Mystery and Donna Lee.
Speaker 3 (00:15):
Hello, this is Dr.
Mystery host of the Armor Men'sHealth Show. Joined every week
by my co-host Donna Lee.
Speaker 4 (00:22):
That's right. You know, I can do this show
without you. Sometimes
Speaker 3 (00:24):
You do the show without me. Sometimes ,
and I think they get morelisteners maybe.
Speaker 4 (00:29):
But you're so busy sometimes, and you have all the
six children and twograndchildren. I mean, and
you're a surgeon. I'm
Speaker 3 (00:34):
An amazing person.
.
Speaker 4 (00:37):
And you see children.
Speaker 3 (00:38):
This is a men's health show. I'm a board
certified urologist. And thisshow is brought to you by the
practice I started in 2007. N Au Urology specialist. Mm-hmm.
. We have fourphysicians growing to six. Soon
we have six advanced practiceproviders, two physical
therapists, a nutritionist, asex therapist, and a strong
(00:59):
commitment to taking care ofyou from your nipples to your
knees , to your knees , to yourknees. Knees . Donna, how do
people get ahold of us and makean appointment with us if they
want to get their holisticurology appointment? That's
Speaker 4 (01:08):
Right. Holistic urology. I love it. It's 5 1 2
2 3 8 0 7 6 2. Our website isarmor men's health.com. And you
know what? We got a really busypodcast.
Speaker 3 (01:17):
We do have a really busy podcast. So you can listen
to them , can catch up onprevious episodes.
Speaker 4 (01:21):
That's right.
Spotify, iHeartRadio, all thepodcast sites. Listen to
wherever you listen to freepodcasts.
Speaker 3 (01:26):
So I became a urologist because I like
playing with balls. Yeah.
Speaker 4 (01:28):
And penises. And the peepees
Speaker 3 (01:31):
And Peepees. People always wonder, do I really
enjoy playing with balls? Youreally do. And the answer is, I
love operating and I loveoperating on testicles. I
Speaker 4 (01:38):
Think we scared away half the audience at this
Speaker 3 (01:39):
Point. That's right.
But you know, there are acouple of balls that I don't
play with.
Speaker 4 (01:42):
I know. Wha what
Speaker 3 (01:43):
Kind of ball is it ?
Speaker 4 (01:44):
Eyeballs.
Speaker 3 (01:45):
Eyeballs.
Speaker 5 (01:46):
Oh man , .
Speaker 3 (01:48):
So today we're joined by one of our newest
friends, Dr. Ravi Patel. He'swith Eye Associates of Central
Texas. Dr. Patel. Uh , so sorrythat you didn't know what to
expect, but welcome.
Speaker 5 (01:58):
Oh , thank you for having me. Actually, I knew to
expect that 'cause I'velistened to a bunch of your
podcasts at this point.
Speaker 3 (02:04):
Well ,
Speaker 4 (02:04):
That's great. He's not scared . That's great.
Speaker 3 (02:05):
So , so, Dr . Patel, you're an ophthalmologist.
First of all, can you spellophthalmology? .
Speaker 5 (02:10):
There's uh , two H's in there, actually at three. I
mean , uh, do you actually wantme to spell ophthalmology?
There's two Hs.
Speaker 3 (02:15):
Yeah , go ahead.
Let's
Speaker 5 (02:15):
See. Oh , okay.
, O P H T h. Mostpeople forget that First H
after the p. Mm-hmm .
, then all , Imean A l m o l o g i S D. Nice
. That's
Speaker 3 (02:24):
Pretty good. He , he passed the test spelling b .
Nice job. So , uh, anophthalmologist is an actual
medical doctor, is thatcorrect?
Speaker 5 (02:31):
That is correct. I think
Speaker 4 (02:32):
An eye dentist .
Speaker 5 (02:34):
Okay . Yeah , that a lot of my friends call me an
eye dentist . We're fairly farremoved from the rest of
general medicine, but yes, weare in fact medical doctors.
Speaker 3 (02:41):
How is an ophthalmologist different than
an optometrist in terms ofeducation and scope of work?
Speaker 5 (02:46):
Yeah, okay. That's a good question. So , um, yeah,
ophthalmologists go throughmedical school and then we
still go through a , a year ofgeneral , uh, year training,
either internal medicine orsurgical residency, and then
finish a three year , you know,medical surgical residency.
Whereas optometrists , uh, oncethey graduate from college,
they can go straight intooptometry school where they
focus a lot on, I , I thinkthey'll, they would call it
(03:08):
general eyecare, if you will.
So a lot of that is glasses andcontacts. And then there are
some routine medical thingsthey'll do. Optometrist,
schools are changing thoughthat I think there're starting
to do like this additional yearof , I think they call it a
residency actually, wherethey'll do a little more in
depth on the medical side.
'cause it's depending on theschool, they may not get as
much of that.
Speaker 3 (03:24):
So after medical school, you did four years of
residency and then you wentbeyond. You, you didn't go to
Baylor College of Medicine,correct? I
Speaker 5 (03:30):
Did . My partners did, but I did not go to Baylor
. I will still listen to you a
Speaker 4 (03:33):
Little bit. Boy .
Hey, I have a quick question.
Do ophthalmologists make fun ofoptometrists?
Speaker 5 (03:38):
No.
Speaker 4 (03:38):
'cause there's more letters in there .
Speaker 5 (03:40):
No, we're definitely not. We gotta play nice and
capable . They're equal . Okay.
Sorry,
Speaker 3 (03:43):
Go ahead . Yeah .
Yeah . That's not nice. No .
The eyes' is a very small placeto fight. . Yeah ,
that's right. That's right.
. So , um, afterresidency you also went to ,
um, an amazing place for your,your, your fellowship. Bascom
Palmer , uh, eye Institute iswhere I took my own son to get
his , uh, posis surgery fixedwhen he was , uh, just a little
kid , uh, to tell us about thatplace and what it was it like
(04:06):
doing your fellowship there.
Speaker 5 (04:07):
Oh, wow. I'm surprised you know what that
is. Uh, yeah. So Bascom Palmerwe're
Speaker 4 (04:11):
Professionals, sir .
Speaker 5 (04:12):
Yeah, I read my bio then . Well, I guess you've
been there. So . Um ,yeah, it's a very, very big eye
hospital in Miami. You think aneye clinic could be a small
like room, but this is actuallya sixth floor building with
each having its ownfloor. And so it's the sort of
the mecca of tertiary care ,um, beyond Florida, people
flying in all over the place toget some sort of zebra
(04:32):
diagnosis managed there. Uh ,so, and
Speaker 3 (04:34):
It's because Florida has a lot of old people and old
people have lots of eyeproblems.
Speaker 5 (04:39):
Well , that is true.
Speaker 3 (04:40):
So I wannas talk about, I wanna talk about, we
should, we should combinemm-hmm . . That's
right.
Speaker 4 (04:44):
The eye in penis clinic featuring Dr . And Dr.
Patel. That does
Speaker 3 (04:47):
Remind me of a funny story. My son needed a
circumcision at the same time.
And so I asked the bascomPalmer guys, if somebody come
into a circumcision, they werelike, our operating rooms are
not equipped withcircumcisions,,
. We just do eyes here. Uh, so, um, uh, what , as people age
, uh, why don't you tell ussome of the most common eye
conditions of aging that , thatyou're gonna see in your
(05:07):
clinic? Yeah,
Speaker 5 (05:08):
So , um, I would say there's probably five main
things , uh, that we sort ofstart seeing as we get older.
One was more related to amedical diagnoses, but just to
list them , there's cataractsthat unfortunately happens to
all of us just as we get older.
It's just the nature of thelens.
Speaker 3 (05:22):
That's , that's when the lens inside your eye gets
kind of fuzzy. Right, exactly.
Speaker 5 (05:25):
Right. The protein starts to cloud up and it
slowly causes a blurriness toyour vision.
Speaker 3 (05:29):
So a as you're looking at bright lights or
driving at night, maybe you'regonna see it le less, less
focused and more blurry.
Speaker 5 (05:35):
Yeah. One of the first symptoms people will get
is difficulty driving at nightbecause the lights themselves
sort of causes light scatteredin the eye. And so you would
interpret that as glare and thelines and stuff might be harder
for you to distinguish. It'sactually probably one of the
earliest symptoms people get.
And , uh, one of the biggerreasons we do cataract surgery.
'cause cataract surgery,fortunately is fairly good at
fixing that problem.
Speaker 3 (05:55):
What
Speaker 5 (05:55):
Else? Um, yeah , so also see things like mac
degeneration. Now not everybodygets that one, but that's a
condition where your retinastarts to deteriorate as you
get older. Um, that affects,you know, millions of
Americans. Actually,
Speaker 3 (06:05):
My, my , my , my grandfather had macular
degeneration. There's a wetkind and a dry kind. What's the
difference between the two?
Yeah,
Speaker 5 (06:11):
So , uh, most people , everyone really, everyone
starts off with the dry kind.
I'd say maybe 90, 95% stay inthe dry kind , but a small
percentage do convert to thewet kind . And effectively what
that means, that these bloodvessels in the back of the eye
kind of break through theretinal layers and they start
either leaking fluid orsometimes even blood into the
retina, which causes asignificant drop in one's
vision. Mm-hmm .,
Speaker 3 (06:31):
This ruined his life because he couldn't read and do
the things that he wanted todo. But, but there are
treatments now for both dry andwet macular degeneration that
wouldn't have been in existence15 or 20 years ago. Is that
right?
Speaker 5 (06:41):
Yes, that is true.
So , uh, there've been , uh,treatments for wet macular
degeneration for a while now.
Uh, they're all effectivelyinjections at this point that
cause regression of those bloodvessels. And by those sort of
leaving the retina, you get animprovement in the amount of
fluid, which should improvevision. Now it doesn't get you
back to being a normal, youknow, 2020 type patient, if you
will, but it does improve thevision. The , the downside is,
(07:02):
unfortunately you have to keepdoing those injections. In a
lot of cases, if you were tostop the, the fluid would just
return.
Speaker 3 (07:08):
If I had to take a poll . Do you think a man would
rather have an injection intohis eyeball or his real balls?
Speaker 5 (07:14):
Hmm . Oh, eyeball.
Eyeball. Yeah .
Speaker 3 (07:16):
I don't , I don't know why. I don't know , man. I
don't know. If I
Speaker 4 (07:18):
Had a penis, I'd want you to go into
Speaker 3 (07:20):
My balls. That sounds frightening. Don't mess
with my eyes. I hope you justturn off the lights before you
inject. Please . .
Speaker 5 (07:25):
You , you don't want your surgeon to look ,
you
Speaker 3 (07:26):
Don't crap. That's right. You have to see you all
. So you named two of them .
What else? What are the otherthree?
Speaker 5 (07:31):
Uh, so , uh, glaucoma's another big one
that, again, it doesn't happento everyone, but can happen as
we get older.
Speaker 3 (07:35):
And that's too much eye pressure, right? Because
there's too much fluid inthere. Well ,
Speaker 5 (07:39):
Sort of , uh, but you know , pressure's sort of a
loaded piece of glaucoma. It'sthe only modifiable piece of
glaucoma. Um, and so you canhave normal eye pressure and
still have
Speaker 3 (07:48):
Glaucoma. I didn't know that. Okay.
Speaker 5 (07:49):
Yeah, that one's called normal pressure
glaucoma. Yeah , that's , sothey got really creative with
that name . But yeah.
Uh , pressure , basically theidea is that high eye pressure
translates to sort of pressureon the optic nerve, which
damages it over time. And thosenerves start dying, which leads
to, at the beginning,peripheral vision loss, but
ultimately can lead to centralvision loss and blindness.
Speaker 3 (08:08):
Is that the puff of air that the guy will puff into
my eye? Yeah,
Speaker 5 (08:11):
They're checking your eye pressure. Hopefully
they're not doing puff of airsanymore. Most people
Speaker 3 (08:15):
Sort of , they , they aren't. No, no .
Speaker 5 (08:16):
Usually people like numb your eye and do what's
called application where thisdevice touches your eye to
actually really?
Speaker 4 (08:20):
That was so 2010.
Really ? Oh my god. I mean,they don't do that
Speaker 3 (08:24):
Anymore . I think my optometrist is just giving me
like some messages. Yes .
Speaker 5 (08:27):
Are you still getting a puff of maybe , maybe
they are , maybe optometristsstill doing puff of airs ? Most
Speaker 3 (08:31):
Of us are . Well , I think that's hitting on me.
Okay . , uh, well whatare the other two? They're
puffing your penis. Uh ,Betty's not doing, he's a penis
puff . If you're going to theoptometrist and you have to
take off your pants, there'ssomething wrong . There's
something wrong .
Speaker 4 (08:41):
Wrong .
Speaker 5 (08:41):
Yeah .
Speaker 3 (08:41):
Yeah . Um , or right.
Speaker 5 (08:43):
I guess another one, and this is actually born
prominent in Texas, is actuallyjust dry eyes. Um , that's
actually extremely common. It'sactually common in younger age
groups as
Speaker 3 (08:50):
Well. I think you're just making that crap up now.
Speaker 5 (08:52):
Dry eyes. Well, I think everyone else thinks it's
made up too, actually . Yeah .
Speaker 3 (08:55):
Yeah . I think I , you're just making up.
Speaker 5 (08:57):
Yeah . I'd say most people complain when those
people complain about somediscomfort of their eyes. It's
usually just dryness and theyjust need to put drops in. But
I mean, dryness can be severe.
It can actually also be ablinding problem, but that's
very, very rare. You'd needsome sort of underlying like
medical condition like wrappersassociation like that.
Speaker 3 (09:12):
So , so what you're saying is that, is that there
are people that have a medicallevel of dry eyes and there are
both all over the counter aswell as prescriptive eyedrops
for that kind of thing, right?
Oh
Speaker 5 (09:22):
Yeah, yeah, absolutely. So, you know, my
cornea training, maybe I'vesort of gathered a lot of dry
eye patients. I would say thisis the main medical condition I
treat in my clinic, actuallyjust because of my background
training. But dry eyes isactually a really, really
tricky , uh, condition to treatbecause all the treatments out
there aren't really curativeand I would say they're not all
the most effective. Um, and soit ends up being a very
(09:44):
complicated puzzle to try toget the right treatment going
for a patient to get theirsymptoms stabilized. Even then
, it's what they understandingthat as they get older, it's
likely gonna start getting alittle worse. A little worse.
Speaker 3 (09:52):
Yeah . What's number five? Gosh ,
Speaker 5 (09:53):
I now I'm like having to think back . What did
I say? Oh, diabeticretinopathy, . Okay. So
that's what I meant by medicalcondition. It's pretty common
as you get older. Just, youknow , diabetic retinopathy
usually isn't a function ofyour acute control. It's
actually more correlated to howlong you've had the condition.
Just that long term of havingthe fluctuation of the blood
glucose , damage , blood and
Speaker 3 (10:10):
Vessel , it can make you blind, right?
Speaker 5 (10:10):
Yeah, exactly.
Right. Yeah. And so I'm sure ,uh, diabetes actually probably
plays a role in your clinic aswell with Ed and the heart
doctors getting , you know,
Speaker 3 (10:18):
You just stay in your lane, buddy. , you
stay with your eyeballs, youeye dentist . Don't you worry
about your,
Speaker 5 (10:22):
I gotta show up . I know more than just about eyes,
right? I can't be an eyedentist here .
Speaker 3 (10:25):
Well, Dr . Ravi Patel, you're with Eye
Associates of Central Texas.
How does somebody make anappointment with you?
Speaker 5 (10:29):
Yeah, so they , they can obviously just call our
number during our , uh, officehours. It's 5 1 2 2 4 4 1 9 9 1
. Or just go to our website, iassociates texas.com.
Speaker 3 (10:39):
Well, thank you so much for joining us. And Donna,
how do people get ahold of us?
You can
Speaker 4 (10:42):
Call us at (512) 238-0762 or visit our website,
armor men's health.com andcheck out our podcast wherever
you listen to free podcasts.
Speaker 3 (10:50):
Hello and welcome to the Armor Men's Health Show.
I'm Dr. Mystery , your host,board certified urologist and
very proud purveyor ofknowledge when it comes to
men's health. But I couldn't dowithout my lovely co-host
Donnel Lee , who
Speaker 4 (11:03):
Knows nothing about men's health. Hello everybody.
Speaker 3 (11:05):
, you've made
a lot of men's lives. Terrible
though. I
Speaker 4 (11:09):
Have because I make them go to the urologist
Speaker 3 (11:11):
. That's
right. . Donna, you're
one of our most importantspokespeople and you
communicate a lot with thepatients and listeners that ,
uh, try to contact us forappointments and things like
that. Mm-hmm. ,um, you , we've, we've gotten
great feedback. And what's someadvice you'd give to somebody
out there that's contemplatingvisiting a urologist? Uh,
Speaker 4 (11:28):
To pick the provider with the smallest hands if
they're having prostate issues?
That's
Speaker 3 (11:32):
Correct.
Speaker 4 (11:32):
And to come with an open mind. I think we educate
our patients really wellthrough the show and through
marketing that they're going to, um, be connected with a
holistic provider. More timesthan not, we're gonna talk
about lifestyle managementsupplements. How's your sleep?
We're gonna do all theseamazing, fun things that other
urology groups might not do.
And
Speaker 3 (11:48):
I think that you should know, you know, as a
patient that not all doctorsare made the same. There are,
you are certainly going to geta different level of care
depending on the expertise andthe interest level of the
doctor that you're going tosee. And so if you're
dissatisfied with your urologiccare, we would love to see you
as a second opinion. If you'vebeen diagnosed with prostate
cancer, you certainly shouldalways consider getting a
second opinion. If you are goundergoing a major prostate
(12:10):
surgery for an enlargedprostate, or you're , uh,
dissatisfied with your ED ortestosterone therapy, we would
love to see you as a secondopinion. Donna, how do people
get ahold of us?
Speaker 4 (12:19):
You can call us at (512) 238-0762 . I've been
asked to slow that down. Youknow , uh, our website is armor
men's health.com and you canfind any of our podcasts on the
topic that you'd like. So let'ssay you wanna talk about
enlarged penis. You can googleenlarged penis , um, armor
Men's health show, and you'llfind the podcast.
Speaker 3 (12:35):
Ironically, they're gonna see my picture and
Speaker 4 (12:37):
They'll .
There's Dr. Ger , this hugepenis.
Speaker 3 (12:41):
We we're joined once again by one of our good
friends, Dr. Robbie Patel withI Associates of Central Texas.
Dr. Patel, thank you so muchfor joining us. You're welcome.
Thank
Speaker 5 (12:49):
You for having me.
So ,
Speaker 3 (12:50):
Um, as I'm getting older and I , I , I've had
glasses for, for many, manyyears, and I feel like
increasingly , uh, a life ofwearing glasses is something
that's going to be kind of inthe past. Mm-hmm . So , uh, I'd
love to talk to you a littlebit about , uh, vision
correction surgery, whether itbe Lasix or as you get older ,
uh, kind of lens replacementsurgery and kind of what's new
(13:11):
out there. And , uh, le let'stalk about LASIK first. So
Lasik's been around for a while. Ha Has it really changed at
all? Uh,
Speaker 5 (13:16):
There are some new iterations of , uh, laser eye
surgery coming out. Um, there'sa new procedure called SMILE
that some practices arestarting to adopt. It's, you
know, with , with lasik whatwe're doing is we're cutting a
flap into your cornea, liftingthat flat up, and then doing
the actual second laser. Do thecorrective procedure to reshape
your cornea and lay the flapback down. What
Speaker 3 (13:34):
Is the cornea?
Speaker 5 (13:35):
The cornea is the clear structure in front. Uh,
it's like a clear dome in thefront of your eye. It's over
the iris in the pupil. That'swhere the majority of the
refractive power of your eyecomes in, is actually in the
cornea. What's
Speaker 4 (13:46):
The flap?
Speaker 5 (13:47):
So the , when we have a corneas, it's about 550
microns or so. Uh, you know,the, the layer, the surface
layer is called the epithelium.
That's kind of constantly beingreplaced, but that's not making
natural shape of your eye.
Mm-hmm. . And sothe stroma , the structure
underneath is, and so what wehave to do is cut a flap to
remove that top layer. We getto the meat of the cornea, and
then we laser it to reshape thewhole cornea to whatever your
(14:07):
prescriptive power should be.
And that when that flap laysdown on top of it, it just
takes on that shape giving youyour new shape and your new
vision. Oh ,
Speaker 4 (14:14):
Nice.
Speaker 5 (14:14):
Um,
Speaker 3 (14:15):
And so , uh, how long does the procedure take?
Oh ,
Speaker 5 (14:17):
Probably about 10 minutes. An eye. It's, that's ,
it's not very long actually .
Wow.
Speaker 3 (14:21):
And that's what she said . So , uh, the procedure
itself does not take a , a , along time. And, and who , um,
who benefits the most from aLASIK operation , uh, versus
something more invasive? Say.
Speaker 5 (14:33):
Yeah, good question.
So lasik uh, procedures aredefinitely much more beneficial
to the younger crowd. So when Isay younger, I mean like
probably around 18 to 35 to 40or so. And the reason that is,
is that when you're younger,your , your eye has a lens
inside of it that can stillchange shapes. It's in a
process called accommodation.
So resting state, your eyeshould be focused out fully to
the distance. We say 20 feetand beyond. And then when you ,
(14:54):
you put your hand in front ofyou, the , the muscles in your
eye change the lens shape tofocus up close. If I do LASIK
and get rid of your glasses,set you perfectly to the
distance when you're younger, Iexpect you to have a full range
of perfect vision really. Butlet's say you to try to get
LASIK done in your fiftieswhere your lens has gone
through a change now where it'slosing that ability to
accommodate, it's losing theability to change its shape.
(15:15):
And so if I set your visionperfectly, the distance, you'd
probably be happy with yourdistance vision, but you'll no
longer be able to read up closeand you'll have to get reading
glasses. And so LASIK won'tnecessarily get people out of
needing glasses at older ages.
Thus it becomes a little bitless
Speaker 3 (15:28):
Effective. And so , um, you know , uh, there ,
there were concerns in the pastabout buzziness or other kind
of complications from lasik.
What are the, the topcomplications you educate your
patients about when they'recontemplating LASIK surgery?
Speaker 5 (15:41):
Oh , mainly dry eyes , actually. That's the number
one thing. You know , a lot offolks after they get LASIK duct
, we'll complain about dry eyesfor about a year or so. There's
a lot of studies showing thatas they age, they're much more
likely to end up with moresignificant dry eyes than a
person who had never had LASIKdone in their thirties. And ,
and just my background, I endup seeing a lot of folks with
dry eyes. Some of that can bereally difficult to treat. And
so I, I definitely spend a longtime talking about dry eyes
(16:04):
with any patient prior to doingany kind of refractive
Speaker 3 (16:06):
Procedure. And you won't do it in anybody under 18
or will you do it in liketeenagers as well?
Speaker 5 (16:11):
No, it's not FDA approved for that. Um, but also
I would, I actually don't do itanyone under like low twenties
actually. Really? Okay. Becausethe idea is that at 18 you're
not necessarily done shiftingin terms of your overall
prescription. And so you don'twanna be doing a permanent
procedure, if you will, on amoving target. Mm-hmm . And so
one of the things that qualifyis showing stability in neuro
fraction, but juststatistically speaking, you can
(16:32):
be stable for a year or two butthen not be stable two years
down the line. And so I like towait really in the early
twenties or mid twenties beforeI start offering lasik.
Probably early twenties if I'mbeing honest about that. But
yeah, so I think waiting alittle bit's probably
beneficial just 'cause you get, in my opinion, a longer
lasting result out of it.
Speaker 3 (16:46):
Is there any way to test whether or not your lens
can still accommodate to see ifeven an older person would be a
candidate for lasik?
Speaker 5 (16:52):
Yeah, I mean , um, I get if you put contact lenses
in, or even with your glasses,if you just get single vision
distance glasses, if you'restill able to read up close
with them on, that means youstill can't accommodate. 'cause
your , your prescriptive poweris really meant to give you
perfect distance vision unlessyou're wearing a bifocal or
progressive glasses or amultifocal contact lens. So for
most folks, if you have singlevision , uh, correction, you're
(17:13):
actually setting your eyes fordistance. And if you're able to
read through that, you actuallyall are still accommodating.
But , uh, just know it's a ,it's a time bomb, meaning in
the sense that as you get olderin your forties, you're gonna
start losing that ability.
Speaker 3 (17:24):
So now I think it's a little unfair that my dad
doesn't have to wear glasses .
Speaker 5 (17:28):
Oh , because ,
Speaker 3 (17:28):
Because he got his eyes fixed when he got his
cataracts done . Oh . So whydon't you talk to us about like
the new generation of cataractsurgery because I feel like
with an aging population,everybody's getting their
cataracts fixed nowadays andall my surgical or time is
being taken up by you peoplethat are taking it up, doing 40
cataracts a day. So talk to usabout cataract surgery.
Speaker 5 (17:49):
Yeah. Okay. So with cataract surgery, what we're
effectively doing is going inyour eye, taking a cloudy lens
out and replacing it with theclear plastic lens. And I'd say
most of the advances happeningin the space are actually
happening with what type oflens implant we're placing back
in one's eye. Traditionally,there's been this paradigm of
having to choose betweenquantity or quality of vision.
What I mean by that is thatthe, you know, the traditional
(18:10):
basic lens implant is amonofocal lens, meaning you get
one focus point. And so we canset you a , as an example out
for distance again, but thatlens implant also isn't
flexible. So in when thestandard lens implant, you'd be
forced to wear reading glasses.
You'd have high quality vision,but low quantity in terms of
range. Hmm . Um, and so whatfolks have been doing to try to
give more qua quantity iswhat's called the multifocal
(18:32):
lenses . I, my guess is that'swhat your dad probably got, but
that's a lens that effectivelysplits the lighter , you know ,
it's called defractive opticsand it gives you a distance ,
uh, focus point, mid-range andnear. And so more or less you
can get the whole range ofvision. But to achieve that,
you have to sacrifice a littlebit of the quality of your
vision. And I think most peoplewill notice that at nighttime
when they're driving carheadlights would start having
(18:53):
this starbursting glare patterncoming off of it. And that's
just the physics and of theoptics of that lens. Uh, but
newer lenses are coming out totry and maintain the quality of
the vision and still providemore quantity if you will .
Speaker 3 (19:05):
Now a lot of these things are covered by insurance
and some things are notcovered. So, so if somebody's
out there and they're thinkingto themselves that they're
gonna go get cataracts and comeout with perfect vision and uh,
uncle Sam's gonna pay for it,that they may be a little bit
surprised.
Speaker 5 (19:17):
Yes. No, uncle Sam will only pay for that first
option that I talked about.
They, they view all the othernicer lens, if you will, as
cosmetic. 'cause they knowthere is a base option that
will give you excellent visionwith glasses in terms of the
rest of your range. And so theywon't cover any of what we call
premium IOLs. Those can range .
That's
Speaker 4 (19:35):
Just the man keeping us down.
Speaker 3 (19:36):
man's
keeping us , but luckily they
still cover penile implants andour Viagra Shut up.
Speaker 4 (19:41):
Just shut up with
Speaker 3 (19:42):
That. . So
, when it comes to
cataract surgery , uh, h howlong is the surgery? Uh, and
how, how quick is the recovery?
Speaker 5 (19:51):
Yeah, the surgery probably only takes me about
five to maybe it's a tough case. 10 minutes to do. It's a
pretty quick procedure. He's
Speaker 4 (19:57):
Got a tough life .
He has these five minuteprocedures all day. Trust me.
Speaker 3 (20:00):
no real
surgeon considers an
ophthalmologist a surgeon, .
Speaker 4 (20:03):
Oh, I opened that story . Well ,
Speaker 5 (20:05):
We do like 20 to 25.
We do a lot of 'em . That totake up , take up your or time
. Oh
Speaker 3 (20:09):
No's lot . Still making a , a one o'clock due
time . ,
Speaker 5 (20:12):
That would be true.
. Um, yeah, but therecovery's fast. Most people
see better the next day.
Actually sometimes it can taketwo to three days or so, but
when we say the full heeltime's about a month. Um , but
the visual recovery is very,very quick.
Speaker 3 (20:25):
And how long will you wait between eyes?
Speaker 5 (20:28):
I only wait a week between eyes actually. Hmm .
Um, you can't do 'em on thesame day. There's some risk
associated with that and I , Idon't think insurance would
even cover that truthfully. Somost people wait either one to
two weeks between eyes .
Speaker 3 (20:37):
And how much can somebody , uh, expect to pay
for that premium i o l to lookand feel Great ?
Speaker 5 (20:44):
Yeah . Varies by practice truthfully , but can
be generally I just ballpark toa few thousand dollars. Mm-hmm
.
Speaker 3 (20:50):
.
Okay. Well thank you so much.
Uh , Dr. Ravi Patel with IAssociates of Central Texas. If
people are looking to lookbetter and feel better, how do
they get an appointment withyou?
Speaker 5 (20:59):
Yeah , um, they can go to our website, i associates
of texas.com or just give us acall during business hours. Our
number 5 1 2 2 4 4 1 9 9 1.
Speaker 3 (21:08):
And if you have problems with your other balls,
your non eyeballs mm-hmm.
, how do they getan appointment with us? Donna,
Speaker 4 (21:14):
You can call us at (512) 238-0762 and visit our
website, armor men'shealth.com.
Speaker 2 (21:19):
The Armor Men's Health Show is brought to you
by N A U Urology Specialist.
For questions or to schedule anappointment, please call 5 1 2
2 3 8 0 7 6 2 or online atarmor men's health.com.
Speaker 2 (00:07):
Welcome to the Armor Men's Health Show with Dr.
Mystery and Donna Lee.
Speaker 3 (00:15):
Hello, this is Dr.
Mystery host of the Armor Men'sHealth Show. Joined every week
by my co-host Donna Lee.
Speaker 4 (00:22):
That's right. You know, I can do this show
without you. Sometimes
Speaker 3 (00:24):
You do the show without me. Sometimes
and I think they get morelisteners maybe.
Speaker 4 (00:29):
But you're so busy sometimes, and you have all the
six children and twograndchildren. I mean, and
you're a surgeon. I'm
Speaker 3 (00:34):
An amazing person.
Speaker 4 (00:37):
And you see children.
Speaker 3 (00:38):
This is a men's health show. I'm a board
certified urologist. And thisshow is brought to you by the
practice I started in 2007. N Au Urology specialist. Mm-hmm.
we have six advanced practiceproviders, two physical
therapists, a nutritionist, asex therapist, and a strong
(00:59):
commitment to taking care ofyou from your nipples to your
knees , to your knees , to yourknees. Knees . Donna, how do
people get ahold of us and makean appointment with us if they
want to get their holisticurology appointment? That's
Speaker 4 (01:08):
Right. Holistic urology. I love it. It's 5 1 2
2 3 8 0 7 6 2. Our website isarmor men's health.com. And you
know what? We got a really busypodcast.
Speaker 3 (01:17):
We do have a really busy podcast. So you can listen
to them , can catch up onprevious episodes.
Speaker 4 (01:21):
That's right.
Spotify, iHeartRadio, all thepodcast sites. Listen to
wherever you listen to freepodcasts.
Speaker 3 (01:26):
So I became a urologist because I like
playing with balls. Yeah.
Speaker 4 (01:28):
And penises. And the peepees
Speaker 3 (01:31):
And Peepees. People always wonder, do I really
enjoy playing with balls? Youreally do. And the answer is, I
love operating and I loveoperating on testicles. I
Speaker 4 (01:38):
Think we scared away half the audience at this
Speaker 3 (01:39):
Point. That's right.
But you know, there are acouple of balls that I don't
play with.
Speaker 4 (01:42):
I know. Wha what
Speaker 3 (01:43):
Kind of ball is it ?
Speaker 4 (01:44):
Eyeballs.
Speaker 3 (01:45):
Eyeballs.
Speaker 5 (01:46):
Oh man ,
Speaker 3 (01:48):
So today we're joined by one of our newest
friends, Dr. Ravi Patel. He'swith Eye Associates of Central
Texas. Dr. Patel. Uh , so sorrythat you didn't know what to
expect, but welcome.
Speaker 5 (01:58):
Oh , thank you for having me. Actually, I knew to
expect that 'cause I'velistened to a bunch of your
podcasts at this point.
Speaker 3 (02:04):
Well ,
Speaker 4 (02:04):
That's great. He's not scared . That's great.
Speaker 3 (02:05):
So , so, Dr . Patel, you're an ophthalmologist.
First of all, can you spellophthalmology?
Speaker 5 (02:10):
There's uh , two H's in there, actually at three. I
mean , uh, do you actually wantme to spell ophthalmology?
There's two Hs.
Speaker 3 (02:15):
Yeah , go ahead.
Let's
Speaker 5 (02:15):
See. Oh , okay.
after the p. Mm-hmm .
. That's
Speaker 3 (02:24):
Pretty good. He , he passed the test spelling b .
Nice job. So , uh, anophthalmologist is an actual
medical doctor, is thatcorrect?
Speaker 5 (02:31):
That is correct. I think
Speaker 4 (02:32):
An eye dentist .
Speaker 5 (02:34):
Okay . Yeah , that a lot of my friends call me an
eye dentist . We're fairly farremoved from the rest of
general medicine, but yes, weare in fact medical doctors.
Speaker 3 (02:41):
How is an ophthalmologist different than
an optometrist in terms ofeducation and scope of work?
Speaker 5 (02:46):
Yeah, okay. That's a good question. So , um, yeah,
ophthalmologists go throughmedical school and then we
still go through a , a year ofgeneral , uh, year training,
either internal medicine orsurgical residency, and then
finish a three year , you know,medical surgical residency.
Whereas optometrists , uh, oncethey graduate from college,
they can go straight intooptometry school where they
focus a lot on, I , I thinkthey'll, they would call it
(03:08):
general eyecare, if you will.
So a lot of that is glasses andcontacts. And then there are
some routine medical thingsthey'll do. Optometrist,
schools are changing thoughthat I think there're starting
to do like this additional yearof , I think they call it a
residency actually, wherethey'll do a little more in
depth on the medical side.
'cause it's depending on theschool, they may not get as
much of that.
Speaker 3 (03:24):
So after medical school, you did four years of
residency and then you wentbeyond. You, you didn't go to
Baylor College of Medicine,correct? I
Speaker 5 (03:30):
Did . My partners did, but I did not go to Baylor
. I will still listen to you a
Speaker 4 (03:33):
Little bit. Boy .
Hey, I have a quick question.
Do ophthalmologists make fun ofoptometrists?
Speaker 5 (03:38):
No.
Speaker 4 (03:38):
'cause there's more letters in there .
Speaker 5 (03:40):
No, we're definitely not. We gotta play nice and
capable . They're equal . Okay.
Sorry,
Speaker 3 (03:43):
Go ahead . Yeah .
Yeah . That's not nice. No .
The eyes' is a very small placeto fight.
that's right. That's right.
um, an amazing place for your,your, your fellowship. Bascom
Palmer , uh, eye Institute iswhere I took my own son to get
his , uh, posis surgery fixedwhen he was , uh, just a little
kid , uh, to tell us about thatplace and what it was it like
(04:06):
doing your fellowship there.
Speaker 5 (04:07):
Oh, wow. I'm surprised you know what that
is. Uh, yeah. So Bascom Palmerwe're
Speaker 4 (04:11):
Professionals, sir .
Speaker 5 (04:12):
Yeah, I read my bio then . Well, I guess you've
been there. So
hospital in Miami. You think aneye clinic could be a small
like room, but this is actuallya sixth floor building with
each
the mecca of tertiary care ,um, beyond Florida, people
flying in all over the place toget some sort of zebra
(04:32):
diagnosis managed there. Uh ,so, and
Speaker 3 (04:34):
It's because Florida has a lot of old people and old
people have lots of eyeproblems.
Speaker 5 (04:39):
Well , that is true.
Speaker 3 (04:40):
So I wannas talk about, I wanna talk about, we
should, we should combinemm-hmm .
right.
Speaker 4 (04:44):
The eye in penis clinic featuring Dr . And Dr.
Patel. That does
Speaker 3 (04:47):
Remind me of a funny story. My son needed a
circumcision at the same time.
And so I asked the bascomPalmer guys, if somebody come
into a circumcision, they werelike, our operating rooms are
not equipped withcircumcisions,
. We just do eyes here. Uh, so, um, uh, what , as people age
, uh, why don't you tell ussome of the most common eye
conditions of aging that , thatyou're gonna see in your
(05:07):
clinic? Yeah,
Speaker 5 (05:08):
So , um, I would say there's probably five main
things , uh, that we sort ofstart seeing as we get older.
One was more related to amedical diagnoses, but just to
list them , there's cataractsthat unfortunately happens to
all of us just as we get older.
It's just the nature of thelens.
Speaker 3 (05:22):
That's , that's when the lens inside your eye gets
kind of fuzzy. Right, exactly.
Speaker 5 (05:25):
Right. The protein starts to cloud up and it
slowly causes a blurriness toyour vision.
Speaker 3 (05:29):
So a as you're looking at bright lights or
driving at night, maybe you'regonna see it le less, less
focused and more blurry.
Speaker 5 (05:35):
Yeah. One of the first symptoms people will get
is difficulty driving at nightbecause the lights themselves
sort of causes light scatteredin the eye. And so you would
interpret that as glare and thelines and stuff might be harder
for you to distinguish. It'sactually probably one of the
earliest symptoms people get.
And , uh, one of the biggerreasons we do cataract surgery.
'cause cataract surgery,fortunately is fairly good at
fixing that problem.
Speaker 3 (05:55):
What
Speaker 5 (05:55):
Else? Um, yeah , so also see things like mac
degeneration. Now not everybodygets that one, but that's a
condition where your retinastarts to deteriorate as you
get older. Um, that affects,you know, millions of
Americans. Actually,
Speaker 3 (06:05):
My, my , my , my grandfather had macular
degeneration. There's a wetkind and a dry kind. What's the
difference between the two?
Yeah,
Speaker 5 (06:11):
So , uh, most people , everyone really, everyone
starts off with the dry kind.
I'd say maybe 90, 95% stay inthe dry kind , but a small
percentage do convert to thewet kind . And effectively what
that means, that these bloodvessels in the back of the eye
kind of break through theretinal layers and they start
either leaking fluid orsometimes even blood into the
retina, which causes asignificant drop in one's
vision. Mm-hmm .
Speaker 3 (06:31):
This ruined his life because he couldn't read and do
the things that he wanted todo. But, but there are
treatments now for both dry andwet macular degeneration that
wouldn't have been in existence15 or 20 years ago. Is that
right?
Speaker 5 (06:41):
Yes, that is true.
So , uh, there've been , uh,treatments for wet macular
degeneration for a while now.
Uh, they're all effectivelyinjections at this point that
cause regression of those bloodvessels. And by those sort of
leaving the retina, you get animprovement in the amount of
fluid, which should improvevision. Now it doesn't get you
back to being a normal, youknow, 2020 type patient, if you
will, but it does improve thevision. The , the downside is,
(07:02):
unfortunately you have to keepdoing those injections. In a
lot of cases, if you were tostop the, the fluid would just
return.
Speaker 3 (07:08):
If I had to take a poll . Do you think a man would
rather have an injection intohis eyeball or his real balls?
Speaker 5 (07:14):
Hmm . Oh, eyeball.
Eyeball. Yeah .
Speaker 3 (07:16):
I don't , I don't know why. I don't know , man. I
don't know. If I
Speaker 4 (07:18):
Had a penis, I'd want you to go into
Speaker 3 (07:20):
My balls. That sounds frightening. Don't mess
with my eyes. I hope you justturn off the lights before you
inject. Please .
Speaker 5 (07:25):
You , you don't want your surgeon to look
you
Speaker 3 (07:26):
Don't crap. That's right. You have to see you all
. So you named two of them .
What else? What are the otherthree?
Speaker 5 (07:31):
Uh, so , uh, glaucoma's another big one
that, again, it doesn't happento everyone, but can happen as
we get older.
Speaker 3 (07:35):
And that's too much eye pressure, right? Because
there's too much fluid inthere. Well ,
Speaker 5 (07:39):
Sort of , uh, but you know , pressure's sort of a
loaded piece of glaucoma. It'sthe only modifiable piece of
glaucoma. Um, and so you canhave normal eye pressure and
still have
Speaker 3 (07:48):
Glaucoma. I didn't know that. Okay.
Speaker 5 (07:49):
Yeah, that one's called normal pressure
glaucoma. Yeah , that's , sothey got really creative with
that name
Uh , pressure , basically theidea is that high eye pressure
translates to sort of pressureon the optic nerve, which
damages it over time. And thosenerves start dying, which leads
to, at the beginning,peripheral vision loss, but
ultimately can lead to centralvision loss and blindness.
Speaker 3 (08:08):
Is that the puff of air that the guy will puff into
my eye? Yeah,
Speaker 5 (08:11):
They're checking your eye pressure. Hopefully
they're not doing puff of airsanymore. Most people
Speaker 3 (08:15):
Sort of , they , they aren't. No, no .
Speaker 5 (08:16):
Usually people like numb your eye and do what's
called application where thisdevice touches your eye to
actually really?
Speaker 4 (08:20):
That was so 2010.
Really ? Oh my god. I mean,they don't do that
Speaker 3 (08:24):
Anymore . I think my optometrist is just giving me
like some messages. Yes .
Speaker 5 (08:27):
Are you still getting a puff of maybe , maybe
they are , maybe optometristsstill doing puff of airs ? Most
Speaker 3 (08:31):
Of us are . Well , I think that's hitting on me.
Okay .
puffing your penis. Uh ,Betty's not doing, he's a penis
puff . If you're going to theoptometrist and you have to
take off your pants, there'ssomething wrong . There's
something wrong .
Speaker 4 (08:41):
Wrong .
Speaker 5 (08:41):
Yeah .
Speaker 3 (08:41):
Yeah . Um , or right.
Speaker 5 (08:43):
I guess another one, and this is actually born
prominent in Texas, is actuallyjust dry eyes. Um , that's
actually extremely common. It'sactually common in younger age
groups as
Speaker 3 (08:50):
Well. I think you're just making that crap up now.
Speaker 5 (08:52):
Dry eyes. Well, I think everyone else thinks it's
made up too, actually . Yeah .
Speaker 3 (08:55):
Yeah . I think I , you're just making up.
Speaker 5 (08:57):
Yeah . I'd say most people complain when those
people complain about somediscomfort of their eyes. It's
usually just dryness and theyjust need to put drops in. But
I mean, dryness can be severe.
It can actually also be ablinding problem, but that's
very, very rare. You'd needsome sort of underlying like
medical condition like wrappersassociation like that.
Speaker 3 (09:12):
So , so what you're saying is that, is that there
are people that have a medicallevel of dry eyes and there are
both all over the counter aswell as prescriptive eyedrops
for that kind of thing, right?
Oh
Speaker 5 (09:22):
Yeah, yeah, absolutely. So, you know, my
cornea training, maybe I'vesort of gathered a lot of dry
eye patients. I would say thisis the main medical condition I
treat in my clinic, actuallyjust because of my background
training. But dry eyes isactually a really, really
tricky , uh, condition to treatbecause all the treatments out
there aren't really curativeand I would say they're not all
the most effective. Um, and soit ends up being a very
(09:44):
complicated puzzle to try toget the right treatment going
for a patient to get theirsymptoms stabilized. Even then
, it's what they understandingthat as they get older, it's
likely gonna start getting alittle worse. A little worse.
Speaker 3 (09:52):
Yeah . What's number five? Gosh ,
Speaker 5 (09:53):
I now I'm like having to think back . What did
I say? Oh, diabeticretinopathy,
that's what I meant by medicalcondition. It's pretty common
as you get older. Just, youknow , diabetic retinopathy
usually isn't a function ofyour acute control. It's
actually more correlated to howlong you've had the condition.
Just that long term of havingthe fluctuation of the blood
glucose , damage , blood and
Speaker 3 (10:10):
Vessel , it can make you blind, right?
Speaker 5 (10:10):
Yeah, exactly.
Right. Yeah. And so I'm sure ,uh, diabetes actually probably
plays a role in your clinic aswell with Ed and the heart
doctors getting , you know,
Speaker 3 (10:18):
You just stay in your lane, buddy.
stay with your eyeballs, youeye dentist . Don't you worry
about your,
Speaker 5 (10:22):
I gotta show up . I know more than just about eyes,
right? I can't be an eyedentist here .
Speaker 3 (10:25):
Well, Dr . Ravi Patel, you're with Eye
Associates of Central Texas.
How does somebody make anappointment with you?
Speaker 5 (10:29):
Yeah, so they , they can obviously just call our
number during our , uh, officehours. It's 5 1 2 2 4 4 1 9 9 1
. Or just go to our website, iassociates texas.com.
Speaker 3 (10:39):
Well, thank you so much for joining us. And Donna,
how do people get ahold of us?
You can
Speaker 4 (10:42):
Call us at (512) 238-0762 or visit our website,
armor men's health.com andcheck out our podcast wherever
you listen to free podcasts.
Speaker 3 (10:50):
Hello and welcome to the Armor Men's Health Show.
I'm Dr. Mystery , your host,board certified urologist and
very proud purveyor ofknowledge when it comes to
men's health. But I couldn't dowithout my lovely co-host
Donnel Lee , who
Speaker 4 (11:03):
Knows nothing about men's health. Hello everybody.
Speaker 3 (11:05):
though. I
Speaker 4 (11:09):
Have because I make them go to the urologist
Speaker 3 (11:11):
one of our most importantspokespeople and you
communicate a lot with thepatients and listeners that ,
uh, try to contact us forappointments and things like
that. Mm-hmm.
great feedback. And what's someadvice you'd give to somebody
out there that's contemplatingvisiting a urologist? Uh,
Speaker 4 (11:28):
To pick the provider with the smallest hands if
they're having prostate issues?
That's
Speaker 3 (11:32):
Correct.
Speaker 4 (11:32):
And to come with an open mind. I think we educate
our patients really wellthrough the show and through
marketing that they're going to, um, be connected with a
holistic provider. More timesthan not, we're gonna talk
about lifestyle managementsupplements. How's your sleep?
We're gonna do all theseamazing, fun things that other
urology groups might not do.
And
Speaker 3 (11:48):
I think that you should know, you know, as a
patient that not all doctorsare made the same. There are,
you are certainly going to geta different level of care
depending on the expertise andthe interest level of the
doctor that you're going tosee. And so if you're
dissatisfied with your urologiccare, we would love to see you
as a second opinion. If you'vebeen diagnosed with prostate
cancer, you certainly shouldalways consider getting a
second opinion. If you are goundergoing a major prostate
(12:10):
surgery for an enlargedprostate, or you're , uh,
dissatisfied with your ED ortestosterone therapy, we would
love to see you as a secondopinion. Donna, how do people
get ahold of us?
Speaker 4 (12:19):
You can call us at (512) 238-0762 . I've been
asked to slow that down. Youknow , uh, our website is armor
men's health.com and you canfind any of our podcasts on the
topic that you'd like. So let'ssay you wanna talk about
enlarged penis. You can googleenlarged penis , um, armor
Men's health show, and you'llfind the podcast.
Speaker 3 (12:35):
Ironically, they're gonna see my picture and
Speaker 4 (12:37):
They'll
There's Dr. Ger , this hugepenis
Speaker 3 (12:41):
We we're joined once again by one of our good
friends, Dr. Robbie Patel withI Associates of Central Texas.
Dr. Patel, thank you so muchfor joining us. You're welcome.
Thank
Speaker 5 (12:49):
You for having me.
So ,
Speaker 3 (12:50):
Um, as I'm getting older and I , I , I've had
glasses for, for many, manyyears, and I feel like
increasingly , uh, a life ofwearing glasses is something
that's going to be kind of inthe past. Mm-hmm . So , uh, I'd
love to talk to you a littlebit about , uh, vision
correction surgery, whether itbe Lasix or as you get older ,
uh, kind of lens replacementsurgery and kind of what's new
(13:11):
out there. And , uh, le let'stalk about LASIK first. So
Lasik's been around for a while. Ha Has it really changed at
all? Uh,
Speaker 5 (13:16):
There are some new iterations of , uh, laser eye
surgery coming out. Um, there'sa new procedure called SMILE
that some practices arestarting to adopt. It's, you
know, with , with lasik whatwe're doing is we're cutting a
flap into your cornea, liftingthat flat up, and then doing
the actual second laser. Do thecorrective procedure to reshape
your cornea and lay the flapback down. What
Speaker 3 (13:34):
Is the cornea?
Speaker 5 (13:35):
The cornea is the clear structure in front. Uh,
it's like a clear dome in thefront of your eye. It's over
the iris in the pupil. That'swhere the majority of the
refractive power of your eyecomes in, is actually in the
cornea. What's
Speaker 4 (13:46):
The flap?
Speaker 5 (13:47):
So the , when we have a corneas, it's about 550
microns or so. Uh, you know,the, the layer, the surface
layer is called the epithelium.
That's kind of constantly beingreplaced, but that's not making
natural shape of your eye.
Mm-hmm.
underneath is, and so what wehave to do is cut a flap to
remove that top layer. We getto the meat of the cornea, and
then we laser it to reshape thewhole cornea to whatever your
(14:07):
prescriptive power should be.
And that when that flap laysdown on top of it, it just
takes on that shape giving youyour new shape and your new
vision. Oh ,
Speaker 4 (14:14):
Nice.
Speaker 5 (14:14):
Um,
Speaker 3 (14:15):
And so , uh, how long does the procedure take?
Oh ,
Speaker 5 (14:17):
Probably about 10 minutes. An eye. It's, that's ,
it's not very long actually .
Wow.
Speaker 3 (14:21):
And that's what she said . So , uh, the procedure
itself does not take a , a , along time. And, and who , um,
who benefits the most from aLASIK operation , uh, versus
something more invasive? Say.
Speaker 5 (14:33):
Yeah, good question.
So lasik uh, procedures aredefinitely much more beneficial
to the younger crowd. So when Isay younger, I mean like
probably around 18 to 35 to 40or so. And the reason that is,
is that when you're younger,your , your eye has a lens
inside of it that can stillchange shapes. It's in a
process called accommodation.
So resting state, your eyeshould be focused out fully to
the distance. We say 20 feetand beyond. And then when you ,
(14:54):
you put your hand in front ofyou, the , the muscles in your
eye change the lens shape tofocus up close. If I do LASIK
and get rid of your glasses,set you perfectly to the
distance when you're younger, Iexpect you to have a full range
of perfect vision really. Butlet's say you to try to get
LASIK done in your fiftieswhere your lens has gone
through a change now where it'slosing that ability to
accommodate, it's losing theability to change its shape.
(15:15):
And so if I set your visionperfectly, the distance, you'd
probably be happy with yourdistance vision, but you'll no
longer be able to read up closeand you'll have to get reading
glasses. And so LASIK won'tnecessarily get people out of
needing glasses at older ages.
Thus it becomes a little bitless
Speaker 3 (15:28):
Effective. And so , um, you know , uh, there ,
there were concerns in the pastabout buzziness or other kind
of complications from lasik.
What are the, the topcomplications you educate your
patients about when they'recontemplating LASIK surgery?
Speaker 5 (15:41):
Oh , mainly dry eyes , actually. That's the number
one thing. You know , a lot offolks after they get LASIK duct
, we'll complain about dry eyesfor about a year or so. There's
a lot of studies showing thatas they age, they're much more
likely to end up with moresignificant dry eyes than a
person who had never had LASIKdone in their thirties. And ,
and just my background, I endup seeing a lot of folks with
dry eyes. Some of that can bereally difficult to treat. And
so I, I definitely spend a longtime talking about dry eyes
(16:04):
with any patient prior to doingany kind of refractive
Speaker 3 (16:06):
Procedure. And you won't do it in anybody under 18
or will you do it in liketeenagers as well?
Speaker 5 (16:11):
No, it's not FDA approved for that. Um, but also
I would, I actually don't do itanyone under like low twenties
actually. Really? Okay. Becausethe idea is that at 18 you're
not necessarily done shiftingin terms of your overall
prescription. And so you don'twanna be doing a permanent
procedure, if you will, on amoving target. Mm-hmm . And so
one of the things that qualifyis showing stability in neuro
fraction, but juststatistically speaking, you can
(16:32):
be stable for a year or two butthen not be stable two years
down the line. And so I like towait really in the early
twenties or mid twenties beforeI start offering lasik.
Probably early twenties if I'mbeing honest about that. But
yeah, so I think waiting alittle bit's probably
beneficial just 'cause you get, in my opinion, a longer
lasting result out of it.
Speaker 3 (16:46):
Is there any way to test whether or not your lens
can still accommodate to see ifeven an older person would be a
candidate for lasik?
Speaker 5 (16:52):
Yeah, I mean , um, I get if you put contact lenses
in, or even with your glasses,if you just get single vision
distance glasses, if you'restill able to read up close
with them on, that means youstill can't accommodate. 'cause
your , your prescriptive poweris really meant to give you
perfect distance vision unlessyou're wearing a bifocal or
progressive glasses or amultifocal contact lens. So for
most folks, if you have singlevision , uh, correction, you're
(17:13):
actually setting your eyes fordistance. And if you're able to
read through that, you actuallyall are still accommodating.
But , uh, just know it's a ,it's a time bomb, meaning in
the sense that as you get olderin your forties, you're gonna
start losing that ability.
Speaker 3 (17:24):
So now I think it's a little unfair that my dad
doesn't have to wear glasses
Speaker 5 (17:28):
Oh , because ,
Speaker 3 (17:28):
Because he got his eyes fixed when he got his
cataracts done . Oh . So whydon't you talk to us about like
the new generation of cataractsurgery because I feel like
with an aging population,everybody's getting their
cataracts fixed nowadays andall my surgical or time is
being taken up by you peoplethat are taking it up, doing 40
cataracts a day. So talk to usabout cataract surgery.
Speaker 5 (17:49):
Yeah. Okay. So with cataract surgery, what we're
effectively doing is going inyour eye, taking a cloudy lens
out and replacing it with theclear plastic lens. And I'd say
most of the advances happeningin the space are actually
happening with what type oflens implant we're placing back
in one's eye. Traditionally,there's been this paradigm of
having to choose betweenquantity or quality of vision.
What I mean by that is thatthe, you know, the traditional
(18:10):
basic lens implant is amonofocal lens, meaning you get
one focus point. And so we canset you a , as an example out
for distance again, but thatlens implant also isn't
flexible. So in when thestandard lens implant, you'd be
forced to wear reading glasses.
You'd have high quality vision,but low quantity in terms of
range. Hmm . Um, and so whatfolks have been doing to try to
give more qua quantity iswhat's called the multifocal
(18:32):
lenses . I, my guess is that'swhat your dad probably got, but
that's a lens that effectivelysplits the lighter , you know ,
it's called defractive opticsand it gives you a distance ,
uh, focus point, mid-range andnear. And so more or less you
can get the whole range ofvision. But to achieve that,
you have to sacrifice a littlebit of the quality of your
vision. And I think most peoplewill notice that at nighttime
when they're driving carheadlights would start having
(18:53):
this starbursting glare patterncoming off of it. And that's
just the physics and of theoptics of that lens. Uh, but
newer lenses are coming out totry and maintain the quality of
the vision and still providemore quantity if you will .
Speaker 3 (19:05):
Now a lot of these things are covered by insurance
and some things are notcovered. So, so if somebody's
out there and they're thinkingto themselves that they're
gonna go get cataracts and comeout with perfect vision and uh,
uncle Sam's gonna pay for it,that they may be a little bit
surprised.
Speaker 5 (19:17):
Yes. No, uncle Sam will only pay for that first
option that I talked about.
They, they view all the othernicer lens, if you will, as
cosmetic. 'cause they knowthere is a base option that
will give you excellent visionwith glasses in terms of the
rest of your range. And so theywon't cover any of what we call
premium IOLs. Those can range .
That's
Speaker 4 (19:35):
Just the man keeping us down.
Speaker 3 (19:36):
still cover penile implants andour Viagra Shut up.
Speaker 4 (19:41):
Just shut up with
Speaker 3 (19:42):
That.
cataract surgery , uh, h howlong is the surgery? Uh, and
how, how quick is the recovery?
Speaker 5 (19:51):
Yeah, the surgery probably only takes me about
five to maybe it's a tough case. 10 minutes to do. It's a
pretty quick procedure. He's
Speaker 4 (19:57):
Got a tough life .
He has these five minuteprocedures all day. Trust me.
Speaker 3 (20:00):
ophthalmologist a surgeon,
Speaker 4 (20:03):
Oh, I opened that story . Well ,
Speaker 5 (20:05):
We do like 20 to 25.
We do a lot of 'em . That totake up , take up your or time
Speaker 3 (20:09):
No's lot . Still making a , a one o'clock due
time .
Speaker 5 (20:12):
That would be true.
see better the next day.
Actually sometimes it can taketwo to three days or so, but
when we say the full heeltime's about a month. Um , but
the visual recovery is very,very quick.
Speaker 3 (20:25):
And how long will you wait between eyes?
Speaker 5 (20:28):
I only wait a week between eyes actually. Hmm .
Um, you can't do 'em on thesame day. There's some risk
associated with that and I , Idon't think insurance would
even cover that truthfully. Somost people wait either one to
two weeks between eyes .
Speaker 3 (20:37):
And how much can somebody , uh, expect to pay
for that premium i o l to lookand feel Great ?
Speaker 5 (20:44):
Yeah . Varies by practice truthfully , but can
be generally I just ballpark toa few thousand dollars. Mm-hmm
.
Speaker 3 (20:50):
Okay. Well thank you so much.
Uh , Dr. Ravi Patel with IAssociates of Central Texas. If
people are looking to lookbetter and feel better, how do
they get an appointment withyou?
Speaker 5 (20:59):
Yeah , um, they can go to our website, i associates
of texas.com or just give us acall during business hours. Our
number 5 1 2 2 4 4 1 9 9 1.
Speaker 3 (21:08):
And if you have problems with your other balls,
your non eyeballs mm-hmm.
Speaker 4 (21:14):
You can call us at (512) 238-0762 and visit our
website, armor men'shealth.com.
Speaker 2 (21:19):
The Armor Men's Health Show is brought to you
by N A U Urology Specialist.
For questions or to schedule anappointment, please call 5 1 2
2 3 8 0 7 6 2 or online atarmor men's health.com.
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