After your routine eye exam, you might be advised to see an ophthalmologist, a specialized eye care surgeon. But how do you find the right one? While online reviews can be helpful, there’s more to consider. Here’s your guide to finding the perfect eye surgeon.
Where do you start?
You could look a doctor up online and hope the reviews are ‘real’ reviews. There may be a list of potential specialists, but how do you decide which is best for your particular concerns. Maybe you will choose the one that is the closest and most convenient, checking to make sure they take your insurance. Here are a few suggestions:
1. Ask your primary care optometrist who do they recommend.
Often optometrists see the handiwork of local ophthalmologists and know their reputations, good or poor. They may have a working relationship with a few specialists and a good line of communication, which would benefit you for the coordination of information and treatment between the two doctors.
The optometrist will be aware of what is the surgeon’s specialty and will guide you to the optimal provider.
2. Understand that there are sub-specialties in ophthalmology.
You are best served by finding the ‘right’ surgeon with the right credentials. Here is a few terms you will see:
“Board certified in …” means that they took an examination to be certified in a particular sub-specialty with the organization that credentials these physicians.
“Fellowship in ..” means that they have spent additional time training in the field of their specialty. It is usually a year or more in an accredited facility.
Here is a list of ophthalmology sub -specialties and examples of the types of surgeries they do:
Retina and Vitreous specialist
- Anti-VEGF injections for AMD,
- vitrectomy,
- repair retinal detachments,
- treats degenerative diseases of the retina, and
- removes retinal lesions.
Learn more about macular degeneration, see my other article: The 7 Truths about AMD
Neuro-ophthalmologist This is a sub-specialty of both neurology and ophthalmology.
- Diagnosis and treatment of disease related to innervations of eye – brain- face,
- treats optic nerve disease,
- facial spasms,
- eye muscles movement disorders,
- double vision, and
- systemic related eye diseases: thyroid eye disease and multiple sclerosis.
Oculoplastic Surgeon specializes in repair and treatment of the orbit and lids of the eye and facial area around the eye. Typically called ‘cosmetic’ surgeon.
- Eyelid ptosis (congenital and age related),
- eyelid surgery (lumps, bumps, and repairs),
- orbital reconstruction/repair (congenital and post-traumatic), and
- tear duct surgery.
Glaucoma specialist treats advanced stages of glaucoma which may require surgical intervention.
- Laser treatment for reducing eye pressure,
- ‘drains’ for decreasing eye pressure,
- cataract surgery.
Cornea specialist. Diagnosis and treatment of the clear front surface of the eye called the cornea.
- Refractive surgery, laser treatment to reduce dependency on glasses (ex: Lasik),
- corneal replacement surgery for keratoconus.
Pediatric and Adult strabismus specialist Children are a specialty. These specialists are equipped for these smaller and sometimes less cooperative patients. Commonly, children are diagnosed with strabismus (problem of eye alignment with an eye that is turned ‘in’ or ‘out.’) Adults may also require eye muscle surgery. For this reason, they are called strabismus surgeons.
- Congenital and early onset diseases of the eye,
- strabismus (eye muscle) surgery, for both children and adults.
General ophthalmologist, also may be called comprehensive ophthalmologist. They diagnose and treat eye problems and diseases, but will often refer to one of their specialized colleagues for the more complex problems.
- Cataract surgery,
- tear duct surgery,
- eyelid lesion removal and repairs,
- laser treatments, refractive surgery, and
- common in-office procedures.
Note on cataract surgery: Many of the above listed specialists also do cataract surgery. It is a surgery that is relatively straight forward (by ophthalmologist standards), and is covered by most insurances.
There are crossover areas of these specialties. For example; a patient with thyroid eye disease may elect to see either a cornea specialist , a neuro-ophthalmologist, or a mild case may be managed by a general ophthalmologist.
3. Does the Surgeon give you options, if there is more than one possible treatment?
Multiple options may not always be available. If there is more than one way to achieve a satisfactory outcome, the specialist needs to explain the pros and cons for you to best understand the options.
The best example, where there are choices to be made, is the types of replacement lenses available after cataract removal:
- Offers premium IOLs (at an additional cost over basic corrective replacement lenses), such as bifocal or the new trifocal lens implants,
- a lens implant that adjusts to different light levels,
- offers to do minimally invasive glaucoma surgery (MIGS) which is a glaucoma surgery that can be done at the same time as cataract removal surgery.
4. Offers post surgical care.
Prior to surgery , the doctors’ staff should set up a follow up schedule.
The surgeon may recommend after care with your primary care eye doctor. This is an acceptable practice.
The surgeon should also be willing to do touch up procedures where needed, for example, plastic surgery or refractive surgery. After cataract removal and lens implant, if there is unsatisfactory visual outcome, the surgeon may offer additional excimer laser correction.
5. Do they offer the latest and best technologies.
This is a little bit more difficult to determine. Few non-professionals will know what is the latest and best technology for the types of treatments or surgeries performed by the specialist, unless they ‘advertise’ what advantages their practice has available. That is not to say that others don’t have the same options.
Things to look for are:
- Testing and imaging technology,
- access to laser technology,
- adequate support staff, and
- available information on qualifications and services available.
Since you have not been to see this doctor yet, you may have to rely on recommendations or the experience of others.
The best doctors will know the best techniques and treatments. The result is satisfied patients with successful outcomes
6. In-office vs Surgical Center vs Hospital
Most surgical eye procedures are done on an one-day outpatient basis. Ultimately, it is the surgeon who decides where to do the procedure. You might consider this when choosing a doctor.
Those factors that determine where the surgeon elects to do the procedure depends on:
- Complexity of the surgical procedure,
- risk for complications,
- age and health status of the patient, who may need to stay overnight for recovery and observation,
- resources available for the operating doctor, and
- availability.
Many procedures are done by the ophthalmologist in-office. Particularly, treatments that are injections (anti-VEG-F), removal of surface lesions, lachrymal duct plugs or dilation, and foreign body removal. Additionally, ophthalmologist offices will very often have argon and YAG lasers for glaucoma, retina, and post-cataract surgery treatments.
Surgical centers are outpatient stand alone, surgical facilities. They are becoming more prevalent because of increased demand for surgical facilities and the insurance companies’ reluctance to pay for overnight stays.
The surgeon may prefer this location for:
- Easier scheduling and availability,
- less expensive than a hospital, and
- some have made arrangements with the center to specialize in certain procedures.
Hospitals are the better choice if the surgeon determines that the complexity of the surgery requires technology available only at a larger, better financed referral center. The hospital will also have more staff to accommodate the surgeon. Patients who are more frail or have other health related risk factors may need overnight recovery, observation, and treatments.
How to find an Eye Surgeon – Resources
Certainly the best way is by internet access. Type into your browser:
Find an ophthalmologist near me, what comes up:
Find an Ophthalmologist at secure.aao.org This is a good site for an international search: Type in country and any other local information, how many miles you are willing to travel, and hit search. What comes up is a list of ophthalmologists with a map of locations. The list also includes the doctor’s specialty.
Find a Ophthalmologist Near You – WebMD Physician Directory Select a state -> select the town. A list comes up with locations and a brief description of the doctor and specialty.
Looking to make sure they are a Medicare provider>
Search: Medicare Find an Ophthalmologist:
Physician Compare – Medicare.gov
Type in your zip code and the type of doctor you need (ex: glaucoma, cataracts, and a drop down menu will appear to help you choose.) Click search and a list of doctors with a brief description of their specialty and a map indicating locations comes up.
For those with other insurances, check the website of your insurance carrier. They may have a list of doctors who accept your insurance
In the End…
In your search for the right eye surgeon, consider these factors to make an informed decision. Opting for a surgeon who matches your specific needs and provides thorough care can lead to successful outcomes and satisfied patients. Remember, your eye health is invaluable, so take the time to find the best specialist for you.
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