2GB Interview – Dr Erica Darian-Smith & Luke Grant

[00:00:00.300] – Speaker 2
Well, you might want to listen closely to this week’s Health Segment, because it’s all about our eyes, from seeing friends and family to completing ordinary tasks. Vision is one of the most important senses, obviously, and it impacts everything. But here’s the surprising part. According to data from Optometry Australia, more than a third of Australians, a third, haven’t had regular eye examinations, and more than a half of us wear prescription glasses and contact lenses. Now, if you’re one of them, you might be tired of constantly reaching for your glasses or juggling the contacts every day. There are now treatments, this is good news, that can actually improve your vision, including laser eye surgery. The surgery is common. It’s a well-established procedure for correcting vision, problems like near-sightedness. In fact, there’s been a major breakthrough in a Sydney-based clinic for laser eye surgery. Dr. Erika Darian-Smith, an ophthalmic surgeon at Eagle Eye Surgeons, and she’s in the studio today. Dr. Erika, thank you very much for your time. Thanks, Luke. Nice to see you. Tell me, foremost, and tell me what your clinic is offering for the first time in Sydney, because this sounds… I love things that we make breakthroughs with medicine all the time, but the fact this is happening in your surgery in Sydney sounds really good.

[00:01:27.540] – Speaker 2
So what are you doing?

[00:01:28.320] – Speaker 1
So, Luc, as you said, laser Laser eye surgery has been around for quite some time, and it’s not particularly new. But there is a type of LASIK, so that’s a type of laser eye surgery that we can offer 40 to 60-year-olds. So these are patients that are now getting presbyopia. So that’s a condition where we lose our near vision, so we’re unable to see. It torment a lot of 40 to 60-year-olds.

[00:01:51.220] – Speaker 2
Can I just stop you there? Is that someone that would wear glasses like mine?

[00:01:55.100] – Speaker 1
Yes. That’s essentially someone who is fine even in the They don’t have a particular refractive error. But for iPhones and for computers, they lose their ability to see up close.

[00:02:08.180] – Speaker 2
In the 40 to 60-year-old group?

[00:02:09.960] – Speaker 1
Yeah, it usually happens around the age of 45. That’s usually roughly when it happens. There’s a spectrum It happens to everyone. It’s a universal problem. It is, isn’t it? It absolutely is. For these patients, we have a type of LASIK or laser eye procedure, which is called Presbyon. This is a procedure where we can get you out of your reading glasses. Also, if you were to have another type of refractive error, like if you were long-sided or short-sided, we can correct that at the same time.

[00:02:37.840] – Speaker 2
Does this require general anaesthetic? Are you knocked out? Are you in the chair or lying down for hours on end? How simple? What’s the procedure?

[00:02:48.540] – Speaker 1
Yeah, of course, not at all.

[00:02:49.340] – Speaker 2
Not that I want to do it ever.

[00:02:51.360] – Speaker 1
Not at all. Basically, you come for a complementary initial assessment at our clinic in Mossman, and we have a laser suite on site. What happens with this procedure is you’re not knocked out. There’s no general anaesthetic. We generally give you a very light sedation, like a little bit of diazopam just to relax your nerves, but you’re awake during the whole procedure. It’s actually a very quick procedure. It takes about five minutes per eye. Five minutes? Yeah, 5 to 10 minutes per eye. It’s very quick.

[00:03:19.840] – Speaker 2
I’ve got to ask you a question I’ve always wanted the answer to. I’ve been told before that with eye surgery, you don’t feel. You don’t feel anything.

[00:03:27.020] – Speaker 1
Is that true? Yeah, your eyes are numbed with some freezing drops. We put some topical anaesthetic in the eye. You do have a little metal speculum, so you can’t blink. People always ask me, I’m going to blink. How am I not going to blink?

[00:03:38.190] – Speaker 2
A speculum holds the eye open.

[00:03:40.400] – Speaker 1
Exactly. It’s like a little eyelid opener. We put that in. Sometimes patients can feel that, but it’s not painful. It just feels a bit awkward because it’s not really normal. Then we put some freezing drops in the eye, so you don’t feel any pain during the procedure. The procedure, as I said, is very quick. I talk to you throughout the whole procedure, so you get very sick of my by the surgery.

[00:04:01.640] – Speaker 2
You just talk, you sing or- Sometimes I dance and sing, but not at the same time as I’m operating.

[00:04:06.780] – Speaker 1
That doesn’t matter. Then we do the procedure, and then you go into our little recovery area in our practise, and we look at you straight after the surgery. It’s not scary in that sense that you’re asleep or it’s a long procedure.

[00:04:19.480] – Speaker 2
Are you fixed pretty quickly? I assume there’s some healing time. Before you answer that, laser is what? The focusing of a light into a part of the eye to correct its now shape or make it what it used to be.

[00:04:35.720] – Speaker 1
Is that-Laser eye surgery, we don’t go inside the eye. It’s a surface-based procedure. I’m a corneal and laser specialist, so I deal with the front part of the eye, which is the cornea. Laser essentially changes the shape of the front part of the eye, like you said. It’s a very minimally invasive procedure overall. Obviously, it still has risks, like any eye surgery. But because we’re not going inside the eye, the risk of really serious is reduced. That’s the process there.

[00:05:06.260] – Speaker 2
Listen, if you want to put a question to the doctor, Dr. Erica, you’re more than welcome to call us, 13187. 3. I just noticed Dr. Erika, we got a text here from a listener, Craig, Can diabetics get laser eye surgery?

[00:05:23.320] – Speaker 1
That’s a great question, Craig. It depends on what your diabetic control is. If you don’t have any diabetic eye disease, so if there are no signs of diabetes in the eye, then you may be a candidate for laser eye surgery. If you have significant eye disease from your diabetes, it’s best not to do eye surgery. It comes down to what your level of control is in your whole body. That’s why it’s important to see your GP or your endocrinologist to make sure that your diabetes is well-controlled. Then we actually have retinal specialists at our practise that look at whether you have diabetes in your eye. If you’re given the all clear, you may be a candidate for laser eye surgery.

[00:05:59.590] – Speaker 2
What What is diabetes in the eye? What does that even look like?

[00:06:02.580] – Speaker 1
That basically means that when your blood sugars are systemically out of control, you can have issues with the blood vessels in your eye, so they can start leaks. The sugar in the blood can cause the blood vessels in the eye to become leaky. You can essentially get fluid build up in the central part of your vision, so cordium macular. You can get diabetic macular edoema. It can make your vision very foggy.

[00:06:24.400] – Speaker 2
Right, okay. Double vision, is that an outcome?

[00:06:27.150] – Speaker 1
No, that’s not really, but you can get blurred vision for the distance. All right.

[00:06:31.500] – Speaker 2
We got some callers online. That didn’t take long, so people are really interested. Martin, how can we assist with you today?

[00:06:39.300] – Speaker 5
Good afternoon. I have been thinking about that procedure. I basically have reading glasses. But just a question about the actual business that we’re talking about here based in Mosman. What are the qualifications of the surgeon who undertake the work? Are they ophthalmologists or Yeah, absolutely.

[00:07:01.560] – Speaker 1
I’m one of the surgeons that does the work there. I’m a fully trained ophthalmic surgeon and ophthalmologist. I’ve done 15 years of training to get to the point where I’m at. I’ve specifically done a two-year fellowship overseas in Toronto to learn about the specific procedure and to do laser eye surgery. Absolutely, we’re fully qualified ophthalmologist. The Ranska, which is our college, obviously, we have full qualification from that as well.

[00:07:30.530] – Speaker 2
Wow. Well, that answers that question. I would have thought completely. I guess sometimes you hear reporting of, and this is certainly not in your field, and clinics are questioned, but that just answers things Perfectly. Ophthalmologist. Good thing to be. When you were… Let me answer me this, when you were five or six- I don’t know.

[00:07:50.820] – Speaker 1
Maybe I should have been on the radio.

[00:07:52.540] – Speaker 2
Well, you’re so good. I tell you what, what about we swap jobs for a day? Have a crack at this. Good on you, Martin. Andrew, How can we help you?

[00:08:02.260] – Speaker 5
I just wanted to know if laser surgery was suitable for someone who had astigmatism.

[00:08:07.820] – Speaker 1
Yes, Andrew. Laser surgery with our modern technology and our lasers. We’re really lucky. We have the latest lasers from Zeiss in Germany. We can treat usually up to about 5 to 6 dioptors of astigmatism. Absolutely. One thing that I do need to note, though, is you do need to have the scans done to make sure that the astigmatism isn’t because of any other reason, like keratoconus or a problem with the eye. But if your eye is overall healthy and you just have astigmatism on its own, then we can treat up quite high levels of astigmatism. Absolutely.

[00:08:36.820] – Speaker 2
Fantastic, Andrew. Thank you. Diane, good afternoon. Diane, your turn.

[00:08:43.640] – Speaker 3
Hi. Hi, Erica. How are you? Hi, Diane.

[00:08:46.740] – Speaker 1
How are you, Luke?

[00:08:47.940] – Speaker 3
Good. Good, thank you. My husband is 76, and last November, he had an eye stroke in his right eye, which he’s lost the vision. He’s just got peripheral vision. But my question is, we’re trying to improve the eyesight in his left eye because he’s had years of herpes infections in there which come and go with treatment. And now, our doctor is currently working on that, and he has got cataracts, and he’s trying to improve the vision on his left eye. So we just don’t know whether he could come and speak to somebody and have him assessed and see if he can do anything.

[00:09:29.380] – Speaker 1
Yeah, absolutely. Absolutely. As I said, I’m a corneal specialist, so I deal with herpes infections on the cornea all the time, and I’m also a cataract specialist. I’m more than happy to see him at our clinic and give him my opinion. No problems.

[00:09:40.960] – Speaker 2
Okay, well, there you are, Diane. Ask for Dr. Erica. I think she wants to be a radio announcement. Moonlighting is her ophthalmic surgeon. I’m now intrigued. The herpes infection of the eye, how does one contract that?

[00:09:58.080] – Speaker 1
There’s Different types of herpes. We’re talking about herpes or HSV type 1. That’s cold sores that little kids have. Lots of us have had herpes throughout our lives, and it’s very common, as you know, in childhood, we all get cold sores. What happens is you get the herpes infection, and it usually stays latent in the nerves, and then it reactivates at some point down the track. You might be a bit immunosuppressed, you might be a bit unwell. It’s actually extremely common. We see it all the time, and we can treat that with some antivirals, and there’s There’s a huge array of different severity of the condition. But yeah, it’s really common.

[00:10:34.280] – Speaker 2
All right. Thank you again, Diane. Ben, good afternoon.

[00:10:38.640] – Speaker 5
Good afternoon. What time, Luke. My question is, if somebody has done LASIK before in, say, 05, and they’re coming up now in a few years to fall into that age bracket, can they still do the LASIK because the doctor back then said, in 20 years time, if you hit 40, you might need. Is there enough thickness on the eye to do the surgery for the lash goals? When you’re talking about the LASIK?

[00:11:12.020] – Speaker 1
Yeah, great question. If you’ve had previous LASIK, you may Maybe a candidate for presbyon. We’ve definitely done presbyon on patients with previous LASIK, but obviously it’s very case-dependent, so we need to assess your eye, look at the health of your flaps, and make sure that there’s enough treatment area left based on what you had previously done. It’s best, again, to make an assessment with a clinic so we can make an individual adjustment for you. But yes, it is possible.

[00:11:36.420] – Speaker 2
Okay, good stuff. I hope that helps, Ben. To me, what we’ll do, we’ll clear a break here. I’ve got a couple more calls to get to, which I will after it. Dr. Erica Darian-Smith from Eagle Eye Surgeons here talking about laser eye surgery. More in a moment.

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Au. Afternoons on 2GB. Got a gurgle? 100% no digging guarantee from The Drain Man. Call us. We’ll fix it fast. 1-800 The Drain Man. My guest is Dr. Erika Darian-Smith, ophthalmic surgeon at Eagle Eye Surgeons. Dr. Erika, you’re a star. I want to say good day, Allen. We’ll get his question on air. We’re going to run out of time here, listeners. I’m sorry. Alan, go ahead. What’s your question?

[00:15:18.120] – Speaker 5
Good afternoon, Luke and doctor. I wear multifocal lenses, short and long-sided. I wear, that’s probably a plus five correction for my long sight. Would I be able to… Am I a candidate for something like that? Would it brand me that I wouldn’t have to wear glasses again?

[00:15:39.760] – Speaker 1
Yeah, absolutely. We deal with long-sided or hyper-roped all the time. I’ve We read it up to plus seven. That’s basically what we do. We do get people out of their multifocals. You may be a candidate for presbyon, or you may be a candidate for a lens-based procedure, so we can put a multifocal lens inside the eye. But either way, you’re definitely Probably someone that would be suitable to come and get an assessment for sure. Thank you, Alan.

[00:16:05.140] – Speaker 2
Another question we got. If you’re 65, are you eligible?

[00:16:09.540] – Speaker 1
If you’re 65, generally, we would say that instead of doing laser, you’re better off doing a lens-based procedure like what I was just mentioning, a multifocal implant inside the eye. But again, best to get an assessment and see if you’re a candidate.

[00:16:24.460] – Speaker 2
Tell me this, how big of an impact is screen time having on our eyes?

[00:16:28.380] – Speaker 1
Luke, screen time is a major We get patients all the time come to our clinic. We have a dry eye spa at our clinic, and excessive screen time causes really bad dry eye. That’s when people get the symptoms of blurring, foreign body sensation. It’s a major problem. There are things that we can do in our work environment to combat that. Typically, what could you do? We have the 20, 20, 20 rule. That is every 20 minutes, you should look away from your screen for 20 seconds 20 minutes, and you should look away at a distance of 20 feet.

[00:17:03.920] – Speaker 2
Right. 20 minutes, look away for 20 seconds.

[00:17:08.320] – Speaker 1
20 feet away. 20 feet. 20, 20, 20. 20, 20, 20. That’s good. Then also, we should make sure that our screen brightness is well adjusted, the heights of our screen, and our posture is good. All these things help with our eyes.

[00:17:20.000] – Speaker 2
What do you make of my work environment?

[00:17:21.460] – Speaker 1
It’s very nice. You’re very lucky at UGB.

[00:17:24.020] – Speaker 2
Damn it. If listeners take one piece of advice away today about caring for their eyes, what should it be?

[00:17:31.380] – Speaker 1
It should be, I can’t give you one, but I can give you a couple, wear polarised sunglasses, limit screen time. Don’t get rid of screens, just balance them. Get your eyes checked at least once a year with your optometrist, and eat a healthy balanced diet. That’s four things, sorry.

[00:17:48.380] – Speaker 2
It’s all right. You can fix size. You don’t have to count. Gosh, it’s been good to have you here. Our listeners have loved it. I should ask you quickly, I’ve only got 30 seconds about cost. Where do we go to find out what it costs?

[00:18:01.230] – Speaker 1
You should go to our website, www. Eglisurgeons. Com. Au. There’s a cost section on our website. Our staff are always happy to take phone calls. It’s not covered by Medicare. It’s an elective procedure, so just something to be aware of. The cost does vary depending on the procedure.

[00:18:16.750] – Speaker 2
Right, so there’s not one answer. Eagleyesurgeons. Com. Au. A delight to meet you.

[00:18:22.660] – Speaker 1
Thanks, Luke. It’s been a pleasure.

[00:18:23.850] – Speaker 2
Thank you. Dr. Erika Darian-Smith, ophthalmic surgeon at Eagle Eye Surgeons.