How do you find a good eye doctor/surgeon?

I'm asking more for other people than for myself. Many posts in here stress the importance of finding a good doctor, but I haven't come across any posts that mention *how* to find one. It would be good to know.

In my case, I had a strong referral from friends. But when I looked up ratings for that doctor on the internet, there were more negative ratings than positive. (One bad rating was downright scary). So who do you believe?

Oh, I'm located in Wisconsin, USA.

Sorry rpk0925 - should have read onto your reply - thought you were looking for yourself.  I rather babbled on.  My apologies.

About the bad ratings - although there are some scary posts on those I tend to place more weight on the favourable ones.   Most people who are happy with a service never really post or say much (much like these forums - and one of the main reasons I kept posting.  I am pleased with my results and in the smaller percentage of people that came prior to surgery looking for info).   Most find this forum after something goes wrong looking for answers.

Thanks Sue.An,

I already saw a surgeon for one eye (4 months ago) ... the other eye still needs to be worked on. But I'm not happy with the way things have been going. It might be too late (or too stressful) for me to change surgeons at this point ... especially with how frustrating everything has been up to this point.

I'll try to be short here. As I said in my previous reply to ethel, I had a strong referral from friends, so I went with that surgeon. His internet ratings were pretty bad, but I went anyway ... thinking like you, in putting more weight on the positive ratings for the same reasons you stated. After the surgery didn't go the way I expected it to, I've been doing all kinds of second guessing. And of course the terrible reviews I saw stand out in my mind. (By the way, I went with the surgeon's recommendation ... which was the Symfony lens. I never expected the side effects to be so severe ... and to my memory, those side effects were never mentioned by the surgeon as something to be overly concerned about, if they were mentioned at all. I don't remember the surgeon ever talking about the concentric circles or the halos while watching movies/TV or the "background milkiness" that I see when there is strong contrast on movies/TV. That was all a surprise after the surgery was over).

I tried very hard to do research before the surgery. It's difficult when you don't know anybody personally who has had that type of surgery. (I did know one person who had a multi-focal lens but it wasn't a Symfony and she wasn't a real close friend ... hardly ever saw her). I asked my eye doctor and the people at the surgery center for people to talk to who have already had this surgery. They couldn't help me because of privacy laws. So I had absolutely nobody to talk with ... only the surgeon's recommendation. I had no legitimate reason not to trust him.

I don't really want to dwell on my situation here. I just thought "how to find a good doctor/surgeon would be a good topic to discuss and that people might have good suggestions for anybody who might be looking.

To answer your questions:

I have had to pay for every visit I've had with a doctor or surgeon so far ... even consultations. Health insurance is really screwed up in the USA. This is costing me thousands of dollars. Enough said.

1. I told my optometrist the surgeon I would be seeing, and was told that they use him and I shouldn't be worried about it.

2. I did look up ratings on the surgeon. One rating system had him at 2.3 stars out of 4 ... hardly stellar. The other rating system had him rated as the #1 ophthalmologist in the area. Again ... what do you believe? I thought like you did, and put less weight on the negatives.

3. My friends were the ones who (strongly) recommended my surgeon to me.

4. Again, I tried very hard to find people to talk to who had the Symfony lens, but didn't have any luck. That was very frustrating!

(By the way, my surgeon didn't even tell me what type of lens he was recommending ... I found that out on my own after repeated calls to the eye surgery center).

That's only a part of the frustration entailing this whole episode. Like I said earlier, I don't want to dwell on my personal situation. I've been doing that enough on my own over the last 4 months ... I could use a break from that kind of thinking. But to help others where I/we might have stumbled can only be a good thing, right?

Yes can certainly relate to not dwelling too much on the negative- especially if it cannot be changed.   Dealing with that myself on an entirely different health matter (developed Tinnitus from a viral flu).  

Although if not tolerable you may want to seek out a second opinion for a lens exchange.  Or wait till 2nd eye is done to see if it is better.  There shouldn’t be an issue with mixing Symfony with a monofocal lens and that would help with the night vision issues you have with Symfony.

Although I would definitely seek out another doctor.  Red flags if he didn’t tell you which lens he was inserting.   I think there are other issues going on - some of the effects you are describing is not due to the lens.  I have 2 Symfony lenses and yes there are concentric circles around certain light sources outside at night when that light source is about 40 to 50 yards away and disappear when you are nearer but there shouldn’t be any issue inside with lights.  Perhaps another surgeon could have a look to see if there is a refraction error or astigmatism that would account for these issues.

I complain about the Canadian health care system (horrible wait times etc) but there at least is no added incentive (monetary wise) for surgeons to talk anyone into paying more. 

Really hope you catch a break and find someone who cares.  

(I said I didn't want to dwell on it too much, but here I go).

I did seek out a 2nd opinion ... from a surgeon who is very well respected in this area. When I made the appointment back in November, (a week or 2 after my first surgery), the earliest I could see him for a 2nd opinion was 3 months away because he was on vacation for the entire month of January. But his reputation was good enough that I thought he was worth waiting for. (Plus I didn't know where else to turn). I saw him in mid-February. After going through a full eye exam, his opinion was that the surgeon who did my one eye (with the Symfony lens) nailed it ... that the lens was perfectly centered in my eye and looked great. He also said that the Symfony was an excellent lens and that the original surgeon was an excellent surgeon. (So why am I having all these issues?) He told me that I could go either way ... I could go back and have the lens exchanged with a monofocal lens ... or I can move forward with another Symfony. lens in the other eye. He recommended going with the Symfony lens and told me that most of the effects I'm seeing should go away after a month or so ... he said that the 2 lenses need to work together to be effective (or something similar to that). Now I'm not sure what he meant when he said "most" of the effects would go away. I "think" he was referring to the concentric circles not going away, but not sure. I asked him if he would mind doing the surgery on me, no matter which way I went. His reply was that he would do it ... but didn't think it was necessary, especially since the first surgery went so well (according to him), and since the place that did my first surgery already had all my measurements in hand.

So that's the short story of where I'm at. I'm struggling.

By the way, you mentioned seeing the concentric circles at 40 yards away or farther. Well I see concentric circles almost every night as close as 6 inches (or less) from my face. They come from the low battery indicator/plug on the side of my laptop, which I often use in bed before going to sleep. I plan to try to draw pictures of what I'm seeing for my next visit to the surgeon ... to help them better understand what I'm seeing (since I'm not sure if I get the terms right).

rok0925 - the visual effects you describe would be bothersome to me as well.  When I had just one eye done I still could see well - just my near vision improved once the 2nd Symfony Lens was implanted.   Never have I see the concentric circles inside or at close range.  The only other difference was there was strong glare - lights were like a big fuzzy ball (again in the distance not close up).  That subsided at about 6 weeks (and still continues to improve).  Once that strong glare/glare or whatever you want to call it subsided was when I saw the concentric circles.  

I am not sure what you describe would go away with a 2nd Symfony Lens.

I know doctors don’t like to step on each other’s toes in the USA so perhaps reason the 2nd opinion doctor doesn’t want to take this on. But do find it strange he wouldn’t wNt to do 2nd operation.   Did he provide you with your exact prescription for that eye?  My surgeon only got me to read the charts and based his prognosis of good outcome on that.  It wasn’t till people on these forums encouraged me to go back to my optometrist that I actually went.  Optometrist can tell you for sure where you are numbers wise.   And also if there is astigmatism.   My optometrist advises me initially against multifocals do I was too anguish to see her.   She really examined my eyes and kept asking about the glare saying ever patient she had that hot multifocals regretted it.  But at the end she said that my vision was surprisingly good and very little astigmatism.   

Just a suggestion that perhaps tour optometrist could shed more light on the outcome.

As the 2nd opinion came from a doctor who knew the one who did the operation that could be a reason why he or she wouldn’t say something against the other.  Perhaps heading to another state would yield more information.  But would be frustrating to fork out additional funds.

It is totally your choice but I would be just as reluctant to do another Symfony and opt for a monofocal.   If difference is night and day you could then consider a lens exchange for first eye.   Is the cataract surgery with a monofocal covered by your national healthcare like it is in other countries?

Do wish you well and hoping you find a person that takes your concerns seriously.

Thanks Sue.An ... To answer your questions, the 2nd opinion surgeon did say that he would do the surgery ... he just didn't seem to understand why I would see somebody else when the first eye surgery went so well (at least from a technical point of view) and when the first eye place already has all of my measurements and paperwork.

I have not been provided with any prescriptions up to this point. The last time I asked my optometrist for one, he told me that my eye might not be settled yet, so a prescription might be a little premature. That was about 7 weeks ago. (I've been busy with other "life things" since then, so haven't been back).

Since one eye has already been operated on, I'm not sure how my insurance would work with all of this. I would expect that they would cover the eye that hasn't been worked on yet (but only if I get a mono-focal lens). I don't know about the other eye.

I was told I could get an exact prescription once 6 weeks went by.  Settling should have taken place.  As it never occurred me to get one as I was managing fine w/o glasses I waited 3 months after 2nd surgery.  But in the end this gives me a baseline for any future follow ups so worth doing.  I know I have slight astigmatism of .50 in one eye and .25 in the other which doesn’t distort much and told glassed not needed for that amount of astigmatism.   Both eyes were 0D (plano).   This information may give you an insight into why you are seeing glow and circles on inside lights.   It could be you have more astigmatism.  Looking technically at your eyes and seeing IOL perfectly centered  does not mean you will see well.  There could be a refraction error or astigmatism that the surgeon doesn’t catch - an optometrist would provide you those details.

If it were me - I would want to know those results before any 2nd surgery.

Not sure what happens in USA whether your Medicare covers surgery but not the upgraded lens (that’s the way it works in Canada - so my out of pocket costs for Symfony lenses was $1,800 for the 2 IOLs.   surgery was covered regardless of lens.  However having family in UK and when I chatted with my uncle he said he either went to NHS to be covered but then they only use monofocal lenses.  He went private for his and nothing was covered.  Is USA same way?   

Cataract surgery itself can cause astigmatism even if little to none noted prior to surgery.

Sue.An ... thank you for the tips. I'll look into getting my prescription, in any case.

I should have mentioned that I'm 62 ... not quite eligible for Medicare yet. I originally paid for both eyes up front. At that time, I think my final costs (for both eyes) was a little over $11,000. Crazy. But since I canceled the surgery on the 2nd eye, they sent me a refund check for part of that money.

For what it's worth, only monofocal lenses are covered by insurance where I live ... although insurance  does cover the facility and (something else that I'm forgetting right now ... I'm not at home as I'm typing this).

I guess Medicare or national health operates so differently country to country.  Canada has no minimum age but only covers cataract surgery if medically necessary.  Basically if you fail the vision test for your drivers license - visual acuity 20/40 or less.  Both eyes were worse than that at 53 (was quite a shock for me).  I am grateful to just be out of pocket $1,800.  $11K is a huge price to pay.

Really do think you’ll get some insight into what is going on once you have an exact prescription- possibly help in deciding what to do for 2nd eye.  Wish you all the best.

Thank you Robert!

Interesting. The biggest compromise I thought I was making going into the surgery opting for Symfony lenses was that I was afraid of losing my near vision (which I've had all my life). I never expected the added side effects I ended up with. Like you, I considered choosing mono-focal lenses set for near instead of far. Through my entire initial consultation, setting my eyes to near instead of far was never given to me as an option ... only setting them to far. When I finally asked them about it, they said yes it could be done ... if I really wanted it. They made it sound like I was crazy for even asking for it. That's a part of why I didn't choose to go that way. It's nice to know that I'm not alone.

Regarding the numbered items you mentioned, I think everything done to me was using the latest technology ... including laser surgery and dropless surgery. As far as I know, everything went okay going that way. (Then again, I don't know too much). ;-)

Hi rpk0925, you may be interested in this video. A 67yo patient had Symfony lens implanted in her right eye (VA 20/20). She was happy with distance, but unhappy with intermediate / near vision. Her original eye-surgeon referred her to another surgeon for a 2nd opinion - distant vision about 20/25, intermediate rage 20/35 J5 near J9, and about a +0.25D hyperopic.  "With EDOF lens, even if you end up hyperopic, you are still on the flat part of defocus curve.  Distant vision still pretty good 20/25, a bit of astigmatism - may be going to drop a little bit.  Pb is if you left-s**t the focus if you loose the near vision, symptom that she had - to go back to her referring surgeon - IOL exchange or post-operative PRK enhancements"

She had cataract surgery on left eye - monofocal lens for near, and quite happy her right eye stays 20/25.

It should read, "Pb is if you left-shift the focus .....  "

Thank you for thinking of me jantje32476. Since my last post in this thread, I saw another ophthalmologist for a 3rd opinion (about 3 weeks ago). (In a nutshell), he said I fall into the 2% of people that Symfony lenses aren't working for, and suggested doing a lens exchange. The last time I talked with the original surgeon that operated on my Symfony eye (maybe 3 months ago), he also suggested a lens exchange, but added that I might be content with a monofocal lens in my unoperated eye ... although he suggested going with a monofocal lens set for distance and using glasses for near vision. So I'm still working my way through all of the different scenarios that have been presented to me. I'll get there eventually ... I only hope I have some sanity left. :-/

Being in the 2% in this instance is disappointing indeed. Hope things work out fine for you eventually. Most ophthalmologists are good doctors, at least that has been my experience since childhood.  I have monofocal lenses (in both my good eye and functional eye).  I have good near and intermediate vision.  I can read J1, unless when my eyes are really dry. My RX glasses are a bit onerous; hubby is a "control freak" ha ha, rushed me to get the RX from the eye-doc, rushed me to get the glasses done (2 pairs) from the optician ALL TOO SOON. Since I don't use them that often, I guess that's ok for now.

Take care and all the best.

Thanks. I don't have any reason to think that the ophthalmologists I've seen so far aren't good surgeons. I just need to figure out how to proceed (and who to proceed with).