5-Star Reviews, “Perfect”…

Have you seen our reviews lately? 210 consistent 5-Star reviews? One might say that that is “perfect,” but hang on a minute. While it’s wild to think about the consistency of these reviews and it really makes you feel like you are doing something right–we are not perfect by any means.

Just a few things about our reviews. All of our reviews are organic. A simple invitation is sent out after a patient visits our office. There is no incentive nor even a mention of it when the patient is in the office. We are just trying to perform to the best of our abilities, not trying to earn a star or a rating, just taking care of patients, taking care of people.

It’s easy to let these reviews go to your head but we stay grounded here, trying to do our best for each person. Our services are not for everyone and we don’t try to be all things to all people. That said, if someone decides to provide us a positive review lauding our service, we graciously accept it and congratulate anyone mentioned or everyone that came into contact with that patient. The same goes for a less than stellar review, we re-evaluate the situation and try and do better. We welcome the feedback.

We are here to humbly serve. Make no mistake about it….despite the reviews…we are not perfect.

#SiennaEyeDoc

You….lazy…..blinker!

Lazy Blink – Not Always the Patient’s Fault 

It has been quite some time now, that eye care professionals (ECP) have been encouraging patients to blink fully and frequently to continually renew the ocular surface to a smooth and pristine state in order to maintain clarity and consistency of vision.  With the use of technology, ECPs are now able to analyze blink rates, blink quality and more specifically, the mechanism of the blink.  

I discovered an interesting phenomenon with one of my patients during a recent visit.  She had mild meibomian gland truncation, so I brought her back for computerized blink analysis using the LipiView II (Johnson & Johnson).  The LipiView II allows us to quantify a patient’s lipid layer thickness and analyze how many blinks are produced over a 20 second interval.  Even more revealing is whether those blinks are partial or complete—do the upper and lower lids touch in an effort to naturally express the meibomian glands?  The video capture can be further broken down into a frame-by-frame analysis and shown to the patient for educational purposes.  While I have traditionally blamed incomplete blinks on “lazy” blinking, I have come to discover this sometimes also occurs as a result of a mild ectropion of the lower lid during the blink itself (see figures 1a and b).  If such technology is unavailable in a practice, this phenomenon also can be visualized via sodium fluorescien pooling in the tear meniscus upon blinking and enhanced with the use of slit lamp video capture. 

This particular type of ‘blink ectropion’ may be caused by the development of lower lid laxity due to age or mechanisms related to years of RGP removal and make-up use etc.1  My intrigue in this area caused me to investigate radio frequency thermal treatment (RFTT).  The basic premise is that RFTT helps strengthen collagen bonds of the periorbital skin which brings the lower lid into better apposition to create a more full and forceful blink.2  An added benefit is that patients also enjoy a non-invasive approach to reducing under-eye bags, and fine lines and wrinkles.3  The treatment is simple, non-invasive, and takes about 10-15 minutes per eye.  It can be conducted by the doctor or a well-trained technician.  Ultrasound gel is applied generously around the periorbital area and a stylus-like probe is massaged in a circular fashion around the orbital rim while the temperature is slowly increased to 105°F. Boney prominences and the globe itself are avoided and there are no restrictions following the procedure.

in the image above the arrows point toward the reflection of the tears and space between the lid and eye

in the image above the arrows point to just one frame later as the upper lid starts to come down and the area between the lower lid and the eye starts to widen (seen in the reflection of the tears)

I was wrong, I’m sorry…

…I don’t ‘sponsor,’ I ‘support’

If I was ever wrong, then I stand corrected especially now. If I ever said that I ‘sponsored’ an event—I was wrong, evidently. My efforts in the community are to ‘support,’ events, organizations, individuals, in anything I put pen to check.

I want to make it very clear that the efforts that I contribute to are because I believe in them and what they stand for, NOT for marketing/advertising. As a matter of fact we have a hashtag (#CommunityMatters) in the office and that’s what it is all about.

As a business person it’s a fine line on how this is viewed, both by myself and by the public. Those that are out there working hard to get sponsorship money from other establishments may take heed of this, for me it is not about ROI (return on investment) but merely just giving back. You know it’s not always about business. I have to make the right decisions based on financials but I budget for the major schools in our community and it’s usually flexible but the thought, “what am I going to get out of this?” rarely ever crosses my mind.  Rather, whether it fits in the budget, who is asking (whether a patient or just a cold call) and of course value (how is the money going to be used) all are considered more heavily.

I opened the office in 2007 and also dropped a stake in the ground in Waters Lake of Sienna Plantation to build a home. I wanted a place to call home, not just a house. I wanted to be a part of the community. As a result, I’ve been around to see two elementary schools develop, a high school and soon to be another middle school. I’ve supported all of them and intend to do the same for the up and coming. I remember when Ridge Point, in its infancy came to ask for assistance with their band and athletics programs. I’m honored that I was asked and even more honored to be able to participate. I am honored that many have remembered that and continue to give me the opportunity. Fast forward to 2017, 10 years later, we were fortunate enough to be able to move the office to an updated and larger location. One thing for sure, #CommunityMatters is even more important and I will not back down from supporting community efforts.

So, while I’ve probably been using the incorrect word all these years, I stand corrected, the intent has ALWAYS been to support the community that I live and am a part of.

 

#SiennaEyeDoc

Random…yes, I am pro-LASIK

given this is a blog, probably a good idea to blog something on my mind, pressing if you will…having worked in the LASIK arena for a number of years, I stepped away from it because it was getting too pushy for me.  I felt like I was being asked to push the limits by both the patient and the surgeon that I employed me.  I had to call it quits when I got to the point of feeling like a “refrigerator salesman” (no offense intended to those that help us keep our food from spoilage).  There are some times when it just didn’t feel right recommending LASIK, you know that “gut feeling” and there are times when it is just not the correct thing to do.  Take a condition like Sjogren’s Syndrome, an autoimmune condition that can be debilitating by the drying effects it causes.  Dry mouth, dry eye, dry every orifice of your body…

Now, don’t get me wrong. I actively recommend LASIK to those that I believe are good candidates, actually for all the cases I have managed since opening Gee Eye Care in 2007, we have a record of everyone being at least 20/20 and very, very happy.  So, it struck me as interesting when a patient of mine accompanied her child to her examination yesterday and I asked how she was doing.  Her reply was, “I got LASIK!”.  Really?  So, I diagnosed you with Sjogren’s Syndrome a few years back.  I recognized some signs of the condition and recommended her get tested by a rheumatologist that started her on methotrexate as a treatment.  And she ended up having LASIK?  I am pleased to hear that she is doing well, I only hope that she will continue to do well, but history and case studies do show that you should approach LASIK with caution when Sjogren’s is present.  I just hope she didn’t end up in an over-zealous LASIK surgeon’s hands…..