Physicians & Surgeons Ophthalmology Toronto

Bochner Eye Institute

Physicians & Surgeons Ophthalmology Toronto
Contact Bochner Eye Institute

Address
40 Prince Arthur Avenue
Place
M5R 1A9  Toronto
Landline
(416) 960-2020
Fax
(416) 966-3335
E-Mail
[email protected]
Facebook
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Website
www.bochner.com
Reservations
www.bochner.com

Description

Another eye care first for the Bochner Eye Institute: Introducing Ray Tracing LASIK The Bochner Eye Institute is the first centre in Canada to offer this revolutionary new procedure. Ray Tracing LASIK combines ultra–high-resolution optical imaging with advanced Artificial Intelligence to create an individualized ablation pattern for each patient – a level of customization that has never before been seen. Book a consultation today to learn more.

Keywords Eye Care Services, LASIK, Ophthalmology.

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  • LASIK Eye Surgery

    What is LASIK? Laser-Assisted in Situ Keratomileusis (LASIK) is a type of laser eye surgery for correcting myopia (nearsightedness), hyperopia (farsightedness) and astigmatism. LASIK uses cool rays of light to reshape the inner tissue of the cornea to the proper curvature. The procedure is quick, painless and heals naturally. Are you a good LASIK candidate? At Bochner Eye Institute in Toronto we see numerous LASIK eye patients and are constantly asked what makes a good LASIK eye surgery patient. The following are some qualities we look for in a good LASIK candidate: Eyes must be healthy Cornea needs to have adequate thickness At least 18 years of age Have stable vision for at least a year Overall good health Realistic expectations LASIK Toronto, Scarborough, Unionville & Oakville The IntraLase iFS Femtosecond Laser Preparing for your LASIK eye surgery Days Before To prepare for LASIK surgery, patients are asked to stop wearing their contact lenses for several days beforehand. You’ll also have several eye tests that allow your surgeon to precisely plan your customized treatment. Immediately Before Immediately before the surgery, you’ll be given anesthetic eye drops to numb your eye, and an instrument called an eyelid speculum will be put in place to hold your eyelid open. During Using an IntraLase laser, your surgeon will safely and precisely create a protective flap that is folded back. Next, the Excimer laser reshapes the inner tissue of the cornea with up to .25 microns of accuracy (about half the thickness of a human hair). The corneal flap is then re-positioned into place and the eye begins to heal. After Afterwards, if you’re like most patients you’ll have little or no discomfort. You’ll have several follow-up appointments. Compare Laser Vision Correction Procedures The Bochner Eye Institute is the Preferred Laser And Eye Centre For The Toronto Maple Leafs™. Learn More The Bochner Eye Institute is the Official Laser And Eye Centre OF The Toronto Blue Jays™. LASIK FAQs How do I know if I’m a good candidate for laser vision correction? You’ll need to undergo a detailed eye examination. We will determine your prescription, evaluate your corneal contour using computerized pentacam corneal analysis, measure the thinnest point of your cornea, and evaluate the interior health of your eyes. Can all prescriptions be treated by laser vision correction? All but the most extreme prescriptions are usually eligible for laser surgery. Patients that are nearsighted can usually have laser vision correction if their prescription is less than 10 diopters. Farsighted patients can usually have laser surgery if their prescription is less than 5 diopters. Can astigmatism be corrected with laser vision correction? Yes, in addition to nearsightedness and farsightedness, astigmatism can be treated. If you have astigmatism, it means that your eye has a curvature like a football rather than a basketball. The laser will typically flatten or steepen one meridian to improve the shape of the cornea and enhance vision. Is there an age limit for laser vision correction? It is recommended that patients be at least 21 years of age for laser surgery. This is the age at which the prescription is relatively stable. If patients have laser surgery and the prescription changes in the future, additional surgery can be performed. There is no upper age limit for laser eye surgery. As long as the eyes are healthy, patients can have laser vision correction. In fact, patients who have had cataract surgery can have laser surgery to refine their vision without glasses. Are there different types of laser vision correction procedures? Yes, there are two main types of laser vision procedures: LASIK and PRK. With LASIK, a thin flap is constructed, the flap is retracted, tissue is removed with an excimer laser, and then the flap is re-positioned. This results in a change in the contour of the cornea resulting in vision correction. The other technique is called PRK. This procedure initially involves removal of the central corneal epithelium and is followed by removal of corneal tissue with an excimer laser. A soft contact lens is worn for 5 days while the underlying epithelium regenerates. Is there a difference in the final outcome between LASIK and PRK? No, the final visual result is the same with LASIK or PRK, however the healing time is longer with PRK. With PRK the epithelium regenerates, typically by 5 days, but it takes a while for the epithelium to smooth out in order to see well. With LASIK 99% of patients can drive within 24 hours after having the procedure. With PRK it is advised not to drive until the contact lenses are removed which is usually in about 5 days. It may take 2 to 4 months after PRK for your best vision to be obtained.

  • PRK Eye Surgery

    What is PRK? During PRK (photorefractive keratectomy), the surface cells of the cornea are removed instead of creating a flap as in LASIK. The excimer laser is used to reshape the cornea and correct vision. The vision improvements are equally impressive as with LASIK, but healing time tends to be longer. Variations in the eye’s anatomy determine whether your procedure should be LASIK or PRK. Preparing for your PRK surgery Days Before The preparation for PRK is much the same as it is for LASIK surgery. You’ll be asked to stop wearing your contact lenses for several days beforehand. You’ll also have several eye tests so the surgeon can precisely calculate the custom treatment. Immediately Before Immediately before the surgery, you’ll be given anaesthetic eye drops to numb your eye, and an instrument called an eyelid speculum will be put in place to hold your eyelid open. During First, surface cells of the cornea are removed. Next, using an Excimer laser, the surgeon reshapes the inner tissue of the cornea with up to .25 microns of accuracy (about half the thickness of a human hair). After Afterwards, you’ll rest for 2 to 3 hours with your eyes closed. Most PRK patients have mild light sensitivity and discomfort immediately after the surgery. You’ll have several follow-up appointments with your surgeon to monitor your progress, starting with your first appointment the day after the procedure.

  • Traditional Cataract Surgery

    What are Cataracts? A cataract is a clouding of the eye’s natural lens that typically occurs as we age. The lens, which lies behind the iris and the pupil, can become cloudy as we age, in turn interfering with our ability to see clearly. Cataracts are the most common cause of vision loss in adults over the age of 40 and are also the primary cause of blindness. If you are experiencing cloudy or blurred vision then cataract eye surgery may be the procedure to help you begin seeing clearly again. How is Traditional Cataract Surgery Performed? Cataract surgery is one of the most common procedures that our Toronto eye specialists perform at the Bochner Eye Institute. Traditional cataract surgery is complex, but safe and extremely effective. Cataract surgery begins with a tiny incision in the side of the cornea. Ultrasound waves are used to break up the clouded lens so that it can be removed. Through the same small incision, the eye surgeon inserts an intraocular lens (IOL) to restore vision. The incision is so small that the eye tissue usually heals itself. How Long Does Cataract Surgery Take? Cataract surgery takes approximately 20 minutes per eye and has a very quick recovery time. The procedure is performed on an outpatient basis and most people return to normal activities within a week following the treatment. How Much Does Cataract Surgery Cost? The cost of cataract surgery in Toronto, Canada will vary depending on a number of factors including the type of lens used, the surgeon’s fee, and insurance eligibility. For a personal price estimate, schedule a consultation with the talented eye surgeons at the Bochner Eye Institute. Please see below for available surgical packages and pricing.

  • Laser Cataract Eye Surgery

    What are cataracts and what are the symptoms? If your vision is getting cloudy, if you are losing your colour perception, if you are having trouble reading or with your night vision, you may be experiencing the early stages of cataracts. When we’re younger, the natural lens inside the eye is normally transparent. As we age, our clear lenses inevitably become cloudy. This is what’s known as a cataract. Cataracts are a normal part of aging. There is no medical treatment to reverse or prevent them. Once they form, the only way to see clearly again is to have them removed and replaced with an artificial lens, known as an intraocular lens. In general, when you are bothered by your vision during your daily activities, it is time to think about cataract surgery. Cataracts will typically not damage the eye while growing, so there is no need to rush into surgery. You can decide when the time is right for you. Although it is surgery, the risks with modern cataract surgery are very low. You should not be anxious or afraid of the procedure. Laser cataract surgery has taken this surgery a step ahead, improving both the surgical precision and outcomes. In addition, exciting advances in intraocular lenses now provide a variety of options as to how you choose to see after surgery. How does laser cataract surgery work? In February 2012, the Bochner Eye Institute became the first eye care centre in Canada to offer laser cataract surgery with the Catalyst precision laser system, considered to be the most significant advancement in cataract surgery in more than 50 years. Steps that used to be performed with hand-held instruments are now completed using a sophisticated femtosecond laser. This includes making the corneal incision and fragmentation of the clouded lens or cataract. The laser procedure is guided by an imaging system with higher resolution than an MRI, customizing the entire procedure to the unique optical characteristics of each patient. In fact, surgeons the world over believe that laser cataract surgery will eventually replace traditional blade surgery completely. What are the advantages of laser vs. traditional cataract surgery? Because of the increased precision, laser cataract surgeries offer better self-sealing incisions, more accurate reduction of astigmatism and the potential for better quality night vision and clearer vision sooner after the procedure. Laser Cataract Surgery FAQs Does the cataract have to be “ripe” for surgery to be performed? With advances in cataract surgery, it is no longer necessary for the cataract to be mature or “ripe”. An early cataract that interferes with the quality of vision can be corrected with surgery. How safe is cataract surgery? Cataract surgery is one of the most successful operations on the body. With a skilled surgeon using advanced technology patients usually have an excellent outcome. There are over 15 million cataract operations performed worldwide each year. Is the surgery painful? No, in fact most patients are very comfortable during the procedure. There are no needles or sutures. The eye can be frozen with the simple application of anesthetic eye drops. Patients will notice a bright light from the microscope and a slight irritation but usually no discomfort. Why does OHIP not cover Laser Cataract Surgery? Laser cataract surgery represents new advanced technology but is not considered medically necessary. It is difficult for our health-care system to continue to pay for all innovations even if they offer an improvement in clinical outcomes. Do I require an implant at the time of cataract surgery? Yes, all patients have an implant of a specific power. After the cataract is removed it is essential to have an implant, otherwise “coke-bottle” or extremely thick glasses are required in almost all patients. The lens or cataract normally helps to focus light on to the back of the eye for vision. An implant will help to focus light and obviate the need for thick glasses. Are there different types of implants? Yes, there are a number of different types of implants. The main classifications of implants are standard, aspheric, toric, and bifocal. The standard implant is provided by the Ontario Health Insurance Program (OHIP). This is a monofocal implant that can provide satisfactory vision but usually requires the aid of glasses to fine tune sight. The other implants are not provided by OHIP but can be purchased by the patient. These include:

  • Refractive Lens Exchange

    Refractive Lens Exchange (RLE) is an advanced form of surgical vision correction in which the crystalline lens of the eye is replaced with an intraocular lens. This procedure is recommended over laser vision correction when patients desire an improvement in both distance and reading vision, have early cataracts, and/or have a high degree of nearsightedness or farsightedness. Dr. Raymond Stein was the first surgeon in Canada to use the CatalysTM Precision Laser to perform both Laser RLE and Cataract Surgery in February of 2012. This technology is thought by the ophthalmic community to be one of the most significant advances in eye surgery over the past 50 years. Although Traditional RLE is considered a safe and effective procedure, many of the steps are performed manually, with a blade or needle. Now, with the technological breakthrough of the Catalys Laser™, many of the more challenging steps can be automated, adding unprecedented levels of precision and accuracy to the entire procedure, while potentially making RLE even safer and improving visual outcomes. RLE is offered in cases of very severe nearsightedness or farsightedness where LASIK and PRK are less effective.

  • Implantable Contact Lenses

    The surgical correction of high degrees of nearsightedness or farsightedness may be accomplished by the insertion of a lens in the eye. This is referred to as an Implantable Contact Lens (ICL). Two types of lens implant techniques are available at the Bochner Eye Institute: Phakic Intraocular Lenses (often referred to as Implantable Contact Lenses or ICLs) and Refractive Lens Exchange (RLE). These techniques are derived from cataract surgery; one of the safest and widely performed surgical procedures. EVO Visian ICL is a type of refractive procedure to help correct common visual problems, such as myopia, hyperopia, and astigmatism. The EVO Visian ICL is an additive technology, unlike other procedures, it does not remove corneal tissue. Patients who are between the ages of 21 and 60, and suffer from farsightedness, nearsightedness, with or without astigmatism may be a candidate for this great procedure and the advantages it provides. Sharp, clear vision over 99% patient satisfaction Available for over 20 years with over 1,000,000+ procedures performed worldwide Excellent night vision Quick results Great for those with thin corneas People who are not candidates for LASIK Does not induce dry eye syndrome A removable option In harmony with your natural eyes UV protection Treats moderate to high myopia (nearsightedness) Treats moderate to high hyperopia (farsightedness) Treats astigmatism Legacy of Success The EVO Visian ICL has been approved in Europe since 1997. In that time, over 1,000,000 eyes have been implanted with EVO Visian ICLs by certified surgeons like Dr. Stein. In a clinical trial, patients reported a 99% satisfaction rate. In Harmony with your Natural Eyes The EVO Visian ICL is an additive technology, unlike other procedures, the EVO Visian ICL procedure does not remove corneal tissue, but works in harmony with your natural eye. Treatment Flexibility for the Future Vision changes as you age and eventually almost everyone will need cataract surgery. An important benefit with the EVO Visian ICL is options for future treatments. Because EVO Visian ICL maintains the structure of the eye, the lens can be removed and replaced if your vision changes substantially, or if you have another procedure at any time. A Quick Procedure and Recovery The EVO Visian ICL is custom made by STAAR Surgical in Switzerland based on a specific prescription and size. The lens is inserted through a micro incision in the cornea and positioned behind the iris and in front of the crystalline lens. The lens is extremely thin with a central thickness of that of a human hair. The visual recovery is usually rapid and noted within hours of the procedure. The Bochner Eye Institute is the only stand-alone eye surgical centre in Ontario approved by the Ministry of Health and certified by the College of Physicians and Surgeons. Dr. Raymond Stein implanted the first phakic implant in Toronto in 2000 and has extensive experience with intraocular surgery. He has performed over 125,000 surgical procedures including cataract surgery and laser vision correction. The Bochner Eye Institute is the Preferred Laser And Eye Centre For The Toronto Maple Leafs™. Implantable Contact Lens FAQs What are the advantages of the ICL? Here are some of the advantages of an implantable contact lens: Potential for excellent quality of vision without glasses or contact lenses. A high percentage of patients report an improvement in vision over glasses or contact lenses. A reversible procedure since no tissue is removed. Near vision remains unchanged, unlike with a refractive lens exchange in which the crystalline lens of the eye is replaced with an artificial lens. Unlike a regular contact lens the ICL does not accumulate deposits and therefore does not need to be changed. Are there conditions that do not make a patient a candidate for the ICL? Some of the contraindications we see regularly are as follows: Large pupils greater than 7 mm. Narrow distance between the cornea and the crystalline lens of the eye. Cataracts that interfere with vision. History of glaucoma with elevated eye pressure. What measurements or procedures are required prior to ICL surgery? Your prescription will be determined in the office. This information is important for ordering the power of the ICL, while an optical measurement is performed to determine the size of the cornea. This helps to determine the correct size of the ICL.

  • Keratoconus Treatment

    Understanding Keratoconus Keratoconus is an eye condition that can affect your vision and quality of life – but it’s treatable. Keratoconus is a common corneal condition occurring in more than 1 in 200 people. It usually begins in adolescence and early adulthood. The disease can progress unpredictably, sometimes requiring a corneal transplant if left untreated. The cornea is the clear window on the front of the eye. In keratoconus, the cornea becomes thin and weak, bulging into a cone-like shape. This leads to irregular astigmatism, distortion, and difficulty correcting vision with glasses or soft contact lenses. Risk Factors For Keratoconus Although the exact cause of keratoconus is unknown, it is believed that the risk factors include: frequent eye rubbing, a family history of keratoconus, genetic predisposition, certain systemic disorders such as Down’s syndrome, ocular allergy, and connective tissue disease. Keratoconus typically affects both eyes (90% of patients) and may progress rapidly during the late teens and twenties. Signs And Symptoms Although the exact cause of keratoconus is unknown, it is believed that the risk factors include: frequent eye rubbing, a family history of keratoconus, genetic predisposition, certain systemic disorders such as Down’s syndrome, ocular allergy, and connective tissue disease. Keratoconus typically affects both eyes (90% of patients) and may progress rapidly during the late teens and twenties. A simulation of the multiple images seen by a person with keratoconus. Diagnosis There are typically four ways in which keratoconus is detected: 1. CORNEAL TOMOGRAPHY Provides a 3D analysis of both the front and back surfaces of the cornea. Maps the curvature of the cornea and detects early cone formation, even before symptoms appear. Identifies irregular astigmatism and steepening patterns typical of keratoconus. Measures corneal thickness (pachymetry) and elevation maps. Keratoconus is often associated with thinning at the apex of the cone. 2. WAVEFRONT ABERROMETRY Analyzes how light travels through the eye to detect optical imperfections, that can affect vision quality 3. Slit Lamp Examination Detects signs like: • Vogt’s striae (stress lines in the cornea from excess steepening) Apical corneal scarring 4. Refraction And Visual Acuity Testing • Patients may have frequent prescription changes or poor vision despite correction. Treatment Early stages often allow for good vision with glasses or soft contact lenses. However, as the disease progresses, patients may require hard contact lenses or a corneal transplant. The most important goal in managing keratoconus is stopping its progression. In 10–20% of keratoconus patients, the cornea may become extremely steep, thin and irregular where vision cannot be sufficiently corrected with contact lenses. This group of patients will require a corneal transplant or graft. Promising new treatments are currently available for the treatment of keratoconus to prevent disease progression and in some cases to enhance quality of vision. Treatment Options: 1. CONTACT LENSES Contact lenses are the most popular treatment and will provide improvement in vision, but this can be temporary as the condition progresses. They can provide good vision in early to mid stages of keratoconus by correcting the refractive error, but lens tolerance and good quality vision can be difficult to maintain as the condition progresses. Although contact lenses can aid vision, they do not slow the rate of corneal deterioration. A traditional soft contact lens has a tendency to conform to the conical shape of the cornea, and not provide satisfactory vision as the disease progresses. Many specialized types of contact lenses have been developed for keratoconus, including scleral or rigid gas-permeable lenses. Some patients find good vision correction and comfort with a “piggyback” contact lens combination, in which gas permeable rigid contact lenses are worn over soft contact lenses, providing clarity of vision and comfort. One precaution with contact lenses: there is a small risk of infection and the risk becomes much greater if the contact lenses are not kept clean, so it is important to strictly follow the hygiene protocol.

  • Dry Eye Treatment

    Tear Film Analysis At the Bochner Eye Institute Dry Eye Clinic, a sophisticated tear film analysis is performed to determine whether the patient suffers from a deficiency in the aqueous (tear) secretions or the Meibomian (oil) secretions. Identifying the cause of dry eye enables a customised treatment plan which may include: Restasis (cyclosporine), a prescribed topical medication that acts on the lacrimal glands to produce an increase in tears. The medication is used twice per day. LipiFlow, a new treatment to reduce blockage and enhance meibomian gland secretions. The treatment involves controlled application of heat and massage to the upper and lower eyelids simultaneously. This facilitates opening of the blocked meibomian glands without damaging the glands or surrounding tissues. Opening the blocked eyelid glands may allow the body to resume the natural production of lipids needed for the tear film. Dry eye can occur after certain laser eye surgery procedures. To schedule a consultation at the Ontario & Toronto Dry Eye Clinic of Bochner Eye Institute, call 416-944-EYES (3937). The evaluation involves an assessment by a dry eye specialist, a detailed analysis of the tear film, and a customized treatment plan. The cost of the tear film analysis is $125.

  • Age-Related Macular Degeneration (AMD)

    What is AMD? Age-related macular degeneration (AMD) is a common aging disease of the back of the eye. The condition involves the retina in an area called the macula, which is responsible for central vision. Degeneration occurs of the photoreceptors in the macula resulting in loss of central vision. The disease can impact an individual’s ability to drive, read, and other activities of daily living. The Bochner Eye Institute is the first eye care facility in North America to offer a corneal procedure that can result in improved vision for patients with AMD and other conditions with central vision loss. Low vision patients with central vision loss and a best-corrected visual acuity between 20/60 and 20/800 are potential candidates for this new procedure. The best candidates are those with dry AMD, Best disease, and Stargardt disease. Other potential candidates are those with macular holes that were unsuccessful with prior surgery, and those with reduced central vision from macular scars. Future conditions to be evaluated include dry diabetic maculopathy, glaucoma with central loss of vision, as well as for a lazy or amblyopic eye. What is the range of improvement in best-­corrected vision? Clinical studies over the past three years have shown significant improvements in vision, as well as quality of life. For the average patient, the improvement in vision provides enhancement of daily activities requiring both distance and near vision. Patients have also noted improvements in colour, peripheral and night vision, together with disappearance or diminution of pre-existing blind spots or wavy lines. How long can one expect the procedure to last? The first patients that were treated specifically for AMD had their surgery over three years, and best- corrected visual acuity and quality of life has continued to improve or has plateaued. The improvement in vision over time is related to neural processes including neuroadaptation. Is the treatment area visible to the naked eye? The laser treats very small and superficial areas in midperipheral regions of the cornea outside the pupillary zone. These faint spots can be visualized only with a high powered microscope that eye doctors use, referred to as a slit-lamp. Treated areas cannot be seen by the naked eye and, therefore are not of cosmetic concern. Is the Corneal Laser procedure easy to undergo? This procedure is much easier to undergo than any other eye surgical procedure. There has been no reported discomfort during or after the laser procedure. What testing is performed to determine if someone is a good candidate? At the Bochner Eye Institute, we determine the best-corrected vision for both distance and near. Sophisticated corneal imaging tests are performed -including computerized elevation of the front and back of the cornea, curvature maps, and thickness tomography. The line of sight is determined, referred to as Angle Kappa, under both normal light and dim light using wavefront technology. Potential visual acuity testing is performed to estimate the amount of improvement that can be achieved with treatment. How is the procedure performed? Anesthetic drops are instilled to freeze the front of the eye. No other medications are required. The patient sits on a motorized chair, which is then reclined. The laser beam is checked by the surgeon to be sure the energy level and other variables are within a specific range. A suction device with a built- in cross- hair is centered over the pupil, and then a vacuum is activated to secure the suction device to the front surface of the eye. A laser head is placed in the centre of the suction device. The surgeon then activates the laser beam to create a corneal treatment outside of the pupillary zone. The vacuum is released and then the suction device is removed from the eye. If both eyes are to be treated, then the procedure is repeated for the other eye. The chair is repositioned and then the patient can walk out of the operating room. Age-Related Macular Degeneration Treatment Toronto AMD Treatment Toronto Macular Degeneration Procedure Toronto What is the postoperative care? No postoperative drops or oral medications are needed after surgery. Patients are typically very comfortable after the procedure. Patients are seen postoperatively at one month, three months, six months, and twelve months following treatment. Follow-up visits can be done at one of the Bochner facilities or by the referring eye doctor. What has been the satisfaction level of patients that have been treated? Satisfaction levels have in general been very high. It is often important for patients to understand their level of vision prior to treatment and then compare that to the way they are seeing after the surgery. Similar to postoperative cataract patients, some low vision patients forget what their vision was like prior to treatment.

  • Cosmetic Eyelid Surgery

    The Bochner Eye Institute has added subspecialty eyelid surgery for patients interested in cosmetic upper and lower eyelid blepharoplasty. Cosmetic eyelid consultations and surgery are both available at the Yorkville location. This setting is ideal for cosmetic patients, as it is a relaxed environment, with ample time put aside for each appointment to discuss the best options for each patient and answer any/all questions that patients may have. Dr. Nancy Tucker is an oculoplastic surgeon with over twenty years of experience in cosmetic eyelid surgery.

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Physicians & Surgeons Ophthalmology
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