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Ophthalmologist has a vision for his practice

When ophthalmologist Jeremy Kieval first started medical school, he was fascinated with neurosurgery, but the thought of dealing with eyes – and their anatomy, physiology and disease – was the furthest from his mind.

“I always felt like the eyes were the window of the soul, and the thought of examining, touching or doing surgery on the eye was very disconcerting to me,” said Kieval, whose practice is part of the Lexington Eye Associates in Lexington.

But as he progressed in the field of neuroscience, he found himself drawn more and more to the ophthalmology as well. “After all, the eye is really an extension of the brain during development,” said Kieval, who went onto complete his residency in ophthalmology at the Boston Medical Center, and subspecialty training at Bascom Palmer Eye Institute, Miami, Fla.

Ironically, as an eye doctor, Kieval has 20/20 vision and doesn’t need glasses, something he appreciates over the years more and more. He specializes in corneal transplants as well as laser vision correction, commonly called LASIK (Laser-Assisted In Situ Keratomileusis). He sees patients of all ages, from 20s to 60s, typically those who are tired of wearing glasses or contacts.

“They want to be able to wake up in the middle of the night and tell what time it is without reaching for their glasses or find a bar of soap in the shower and not have it be a challenge,” said Kieval.

He likes to cite research that shows that low or poor vision can even be linked to emotional states such as depression or anxiety.

“The beauty of my work is being able to provide better vision to many patients,” said Kieval.

Q: What is LASIK and how is it performed?

A. LASIK is a surgical laser procedure which helps reshape the cornea in order to more precisely focus light rays on the retina, leading to better vision. (The cornea is the transparent front part of the eye that covers the iris and pupil. The retina is the light-sensitive membrane lining the back of the eye.) Before LASIK is performed, topical anesthesia or eye drops are applied, and the whole procedure takes less than 10 minutes per eye to complete.

Q: What are some common questions patients ask you about laser vision correction?

A: They’re worried about moving or shifting positions while the laser is working, but actually the speed and precision to which it molds the cornea is practically instantaneous. Also, with all the hype lately about LASIK, people think it is a risk-free surgery, but advertising skews reality. Like any surgery, it can have its limitations.

Q: What is the typical procedure if someone wants to have laser correction surgery?

A: The biggest piece is doing very specialized testing of the cornea and its shape, thickness and symmetry to make sure someone is a candidate. As long as eye health is good, next I go over the pros and cons of the procedure, what to expect, and post-operative care.

Q: How much does it cost to have done?

A: The typical costs ranges from place to place, in some businesses you’ll see a $299 special but in most reputable places, it is around $5,000 to have both eyes done. People pay all this money for solutions, contact lenses, cases, and visits to the doctor, and usually, in the end, it’s more than the cost of laser vision correction.

Q: Is there a lot of confusion about the three O’s of eye care – the difference between ophthalmologists, optometrist and opticians?

A: Yes, but I don’t mind helping people sort through the different kind of eye care services. Ophthalmologists like me are physicians, or doctors of medicine, who specialize in medical and surgical care of the eye; an optometrist is a primary eye care provider who often prescribe eyeglasses and contact lenses; an optician adjusts and fits optical products such as glasses.

Q: What’s next around the corner with laser correction surgery?

A: Like anything, technology is getting small and faster, making the laser even quicker. Cutting down on time can improve outcome.

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