Amanda Wilde (Host): A look at comprehensive ophthalmology on this episode of Curating Care, a podcast brought to you by St. Clair Health, expert care from people who care. I'm Amanda Wilde. And joining me is Dr. Aaron Wang, ophthalmologist with Glaucoma Cataract Consultants on the campus of St. Clair Health. Dr. Wang, so great to have you. Thank you for being here.

Dr. Aaron Wang: Thanks for having me.

Host: So, I know this much that Glaucoma Cataract Consultants, with whom you work, is a multispecialty group of ophthalmologists who deliver advanced eye care. Now, what would you want new patients to know about your team?

Dr. Aaron Wang: We at Glaucoma Cataract Consultants, or GCC for short, have an excellent team of physicians and staff to give patients the best medical and surgical care possible. I believe we have very caring doctors who are highly trained in cataracts, glaucoma, cornea, and retina. In addition, GCC has a very dedicated staff who will make patients visits as efficient as possible, considering that there are so many tests and images that are needed at most visits. And we employ the most advanced technologies to detect and treat early disease. We keep very much up to date with the latest medical treatments and latest surgical techniques to provide the best outcomes. Furthermore, we know that when it comes to vision and surgery, it can be a very stressful time for patients. So, we aim to get to know our patients and answer all their questions so we can provide individually tailored management and patients can make informed decisions.

Host: So, you have this dedicated staff and advanced equipment, and then I like what you're saying about seeing each person as an individual and for them to be able to be proactive in their own treatment. Do you need a referral from an optometrist or can you call directly to schedule a consultation?

Dr. Aaron Wang: Yeah. Patients can certainly make appointments directly with us at any of our convenient office locations, with or without a referral from their optometrist or their primary care doctor.

Host: Good to know. Well, let's focus on some of the common eye conditions you and your team see in your practice and how you approach treatment. Glaucoma and cataract is in your name, so let's start with the cataract. I know it's a clouding of an eye lens, and that can ultimately lead to vision loss. But it's quite common, isn't it? What are some of the early signs and symptoms that you would tell potential patients to pay attention to?

Dr. Aaron Wang: Yeah. Almost everybody at one point will get cataracts. People live long enough, they'll most certainly develop clouding of the lens, and we call that cataracts. And the common signs and symptoms of cataracts are blurry vision, near or far away, light sensitivity, glare and halos, and decreased vision in dim light. There is no medical urgency in getting cataract surgery done, but it is perhaps better to get it done sooner than later if it compromises your ability to drive safely.

Host: I was just thinking, wouldn't it?

Dr. Aaron Wang: Yeah. And once you get it done, you start to enjoy vision and life more, and cataracts don't come back. It's a one and done procedure..

Host: Oh, that's great. And I know from people who've had it done, that it just is a world-changing difference. So, what kind of treatments do you offer for cataracts?

Dr. Aaron Wang: GCC and St. Clair offers the latest and greatest tools in cataract surgery. In the Surgery Center, they have the latest and most efficient cataract extraction machine, we call phaco. And they uniquely offer digital marking tools to provide the most precise surgical outcomes. And they also offer the range of standard and premium lenses implant options currently available such as torics and multifocals.

St. Clair also has a number of staff trained specifically to handle ophthalmic cases. They also offer us surgeons the ability to perform dropless cataract surgery. That's why GCC bring many of our cases to St. Clair Hospital.

Host: What is dropless cataract surgery?

Dr. Aaron Wang: Traditionally, after cataract surgery, you need eye drops to help with the healing process, but eye drops can get cumbersome for many patients, especially if a patient has arthritis and can't squeeze little bottles, and they don't have help around the house. So, we can perform droplets cataract surgery where we inject the medication they need into their eye at the time of surgery, so they don't need drops afterwards.

Host: And you were mentioning with the tools you use, which are the latest to provide the most precise surgical outcomes. And more precise, what does that mean for the patient? Obviously, that could lead to better outcomes. Does it also translate into shorter recovery times or different reactions to surgery?

Dr. Aaron Wang: Yes, we are very excited at the digital marking tools that are available at St. Clair. It is the latest advancement in accuracy of cataract surgery. Traditionally, we would handmark freehand with a pen in the operating suite where we need to place the lens in certain orientations to minimize refractive error, to minimize astigmatism. But freehand marking with a pen is old technology. In these days of digital marking, we can take data directly from the measurement tools and overlay digitally in the surgical microscopes, where the lens needs to be oriented and placed in the eye. And with that done digitally, you have more accuracy in placement of the lenses.

And there's no translation error, where before you would have to look at the patient chart, find the axis, mark it on the eye, whereas doing it digitally, you take the data directly from the measurement tool and it overlays directly on the patient's eye, so there's no translation error. That does improve better, more precise outcomes. But recovery is still the same. Recovery from cataract surgery is relatively quick over a matter of days or weeks.

Host: So, cataracts are curable, is what I'm hearing.

Dr. Aaron Wang: Yes, it's a very successful procedure is probably the most commonly performed procedure of all of medicine, head to toe, and one of the safest and most effective procedure in all of medicine.

Host: Well, let's talk about glaucoma, because that is a chronic eye condition, and I don't know if it is curable. I know it can progress and cause vision loss, ultimately blindness by damaging the optic nerve, but how do you identify glaucoma, and how do you treat it, and is that curable?

Dr. Aaron Wang: Glaucoma is a silent thief of vision because it can cause irreversible vision loss without any early symptoms, neither pain or obvious vision changes. Glaucoma, which is damage to the optic nerve causes tunnel vision and can be detected early through routine dilated exams and specialized tests, such as measuring the eye pressure, the size of the optic nerve, or doing visual fields.

Host: I think I remember getting that done at my annual checkup. Is that standard now?

Dr. Aaron Wang: Yes. As much as measuring vitals like heart rate and blood pressure at your primary care doctor's office, measuring eye pressure is one of the vitals that we get when a patient walks in through the door. However, further specialized testing, such as imaging the optic nerve, doing visual fields, can be done if there is suspicion of glaucoma.

Host: Now, is this one of those conditions that can be treated less invasively and more successfully the earlier that you find it?

Dr. Aaron Wang: Yes. There are a number of simple, safe, and effective treatments for glaucoma to halt its progression. And many times it's as simple as a quick in office laser procedure or an eye drop and that would be enough to preserve vision and keep glaucoma in check. Thus, it would be a shame to miss glaucoma in its early stages. If patients simply wait until there's obvious symptoms of glaucoma to get an eye exam, then there would be already significant irreversible optic nerve damage.

Host: So, it's really important actually to keep up those eye exams.

Dr. Aaron Wang: Certainly.

Host: Now, also you deal with a number of diseases that affect the cornea or the outer window of the eye. What are some of the common diseases you see in treatments for the cornea?

Dr. Aaron Wang: The cornea is that front part of the eye that acts as the window that you look through. If, say, the front surface of the cornea is rough, well, we can polish it or laser it to make it smooth again. If, say, the inner layers of the cornea are swollen or scarred, well, we can replace it by doing a corneal transplant with a graft harvested from a donor. This type of procedure is called keratoplasty. The most advanced techniques include doing partial thickness keratoplasties, and these procedures involve replacing the diseased cornea with tissue paper-thin grafts. And we are quite good at doing these type of procedures.

Host: Well, how do the surgical capabilities, the advanced capabilities at St. Clair help patients who ultimately need a corneal transplant?

Dr. Aaron Wang: Since this is a very specialized surgery, not many surgery centers allow for such procedures to be done. We are fortunate that St. Clair has the equipment, the tools, and the trained staff to allow GCC surgeons to perform these partial thickness keratoplasties.

Host: Now, reshaping the cornea to correct vision problems is known as LASIK, which a lot of us have heard of. It was really common before the pandemic and now has rebounded since. What makes someone a good candidate for LASIK?

Dr. Aaron Wang: Yeah, you're exactly right. Not everyone is a candidate for LASIK. Thorough evaluation by one of our LASIK surgeons will reveal if your eye is healthy enough to undergo LASIK and benefit from LASIK. Ideally, if patients do not significantly have significant dry eye disease, ideally, they don't have a high refractive error, and that I mean their glasses prescription is not very thick, or ideally they do not have irregular, diseased, or thin corneas. Fortunately, for those who are not good candidates for LASIK, they may benefit from other refractive procedures to minimize the need for glasses. GCC is currently offering free LASIK evaluations. And if patients are not a candidate for LASIK, we do have other options on our tool belt belt as well.

Host: Yeah, there's a statistic that less than 1% of people with vision problems utilize laser correction. As an expert surgeon, what's your advice to someone who's on the fence about LASIK?

Dr. Aaron Wang: I simply recommend coming in to get an evaluation. And by coming in to get an evaluation, it does not commit you to surgery. The visit will allow you to learn about your eye, allow you to understand if you're a good candidate. Our LASIK surgeons will address any questions or concerns to allow you to make an informed decision. And typically, it is a simple, low-risk outpatient procedure that is potentially life changing.

Host: Well, that sounds good. Are you excited about potential technological advances coming up in the future?

Dr. Aaron Wang: Every year, there's always new technologies and techniques coming out. It's constantly on our end as surgeons to keep up with the latest and greatest. We just had the annual ophthalmology conference in Chicago two weeks ago, and we definitely learned a lot. And we are all eager to apply these new treatments and surgical techniques for the betterment of our patients.

Host: And so, it would seem that your partnership with St. Clair would be all the more important in light of that. You're on the seventh floor of the Dunlap Family Outpatient Center, right on St. Clair's main campus. What are some of the benefits of that space?

Dr. Aaron Wang: We are in a relatively new, spacious, state-of-the-art facility. We call it the Dunlap Family Outpatient Center. It has plenty of parking. The Surgery Center, which is conveniently one floor below our office, truly does provide a patient-centered experience. Each patient will have their own room with seating for friends and family. And the room is theirs through the duration of their stay, from pre-op to post-op recovery.

Host: And these advanced surgical treatment options are all offered as same-day service?

Dr. Aaron Wang: That is correct. All the procedures we performed are relatively quick, painless, and same-day procedures. They're done under IV sedation and the patient goes home the same day.

Host: Well, it sounds amazing how far advanced eye surgery has become. Thank you for discussing St. Clair Health's advanced surgical capabilities and for this other information on all of the common ailments that you see and how you treat them over there at the Dunlap Family Outpatient Center. When it comes to eyes, you have the prize.

Dr. Aaron Wang: Thank you for allowing me to talk about our practice Glaucoma Cataract Consultants and St. Clair Surgical Center where we bring many of our patients.

Host: Thank you, Dr. Wang. Dr. Aaron Wang is an ophthalmologist for Glaucoma Cataract Consultants on the campus of St. Clair Health. Thank you for joining us for this insightful conversation on Curating Care. Remember, at St. Clair Health, you're more than a patient. Be sure to tune in for our next episode to learn more about the innovative care we're bringing to the community.

If you found this podcast helpful, please share it on your social media and check out our entire podcast library for topics of interest to you. This is Curating Care, a podcast from St. Clair Health.