Written by: Dr. Joel Hunter

Posted on Feb 25, 2012

Today we’ll answer another of the “50 Tough Questions for your LASIK Doctor.” As I looked through the list again, I feel like maybe it should be named “50 Tough Questions for a Bad LASIK Doctor.” These questions, as it is in many other areas in life, are only tough if you’re wanting to hide something. “What did you do after work?” is an easy question for a husband that went to the florist to pick up flowers for his wife. It is a tough question for a husband that went to the dog track and lost all the money in their savings account. So with that clarification, here’s another of the 50 questions.

“What percentage of your previous patients have had enhancement surgery?”

I get a version of this question a lot. Most people are concerned that if they do this, they want it to be permanent and not have to worry about more surgery over the next year or two. To clarify, an enhancement is a “touch up” laser procedure to get someone to 20/20 if they didn’t quite do perfect the first time. There are a lot of factors at play in how often this happens. An enhancement rate will never be zero because whenever there is living tissue involved, there is the potential for unpredictability.

Here’s my answer up front. Our enhancement rate is about 1% and as far as I know, it is the lowest one in the galaxy. Here’s how we got it there:

First off, we spend a lot of energy on the front end trying to separate out good candidates from so-so candidates. Much of the reason for that is that good candidates have a much lower risk for having problems or needing enhancements (see this blog for more on that). After a whole host of 3D images of a candidate’s eyes show that we can help them, we can then proceed with 3D LASIK.

Secondly, not all lasers that perform LASIK are created equal. It is important to know that there are different makes and models that have different results in clinical studies. When we decided what lasers to get, we said, “Let’s get the absolute newest, most expensive, fastest, most technologically advanced lasers available.” And we did. And they were expensive! But wow, has it made a difference.

Lastly, I am neurotic about the drops that we give patients to use after surgery. Post-operative care is almost as important as the pre-op and intra-op. We spent a lot of time working out the perfect post-operative plan, and it helps deliver amazing results time after time. I have been called the “The Dwight Howard of Eye Drop Instructions” more than once—not really, but I’d like to get that started.

There are other factors that go into making an enhancement rate very low, but these are the main three. You should feel free to talk about enhancement rates at your consult. It is an important question to ask a LASIK doctor, but it shouldn’t be a tough one.

Written by: Dr. Joel Hunter

Posted on Feb 11, 2012

Kate, our Clinic Director, found a website with “50 Tough Questions for your LASIK Doctor.” She sent it on to me and thought it would be a good idea if I answered some of them for our blog. I said, “You don’t think people just want to hear about what I did for Thanksgiving or my son’s latest toddler escapades?” She has a point. For a LASIK practice’s blog, there is not a ton of LASIK focused writing. So I’m going to try to answer a few of the questions from the “Tough Questions” website. There are several good questions on there (and some ridiculous ones), but also, they have this amazing picture.

Here we go.

What percentage of refractive surgery candidates do you decline?

Great question! First off, you wouldn’t believe the variability, found clinic to clinic, in the testing that determines if someone is a candidate for LASIK. There are some places that do the bare minimum (check your prescription, and check to make sure your cornea isn’t too thin), and there are some places that do much more (things like corneal topography, dilated eye exam, cycloplegic refraction, etc.). Now that I come around to what we do at Hunter Vision, I am embarrassed to realize that I have to talk about how much more thorough a 3D LASIK evaluation is than what is done pretty much anywhere else. And I randomly picked this question! (maybe)

The average candidacy rate at many LASIK clinics is in the 85% range. At Hunter Vision, depending on the month, it ranges around 60%. We screen a lot of people out that have LASIK as an option, but not as their best option. The truth is, some people just will do better in glasses for now. On the flip side, some people will have way, way happier lives without glasses and contacts. The 3D candidacy exam is our way of sorting out these people. Kind of like sorting the sheep from the goats, but more like sorting the goats that should wear glasses or shouldn’t wear glasses. (Our editors strongly recommended I remove that terrible joke.) With 3D scans of the retina inside the eye, 3D scans of the cornea and lens at the front of the eye, and everything in between, it starts to become clear who should move toward LASIK and who should not.

But there is one thing that matters as much or more than that. Time. I spend about 20 minutes or so with each person that comes to Hunter Vision for their first (and only) evaluation, in that visit, we work together and figure out what would be best for their eye health and vision needs. My goal is not to get people under a laser, my goal is to provide results that will make people happy. That makes the decision making process more involved, but immeasurably more fun because it means that even with a low candidacy rate, there is a really, really high happiness rate.

Written by: Elizabeth Hunter

Posted on Jan 13, 2012

Happy New Year!

It is the time of year to make our resolutions and to decide how to better our lives. As we are testing will power and perseverance in our own lives, why not, in one more simple act, make someone else’s better.

THE EYEGLASS PROJECT is well underway and we’ve experienced an amazing outpouring of generosity from the community. We have accumulated about 700 pairs of glasses between drop locations in Hunter Vision, the RDV Sportsplex, and Northland Church. 

As we continue on this venture, we are adding some drop locations through Track Shack. If you are a runner as I am not, you can drop off any eyeglass donations at packet pick-up for all Track Shack races. As Hunter Vision proudly sponsors Track Shack, we will also have a Hunter Vision booth at all Track Shack races. If you are running or cheering or just staring in amazement that people can run so far and fast without being chased by a tiger (That’s me. I do that. While eating a churro.), bring your used eyeglasses and drop them off at our booth.

700 pairs donated and more to come! Isn’t this fun?

Written by: Dr. Joel Hunter

Posted on Dec 22, 2011

Knock, knock.
Who’s there?
A bunch of super nerdy people.
The American of Academy of Ophthalmology who?
We’re nerds.

I made that joke up this year after attending the Annual AAO Meeting in Orlando. 25,000 people who spend their lives working on eyeballs all descend on a city once a year for this meeting. I am fully aware that I am one of these nerds. I am reminded of it every time I make a joke in a room full of people like, “I’ll have my Diet Coke in a bottle, because I can’t stand to use glasses!” and am met with stares of indifference and/or pity. All that to say, I love the AAO meeting because it feels like coming home.

This year, I was invited to teach a few courses. I have a couple preachers in my family and asked them, as truly excellent public speakers, how they get ready for talks. It turns out they prepare for weeks!  I decided then that I would lower my aim from “excellent” to “very good.” My favorite course was teaching people new to refractive surgery how to do LASIK. A lot of people sign up to get to do LASIK on pig eyes (you read that correctly) each year at AAO. It is really thrilling to be there and help the first time someone does a procedure that they could end up doing for the rest of their life. I remember when I did LASIK for the first time during that course. It is really satisfying to watch things come full circle.

Each year at these meetings, I’m reminded how happy I am to get to do what I do for a living. I spend between 60 and 80 hours a week looking at, operating on, or discussing eyeballs and couldn’t be more thrilled with it. It is part of what makes me think God puts some pretty specific desires in our hearts. Who would think that anyone would want to spend that much time with eyes? But I was made to be an eyeball doctor. And if that makes me a nerd, it just has to come with the territory.

Written by: Elizabeth Hunter

Posted on Dec 8, 2011

In a world where we have access to all kinds of luxuries, it is hard to imagine living life without access to something as simple as sight. If we can’t see the newspaper, we buy a pair of readers. If our world is blurry, we get a new glasses prescription.

The large majority of us have some sort of refractive error that requires a simple pair of glasses to enable us to see clearly. The same is true all over the world. The difference for people that are less fortunate is that many have no access to a pair of glasses.

So there are people walking around legally blind, that require no heroic intervention to give them sight, other than a simple pair of glasses. It seems like a pretty wonderful opportunity to change people’s lives!

We started a charity called The Eyeglass Project. I know it seems ironic, a LASIK practice working to get people in glasses. 3D LASIK is amazing. I personally am a big fan of it. It provides an end to the inconvenience of glasses. But then what’s left? A pile of glasses that have lost their purpose.

Hunter Vision is partnering with TIME Ministries to bring those used eyeglasses (and any others we can get) to those who need them. We will be collecting eyeglasses beginning December 10th and will have drop boxes at two locations, Hunter Vision (located in the RDV Sportsplex), and Northland, A Church Distributed.

In 2012, a team from Hunter Vision will take used eyeglasses donations to the Dominican Republic to bring clear vision to those who don’t have access to it. But we can’t do it without your help. The donation of your used eyeglasses, something so seemingly simple, could give sight to the blind.

What do you think of being a part of this? How about telling your friends too? It doesn’t require money, just a pair of glasses that you don’t use anymore. At each of our drop locations, we will have tags for your glasses that give you the option of sharing your information with us. The purpose of getting your info is to let you see the difference that your glasses made. Our hope is to be able to send you a picture of a very happy person in glasses that were once your own. What fun!

Written by: Dr. Joel Hunter

Posted on Dec 5, 2011

Man alive, I haven’t updated this thing in a long time. It is not for lack of reminders. When I say “hi” to Kate, our Clinic Director, in the morning, she says, “You should update the blog.” She has a better grip on the To Do list than I do, either that or she just doesn’t want to talk to me in the morning. Either way, I fully intend to write blogs, then find other things that need to be done more, like answer email, or call patients, or stare out my window.

The same thing happened to me when my wife and I had our own blog for a while (www.lizzyandjoel.com). I would feel flourishes of creativity and write a few blogs, and then spend weeks wringing my hands that I had no exciting news to update. Never during this time did it occur to me that people probably weren’t sitting around biting their fingernails waiting for a new blog (“What does he think about ?!?”). But I digress, keeping a blog updated is an endeavor that is much easier in intention than in execution.

To get things caught up, Hunter Vision is growing by leaps and bounds. We are all really happy about it. I got to teach a few courses at the American Academy of Ophthalmology meeting this year, which was a lot of fun. Luke (my son) has learned a lot of words like “boo” “nu” and “baybo,” which are whimsical translations of “blue” “Luke” and “belly button.” He’s a pretty much a genius and I couldn’t be more proud of him. Thanksgiving was great. Lizzy made a feast for my parents and hers. I learned how gravy is made and almost barfed, but then ended up still really liking it in spite of how disgusting it is. I need to remember to stay ignorant about foods I like.

And now the blog is updated. It will definitely stay updated from this point forward. I am sure of it. Also, now that this is done, Kate is going to have to talk to me in the morning. The first thing I’ll cover with her is how gravy is made.

Written by: Dr. Joel Hunter

Posted on Jul 7, 2011

You can’t open a LASIK magazine (yes, they make those) or a practice management journal without reading about Facebook. Social media is how you reach the young people, they’ll tell you. If you’re not using the Facebook, you are missing the best way to talk to your target demographic. The young people.

It is fine advice. I get where they are coming from. The problem is that social media is a social media. And social settings have rules for normal interaction. If you go to a Christmas party and try to sell Amway, you are going to be more disliked and pitied than the guy that accidentally on purpose stands under the mistletoe all night. There’s little room among friends for lots of ulterior motives.

Hunter Vision joined Facebook in July last year. It’s become clear over time that it is a good place to cheer for someone when they are happy about their vision, but a bad place to explain in detail the difference between SBK and LASIK. It is a good place to connect with friends we’ve made, but it is nails on a chalkboard for people to hear “like us on Facebook!” We’ve learned that a business can’t be friends with people, only the people that work there can do that.   

Written by: Dr. Joel Hunter

Posted on Jul 2, 2011

I was in Kansas City last weekend. The occasion? The 26th Annual Durrie Fellows’ Reunion. Dan Durrie M.D. has worked with a doctor each year for 26 years to tell them the secrets of how to be the world’s greatest refractive surgeon. (“First, buy a coffee mug that says “World’s Greatest Refractive Surgeon,” is the type of thing you might hear on day one of your fellowship.) Each year we all gather together to talk about what’s going on in our lives, and more importantly, what’s going on in the world of SBK, LASIK, PRK, ASA, and other laser eye surgery acronyms.

It’s good to be around people that like the same thing you like. I remember when I was little and that was all it took to make a best friend (“You like ‘The Princess Bride’?, me too! Let’s quote it all day long!”) It’s kind of like that at the reunion, except a lot of the talk revolves around eye drops.

Mostly, it was just good to be around Dan Durrie again. The man is a living legend. He is the Johnny Cash of ophthalmology. It is well worth a trip to KC once a year to spend some time with him again, and remember, “yeah, I’m with that guy.” Hunter Vision is doing some great things, but there are even bigger and better things on the horizon. It is good to be on the journey with friends.

Written by: Dr. Joel Hunter

Posted on Jun 28, 2011

My wife hates flying. She hates it. We are on our way back from Kansas City and we had to fly there and back (the only other route is via cattle drive). I’ve tried to explain to her that hurtling through the air 5 miles above the earth at 600 miles per hour is the most natural thing in the world. But phobias are phobias.

I’m actually writing this on the plane and because irony chooses the most ironic times to show up, we are experiencing some turbulence. I tried to comfort her by having her read the first paragraph of this blog, but it must be the kind of thing that’s only funny to read from the ground.

Flying never bothered her until we had Luke. If it had, she might not have developed the love of traveling that she has. As it is, there is nothing more desirable she can imagine than being in a beautiful foreign place, and nothing more terrifying than getting there. I know what you’re thinking, “You should get an RV!” And you’re right, we should. But say that to Lizzy and she’ll react like you just told her we should replace our indoor plumbing with an outhouse. So I guess there are some things she hates more than flying.

Written by: Dr. Joel Hunter

Posted on Jun 5, 2011

A week ago, I was interviewed on The Good Life. The show is on TV 45 and is very
much like Live with Regis and Kelly, but only if Regis and Kelly were much wiser
and more warmhearted. It was my first time being on television.

There’s a lot more that goes into the production of a TV show than I realized. A
lady put makeup on me. They explained that if you don’t have some makeup with all
those lights and cameras on you, you end up looking like a zombie. They gave me a
tour of the studio where I saw room after room full of flat screens with
different camera feeds and people sitting in the dark running the editing and
production process. At least I think that’s what they were doing. While it was
being explained to me, I was thinking mostly about how I’d figure out which
camera I was supposed to look at. I realized this must have been how Michele
Bachmann felt right before she gave her reply to this year’s State of the Union
Address.

The interview itself went fine. I answered a bunch of questions about LASIK, and
since that’s pretty much what I do all day every day anyway, I felt comfortable
with it. I never did figure out which camera I was supposed to look at, so I just
looked at the hosts the whole time, even when they were looking at the camera. I
figured that no matter what, it would seem like I valued eye contact a great
deal.

If you’d like to see the finished product, here it is.