ORA stands for Optiwave Refractive Analysis. It is the only means of intraoperative aberrometry approved in the country.


ORA is designed to deliver superior refractive outcome to patients undergoing cataract surgery. This means treating nearsightedness (Myopia), farsightedness (Hyperopia), and astigmatism at the time of your procedure. For some basic information on these, please refer to the section on Lasik.

How it works

Before understanding how ORA works, we must first understand how myopia and hyperopia are typically treated. Before a patient has cataract surgery, the anterior curvature of their cornea and the anterior-posterior diameter of their eye are measured. This information is entered into equations that allow us to predict the IOL (intraocular lens) power that would suit them best.

ORA adds an additional safety net by taking a refractive measurement of the eye during the course of surgery using infrared light (completely safe for your eye in this context). In less than a minute, ORA takes 40 measurements which allow for a much more reliable measurement of predicted myopia, hyperopia, and astigmatism.

Why Use it?

Well, to put it simply it delivers superior refractive outcomes without being invasive or adding any risk to the procedure

Unlike the traditional methods of simply measuring the corneal curvature and axial length of an eye, ORA factors in posterior corneal astigmatism. And as we’re learning, posterior corneal astigmatism is becoming increasingly recognized as a factor that must be considered for delivering good outcomes.

Lastly, there are some cases in which ORA is particularly useful and consistently offers a clear advantage.

Eyes that have had LASIK or PRK.

These eyes are notoriously unpredictable in terms of refractive outcomes. Traditional formulas that are used cannot reliably account for refractive changes in the structure of the cornea. ORA lets us bypass these formulas and offer patients the best chance of an ideal outcome.

Premium IOLs (intraocular lenses)

It is vital that the correct lens power is chosen for any of these lenses to function properly. ORA maximizes this chance and greatly increases patient satisfaction along the way. In astigmatism correcting lenses, there’s another fold to this. ORA not only helps predict the best lens power but also helps guide positioning to treat the maximum amount of astigmatism. Here are some pictures of ORA guiding lens positioning.

In the top picture, ORA suggests rotating the lens clockwise to maximize astigmatism. The bottom picture was taken after the lens was rotated successfully. NRR just means “No Rotation Recommended” or “Good job”.





Dry Eye Syndrome

What does Dry Eye look & feel like?

  • Blurred Vision
  • Eye redness
  • Tired eyes
  • Burning
  • Grittiness
  • Irritation
  • Watery Eyes
  • Foreign body sensation

What causes Dry Eye?

Here are some of the major causes of Dry Eye:

  • Exposure (i.e. poor closure of the eyelids)
  • Poor production of your natural tears
  • Decreased lipid content of tears (which may be related to blocked or inflamed glands of the eyelid)
  • Certain prescription medications
Here is a magnified picture of blocked Meibomian glands of the eyelid taken from dryeeyezone.com.

Blocked meibomian glands

Dry Eye Testing

Before starting treatment, it is important to understand what is causing your Dry Eye. This information will allow a more focused approach to your dry eye treatment.

Appropriate dry eye testing entails a full exam with your Ophthalmologist and may involve certain in-office tests to determine the cause.

Dry Eye Treatment

There are various modes of Dry Eye treatment. Common therapies include the following:

  • Artificial tears or lubricant drops
  • Tear gels/ointments
  • Lid Scrubs
  • Fire and ice mask
  • Hydroeye
  • MiBo
  • LipiFlow
  • IPL

New treatment options

There are a lot of new and exciting treatments for Dry Eye. MiBo and LipiFlow have both shown very promising results in recent studies. However, these therapies are not suited for every type of patient. They work especially well for patients whose Dry Eye is related to blocked glands of the eyelid (pictured above). Ask your eye doctor if you fit into this category.


Saying Goodbye to Glasses

There are many reasons why patients are dissatisfied with eyeglasses.

  • Eyeglasses distort or block peripheral vision.
  • They may become scratched, smudged, or foggy.
  • They can exert pressure on your nose and ears.
  • They can fall off during sports or activities.
  • Adjusting to the bifocal or progressive segment can be very difficult.

Recently, I have had a lot of patients express their frustration with eyeglasses. Usually, the problems involves a problem with the bifocal or progressive segment. Often, these patients ask if they are candidates for LASIK or if there is any way they can reduce or eliminate their need for glasses.  With this in mind, I decided to summarize some basic options for patients who are looking to see the world clearly without any glasses.


LASIK is a great option for patients who are looking to correct their distance vision. In this process, a laser is used to re-shape the Cornea (front part of the eye). This allows perfectly clear vision and can eliminate the need for glasses or contacts.

In patients who need some additional reading help such as a bifocal or progressive segment, the LASIK measurements can be set for “mono-vision” which allows patients to see clearly up close and in the distance.

There is much more information about “How it works”, “Pro’s and Con’s” and “Cost” in the LASIK section. Feel free to check it out.

Lens Exchange

In eyes that are Myopic (nearsighted) or Hyperopic (farsighted), the eye’s natural lens has either too much or too little power relative to its size. The result of this is blurred vision. In “Lens Exchange”, the eye’s natural lens is replaced with a synthetic lens which is designed specifically for your eye. As a result, patients have clear vision after a lens exchange without the need for contact lenses or glasses. All of this is done through a self-sealing micro-incision that is often created with a laser.

An added benefit of Lens exchange is that clear vision at distance and up-close may be obtained with a Premium implant. In addition, cataract surgery will never be required in the future since your natural, aging lens has already been replaced!

There are risks and benefits to every procedure. If you are interested in saying ‘Goodbye’ to glasses, please see an Ophthalmologist who will do a thorough exam and complete the necessary testing to see if you are an appropriate candidate for either of these procedures.