Dr. Dal Won Chun, MD

The choice of reconstruction technique depends on the size and severity of the defect. If tissue loss is small to moderate, the wound may simply be sutured close. For larger defects, however, tissue from other parts of the body may be needed. Tissue may be taken (or harvested) from the ear, scalp, abdomen, roof of the mouth, inside of the check, or the eyelid itself.

The Hughes procedure and the Cutler-Beard procedure are reconstruction techniques that use eyelid tissue. In the Hughes procedure, a piece of neighboring tarsoconjunctival tissue is cut, slid onto the wound, and then sutured together. The tarsoconjunctiva is made up of the connective tissue that provides support to the eyelid, called tarsus, and the membrane covering the white of the eyes, called conjunctiva. This technique is suited for defects that are located on the sides of the eyelid. The Cutler-Beard procedure requires a thicker segment of tarsoconjunctival tissue and is used to repair defects in the center of the eyelid.

Eyelid reconstruction is commonly done at an outpatient facility. There will be bruising and swelling for about four to ten days following surgery. Patients should keep their heads elevated, use cold compress, and apply antibiotic cream on their eyelids for the first few days. Strenuous activities must be avoided for four weeks, but patients may be able to return to work after about a week.

IBS, or irritable bowel syndrome, happens when the muscles surrounding the colon contract too easily or frequently. The result is abdominal pain, cramps, diarrhea or constipation, gas and bloating. IBS attacks can often be brought on by specific triggers, so a key part of treatment is learning which foods trigger IBS attacks and avoiding them. Treatment also includes exercise, avoiding stress, and medications if needed.

Constipation, or large, hard, or infrequent stools, happens to everyone at some point. It can be caused by a disruption in routine or food, or by eating a diet without many fresh fruits and vegetables. Although it is uncomfortable, constipation is common and usually not serious, but it can sometimes become chronic. Adding fiber to the diet, exercising, and taking medications may help.

GERD, or gastroesophageal reflux disease, is a severe form of chronic heartburn where stomach acid spills back up into the esophagus. Left untreated, the acid may even eat away at the esophagus and cause serious damage. Treatment includes changing the diet to avoid trigger foods, losing weight if needed, medications, or even surgery.

Hemorrhoids are blood vessels around the rectum that become irritated, swollen or torn while straining during a bowel movement. They are most often caused by constipation, but can also be caused by pregnancy, diarrhea, or simply a genetic predisposition towards hemorrhoids. Treatment involves first treating any constipation issues, then keeping the area clean and soothed until it has healed. If these measures are ineffective, surgery is sometimes used.

Peptic ulcers are sores or spots of inflammation in the lining of the stomach or close to the stomach in the small intestine. Usually this area is coated with a protective lining that shields the tissue from the strong stomach acid, but a break in the lining can let acid in, causing the sores. It used to be thought that stress caused ulcers, but now it is known that is not the case. Most often, they are caused by an infection by H. pylori bacteria, but ulcers can also be caused by alcohol abuse or overuse of aspirin, ibuprofen, naproxen, or other NSAIDS. The symptoms of an ulcer are pain, hunger, nausea, and fatigue.

Gastrointestinal problems, perhaps more than any other area, are markedly affected by lifestyle. Many disorders can be prevented or treated at least in part by eating a healthy diet high in fiber, exercising regularly, drinking enough water, and limiting alcohol intake. Still, the frequency of digestive disorders means that even the healthiest person can be affected by them. Anyone who notices blood in their stool, experiences abdominal pain, unexplained weight loss, or any significant change in bowel movements should see a doctor.

LASIK is generally considered an elective procedure (not medically necessary) since patients can wear glasses or contact lenses instead of undergoing LASIK. Nevertheless, many people still elect to undergo LASIK to have better vision without having to wear corrective lenses. Certain professionals, such as pilots, military members, firefighters, and athletes, might particularly benefit from LASIK.

Ophthalmologists (eye doctors) evaluate patients before surgery, measuring the cornea and checking for any eye irregularities that would disqualify patients from LASIK. A special eye scanner is used to create a map of the cornea. This map guides the surgeon in developing an individualized LASIK treatment plan. Once approved for LASIK, contact-wearers are advised to switch to glasses for the three weeks leading up to their surgery.

LASIK is a brief procedure, lasting for about half an hour, depending on the state of a patient's eyes and the corneal reshaping required. Patients lie down on a reclining chair and have numbing eye drops applied to one or both eyes to eliminate pain and discomfort during the procedure. While the eyes are held open by a device, the eye surgeon raises a fixation light where patients direct their eyes. The surgeon uses a femtosecond laser to cut a precise circular incision in the cornea's surface. The surgeon then manually folds back the corneal flap to access the stroma (inner cornea).

An excimer laser is then used to remove certain amounts of corneal tissue. For patients with farsightedness, the laser cuts tissue on the outer regions of the cornea, making the central cornea more prominent. For patients with nearsightedness, the opposite is done; central corneal tissue is removed while the outer tissue is left alone, flattening the eye. In patients with astigmatism, the laser is used to even out the surface of the corneal tissue, making the eye more spherical. When the lasering process is complete, the ophthalmologist folds the corneal flap to its regular position. The flap quickly begins to heal and naturally reattach itself to the eye.

LASIK patients need someone to drive them home from the procedure and cannot drive for the following 24 hours. Recovery from LASIK lasts about five days. Patients typically notice improved vision within a day or two of surgery. Prescription eye drops are given to patients to alleviate discomfort and promote eye healing. During this recovery time, patients must be incredibly careful not to touch or rub their eyes. Ophthalmologists often instruct patients to wear protective glasses during the day and night to prevent potential damage from eye rubbing.

LASIK can improve the experience of certain activities such as swimming or reading, and in some cases, LASIK can be a life-changing procedure for those with severe refractive vision errors. LASIK may also save patients money by eliminating the recurring need for updated corrective lenses.