Nvision Blog

Dr. Paul Casey: How the KAMRA Inlay Can Help Restore Near Vision

Posted on January 28, 2018

Dr. Paul Casey of Nevada Eye Care, an NVISION Company.

Dr. Paul Casey of Nevada Eye Care, an NVISION Company, discusses how the KAMRA inlay helps restore near vision and reduce the constant frustrations of reading glasses for those with presbyopia or blurry near vision with the eHealth Radio Network. By providing a natural range of vision you can see — from near to far. It also offers long-term performance to help you continue to enjoy clear vision over time, even as presbyopia progresses.

Listen to interview with host Eric Michaels & guest Dr. Paul Casey discuss the following:

  • What is presbyopia?
  • What is the KAMRA inlay?
  • Who can the KAMRA inlay help most?
  • Do all eye surgeons offer this technology?
  • How can someone get more information on the KAMRA inlay?

To see if you're a candidate for the KAMRA Inlay, visit our website and request a consultation.


Eric (Host): Today we are speaking with Dr. Paul Casey at Nevada Eye Care, an NVISION Company. Dr. Casey is a board-certified ophthalmologist, specializing in corneal and refractive surgery. Dr. Casey, good morning and welcome to eHealth radio.

Dr. Paul Casey: Good morning, and thank you for having me on.

Eric: You’re welcome, so let’s get started with telling us, what is presbyopia?

Dr. Casey: Presbyopia is probably the most common vision problem in the world. It happens to everyone as the eye ages. When we’re younger, we’re able to see far away and then up close, and then far away and up close because we have a lens inside the eye that can change focus, like it does on your camera. You press it halfway down, it makes a noise, and then determines how far away it is from everything. We have that autofocus in our own eye, we don’t realize or hear it when it happens, but it’s going on when you’re younger. As you get older, the lens inside your eye literally gets stiffer and stiffer and stiffer, and our ability to change focus from distance to near gets worse and worse and worse.

Dr. Casey: Presbyopia refers to the condition that happens as we get older and have trouble seeing small type, needing extra light on things, and pushing things further away from us to read until the arms aren’t long enough. It’s incredibly common; people with good vision typically get reading glasses or make whatever adjustments as necessary. People who wear glasses or contact lenses start needing bifocals or reading glasses on top of their contacts. It’s an aging process of the eye that happens and affects everyone as they get older.

Eric: Continuing on, what is the KAMRA inlay, and what would be the history of the KAMRA inlay, and how does it work?

Dr. Casey: The KAMRA inlay is a fascinating new technology that is now FDA approved, available at our practice and others around the country. Of the different types of vision problems that I, and doctors like me, treat, presbyopia has been one of the hardest ones. If you get a stiff lens inside your eye, we can change the focus. We can give a person who has bad distance focus good distance focus usually by doing that with a laser. Similarly, if someone has good near vision, that’s great, but then they can’t see well far away. In conclusion, correcting the eye so that it can see at multiple distances has been very difficult.

Dr. Casey: Historically, there have been procedures that have attempted to try to give people a range of vision. Probably the most known about approach is one called monovision, where we would set one of the two eyes to focus on distance, and the other eye set to focus on near. The patient would then have to adjust their eyes. There is a considerable compromise when you do that; many people can get used to it and have very good success with the monovision set up, either in contacts or in laser vision correction.

Dr. Casey: The KAMRA inlay is a procedure; it’s a device that’s used as part of a procedure that is intended to allow patients to do better than that. The KAMRA inlay doesn’t change the focus from distance to near, as you would in a monovision procedure. It extends the focus so that the eye that’s being treated can see better up close, but continue to see well far away. It’s called the KAMRA because it relies on principles that photographers use when they’re producing photographs and they want the photographs to have a certain type of effect. When you’re taking a photo, you can adjust the size of the aperture. We call that the F-stop in the camera, and if you want to have distance and near both in focus, you would make the F-stop large, which works in reverse. It means that the aperture becomes small and everything is in focus and the depth of focus is great. When you make the pupillary aperture large by opening up the F-stop, you need to be very certain that you focus the camera very carefully. You can focus on something and that will cause the things that are behind it or in front of it to be out of focus, like you would if you were to take a wedding portrait. You would want the background to be fuzzy; it looks nicer in a portrait setting. But if you’re at the Grand Canyon, you’re going to want the person and the Grand Canyon both in focus, so you would want the aperture to be small.

Dr. Casey: The KAMRA works to make your eye work like the latter case that I just explained where both the distance and near targets are in focus. The inlay itself is implanted in the cornea, in the clear window in front of the eye. It only allows certain light rays into your eyes, those that are in focus for both distance and near. It effectively gives you a small pupil in the eye that’s treated. That improves your near vision because the depth of focus is increased but you don’t lose your distance vision. KAMRA inlay is for people who want to have better near vision, but enjoy their good distance vision. It’s really a breakthrough in the treatment of presbyopia, and presbyopia is the most common condition afflicting people on the planet today. It’s pretty important.

Eric: I would say so as well. Now, who can the KAMRA inlay help the most?

Dr. Casey: We typically don’t put a KAMRA inlay in anybody under 45 years of age; they just don’t need it. If you’re still young enough to change focus on your own, you would just use what Mother Nature gave you. Patients over 45 can be helped with a KAMRA inlay. In it’s purest form, you would be talking about a person that already has excellent distance vision but can’t see up close. People using reading glasses would be the mainstream candidates for this procedure. However, we can use the KAMRA inlay in conjunction with other technologies, like LASIK for example, to improve the near and distance vision. We may need to do LASIK to get the good distance vision and use the KAMRA to make that better by improving the near vision as well. It can help a lot of people, whether you have blurry distance and near vision, or blurry near vision only, the KAMRA inlay can work well to provide you that range of vision that people would ideally want.

Dr. Casey: I have never evaluated a patient and said, “Well I can improve your distance vision but you’re going to need reading glasses if you want to do both eyes,” and then hear the patient say, “Well, I just want my distance vision corrected”. It’s natural that if you’re older and you know that you have a problem about distance and near, you’re going to want them both corrected. It really has a very broad applicability because it’s not like LASIK or cataract surgery where you have to have a focus problem, like nearsightedness for LASIK, or astigmatism, or a cataract. This applies to virtually every person as they age.

Eric: Do all eye surgeons offer this technology?

Dr. Casey: The KAMRA inlay has been around for quite awhile around the world where technologies in other countries can get approved faster than they can here in the United States. There is a great deal of experience with this technology and tens of thousands, possibly over 100,000 people are getting surgeries done and have had KAMRAs implanted. However, in the United States, the KAMRA received its FDA approval in 2015, and at this point, it’s not like every doctor is doing it. In our Las Vegas, Nevada market, there’s two surgeons, myself and one other, who are performing KAMRA inlay surgery. In larger markets, there are some times about a half dozen or so. If you go to KAMRA.com, you’ll find your market, you can put your zip code in and find a doctor that offers the technology.

Dr. Casey: It’s not like everybody is doing it, the adoption of this particular technology is fairly intense from the standpoint of a practice or a surgeon. Other technologies are sometimes very easy to adopt them and add them to the list of things that you do. This one requires a lot of training and developing the surgical techniques to place the implant in the cornea. It is best if the surgeon is a specialist and does a lot of corneal surgery to begin with; they sort of understand what’s involved. Potentially, and there was in our practice, a great deal of investment that is required in both diagnostic and therapeutic equipment that enable me to be able to offer the surgery. Those factors have thus far limited the availability of the KAMRA to everybody and to be done everywhere. Over time, more and more surgeons will begin to offer it because the surgery is applicable to such a large segment of people. Half the people that come into my office every day are more potential candidates. Most of those are LASIK surgeons because it is a natural fit. LASIK surgeons or refractive surgeons, who would have previously used a monovision procedure for correcting the distance and near, are now saying that, “I can now do an even better job recovering the distance and near than I used to be able to do so I’m going to make the effort to get this available at my practice too”.

Eric: As far as the KAMRA inlay technology, I’m assuming that people can get more information on the website that you just mentioned?

Dr. Casey: Right. I would probably say if this is going out over the internet and people are going to be all over the place, they are probably going to want to go to www.KAMRA.com and then do a search as I described. Anybody in Las Vegas can call us at Nevada Eye Care and get an appointment with me. I imagine it’s better to have listeners go ahead to the website. They can also learn a lot more about the KAMRA inlay and how it works, and whether they are a candidate. If they want to get a better feel for what is going on or get some literature or read through a few webpages to understand it better, I think that would be the best way to go.

NVISION Surgeon Dr. Brar Travels to Fiji to Help Patients at The Mission at Natuvu Creek

Posted on January 22, 2018

The winter holidays are widely known as the season of giving, and NVISION Ophthalmologist Amarpreet Brar, M.D. is a firm believer. In the week between Christmas and the New Year, Dr. Brar and his family volunteered at The Mission at Natuvu Creek, a non-profit organization in Fiji founded by the Tooma Family Foundation. Since 1998, thousands of patients have received free medical care by hundreds of volunteers who have come to the beautiful island.

While in Fiji, Dr. Brar worked with the staff at Mission and conducted a free eye clinic for several days. This included eye exams and dispersion of glasses to people who could not afford them. He even performed a few pterygium surgeries, which is a growth on the cornea that may distort vision.

NVISION® Lifetime Commitment

Posted on January 1, 2018

The NVISION Lifetime Commitment is our promise to you that we stand behind your LASIK vision correction results—for life. We have confidence in our surgeons and in the stability of our patients’ results over the long term.

Find a surgeon near you who participates in the NVISION Lifetime Commitment:

Scott Perkins AZ 4800 North 22nd Street, Phoenix, AZ 85016 (602) 955-1000‬ (602) 759-1341 goodeyes.com
Robert Fintelmann AZ 4800 North 22nd Street, Phoenix, AZ 85016 (602) 955-1000‬ (602) 759-1341 goodeyes.com
David McGarey AZ 350 N Switzer Canyon Dr., Flagstaff, AZ 86001 (928) 779-0500‬ (602) 759-1341 goodeyes.com
Jay Bansal CA 3540 Mendocino Ave., #200, Santa Rosa, California 95403 (800) 527-3745 (707) 544-2024 laservue.com
Richard Burns CA 40700 California Oaks Road, Suite 108, Murrieta, California 92562 (951) 696-4129 nvisioncenters.com
John Davidson CA 771 E. Daily Drive, Suite 245, Camarillo, California 93010 (805) 437-7150 nvisioncenters.com
Franklin Lusby CA 2575 Yorba Linda Blvd, Fullerton, California 92831 (714) 257-0560 nvisioncenters.com
Franklin Lusby CA 23550 Hawthorne Blvd Suite 220, Torrance, California 90505 (310)- 784-2020 nvisioncenters.com
Richard Meister CA 5959 Greenback Lane, Ste 310, Citrus Heights, California 95621 (916)723-7400 nvisioncenters.com
Jonathan Pirnazar CA 24022 Calle de la Plata, Suite 300, Laguna Hills, California 92653 (949) 951-1457 nvisioncenters.com
Jonathan Pirnazar CA 3155-D Sedona Court, Ontario, California 91764 (909) 605-1975 nvisioncenters.com
Max Parikh CA 3655 Nobel Drive, Suite 130, San Diego, California 92122 (858) 558-6000 nvisioncenters.com
George Simon CA 1390 Willow Pass Road Suite 120, Concord, California 94520 (877) 370-7727 nvisioncenters.com
George Simon CA 950 Tower Lane Suite 130, Foster City, California 94404 (877) 370-7727 nvisioncenters.com
Tom Tooma CA 3501 Jamboree Rd., Newport Beach, CA (949) 854-7400 (949) 854-7331 nvisioncenters.com
Richard M. Awdeh FL 900 Northwest 17th Street Miami, FL 33136 (305) 482-5135 (305) 243-7487 bascompalmer.org
John Olkowski HI 3660 Waialae Avenue Suite 304 Honolulu, HI 96816 (808) 735-1935 (808) 735-6875 eyesightHawaii.com
Frank Price IN 9002 N. Meridian St., Ste 100, Indianapolis, IN 46260 (800) 317-3937 (317) 844-5590 pricevisiongroup.com
Michael L. Keil MI 2500 East Beltline SE, Suite C, Grand Rapids, MI 49546 (616) 365-5775 (616) 365-5778 keillasik.com
Ralph Chu MN 9117 Lyndale Ave. South, Bloomington, MN 55420 (952) 835-1235 (952) 835-0534 Chuvision.com
Lance Kugler NE 13923 Gold Circle, Suite #101, Omaha, Nebraska 68144 (402) 558-2211 (402) 558-3456 lasikomaha.com
Paul Casey NV 2090 East Flamingo Rd., Suite #100, Las Vegas, NV 89119 (702) 633-2020 nvisioncenters.com
Paul Casey NV 2090 East Flamingo Rd., Suite #100, Las Vegas, NV 89119 (702) 633-2020 nvisioncenters.com
David Bernitsky NM 6401 Holly Ave NE Albuquerque, NM 87113 (505) 323-0800 (505) 323-6221 bernitsky.com
William F. Wiley OH 833 East Broad Street, Elyria, OH 44035 (440) 366-6969 (440) 366-9513 clevelandeyeclinic.com
Stanley Teplick OR 9975 SW Nimbus Avenue, Beaverton, Oregon 97008 (503) 520-0800 nvisioncenters.com
Brian Will OR 2601 25th SE, Suite 120, Salem, Oregon, 97302 (877) 542-3937 (360) 885-1333 willvision.com
Kerry Solomon SC 2060 Charlie Hall Blvd., Suite 201, Charleston, SC 29414 (843) 881-3937 (843) 884-8584 drkerrysolomon.com
Ming Wang TN 1801 West End Ave, Nashville, TN 37203 (615) 321-8881 (615) 321-8874 wangvisioninstitute.com
Mike Mann TX 5115 Main Street, Houston, TX 77002 (713) 580-2500 (713) 580-2597 manneye.com
Thomas Clinch VA 8230 Boone Blvd Suite # 125, Vienna, VA 22182 (703) 962-7104 (703) 883-0222 cornea-dc.com
Paul Kang VA 8230 Boone Blvd Suite # 125, Vienna, VA 22182 (703) 962-7104 (703) 883-0222 cornea-dc.com
Brian Will WA 8100 NE Parkway Dr., Suite 125, Vancouver, WA 98661 (877) 542-3937 (360) 885-1333 willvision.com

Corneal Conditions

Posted on December 12, 2017

The cornea, the part of the eye on which contacts are worn, is a transparent surface where the light passes through and imprints an image on the retina. The light passing through creates a chemically and electronically induced reaction that travels through optic nerves to the brain allowing us to see.

The cornea is normally clear because it does not have blood vessels and has a shiny surface. It must be completely transparent for us to see clearly and is extremely sensitive to light because it has more nerve endings in the body than anywhere else.

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