Conjunctivochalsis surgery performed at The Gulani Vision Institute

[Richard Esser]

On 10/28/08 Arun Gulani, M.D. of The Gulani Vision Institute in Jacksonville, Florida performed conjunctivochalasis surgery with an amniotic membrane graft on my left eye. For the past year I had been experiencing tearing, burning, and blurred vision in my left eye. I live outside of Chicago, Illinois and had to travel to Jacksonville, Florida for this procedure. I was seen by some of the top physicians in the Chicagoland area who tried to treat this condition with steroid and antihistamine drops without success. I am less than one week post-op but have noticed an improvement in symptoms of dryness, burning, tearing, and blurred vision. It takes up to six weeks for the eye to fully heal following chalasis surgery so I am hoping to see marked improvement. For those with Dry Eye Dr. Gulani teaches other physicians advanced surgical and medical approaches to this complex eye disorder. I plan on keeping everyone on this Board updated as to my progress over the next six weeks. In addition, Dr. Gulani has a very informative web site that can be accessed at www.gulanivision.com.

[Lucy]

Thanks for this information, Mr. Esser. Can you tell us how much the surgery cost and if your insurance paid for it? Thank you. Lucy

[autumnn]

Hi Richard- So, was it pretty clear that the conjunctivochalasis was your problem? Was this diagnosed easily? DO you have MGD, blepharitis or aqueous deficiency? I am asking because my eye doc mentioned that I have conjunctivochalasis to a mild degree and is certain it isnt causing my pain.....but, I am still wondering about it. Can you describe a bit more your symptoms as well as the process of being diagnosed and later referred to surgery? Thank you so much for your help and welcome!
Autumnn

[Richard Esser]

Cost of Conjunctivochalsis Surgery

Thanks for this information, Mr. Esser. Can you tell us how much the surgery cost and if your insurance paid for it? Thank you. Lucy

Lucy:

I was very fortunate and my Blue Cross & Blue Shield Insurance is paying for 100% of the surgery. I had met my out-of-pocket for 2008. I do not know how much Dr. Gulani will be billing. The only thing I had to pay him was a $20.00 co-pay for my initial evaluation. I did call two other Florida based physicians that do this procedure and was given some crazy numbers ranging from $4500.00 on up.

Hope this helps,

Richard

[Richard Esser]

Diagnosing of Conjunctivochalasis

Hi Richard- So, was it pretty clear that the conjunctivochalasis was your problem? Was this diagnosed easily? DO you have MGD, blepharitis or aqueous deficiency? I am asking because my eye doc mentioned that I have conjunctivochalasis to a mild degree and is certain it isnt causing my pain.....but, I am still wondering about it. Can you describe a bit more your symptoms as well as the process of being diagnosed and later referred to surgery? Thank you so much for your help and welcome!
Autumnn

It was very clear after 10 months of an inflamed conjunctiva that conjunctivochalasis was my problem. It was not diagnosed easily. I initially was told I had blepharitis, dry eye, and an allergy. The chalasis was finally diagnosed by a physician at The University of Illinois at Chicago. However, they did not have a surgeon on staff with the skill to do the surgery. Dr. Gulani's name first came to me through the Dry Eye Zone. I then phoned his office and made an appointment for an evaluation. The symptoms I had were burning, tearing, dryness, and blurred vision that would not respond to steroids, restasis, punctal occlusion, artificial tears etc. Dr. Gulani performed the surgery with great skill on 10/28/08 and I have already improved.

Richard

[autumnn]

Thank you for your response Richard- one more question- did you have redness or signs that were obvious to the naked eye?

[Richard Esser]

Thank you for your response Richard- one more question- did you have redness or signs that were obvious to the naked eye?

Yes, I had lots of redness. Initially I could clear it for 24 hours with a steriod such as Pred Forte 1% solution, but as this pathology increased the eye was chronically red and I began to experience subconjunctival hemorrages. Also my tear film became more unstable due to the the conjunctival folds that were present. These folds were obvious to my naked eye if I turned my head
to the side. I could see the chalasis bunching and it appeared to be elevated from the underlying membrane that it is attached to. Eye is now less red six days post op.

Richard

[autumnn]

Thank you so much for this info- very helpful!

[Linda Higgins]

Same Story in Brandon, FL

Richard, since I'm new to this site and wasn't sure how to reply on this "thread", I sent you a private message last night, but not sure if I did it right. I am very anxious to continue hearing about your recovery from the surgery you had. I have the same condition - conjunctivochalasis - for 5 yrs. and it is progressively getting worse!! I use drops all day long - prescription and OTC - and do find some measure of comfort, but I may be getting closer to having the transplant surgery. Honestly, though, just thinking about the procedure scares me! I am seeing a well respected corneaologist here in the Tampa area. He says this condition is quite rare - only 3% of his patients are diagnosed with it.

[Linda Higgins]

Same Story in Brandon, FL - continued

opps - I hit the 'submit' button by mistake!

Anyway, I am so glad to have found this website and your story in particular has encouraged me so much! My goal is to find another patient of Dr. Fouraker's (part of the Brandon Cataract Center) who has had the surgery done by him. But I do hope you will continue to post your progress. I am a busy mom who is always on the go, so if I decide to definitely go for it, I'm thinking of scheduling it in Jan - after the holidays! Again, thank you for sharing and I pray your recovery continues to go well.
Linda

[Richard Esser]

Richard, since I'm new to this site and wasn't sure how to reply on this "thread", I sent you a private message last night, but not sure if I did it right. I am very anxious to continue hearing about your recovery from the surgery you had. I have the same condition - conjunctivochalasis - for 5 yrs. and it is progressively getting worse!! I use drops all day long - prescription and OTC - and do find some measure of comfort, but I may be getting closer to having the transplant surgery. Honestly, though, just thinking about the procedure scares me! I am seeing a well respected corneaologist here in the Tampa area. He says this condition is quite rare - only 3% of his patients are diagnosed with it.

Linda:

I do not believe the condition is that rare. It just goes undiagnosed. Patients are told they have dry eye, blepharitis, allergy, conjunctivitis, etc.
Do not fear the surgery. It is actually quite simple. Dr. Gulani teaches ocular surface surgery and is a master at this procedure. I am one week post op, back to work, and my co-workers can barely tell I was operated on. Improvement is almost immediate following surgery. My symptoms of redness, burning, dryness, and blurred vision have improved by 50% - 60%.
I am happy to answer any questions you might have. My e-mail is rickesser@hotmail.com.

[Jen72]

I actually live in the Jax area, so I am interested to hear about this dr. Is he DES specialist? I see the surgeon who did my Lasek regularly (too often!) and I think that she is doing all she can also its only been 4mos since surgery. However, if a leading specialist is in my backyard it may be time for another opinion. Curious, did he do the dry eye tests? Mine just seems to do visual checks of my eye with the staining. Were you satisfied with the Dr. and practices? Thanks in advance.

[Richard Esser]

RE: Dr. Gulani and post lasik dry eye

I actually live in the Jax area, so I am interested to hear about this dr. Is he DES specialist? I see the surgeon who did my Lasek regularly (too often!) and I think that she is doing all she can also its only been 4mos since surgery. However, if a leading specialist is in my backyard it may be time for another opinion. Curious, did he do the dry eye tests? Mine just seems to do visual checks of my eye with the staining. Were you satisfied with the Dr. and practices? Thanks in advance.

Jen72:

You are very fortunate you live in the Jacksonville, Florida area and have such easy access to Dr. Gulani. I had to fly 1500 miles to see him. To answer you question, Dr. Gulani is a surgeon and a large part of his practice is focused on dry eye. He also teaches ocualar surface disorder surgery and mentioned to me when I saw him there are actually seven surgical procedures that can be perfomed to relieve dry eye. Conjunctivochalsis surgery is one of the seven. I would suggest you review his web site at www.gulanivision.com.
It is very informative.

Richard

[Francesco]

I'm not a moderator and probably shouldn't write this..but this seems too much an advertising...also cause the Dr. you are mentioning is quite known of being very narcisistic (i read that he paid people to write good things about him)...sorry but it hurts me when people who are suffering are involved......

[Richard Esser]

Reply to Francesco

I'm not a moderator and probably shouldn't write this..but this seems too much an advertising...also cause the Dr. you are mentioning is quite known of being very narcisistic (i read that he paid people to write good things about him)...sorry but it hurts me when people who are suffering are involved......

Francesco:

I spent an entire year trying to find a surgeon that could help me with my conjunctivochalasis and Dr. Gulani successfully treated this condition for me.
I am 56 years old and had RK back in 1982. In 1999 I developed a lasik infection in my right eye. Between lasik and RK I suffer from irregular astigmatism in both eyes ( but am still able to work ) . For fifteen years I sold orthopaedic and respiratory equipment and on a personal level have been dealing with many eye issues such as irregular astigmatism, cataracts, vitireous detachment, dry eye, and ocular hypertention. After my procedure I phoned Rebecca Petris and informed her of my experience with Dr. Gulani. She knows several patients that he has treated. The reason I am being so detailed regarding my experience is so that others know where to go for help and I truly appreciate the fact that Dr. Gulani performed a state of the art chalasis repair to my left eye. I was seen by a top surgeon at The University of Illinois at Chicago who told me he was not comfortable doing the procedure because of my previous refractive surgery. My symptoms of burning, dryness, and blurred vision have already improved 60% and I am now going on 10 days post op and hoping to improve even more over the next two months.

Richard