FAQs

General Information

What to expect for your first consultation

Our professional practice aims to make your visit comfortable and pleasant. On arrival, you will be greeted by front-desk reception staff.

You will then be seen by our friendly Orthoptist (aid to Ophthalmologist) who will conduct initial vision testing. Some specialised tests may be required to best care for your vision – these may have costs additional to the consultation fee.

After initial testing, you will meet Dr Skalicky. Please feel comfortable to ask whatever questions you may have about your eyes and treatment.

Do I need a referral for a consultation with Dr Skalicky?

You will need a valid referral: either from your General Practitioner, Optometrist or another specialist. If you are a returning patient, your optometrist or GP referrals last 1 year (other specialist referrals only lasts 3 months): check to see if you need a new referral.

Where does Dr Skalicky consult and operate?

In Melbourne, Simon consults privately at Eye Surgery Associates in Malvern, East Melbourne and Vermont South. He operates at Cabrini Hospital Malvern and Victoria Parade Surgical Centre, East Melbourne. He holds public hospital posts at the Royal Victorian Eye and Ear Hospital and Royal Melbourne Hospital.

How much will it cost?

Every test or procedure is different, but we can provide you with an estimate for what you are expected to have by calling us on (03) 9509 4233. We can provide you with a breakdown of the costs involved in your specific procedure, including how we may be able to help you spread the cost of procedures.

Cataract Surgery

Is cataract surgery uncomfortable?

Most people find cataract surgery to be an easy experience. Numbing medications will be given to ensure the procedure is pain-free. You will be pleasantly sedated during the procedure.

Can I receive cataract surgery via laser?

With our access to the latest of technologies we can offer you conventional cataract surgery, or laser-assisted cataract surgery. Talk to Dr Skalicky about the pros and cons of either approach.

Will I still need my glasses after cataract surgery?

Our team will aim to provide crisp vision without glasses, however you may still need glasses for very fine print, especially for reading. Rarely glasses are required following cataract surgery for optimal distance vision, however, despite best measurements, some patients may require glasses for long distance vision.

If you need cataract surgery, you may want to consider premium presbyopia-correcting intraocular lenses or multifocal lenses that potentially can bring back a full range of vision without eyeglasses. Whilst multifocal lenses reduce the likelihood of glasses after cataract surgery, multifocal lenses are not without their problems. They can result in glare, haloes or reduced contrast in vision.

Studies have shown that surgeon experience is a key factor in successful outcomes when electing multifocal lenses. You can read more about the best choice of Intraocular lens here or talk to Dr Skalicky and our clinical team.

Will I be sedated for surgery?

Most eye surgeries are done with sedation and local anaesthetic. This means you will be awake during your procedure, but no pain should be experienced. The experience Is generally relaxed, pain-free and comfortable. A trained and experienced anaesthetist will administer your anaesthetic – usually by a local anaesthetic injection behind the eye. This will be administered comfortably and painlessly with the aid of local eyedrop numbing and sedation.

How soon will I recover from eye surgery?

With all eye surgeries, you should avoid strenuous activity for the first two weeks including swimming, tennis, jogging, and contact sports. However, the length of time for your recovery will depend on the nature of your procedure. You will be provided specific information about the estimated recovery times when booking your procedure. Please feel free to consult with Dr Skalicky for an individualised assessment. Dr Skalicky will confirm your precise post-operative-care and recovery time based on the nature of the work done.

What are the risks of cataract surgery?

Cataract surgery is generally very safe with excellent outcomes. Sometimes the vision improves immediately; sometimes it can take a little longer. Very rarely you may need a second operation to achieve excellent vision.

You may develop a watery, dry or irritated eye after surgery which can sometimes last up to 6-10 weeks. There can also be sensitivity to bright light. This is generally due to dry eye and surface irritation from the procedure and/or drops. It is worse if you have pre-existing dry eyes or are on glaucoma medication. Lubrication of the eyes prior to cataract surgery minimises this. The symptoms generally resolve with time.

Some patients have cataract and other eye conditions, for example, macular degeneration or glaucoma. These other conditions can sometimes limit the visual benefit from a successful cataract surgery.

Some patients can develop swelling at the back of the eye (macula) following surgery, lasting for 2-3months. The swelling can delay visual outcomes; however, this is rare.

More serious complications can lead to a loss of vision. This includes infection, retinal detachment, cataract surgery in one eye resulting in problems with the other eye and bleeding within the eye (Bleeding outside the eye is common and fortunately harmless). These conditions however are extremely uncommon.

Other rare but serious incidents can occur in relation to the administration of anaesthesia. The most extreme circumstances can be life-threatening.

Are there alternative methods to surgery for treating cataracts?

No - at present cataracts can only be treated by surgery. However, wearing sunglasses in bright sunlight, a healthy diet, avoiding smoking and reduced alcohol intake can decrease the development of cataracts.

Can cloudy vision return after cataract surgery?

Months or even years following surgery, clouding and scar tissue (called capsular opacification) can form behind the artificial lens, causing a secondary reduction of vision. This can be treated with a simple laser procedure performed in our office. For information regarding Laser Capsulotomy, click here.

If I have cataracts in both eyes, will both eyes be operated on at the same time?

If you require cataract surgery in both eyes, Dr Skalicky will wait one to three weeks before the second surgery is performed, so that your first eye has healed sufficiently and has clear vision.

What makes a lens better than others?

The best intraocular lenses are clear, with excellent optics, and yellow tinged; the yellow absorbs harmful ultraviolet and short wavelength light from damaging the macula.

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Capsulotomy

Will I have any restrictions after the Laser Capsulotomy treatment?

Drops to dilate your pupil will be administered prior to the laser treatment, which can temporarily blur your vision. You should not drive for 4-6 hours following this treatment.

When will my vision improve after Laser Capsulotomy treatment?

Vision may be temporarily reduced in the first few minutes/hours following treatment; the visual improvement is noticed shortly afterwards. You may notice a floater for the first few weeks following treatment – this is the area of capsular clouding that was removed from behind the lens.

Are there complications with Laser Capsulotomy treatment?

The treatment is very safe and hardly ever causes problems. Rarely it can cause mild inflammation or mild raised eye pressure. Occasionally energy from the laser can affect the lens, but this generally does not disturb vision. Very rarely the laser treatment can result in sight-threatening complications. These risks are very rare; they are greatly outweighed by the benefit from treatment.

Does Laser Capsulotomy treatment need be repeated?

No – Laser Capsulotomy is a once-only treatment. Very rarely it is performed over a few sessions.

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iStent

If my degree of glaucoma is stable, do I still need a iStent?

In most cases it makes sense to insert an iStent or CyPass at the time of cataract surgery. The iStent provides further eye pressure control to minimise the chance of future glaucoma problems. It adds hardly any extra risk or significant time to the cataract procedure.

Will I be able to stop taking my glaucoma eye drops if I have a iStent?

The iStent will probably reduce your need for glaucoma eye drops. This is of great benefit, as the drops may cause damage to the ocular surface resulting in dry eye symptoms, and may not provide great 24-hour eye pressure control.

Are there alternatives to the iStent?

If your glaucoma is not well controlled or getting worse, the iStent is likely to help, but you may be more suited to a stronger means of eye pressure control, such as the CyPass ®, Xen ® implant or trabeculectomy

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Glaucoma

Is glaucoma common?

Glaucoma is the leading cause of preventable irreversible blindness worldwide. In Australia it effects 2% of adults over 40 and 10% older than 80. Risk is greater for those with glaucoma in the family.

Who should be screened for glaucoma?

If you are older than 40 years or have a family history of glaucoma you should be screened.

I have glaucoma. Are my relatives at risk?

The most common types of glaucoma tend to run in families. If you have parents, brothers, sisters or children over 40 years old, they should be assessed for glaucoma.

Is eye pressure related to blood pressure?

The pressure in your eye is generally not related to your blood pressure.

Is there anything I can do in my life to treat or prevent glaucoma?

A balanced, healthy diet with a variety of fresh fruit and green, leafy vegetables, and Omega-3 fatty acids (eg fish, some nuts) can be beneficial in glaucoma. Vitamin B3 (found turkey, chicken, peanuts, mushrooms, tuna and Vegemite) can be beneficial for glaucoma. Smoking, excessive drinking, excessive weight gain and inactivity are harmful to the optic nerve and should be avoided. Yoga with head-down positions increases eye pressure and should be avoided. Some wind instruments with heavy blowing (eg bagpipes, trumpet) can be bad for glaucoma.

The most important ways in which you can influence the progression of glaucoma is by:

Attending all follow up appointments,
Using your eye drops as directed, and
Encouraging your close relatives to be screened for glaucoma.

I get pain around, or in my eyes. Could this be due to eye pressure?

Pain around the eyes is mostly this is due to an unstable tear film or dry eye. Raised eye pressure is usually painless, however high eye pressure can occasionally cause pain around the eyes and head.

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SLT - The Gentle Glaucoma Therapy

Will SLT reduce my need for Glaucoma eye drops?

SLT lowers eye pressure on average by 25% for most patients. If you are already on pressure-lowering eye drops, you probably will be able to reduce the number of these. If SLT is your first treatment it may delay your need for eye drops, sometimes indefinitely.

Can SLT treatment be repeated?

Yes, it can.

What effects will SLT have on my vision?

Glaucoma can lead to loss of vision, and SLT can prevent this by reducing the eye pressure. SLT is performed to preserve vision; it will not restore or improve vision, or cause any deterioration in vision. However, some patients experience a temporary blurred vision following the treatment, which resolves promptly.

Is SLT treatment uncomfortable?

Usually there is no major discomfort. Numbing eye drops will be given to ensure the treatment is generally painless; often some people may feel eye irritation, discomfort or headache during or following the procedure that resolves within days.

Will I have any restrictions after laser treatment?

You may find the vision blurred following the laser, but there are no restrictions on your activities and you will be able to drive provided the other eye is fine. If you work you may wish to give yourself that afternoon off.

Can SLT cause me any other significant problems?

No; it is a very gentle and safe procedure. You may have mild discomfort or blurred vision for the next few days, or a mild brief rise in eye pressure. These rarely cause harm and you will be monitored closely after the treatment. If you are someone that SLT does not work for, other forms of treatment including eye drops can still be highly effective.

How long does the treatment take?

The SLT is done in the rooms. Shortly after you arrive, you will see our friendly staff for an IOP assessment and be given eye drops for the laser. The laser procedure itself takes approximately 1-2 minutes.

Does SLT always work?

SLT does not always work – the reasons for this are unclear. Our success rates published in the Journal of Glaucoma indicate a 75-80% success rate; this is slightly higher than international average.

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Laser Peripheral Iridotomy

Will Laser Peripheral Iridotomy (LPI) impact my vision?

Glaucoma can lead to loss of vision, and a laser peripheral iridotomy can prevent this by reducing the eye pressure. The treatment is performed to preserve vision; it will not restore or improve vision, or cause any deterioration in vision. Occasionally patients may experience transient blurred or dimmed vision following the procedure lasting hours or even one day, which generally resolves.

Are there any risks with Laser Peripheral Iridotomy?

This is a very safe treatment. Any risks are very rare and nearly always transient. Occasionally there may be a brief rise in pressure and inflammation in the eye; you will be closely monitored for this following the procedure. There may be a tiny amount of bleeding within the eye but this is usually inconsequential.

Very rarely patients may notice glare or a horizontal line in their vision following this laser. People find this bothersome, however it is not dangerous. At our practice we carefully position the LPI to minimise this risk.

Does Laser Peripheral Iridotomy need repeating?

Generally, not. Usually once the iridotomy hole is formed it stays open. In rare circumstances the hole can close over, in which case the treatment needs to be repeated only once.

Sometimes after successful treatment the angle does not widen sufficiently – then other treatments (eg cataract surgery) to widen the angle may be considered.

From time to time patients who have received successful treatment, still have high intraocular pressure – subsequent intraocular pressure-lowering treatment might then be necessary, such as glaucoma drops or SLT laser.

Is narrow angles hereditary?

Narrow angles tend to run in families. If you have parents, brothers, sisters or children over 40 years old Dr Skalicky would be happy to review them for narrow angles.

I have narrow angles but my eye pressure is normal. Do I need this treatment?

Often yes. The narrow angles can cause glaucoma damage despite normal measured eye pressure – this may be because the eye pressure can fluctuate and we might be missing night-time pressure spikes.

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Glaucoma Eye Drops

Too many drops come out and roll down my cheek.

You may find that many excess drops roll down your cheek – don’t worry, if you feel one drop of wetness in your eye then you can be assured the eyedrop was successfully administered.

I find it hard to hold or squeeze the bottle or place it near my eye.

You may find it difficult to use the bottle – speak to our clinicians about techniques and aids that can help you.

I am too busy or just find it too hard to remember to put my drops in.

You may find it difficult to remember to put in your drops every day – speak to Dr Skalicky or his team about strategies or other treatment options that may be suitable.

The drops sting my eyes and/or make them red.

You may have developed intolerance to the drop or the preservative – please speak to Dr Skalicky or his team about alternative treatments, such as SLT or a preservative-free solution.

I have two types of drops to put in at the same time; I don’t know which one first.

Generally, if you have drops from two bottles to instil at the same time, the order does not matter, however you should wait 5 minutes between them to prevent the second drop washing out the first.

What if I miss a dose?

For drops that are once or twice a day, the exact hour of instillation is not crucial. If you have forgotten a dose from several hours ago, just instil a drop now.

I have my appointment tomorrow – should I still use my drops today?

Yes – unless otherwise advised.

I am pregnant – is it safe for me to use these drops?

If you are pregnant, check with your clinician or pharmacist before using any eye drop or other medication.

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Trabeculectomy Surgery

Will the surgery be uncomfortable?

Most patients are pleasantly sedated, pain-free and completely comfortable during the procedure – if you do have some discomfort or pain, please inform us and we can make you more comfortable.

What are the risks of Trabeculectomy surgery?

Any medical treatment involves potential risks. These are rare and need to be compared to the risk of permanent loss of vision if glaucoma is undertreated. You will only be recommended this treatment if the benefits outweigh the risks.

For a period of time your intraocular pressure may become too high or too low – this is not so significant as it can be adjusted.
If the trabeculectomy is not successful the operation may need to be repeated or further treatment may be required.
In some cases, a cataract may develop. This can be treated if necessary.
Serious yet rare complications, such as major infections and internal bleeding can occur.
Very occasionally the sight can get worse after trabeculectomy and may not completely recover.
Occasionally the upper lid may droop following surgery. If this happens, it can be corrected later by restorative eyelid surgery.
Very rarely a serious incident can occur in relation to the administration of anaesthesia, which in the most extremely rare cases can be life-threatening.

After surgery will I need new glasses?

After your final post-operative visit you may benefit from a new pair of glasses; please see your optometrist for this once your surgeon advises it is time to do so.

Will I need removal of sutures?

In most cases sutures are removed several weeks after the surgery. This is performed simply and painlessly in the clinic during routine post-operative appointments.

For how long will I be in hospital?

Most patients go home on the day of the surgery and are reviewed on the following day. If it is difficult for you to arrange transport or if you live far away, then we can arrange an overnight stay in the hospital – please speak to our practice staff.

What is safe for me to do after my surgery?

It is important to “take it easy” 1-2 weeks following the surgery: no bending over, heavy lifting or significant exertion. Please be careful not to bump your eye. After 5 days you can wash your hair, but avoid getting soap or water in your eye. You should avoid swimming or sport for 2-3 weeks following your surgery. Please make sure you do not unnecessarily touch/rub your eye, and wash your hands carefully before administering eye drops.

We generally recommend taking one week off work, but please feel free to discuss this with our surgical booking team.

Once you feel safe to drive and if you feel you have sufficient vision, you can start driving again 3-4 days following surgery. Please check with your Ophthalmologist after the surgery if you are uncertain that it is safe for you to drive.

I am having problems with my post-operative drops – what should I do?

Some people develop a red, sore eye after use of the drops – you may have an allergy to one of the drops. Please contact our practice if this or other problems occur and we can discuss alternative treatments.

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Glaucoma Drainage Tube Surgery

What are the risks of Glaucoma Drainage?

Any medical treatment involves potential risks. These are rare and are generally not as significant as the risk of visual loss if the procedure is not performed.

It is common for the pressure to be high for the first few weeks after the operation, and this can result in some discomfort. This is best treated with eye-pressure lowering drops and sometimes oral acetazolamide tablets until the drainage tube begins to work.

If the pressure remains high after several months the nylon stent can be removed. This is generally a simple procedure performed in the clinic.

For a period of time the pressure may become too low – this is not as significant as the long-term trend and can be adjusted.

In some cases a cataract may develop. This can be treated by an operation if necessary.

Occasionally the upper lid may droop following surgery; this can be corrected later by restorative eyelid surgery.

Serious complications are rare, but very occasionally the sight can get worse after tube insertion and may not completely recover or require further operations.

Very rarely a serious incident can occur in relation to the administration of anaesthesia, which in the most extremely rare cases can be life-threatening.

After Glaucoma Drainage surgery will I need new glasses?

After your final post-operative visit you may benefit from a new pair of glasses; please see your optometrist once your surgeon advises it is time to do so.

Will I need removal of stitches?

In most cases stiches do not need to be removed; occasionally this is necessary several weeks after the surgery and is performed simply in the clinic.

How long will I be in hospital?

Most patients can go home on the day of the surgery. If it is difficult for you to arrange transport or if you live far away, then we can arrange an overnight stay in the hospital – please speak to our practice staff.

What is safe for me to do after my surgery?

It is important to “take it easy” 1-2 weeks following the surgery: no bending over, heavy lifting or significant exertion. Please be careful not to bump your eye. After 5 days you can wash your hair, but avoid getting soap or water in your eye. You should avoid swimming or sport for 3-4 weeks following your surgery. Please make sure you do not unnecessarily touch/rub your eye, and wash your hands carefully before administering eye drops.

We generally recommend taking one week off work, but please feel free to discuss this with our surgical booking team.

I am having problems with my post-operative drops – what should I do?

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The Xen

When is Xen used?

Xen is used as an operation to treat glaucoma performed by a glaucoma specialist in melbourne, typically as an alternative to eyedrops or SLT laser, or when drops and/or SLT laser do not control the glaucoma sufficiently.

Does the procedure need to be performed at the same time as cataract surgery?

No. Xen is a Minimally Invasive Glaucoma Surgery device permitted for use as a standalone procedure and is suitable for patients who already have had cataract surgery or who don’t need cataract surgery.