FAQ

If you arrive on time with the pre-exam forms filled out on-line beforehand the eye exam itself will take roughly an hour for glasses only. If you are doing contacts add an additional 20 minutes and if you choose dilation add an additional hour.  We do hope that all our patients will give us the opportunity to style them in the optical after the exam which can take anywhere from 30-45 minutes.  

We only perform comprehensive eye health exams. We start with a detailed history through our pre-exam on-line paperwork. This lets us know what to take a closer look at when we get to the eye health portion of the exam. Many systemic medications can also have eye side effects.

We will always check your vision when you arrive, get a rough estimate of your prescription from our autorefractor, measure and document any glasses or contact lenses brought in, and check eye pressure.
Next you get to decide how you want to check the health of the back of the eye. We have 2 options: Dilation vs. Optomap. The optomap gives a panoramic view of the back of the eye and has no side effects but there is a $50 fee. Sometimes less with insurance. Another advantage is the picture can be compared year to year. This is Dr. Elizondo’s preferred method. If you choose dilation, it will happen later in the exam but also gives a view of the back of the eye. It involves 3 sets of drops that will cause the pupil to open and be fixed for 4-6 hours. It adds an additional 45min-1hr onto the exam as we do have to wait for the pupils to dilate and will see a patient in between. After the exam the patient will be blurry and have light sensitivity for roughly 4-6hrs.

Once in the room we review your medical history and go over your main reasons for coming in. Once everything has been entered into the chart the doctor will come in.

She checks to make sure some basic neurological functions of your visual system are intact with what are called entry tests. Then we move on to checking the prescription if you chose to have it checked. At this point we’ll discuss your best lens options for giving you the vision you want.
Then we’ll check the front surface of the eye with the slit lamp. This gives a magnified 3D look at the front of the eye. If a patient wears contacts this is the point where we would discuss options and chose some trials to try on. We may also do a few additional tests to check the front surface of the eye.
Finally we’ll go over the optomap photos or put in drops to begin the dilation. If you took the photo the exam is over, we’ll discuss any final questions and then head up to optical to check out. If you chose dilation we’ll head up to the front to begin waiting for 45 minutes. After you are fully dilated we’ll return to the room and I’ll use bright light and a lens to take a look around the retina.
After the exam, this is where the fun of your personalized eyewear styling consultation begins.

We aim to change choosing eyewear from a nightmare of looking at endless rows on a frame board to an easy decision with some well selected pieces that we help you out with.  Want to make sure that you are catered to as soon as you walk in?  Book an eyewear styling consultation and we’ll make sure someone is available to cater to your needs.  By the end of our process the decision is easy. Let us take the work out of choosing glasses and make it an enjoyable experience.

We personalize the experience and go over what makes you tick and how your visual needs play into your day to day. We go through what your needs are in our styling consultation. Are you getting a crick in your neck from tilting up to see the computer? Do you need a power pair for meetings vs. your gardening getting dirty pair for working outside? We aim to create that tailored experience in a laid back pressure free environment.  

We work hard to bring in unique collections from independent eyewear brands that are made in a sustainable way. Were each frame supports a small business and is someone’s livelihood. We recently brought Henry Jullien, a line from France that has some pieces that are actually gold filled.

We also give a 60 day love your glasses guarantee.  We understand that glasses are important not just for function but so you feel confident in your different day to day settings.  If you are unhappy with the vision or just how your frame looks we will reframe style you or adjust the prescription within 60 days of purchase.

In our office we are constantly striving to change and improve in how we do things. We believe that good customer service should just be baseline expectation at your visit. We genuinely want to get to know all of our patients as people and grow with them and their families over the years.

Our latest addition to our frame family is UDM. We aim to bring in unique eyewear lines not seen in any other places.

Our other independent lines include Chopard, Henry Jullien, Gotti, Blackfin Mattisse, Francois Pinton, Binoche, and Plein Les Mirettes. For more info on these lines visit our Frame Styling page.

We also carry some unique vintage sunglasses that vary throughout the year.  They are one of a kind pieces so once they are sold they are gone.

We make sure our technology makes your like easier. 

There are a couple parts of the eye exam that everyone hates. Paperwork, the air puff, and the dilation. From the very opening of the practice we brought in technology to streamline the exam process while making it comfortable and convenient for our patients. Instead of the air puff eye pressure test, we use another much less invasive device. We also brought in a retinal camera known as the optomap so that for most of our patients we no longer have to dilate. We can get a good thorough look at the health of the back of your eyes without the torture of dilation.

We also made it so appointments can be booked on-line and all the paperwork can be done on-line before one gets to the appointment. We just need to set the passcode if you are an established patient. Passcode not working… TEXT us.

We also switched our phone system so you can now text our office. It’s a quick easy way to get your questions answered.

What’s our next technological venture? We are working on making it so we can give you payment plan options for your glasses. Stay tuned……

So many benefits! Glasses are a functional fashionable medical accessory that we wear on our face everyday.  We find like our shoes different pairs of glasses can have different functions.

Are you over 40 and on a computer all day? There are lenses that will help your eyes relax and get rid of the eyestrain at the end of the day. Are you under 40 and just on an electronic device all day.  We can help you there.

There are clear glasses for night driving, sunglasses for day driving, a power pair for business meeting and a fun pair for gardening. Do you travel often? Have you thought of having 2 pairs in case one is left behind, stolen or damaged during a trip? 

Let us help you create an eyewear wardrobe for every occasion, both functional and fashionable.

Our practice is geared towards adults but we do start seeing patients at ages 5 and older.

Our cash pay exams include the exam, refraction (part where you get your prescription) and an Optomap photo. Since these exams are not restricted by insurance guidelines, we can take care of all your visual and eye health needs in one visit. Our pricing for an exam is $249 but we do give a $50 dollar discount if you purchase glasses within 30 days.  Contact lens exams are an additional charge depending on what type of contacts are needed.

The doctor uses several ways to determine whether treatment is recommended.  The doctor will talk to patients about lifestyle and their needs.  The doctor will check the glands that run along your lower lids.  These are called Meibomian Glands.  They produce the oily layer of your tear film.  This oily layer keeps your tear film from evaporating as quickly.  When we blink, this should naturally cause the oil to be released from the glands and spread over the top of the eye.  Long hours of computer work and contact lens overwear can cause the glands to function improperly or atrophy due to prolonged staring.  When the doctor puts gentle pressure on the lower lid margins, the glands should release an Extra Virgin Olive Oil consistency oil.  There are 20-30 glands along the lower lid margin and 30-40 glands along the upper lid margin. Over time, these glands can clog, the oil can become wax-like, or the glands can atrophy. 

When our eyes are dry, we can feel it several different ways.  They can feel gritty or itchy, tired or strained, and, sometimes they can water.  Our normal tears are like a sprinkler system that keep things moist.  Tears that happen when our eyes are dry are like fire hose water that is salty.  It’s too much and not the right consistency.

If our eyes are dry for a prolonged period of time, it can cause inflammation and abnormal blood vessel growth along our lid margins.  We can sometimes see signs of this in the form of redness in our cheeks.

We use a SPEED Questionnaire, lid and tear assessment, and consultation to determine what will work best for you.

IPL works well for those that show signs of inflammation along their lids and in their cheeks.

RF works well for those that have clogged glands or meibomian gland dysfunction.

Oftentimes, patients will need both to improve symptoms.

Another fantastic side effect is that IPL can improve overall complexion tone and RF has a skin-tightening effect that can reduce fine lines and wrinkles.

For treatments around the eye, both RF and IPL treatments last anywhere from 15-20 minutes.  If you are doing a combined treatment with RF and IPL on the same day, it can take anywhere from 30-40 minutes for an eye only treatment.

For a larger treatment area, it can take up to 60 minutes for RF and 60 minutes for IPL. Due to the length of time, it is recommended the appointments be booked on separate days

For RF it feels like a hot stone massage. Every patient’s heat tolerance is different.  If you feel any discomfort, please let us know and we will adjust the instrument settings to a more tolerable level. We realize it sometimes is awkward to speak up so we give you a little clicker to hold in your hand.  If you find the heat is a little strong just give us a click and we will adjust.

For IPL, a dose of light is released every time we press a button. The dose can feel like a mild rubber band snap.  Again, we depend on your feedback for comfort tolerance and can adjust our settings to make sure you are more comfortable.

The doctor will recommend the number of treatments based on your history, lifestyle, and current symptoms. Generally, it’s one treatment per decade of life.

Whether you need IPL, RF, or both, the exact number will be determined at the work up.

For patients with more severe cases of dry eye more treatments may be needed.

RF treatments can be spaced 4 to 6 weeks apart. IPL  treatments ideally should be spaced anywhere from 3 to 6 weeks apart.  The effectiveness of the treatment is reduced outside those ranges.

You could have the treatment done once month for the rest of your life if you wanted.

Yes,  we recommend 1-2 maintenance treatments a year.  The more severe your dry eyes the more maintenance treatments you may need.

Most patients feel and notice some change after the first treatment. If IPL and RF are done at the same appointment, you will generally feel and see a more pronounced result. 

The final results for both wrinkle reduction and eye dryness will appear 4-6 weeks after the last treatment.

You will have redness from the heat applied during treatment, which will fade within a few hours.  After treatment, sunscreen must be applied and skin cream containing retinoids should not be used.  We also recommend a calming cream as well.  We will let you know the products we recommend at treatment.  There is no downtime after the treatment. You should avoid prolonged sun exposure for 3-4 days after either treatment.

For those who undergo IPL treatment, the procedure improves the complexion and will break up dark spots and freckles.  The breakdown of this pigment will cause a pepper like effect on the skin about a week after the treatment in the area where dark spots were removed.  This pigment should flake off on its own. Do not pick at it.

RF treatment will reduce fine lines and wrinkles by tightening the collagen in our skin. IPL will reduce redness and improve complexion. 

RF and IPL will both reduce the symptoms of dry eye…. this is an intended side effect.

The treatment will sometimes make your vision seem better because now you get to look through a nice uniform tear layer.

If you are post-blepharoplasty with abnormal blood vessel growth, we will contact your surgeon for approval before beginning treatment.

If you are in a category that is contraindicated (Contraindications are listed below for both RF and IPL) but still wish to pursue treatment, we request a note from your doctor following that condition that you are able to receive treatment.

Yes, you can use your HSA/FSA card on anything in our office.  We also offer Care Credit which is a credit card for health expenses that gives you deferred interest for 6 months and no interest if paid off within 6 months.

RF Short answer: RF will help the oily glands along the lid margin produce a better-quality tear film making your eyes feel less dry.

RF Long answer: RF heats the glands along the lid margin to melt the oils within, remove waxy deposits, and clear out (express) the glands so they can function properly.  There are ~20-30 glands along the lower lid margin. There are ~30-40 glands along the upper lid margin. These oily glands are called Meibomian Glands.  They produce the oily layer of your tear film.  This oily layer keeps your tear film from evaporating as quickly.  When we blink, this should naturally cause the glands to be squeezed and  the oil to be released from the glands and spread over the top of the eye.  Long hours of computer work and contact lens overwear can cause the glands to function improperly or atrophy due to prolonged staring.  The glands should release an Extra Virgin Olive Oil consistency oil.  Over time, these glands can clog, the oil can become wax-like, or the glands can atrophy.  When this happens the outflow of the gland is clogged so no oil, very little oil, or oil of the wrong consistency can reach the surface of your eye.  The less oil of the proper consistency, the faster that tear film will evaporate off between blinks. For example, if you blink every 10 seconds but the tear film is evaporating after 5 seconds, then your eyes will feel dry or uncomfortable. 

This poor tear layer will also affect the quality of your vision. If you are not looking through a uniform front surface, you can experience glare, foggy vision (especially with contact lenses), or light sensitivity.

When our eyes are dry, we can feel it several different ways.  They can feel gritty or itchy, tired or strained, and sometimes they can water.  Our normal tears are like a sprinkler system that keep things moist.  Tears that happen when our eyes are dry are like fire hose water that is salty.  It’s too much and not the right consistency. Having a good sprinkler system will keep your eyes from watering from dryness.  Your Meibomian Glands are a critical part of this system.  Fixing them will help the system work better as a whole.

IPL: If our eyes are dry for a prolonged period of time, it can cause inflammation and abnormal blood vessel growth along our lid margins.  We can sometimes see signs of this in the form of redness in our cheeks.  IPL gets rid of these vessels and inflammation. Reduce the inflammation and you reduce the dry eye symptoms.

With either treatment we will also give lifestyle recommendations that will aid the effects of the treatment to give you the best possible results.

IPL targets inflammatory blood vessels near the surface of the skin and prunes them back. There are typically several layers, so to be truly effective, IPL needs to be done often 4-6 times depending on the redness and inflammation. The more pronounced the redness the more treatments needed.

RF heats the clogged glands along the upper and lower lids and we are able to manually express the glands while the oil is liquid clearing out the gland.  This gets rid of stagnant oil which bacteria feed off and can lead to inflammation. Glands that are not completely atrophied can now start to recover functionality.

Pacemakers ( or other implantable electrical devices)

Active autoimmune disease

Active corneal or lid infections

Overly tight skin (post-blepharoplasty or very young patients)

*Before treatment we will have you read and sign off on a fairly thorough list.

IPL will sometimes not work well for darker skin pigmentation. Our IPL instrument can be used on Fitzpatrick skin types I-III.

We will always do a test spot on the skin before treatment begins. If there is any adverse reaction, we will reset the instrument or discontinue treatment.

Recent sunburn

Pregnancy

History of seizures

Severe dermatitis or eczema (within the treatment area)

Active infections

Roaccutane use in the last 6 months

Herpes 1 or 2 (within the treatment area)

Very dark skin

Removing hair by the root e.g. waxing or tweezing in the area to be treated 2-4 weeks before treatment

Photosensitizing medications are best avoided.

Due to needing several treatments to be effective, the cost can vary widely. RF treatment around the eyes starts at $550 per session and IPL treatment starts at $500 per session.

If you choose to purchase a package, which is the recommended way, you will receive the aftercare products of Epionce Enriched Firming Mask and Epionce Ultra Shield SPF 50 as an added gift.

If the recommended treatment package is done, we offer 10% off.

• No tanning or extensive sun exposure 2 weeks prior to treatment
• Refrain from alcohol immediately before treatment and 3-4 days after treatment. Why? After the initial treatment it reduces the size of those blood vessels near the surface.  If you drink alcohol, it causes vasodilation and counteracts everything we just did.
• Limit sun exposure for 3-4 days after treatment
• Do not use products containing retinols or retinoids
• Do no use exfoliating products for 3 to 4 days
• Products that are safe to use on your face are Epionce gentle foaming cleanser to clean the face before and after treatment. We recommend you use this indefinitely for cleaning along the lids, morning and night. Gently go back and forth along the lid margin (do not get the product in your eyes!) about 10 to 20 times.  After 3 to 4 days post-treatment, you may switch to Ocusoft lid foam for lid hygiene.
• For at least 3 to 4 days (you can use them indefinitely though) use the Epionce Enriched Firming Mask as a face lotion at least once a day.
• For at least 3 to 4 days post treatment (again, you can use this indefinitely) use the Epionce SPF lotion once a day.
• A predominantly unprocessed diet high in whole grains, beans, fruits and vegetables is recommended. Avoid processed foods when able.
• Briogeo Omega 3, 6, & 9 supplement is recommended
• Just general eye health bonus tips. Have a diet high in carotenoid rich fruits and veggies (that’s anything yellow, orange, red, or dark leafy green) a diet low in saturated fat, wear UV protection, and get the daily recommended amount of exercise (that’s 150 min per week of aerobic exercise and 2 days of strength training)

• Do not use facial products containing retinols or retinoids
• Do not use exfoliating products for 3-4 days
• Products that are safe to use on your face are Epionce gentle foaming cleanser to clean the face before and after treatment. We recommend you use this indefinitely for cleaning along the lids, morning and night. Gently go back and forth along the lid margin (do not get the product in your eyes!) about 10 to 20 times.  After 3 to 4 days post-treatment, you may switch to Ocusoft lid foam for lid hygiene.
• For at least 3 to 4 days (you can use them indefinitely though) use the Epionce Enriched Firming Mask as a face lotion at least once a day.
• For at least 3 to 4 days post treatment (again, you can use this indefinitely) use the Epionce SPF lotion once a day.
• A predominantly unprocessed diet high in whole grains, beans, fruits and vegetables is recommended. Avoid processed foods when able.
• Briogeo Omega 3, 6, & 9 supplement is recommended
• Just general eye health bonus tips. Have a diet high in carotenoid rich fruits and veggies (that’s anything yellow, orange, red, or dark leafy green) a diet low in saturated fat, wear UV protection, and get the daily recommended amount of exercise (that’s 150 min of aerobic exercise per week and 2 days of strength training)