• Ethical, personalized care and attention
• Harvard and University of Chicago trained surgeon
• Top-of-the-line technology at Scripps surgical center

Were your friends and family already delighted by our excellent care, so they're sending you to us?

Are you already impressed by the things our real patients have to say, by Dr. Nahl's Qualifications, and by the technology we use at La Jolla LASIK?

If you are already convinced that you'd like to come talk with us about LASIK in San Diego, please call our office at (858) 551-4100 or fill out this form to make an appointment.

Otherwise, please read on to learn what makes Dr. Nahl and La Jolla LASIK different and special.

A LETTER FROM DR. NAHL

This is me, Dr. Nahl, talking to you -- not some generic marketing person writing generic web marketing copy. I don't really like to talk about myself, because it's not really about me, it's about you, my patient. But you have to choose your doctor somehow, and I want you to come and be a member of my practice family, so let me just give you a sense of who I am and how I think.

You can read about my qualifications here and about the good technology I use there, and it's all just as good or better than any other laser center in San Diego. But ultimately when you're choosing eye surgery, the critical thing you have to choose is the surgeon, right? You've only got two eyes, so who are you going to trust to do surgery on them?

I think in a surgeon you want three things: good hands, a good head, and a good heart. You probably already get what I mean, and I don't mean to sound braggy saying it, but I think you'll see when you meet me that I have all three.

The good hands -- when I operate on your cornea it's micro-surgery, meaning I'm using my hands to do things to your eye, but it requires a microscope to see it. The hands matter! And I'm one of these people who is always doing little things with her fingers… it's almost like they always want to practice on their own, doing tiny things, picking at a thread on my clothes, or feeling for the nick on a pen or whatever. Or like the way I learned to sew as a six-year-old and won the sewing prize in my elementary school. Or when my kid gets a thorn in her finger, I put on two pairs of magnifying glasses and I remove it with a pair of tweezers without her feeling it. In eye surgery the tiny details matter, like the ability to smooth out and correct things you can't even see with your bare eye. The details matter!

Which is why you need a good head -- clear perceptions, good training, good judgment, and a quest for the best way to do everything. The quest for the best is much a part of my personality that my mother-in-law tried to tease me that I should write a book called "The Best of Everything" -- cooking, gardening, whatever. I didn't even realize she was joking. I was like "Oh, good idea, yeah!" Of course you should do everything the best possible way. If you're going to bother doing anything, why would you not do it the best way? The idea is nonsense to me, actually totally intolerable, actually quite offensive. So there's this side of me that's always analyzing, critiquing, studying better ways of doing things, questioning and demanding the best.

But I have a good heart too -- I actually care about you, want to get to know you. I'm always asking my patients about their hobbies and thoughts on things -- food, kids, cars, your job, your family. I love learning from everyone I meet, and I've been told I have a goofy loud laugh, which you may hear. I'm not in this business because I want to drive a fancy car and wear fancy clothes. I mean, I drive a Subaru and wear scrubs! I do what I do because I actually love having a tangible and ethical way that I can make peoples' lives better every day with nearly perfect reliability.

So there you have it, that's me, Angela Nahl, M.D. This is my actual voice talking to you: I swear that if you come to me I will be direct and honest and ethical and as skilled as anyone can humanly be.

Schedule Your Free LASIK Consultation

DR. NAHL'S QUALIFICATIONS

• Undergraduate degree from Harvard College
• Medical degree from University of Chicago
• Residency training in Ophthalmology from USC, Doheny Eye Institute
• LASIK training with Stanford master surgeon
• Thousands of successful LASIK and PRK surgeries in 20 years of practice

La Jolla LASIK Technology:

• Full suite of pre-test equipment in my office on the Scripps Memorial campus
• Surgery performed at state-of-the art Scripps facility

WHY ETHICS MATTER

You and I both know you want to see better, to wake up in the morning and see everything clearly. Right? Otherwise you wouldn't be here reading this site. You can picture yourself exercising, wearing non-prescription shades, swimming, whatever. We all know people who are so pleased with the results, and we all know the advantages! So I'm not here to give you a sales pitch on why you might want refractive surgery -- you probably already know you want it.

But you probably have those fundamental questions about eye surgery -- most importantly, "is it safe?" and "will it work for me?" Because the fact is, there are some conditions that may make LASIK unsafe. If your cornea is too thin, or has a steep slope (i.e. has a condition called keratoconus) then refractive surgery could not only be ineffective, it could even endanger your vision!

And this is why finding an ethical doctor is critical. We have all had experiences with people who will be glad to make a few quick bucks at our expense. This happened to me when I had to get some repairs on my Mitsubishi Mirage, at the end of my training in LA… they were happy to take my money and pass off cheap second-hand parts as genuine. It's happened to all of us. But the thing is: you just can't take that kind of risk with your eyes! Because you only get two of them, and they can't be replaced.

So you look at a LASIK practice, and you're like: Technology? check. Training? check. Ethical? Ethical... how do you evaluate that?

Well you could certainly put on your Sherlock Holmes hat and investigate online, because unethical people leave tracks in the form of lawsuits and complaints. You don't have to search very hard to find some people claiming to be giants of vision research, with a list of Superior Court records a mile long. For these people, it's "anything for a buck."

For me personally, the whole point of being a doctor is to help people. I want to help people to see better, and like I swore in the Hippocratic oath to "do no harm." The idea of doing an unsafe procedure is totally repugnant to me!

I'm a straight shooter, and you'll know when you meet me that I'm telling the truth. If something seems "off" to me, I call it like it is, and I demand that things be done right. A dear old friend of mine tells the story from residency about when we were cooking together, and in my opinion, she hadn't zested the lemon thin enough. "Oh!" I said, as I dumped her entire cutting board's contents into the trash. "Let's start over!" We're still good friends all of these years later, because I'm also loving and fun and caring. It's just that my friends all know that "earnest and direct" is a core part of who I am.

This is why I've set up my practice the way it is -- small and personal enough that I can get to know you, where I can make my own observations about each patient and control the detailed factors and processes that lead to the best results. There are a lot of tiny details that all add up to tipping the odds towards excellence. You may be able to find LASIK for a lower price, maybe at a big "LASIK mill" practice where you are handed from receptionist to technician, you only meet the surgeon on surgery day and they use an old laser. I'm not saying that's necessarily unethical… but it's certainly not the way I want to practice medicine.

LASIK AND PRK: WHAT TO EXPECT AT LA JOLLA LASIK

In refractive eye surgery -- LASIK and PRK -- we use a high-precision laser to reshape your cornea to give you the best possible vision. These procedures are extremely safe and low-risk. While there are some limitations to who can qualify for LASIK surgery, most can, and the success rate is extremely high.

You can read in more detail about LASIK and PRK on these pages, I want to outline for you the basic 4-step process of preparing for and undergoing LASIK at my practice:

1. The Initial Consultation
   You can contact us online or over the phone to set up an initial consultation. This consultation only takes about an hour and is meant to determine if you are a good candidate for LASIK or another laser eye surgery we offer at La Jolla LASIK Institute.

   One of my team members will take careful measurements of your eyes and contacts/glasses. I will personally review these measurements, and will review your medical records and ask if which medications, if any, you are taking. It's also important to ensure you're not pregnant or nursing and that your eyes are in good general health, aside from the vision problems that LASIK is meant to correct.

   After this review, I will make a determination whether vision correction is safe and appropriate for you. If so, you may proceed to the more detailed preoperative exam.

2. The Pre-op Eye Exam
   At your preoperative exam, we take an additional set of measurements of your eyes and make a detailed surgical plan. Please note that you may call ahead to schedule your initial consultation and pre-operative eye examination on the same day, if you wish. If you wear contact lenses -- depending on which type -- you may need to stop wearing them for up to a month before these pre-op measurements.

   At the pre-op you can expect that we will dilate your eyes -- i.e. we will give you drops to make your pupils wide -- so I can examine inside your eyes. And we'll take careful measurements with a machine that makes a detailed, incredibly precise topographical map of your cornea (the front surface of your eye). From your perspective, this will be one of those moments where we say "rest your chin here, rest your forehead there", and you peer into a machine that flashes a bunch of lights into your eye.

   The result is a colored topographical map that I will use to plan exactly how to reshape your cornea. This is another opportunity for us to discuss which procedure is best for you (PRK or LASIK or none at all), and for you evaluate whether you are comfortable proceeding with surgery.

3. LASIK Surgery Day
   If the initial consultation determines that LASIK or PRK will be safe and beneficial for you, and the pre-op exam confirms that and gives us the information we need to customize your experience - then we will set up a surgery date.

   LASIK and PRK are outpatient procedures, performed under local anesthesia. The whole thing takes about a half an hour. For both LASIK and PRK I'll use the laser to reshape your cornea; the difference between the two procedures is that for LASIK I first cut and move aside a thin flap in the cornea, treat the cornea underneath the flap, and replace the flap over the treated area.

   After I check everything carefully you'll be ready to go -- note that you'll need to have someone drive you home. Most people recover fully from LASIK surgery within 24 hours and are already back to work and active.

4. The Post-op Eye Exam
   After your surgery, we'll ask you to come back in for a post-op eye examination to ensure you're recovering properly and that your vision benefited from the surgery like it should have.

   These post-op eye exams will vary in how long after the procedure they are scheduled depending on your specific needs and availability.

   We will give you a set of post-op eye care instructions to follow, and we'll want to confirm at the post-op exam that you've been following them. For example, it's incredibly important that you not rub your eyes after LASIK surgery. And in some cases, we may prescribe you to wear protective sunglasses during the day and/or "eye shields" at night while you sleep for a week after surgery.

   Your post-op protocols will vary based on your needs. And the immediacy of the improvement you detect can vary too - for example, those with higher prescriptions tend to be more struck by the size and speed of the change than those with lower prescriptions. But everyone will see significant improvements, and the large majority achieve 20/20 or better vision.

CAN EYE SURGERY CORRECT YOUR VISION?

Are you thinking you can't have LASIK because:

• You have astigmatism?
• You have a high prescription?
• You think you're too old?
• Your reading vision is starting to get blurry?

So many of my patients have these concerns when they first come to me. And I tell them none of these reasons mean they can't achieve better vision and love the results! LASIK technology has advanced so much in the past few years, which allows me to treat conditions that couldn't be treated in the past. This means LASIK may really be for you, even if you have previously been told you're not a candidate.

In order for me to clear you as a LASIK candidate, you will need to be at least 18 years old and able to follow instructions. I will need to know about any medical conditions, eye diseases or infections, medications (past and current), allergies to medications, infections (especially MRSA), and any past surgeries. I'm your doctor, so it's important that you let me know your full medical history, especially dry eye, glaucoma, previous eye surgeries, and other conditions I will ask you about.

"But I'm in my 40's. Am I too old?" No, not by a long shot! You're still young for LASIK. I have helped so many people in their 40's and 50's correct their distance and near vision. And because LASIK takes place on the part of the eye that stays very stable over long periods of time, LASIK does not change the rate at which your eyes age.

"OK, 40 is still young. But what if I'm a lot older?" Older patients in their 60's can opt for LASIK or early cataract surgery. The choice depends on your eyes and your prescription. If you are in your 70's or 80's, there's a good chance that the main source of your refractive error is cataracts, so that may be a better way to address your situation.

"My arms are no longer long enough to read the newspaper. Can you help?" The normal aging process in our eyes leads to this condition called presbyopia, in which it becomes harder to focus at close distances. Some simple tests in my office can help determine if there is an appropriate surgical solution for this.

Of course, every person's eyes are unique. So the best thing to do is come talk to me.

But here's the bottom line: I can give you many options for vision correction that fit your age and prescription. In addition to LASIK, I also specialize in cataract surgery and advanced implantable contact lenses. When you come in for your consultation, we will discuss and decide together which option best fits your circumstances and needs. Call 858-551-4100 or click here to schedule your free consultation today.

WHY CHOOSE LA JOLLA LASIK INSTITUTE?

Here is what one of my patients had to say:

"I got the sense of a real concern for what my concerns were. The cost was more than reasonable, and as for the value, that's immeasurable."-Arnel

My patients have asked me, "Dr. Nahl, you're San Diego's Best LASIK Surgeon. Why don't you charge more?" I tell them that if I charged more, only the richest people could afford to have me fix their eyes.

My grandpa was a country doctor in Oklahoma, and when people couldn't afford his services they paid him in eggs, produce, carpentry, or however they could. Psychiatrist friends see their patients on a sliding scale. I offer 0% interest financing, extended payment plans, fair prices, and procedures to fit every pocketbook. My prices are average, not expensive, for San Diego LASIK. And most of all, I do everything I can to make your dreams come true.

Thank you for sticking with me and learning more about what makes my practice special and different. Let me sum it up for you. When you come to La Jolla LASIK you get:

• An earnest, ethical surgeon with top-notch training
• Uncompromising focus on details to serve your well-being and ensure good outcomes
• Excellent technology maintained by competent Scripps staff
• Competitive pricing and financing options from 6 to 60 months
• A proven track record of success with 6 Union-Tribune "San Diego's BEST" awards

Schedule Your Free LASIK Consultation

THANK YOU!

At this point, I've done my best to answer typical questions, but you probably have some additional thoughts and concerns. So the next step is for us to get together. Please give my office a call at 858.551.4100 or click here to book an appointment. When we get together I will gladly answer all of your questions.

I hope to see you soon!

-- Dr. Nahl

p.s. Thank you for reading this far! To learn more about the types of procedures my team and I offer at La Jolla LASIK, please continue reading.

OUR LASIK & OTHER LASER EYE SURGERY SERVICES

At La Jolla LASIK Institute, we offer both traditional LASIK and a number of other, closely related, laser eye surgeries. Our services can correct farsightedness, nearsightedness, astigmatism, presbyopia, and more. The goal of these surgeries is to adjust your prescription, aka "refraction"; for this reason, we refer to these procedures as "refractive surgery."

The basic idea in all refractive surgeries is to reshape the clear window at the front of your eye, known as the cornea. The cornea acts like a lens at the front of your eye. A cornea with perfect focus is close to an "aspherical" shape -- this is exactly the shape used in many camera lenses. But in real peoples' bodies, corneas may be slightly different shapes, all of which lead to different kinds of visual problems:

• If the cornea is symmetrical but has the wrong focal length, we call that "spherical aberration", and that leads to nearsightedness or farsightedness.
• If the cornea has an asymmetrical bump, that can lead to a directional distortion of the images known as astigmatism. We refer to this as "cylindrical aberration".
• In reality, corneas grow as part of a human body, so they have a more complex and irregular shape. We refer to these irregularities as "higher order aberrations".

For all types of refractive surgery, our goal is to use a laser to precisely cut away the corneal aberrations, leaving your cornea with a nearly ideal shape, focusing images clearly on the retina. This goal -- reshaping the cornea -- is common to all refractive surgery, including LASIK, wavefront-guided LASIK, topographic-guided LASIK, and PRK.

We will explain some of the differences among these procedures in the following sections. The main differences to keep in mind are whether we cut a flap in the cornea before applying the laser (LASIK: yes, PRK: no), and exactly which technology we use to measure the cornea and plan for the laser treatment.

PRK Laser Eye Surgery

The easiest of these procedures to understand is photorefractive keratectomy, or PRK. This was the first type of refractive surgery to use a laser, and is still the safest and best option for many patients. Dr. Nahl may recommend PRK for you, depending on the precise shape and thickness of your cornea, your age, and your physical activities.

The PRK procedure is actually the most intuitive approach: the laser cuts away the outer surface of the cornea to reshape it. Because the surface of the cornea has been directly treated, it can be quite uncomfortable for the first couple of days, and we give medications to get you through any pain. The vision improves gradually as the cornea heals, and typically reaches the target refraction any time from 3 to 4 months. The ultimate outcomes depend a lot on the patient complying with post-operative instructions, including taking eye drops as directed, avoiding things that lead to dry eye like fans and wind, and avoiding rubbing/bumping/touching your eyes.

The advantage of PRK is that it is less invasive than LASIK, so the eye tends to be less prone to future injury.

LASIK Laser Eye Surgery

LASIK is similar to PRK, in that both procedures use the laser to reshape the cornea. But in LASIK, we apply the laser to the middle layer of the cornea, rather than the outer surface. This leads to much less discomfort and pain for the patient, quicker recovery time, and a much faster achievement of the target refraction -- typically a day, in contrast with the several months timeline for PRK.

In order to apply the laser treatment to a middle of the cornea, we first cut a microscopically thin flap of cornea tissue and flap it aside. Dr. Nahl prefers to do this using a special flap-cutting laser; you may hear this technology referred to as "Intralase" or "bladeless LASIK", which distinguishes it from the classic LASIK technique using an extremely precise mechanical blade system called a microkeratome.

After I cut the flap and apply the custom laser treatment, I follow careful procedures to put the flap back in place and smooth it perfectly. The whole process is quick and painless, and requires only local anesthetic -- plus some medicine to help you stay relaxed. The result: most people see clearly 8 hours later, almost all within a day, with further refinement and improvements settling in over the next couple of months. And because the treatment of the cornea is covered with the flap, there is much less discomfort than with PRK.

Both LASIK and PRK are excellent options for vision correction, and when you come for your consultation we can help you to understand which option is right for you.

Schedule Your Free LASIK Consultation

Corneal Cross-Linking Surgery for Keratoconus

Keratoconus is a disease of the cornea, in which the cornea thins, weakens, and buckles over time. Many patients first notice the condition as a deterioration in their glasses prescription; over time, the condition can worsen, and can even lead to the need for corneal transplants.

Keratoconus affects one out of every 750 people in the US. Screening for this condition is a critical step in checking that refractive surgery is safe for you: performing laser refractive surgery on a cornea with this disease could seriously endanger the safety of that eye. This is why Dr. Nahl carefully examines the topographical maps of your cornea for signs for keratoconus.

Luckily there is a treatment available that can halt the progression of this condition: corneal cross-linking (CXL). In this procedure, we apply a special preparation of vitamin B12 to your cornea, and use an ultraviolet (UV) light to help the collagen in your cornea to strengthen their bonds and recover their integrity. This can help recover the quality of your vision, and slow down or halt the progression of the corneal disease. This recovery may make it easier to fit you for contact lenses, and can reduce the strength of glasses or contact lenses you require for proper focus.

Crosslinking prevents the continuation of vision loss in about 95% of patients, and improves vision to some degree in about two-thirds of cases. The goal with this treatment, unlike with LASIK or PRK, is not to eliminate the need for glasses/contacts, although it often lowers your prescription. Rather, the goal is to prevent further damage to your corneas, keep your eyes safe, and ensure that you can continue to have good corrected vision.

Because keratoconus is a progressive disease, and crosslinking only halts its progression, it is generally advisable to move forward with treatment -- if it is required -- sooner rather than later. Dr. Nahl will take the time to discuss with you whether this procedure is required, and whether it is safe for you. It may not be safe to proceed if the patient is too young, or if the cornea is already too thin and/or scarred.

It is important to note that there is a hereditary component to keratoconus. So if someone in your family is diagnosed with the disease, we recommend that your whole family -- parents, children, siblings -- be screened.

The most common complaint that leads to a diagnosis of keratoconus is poor vision correction from glasses or contacts. So it makes sense that a practice like La Jolla LASIK would tend to see these cases; people come to us thinking that LASIK might improve their vision. While it's true that crosslinking may improve your vision, by far the most important priority is to prevent the progression of the disease and help you to avoid the deterioration of your corneas, leading to the eventual requirement for a cornea transplant.