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Patient Information

1. CLINICAL CARE AT THE GCE
2. DETAILED PATIENT INFORMATION
3. INFORMATION FOR PATIENTS UNDERGOING GLAUCOMA SURGERY
 

1. Summary of Clinical Care at the GCE

All Patients are welcome

  • It is not necessary to be referred by another doctor to be seen here
  • We see the most complex cases and those simply suspected of glaucoma due to having an affected family member
  • We see babies from the first day of life to those over 100 years old
  • More than  50% come from outside Baltimore, 25% from outside Maryland, often International
  • New patient visits are available within 2 weeks, and immediately for emergencies

Helping patients take their glaucoma eyedrops

  • While 95% of our patients believe they are taking their eyedrops exactly as prescribed, our research shows that the average patient misses one out of four drops.
  • In the first study of its kind, we showed that reminding patients to take their drops can improve eyedrop taking by 50%.
  • This would translate into years of vision saved.
  • We recently showed that some instructions given to patients in the past were not needed, saving time and making drop-taking easier.

Patient-centered decision-making

  • Wilmer glaucoma doctors answer patient emergency calls themselves, 24 hours a day, 7 days per week.
  • By videotaping doctors with their glaucoma patients as part of an approved study, we determined that open communication led to greater patient satisfaction and better drop taking.  The doctor who listens instead of only asking questions can provide better care.
  • Once medical and surgical steps have been used as effectively as possible, we work with patients to improve their quality of life through study of their activities of daily living, such as driving, reading, and mobility.

Leaders in Laser treatment (see the video library)

  • The latest in laser treatments are carried out with our patients when appropriate
  • Wilmer trained faculty developed laser iridotomy and laser trabeculoplasty, and showed that the present method for laser ciliodestruction is useful and safe.

Surgical success with fewer complications  (see the video library)

  • Our surgeons have performed thousands of glaucoma operations, both standard and complex.
  • Recently, we completed a review 750 of our trabeculectomy operations from 2000-2008.
  • We found that our improved approach to trabeculectomy reduced two major complications by 75% over the previous method, without any decrease in success rate.
  • Wilmer’s two outpatient surgery centers have superior amenities for Patients and Families, including free parking

 How does our research program help? 

  • Patients are offered the opportunity to participate in safe, important new approaches to the diagnosis and treatment of glaucoma.
  • Recent research showed that a simple, painless test (optical coherence tomography) may in the near future show who should have laser treatment for angle closure glaucoma.
  • Recent research has shown that many persons who have been prescribed eyedrops for glaucoma could be followed without them.

2. Detailed Patient Information

Emergency Contact for Existing Patients

  • Call 410-955-6052 and speak to the Wilmer Call Center Operator
  • If you come to the Johns Hopkins Emergency Department, tell them that you are our patient, give them your faculty doctor's name, and ask them to call the resident on-call immediately.Directions and Travel to Glaucoma Center Locations

International Patient Information

Johns Hopkins Medicine International- For Patients

What to Expect on Your First Visit to the Glaucoma Center

  • Bring in your hand the office visit notes, images and visual fields from all prior eye doctors
  • Bring your eyedrop bottles and pill bottles for all medications taken
  • Please come in 30 minutes before your appointment time to register for your visit.
  • Please bring your Medicare, Medicaid and/or insurance cards and identification with you to each visit.
  • All new patients must show identification, preferably picture ID, with proof of address, when you come for your first visit. 

Billing - Insurance Information

  • We accept all coverages that will accept Johns Hopkins care
  • Discuss billing issues prior to arrival with our billing staff (Wilmer Billing Information)

Low Vision Services

Lions Low Vision/Vision Rehabilitation Center

Non-English Interpreters and Hearing-Impaired Assistance Available

  • For intepreter services, call: 410-614-4685
  • For sign language interpreters or TTY, call: 410-955-2273

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3. Information for Patients Undergoing Glaucoma Surgery

If you have any questions about your upcoming surgery, do not hesitate to ask your physician. Our goal is to make your procedure as pleasant and safe as possible. Therefore, we ask that you take the time to read these instructions and complete necessary paperwork and testing before arriving at the hospital. This will help to minimize delays on the day of your surgery. Our health care team is dedicated to ensuring your experience is a positive one.

  • Your surgery will be carried out at either the Bendann Surgical Pavilion or at the Greenspring Station Surgicenter. Please note which has been assigned. Only rarely is surgery performed in the main Wilmer Operating rooms, so, unless you are told differently, do not come to the main Wilmer Building where your outpatient examinations were performed.
  • All post-operative outpatient visits will occur in the main Wilmer Institute building, the Greenspring Station outpatient examining facility or at the Bayview Medical Center. Your doctor will tell you which location to come for the first post-operative day visit. Do not come to the Bendann Pavilion
  • You will go home the same day of surgery—all eye surgeries are now outpatient procedures.
  • If you have an advance medical directive, please bring it with you. An advance directive enables you to give written or oral instructions to doctors and other health care professionals regarding the type of medical care you would want or name the person you would wish to make health care decisions for you if you could no longer speak for yourself. Upon advance directive appointing a family member or friend to make treatment decisions on your behalf, you should discuss your intentions with the individual appointed to act on your behalf. 

Presurgical Testing

A complete set of instructions about your presurgical testing requirements will be given to you by your doctor.

Insurance Carrier

Remember to contact your insurance company prior to the date of surgery to advise them of your scheduled surgery and to confirm coverage. You should check for and verify any co-pays and/or deductibles you will have to pay at the time of your admission. If you have any questions regarding your insurance coverage, please call the Surgical Billing Office at 410-955-7493 or 410-955-5489.

Other Important Instructions

  • Remove nail polish and nail wrapping from all fingers prior to coming to the hospital.
  • Do not apply any makeup, cream or aftershave lotion the day of surgery.
  • Please shower and wash your hair the night before or the morning of surgery.
  • If you develop a cold, virus, sore throat or other illness during the week before your scheduled surgery, please contact your physician immediately. Your physician will determine whether your procedure should be rescheduled.
  • We recommend that you wear casual, comfortable, loose-fitting clothing that buttons or zips down the front and is easy to take off and put back on after surgery. Shoes should be flat and without laces.
  • Leave all valuables and jewelry, including wedding rings, at home since we cannot assume liability for personal property.
  • Dentures, contact lenses, glasses and hearing aids may be removed prior to surgery. Since these personal items can easily be misplaced, please keep them in appropriate cases or containers (that won't be mistaken for trash) when not in use and give them to the person escorting you.
  •  If you find yourself in a situation that makes it necessary to cancel your surgery, please call your physician as soon as possible.
  • The anesthesiologist or certified registered nurse anesthetist (CRNA) is responsible for your comfort and well-being before, during and after your surgical procedure. Prior to surgery, the anesthesiologist/CRNA will meet with you, if necessary, to discuss your anesthesia and answer any questions you may have. If you have had any experiences in the past with anesthesia, please inform the anesthesiologist. In the operating room, the anesthesiologist/CRNA will manage your anesthesia and monitor vital signs. In the Peri Anesthesia Care Unit (PACU), the anesthesiology staff ensures that all patients remain stable following surgery. There are several ways to administer anesthesia. The anesthetic choice is related to your general condition and medical history, as well as the surgery or procedure being done.
  • Your surgeon leads the OR team. Other team members usually include nurses, an anesthesiologist or nurse anesthetist, and a surgical assistant. As a team, they provide a sterile and safe surgical environment. If the OR feels cold, you can ask for a blanket.
  • In preparation for the procedure, an intravenous (IV) line will be started in an arm or hand vein. This will be used to deliver medications and fluids during surgery. Vital signs are monitored through a cuff placed on your arm to measure blood pressure; pads placed on your chest will track your heart's function; and a clip placed on your finger will measure the oxygen level in your blood. During the operation, the blood pressure cuff will inflate automatically at intervals and you will feel pressure on your arm.
  • After your surgery, you will be taken to the recovery room, also called the PACU (Peri Anesthesia Care Unit), or to the Ambulatory Surgery Center, where you will be closely monitored until the anesthesia wears off and you wake up. Your blood pressure, pulse, temperature and breathing, as well as the area of your body where you had surgery, will be checked.
  • You may feel drowsy and cold, and you may have some pain, which is normal after surgery. The PACU or Ambulatory Surgery Center nurses will take care of your needs and make you comfortable. Once you are sufficiently awake, you either will be discharged home if you are an ambulatory surgery patient, or you will be transferred to your room in the hospital until you are well enough to go home.
  • Pain Management: we are committed to recognizing and treating your pain using medicines and treatments that will provide the best level of relief. As the patient, you have valuable information to give the staff regarding your pain. Remember that you know your pain best.
  • Always tell your doctor, nurse or other staff member when you are having pain. Don't be afraid to ask for pain medicine. Many people are so worried about "getting hooked" or addicted that they don't talk about their pain or take the medicines that are prescribed. In most cases, addiction is not a concern and medicines can, and should, be taken to relieve pain. If you have concerns about addiction, you should speak openly about them to your doctors and nurses. Managing pain is an important aspect of getting well.
  • You will be given written discharge instructions upon leaving. Please follow these instructions regarding the medication, rest, activity and diet and any other after-care advice to help you recover faster, be more comfortable, and reduce the risks of complications when you follow your doctor's orders.
  • Prescription Medications:  After surgery, your physician will probably prescribe medications. These prescriptions may be filled either at your neighborhood pharmacy or at available Johns Hopkins Pharmacies, which staff can give you directions to find. Please bring your prescription care card or information with you. It is best to fill the prescriptions on the day of surgery so that they can begin first thing the next morning after seeing the doctor.
  • Escorts: For your safety, a spouse, friend or relative must accompany you when you leave the hospital. You will not be permitted to have surgery unless you have made proper arrangements for an escort upon your departure. We can refer you to a private patient escort service if needed. You will be discharged from the surgical center with your escort accompanying you. If you live alone, you may want to arrange for someone to stay with you on the first night after your surgery.

Procedures in Children:
Hospitals can be frightening places for children. In order to make your child's stay here as smooth as possible, we ask that you follow these suggestions:

  • Follow your doctor's orders about not giving your child anything to eat or drink before surgery. We realize this is very difficult with small children, but it is essential in order to give them anesthesia and perform the scheduled procedure safely. If your child does have fluids or food after the recommended time, the surgery will have to be rescheduled.
  • Please feel free to bring one of your child's favorite toys to the hospital. It will help your child feel more secure if he or she has a familiar toy for company.
  • Only the parents or one parent and one escort should accompany the child. Bringing other relatives to the hospital may upset the child and also makes it difficult for our staff to do their jobs.
  • One person must stay at the hospital during surgery. You will be allowed to be with your child at all times on the unit and in the operating room before anesthesia. A parents' waiting room is available for convenience and comfort. The nursing staff will let you know as soon as you can rejoin your child in the Peri-Anesthesia Care Unit (PACU).
  • For your child's safety, we will not discharge him or her to anyone other than a parent or legal guardian.
  • If you are escorting a child and driving, it is necessary to have a second adult present who is free to give the help and attention that are needed to bring a child home after surgery.

Consent for Medical Procedures

  • Your surgeon will discuss the details of your operation with you prior to your surgery.
  • Please feel free to ask any questions regarding your procedure, and follow your surgeon's advice before and after your surgery. Before any major medical procedure can be initiated, you or an authorized member of your family will be asked to sign a consent form.
  • You are entitled to a full explanation of your diagnosis, treatment plan and prognosis, as well as the risks, benefits and alternatives associated with your care. If you do not understand what is being recommended, or if you are uncertain about whether you want the procedure, ask your physician or nurse.