Preoperative Information for Patients

Insurance Coverage

Many insurance companies require a second surgical opinion, pre-authorization, pre-certification or all of these. Please check your health insurance policy or contact your insurance company about their special requirements. If you do not meet these requirements, the insurance company may refuse to pay or may pay a reduced amount for your surgery. In that case, you would be responsible for payment of all bills not covered by your insurance. It is your responsibility to contact your health insurance carrier regarding its policy concerning authorization and second surgical opinions. Please bring your insurance cards with you on the day of your preoperative evaluation at the Wilmer Eye care Pavilion and/or on your day of surgery.

Bills
There are generally two bills that you or your insurance company will receive: One covering surgeon, anesthesiologist, and assistant surgeon fees and one from The Johns Hopkins Hospital covering all facility, equipment, anesthesia supplies and service charges.

If you are not covered by insurance, please meet before surgery with the financial coordinators in Maumenee 101 on the first floor. It is the policy of The Wilmer Institute that financial arrangements be made before surgery can proceed. Please ask the registration personnel or financial coordinator on the first floor, or call the Wilmer Surgical Billing Office at 410-955-7493 or 410-955-5489 if you have any questions about the bills or the billing procedures.

Blood Thinners and Anticoagulants

If you are taking aspirin, aspirin-containing products, or aspirin-like products such as Indocin, Naprosyn, Motrin, Advil, Aleve, Nuprin, or if you are on anticoagulants such as Coumadin, PLEASE INFORM THE DOCTOR OR THE SECRETARY. THE DOCTOR MAY GIVE YOU SPECIAL INSTRUCTIONS.

Aspirin and similar drugs interfere with blood clotting and may lead to excessive bleeding during and after surgery. Tylenol (acetaminophen), may be taken as a replacement for aspirin, if needed. If you have any questions concerning discontinuation of such medicines, please contact your family physician and then contact your eye doctor.

Insulin and Oral Hypoglycemics

If you are a diabetic patient taking insulin or an oral hypoglycemic agent, do not take your insulin or oral hypoglycemic medication the morning of surgery. When you come to the Wilmer Eye Care Pavilion, your nurse will check your blood glucose level and give you any medication that may be required

Adult Presurgical Information

If you have any questions, please call your Eye Doctor.

1. ARRANGE FOR A RESPONSIBLE ADULT TO TAKE YOU HOME AFTER YOUR SURGERY

• If you do not have a responsible adult to take you from the hospital, we may have to cancel your surgery or only use a local form of anesthesia which will numb your eye without putting you to sleep. If you do not have someone to take you home, call your Eye Doctor's office.
• The anesthesia you receive during your eye surgery may affect your judgment and reflexes for as long as 24 hours after your surgery. This could cause you to have an accident and injure yourself, including your recently operated eye. Arranging for an escort may seem like an inconvenience; however, our concern is for your safety.
• Consider if you will need to have someone available to stay with you after surgery.

2. DO NOT EAT OR DRINK AFTER MIDNIGHT UNLESS INSTRUCTED TO DO SO BY YOUR PHYSICIAN

3. BEFORE YOU LEAVE HOME THE DAY OF SURGERY:

• Arrive 2 hours before your surgery. This will allow time to change clothes, talk with the nurse, and get answers to your questions.
• Do not bring jewelry or large amounts of cash. you will need money for telephone and TV service (if you are staying overnight), parking and to pay any required payments.
• Do not wear make-up or nail polish.
• Bring your completed Patient History form.
• If you have an Advance Directives (Living Will, Power of Attorney), please bring a copy with you.

Child Presurgical Information

If you have any questions, please call your child's Eye Doctor.

1. ARRANGE FOR A RIDE HOME

• Children must be accompanied by a parent or by a responsible adult with guardianship documentation.
• The adult will be responsible for the child's discharge instructions and a safe ride home. If you do not have someone available to take your child home after surgery, call your child's Eye Doctor's office.

2. IF YOUR CHILD IS HAVING OUTPATIENT SURGERY, PLAN TO REMAIN AT THE HOSPITAL UNTIL YOUR CHILD IS READY TO GO HOME.

3. YOUR CHILD SHOULD NOT EAT SOLID FOODS AFTER 12 MIDNIGHT THE NIGHT BEFORE SURGERY

• For children one (1) year of age or older, breast feeding may continue until 4 hours prior to the scheduled surgical procedure. Clear liquids may be continued until 4 hours prior to the surgical procedure.
• For Children less than one (1) year of age, breast feeding may continue until 4 hours prior to the scheduled surgical procedure. Clear liquids may be continued until 2 hours prior to the Scheduled surgical procedure.
• Clear liquids include: water, apple juice, clear non-pulp juice drinks, plain Jell-o, clear broth, Pedialyte, popsicles. (Refer to attached list)

IMPORTANT: The time used for the above schedule is the scheduled time of surgery, not the time the patient is told to arrive at the hospital.

4. BEFORE YOU LEAVE HOME THE DAY OF SURGERY:

• Arrive 1 hour before your child's surgery. This will allow time for your child to change, and for you to get answers to your questions.
• Your Child should not wear jewelry, make-up or nail polish.
• Your Child should wear casual, easy to store clothing.

History and Laboratory Tests

Dear patient and primary care physician:

Attached you will find a copy of our history and physical examination form and our guidelines listing appropriate lab tests to be obtained prior to surgery. These forms and tests must be completed NO LATER THAN 3 DAYS PRIOR TO THE DATE OF SURGERY. The forms may be faxed or mailed back to your Eye Doctor's office.

If returning the history and physical form and lab/test results by fax, send to (410) 614-0316.

If returning form/test results by mail, check with your Eye Doctor's Office for the correct mailing address. In addition, please hand carry a copy with you on the day of your surgery.

For any questions regarding the content of the history and physical or the required lab tests, please contact the Wilmer Pre-Operative Evaluation Center, at (410) 955-5730.