Frequent Questions

• If you have a referral letter to see a medical specialist, you will be entitled to a Medicare rebate for your consultation.  Without a current referral letter, Medicare will not accept your claim for rebate.
• A referral letter from a GP or Optometrist is valid for 12 months from the date of your first consultation with Dr Kuzniarz.  A referral letter from a Specialist is valid for 3 months.
• After the initial referral expires (12 or 3 months) you will need another referral to continue receiving Medicare rebates for your visit.  Please ensure you always have a current referral letter for your visit.

• You will be first examined by an orthoptist before being seen by the doctor.  The orthoptist will take history, test your vision and if required, dilate your eyes and perform other tests in preparation for your consult with the doctor.
• On average you should allow approximately 2 hours for your visit.  The time required will depend on any extra tests you may require and whether you have been dilated.
• Sometimes unexpected situations or even emergencies arise which can be serious and sight threatening - these cases will require immediate treatment and will cause the doctor to run overtime.  In these situations, we thank you for your patience while we manage these urgent cases.

Bring:

• A copy of your referral letter
• Medicare, Pension or DVA card
• Current prescription glasses
• A list of your current medications and allergies
• Sunglasses to help with glare after being dilated
• A carer to drive you home - if you have been dilated you will not be able to drive for 2 hours

• It is likely you will be given drops to dilate the pupils to allow the doctor a 'larger window' to see to the back of the eye for a full examination.  These drops blur vision and cause light sensitivity for approximately 2 hours (although every patient is different).
• For this reason, we advise all patients not to drive to/from your appointment if possible and to bring a carer.  If you have to drive, please allow up to 2 hours after your consultation if your eyes have been dilated.
• We advise you to bring a carer with you to drive you home safely.

All patients will undergo basic vision testing and some patients will be required to do additional tests looking for particular markers to make accurate assessments for various conditions.

• These tests will be performed by the orthoptists or other trained staff usually before you see the doctor.
• Even if you have done some of these tests before (eg with your optometrist or with another doctor) you may still be required to repeat these tests with us.  Your referring optometrist/doctor would have performed some tests and from their initial review, they have determined that further assessment by an ophthalmologist is required.
• We need to perform those tests using our own specifically calibrated machines.  We may also be looking for other specific markers that previous reviews did not focus on.
• The doctor will rely on our own testing to make his own accurate assessment of your eye condition.  It is not appropriate for us to rely on eye tests performed by others to make clinical decisions for ongoing medical treatment or surgery.

Visual field tests and OCTs are 2 of the more common tests you may be asked to do regularly.  These tests are typically repeated periodically (eg every 3, 6 or 12 months).  By repeating these tests we are able to over time, monitor changes in eye health and other conditions.

Visual Field Test (VF)

• Measures central and peripheral vision - it tests how far left/right and up/down you can see.  It also measures how sensitive the vision is in these different fields of vision.
• It is a non-invasive test and takes 20-30 minutes and does not require dilation of the pupils.
• The test will detect area/s and degree of vision loss and helps the doctor diagnose the cause of that loss of vision.
• Visual field tests are particularly important for the detection and management of glaucoma.  Areas of vision loss can also be caused by tumours, stroke, diabetes, high blood pressure or neurological (brain and nerve) conditions.
• There are different types of visual field tests depending on what the assessment is for.
• Visual field tests may be required for license renewal, pilot license assessment as well as for certain lid surgeries.  These visual field tests may take slightly longer.
• Visual field tests carry a Medicare rebate.

Optical Coherence Tomography (OCT)

• This test is essentially an optical ultrasound taking highly detailed 3D cross section images of the back of the eye (retina).
• It is typically a relatively quick test, is non-invasive and requires the eye to be dilated - no driving afterward for 2 hours.
• The detailed images can detect early stages of eye disease even before symptoms start to show eg. age-related macular degeneration, glaucoma, diabetic eye disease.
• At present, OCTs do not have a rebate from Medicare.

We are a private specialist practice and do not bulk bill our consultation or surgery fees.  We respectfully request full payment of fees on the day of your visit.

• If you have a valid referral, your paid account will be lodged electronically to Medicare by us at the end of the day.  Typically you should expect your rebate to be paid into your registered bank account within 24-48 hours.

DVA Patients - Consultations

• We see DVA consultations and do all eye tests at the DVA rates with no out-of-pocket expenses for Gold DVA Card holders.
• White DVA card holders will will seen with no out-of-pocket costs if they are being examined for the specific condition as approved by the DVA on their White Card.

DVA Patients - Surgery

• Dr Kuzniarz performs DVA surgeries at his private operating lists at Calvary Private, Bruce and at the Canberra Microsurgery, Woden.
• We do all DVA surgeries at DVA rates with no out-of-pocket costs to patients.  However, we are unable to offer plastic surgery at the DVA rates. Regrettably, this type of surgery is not viable for us to maintain at DVA rates.

Public Surgery

• Dr Kuzniarz operates at private hospitals.  We are unable to offer surgery at the public hospitals.

• If you are a non-English speaker OR you feel you need translating or interpreting help during the consultation with the doctor - please let us know at the time of booking.
• Our advice is to bring a family member or trusted friend to the consultation.  Bring someone who has good English language skills to help you communicate with the doctor and staff.
• If you do not have anyone to bring with you and you need help with language, please let us know at the time of booking.  We will arrange for an independent interpreter to be present during your appointment in the language of your choice.  Please note, depending on availability, often these services need to be booked many weeks in advance.
• The interpreter is a government service, provided free of charge.

Ophthalmologists are medical doctors who have undertaken additional years of specialist training in the diagnosis and treatment of medical eye disease. Ophthalmologists will prescribe medication and if necessary perform surgery to manage eye conditions.

In Australia, ophthalmologists must complete a minimum additional 5 years specialist training on top of their (6 year) medical degree plus 2 years (minimum) practice in general medicine before qualifying to register as an ophthalmologist.  Some ophthalmologists choose to undertake further years of subspecialty fellowship training in an area of their interest.

Dr Kuzniarz is an ophthalmologist who has undertaken a further 2 years of subspecialty fellowship training in the UK as an oculoplastic surgeon.  Oculoplastic surgeons are eye doctors who specialise in a variety of surgical procedures dealing with reconstruction of the eye and associated structures for either functional or cosmetic reasons - eg. eyelids, skin malignancies around the eye, tear duct obstructions and more.

Optometrists are highly trained eye professionals typically completing a 5 year university degree qualification.  They provide primary vision care ranging from performing sight testing and eye health examinations, prescribing and dispensing corrective lenses and detection of abnormal eye conditions or vision defects.

Optometrists play a crucial role in the early detection of potential eye disease.  Optometrists and ophthalmologists work collaboratively to investigate and manage patient eye care.  If eye disease is suspected, an optometrist will refer patients to an ophthalmologist for further assessment and management.

Orthoptists are highly trained allied health professionals specialising in assessing and managing eye health and vision conditions. In most ophthalmology practices, you will be first examined by an orthoptist.  They provide primary specialist assessment and testing of patients prior to the patient being seen by the doctor.

In Australia, orthoptists complete 4-5 years university degree qualifications, some involving a Masters degree in Orthoptics.  Orthoptists are highly trained to detect vision disorders and medical eye disease.  They are specialists in the evaluation and non-surgical treatment of vision problems caused by an imbalance of the eye muscles.

Specific preparation before surgery or other treatment will depend very much on the procedure you are about to undertake.

After any eye surgery or treatment, you will not be able to drive home afterward and in some cases, you may be unable to drive for a period afterward. You should arrange for travel to and home from surgery or treatment as well as organise appropriate care for the following days/weeks.

For hospital procedures

In general, if the surgery is to be performed as a day procedure at a hospital, the hospital will contact you a day or two before the operation with specific instructions.

For patients taking blood thinning medications, you will need to consult with your GP, cardiologist or prescribing doctor regarding your impending surgery. Generally, blood thinning medications need to be stopped a number of days before surgery but this must be done in consultation with your doctor. Stopping these medications may increase the potential for cardiac arrest, stroke or cause other serious medical conditions.

For in-room procedures

We will advise you directly about the required preparations when booking your surgery or treatment.

The care for your eyes after surgery will vary depending on the type of procedure you have undergone. You will be given detailed instructions on how to care for your eyes and/or apply drops or ointment. It is important you follow these instructions carefully including any instructions on how to take medications as prescribed.

For cataract procedures:

After surgery your eye will be padded overnight. The dressing will be removed on the next day in our office during your first follow up appointment. The recovery period may take up to 5-6 weeks and your vision may initially be blurry, this is normal. Your eye may feel scratchy for up to 2 months, this is due to the clear part of the eye (the cornea) being slightly irregular over the main wound through which the lens was inserted into the eye.

It is important to use the prescribed eye drops regularly for 3 weeks. If you are running out of the drops please let us know. The drops reduce the rate of infections in the eye and also the redness around the eye.

You must report any changes for worse to your vision or your eye immediately. Although infections after cataract surgery are rare (1:1000) they are usually devastating, leading to the loss of sight or the eye. The highest incidence of infection is at 7-10 days after the surgery. Watch for increasing redness, swelling, pain or reduction in vision, these MUST be reported immediately. If you cannot contact our rooms, report immediately to the Emergency Department at the Canberra Public Hospital. Delay in treatment will result in a loss of your eye.

You do not need to reapply the pad once it is removed after the surgery. You may be asked to use a shield over your eye at night only for a week after the surgery.  If you require a glasses upgrade, you should wait till your last follow up appointment to allow your eyes to adjust after the surgery before visiting an optometrist for new glasses.

Dacryocystorhinostomy

Following a DCR procedure you may remove the eye pad on the following day. Patients undergoing external DCR (through skin incision) will need to have their skin stitches removed 5 days following the operation. This can be done by your GP or in our rooms. It is not uncommon to experience some blood spotting from the nose during the immediate 24-48 hours after the procedure. Severe bleeding is uncommon.

To reduce the risk of bleeding we request all DCR patients to refrain from blowing the nose, using hot water around the face, eating hot and/or spicy food and drinking hot beverages for 7-10 days after the surgery. All patients undergoing the procedure will have a silicone stent left in the nose. This will be removed in our rooms 3 weeks to 3 months after the surgery.

Pterygium surgery

Following pterygium surgery your eye will be padded overnight. When you remove the pad your vision will be very blurry, this is normal, it will improve over the next few days.

The eye will also be quite uncomfortable therefore taking regular medications for pain starting immediately after the procedure is important. Use of cold compresses to the eye through closed lids and regular application of the prescribed antibiotic ointment into the eye may soothe the discomfort as well.

The eye and the graft will be very red for several days. You will notice that the graft will swell after few days before it thins out and starts to become less red. Eye discomfort will subside significantly after the first 48 hours this is due to corneal healing. The entire recovery process usually takes 2 months during which time you need to use prescribed medications. Premature stopping of medications may increase your risk for pterygium recurrence. At times if the healing process around the graft is too vigorous a special medication may need to be injected around the graft, this is done in the rooms under topical anaesthesia

For care after eyelid procedures

After surgery, an antibiotic ointment will be applied to your eyes and the skin then your eye(s) will be padded for 1-5 days (depending on procedure). Your eyelids may feel tight and sore as the anesthesia wears off. You will be prescribed pain medication to control any discomfort. Please do not use aspirin and NSIDS based medications as these can worsen bruising and may cause bleeding.

If you feel any severe pain, call the doctor on the number provided immediately.

It is important that you keep your head elevated for several days. There will be bruising and swelling around the eyes which may be reduced by use of cold compresses 3 to 4 times a day. Bruising will peak in the first week and usually settles after 3-4 weeks.

Your eyes may be gummy for a week or more and it is important you keep your eyes clean as instructed. The prescribed eye drops and ointment need to be applied regularly after the dressings have been removed. Your eyelids may feel dry, may burn, itch, water and be sensitive to light. You may also experience temporary changes in your eyesight, such as blurring or double vision.

Your will be monitored closely for the first week or two and stitches will be removed at 5-7 days after surgery. Swelling and bruising around your eyes will gradually disappear. At this stage, you will feel and look much better. You should be able to read or watch television as comfort allows. Contact lenses should not be worn for about two weeks. After this upon initial re-use, it may feel uncomfortable for a while wearing contact lenses.

Most people feel ready to return to work after 10 days or so. You may be sensitive to sunlight and wind, sunglasses and a special sunblock made for eyelids may help with that. Infections in the skin after eyelid surgery are rare. However if your skin suddenly starts feeling hot, it is red or painful please let the doctor know immediately.

The doctor is very happy to take calls if there are problems or questions after surgery. You will be given contact details following the surgery for emergency contact.

We are private specialist practice and do not bulk bill our consultation fees.  We respectfully request full payment on the day of your visit.

• You will be advised of the standard consultation fees when making your booking.  We have reduced fees for valid pension cardholders.
• At the time of booking it is not always possible to predict if you will need additional tests.  The fees for tests will be additional to the consultation fee and will also carry a Medicare rebate with a valid referral letter (note - OCT tests currently do not have a Medicare rebate)
• Consultations for DVA Gold cardholders have no out-of-pocket costs to patients.  There are no out-of-pocket consultation costs for valid DVA white card conditions.
• The doctor may ask you to do external tests - for example pathology or imaging (blood tests, MRI and etc).  These have been requested because they are needed to provide detailed and important diagnostic information to manage your eye condition.  These tests are performed at external clinics and assessed in external laboratories run by other specialists.  These tests will be billed separately by the other doctor/s.

We respectfully request full payment of fees on the day of your consultation.

We accept payment by EFTPOS, Visa, Mastercard, cash or cheque. Unfortunately we do not accept AMEX cards.

If you have a current referral letter and Medicare have your bank account details, your paid account will be automatically lodged by us to Medicare on your behalf at the end of the day.  Your rebate will be paid directly into your bank generally within 24-48 hours.

Please note, Medicare rebates are now only paid direct to your nominated bank account.  Payments by cheque are no longer available.

Fees for surgery in hospital usually comprises 3 components:

• Surgeon's fee (Dr Kuzniarz)
• Hospital costs
• Anaesthetist fee

If surgery is required we will give you a fee estimate for Dr Kuzniarz's surgeon's fee and can advise you regarding what rebates you might expect to receive from both Medicare and health fund if you are insured.

The hospital and anaesthetist fees are prepared independently from us and they will contact you direct to provide you with their fee estimates separately.

Dr Kuzniarz only operates at private hospitals, he cannot offer surgery on public hospital lists.

If you do not have private insurance, you can still have surgery at a private hospital however you will be responsible for full payment of all associated surgery costs (surgeon fee, hospital fee and anaesthetist fee).  Typically you will be eligible to receive a Medicare rebate on the surgeon's fee and possibly also on the anaesthetist fee.  You will not however be eligible to receive any rebate from Medicare for the hospital charges.

• Yes – a portion of your surgery costs are typically claimable through Medicare. We can explain more when we give you your fee estimate.
• If you have private health insurance, depending on your level of cover and if you are covered for the specific surgery type, you may be eligible for further rebates from your health fund.