Five Questions With: Dr. Richard Sayegh

Dr. Richard Sayegh joined Koch Eye Associates in 2011 for fellowship training under the supervision of Dr. Paul Koch, where he received extensive training in LASIK, photorefractive keratectomy and cataract surgery. 

Sayegh completed his undergraduate work at Marist College in New York, obtaining a baccalaureate degree with honors in biology. He then earned his doctor of osteopathic medicine degree with honors from Touro University of Osteopathic Medicine in Mare Island, Calif. He completed his ophthalmology residency at Interfaith Medical Center in Brooklyn, N.Y., and his surgical residency at St. John’s Episcopal Hospital in Queens, N.Y., following his residency with his Koch Eye Associates fellowship.

PBN: What role does sharp vision play in child development?

SAYEGH: Good vision is key to a child’s physical development, success in school and overall well-being. The vision system is not fully formed in young children, and equal input from both eyes is necessary for the brain’s vision centers to develop normally. If a young child’s eyes cannot send clear images to the brain, his or her vision may become limited in ways that cannot be corrected later in life. But if problems are detected early, it is usually possible to treat them effectively.

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Both schools and pediatric offices provide school vision screenings, however a full eye exam by an ophthalmologist or optometrist is recommended by the American Academy of ophthalmology if:

  • Their child fails a vision screening.
  • Their child has “misaligned” eyes.
  • Vision screening is inconclusive or cannot be performed.
  • Referred by a pediatrician or school nurse.
  • Their child has a vision complaint or observed abnormal visual behavior or is at risk for developing eye problems. Children with medical conditions (e.g., Down syndrome, prematurity, juvenile idiopathic arthritis, neurofibromatosis) or a family history of amblyopia, strabismus, retinoblastoma, congenital cataracts or congenital glaucoma are at higher risk for developing pediatric eye problems.
  • Their child has a learning disability, developmental delay, neuropsychological condition or behavioral issue.

PBN: What is the UV protection on sunglasses really doing for us?

SAYEGH: We all seem to remember sunscreen for our skin to protect from the harmful effects of UV light from sun exposure, however we often neglect our eyes. UV-protective eyewear rated for 100 percent is recommended when outdoors not only in the summertime but year-round, to minimize the sun’s harmful effects and potential for developing conditions such as cataract, macular degeneration, pterygium and even certain forms of cancer. Also, don’t be fooled by the clouds. The sun’s harmful rays can pass through the haze and thin clouds.

PBN: Please explain cataracts and how surgery treats them.

SAYEGH: I prefer to refer toward the formation of cataracts not as a disease process but more of an occurrence in our lives that develops in conjunction with wisdom, and by wisdom, I do mean age.

In our lifetime, the natural crystalline lens in each of our eyes loses its clarity and opacifies. This clouding of the natural lens is called a cataract. This clouded lens can no longer sharply focus light rays onto our retinas for sharp clear vision without significant glare and distortion, thus affecting our daily visual functioning.

The reality is not in whether we will in fact develop cataracts, but when will we develop cataracts that significantly affect our busy daily lifestyles. In this country, cataract surgery is the most commonly performed out-patient surgery, over 4 million procedures performed annually and growing. The average age being around 70.

The procedure can be best described as having evolved into a safe, and quite elegant, procedure performed under twilight sedation in less than 10 minutes, allowing for a rapid visual recovery, enabling most patients to return to their normal routine the next day with few restrictions and better vision. It is a simple process, which removes the clouded cataractous lens and replaces it with a new clear lens implant.

This precision of this procedure can be further assisted with the use of femtosecond laser, which can greatly reduce a patient’s dependence on glasses postoperatively. Cataract surgery appropriately performed should not be required more than once per eye, benefiting a patient for the remainder of their lifetime.

PBN: What about LASIK?

SAYEGH: LASIK surgery is a safe and accurate procedure that can be performed in a relatively painless manner to minimize a patient’s dependence on glasses or contacts. Lasers are used to reshape the cornea in approximately 10 minutes, allowing the eyeglass or contact lens prescription to be placed directly on the eye, allowing it to focus properly, thus eliminating the dependence on glasses for seeing clearly.

What advancements in your field do you look forward to?

SAYEGH: I look forward to the advances and improvement upon our current technology to minimize the dependence on glasses or contact lenses for patients of all ages. I also look forward toward further advances in treatments for diseases that affect the eye, such as glaucoma and macular degeneration, for which we currently treat aggressively, however, can currently offer no cure.

Rob Borkowski is a PBN staff writer. Email him at