Boxer Wachler Vision Institute * 310-860-1900 * www.BoxerWachler.com/whiteeyes

I-BRITE™ Eye Whitening - What You Need to Know What is I-BRITE™ Eye Whitening? This procedure makes your eyes whiter and brighter by removing a thin membrane covering the white portion (sclera) of the eye. This membrane holds the unsightly red veins and yellow or brown material. A crystal clear membrane (without red blood vessels, yellow or brown spots) grows back in its place. In addition to whiter and brighter eyes, many people even feel their self-confidence is improved afterwards too. This is a 100% no-stitch, no-graft, pain-free procedure. It is quick, typically less than 15 minutes, and you can resume work and your daily routine the very next day. The full “whiter and brighter eye” results are visible within 2-8 weeks after the procedure. You will use eye drops for 8 weeks to allow for full recovery.

Examples of White and Bright Eyes in Youthful Healthy Eyes

I’ve never heard of I-BRITE™ Eye Whitening, is this new? This procedure is similar to a Pinguecula Removal, Pterygium Removal, Conjunctivochalasis (which is the removal of excess conjunctiva tissue) or Conjunctivoplasty (elective surgery of the conjunctiva); it has been performed successful for over 30 years. How is I-BRITE™ Eye Whitening performed? This is a surgical procedure that removes a thin membrane covering the white portion of the eye that contains the excessive blood vessels, yellow growth, white lumps and/or brown spots (hyper-pigmentation/freckles). Do you use laser? Since this procedure involves removing the membrane, lasers are not needed. Lasers can lighten areas, but they do not resolve the source of the excessive blood vessels, yellow growth, white growth, or brown spots. Direct removal of this membrane is most effective to resolve these issues. Am I a candidate for I-BRITE™ Eye Whitening? If you are at least 16 years old you may be a candidate for this procedure. You can come in for a complimentary no charge evaluation with Dr. Brian Boxer Wachler. Please plan 1 ½ - 2 hours for this visit If you do not live in the Los Angeles area you may e-mail a close-up picture of just your eye for a preliminary determination of candidacy. Please e-mail to: info@boxerwachler.com If you have been diagnosed with any auto-immune diseases by your physician, you may not be a candidate due to the risk of an inflammatory response which could cause complications. Also, we recommend that pregnant and nursing women not to undergo the procedure and wait until after breastfeeding has stopped for at least 30 days.

Boxer Wachler Vision Institute * 310-860-1900 * www.BoxerWachler.com/whiteeyes

Examples of I-BRITE™ Eye Whitening Candidates

What if I don’t live in the Los Angeles area? You could schedule a 3 day visit to Los Angeles and complete all your testing the first day, the procedure the second, and a one- day post operative visit on the third day. You can return home and continue your follow up care with your local eye doctor. We would recommend a 1 month, 3 month and yearly eye exams. Is there a website with more information about the I-BRITE™ Eye Whitening that can help patients? You can visit our website, www.boxerwachler.com/whiteeyes, as well as a link to a video that shows the doctor who originated the idea not using stitches/sutures: http://www.youtube.com/watch?v=vj4hzpWLlYM. Are there any doctors in my area that are performing I-BRITE™ Eye Whitening? Dr. Brian is actually the only doctor in the United States performing I-BRITE™ Eye Whitening. He pioneered this treatment. How long has Dr. Boxer Wachler been performing I-BRITE™ Eye Whitening? Dr. Brian has been performing an earlier version of this procedure for 13 years. Approximately, 1 year ago he perfected it which includes the use of Mitomycin C (MMC) drops. The MMC drops combined with other aspects of his techniques assist in preventing the regrowth of blood vessels and improve the wound healing. This has eliminated the need for stitches/sutures or grafts in virtually all patients and appears to be eliminating irregular tissue growth or visible scarring. How long does I-BRITE™ Eye Whitening take? Will I be awake? Is it painful? This pain free procedure takes 5-20 minutes per eye. We give you some Valium to help you relax during the procedure, most patients remember very little about the procedure. The common comment is: “that was easier than going to the dentist.” Are there any side effects involved with I-BRITE™ Eye Whitening? There are minimal side effects from I-BRITE™ Eye Whitening. Patients may have a temporary increase of redness from blood vessels that are intersected and rupture during the procedure. The white portion of your eye may have a bruise-like appearance for 2-4 weeks, most prominent the first 3-5 days. On occasion, there can be some temporary light sensitivity. There is a rare occurrence of pain, discomfort or scratchiness beyond the 1 day visit. It will be important to follow the postop eye drop regime, avoid swimming for 2 weeks, and avoid working in dusty environments or gardening for 2 weeks.

Boxer Wachler Vision Institute * 310-860-1900 * www.BoxerWachler.com/whiteeyes

What is the success rate? We have not had to perform a retreatment of the procedure on patients who were not diagnosed with pterygium. Patients who are diagnosed with a pterygium have a 3%-20% chance that a secondary treatment may be needed to fully remove red blood vessels and growths. The procedure can be repeated if necessary, although rare. Sunglasses are a must when you are outside to protect your eyes and help inhibit the re-growth of yellow tissue and blood vessels. Also, artificial tears are beneficial 1-2x’s daily to also inhibit re-growth.

I-BRITE™ Eye Whitening Before and After Photo

Before After

I currently wear contact lenses, do I need to remove? Would I still be a candidate? You may still be a candidate for the eye whitening procedure even if you are a contact lens wearer. Please remove your contact lenses 3 days before the initial evaluation or procedure. After the procedure you will need to refrain from wearing contact lenses for 1-2 weeks to allow for full healing. If I am currently using over-the-counter vasoconstrictors, is it ok to continue using? We highly recommend patients to stop using vasoconstrictors (get red out eye drops) such as Visine, Clear Eyes, etc. at least 3 days prior to the consultation in order for Dr. Brian to examine your eyes in its natural state. I have issues with dry eyes. Would I still be a candidate? Most patients have improvement with dry eye symptoms since the areas that are being removed often contributes to the cause of dry eye symptoms. With our technique, the worsening of dry eye symptoms is quite rare and uncommon. We suggest all patients to start taking Flaxseed Oil 3-6 capsules daily, alleviates dry eye. Do you use AMT? Amniotic membrane transplant (AMT) is not typically needed with I-BRITE™ Eye Whitening. What is the concentration of the Mitomycin C drops? How long are the Mitomycin C drops used and why do you use Mitomycin C drops? The concentration of the Mitomycin C drops is extremely low with 0.02% concentration. The drops help to prevent the re-growth of the blood vessels and improve wound healing. This medication has been safely used in ophthalmic procedures for 10 years. I heard Mitomycin C drops can cause the scleral to melt? There is very low risk with this drop due to the very low concentration of the drops. We have not had any patients present with a sclera melt complication after use of these drops.

Boxer Wachler Vision Institute * 310-860-1900 * www.BoxerWachler.com/whiteeyes

How do I prepare for I-BRITE™ Eye Whitening? Discontinue contact lenses 3 days prior to the treatment; you may resume 1-2 weeks after the procedure. Discontinue Aspirin products 3 days prior to treatment; you may resume 5 days after the procedure. Discontinue Accutane or Tetracycline for 60 days prior to treatment; you may resume 30 days after treatment. Discontinue vasoconstrictor eye drops (get the red out eye drops) 3 days prior. Can I have LASIK or other vision correction procedure at the same time? You would need to wait for 3 months after I-BRITE™ Eye Whitening before having another procedure. How much does I-BRITE™ Eye Whitening cost? Many of our patients finance their procedures. It’s very popular due to low or no interest options. The monthly payments are about $150-200 per month. You can apply for financing with: www.CareCredit.com (interest rates as low as 9.99% or 6 month interest free option) or www.ChaseHealthAdvace.com – provider id 30665 (12 or 24 month interest free option). If you were to pay upfront for the procedure, the range is from $3050-$5050 per eye. Also, if you have one, you can use your medical FLEX spending account through your employer. No Previous Conjunctival Surgery - $3050/per eye Eye White with Pterygium Removal Necessitating a graft - $4050/per eye (less than 5% of patients) Previous Conjunctival Surgery - $5050/per eye (less then 2% of patients) Does insurance cover I-BRITE™ Eye Whitening? Unless you have been diagnosed with a pterygium that has caused a change in your vision, this procedure is considered by insurance companies as a cosmetic procedure. We will provide you with a bill and an operative report that you can send to your insurance company to request reimbursement; however, be prepared, they will likely reimburse very little or nothing giving the reason they consider the procedure cosmetic in nature. Unfortunately, we are not able to bill insurance directly. You can ask your insurance company if they cover code: 68399 for diagnosis code: 372.71

Close your eyes for a moment and visualize how much better your life would be with new "whiter, brighter eyes"! It's not a dream anymore. It can now be your new reality.