Bob Puzio did not know how the world really looked until he saw it in a new light.
A husband, father and retiree, Puzio lives a busy life in Roxbury Township, New Jersey, traveling with family and pursuing his hobbies as a documenter and collector of craft brewing memorabilia.
So, it was a surprise when Dr. Eric Mann, an ophthalmologist with Ridgedale Surgery Center in Cedar Knolls, New Jersey, diagnosed Puzio with cataracts in both eyes and glaucoma during a comprehensive eye exam.
“One thing you find out [during an eye exam] is that you could be clueless that your vision is anything but normal,” he said. “If anything, I thought my vision was getting better as I aged.”
As Puzio’s sight improved following months of treatment, he wanted to thank the people who gave him the vision he thought he always had.
But how? A card or a small gift would be more than most people offer, but Puzio had an idea, one that could help others see the world in a new light.
“There’s this Bible quote about how 10 lepers were cured, but only one said, ‘Thank you,’ and I wanted to be the one to say thank you,” Puzio said. “You can buy people donuts and coffee, but I had to do more than just say, ‘Thank you. Good job.’”
“A Triple Whammy” Diagnosis
To say the findings from his eye exam caught Puzio off guard would be an understatement.
“I joked that the diagnosis was a triple whammy,” Puzio said. “Glaucoma and cataracts in both eyes were not what I was prepared to hear.”
A cataract is a hazing of the eye lens that impedes passing light into the eye. At first, the cloudiness may affect only a small part of the lens, and you may be unaware that you are developing vision loss.
Cataracts are the leading cause of vision loss among people older than 55. According to the American Academy of Ophthalmology, over half of all Americans will develop cataracts by age 75.
Cataracts can impair vision or destroy it if left untreated. At first, stronger eyeglass prescriptions can help with cataracts. Dr. Mann noted that many patients may reach a point where surgery becomes the only option.
“We can often tweak glasses to work around different changes in prescriptions, but at some point, glasses can’t be tweaked any further,” Dr. Mann said. “Robert had received steady changes to his prescription, but he was still presenting issues and we couldn’t run the risk of waiting too long and there being complications.”
Patient Undergoes Cataract Surgery
Unlike other eye diseases like glaucoma, doctors can remove cataracts to restore eyesight. The operation includes removing the clouded lens and replacing it with an artificial one, called an intraocular lens (IOL). The construction of an IOL involves using silicone, acrylic or other plastic materials and frequently applying a protective coating against UV rays.
“Cataracts are a natural clouding and graying of that lens inside the eye,” Dr. Mann said. “Patients describe it as a fuzz or blur you’d normally fix by cleaning your eyeglasses. But it’s not glasses: it’s the lens inside your eye that’s turning gray, and we can go in and replace that with a man-made lens.”
In late 2023, Puzio received an injection to treat his glaucoma procedure and reduce eye pressure at an ambulatory surgery center (ASC). Two cataract surgeries — one in each eye — followed, performed by Dr. Mann in January and February 2024.
Puzio said the improvement to his vision was obvious in the weeks between his cataract procedures. Taking advantage of a snowfall that had blown through his area, he tested what his “new” right eye could see.
“Just for kicks, I put my hand to my right eye, and the snow looked like it was yellow straw colored through my left eye,” Puzio remarked. “I did the opposite and that same snow looked as bright as an LED light.
“Seeing the difference in my vision was a total ‘woah’ moment.”
Compassionate Care
A traumatic eye injury in his youth made Puzio apprehensive about undergoing treatment. Despite his reservations, the staff at Ridgedale Surgery Center worked with him throughout the process to find approaches unique to him.
“When Dr. Mann or anyone gets close to my eyes, I spasm, and I just can’t control it,” he said. “And the thing with LASIK surgery is that you must be awake throughout. I knew I wouldn’t be able to control myself if I was awake, so Dr. Mann opted for the traditional cataract surgery.”
Patients undergoing cataract surgery typically remain awake, using local anesthesia administered either through eye drops or needle-based blocks. Recognizing that neither solution addressed Puzio’s unique circumstances, Dr. Mann and his team collaborated on alternative sedation methods, ensuring the procedure could be executed successfully while addressing his specific concerns.
“The anesthesiologist working with Dr. Mann came up with a different way to sedate me so that I would be out of it, as far as I knew, but not totally under like with general anesthesia,” Puzio said. “The only pain I felt with both surgeries was when the IV went in; it was easier than going to the dentist.”
Dr. Mann highlighted that Puzio’s positive experience, before, during and post-procedure, serves as a testament to the unwavering commitment of Ridgedale’s dedicated staff and the level of care available in the ASC setting.
“Robert told us after that everyone from the first interaction at registering at the front desk to the nursing staff and then the anesthesiologist took their time with him,” Dr. Mann said. “It gives me pride to know our team cares. They’re not just clocking in; they love what they do, and when you love what you do, you can do amazing things for patients.
“At a big hospital, you might hear, ‘It’s not my job,’ or hear things that staff are told to tell patients, but that’s not going to be your experience [at an ASC].”
Helping Others to See a Way Forward
A hub for service dog training, the neighboring town of Morristown, New Jersey, is home to The Seeing Eye, an internationally recognized nonprofit dedicated to training service dogs. For nearly a century, the local charity has raised generations of dogs to help the blind achieve greater independence and freedom.
To thank those responsible for his improved vision, Puzio made multiple donations to The Seeing Eye, including gifts on behalf of Dr. Mann and his ASC staff.
“[The ASC staff] did something grand for me, so the least I could do is pay it forward,” Puzio said. “The Seeing Eye is local, so I see them training around town, and I know the great work they do. What better way to say thanks than to benefit others?”
Dr. Mann said Puzio’s gesture signified something more profound than a simple positive review.
“People who have a good experience usually leave a positive review, but Robert’s case is unique,” Dr. Mann said. “It’s almost spiritual to want to connect with something bigger.
“[Puzio] was able to have a surgery to see better, and he paid that forward by providing resources so that others could get back a different kind of sight.”
Now months removed from treatment, Puzio is back at his hobbies and enjoying spending time with his wife and children. Cataract surgery, he said, has changed the way he sees the world.
“When Dr. Mann told me that I needed surgery as soon as possible, I thought, ‘Why?’ But now, everything I see is sharper, brighter, and clearer.
“I’m really seeing the world in a completely new light.”
Partner With AMSURG
Every day, AMSURG surgery centers provide world-class care for patients, making us a leader in the ASC industry, performing more than 200,000 ophthalmology procedures annually.
Physicians can greatly benefit from a surgery center partnership with national reach and perspective. AMSURG, along with its extensive network of over 2,400 physician partners across approximately 250 facilities, enables independent physicians to realize their personal and professional goals through innovative management, clinical support and strategic services.
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About AMSURG
AMSURG is an independent leader in ambulatory surgery center services, operating a network of approximately 250 surgery centers nationwide. In partnership with physicians and health systems, the organization delivers high-quality patient care across a diverse spectrum of medical specialties, including gastroenterology, ophthalmology and orthopedics. With a focus on strategic growth and innovation, AMSURG is committed to transforming the future of ambulatory surgery center care and services. To learn more about AMSURG, visit www.amsurg.com.