W. John W. Murrell, M.D.

Dr. Murrell specializes in cataract surgery. Performing thousands of cataract surgeries throughout his career, he receives rave reviews from patients and is proud to help clear their cloudy vision. Before each cataract procedure, patients will have one or more consultations, during which Dr. Murrell will help forge a shared plan for the results they want to achieve. Have Your Cataracts Surgery Performed By Dr. Murrell Having invested in the latest cataract surgery equipment and technology, Dr. Murrell can detect eye diseases that a standard exam cannot. Dr. Murrell can also treat many of these diseases if he can identify them in advance. This can also to improve the quality of the patient’s post-operation vision. Although some diseases cannot be cured, detecting them in advance allows Dr. Murrell to provide the patient with a more realistic expectation of their post-operative vision. Using this technology allows for a happier, healthier, and more educated patient. Contact Us Today What Are Cataracts? A cataract is when the natural lens is no longer clear. The lens in your eye is initially clear and it focuses the images seen by the eye on the light-sensitive retina at the back of the eye. As cataracts develop the lens begins to become cloudy. This increases to the point where it eventually impacts vision, particularly at night. Cataracts are the most common cause of vision loss in people over the age of 40; they are the principal cause of blindness across the world. What Causes Cataracts To Develop? The most common reason is when the proteins present in the lens start to denature. As this denaturing condition worsens the lens gets yellow and cloudier to the point where it interferes with the vision more, blocking some of the light coming through the lens. This is usually a slow process, and the patient doesn’t often realize their vision is becoming more cloudy. Eventually, the cloudiness will be to a degree that it can appear you’re looking through a perpetually dirty window. Who Is At Risk For Developing Cataracts? Cataracts are common as we age. It’s estimated that by the time an American turns 80, he or she has a 50/50 chance of either having cataracts or having already had surgery to address them. Surgery is the only treatment option for cataracts. Intraocular Lenses (IOL) By Dr. Murrell Cataract surgery has become very quick, high tech, very effective, minimal to no discomfort procedure that has very good to excellent visual results that can last a lifetime. Improved technology has significantly increased the precision and safety of cataract surgery and gives the patient many options in regard to their post operative vision. During cataract surgery, the cataract (the cloudy lens in your eye) will be removed and a new artificial intraocular lens (IOL) will be put back in your eye. I have chosen two companies for the IOL’s that I use, Alcon and RxSite The cataract patient today has many IOL options to choose from depending on their lifestyle needs and how much independence they want from glasses. Let’s review these IOL options so that you can make a well thought out decision for your vision and your life style. I would like you to choose the IOL that is best for you. There are six types of Alcon IOL’s available: Alcon Standard IOL Alcon Toric IOL Panoptix IOL Panoptix Toric IOL Light Adjustable Lens (LAL) Alcon Standard IOL This is by far the most common IOL implanted (approximately 80% of the time). It is a spherical lens that will correct for one focal point (usually for distance) and will not correct the eye for astigmatism (irregular cornea). After surgery with this IOL, the patient will always need prescription glasses for uncorrected astigmatism and for intermediate (computer and dashboard) and near (reading). All insurers cover this IOL. Dr. Murrell’s office can help with the insurance pre-certification and costs upon verification of benefits. PanOptix IOL: This IOL gives vision at all 3 focal points: distance, intermediate (computer/dashboard) and near (reading). This IOL is becoming more popular and I am implanting them now in 5% of the patients. Most of the patients will not need glasses for distance, intermediate or near. This IOL design may give glare &/or halos of light (disphotopsias) when looking at bright objects (auto lights) at night. While some patients have this, very few are bothered by it. Remember, this Panoptix IOL is a premium IOL that is not covered by insurance and will be a an out of pocket cost to you.

What Is Thyroid Eye Disease? Thyroid Eye disease is an ocular condition that usually occurs as a result of Graves’ disease. This autoimmune disease involves antibody action against receptors within thyroid cells and also within cells behind the eyes. People with Graves’ disease usually experience hyperthyroidism. Approximately half of them develop symptoms affecting the eyes. Because thyroid eye disease can worsen to a point at which it becomes difficult to close the eyes completely, it is important that patients with the signs of this condition receive appropriate care. What Are The Symptoms Of Thyroid Eye Disease? The symptoms of thyroid eye disease include the following: Persistent inflammation and redness of the white part of the eyes Persistent sensation of grittiness and general eye irritation Dry eyes Excessive tearing Eyelid swelling Photosensitivity Proptosis, bulging of the eyes Double vision The severity of the symptoms of thyroid eye disease is completely independent of the severity of hyperthyroidism. How Can Thyroid Eye Disease Be Treated? There are several approaches that may be taken to diminish the symptoms of thyroid eye disease. Historically, these have included: The use of cool compresses to reduce inflammation around the eyes Wearing sunglasses to reduce photosensitivity when outside The use of lubricating eye drops to soothe irritation caused by dry eye Steroid medication to reduce swelling behind the eyes For more advanced cases of thyroid eye disease, a patient may be advised to have eyelid surgery to reposition tissue and acheive better eyelid closure. Surgery may be recommended to lengthen the muscles around the eyes to correct double vision. Finally, some patients need orbital decompression surgery to create more space within the eye socket. In addition to lifestyle remedies and surgery, we now have a mid-range treatment for thyroid eye disease, Tepezza. What Is Tepezza? Tepezza (teprotumumab) is the first medication of its kind. The FDA has approved the drug, administered via IV infusion, to reduce the symptoms of thyroid eye disease. Patients who have received Tepezza report a reduction in redness, double vision, bulging, swelling, and irritation. How Does Tepezza Work? Thyroid eye disease can cause the eyes to bulge through action within the tissue behind the eye socket. Here, the tissue has receptors that receive nerve signals. Thyroid eye disease “turns on” these receptors by creating autoantibodies that attack the tissue. In response to the activated receptors, the fat and muscle tissue behind the eyes swells. The ocular surface also becomes inflamed as a result of the activation. Tepezza works by binding to the receptors that would otherwise get activated. By preventing the receptors from turning on, Tepezza helps reduce the swelling and inflammation that occurs around the eyes. This medication has been proven to improve aesthetics as well as visual stability. Am I A Good Candidate For Tepezza? Thyroid eye disease is a complex condition that requires careful and comprehensive evaluation. Our objective is to provide the most appropriate care for each patient, and we are familiar with the multiple criteria that are used to determine who may respond optimally to this treatment. The criteria that are used classify the stage, subtype, and variations that may be involved in each case. With evaluation of each, we can determine who is a good candidate for Tepezza. As much as we wish there were a straightforward answer to this question, the nuances of thyroid eye disease make it difficult to do so outside of a personal consultation.Schedule Your Consultation How Long Will It Take For My Thyroid Eye Disease Symptoms To Improve? Data received through clinical trials suggests that patients can experience improvements in the symptoms of thyroid eye disease within six weeks of starting Tepezza treatment.

What Is Dry Eye? The Tear Film is made of a combination of 2 tear water producing glands and 1 tear oil-producing gland located in the covering of the eye and in the eyelids. A dry eye most often is due to the decrease of water and or tear oil. The result is a condition called dry eye. Contact Us Today Dry Eye Treatment Amarillo How Do Tears Work? Tears keep the ocular surface lubricated. They do so with three key ingredients: oil, water, and mucus. The oil layer is the outermost layer of the tear film. This layer keeps tears from evaporating too quickly. The oil in tears is produced by the meibomian glands. Water makes up the middle layer of the tear film. It is the most substantial layer, responsible for cleansing the eye and washing away particles that do not belong. The water in tears comes from the lacrimal glands that are located in the eyelid. The innermost layer of the tear film is made of mucus, which helps water and oil stick to the ocular surface. This part of the tear film is made in the conjunctiva. The layers of tears are produced by the appropriate glands in vital proportions to achieve adequate moisture. When we blink, the tear film is spread across the eye and each gland involved in tear production is stimulated. Why Does Tear Quality Matter? Tears need to have all three layers to perform their function on the eyes. Without the right balance between oil, water, and mucus, the eyes can become irritated and susceptible to infection. What Causes Dry Eye? Generally speaking, dry eye can result from various problems. As we age, everyone’s tear production drops. This is especially true of women after menopause. Often, tear quality is diminished when the meibomian gland is blocked because tears evaporate too quickly from the eye without the protection of the outer oil layer. A variety of medications can also reduce tear production: antihistamines, diuretics, beta-blockers, sleeping pills, nerve medications, and pain relievers. Dry eye really comes down to one of these (or a combination of) glands located around both eyes: Lack of tear water Lack of/or dysfunctional meibomian oil glands (tear oil) Both lack of tear water and tear oil What Are Symptoms Of Dry Eye? For example, some symptoms of dry eye can include: Stinging or burning eyes Stringy mucus in or around the eyes Excessive tearing Excessive eye irritation in windy or smoky conditions Scratchiness on the eyes Discomfort wearing contact lenses Am I A Candidate For Dry Eye Treatment? You’re a good candidate for LipiFlow if the basis of your dry eye is the quality of your tears. When the Meibomian glands are blocked, necessary lipids are not released, so your tears don’t have the necessary oils to effectively regulate evaporation. This is the cause of dry eye in 86 percent of those with the condition. To assess your candidacy for LipiFlow, Dr. Murrell will evaluate your tears’ lipid layer and identify gland blockage. Certain patients with various eye conditions cannot have LipiFlow. These are patients who have had ocular surgery or injury within the past 3 months. Those with active ocular infection or ocular herpes within the last 3 months. Also, abnormalities with the eyelid, such as entropion, ectropion, severe ptosis, and others, can preclude a patient from being eligible for LipiFlow. Lipiflow Treatment For Dry Eyes Dr. Murrell is one of the few M.D. in the United States to use two state-of-the-art treatments that are FDA approved to manage severe dry eye due to oil dysfunction: Lipiflow. This systems heat the dysfunctional Meibomian oil glands, but in different manners. Using Lipiflow synergistically, he can give the significantly improved comfort to patients suffering from this painful condition. By taking photos and videos of your eye, Dr. Murrell can accurately diagnose dry eye and can easily show that diagnosis to his patients. Dr. Murrell then works together with the patient to create a successful treatment plan that can be performed totally or partially in office. Dr. Murrell completed his ophthalmology residency at Texas Tech University, one of the premier Dry Eye research centers in the United States. Researchers at Texas Tech developed one of the first artificial tear drops to treat Dry Eye. What Is LipiFlow? LipiFlow is an FDA-cleared medical device for Meibomian Gland Dysfunction (MGD). The LipiFlow® Thermal Pulsation System has a single-use Activator through which controlled thermal energy is applied to the inner eyelids. It is called Thermal Pulsation System because, as heat is being applied to the Meibomian glands, so is gentle, intermittent pressure. In combination, heat and pressure release lipids that have become trapped in the Meibomian glands. The unblocked glands that then resume the natural flow of lipids into the tear film.

Botox® is one of the world’s most famous brands. Every year since 2002, when Botox® was approved by the FDA for the treatment of wrinkles on the upper third of the face, Botox® injections have been the most popular cosmetic procedure performed in the U.S. The reason? Botox® works. It erases forehead lines, crow’s feet, and the 11s between the brows for around four months. Dr. Murrell offers Botox® in his practice. What Is Botox? Botox® is made from the botulinum toxin type A. Those are the same bacteria that cause botulism, but it works. Back in the 1950s, doctors discovered that when a small amount of the botulinum toxin was injected into a muscle, it temporarily stopped that muscle from contracting. This lead to the Botox® brand being born. Initially, the FDA approved Botox® for the treatment of involuntary eyelid spasms, and other uses followed. But it was when the FDA approved it for treatment of wrinkles that Botox® became legendary. What Botox Can Be Used To Treat Everyone, it seems, knows about Botox® and its treatment for wrinkles on the upper third of the face. But this neuromodulator has a variety of other uses. Botox® is also used to treat: Crossed eyes (strabismus) Uncontrolled blinking Muscle stiffness/spasms Temporomandibular joint disorder Migraine headaches Overactive bladder Excessive underarm sweating What Is The Benefit Of Having Botox Injections? Botox® is one of the world’s most famous brand names. You’d be hard pressed to find a person in most places around the world who has not heard of Botox®. Why is this? Because it is remarkably effective for removing wrinkles and lines on the upper third of the face. Botox® removes crow’s feet, frown lines between the eyebrows, and forehead lines. It does so without a minute of downtime, and the injections take just a few minutes. There are no incisions, no anesthesia. What’s not to love? Areas Of The Face That Can Be Treated Botox is a popular treatment for numerous cosmetic concerns that arise from regular muscle use. Common treatment areas include: Horizontal forehead lines Brow Vertical frown lines Crow’s feet Horizontal Bunny lines at the bridge of the nose Marionette lines from the corners of the mouth to the chin Chin “dimple”/cleft chin Smoker’s lines around the mouth Vertical necklines Botox is also a treatment for Hyperhidrosis, excessive sweating Do Men Receive Botox Treatments? Men are under increasing pressure to compete with younger counterparts at the office. This is behind the trend where more and more men are having blepharoplasty, eyelid surgery, to rejuvenate their eyes. For the same reason, men are coming to Dr. Murrell for Botox® injections. After all, crow’s feet, frown lines, and forehead creases age the face just as much as sagging eyelids. Gone are the days when the “weathered” look is the look that men strive for. Best Candidates For Botox If you want to feel more confident with the appearance of your skin, having this cosmetic treatment could work for you. You may be a good candidate for Botox® if you want to improve the look of: Forehead furrows Crow’s feet Frown lines Skin bands on the neck At What Age Should I Consider Botox? Botox treatments can begin whenever you are ready. This FDA-approved drug is popular among younger adults who want to postpone the onset of dynamic wrinkles. Adults of all ages commonly turn to Botox to smooth lines and creases that have developed as they have gotten older. The right time to consider Botox is more about your treatment objectives than your age. The Amount Of Injections You Can Receive Dr. Murrell injects Botox® in a single session. These are not meant to be multiple treatments to achieve your results. Once Dr. Murrell injects your Botox®, it takes from 3-4 days for the botulinum toxin to fully relax the muscle and erase the wrinkle on the surface skin. From there, your results will last around four months from that single injection session. Is There Any Preparation Before My Appointment? There isn’t anything you need to do prior to your appointment with Dr. Murrell. Botox® sessions were named the original “lunchtime procedures,” as they take just 10-15 minutes, and the patient can return to work or their other normal activities immediately afterwards. The process is simple. How Botox Works Botox® injects right into the facial muscles causing furrows and deep wrinkles by using a very fine needle. When injected into a muscle, Botox® works by blocking the nerve messages sent from the muscle to the brain. The brain never receives the message to contract the muscle, so the muscle stays relaxed.

How Can I Grow My Eyelashes? Everyone wants to have thick, lush eyelashes. But normal aging leads to thinner eyelashes. To mask the deficiency, an entire segment of the cosmetics industry has been devoted to thicker, longer eyelashes — mascara. But mascara is fickle, messy, a pain to apply and remove, and can be a factor in your eyelash loss. While there are many ways to grow eyelashes including: Eat a good healthy diet filled with nutrition Use over-the-counter lash conditioning treatments Take multivitamins Dr. John Murrell has a better way for his patients to have longer, thicker eyelashes. It’s called Alphalash, and you can get the product at our office (currently on backorder). Alphalash Eyelash Serum Amarillo What Is AlphaLash? If you notice that your eyelashes are thinning, there’s something you can do about it. You can strengthen those thinning lashes with AlphaLash, available at Dr. Murrell’s practice. AlphaLash is fortified with peptides to help stimulate eyelash growth, plus biotin to encourage growth and prevent the lashes from becoming dry and thinner. AlphaLash Serum also contains pumpkin seed extract, which is rich in fatty acids and essential minerals, to nourish and fortify the hairs. Finally, sodium hyaluronate, a form of hyaluronic acid (a naturally occurring substance in the body that is responsible for hydrating the skin), helps condition and moisturize the eyelashes. Bottom line? Regular use of AlphaLas leads to fuller, thicker eyelashes without any side effects. What Causes Thin Eyelashes? Thinning eyelashes are just one more thing to love about the aging process. If your eyelashes aren’t as long or as full as they once were, it’s not your imagination. Eyelashes grow out of hair follicles, just like the other roughly five million hairs on the average human body. And they go through the same growth stages: anagen (growth), catagen (transition to resting), and telogen (resting/shedding). But as we age, the process of resetting an eyelash follicle after it sheds a lash sometimes doesn’t work properly – either the eyelash follicle grows a new lash extremely slowly or it may stop producing altogether. The result? Thinning eyelashes. Is Mascara Bad For Your Eyelashes? Misuse of mascara is the main cause of eyelash thinning. Mascara left on overnight causes delicate eyelashes to break, and combing through mascara to remove clumps can actually pull out lashes. Can I Buy Alphalash Online? Patients that cannot make it to our office to purchase this serum or want to reorder after their visit can order Alphalash by calling our office 806-351-1177. We can ship it directly to you for an extra flat fee of $5. For more information on where to purchase this call our Amarillo office. Alphalash Serum Results After eight weeks of using Alphalash in a clinical test: 80% of the women thought that Alphalash has improved their overall eyelash appearance. 76% agreed that their lashes appeared longer, thicker, and more conditioned. 72% agreed that their lashes appeared less sparse. How Long Do I Need To Use AlphaLash Eyelash Serum For? The recommended protocol is to use AlphaLash once a day for 8 weeks to achieve maximum effects. Once the desired results have been achieved, usage can decrease to every other day. What Happens When You Stop Using Eyelash Serum? Eyelash serums work with continued use. If you stop using AlphaLash or any other eyelash serum product, your eyelashes will eventually go back to their previous condition. This is because eyelash serums are somewhat like vitamins for the lashes! Without consistent use, the eyelash follicles are not as healthy as they are when nourished with proprietary ingredients.

Plastic surgery is a term with which most people are familiar. This term may bring to mind cosmetic procedures such as a facelift or tummy tuck. Oculoplastic surgery is similar enough to the broader term that it may create misconceptions or confusion. As a board-certified, fellowship-trained oculoplastic surgeon, Dr. Murrell has helped many people regain confidence and comfort through precise procedures and treatments. Here, we discuss the particulars of this medical specialty and what it may mean for you. What Is Oculoplastic Surgery? Oculoplastic surgery is the term used to categorize procedures that correct some aspect of the eye, including the eye socket, eyelids, tear ducts, and more. Procedures performed by an oculoplastic surgeon may be either reconstructive or cosmetic in nature. Each treatment that is conducted is done in a way that improves appearance, vision, comfort, and the overall health of the eye. Oculoplastic Surgery Amarillo TX Benefits Of Going To An Oculoplastic Surgeon An oculoplastic surgeon is first a board-certified ophthalmologist. An ophthalmologist is a medical doctor who has received extended training beyond medical school to diagnose and treat eye diseases and conditions such as cataracts and more. In addition to ophthalmology training, an oculoplastic surgeon has also undergone specific experiences in which the eyes and structures around the eyes are diagnosed and treated. Dr. Murrell completed an oculoplastic fellowship under an esteemed medical specialist who has contributed to medical textbooks in the area of oculoplastics. A general plastic surgeon is a specialist who has been trained in the broad range of all plastic surgery procedures. In contrast, an oculoplastic surgeon has been trained specifically in the eye and peri-orbital area. The narrower focus of the oculoplastic surgeon compared to a general surgeon or general plastic surgeon provides patients with the highest degree of familiarity with ocular anatomy possible. How Will I Know If I Need Oculoplastic Surgery? Many of these surgeries are necessary for the health of your eyes. For instance, no one should leave a tumor on an eyelid to avoid surgery. When an eyelid is turned inside out or outside in, these conditions won’t heal on their own. They are usually due to problems with the levator muscles and surgery is necessary to correct the eyelid function. There’s no reason to live with the scratchy, dry eyes that are a result of these eyelid problems. The one area where there could be vacillation would be aesthetic eyelid surgery, blepharoplasty. When will you know it’s time for this surgery? When you look in the mirror and your eyelids are aging your face beyond your years. Maybe friends and coworkers have asked if you’re tired when you’re not; they’re looking at your sagging eyelids. These are completely personal decisions, but cosmetic eyelid surgery is not a difficult procedure. This is a highly satisfying procedure that takes a decade or so off your facial age. Reality? Just about anyone of the age of 40 could benefit from blepharoplasty. Would I Be A Good Candidate For Oculoplastic Surgery? Patients come to Dr. Murrell for a variety of oculoplastic procedures. They trust his training, expertise, and experience as a board-certified ophthalmologist. That focus on the eyes gives our patients an added degree of confidence heading into these surgeries. Candidacy for these surgeries may be purely for aesthetic reasons or they may be necessary to correct problems such as ectropion/entropion or eyelid tumors. If you feel as if your sagging, droopy eyelids are aging your face beyond your years, blepharoplasty is a great procedure. It’s acknowledged to take about a decade off your facial age. The same is true with ptosis, but the more extensive drooping that merits this surgery can usually lead to insurance coverage. As for issues such as an eyelid turned the wrong way and causing dry eye, these are conditions that need correcting, so you don’t damage structures such as your cornea. Candidates need to be healthy enough for surgery, and expectations need to be realistic, but there’s no reason to avoid these surgeries if they are needed or wanted. Does My Health Insurance Cover Oculoplastic Surgery? That’s a big “It depends.” Insurance companies are reluctant to cover blepharoplasty, as it is typically deemed elective for aesthetic reasons. The exception here is if the drooping of your eyelids is to the degree they are infringing on your field of vision (more likely a case of ptosis). Most other eyelid and tear duct surgeries with Dr. Murrell are for the health of your eyes. These are deemed medically necessary and are usually covered. We work with insurance companies to gain the highest level of coverage we can.

After Dr. Murrell completed his ophthalmology residency, he trained at a prestigious oculoplastic fellowship with Robert Wilkins, M.D. at the University of Texas. Dr. Wilkins wrote the landmark chapter on Blepharoplasty in the textbook “Oculoplastics.” One can consider this textbook a cornerstone of Oculoplastic knowledge. Since learning from the best, Dr. Murrell has performed thousands of eyelid surgeries. His goal is to eliminate any medical issue in the eyelid and to provide aesthetically beautiful, natural-looking results with as minimal treatment as possible. Dr. Murrell wants his patients to walk away looking and feeling more confident, more youthful, and more like themselves. What Is Eyelid Surgery? Eyelid surgery is a procedure that helps correct eyelid malpositions, improve eyelid function and enhance eyelid appearance. The most common eyelid surgery is blepharoplasty which is done to remove excessive eyelids skin and underlying fat. The goal of blepharoplasty is to tighten the skin and lessen or remove puffiness and sagging. Since the eyelid skin is very thin it is often one of the first areas to show signs of aging. Eyelids that sag or droop can affect peripheral vision, making daily activities such as driving more difficult. Patients may require a blepharoplasty when various factors such as aging, sun damage, smoking, and obesity, cause the skin to stretch and underlying tissues to weaken. Who Is A Good Candidate For Blepharoplasty? Eyelid surgery is one of the few cosmetic procedures that are popular with both women and men. This is because aging eyes don’t play favorites by gender. In fact, over the last decade, more and more men are having the procedure to compete with younger counterparts at the office. Blepharoplasty candidates commonly have sagging skin and fat pockets under their eyes. In addition, the sagging skin and excess fat can interfere with the patient’s field of vision. In both cases, patients can receive a blepharoplasty to correct one or both concerns. Patients that are interested in undergoing surgery must have eye conditions, such as dry eye, under control first as it would interfere with the surgery and the results. Benefits Of Eyelid Surgery With Dr. Murrell Most people say the eyes are the area of the face they notice first when meeting a new person and sagging eyelids can make a person appear tired and much older. Cosmetic eyelid surgery with Dr. Murrell can take years off the facial age of the patient. Plus, those improvements can last up to 10-20 years. Eyelid surgery will make you look younger and more refreshed. Types Of Blepharoplasty If patients are unhappy with the appearance of their eyelids or having trouble seeing, they can undergo eyelid surgery. Dr. Murrell performs eyelid surgery for functional, reconstructive, and cosmetic purposes. Functional Blepharoplasty If the eyelids begin sagging into the field of vision, patients may want to consider a functional blepharoplasty. The procedure may be covered by medical insurance if it is deemed medically necessary. Dr. Murrell can determine how much vision is affected by checking the peripheral visual field with an instrument called the Humphrey Visual Field (HVF) Analyzer. Eyelid Reconstruction Surgery Dr. Murrell usually performs reconstructive surgery after the removal of an eyelid tumor. Dr. Murrell takes tissue from an adjacent eyelid or nearby area and uses it to reconstruct the eyelid that previously had the tumor. Cosmetic Blepharoplasty Cosmetic blepharoplasty is ideal for patients with stretched skin or fat protrusions that do not interfere with vision or field of vision. The blepharoplasty procedure is therefore not medically necessary in this case and will not be covered by insurance.