At Eye Specialists and Surgeons of Northern Virginia we are excited to be able to offer the latest in corneal surgery.  For patients suffering from endothelial disease like fuchs dystrophy the only option used to be a full corneal transplant.  Over the last few years we have been excited with techniques to do partial corneal transplants such as DALK (Deep Anterior Lamellar Keratoplasty) for anterior corneal disease and DSEK/DSAEK (Descement Stripping Endothelial Keratoplasy) for posterior corneal disease.  Dr Josephson is excited to be the first in Northern Virginia to offer DMEK (Descement Membrane Endothelial keratoplasty) which allows us to replace the thinnest layer of diseased tissue and replace with the same thin layer.  This technically advanced surgical technique allows us to restore the full potential of a patient’s vision quickly with a virtually zero percent rejection rate.  Dr Josephson has done numerous cases with a very high success rate.  Photographed in the picture is one of our cases.  You can not even see the outline of the transplant since it is so thin but the clue is the small imprinted purple S which tells us the new tissue is attached perfectly.  This is only a few days after surgery and the cornea is already clear.

We are always excited to discuss the newest advances in corneal disease treatment.  If any questions or you think you may have a corneal disease please reach out to us at 571-349-2191 or visit us at

Beautiful letter from a patient after cataract surgery

We love what we do at Eye specialists and Surgeons of Northern Virginia.  Even better when we receive words of affirmation from our wonderful patients.  With permission we would like to share one patient’s experience after having surgery with Dr Josephson. We are honored, blessed, and humbled to be a part of our patient’s vision restoration.



Dr Josephson and team

We are honored to share our patient video testimonials

Our most valuable content to share is our own wonderful patients experience.  No better source of information than those who have been through it before.  Please view our Youtube page to hear the experience from their own mouth.

Thank you for visiting our blog.  If you have questions or are in need of eye care feel free to contact us at 571-349-2191 or visit us at

Eye Surgery Mission in Ethiopia

We are honored to post pictures from our recent mission trip to Ethiopia last month.  Dr Josephson had the blessing to go to a hospital and start a corneal transplant program for the indigenous population in the region.  He also had the opportunity to teach and operate with the eye surgery residents that will lead the future of eye care in the country.  We were able to perform many surgeries, see hundreds of patients, and provide hope and vision for tomorrow.  We are happy to share the award Dr Josephson was given as a token of appreciation.  Also if you want to see pictures from the trip please visit our website at . We pray we will have the opportunity to serve this wonderful community again soon.

Intacs: More options for Keratoconus

With the FDA approval of Collagen Cross-linking many patients suffering with keratoconus have resurfaced asking what options are available.  Dr. Josephson, a fellowship trained Cornea Surgeon, is a pioneer in the latest technology for keratoconus.  We offer FDA approved collagen cross-linking in our office.  We also offer INTACS which with a very quick and easy laser approach we can place a segment that allows the cornea to mold into a more normal shape.  Intacs with cross-linking can make a reshaped-better cornea a permanent reality.  If you are having haloes and glare with suboptimal vision you may have this debilitating condition that now is treatable.  Furthermore many insurers are recognizing these procedures and providing coverage.  Call our office at 571-349-2191 or visit us at to schedule your evaluation.

Happy New Year and Eye Healthcare in 2018

A Happy and Blessed New Year to you all!

We understand the excitement a new year brings but 2018 also brings a lot of anxiety in regards to healthcare.  At Eye Specialists we could not be more aware of the ever changing healthcare landscape in our region.  The Healthcare Exchange in Fairfax County has left little options for many of our patients and possible future patients.  You are not alone.

We want to ensure you that we are here for your eye care needs even if we are not in your network or if you do not have insurance.  We have implemented a fee schedule that is fair and discounted to allow for those in need of expert care to have access.  This is not only for exams but for tests and procedures.  During your exam we will discuss tests that may need to be done and the cost before we do them. If you need a procedure we will review the options so there are no surprises.

We look forward to seeing you soon.

All the best for 2018

John Josephson MD and ESSNV team

Going Deeper into a Cataract

(Posterior subcapsular cataract)

I’m often asked what grade is my cataract? or is my cataract ripe?  This is a difficult question to answer because a cataract comes in many forms.  There are actually over 20 different types of cataracts.  There are cataracts that younger people can have and then there are those we see in the more advanced in age.  Some are due to trauma or medications.   All of this information is important for your surgeon to evaluate not only for surgical approach but also to determine if a work up is needed.   An medically trained eye specialist can often diagnose diabetes, medication toxicity, autoimmune disease, and various other ailments just by a thorough eye evaluation.  At the same time a superficial exam may miss many of these issues and leave them diagnosed.  In the picture above this cataract was seen in a young person and we were able to diagnose an autoimmune condition from one eye exam.

Once it is determined that a cataract is there and is causing visual issues we are fortunate to have the latest advancements in vision correction and laser cataract surgery to obtain the highest in patient satisfaction.   If the cataract is very mature we have access to the ORA calculator to ensure proper measurements in the Operating room.

If you having blurred vision, glare, trouble driving at night, or any other visual concern a thorough eye evaluation from an Eye Specialist may reveal a cataract or many other issues that may be occurring.  We would be glad to take care of you.  Please call us at 571-349-2191 to schedule an evaluation.

Is this lump on my eye anything to worry about?

Many times we see a spot on the eye and we do not know if it is concerning or not.  During my fellowship in San Diego I had the privilege to see many Sun related growths on the eye.  Most of these were a growth called a pterygium.  A pterygium is a common growth on the eye that can grow onto the cornea.  Thankfully we can remove these and restore the look of the eye. It is best to remove before scarring occurs on the cornea.

The picture here is of an elevation or growth on the eye that had a peculiar look to it.  Three different eye doctors passed this patient along but were not sure what to do.   The patient was sent to us due to our specialty training in Cornea and external disease.  With special staining and testing we determined this growth was more likely a carcinoma of the eye and set her up to have excisional biopsy with us right away.  We are confident with continued care and treatment we can preserve vision in this otherwise detrimental situation.

If you have a growth on your eye or any changes in your vision it is important to have an evaluation with an EyeMD familiar with the subtleties of these conditions.  We would be honored to see you at Eye Specialists and Surgeons of Northern Virginia.  Call us at 571-349-2191 or check us out at

I had Lasik many years ago and now I have a Cataract?!?!

Cataract Surgery Ora Lens Calculator


I was asked this week as I have been before “is there any increased risk in having cataract surgery since I had lasik years ago?”  It is actually a great question and I’ll try to answer in this post.  There are many important points.  First of all, Lasik is done on the cornea (the window of the eye) and it molds the shape of the cornea to allow images to be in focus.  Cataract surgery is done where we remove the cloudy lens material.  Surgery-wise there is no technical difficulty doing cataract surgery when you had prior lasik, especially in the hands of fellowship trained cornea cataract and refractive surgeon.

The challenge is making sure that we place the correct lens in place of the cataract with the right power to help give you the focus you desire.  Cataract surgery has become to our patients an opportunity to enhance vision better than what they could see before they developed a cataract.  Your surgeon has to use special formulas and calculations to ensure proper measurements and lens power is being used.  Even a smooth uncomplicated surgery will have a poor vision outcome if time and detail is not put into the calculations before the surgery.

At Eye Specialists and Surgeons we pride ourselves on getting to know our patients. We take time to understand your goal in surgery.  We then take time to make sure our measurements are as accurate as possible and our formulas are correct. Nothing is one size fits all.  We have the latest in office calculators in our LENSTAR and PENTACAM to measure your eye in the office. To go even a step further we have access to the latest technology including Femtosecond laser incisions (Catalys)  and ORA Calculator (Intraoperative Measurements) to try our best for your precise visual outcome.  The ORA calculator is crucial, especially in those with prior eye surgery, to allow for an additional REAL TIME measurement in the operating room during cataract surgery.  This REAL TIME measurement is actually the most accurate time to measure the eye and we offer this technology option routinely to our patients.   

If you have any questions about your eye condition or would like to know more about our world class care and technology offered by Dr John Josephson at Eye Specialists and Surgeons of Northern Virginia please see our website at or call and schedule a consultation at 571-349-2191.