All posts by uppercut

How do I know which surgery is best – Epi-LASIK, PRK, LASIK, or Intra-LASIK?

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There are several choices that have to be made when considering laser vision correction. In Calgary, Alberta there are a variety of surgeries being offered at multiple centres.

From surface no-flap treatments such as PRK and Epi-LASIK, to flap treatments such as LASIK and Intra-LASIK, to intraocular treatments such as lens exchange or implantable contact lens.

It can be helpful to start by asking your existing optometrist or ophthalmologist if you might benefit from laser vision correction. There are a number of reasons why it might not be a good choice for you. For example, many people who are over the age of forty and do not wear distance glasses may believe that laser vision correction can be done to get rid of the need for reading glasses – it is not possible for laser vision correction to correct for reading glasses due to the natural age related weakening of the focus ability which occurs inside the eye. Another example would be extremely high nearsighted or farsighted people may not be good candidates for laser vision correction. Your current eye care provider who is familiar with your vision needs will most often be able to give you some preliminary information.

If you are over age 18, have a stable eyeglass prescription, and healthy eyes, you may be a good candidate for laser vision correction. It can help to learn about the types of treatments available by looking on-line at reputable websites such as which is a patient information site affiliated with the American Academy of Ophthalmology . You can also check out the websites of the local surgery centres such as Western Laser Eye Associates. More information can be found in Dr. Anderson Penno’s latest book “Laser Vision Correction: What You Need to Know”, available at and coming soon to Kindle. If you are familiar with the types of laser vision correction surgeries available, the next step is to book an assessment.

The assessment for laser vision correction can take up to two hours. Each centre may have different requirements for the length of time you should leave your contact lenses out before your appointment. In some cases there may be a fee for an assessment. The assessment is an opportunity for you to learn more about specific laser vision surgeries that are offered at a particular surgery center. There may be differences in which treatments are offered (flap or no-flap treatments) and in the types of lasers available. For example, not all lasers are capable of performing true custom wavefront treatments. The Visx S4 IR is the only laser available in Canada at this time that can perform custom wavefront treatments with iris registration and cyclotorsion control which is an adjustment for natural rotations of the eye during treatment. In most centres you will be offered an educational video to watch. The assessment is your opportunity to learn more about your choices, so it can be helpful to bring a pen and paper to write down questions as you go through the assessment. Some people will choose to have more than one assessment in order to compare the services offered at each center.

Once you have had an assessment and are confirmed to be a good candidate for laser vision correction you will have to decide which treatment and which centre is best suited to your individual needs. Understanding the basics of laser vision correction will help you understand the risks and benefits, will allow you to have the right expectations about what laser vision surgery can do for you, and will help you make the best choice for you.

To book a complimentary assessment with Dr. Anderson Penno, contact Western Laser Eye Associates today.

World Glaucoma Week: Whether You Have LASIK, Epi-LASIK, Intra-LASIK, PRK Or No Surgery – Get Screened At Age 40

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SAN FRANCISCO—Glaucoma continues to be a major cause of blindness and vision loss both worldwide and in the United States, where an estimated 2.2 million people have the disease.

During World Glaucoma Week 2010, the American Academy of Ophthalmology’s EyeSmart™ campaign and EyeCare America Foundation remind Americans that knowing your risks for glaucoma can save your sight. People with the top risk factors for the disease need to be especially vigilant. A recent National Eye Institute (NEI) report found that fewer than 10 percent of Americans surveyed knew that glaucoma has no early warning signs, in most cases.

“Glaucoma’s silent onset is a key reason the disease so often damages people’s vision before they know they have it, and why eye exams are vital,” says Andrew Iwach, MD, spokesperson for the American Academy of Ophthalmology (Academy) and glaucoma expert. “Ophthalmologists–Eye M.D.s–can detect the subtle, early signs of glaucoma and provide treatment that will help people keep their best possible vision.”

Top risk factors for glaucoma are:

  • Age (65 years and older)
  • Elevated eye pressure
  • Family history of glaucoma
  • African, Asian or Latino ethnicity
  • Related health problems, including diabetes, low blood pressure, migraine headaches

For people of any age with symptoms or risks for eye disease, such as glaucoma, the Academy recommends seeing an Eye M.D. to decide on eye exam intervals and other needed care. For adults with no signs or risk factors for eye disease, the Academy recommends a baseline screening at age 40—the time when the early stages of age-related eye disorders and vision changes may begin. Based on this screening information, the Eye M.D. will prescribe how often to return for follow-up exams.

NEI and other research show that timely treatment helps save people’s vision. Such studies also give ophthalmologists new data on improving patient care. For example, the Ocular Hypertension Treatment Study found that eye pressure-reducing medications lowered the risk of glaucoma by more than 50 percent in high-risk patients.

About Glaucoma
Glaucoma damages the optic nerve that transmits images from the eye to the brain. As glaucoma worsens, cells also die in the retina–a special, light-sensitive area of the eye–which further reduces the optic nerve’s function. The most common form of the disease is primary open-angle glaucoma (POAG). Fluid builds up in the front chamber of the eye, and the optic nerve is damaged by the resulting increase in eye pressure.

If a person has POAG, the lack of obvious symptoms makes it nearly impossible for him to know he has the disease. Since POAG-related vision changes are so gradual and easily overlooked, regular eye exams are important. Symptoms of the less common but more immediately dangerous closed-angle glaucoma include: blurred vision, severe eye pain and headache, rainbow-colored halos around lights, and nausea and vomiting. Anyone with these symptoms needs to be seen by an Eye M.D. right away

Reprinted with permission from AAO’s

More information about LASIK, Epi-LASIK, Intra-LASIK and PRK can be found in Dr. Anderson Penno’s latest book “Laser Vision Correction: What You Need To Know” available at

To book your complimentary refractive surgery assessment, contact Western Laser Eye Associates today.

Nearsightedness On The Rise

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A new study released from the National Eye Institute (NEI) shows that rates of myopia (nearsightedness) are on the rise amongst Americans.

According to the researchers, the rates of myopia in people age 12 to 54 increased from 25 percent in 1971-72 to 41.6 percent in 1999-2004. The survey included people with mild to severe myopia.

The 66.4 percent increase in myopia in Americans since the 1970s, is significant and will impact healthcare costs as well as vision quality. Today, 47 million Americans aged 20 and older are myopic and billions of dollars are spent annually on glasses and contact lenses. In addition, the majority of LASIK and related refractive surgical procedures in the United States are performed to correct myopia. Get more information about myopia here.

This article reprinted with permission from the American Academy of Ophthalmology’s EyeSmart™ campaign (
More information is available  in Dr. Anderson Penno’s latest book “Laser Vision Correction: What You Need To Know” available at

To book a complimentary assessment at Western Laser Eye Associates, contact us today.

Calgary Epi-LASIK, LASIK, PRK, Intra-LASIK: What is Custom Wavefront Laser Vision Correction?

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Once you decide you are interested in having laser vision correction surgery there are several things to consider. Which procedure is best for you? Which surgeon to choose? How much will it cost? What type of laser will be used?

Laser vision correction can be done by making a corneal flap and placing the laser treatment under the flap; the flap can be made by a mechanical microkeratome for LASIK or with the femtosecond laser with Intra-LASIK. Many surgeons are favoring surface no-flap treatments due to the lower risk and equally good long term results; no flap treatments include PRK and Epi-LASIK.

For either no-flap or flap treatments the application of the laser can be a standard treatment or a customized wavefront treatment. The standard treatment will treat simple sphere (nearsighted or farsighted) corrections as well as astigmatism corrections. For a true custom wavefront treatment measurements are made using a wavefront analyzer before surgery. The wavefront analyzer uses infrared light which is projected into the eye; the light is measured as it exits the eye and analyzed to provide an aberrometry map. The aberrometry map contains information about the simple sphere and astigmatism corrections along with more complex higher order aberrations. Each individual will have a unique set of higher order aberrations. The Wavescan aberrometer uses approximately 240 data points to create a unique aberrometry map that can be used for a truly customized wavefront treatment by the Visx S4 IR excimer laser.

The Visx laser is the most widely used excimer laser in North America. For customized wavefront treatments the wavescan aberrometry map data is loaded into the Visx S4 IR excimer laser for each unique eye to be treated. The wavescan aberrometry map also contains information regarding iris landmarks (the iris is the colored part of the eye surrounding the pupil). This iris information is used during treatment to recognize the unique eye to be treated and to adjust the treatment for cyclorotation and iris centration. Cyclorotation is the rotation of the eye which can occur between sitting upright and laying down. For some people this rotation may be greater than 10 degrees. The pupil may also shift slightly in response to lighting conditions. The iris recognition feature available on the Visx S4 IR excimer laser system allows for the precise application of the laser treatment for optimal results.

While many people have had satisfactory results with standard laser treatments, there is evidence to show that true custom wavefront treatments offer better results. An analogy that is often used is that of an off the rack suit compared to a tailor-made suit. Custom wavefront laser vision correction is tailored to your individual eye.

Choosing to have laser vision correction is a big decision. Considering all the factors involved including laser type and standard versus wavefront corrections will help you make the choice that is best for you.

More information is available in Dr. Anderson Penno’s latest book “Laser Vision Correction: What You Need to Know” which is available here.

To book a complimentary assessment with Dr. Anderson Penno, contact Western Laser Eye Associates today.

Epi-LASIK, PRK, LASIK & Epi-LASIK: Laser Vision Correction When You’re Over Forty

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For those over the age of forty who are considering laser vision correction, it is important to understand the effects of age on the ability to focus up close.

This age related loss of focus ability is called presbyopia. For people with good uncorrected distance vision and for those who have a full contact lens correction for distance, presbyopia means that at some point after the age of forty you will begin to need reading glasses (or reading glasses over your contacts) in order to read up close. As this age related process continues you will begin to need glasses for computer work and other intermediate work. People who wear glasses full time will need a progressive lens or a bifocal in order to read with their glasses on. Before progressive (lineless bifocal) lenses were available you would likely get a bifocal sometime in your forties, and then a trifocal to include the mid-range correction in your fifties. People with mild nearsightedness may simply take their glasses off to read rather than getting a progressive or bifocal eyeglass.

Those who wear contacts for distance with reading glasses over their contacts will eliminate the need for their distance contact lenses but will still need reading glasses after laser eye surgery if both eyes are corrected fully for distance. For people who wear bifocal or progressive lenses, laser vision correction will eliminate just the top distance correction if a distance target is chosen. Reading glasses will still be needed following surgery, and if you are in your fifties then a mid-range correction might be required as well. For the mildly nearsighted people who are over the age of forty, they may be trading their distance glasses for readers with a full laser vision correction. For this group, anything the ordinarily do with glasses off will require readers. An example is someone who does desk work all day with their glasses off and then puts their glasses on to drive home; this person will wear readers and possibly computer glasses all day at work and then take them off to drive home. It is important to understand the effects of presbyopia in order to make sure you will be satisfied with the outcome of surgery.

The only alternative to readers for those who undergo laser vision correction and are over the age of forty is to consider monovision. Monovision is when one eye is corrected fully for distance and the other is left mildly nearsighted for close work. This arrangement may work well for some people, but it is important to simulate monovision with contact lenses or with a trial-frame in your eye doctor’s office before considering it for a permanent laser vision correction. For a mildly nearsighted person, monovision may mean that a correction is done only in one eye and the other is left untouched. If possible the trial should include both ways – right eye for distance and left for close and then left eye for distance and right for close. Your optometrist can assist you in doing a monovision trial with contact lenses.

If you can adjust to monovision and are over forty, this option will give you the widest range of functional vision without having to put readers on and off. Monovision may not completely eliminate the need for glasses. Some people with monovision might prefer to wear glasses for night driving or to wear readers for detailed close tasks like sewing. Monovision is a compromise. Your best vision will be obtained with both eyes corrected, which is why some people with monovision will wear glasses for specific tasks. People who spend a large amount of time doing hobbies like tennis or golf or who depend on distance vision for their jobs like professional drivers may not be good candidates for monovision. In general, monovision is not recommended for younger people since the benefit of monovision will not be present until sometime after the age of forty.

Whether to do a full correction for distance or to do monovision with any of the laser vision correction techniques is a personal choice. It is important if you are over the age of forty to understand the choice you are making so you are not disappointed by having to wear reading glasses or computer glasses after surgery.

More information on monovision and other laser vision correction options is available in Dr. Anderson Penno’s book “Laser Vision Correction: What You Need To Know”. It is available at Amazon here.

To book your complimentary laser vision assessment, contact Western Laser Eye Associates today.

New Book About LASIK, PRK, Epi-LASIK, and Intra-LASIK

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Dr. Anderson Penno is pleased to announce that her latest book “Laser Vision Correction: What You Need to Know” is now available on

This book is an excellent resource for anyone considering vision correction surgery. You can find out more and buy the book here.

“Laser Vision Correction: What You Need to Know” is also available at and is coming soon to Kindle.

To book your complimentary assessment with Dr. Anderson Penno, contact Western Laser Eye Associates today.

Recovery after No-Flap Laser Vision Correction: PRK and Epi-LASIK

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Laser vision correction surgeries can be divided into flap and no-flap categories.

Flap treatments include LASIK and Intra-LASIK. These treatments involve creating a corneal flap, lifting the flap, and then applying the excimer laser energy to reshape the tissue under the flap. The corneal flap is then replaced. Creating a corneal flap carries some risk of flap problems at the time of surgery or possible flap shift after surgery. The flap allows for more rapid recovery of vision and less discomfort in the first few days.

The long term results are equally good according to many studies that compare flap to no-flap treatments. No-flap laser vision correction treatments, PRK and Epi-LASIK, have gained in popularity over the past few years due to the longstanding safety record of surface no-flap treatments. PRK was introduced over twenty years ago in North America. For PRK the surface cells called epithelium cells are removed with a brush or spatula. Epi-LASIK is a newer treatment that uses an epikeratome to remove the surface cells to prepare the surface for laser reshaping.

No-flap laser vision correction carries a lower risk than flap treatments and will take longer to recover from than flap treatments. No-flap treatments like PRK and Epi-LASIK require an investment of time for healing in return for an added level of safety with excellent long term results. The recovery from no-flap treatments can be divided into days 1-4, 3 days to 1 week, 1 week to 8 weeks,2 months to 1 year.

Days 1-4 following PRK and Epi-LASIK are when the surface epithelial cells regenerate. During this time a bandage contact will remain in place to help with comfort. The amount of discomfort in the first few days will range from mildly gritty or sore to more significant burning, stinging, and light sensitivity. During these first few days following a no-flap laser vision correction treatment it is important to use medicated drops as directed, to use copious lubricating drops, and to plan to rest as much as possible with the eyes closed. Most people will find the comfort and vision worsens over the first few days following surgery. Many people find that the worst of the discomfort occurs in the second 24 hours after treatment and then improves. Pain medications including special eye drops are provided for use if needed. While not everyone will need these pain relievers, a minority of people will be staying in a dark room with their eyes closed for a day or two.

Days 3 to 7 will be a period of vision improvement. In most cases the epithelium will be healed and the bandage contact lens will be removed on day 3 or 4. Following Epi-LASIK many people may be legal to drive within 5 days. With PRK the healing may result in vision in the legal to drive range at about 7 to 10 days. It is important to know that legal to drive is a few lines away from 20/20, so some people will chose to wait longer before driving. While many people will return to usual activities in this time, some modifications may be necessary such as more breaks from computer work or avoiding night driving. During this time fluctuations of vision may be present and the vision will continue to improve. Post-operative examinations are usually done every 1 to 2 days until the bandage contact lenses are removed.

Weeks 1 to 8 are a time of continued sharpening up of vision. During this time symptoms of dryness, night vision problems, and overall vision will improve. Some people will continue to need frequent lubrication drops. Most surgeons will recommend continuation of steroid eye drops to aid in healing. While many people will be very happy with their vision within several days after surgery, others will be happier after 1 to 2 months following surgery. Patience with healing is important following PRK and Epi-LASIK.

Post-operative vision checks are usually scheduled every 1 to 2 months for 3 to 6 months. In most cases it is advisable to wait up to 6 months before considering an enhancement surgery (touch up). The majority of people will have a stable correction following PRK or Epi-LASIK for many years following laser vision correction.

When considering a no-flap laser vision correction treatment it is important to understand the benefits of safety and excellent long term results in return for a longer recovery than with flap procedures. The majority of people have excellent results with PRK and Epi-LASIK.

For more information or to schedule your free laser vision consultation, contact Western Laser Eye Associates today.

LASIK, Epi-LASIK, PRK, Intralase and Diabetes

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Diabetes does not automatically disqualify you from laser vision correction surgery.

If the blood sugar is under good control and the prescription is stable you may qualify. If the blood sugar is fluctuating to very high or very low levels then the prescription may be unstable. In some cases a diagnosis of diabetes is made when fluctuating vision leads to a check of blood sugar.

Diabetic people are also at risk for diabetic retinal problems. Whether or not laser vision correction is being considered, people with diabetes should have annual eye examinations regardless of age. The American Academy of Ophthalmology’s patient education site Get Eye Smart has a campaign to get 10,000 diabetic people committed to annual eye examinations.

Over half of diabetic people do not get annual eye examinations and are at risk for vision loss. Over 90 percent of severe vision loss due to diabetes can be prevented by routine examination. For every pledge to have annual eye examinations the Academy of Ophthalmology will donate one dollar to diabetic eye health education.

For more information about laser vision correction in Calgary contact us today.

H1N1 (Swine Flu) in Calgary

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The H1N1 (Swine Flu) virus appears to be very active in Calgary at this time. While the H1N1 flu will not impact your suitability for laser vision correction, it is important to be aware of how the flu might impact you.

The Alberta Health Care (AHC) service has identified high risk groups for priority vaccination. These groups include children from 6 months up to 5 years old, children up to age 10 with chronic disease, pregnant women, care-givers of infants less than 6 months, and health care workers. Most health care workers have received the H1N1 vaccination. Health care workers are also instructed not to come to work if they have a fever. This will help to protect you when you come into a medical office for evaluations including if you choose to undergo a laser vision correction assessment or surgery.

The majority of people will recover from H1N1, however young children, pregnant women, and people with underlying problems like asthma or other health conditions are at risk for more serious disease. The CDC reports that over 70% of of the deaths from H1N1 have occurred in people that have underlying medical conditions.

If you are in a high risk group and qualify for the vaccination, it is recommended. Although the vaccine is new, so far there have been no significant numbers of adverse reactions to the vaccine. If you have symptoms of flu which include sudden onset of upper respiratory symptoms, fever, sore throat, and in some cases gastrointestinal distress and are in a high risk group then taking Tamiflu at the onset of symptoms may shorten the duration and severity of the flu. If you have a fever then you should avoid going to work and reschedule elective medical appointments to reduce the chance of infecting others. Frequent hand washing may help protect from infection. Wearing a mask will not protect you from the flu in most cases. More information about the H1N1 flu can be found at

To schedule a laser vision correction assessment or to learn more about laser vision correction call 403-547-9775 or contact us through

What is laser vision correction – LASIK,Epi-LASIK, PRK, Intralase?

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Laser vision correction refers to any surgical procedure that uses an excimer laser to reshape the cornea. The cornea is the clear surface on the front of the eye through which you can see the iris (colored part of the eye) and the pupil. The laser is used to vaporize the tissue in a precise pattern which reshapes the corneal surface such that dependence on glasses or contact lenses is reduced or eliminated. This process of vaporizing corneal tissue by the excimer laser is called ablation. In Calgary there are several surgeons who offer a variety of laser vision correction options. The main four treatments are no-flap treatments which include Epi-LASIK and PRK, and flap treatments which are LASIK and Intra-LASIK.

The surgeon who performs the procedure is an ophthalmologist who is a medical doctor (MD) with a specialty in the diagnosis of eye disease, treatment of eye disease, and eye surgery. The surgeon should be board certified. A surgeon who is board certified in the United States is designated as a Diplomate American Board of Ophthalmology (Dipl. ABO) and in Canada as a Fellow of the Royal College of Surgeons of Canada (FRCSC). There are often optometrists who work in association with an ophthalmologist who may do the initial assessment at some centers. Other staff such as technicians will also participate in your care.

The types of staff involved in your care may include:

Ophthalmologist (MD): medical doctor specialized in eye care and eye surgery
Optometrist (OD): doctor of optometry trained in medical eye care
Certified Ophthalmic Medical Technician (COMT): the highest technician
designation that assistants in eye care can achieve through the Joint
Commission on Allied Health Personnel in Ophthalmology (JCAHPO)
Certified Ophthalmic Technician (COT): second highest level of JCAHPO
certification held by assisting staff
Certified Ophthalmic Assistant (COA): first level of certification available to
eye care assistants through JCAHPO
Counselors: staff specializing in giving detailed information to patients.
Receptionist: staff who will be involved in scheduling appointments.

Pay attention to the quality of the front office staff including reception and secretaries. A well run center should have prompt and courteous care starting from your initial telephone inquiry and throughout your visits. If you choose to undergo surgery you will be spending time with a variety of staff members during your testing, counseling, surgery, and post-operative care.

Laser vision correction is also called refractive surgery or laser eye surgery. The procedures can be divided into two groups: those with flaps and those without flaps.

The most commonly available specific types of surgeries are:

Photorefractive keratectomy (PRK): the original no-flap surgery introduced in
in the US in1988 by Margueritte MacDonald.
Epi-LASIK: the latest no-flap procedure in which an epikeratome is used to
remove the outer epithelial layer to prepare for laser application.
Laser in situ Keratomeleusis (LASIK): the first flap procedure introduced in the
1990s in which uses a mechanical microkeratome to create a flap.
Intra-LASIK: a newer flap procedure which uses a femtosecond laser to create a

For PRK and Epi-LASIK the surface corneal epithelial cells are removed and the laser is applied directly to the corneal surface. For PRK the surface cells can be removed using dilute alcohol or with a brush. For Epi-LASIK an automated device called an epikeratome is used to remove the surface cells to prepare the corneal surface for the laser reshaping.

PRK has been around for over two decades and has an excellent long term safety record. Epi-LASIK is a newer technique that creates a precise epithelial removal that will help speed recovery. Because there is no flap to protect the surface while healing, PRK and Epi-LASIK result in more discomfort for the first few days after surgery and take four to ten days before the vision is recovered enough to resume driving and/or work. Medicated drops may be recommended a few times per day for a number of weeks or months after surgery. The long term vision results are excellent. The simplicity of the surgical technique means there is a lower chance of complications during surgery and no flap that could become damaged or dislodged due to injury in the future. Recently many surgeons have returned to PRK and Epi-LASIK as their recommended vision correction surgery due to the low rate of complications.

With LASIK and Intra-LASIK a corneal flap is created and the laser treatment is applied to the bed of tissue under the flap. LASIK was developed in the 1990s. LASIK is a combination of an older technique called lamellar keratoplasty in which a corneal flap was created and PRK. It has been called “flap and zap” in the past. For LASIK a mechanical device called a microkeratome is used to create a corneal flap. Flaps can range in thickness from 90 microns to 180 microns depending on the device used. For Intra-LASIK an ultrafast femtosecond laser is used to create the flaps.

Vision recovery following a flap procedure is quicker than with a surface treatment. In an uncomplicated case the patient may expect some discomfort and blurred vision for the first twenty-four hours. By the following day in most cases patients will be legal to drive, although there is long term healing that will be occurring so some patients may find the vision continues to sharpen for a number of days to weeks. There is a higher risk with flap procedures due to the complexity of creating the flap and the possibility that the flap could become damaged or shifted if a future eye injury occurs. In rare cases flaps may be shifted even months or years later. In most cases common sense eye safety should protect you from this type of injury. However, if you are in a high risk occupation or have high risk hobbies PRK or Epi-LASIK may be a better choice. Although higher risk, some consumers will opt for LASIK or Intra-LASIK due to the shorter recovery.
There may be reasons why a specific type of vision correction surgery may be recommended as safest for your individual case. Alternatively you may be given a choice of procedures, in which case you will need to weigh the risks and benefits of each procedure to make the choice that is right for you.

Regardless of the type of treatment you choose – flap or no-flap – the laser reshaping will be the same. Each center will have a different laser which is capable of different laser patterns. Some systems such as the Visx S4 IR can do a true wavefront treatment which can treat both the prescription as well as the higher order aberrations. The difference between a wavefront laser pattern and a non-wavefront pattern is like the difference between a tailored suit and an off the rack suit. Some systems will do a treatment with a specialized blend zone called an aspheric treatment. Aspheric treatments are not true wavefront treatments.

Your choices for laser vision correction include:
1. Flap or no-flap.
2. For flap treatments the choice is LASIK or Epi-LASIK.
3. For no-flap treatments the choice is Epi-LASIK or PRK.
4. Choice of surgeon & surgical center.
5. Choice of wavefront treatment (if available) or non-wavefront treatment.

If you have the time to undergo an assessment at more then one center you will be able to learn more about the options available at each center. For more information or to book an assessment, contact us at 403-547-9775 or