I Can See Clearly Now...

by Steve Friedman


In January of this year I found out that I had cataracts in both eyes. By May, it had become a significant visual impairment. Since I was diabetic, I had very limited health Insurance options in the US and my insurance carried a $7500 deductible. Even with my insurance, the cost for cataract surgery (in the US) would possibly exceed my deductible!  Since we were planning on moving to Costa Rica anyway, I decided to look into having the work there.  This is my story.

My research lead me to the ARCR Internet Forum.  For those not in the know, ARCR is the Association for Residents of Costa Rica, a group designed to assist others with planning or executing a move to Costa Rica.  There, I found the name of a doctor in San Jose who does cataract and other ophthalmologic surgery.  I emailed him in April and indicated that I need surgery and wanted to know how much such a procedure might cost.  Since I would not have insurance benefits in Costa Rica, I would have to bare the full cost. 

He quickly responded, explained the procedure and also pointed me to his website where he went into greater detail.  He also talked the costs and those factors that would impact the total cost.  Much would depend on the type of lens I chose and the type of anesthesia I selected, local or general.

The doctor, Adrian Rubenstein, is an Oxford trained physician who has his own clinic in San Jose.  He itemized exactly what my costs would be, and they were less than half of the estimate I received from my U.S. physician.  In total, I was looking at $3200!

This included the initial exam, surgery with lens replacement on both eyes and all post operative aftercare.


I set up my initial appointment by email.  My initial exam would take place upon our arrival  followed by the surgical procedure the next day.  Although this meant we drive to San Jose (about 3 1/2 hours) for the surgery, I figured it was more than worth it.  Plus, it gave us a chance to experience San Jose.

We booked a hotel room near the doctor's office and then took a taxi.  Thank goodness we did that because driving in downtown San Jose is a white knuckle experience. 

The clinic was nothing to look at from the outside, but one inside, it was clean and comfortable and well equipped. The doctor was prompt and it was very easy to understand him since he spoke fluent English (albeit with a slightly British accent).  We discussed my options and decided to go with the basic lens. Due to a heightened risk of infection, we opted to do one eye tomorrow and the second eye in a few weeks.


On the day of the surgery the office staff greeted me and began the preparation.  After receiving drops (I am assuming medication to dilate and anesthetize), I put on my surgical gown and assumed the surgical position.  From there it all became a wonderful, blissful blur.  In only 30 minutes Dr. Rubinstein was finished.

Since this was not covered by insurance, I did have to pay in advance for both the exam and the surgery, but the good news is I was able to use my US debit card!

The next day I returned for my follow-up visit but instead of seeing Dr. Rubinstein at his surgical center, I saw him at his other office located at Hospital CIMA in Escazu.  His report to me was nothing short of excellent.  I left his office with a prescription for eye drops and was told to avoid the pool or ocean for a few weeks.  Oh yeah... I was also told to take it easy!   No problema para mi.


The next week, we drove into San Jose again for a quick follow-up appointment, and then surgery on the other eye.  Again the procedure was a breeze, and my vision improved immediately.  The doctor wanted to see me back in a week and told me to call him anytime if I had any problems or concerns.

When my eyes appeared a bit bloodshot, I emailed him pictures.  He quickly responded and told me that there was no reason for concern.  Just continue with the drops. 


It has now been about a month since the last surgery and I can finally go in the water again. My vision has markedly improved to the point where glasses are no longer needed for any distant vision.  However I still need reading glasses for close work.  Hmmm... maybe I should have opted for the other lenses?

Considering the cost and level of care I received, I have no regrets and would do it again in a heart-beat.

The only difficult part of this was the travel to San Jose, but I was happy to do so for the result I got.


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