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Patient pathway

What happens during a
diagnostic examination for laser eligibility.

From the first phone call to the final decision, the EasyLaser patient pathway is designed so that you arrive at the examination already informed — and leave with a complete clinical assessment, not a sales pitch.
Dr. Federico Mossa·FMH Ophthalmology·April 2026·9 min read

The pre-operative diagnostic examination is the most important medical act of the entire pathway. The laser procedure takes 20-30 seconds per eye. The examination takes approximately 30 minutes. This disproportion says it all: the value lies in the diagnosis, not in the surgical gesture.

But the pathway begins before the examination. And continues after.

Before the examination: the patient portal

1
First contact
You contact us by phone, WhatsApp or via the website. The secretariat collects the essential data and schedules the appointment at the nearest clinic — Lausanne, Yverdon, Geneva or Mendrisio. One important reminder: no contact lenses in the 48 hours before the examination. Soft lenses temporarily alter corneal curvature and distort measurements. Rigid lenses must be removed at least 2 weeks beforehand.
Secretariat · Phone / WhatsApp / Website
2
Patient portal — digital access
You receive by email an access code to the EasyLaser patient portal, a secure area where you can comfortably complete from home — in your language — the necessary documents: privacy consent, medical history questionnaire, treatment information. Everything is digital, no forms to fill in the waiting room. When you arrive at the clinic, the secretariat already has your complete file and the examination time is entirely dedicated to diagnostics.
From home · Patient portal · IT / FR / DE / EN
Why the portal changes the examination. In a traditional clinic, the first 10-15 minutes of the examination are spent on paper forms, signatures and bureaucratic explanations. With us, all of this happens beforehand, digitally, in the patient's language, with time to read and reflect at home. The patient arrives at the clinic informed. The examination starts with diagnostics, not bureaucracy.

At the clinic: diagnostics

3
Welcome and data verification
The optometrist — Miorica Bertelli in Mendrisio, Clémence Gagnaison in Lausanne, Yverdon and Geneva — verifies the digital file, confirms the medical history and briefly discusses the patient's expectations. Why do you want to remove your glasses? What work do you do? Do you practise sports? This initial conversation guides the entire examination.
5 minutes
4
Objective and subjective refraction
The optometrist measures the refractive error with the autorefractometer (automatic measurement) then refines it manually with the subjective test if necessary — the classic lenses "better this way or that way?". Both measurements must converge. The refractive error determines how much cornea needs reshaping — and is therefore the first eligibility filter.
5 minutes
5
Corneal topography and tomography — MS-39
The heart of the examination. The CSO MS-39 tomographer scans the cornea with a combination of Placido disc and anterior OCT, generating over 25,000 measurement points. It produces a complete three-dimensional map: anterior and posterior curvature, thickness point by point (full-field pachymetry), elevation profile, epithelial map. This map reveals what a traditional pachymeter cannot see: a localised epithelial thinning is often the first sign of subclinical keratoconus. The examination takes 2-3 seconds per eye — the patient fixates a light, without contact.
3 minutes
6
Aberrometry — Peramis
The SCHWIND Peramis aberrometer measures the optical aberrations of the entire visual system — cornea, crystalline lens, vitreous. It captures the complete wavefront profile: low-order aberrations (sphere, cylinder) and high-order (coma, trefoil, spherical aberration). This data directly feeds the calculation of the personalised ablation profile — the AMARIS 1050RS laser does not apply a standard treatment: it calculates an individual profile for each eye.
2 minutes
7
Pupillometry and ocular dominance
We measure the pupil diameter in mesopic and dynamic light conditions. A very wide pupil in low light influences the optical zone of the treatment and the risk of night halos. We also determine which eye is dominant — essential information for PresbyMAX and any presbyopia strategy.
3 minutes
8
Slit-lamp examination and fundoscopy
The optometrist examines the eye with the biomicroscope: cornea (scars, opacities, neovascularisation from contact lenses), crystalline lens (early cataract?), anterior chamber. After instillation of mydriatic drops, the fundus is examined: retina, macula, optic nerve, vitreous. This is the examination that no machine can replace — it requires the clinical eye of the examiner.
10 minutes
9
ForeSight AI simulation and final consultation
All data converges in the ForeSight system integrated into the AMARIS 1050RS laser. The patient sees the estimated result of the procedure: planned correction, visual profile at all distances, safety margins. The optometrist explains the results, answers every question, and formulates the clinical recommendation: proceed, do not proceed, or wait. All results are always verified by Dr Mossa, who personally sees every patient before the procedure. No pressure, no urgency.
15 minutes

After the examination: time to decide

The patient receives in their digital portal the complete measurement report and clinical recommendation. They can reread everything, discuss it with whomever they wish, and make their decision independently. If they decide to proceed, the secretariat schedules the date — usually within 2-4 weeks. If they decide to wait, the data remains valid for 6 months.

The day of the laser: nothing is taken for granted

On the day of the procedure, the patient is not taken directly to the laser room. They are re-examined by the optometrist and Dr Mossa. We verify that nothing has changed since the diagnostic examination: refraction, corneal status, general conditions. The patient has time to ask their final questions or express any concerns. Only after this confirmation do we proceed.

Pre-operative offset evaluation

Before each procedure, the AMARIS system performs a measurement called offset: the distance between the pupil centre and the corneal vertex. This difference — often less than half a millimetre — is different for each patient and changes between sitting position (during the examination) and supine position (during the laser). If the laser does not compensate for the offset, the treatment is decentred. The AMARIS 1050RS measures and compensates for it automatically before starting the ablation.

AMARIS 1050RS: the only one with real-time verification

The SCHWIND AMARIS 1050RS laser is the only system in the world that integrates a series of measurements in real time, before, during and after the procedure, within the same laser session:

Pupillary offset — measured and compensated automatically in supine position, before ablation.

Cyclotorsion — the rotation of the eye when the patient moves from sitting to lying position. The AMARIS detects it by comparing iris markers and compensates in real time: without this correction, the astigmatism treatment would be shifted from the correct axis.

Integrated pachymetry — corneal thickness is measured before and after ablation during the same session, confirming that the tissue removed corresponds exactly to the plan.

Intraoperative OCT — optical coherence tomography monitors the corneal profile in real time during ablation. The surgeon sees the cornea layer by layer while the laser works — not afterwards, not the next day: during.

7D eye-tracker at 1050 Hz — tracks eye movements across 7 dimensions (x, y, z, cyclotorsion, pupil) one thousand times per second. If the eye moves too much, the laser stops automatically.

No other excimer laser available today integrates all these measurements within the same surgical session. Most competing systems rely on data acquired during the diagnostic examination — hours or days before — without verifying them in real time at the time of the procedure.

Informed consent: an act of transparency

Before each procedure, the patient signs an informed consent. It is a document that describes the procedure, expected results and theoretical risks. This is a mandatory standard in all surgical clinics — it is not a particularity of ours, it is a legal and ethical requirement that no surgeon can avoid.

Informed consent can be concerning when read for the first time: it lists scenarios which, however extremely rare, must be mentioned by law. It is normal to feel apprehension.

A fact from our experience: across more than 25,000 procedures performed by Dr Mossa, there has never been a case of vision loss after laser. This does not mean that the theoretical risk is zero — no medical act has zero risk — but in real clinical practice, with the instrumentation and protocols we use, the safety margin is extremely high.

Why the safety margin is so high

Our clinical pathway is ISO 9001 and ISO 13485 certified — the international standards for quality management and medical devices. Every step of the pathway is tracked, verified and documented. The AMARIS 1050RS laser undergoes regular inspections by SCHWIND and certified periodic calibration. The 7D eye-tracker at 1050 Hz, intraoperative OCT and integrated pachymetry verify every parameter in real time during ablation. Under these conditions, technical error is virtually impossible.

Your right to full control.

Informed consent and all legal documents — privacy information, pre- and post-operative instructions, drug therapy — are always available in the patient portal and can be downloaded at any time.

At any time before the laser, the patient has the right to withdraw and completely delete all their data, directly from the portal, with a single click, without any prior communication. No phone call, no email, no justification. One click.

After the procedure: the portal accompanies you

Once the laser is complete, the patient receives post-operative instructions and drug therapy (eye drops) directly from the optometrist — and finds them all in their patient portal, accessible at any time in their language. No paper to lose, no doubts at home at 11pm. The portal reminds them of check-ups, instructions for drops, and offers direct contact with the clinic.

What we look for — and who we exclude

The examination is a filter. We look for anomalies that contraindicate the procedure: signs of keratoconus (even subclinical — the posterior tomography of the MS-39 is more sensitive than any automatic index), corneas too thin for the error to correct, early cataract, retinal pathologies, expectations not aligned with the possible result.

A fact: approximately 10-15% of patients who come for an examination are not eligible for laser. In these cases, we explain why, suggest alternatives (specialised contact lenses, ICL, CLE where indicated), and the patient pays nothing. The examination is free even when the answer is no.

Why technology makes the difference

An ophthalmologist with a keratometer and an ultrasound pachymeter measures 4 curvature points and 1 thickness point. We measure 25,000 points of curvature and thickness, the complete aberrometric profile, and the predictive simulation of the result. Subclinical keratoconus escapes the keratometer. It does not escape MS-39 tomography.

If eligibility was denied with less advanced instrumentation, a second evaluation with tomography and full aberrometry can change the answer.

FOTO
Dr. Federico Mossa
FMH Ophthalmology · Medical Director CEMO
Specialisation University of Oxford. +25'000 procedures.
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Dr. Federico Mossa FMH Ophthalmology  ·  Medical Director CEMO since 2011  ·  +25'000 procedures  ·  6 publications: JCRS · JAMA · BJO · Eye · Springer  ·  Updated April 2026
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