Clearview Eye and Laser Medical Center

BI² Technologies™ in Plymouth, MA, a company that provides technology for biometric intelligence and identification, has developed an iris recognition technology that gives reliably accurate identification. It is named I.R.I.S.™ which stands for Inmate Recognition and Identification System.

How Iris Scanning Works

The system uses automatic voice prompting and automatic focusing. It detects an individual immediately as he or she approaches the digital camera. The person simply looks briefly in the aperture mirror and images are captured of both irises. These are processed into a format called an IrisCode® record. The person being identified must agree to participate and must look into the camera from a distance of 3" to 10".

Portable or Fixed

Law enforcement officials can use a portable system in the field or in their vehicle. It adds accuracy and speed to fingerprint identification and can be integrated with existing jail management systems. It could help prevent escape attempts based on false identities. It can catch each new alias an offender might have, as he is apprehended under each alias.

Identifying Sex Offenders

This is to warn family neighborhoods of a sex offender moving in after being released from jail. Minnesota led the way in its Sex Offender Registration Act, and the nation has been working to build a comprehensive, nationwide registry of sex offenders. Sheriff's offices in California, New Mexico, and Massachusetts have acquired iris recognition technology and begun to create their own databases.

How is This Accuracy Possible?

Because no two irises are the same. Not only is the iris unique, but each human eye is unique, as every LASIK surgeon knows who has used Wavefront technology. Your two eyes are each one-of-a-kind, and if Dr. Feldman were to give them LASIK treatments, each treatment would be unique. Nor do twins have similar irises. After the age of about one year, the iris does not change throughout a person’s life.

Growing Popularity

BI² Technologies has also developed a similar system for locating missing children. It is called The Child Project™. Similar technology is becoming more popular in:

• Health care – where it limits access to sensitive areas such as newborn nurseries and medical records storage
• Aviation – where it speeds up boarding procedures
• Schools – where it helps in identifying students and ensures that only authorized parents or caregivers can pick children up after school
• Corporate buildings – where it provides access control

Vision and eye health research is being done constantly and technology continues to become more refined and sophisticated. At ClearViewEye, we keep up with all new vision correction technology and ideas, and when we feel they are safe and reliable we use them to give you the best vision possible. Please contact us for a free consultation if you would like to know more.

Intacs™ eye implants are used to treat nearsightedness, as this space discussed on January 22. Not everybody is a good candidate for LASIK, and Intacs are a good alternative. Intacs are also a good way to treat Keratoconus.

What is Keratoconus?

It’s a condition of the cornea, the front clear part of the eye. Our eyes are filled with fluid and under a certain amount of pressure. The cornea resists the internal pressure and holds the eye's shape. Sometimes, the cornea weakens and the pressure causes it to bulge forward, impairing vision.

It develops slowly in most cases, and is therefore not noticed right away. But the eye becomes more myopic and astigmatic as the cornea becomes steeper and less smooth. You might also notice increased light sensitivity. Your prescription would be changing quite often.

Causes are not fully understood. But it is thought that an enzyme imbalance in the cornea might make it more susceptible to damage from free radicals. It tends to run in families. It is associated with too much sun exposure, chronic eye irritation, excess rubbing of the eyes, and poorly-fitting contact lenses.

Treatments have been:

• Soft contact lenses, which are not effective for very long
• Rigid gas-permeable contact lenses which help give a smoother shape to the cornea but are uncomfortable
• Use of both soft contact lenses and rigid lenses over them, which helps cushion the discomfort of the rigid lenses but can reduce the amount of oxygen passing through to the eye
• Hybrid contact lenses which have an oxygen-permeable, rigid center and a soft periphery.

Advantages of Intacs

These small plastic slivers were FDA-approved for keratoconus and myopia in 2004. By slightly raising the corneal edge, they have the effect of flattening the keratoconic bulge without pressing down uncomfortably on the center of the cornea.

• The procedure for inserting them takes only about ten minutes
• They can be easily removed if necessary
• They have been shown to improve vision by two lines on the standard eye chart

To learn more about Intacs and whether they might be a good option for you, please call or email us to arrange for a complimentary consultation.

A myopic eye has strong refractive power. Alternatively, you could say it is too long, relatively speaking. In other words, the cornea bends incoming light at too great an angle, making it focus before it gets to the retina. That leaves the light-sensitive retinal cells with less-than-clear image information. They send it on anyway, via the optic nerve to the brain's vision center. The brain has insufficient information to give you a clear image.

Why does a myopic cornea bend light too much for the length of the eye (that is, the distance to the retina)? Because it is too curved. All translucent curved structures bend light rays (the eye's lens is another example). A nearsighted eye is too steeply curved and that is why a LASIK laser can correct it. The laser vaporizes tiny pieces of it to flatten the curvature exactly the right amount for clear vision.

Intacs are an alternative treatment. They are extremely thin, new-moon-shaped, transparent plastic implants. Each cornea receives two, on opposite sides. Their presence changes the cornea's curvature by very slightly raising the periphery. This makes the curvature less steep.

You can't feel them once they're positioned in the cornea. They need no maintenance. They are FDA-approved. They are removable by an ophthalmologist, which makes it a reversible procedure, unlike LASIK, which is permanent. To date they are available only for low degrees of myopia, namely -1 to -3 diopters – however, this takes care of over half of myopic people.

If for some reason you would prefer not to have refractive surgery, or if you have been ruled out as a good candidate for it, Intacs may be an excellent alternative. Please give us a call or send an email to set up your consultation about it.

January is National Glaucoma Awareness Month, a time to learn about this eye disease that causes blindness. Only cataracts cause blindness more often than glaucoma.

Glaucoma is a quiet condition that creeps up slowly. You would not notice it at first. If you seldom have your eyes checked, it could progress quite far before being discovered. It consists of increased pressure inside the eye. The eye is filled with fluid, and there are tiny drainage holes in the inside corners of the eyes to allow it to leave the eye as it is refreshed, thus keeping the pressure constant.

In glaucoma, the small drainage holes known as the puncta become blocked or constricted. Fluid thus builds up, causing intraocular pressure to build up. The result is damage to the optic nerve.

The optic nerve

This is a large nerve running from the retina at the back of the eye, to the vision center in the brain. It carries information which the retina has received in the light entering the eyes, and has converted from light energy to neural energy. When optic nerve fibers are destroyed, they do not grow back and cannot be replaced. You can see a good diagram of the eye on our How the Eye Works page.

Blood flow to the optic nerve is also involved, and ophthalmologists are continually learning more about how and why glaucoma develops, and how to treat it. The important thing is to catch it early.

If you have any family history of glaucoma, be careful to have your eyes checked every year.

Today this writer watched a live IntraLase procedure, done for a co-worker (not at Clearview Eye and Laser Medical Center, but it’s the same treatment as is done here). These are some things that took longer than the vision correction:

• Driving to the office in commute traffic
• Finding a parking place
• Finding the Ladies' room (I should have asked!)

It took no time at all to obtain permission to watch, as there is a viewing window for this purpose, with a video screen that shows close-up detail. My co-worker had worn spectacles most of his life and had saved up for this life-changing day. He looked comfortable lying on the VISX patient bed and I could see how easily the surgeon moved the bed's position with his knee.

The IntraLase laser machine was as large as the VISX CustomVue machine, one on each side of the bed. On the video screen I could see the eye image changing from dark to light as the IntraLase laser rapidly moved from side to side up the entire treatment area, making its microscopic little bubbles in the cornea. Then the screen showed a close view of the surgeon lifting back the corneal flap. It was truly thin and delicate, very precisely created, and lay back on its tiny hinge quite easily.

The excimer laser treatment took mere seconds. Of course, the treatment plan had taken more than seconds to devise, so that exactly the right corneal area would be targeted, at exactly the right depth. The surgeon replaced the flap with no trouble, smoothing it down in various directions so that it would heal easily.

My co-worker was on his feet and being led gently to the recovery room almost before I realized his procedure was finished. His vision was blurry at this point, but his instructions were to go home and sleep, and to use the prescribed eyedrops at the right intervals. He had printed instructions. An important item was not to rub his eyes, as that would potentially displace the corneal flap before it healed.

As I left, he said, "See you tomorrow!" He’ll be back at work as usual, minus his spectacles.

Lazy Eye is the popular term for amblyopia, which is too large a discrepancy between the dominant eye and the other one. When one eye does most of the work, the brain discounts what comes from the other eye, and it does even less work.

Lazy Eye is a rather inaccurate term because no laziness is involved. When a baby is first learning to focus on things near and far, the eyes need plenty of light so that sharp images will be possible. Without adequate light and enough things in the environment to look at, eye development is impaired.

Amblyopia is not an eye structure problem like myopia, hyperopia, or astigmatism, which are all correctable by LASIK. The eyes may be perfectly fine 20/20 eyes, but the brain/eye connection is impaired. The brain is giving preference to one eye's visual data.

Sometimes amblyopia results from the eyes being crossed, sometimes from one eye being better at focusing than the other. Whatever the exact cause, the end result is that one eye becomes dominant to the point of being the only one used by the brain, and the other one becomes weaker until it is useless. Lazy Eye is often associated with Strabismus, a condition where the eyes are uncoordinated and focus in different directions. (One eye is “turned”.)

Treatment depends on what the cause is. For example:

• If the eyes are crossed, surgery on the eye muscles can straighten them.
• If the eyes have unequal focusing power, glasses can be prescribed to restore the balance.
• An eye patch can be worn over the dominant eye to force the "lazy" eye to function more fully
• Eye drops or an ointment can be used to blur vision in the dominant eye and thus force the other eye to work harder

Early detection is crucial for successful treatment. If a child's amblyopia goes uncorrected, binocular vision will not develop. Be sure and have your child's vision checked at an early age.

Our two eyes work together, each sending its image information through its optic nerve and leaving it for the brain to sort out the differences, determine what the image is, and find a name for it.

Subjectively, we aren’t usually aware of seeing two slightly different versions of everything. But if you close one eye and then the other you'll see the slightly different perspectives. All of us have a dominant eye, though it's not an issue and not something we would ever think about. It's also not connected to being right- or left-handed.

You can find our which is your dominant eye with a simple test.

1. Take a piece of paper and cut a hole in the middle about an inch square.
2. Hold it at arm's length and look through the hole at something stationary.
3. Keep your eyes on that object and slowly bring the piece of paper towards your face until it touches your nose.
4. Now the hole is directly in front of your dominant eye.

Our dominant eye is the one that looks directly at objects. The non-dominant eye looks at a slight angle. It's a good thing we have this discrepancy because it gives us depth perception. Using the two perspectives, the brain can judge relative distances.

Eye dominance becomes an important factor if you are considering monovision to correct presbyopia ("middle-age" vision with those darn reading glasses). A monovision treatment gives one eye a contact lens or LASIK treatment for near vision and leaves the other eye as is. How would Dr. Feldman decide which eye to treat? It would be the dominant eye, because that's the one which looks directly at objects.

One of the disqualifying conditions for a LASIK candidate has long been myopia (nearsightedness) that's "too severe". It's been a judgment call by the LASIK surgeon. However, for many years now, some severely myopic people have been having LASIK anyway. But for lack of any solid research results, controversy has continued as to how effective LASIK can be for severe myopia.

The January 2008 issue of the American Journal of Ophthalmology has just published results of a study which evaluated high-myopia patients ten years after their LASIK surgery had been done. It was conducted by university researchers in Spain and Turkey. They worked with 118 patients -- 196 eyes. (In discussing LASIK research, one usually talks about 'eyes' rather than “people”.)

These 118 LASIK patients had needed strong eyeglasses before their surgery -- at least 10 diopters. (A diopter is the unit of measurement for a lens. A lens of 10 diopters is very convex and we would probably call such glasses "coke bottle glasses".)

The researchers found that:

• 40% of patients now wore no glasses;
• 60% of the treated eyes were within 2.00 diopters of 20/20 vision;
• Only 5% of eyes had lost visual clarity to the extent of 2 lines on the Snellen eye chart;
• The retreatment rate was 27%;
• Only 2 of those 196 eyes had developed corneal ectasia. That is a complication of an over-treated eye, where too much corneal tissue has been removed, and the remaining tissue is not thick enough to contain the eye's internal pressure. The result is a bulging of the eye and vision impairment. This is one of the reasons why LASIK surgeons have been reluctant to treat severely myopic people, for fear that too much tissue would have to be removed for safety.

These results are thought to be very positive as to LASIK's effectiveness over the long term for severe myopia.

LASIK 10 years ago vs LASIK now

These people had LASIK 10 or more years ago. Since then, LASIK has improved and refined enormously, with Wavefront-guided treatments and IntraLase giving far superior results than any LASIK done 10 years ago. At ClearViewEye, we offer both Custom LASIK using the WaveScan wavefront system, and IntraLase. Give us a call or send an email if you’d like to look into things further.

• LASIK
• PRK
• IntraLase
• Presbyopia
• Implantable Contact Lenses
• Intacs
• Cataracts
• BOTOX®

Previous Posts

• LASIK 101
• LASIK For Astigmatism
• Preparing for LASIK surgery
• What to expect at a LASIK consult
• Iris registration and LASIK
• Affordable options for LASIK
• Is LASIK possible after implantable contact lens s...
• How long is recovery from implantable contact lens...
• How long do implantable contact lens last?
• Are there different types of implantable lenses?

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