Clearview Eye and Laser Medical Center

Just as with any surgery, there are risks involved with LASIK eye surgery. A good LASIK surgeon such as the ones at Clearview Eye and Laser Medical Center in California will discuss all possible risks with you before you schedule your LASIK surgery. The most common potential problems that may occur during laser vision correction surgery are over-correction, under-correction and what is called “wrinkling.” Wrinkling is a bit more serious than over or under-correcting your vision. Wrinkling means that the corneal flap might have been moved causing wrinkles that could possible lead to permanent blurry areas.

Some other side effects include:

Increased sensitivity to light
Halos around eyes
Blurred vision
Double vision

These symptoms typically lessen in the first few weeks following LASIK surgery. However, there is also a chance for corneal damage and/or scarring, which can lead to partial or full vision loss. Making sure you are a good candidate for LASIK is a good way to avoid these complications from occurring.

Please contact Clearview Eye and Medical Laser Center in San Diego today to get started on your brighter, clearer future!

Even if you undergo LASIK or PRK (photorefractive keraterctomy) as a young person and achieve 20/20 vision, you will still develop a condition called presbyopia usually between the ages of 40 and 50. Presbyopia is the inability of the eye to focus at all distances and is usually noticed when fine prints begin blur.

Doctors often disagree about what is the cause of presbyopia, but most believe that stiffening of the eye's lens contributes to the condition. Others believe that presbyopia could also be associated with continued growth of the lens or atrophy of the muscles controlling the lens. In the past, the remedy for presbyopia was to wear reading glasses or bifocal lenses. In modern times, however, surgical remedies for this condition are available for qualified patients.

Monovision to Treat Presbyopia

One of the first effective surgical options for presbyopia correction involved producing what is known as "monovision" during LASIK. One way that eye care professionals treat presbyopia is by producing monovision. Normally, both of our eyes work together equally when we look at an object, to produce what is called binocular vision. However, most of us have a dominant eye that our brain tends to favor.

Contact lens fitters take advantage of this one-eye dominance to produce monovision with the contact: they fit one eye for distance vision (the dominant eye) and one for near vision. In monovision, one eye does more work than the other one. If one of our eyes is set for distance vision and the other is set for near vision, the distance eye will do most of the work when looking at objects in the distance, and the near vision eye will do most of the work when looking at objects close by.

LASIK surgeons will sometimes produce monovision in their presbyopic patients by purposely leaving the non-dominant eye slightly near-sighted so that they can see up close without glasses (out of one eye). Many, however, are wary of this technique because not everyone can become used to the absence of binocular vision. It is suggested to try monovision with contact lenses or trial lenses in the doctor's office first to be sure you can adapt.

FDA Approval

Monovision LASIK initially was used off label, meaning that it had not yet received official Food and Drug Administration (FDA) approval as an approach to correcting presbyopia. In July 2007, the FDA announced approval of the Advanced Medical Optics (AMO) and Visx CustomVue excimer laser for performing the monovision procedure. The FDA has asked AMO and Visx to conduct a six-month study evaluating visual outcome and quality-of-life issues for 500 individuals who have undergone monovision LASIK.

Please contact Clearview Eye and Medical Laser Center in San Diego today to get started on a clearer, more vivid path in life!

iLASIK, or the two laser method of LASIK is the latest revolution in LASIK. and represents a decade worth of technological advancements. There has never been a better time to have LASIK as it is safer and more precise than ever before.

• iLASIK, involves the combination of two lasers to customize the treatment on your eyes.
• No two people get the same treatment and almost everyone, achieves 20/20 vision [98% 20/20 or better in low to moderately nearsighted individuals with or without astigmatism].
• Studies from the military showed that almost 90% of Navy pilots reported seeing better for landing on aircraft carrier
• And more than 90% of marksmen had improvement in their skills after LASIK!

Why wait? iLASIK is truly a medical innovation...... Read below for more information on iLASIK...

iLASIK is the name for a treatment which combines wavefront-guided LASIK with IntraLase.

For several years now, the VISX Wavefront-guided LASIK system has been a leading technology for delivering LASIK treatments. At ClearView Eye and Laser Medical Center, this is the system we have used for years, and we have found it to be outstanding in its results and safety record.

It consists of:

• A diagnostic unit which sends light to the patient's eyes, receives the returning reflected light, and records it as a colored 3-D map of the eye's microscopically precise contours
• A computer which uses this information to guide the treating laser, under Dr. Feldman's control
• The excimer laser for treatment
• Iris Registration for tracking any eye movements during treatment and keeping the laser correctly focused
• A microscope for Dr. Feldman to see exactly what is being done during treatment
• A comfortable patient bed

What is IntraLase?

Some people have corneas which are too thin or too steep for LASIK. IntraLase is an alternative way of doing LASIK which is safer for these people. Instead of creating the corneal flap with a blade, it uses a second laser, known as a femtosecond laser. A femtosecond is a quadrillionth of a second, and this is the speed of this laser's light pulses. So extraordinarily fast that the human mind can't imagine it.

To create the flap, which must be thinner than average because of the person's thinner corneas, the femtosecond laser is directed across the treatment area in a pre-determined plan. Each rapid pulse of its light creates a tiny bubble below the corneal surface, where bonds are broken between molecules.

Now Dr. Feldman only has to gently fold this loosened flap back and proceed with treatment. No cuts have been made. Only tiny pieces of tissue have been evaporated to loosen the flap tissue.

An IntraLase Flap and Wavefront-Guided Treatment

iLASIK is a new name for this combination which has been done before. A new name was devised because the VISX company was purchased by AMO (Advanced Medical Optics). They are the manufacturers of the ReZOOM™ intraocular lens and many other eyecare products. They have combined their technologies with those of VISX.

At ClearView Eye and Laser Medical Center, we offer iLASIK. If you would like to learn more about it, and whether it might be the best option for your vision correction, please call or send us an email to set up your complimentary consultation.

PresbyLASIK, also called multifocal LASIK, is not yet approved by the U.S. FDA, but it is apparently bringing great results in Canada. The idea is similar to that used by ReZoom™ and ReSTOR®, two of the intraocular lenses (IOLs) used to treat both cataracts and presbyopia in the U.S. In an IOL procedure, the natural lens is removed and an artificial lens replaces it.

A ReZoom or ReSTOR lens has concentric circles built into it, each a different refractive zone. Refraction is the bending of light rays. If light entering your eyes is to focus on the retina and give you clear images, it must be bent, refracted, at the right angles. The ReZoom lens has a central area designed to give clear distance vision, and four concentric rings around it, each designed to give clear vision at closer and closer distances.

PresbyLASIK is founded on the same principle, except that those concentric circles are created right on the cornea. The central cornea is steepened for clear near vision and the rest of the cornea is slightly altered in concentric zones for clear vision at intermediate and far distances.

So far, hyperopic eyes seem to do better with it than myopic eyes, according to Dr. Jackson, professor and chairman of ophthalmology, University of Ottawa, Ontario, Canada. They have not yet tried it with normal eyes, that is, with people who have 20/20 eyes but have developed presbyopia.

In the U.S., PresbyLASIK is being done in trials only. Several ways of doing it are being tested to see which is more effective for myopic eyes and which is more effective for hyperopic eyes.

Our FDA does not rush into things. If you are developing presbyopia and would like to learn more about how it can be treated right now in the U.S., please contact us for a consultation with Dr. Feldman.

The expansion of health food stores attests to the increasing interest people have in preventive health care. We'd like to avoid health problems by eating well and perhaps taking supplements. One big problem is the lack of definitive information about effectiveness of any given food or ingredient. Research goes on all the time, worldwide, and at times we hear of study results which suggest that a certain ingredient or chemical helps in some particular regard.

The January issue of The Archives of Ophthalmology reported on a ten-year study of 35,000 women. After they adjusted statistically for variables such as smoking, body mass index and alcohol use, the researchers found that cataracts were less likely if the women ingested more Vitamin E and lutein. They found a 14% difference in cataract risk between the one-third of women who consumed the most of these and the one-third who consumed the least. Cataracts are a clouding-up of the eye's lens and if left untreated will cause blindness.

Both Vitamin E and lutein are antioxidants. To cut a long chemical story short, an antioxidant is a molecule which helps reduce free radicals in the body. Free radicals are unstable molecules that cause tissue damage which could lead to disease. Vitamin E is the most abundant fat-soluble antioxidant in the body.

Vitamin E is in nuts, whole grains and leafy green vegetables. Lutein is in corn, kale, spinach, and some other fruits and vegetables. So the old advice of “eat fresh fruit and vegetables every day” is still good advice. Supplements of Vitamin E and Lutein may not be necessary, since more is not always better. But a healthy diet will never lead us astray.

Please call or email us if you would like to consult with Dr. Feldman.

This year I wanted to do something special and a little different. I have lived and practiced in San Diego for the past 22 years and think this is the best city in the world. I just wanted to do something to give back especially after October 2007 – what a year.

In the three most romantic spots across the city, Dr. Feldman has placed three Red Murano Hearts. The first to find all of the hearts wins two box tickets to a 2008 Padres baseball game for you and your significant other to enjoy.

Below are the clues to each of the hearts - Good Luck.

1st Clue:
Coming from around Cape Horn to find a home in the heart of the city – I left my heart across from where eggplant is always at the top of the menu.

2nd Clue:
Across from my favorite cove where a “Passionate Pepper” always makes me smile, I’ve left my heart in one of two bouquets which hang in front of a woman’s best friend.

3rd Clue:
Rising from the water’s edge is my favorite island where romance and magic are served daily. This lovely Victorian has been host to President’s and Hollywood stars alike --- my favorite spot is as the water touches my toes and the view of the sunset is warming my face.

For more information on Dr. Feldman and the ClearView Eye and Laser Medical Center email or call us at (858) 452-3937.

Corneal ectasia happens after LASIK very infrequently. It arises from the flap that is created on the corneal surface as the first step in LASIK vision correction. The flap must not be cut too deeply. If it runs too deep, it could damage the cornea's structural integrity. The cornea has several crucial jobs to do if we are to see well. One is to let light through and bend it at the right angle. Another is to contain the eye's internal pressure. It needs to have a minimal thickness to contain the pressure successfully.

If the cornea were to be weakened by a flap cut too deeply, it could start to bulge forward from the pressure behind it. This is corneal ectasia and it impairs your vision, making you more nearsighted. There is no way to correct this new nearsightedness, as another LASIK treatment would remove more tissue and weaken the cornea further. The only way forward would be a corneal transplant.

We each have corneas of a specific thickness – some are too thin to have LASIK safely done. Corneal thickness is one of the things tested in determining your candidacy for LASIK. At Clearview Eye and Laser, we screen our candidates very thoroughly. Among many other things, we measure corneal thickness and do corneal topography to make sure there is enough corneal tissue for a safe eye surgery.

Please contact us for a consultation and eye examination if you are thinking of having any vision correction.

Many patients have quite a few questions about the do's and don't after LASIK eye surgery. They are quite simple and as follows:


Do's:

• Go home and rest after surgery. It is wise to sleep after LASIK surgery for a few hours.


• Showers and baths are fine after LASIK. Just avoid getting water in your eyes.


• Wear sunglasses the day after the procedure.


• You may exercise beginning three days after the procedure as long you avoid rubbing and the sport is not contact.


• Enjoy seeing the license plates on your way home.

Don'ts:

• Do not rub your eye for one month after your procedure.


• Avoid swimming, hot tubs and gardening for seven days after LASIK.


• Do not wear make up for one week after surgery. Be sure to buy new mascara and eyeliner as once opened, these containers are no longer sterile.


• Do not drive after surgery until you are examined after the first postoperative appointment.

These are quite easy for patients to follow immediately following LASIK.

Dr. Feldman

Labels: After your LASIK

Some say that Glaucoma is on the rise these days. That's how it might seem, but the reality is that ophthalmologists are better now at finding it, and we have more people living to the age when it typically develops. The older we grow, the more at-risk we are for glaucoma, but some groups are more at risk.

• Those with a family history of glaucoma
• People with high blood pressure
• People with thinner corneas
• African-Americans and Asians – because they tend to have thinner corneas
• Diabetics

Glaucoma is increased pressure within the eye which slowly damages the optic nerve. This gradually shrinks your field of vision, so gradually that you won't notice it until a lot of it is already lost and can't be restored.

Glaucoma is not hard to live with if it's detected early. You just need to use your eyedrops as directed and go for your regular check-ups. There are several ways to detect glaucoma, such as:

• The Puff Test -- which shoots a puff of air at the eye to measure its pressure
• Visual Field Test -- which is done with a machine you look into for about 20 minutes. Tiny lights flash on and off, here and there, and each time you see one, you press a little button on a computer-mouse-like device. A print-out will show a diagram of each eye's visual field and where vision is lost, because you didn't see the lights flash on in that area.
• A Pressure Test -- where a machine touches the cornea to detect the intraocular pressure. For this you have numbing eyedrops, and there's no pain or discomfort.
• Use of a gonioscope to examine the eye's drainage system. Dr. Feldman would first numb your eyes, then gently hone in through her slit lamp and the goniolens. (The slit lamp is that tall lens apparatus which is usually in examination rooms. It focuses a bright light into your eye as you rest your chin and forehead against it.)
• Use of a pachymeter to measure corneal thickness.

There are other tests too, and putting it all together, Dr. Feldman can tell you whether you are beginning to show signs of glaucoma. If you are, you would come for regular eye checks to monitor your progress, and start using the special eyedrops to lower the eyes' pressure.

Don't wait too long! As with cancer, early detection is crucial.

One of the causes of cataracts, that clouding of the lens which causes blindness, is the sun's ultraviolet rays. About 185,000 people in Nepal are now blind from cataracts. The country has 80 eye doctors, one for every 400,000 people.

Wanda Vivequin is a Dutch-born New Zealander who as a child was inspired by Sir Edmund Hillary, the first person to climb Mt. Everest, which is in Nepal. She has been fascinated by the Himalayas ever since, and in 2000 she visited the country. Nepal borders Tibet and its altitude ranges from about 16,000 feet to 29,000 feet. That high altitude intensifies the sun's UV rays.

Seeing the poverty of Nepal's villages, Ms. Vivequin began a campaign to send caps to them to protect children's eyes from the sun. Caps Against Cataracts. She began recruiting Canadians bound for Nepal to use any extra luggage space for caps and so far has sent about 4,000 caps.

Once they're in Nepal, they go on a bus and small plane and then a three-week return yak voyage. She has sponsors to pay for the yaks, who receive a photo of their yak carrying caps with their corporate logo on it.

Shielding your eyes from the sun will certainly help against cataracts, especially if you live at a high altitude such as Nepal, or even Colorado. Sunglasses will also help. But cataracts are also a part of aging, regardless of how much time you spend in the sunshine. Cataract causes are not fully understood. The lens consists of water and proteins and as we age, the protein fibers start to clump together in tiny opaque areas which block vision.

At ClearViewEye we offer treatment for cataracts. You can have an intraocular lens implanted in place of your natural lens. This restores full vision and ensures that you will never again develop cataracts. Please contact us if you would like a complimentary consultation.

On January 18, this space wrote about Glaucoma Awareness Month. Now the first-ever World Glaucoma Day has been set for March 6, organized jointly by the World Glaucoma Association and the World Glaucoma Patient Association. You can read their Fact Sheet by using the link at the bottom of this page. There are plans such as:

• Public glaucoma screening campaigns
• Open-door days at glaucoma clinics
• TV and radio spots
• Print media articles

Raising awareness of glaucoma is a good and necessary goal, since it creeps up on a person so quietly. It can be in an advanced stage before the symptoms become obvious, and by then you have lost a lot of your vision permanently.

People at most risk

Everyone is at risk for glaucoma, just by being human. But some groups are more likely to develop some form of it.

• Those with a family history of glaucoma – the risk is increased four to nine times over the general population
• Diabetics – three times more likely than non-diabetics
• People of African descent – three times more likely than other racial groups to develop open angle glaucoma. Glaucoma is the leading cause of blindness in this group.
• Hispanics – at greater risk, the exact number not yet determined; Hispanics over age 60 have more risk than younger Hispanics
• Those who use steroids – This is a newly-discovered category, resulting from studies done on asthma sufferers. People who use a steroid inhaler at somewhere between 14 and 35 puffs a day have a 40% increase in ocular hypertension and open angle glaucoma. This would be very severe asthma.
• People with eye injuries – An eye injury can cause glaucoma immediately or years later. That's because an injury that bruises or penetrates the eye can damage its drainage system.
• Anyone over age 60 – this group is six times more likely to develop some form of glaucoma

Other risk factors are severe myopia, high blood pressure, and a central corneal thickness of less than 0.5 mm. If you are in any of these risk groups, please do yourself a favor and schedule a glaucoma check today.

• 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?

Archives

• May 2007
• October 2007
• November 2007
• December 2007
• January 2008
• February 2008
• March 2008
• April 2008