The LASIK Blog

Eye MakeUp Allergies

If the skin around your eyes becomes itchy, red, puffy or scaly after using makeup, you have probably developed an allergy or sensitivity to one of your cosmetics. The whites of your eyes may also become red and swollen. Depending on the offending material, the reaction may continue to get worsen, or may clear up spontaneously. The allergic reaction usually involves both eyes, but one side may be more affected than the other.

The eyelid and surrounding areas is especially vulnerable because its skin is extremely thin and loose, allowing chemicals to penetrate more easily. This may cause the skin to swell more readily than on other parts of the face.

An allergy is your body’s reaction to “foreign” substances. The basic ingredients of all cosmetics are waxes, oils, detergents, dyes, perfumes, lanolin, and preservatives. Any of these can cause an allergic reaction in the delicate skin around your eyes.

It might seem strange to suddenly become allergic to a makeup you have been using for years. Actually, your body has probably been slowly building up a sensitivity to the makeup. Once an allergic response to a substance occurs, the reaction usually gets worse every time you use that substance.

The first step in treatment is to stop using the offending material. Since you usually can’t identify the specific culprit, all cosmetics should be stopped until the reaction clears up. A steroid ointment may be prescribed to aid in clearing the allergic reaction.

To prevent recurrences, it is important to find the exact cause of the problem. This will equire some detective work. After your skin has cleared, start using one makeup product at a time. After one week, if there is no reaction, add another product. Continue adding one product each week until your skin gets red and itchy again. Then eliminate the last product that caused the reaction.

You may also need to use hypo-allergic cosmetics, which tend to cause fewer and less severe allergic reactions. This is because they contain fewer allergy-causing substances. Some cosmetics that are labeled hypo-allergenic really aren’t.  It is important to read the label. Don’t use any product that contains lanolin and perfume, the most common causes of skin reactions.

If your skin can’t even tolerate hypo-allergenic products, you may be able to use non-allergenic cosmetics. They do not contain any chemicals that can cause allergies.

Shout out to Mark Cuban: Help LASIK the Refs!

There was a very good interview on NPR last week about Mark Cuban, and it got me thinking…

  

Mark Cuban, owner of the Dallas Mavericks, has often criticized NBA referees for years.  He has had frequent run-ins with NBA commissioner, David Stern, about this, and has been fined hundreds of thousands of dollars.  His outspoken voice is refreshing, and generally on the money; referees generally do a good job, but blown calls can affect the outcome of games. Cuban has even blogged about how to improve officiating in the NBA playoffs:  

“NBA should rank its officials, seed them if you will. Top 12 get playoff assignments. Thats it. If an official does a great job and rises to the top 12, he or she gets the reward. If not, not.

Giving less qualified officials an opportunity to officiate playoff games as a reward gives the official a nice attaboy, but it risks the quality of our product.

It makes absolutely no sense to do it the way it is currently done. If the league wants the best officiating in every game, only use the best officials. Anything less cheats us all.”

I certainly agree that there is an hierarchy of referee ability in any sport.  Why not try to improve the ability of the referee pool, in that way we might be able to chose from the top 20…  There are many things that go into making an excellent referee including knowledge of the game, reflexes, physical fitness, vision, and demeanor.  Some of these we can control, and some we can’t.  We can certainly improve a ref’s vision, as I have publicly offered before, I will provide free LASIK surgery on any NBA ref that is deemed a good candidate and needs it.  Maybe Mark Cuban can do his part and fly these refs to me on his jet for their treatment!  Or maybe he should start refing the games himself.

BTW, I also wish him luck with his upcoming legal issues, and hope he puts it all behind him quickly!!

Happy Thanksgiving!

From all of us at EyeCare 20/20, we send our best wishes to you and your family for a happy and healthy Thanksgiving.

Thanksgiving is a time to recall all of the things we have to be grateful for. At EyeCare 20/20, we can think of no better things to be thankful for then for you, our valued patient.

For each new morning with its light,

For rest and shelter of the night,

For health and food, for love and friends,

For everything Thy goodness sends.

~Ralph Waldo Emerson

Here are a few Thanksgiving "Turkey" tips courtesy of the Food Network:

1. Thawing a frozen turkey requires patience. The safest method is to thaw turkey in the refrigerator. Be sure to plan ahead — it takes approximately 3 days for a 20 pound turkey to fully defrost.

2. For crisper skin, unwrap the turkey the day before roasting and leave it uncovered in the refrigerator overnight.

3. Cooking times will differ depending on whether your bird was purchased fresh or frozen. Plan on 20 minutes per pound in a 350 degree F oven for a defrosted turkey and 10 to 15 minutes per pound for fresh.

4. A turkey will cook more evenly if it is not densely stuffed. Consider adding flavor by loosely filling the cavity with aromatic vegetables — carrots, celery, onion or garlic work nicely — or by carefully tucking fresh herbs underneath the breast skin. For the stuffing lovers, cook the dressing in a casserole dish on the side.

5. For even roasting, truss your turkey.

6. Before roasting, coat the outside of the turkey with vegetable or olive oil, season with salt and pepper and tightly cover the breast with aluminum foil to prevent over-browning (it will be removed in step 7).

7. Don't be a peeping tom (no pun intended)! Once you get the turkey in the oven, resist the temptation to open the oven door and admire your handiwork. When the oven temperature fluctuates, you're only increasing the likelihood of a dry bird. About 45 minutes before you think the turkey is done, remove the foil from the breast to allow it to brown.

8. Remove the turkey from the oven when the deepest spot between the leg and the breast reads 180 degrees F on an instant-read thermometer. Check the internal temperature of the stuffing as well; it should be at least 165 degrees.

9. Tent the bird with foil and let rest for about 15 minutes before carving. If you need more time to make gravy, heat up side dishes, etc., you can let the turkey set for up to an hour without losing too much heat.

10. Remember to carve your turkey with a very sharp or electic knife.

Jill Kintner Talks About Her LASIK in Her Blog

Olympic BMX Bronze Metalist, Jill Kintner posted her LASIK experience last week in her blog.  The post is titled "The light show- 20-20".  Below is an excerpt:

"ANYWAY,,, Here is how it works....After not wearing contacts for about a month, you go in, run through a half a dozen computerized and other line reading tests. They scan everything, check the shape of your eye, thickness, RX, etc. Dilate your pupil, then reverse dilate, double check, triple check, Then program the laser. After your eyes are back to normal from being dialated, they give you a vallium to relax , then some numbing drops before the surgery. THe surgery takes no time. Eyelids are clamped open, then they cut a flap in your lense, peel it over to get to the cornea, you go kinda dark for a bit and cant see, then a crazy light show, smell your burning cornea getting reshaped, then he peels the flap back over, you blink, and on to the next one, no pain at all. It happened so fast that I really was speechless afterwards trying to make sense of what just happened. This was the only surgery I have ever been awake for, cause you have to focus your eye, and it was crazy. Slept the rest of the evening, and was good to go the next day. Sweet. I am so glad I did this.

Seriously, worth every bit of the emotion and fear. So pumped. No more contacts, no more annoyingness. My brain is just happy to be seeing clear. www.eyecare2020.com

Thanks to Dr.Silverman, who probably thought I was the biggest sissy ever, Keri, and Amy Stanton for lining this up for me!! Think I am as spruced up with surgeries as I would ever want to be. Wish my knee would heal this fast."

Computers and Your Eyes

With the popularity of computers in the workplace, it has become more and more common to see patients with numerous eye complaints attributed to their computer monitors. Many studies have been done, and have concluded that PC monitors are not associated with any permanent ocular or visual damage.

Working long hours in front of the computer is associated with many eye symptoms including; irritation, difficulty in focusing, and blurriness. Other symptoms might include neck aches and backaches. These symptoms do not indicate any real damage, but may point to the following causes and solutions:

1. The design of the work station is often not given enough attention. Lighting, position of reflecting surfaces, seat height, and the angle at which the monitor are viewed are all important in making the operator comfortable.
2. The intensity, focus, and clarity of letters are all major sources of eyestrain. The brightness and contrast of the monitor can be controlled to provide the most comfortable levels. An ultraviolet and infrared filter screen placed over the monitor may also alleviate eyestrain.
3. Periodic rest breaks are essential for comfort and relief of fatigue. It is also common for people to forget to blink while staring at the monitor. It is important to remember to blink, or use a lubricating drop such as artificial tear substitutes while working for long periods.
4.  It is also important to wear your proper prescription glasses. Uncorrected refractive errors may cause eye fatigue. People who need reading glasses may benefit from special bifocals designed for use at the computer.

In conclusion, there is no evidence that working on a computer can cause permanent damage to the eye, either from radiation or eyestrain. Most ocular complaints are due to other factors such as seating, head position, location of terminal, reflections, lighting, and the quality of the display images.

If, after correcting the above factors, you are still having eye problems while using your computer, a complete eye exam and refraction is recommended. This will determine whether or not you need glasses, or whether your current glasses are adequate for your visual needs.

Jill Kintner, Olympic Bronze Medalist Has LASIK at EyeCare 20/20

Jill Kintner,the 2008 Summer Bronze Medalist in women's BMX racing, flew in from San Diego this week to have her LASIK eye surgery by me.  Jill was the first American woman selected to BMX by the US Olympic Team.  Their selection paid off with her strong showing in Beijing.  

Here is a great video interview of Jill before this year's olympics:

Since Jill is currently rehabbing a knee injury, she felt this would be a good time to get rid of her glasses.  Surgery was preformed yesterday.  I saw Jill this morning and her vision is already 20/25 without glasses!  There is no telling how well she will do after her rehab and new vision...

December is Safe Toys and Gifts Month. Be Sure To Select Age Appropriate And Eye-Friendly Toys For A Safe Holiday

The holidays are filled with anticipation of gifts and new toys. When making decisions for selecting new toys, parents need to tell Santa and loved ones to pick eye-safe and age appropriate toys for children.

Many times an accident can happen when a toy is not age or developmentally appropriate. We want to avoid eye injuries by suggesting to parents that they be careful in selecting toys with this in mind.

So, in general, what toys should parents avoid? Toys with pointed, sharp or rough edges or pieces. Blocks are great for almost any age as long as corners and edges are blunted to reduce the risk of eye injury. Also, to avoid eye injuries, beware of long-handled toys, like mops, brooms, pony sticks and rakes. Check to make sure that they have rounded handles and watch closely children under 2 with such toys.

Be careful to avoid toys that may be age appropriate for an older child but could be dangerous for a younger child. Always supervise children in situations when they might share an inappropriate toy with a younger sibling.

Avoid slingshots, dart guns and arrows for children under 6. The best suggestion is to avoid these toys completely, especially if you have younger children in the house. Second best suggestion is to supervise any child with these toys – they have the potential to be harmful.

Great toys for children are those that stimulate visual development, improve hand-eye coordination and demonstrate spatial relationships.

Toys for children under age 2 include: brightly colored mobiles, stuffed animals, activity gyms, blocks, balls, stacking and nesting toys, buckets and measuring cups, puzzles, shape sorters, and musical toys. Appropriate and eye-friendly toys for children over age 2 include: child-sized household items like brooms, vacuums, rakes, lawn mowers, refrigerator and stove sets and outside toys like sandboxes, kiddie pools, riding toys and backyard gyms and swings. Magnetic letters, stringing beads, toy cash registers are great for fine motor skills and hand-eye coordination.

Some toys are simply not safe and may be recalled by the U.S. Consumer Product Safety Commission (CPSC). For a list of toy recalls, call (800) 638-2772.

Treatment of Cataracts in Post-LASIK Patients

Jose Alfonso, MD et al. presents an interesting article in this month'sJournal of Cataract and Refractive Surgery.  Visual quality after diffractive intraocular lens implantation in eyes with previous myopic laser in situ keratomileusis describes the author's results of implanting a multifocal IOL in 80 eyes of 46 patients who developed cataracts years after undergoing LASIK.  They reported excellent results and concluded that the multifocal IOL provided "good visual acuity at distance and near."

I have been implanting multi-focal IOLs in LASIK patients who develop cataracts for years.  I also find the results to be excellent.  These patients are able to both read and drive without the need for glasses or contact lenses.  I do caution these patients that there is a good chance that their LASIk will need to be fine tuned following the cataract surgery.  I generally will preform a LASIK enhancement 1 month after the cataract surgery, once the refraction is stable.

I have actually preformed LASIK on both my parents 8 years ago.  They both went on to develop cataracts.  I was able to preform cataract surgery and implant a ReStor IOL in my mom last year.  She had a LASIK enhancement 1 month later.  My dad underwent his cataract surgery with ReStor implantation last month,  He does not need an enhancement.

I am please to report that both my parents are able to both read and drive without the need for glasses.  Their vision is now 20/25 at both distance and near.  Needless to say, their friends are jealous, and they are both still talking to me!!

Warning: Wearing Swimming Goggles Can Increase Eye Pressure!

As many of you might know, I am an avid cyclist.  I try to ride at least 3 times a week, both road and mountain,  year round.  This gets difficult in New Jersey when the temperature dips into the teens.  My wife, Melissa rides with me usually a day a week, as she trains for triathlons.  This gets her into the pool at least 3 times a week!

An interesting article appears in the British Journal of Ophthalmology:  Wearing Swimming Goggles Can Elevate Intra ocular Pressure.  W H Morgan; T S Cunneen; C Balaratnasingam; D-Y Yu report that swimming goggles were measured to increase intra ocular pressure by 4.5 mm hg.  This is quite significant.  They further state that Swimming is a popular form of exercise with many swimmers wearing goggles to improve underwater visibility. Tension from the goggle headband keeps the goggles in place. This force acting on the goggles may compress orbital vasculature and other structures to cause an elevation in intra ocular pressure (IOP). Continuously elevated IOP is a significant risk factor for glaucoma development and progression.

The take away message from this article is that patients with glaucoma, or those predisposed, should consider the effects of wearing swim goggles in the management of their disease, and inform their ophthalmologist of this activity!

Photo: Princeton Legends after LASIK

In yesterday's post, I mentioned EyeCare 20/20 is a corporate sponsore of this year's Princeton Sports Symposium.  I also mentioned having personally performing LASIK on several Princeton sports legends.  Keri, my office administrator came across this photo taken over 8 years ago after the LASIK surgeries were performed.

 

 

From left to right, they are:

 

Christian Cook:  1998 grad.  All American Defenseman.  Member of US National LAX team.  Played professionally for Baltimore and Denver.

 

Jesse Hubbard:  1998 grad.  Hall of fame lacrosse player.  Went on to play for the NJ Pride professional LAX team.  Number 11 on Princeton's all time athlete list. 

 

Trevor Tierney:  2001 grad.  All American goalie and member of US National team.  Member of All World Team in 2002 ILF World Championships.  Played professional LAX with Baltimore and Denver.

 

Keith Elias:  1994 grad.  Played for NY Giants and Indianapolis Colts.  Number 20 on Princeton's all time athlete list.