The LASIK Blog

Clip A Label And Help The Guide Dog Foundation

Are you a pet owner? Do you feed your canine or feline companion Iams or Eukanuba pet food? The Guide Dog Foundation for the Blind needs your help and support. By  saving your UPC labels and sending them to the Guide Dog Foundation for the Blind, Iams will in turn send them coupons to buy food and help defray the cost of feeding their special dogs. Since 1946, the Guide Dog Foundation for the Blind, Inc. has provided guide dogs free of charge to blind people who seek enhanced mobility and independence. They are supported entirely by donations from generous individuals, corporations and foundations and no government funding.

Please mail all UPC labels to Grete Eide, Director of Canine Care, Guide Dog Foundation for the Blind, 371 E. Jericho Turnpike, Smithtown, NY 11787 and be sure to include the words "Proof of Purchase" on the envelope.

To learn more about the Guide Dog Foundation or how you can donate to this worthy cause, simply visit their website at www.guidedog.org or phone them at 800-548-4337.

We Can't Let This Bank Fail

While reading the blog, Down the Shore With Jen (A Great Blog about the Jersey Shore), I learned that yesterday New Jersey Bloggers blogged about the problems being encountered by the Community FoodBank of New Jersey.  Being relatively new to the blog scene, and out of town for the weekend, I was unaware of this blogging effort.

Well better a day late than never... watch the video, click the link, and donate to this worthwhile cause!

LASIK the Refs!: Better Than Using the Jumbotron!

According to Tory Holt, one of the officials used the Jumbotron to make an offensive pass interference call against him in the Ram's 23-20 loss to the Seahawks on Sunday.  As reported in Yahoo Sports:

“He said he looked up in the Jumbotron and saw that I pushed off,” said Holt, who is in his 10th year with the Rams (2-12). “I told him I never extended my arm. It is one thing if you extended, because that is pass interference. But everything was in motion catching the football. I don’t even know if I had my hands on the guy.

“That was his explanation, and I told him it was a bad call.”

“I was surprised,” Holt said of the key penalty. “I could understand if I did because I would take that, but I could not understand it. It was a big play for our team. It was something that we needed. We needed some energy, something to get us going.

“To take that from us was not fair. They get paid to do what they do and we get paid to do what we do.”

Rams coach Jim Haslett said he was “not going to touch” the official’s decision.

“That is a young guy over there, a rookie referee,” Haslett said. “I am not sure what he saw but obviously he thought it was pass interference, and we have to live with it. If that is what he called then that is what he called.”

It seems we are seeing more and more bad calls in professional sports, this is the second one this past weekend!  What gives?  We all know being a professional ref is no easy task,  I am all for helping the refs be all they can be...  I've said it before, and I'll say it again.  I offer to perform free LASIK on any NFL ref in need of LASIK, who is a good candidate!!  Hey guys, get with it and give me a call!!

LASIK the Refs!: Another Questionable Call

Did you see the end of the Steeler Raven game today? Another quesionable call!  According to Chris Chase, the Ravens were Hochuli'd.  In his blog Shutdown Corner, on Yahoo he describes it perfectly:

"Pittsburgh had the ball on the Ravens' 4-yard line, down by three points with 43 seconds left  the game. On a third-and-goal, Ben Roethlisberger threw a bullet to Santonio Holmes who caught the ball while standing in the end zone. However, Holmes reached across the goal line to catch the ball, leading officials to rule that it was to be spotted six inches from the end zone. After reviewing the replay, however, referee Walt Coleman awarded the touchdown to Pittsburgh, giving the following explanation:

"After reviewing the play, the receiver had two feet down in the end zone with possession of the ball, we have a touchdown."

I'm no referee, but I'm pretty sure that having two feet down in the end zone makes not a touchdown. According to the official NFL Rulebook, a touchdown occurs "when any part of the ball, legally in possession of a player inbounds, breaks the plane of the opponent's goal line, provided it is not a touchback." The ball, in this case, didn't cross the plane of the opponent's goal line. Thus, it isn't a touchdown. That Walt Coleman didn't even mention a ball or a plane in his explanation is baffling.

Take a look at the picture. This is the first frame in which Holmes has clear possession of the ball. And that ball isn't in the end zone."

I've said it before, and I'll say it again.  I offer to perform free LASIK on any NFL ref in need of LASIK, who is a good candidate!!  Hey guys, get with it and give me a call!!

Preventing Serious Contact Lens Infections

In the September issue of Eye & Contact Lens, Anger, Et al. published an article titled:  Acanthamoeba: A Review of Its Potential to Cause Keratitis, Current Lens Care Solution Disinfection Standards and Methodologies, and Strategies to Reduce Patient Risk.  

This article discusses the incidence of a serious contact lens infection called Acnthamoeba Keratitis (AK).  AK is caused by an organism called a trophozite, which can be found in tap water.  The incidence of AK is very low, .00005% fo the 33 million soft contact lens wearers in the US.  Although rare, this infection is often difficult to diagnose, and difficult to treat.  Patients can at times require corneal transplants.  

The key risk factor is a corneal abrasion that is then exposed to the Acanthomeba.  The authors stressed that the key to prevention of AK is the education of patients on the proper handling, and cleaning of contact lenses, along with the avoidance of swimming with contact lenses in.  Guidelines for municipal water-testing were also discussed.

TAKE HOME MESSAGE:  Use only commercially available contact lens cleaning solutions.  Do not rinse contact lenses with tap water.  Do not swim with contact lenses in.

LASIK Costs

I saw a twitter tweet today asking about the costs for LASIK and then saw an excellent blog post written by Jeff Kimball two minutes later.  The blog post, Lasik EYE Laser Surgery costs, gives a great overview of why there are differences in LASIK pricing.  There is no doubt in my mind that many patients think of LASIK as a commodity, shopping for the cheapest price possible.  In my area, Northern New Jersey, I have seen prices range from a low of $1000 per eye to a high of $3500 per eye.  As Kimball stated in his blog many factors go into these prices including:

• Surgeon experience
• State of the art equipment and facility
• Staff Training 
• Follow-up with surgeon vs. local optometrist vs. technician 
• Success rate of surgeon and center
• Laser located on site vs. shared laser at a center 
• Breadth of procedures offered.  Does center only do one procedure, or does it offer a wide gamut of procedures based upon the need of the patient?  

Insurance generally does not cover LASIK.  There are several ways to keep costs down including:

• If offered at work, flex spending dollars allow you to use pre tax dollars to pay for the procedure.
• Many practices offer 0% financing. 

When deciding where to get your LASIK, it is important to actually meet and "interview" your surgeon. Not only must you need to determine if you are a good candidate for LASIK, you must also determine if the surgeon is the right surgeon for you.  There are many questions that can help to determine this.

In conclusion, when deciding on LASIK the most important determination is the quality of the surgeon, not cost.  We are, after all, talking about our eyes!  I can honestly say that it is very common to hear my patients state that "the money spent on LASIK was the best money ever spent."

LASIK: That Perfect Holiday Gift

 

Don’t know what to get that hard to please person on your list this year? Does she really need another sweater? Do you think he wants another tie?  How about helping someone to throw away their glasses?

 

This holiday season why not give a gift that can be opened every day, consider the gift of sight with LASIK. Imagine being able to help that special someone have the chance to open their eyes every morning and be able to see without glasses. The freedom to toss their contact lenses, solutions, and all the hassles that come with them. LASIK is the perfect gift that will keep on giving for the rest of their lives.

At our office, we see a significant increase in procedures booked between December and January. We see spouses giving LASIK to their significant others, parents treating their children who are home from college, and friends enjoying the experience together. LASIK allows people to focus on what’s really important during the holidays. After all, who wants to worry about a trip to the mall and having to find a parking space?”

Red Reflex Exam Called for in Children

An examination of the red reflex of the eyes of all neonates, infants and children should occur prior to discharge from the neonatal nursery and during all subsequent routine health visits, according to a newly updated policy statement published in the December issue of Pediatrics, the journal of the American Academy of Pediatrics.  Red reflex testing is vital for early detection of vision- and potentially life-threatening abnormalities such as cataracts, glaucoma, retinoblastoma, retinal abnormalities, systemic diseases with ocular manifestations, and high refractive errors. 

The new protocol includes the following:

The red reflex test uses transmission of light from an ophthalmoscope through all the normally transparent parts of a subject's eye, including the tear film, cornea, aqueous humor, crystalline lens, and vitreous humor. This light reflects off the ocular fundus, is transmitted back through the optical media and through the aperture of the ophthalmoscope, and is imaged in the eye of the examiner. Any factor that impedes or blocks this optical pathway will result in an abnormality of the red reflex.

All infants and children with a positive family history of retinoblastoma; congenital, infantile, or juvenile cataracts; glaucoma; or retinal abnormalities should be referred to an ophthalmologist who is experienced in the examination of children  for a complete eye examination regardless of the status of the red reflex, because these children are at high risk of vision- and potentially life-threatening eye abnormalities. Age of referral to an ophthalmologist depends on specific risk factors (eg, genetic condition, familial eye disease, etc), which can vary in age of presentation. However, it is still valuable for the pediatrician to perform red reflex testing on these patients to help determine if it is necessary to expedite this referral. Whenever an opacity or tumor is suspected, an expedited referral is indicated. Because of the urgent nature of diagnosis, it is prudent for the pediatrician to contact the ophthalmologist personally about the possible diagnosis and express (and document) the urgency of the appointment to the parent. 

TAKE HOME MESSAGE:  The red reflex is an easy exam to learn and can be preformed by most healthcare personal.  It should be preformed on all children and infants as part of the routine exam.  Any uncertainty should be referred promptly to an ophthalmologist.

Ortho-K Study in this Month's Ophthalmology

Orthokeratology(OOK) is system where a patient wears a gas permeable lens at night, causing a flattening of the cornea, leading to improved visual acuity during the day without the need for glasses or contact lenses. The improved vision with these night lenses is temporary, and the patient must continue to wear these lenses at night to achieve good vision during the day.  One can liken this approach to "braces" for the eyes. Some people see this as a safe alternative to LASIK surgery.  Orthokeratology has occasionally had severe side-effects, even blinding complications.

In this month's Ophthalmology, Van Meter, et al. discuss:  Safety of Overnight Orthokeratology for Myopia: A Report by the American Academy of Ophthalmology.  This article reviewed the published literature to evaluate the safety of overnight orthokeratology (OOK) for the treatment of myopia.  They found the prevalence and incidence of complications associated with OOK have not been determined. Complications, including more than 100 cases of infectious keratitis resulting from gram-positive and gram-negative bacteria and Acanthamoeba, have been described in case reports and case series representing observations in undefined populations of OOK users.

The article concluded:

Risk factors for various complications cannot be determined. Because OOK puts patients at risk for vision-threatening complications they may not encounter otherwise, sufficiently large well-designed cohort or randomized controlled studies are needed to provide a more reliable measure of the risks of treatment and to identify risk factors for complications.

My feeling on orhto-K is "I don't get it".  If you  are going to wear contacts at night where there is an increase risk of infection, why not wear them to see with during the day?  If you don't want to wear contacts, then wear glasses.  If you don't want to wear glasses, get LASIK!!

How To Jump Start Your Car Safely

I was down the shore today and decided to ride my bike from Margate to Ocean City, not so easy with 35 degree temps and 30 mph winds.  Going over the Ocean City Bridge felt like I was standing still!!  The weather reminded me that it would be a good time to post this blog post from Keri:

Nothing is more annoying than finding your car won’t start on a cold winter morning. The first source of help in such a situation is to find someone who can jump start your car with a good battery. Most people are not aware that this procedure can be very hazardous unless done properly.

Every year hundreds of injuries result from batteries that explode while being jump started. The reason they explode is that in the cranking procedure of starting the car, the battery produces a lot of hydrogen gas as a by-product of the chemical reaction that generates the electricity. An explosion will result from any spark caused by improperly attaching the cables to the battery.

An exploding car battery is like a bomb that sprays chunks of plastic casing and sulfuric acid towards anyone nearby. The most vulnerable part of your body in such accidents is your eyes, which can sustain lacerations and acid burns resulting in loss of eyesight. In the case of such an injury, you should immediately wash your eyes under running water for at least 15 minutes, and then seek immediate medical attention at the nearest emergency room or ophthalmologist.

 

The proper way to jump start your car does not cause any sparks around the dead battery, and will minimize the risk of explosion. It might be a good idea to clip this posting and keep it in your glove compartment where it may come in handy one cold winter morning.

How to jump start your car properly:

 

Before you begin:

 

1. Make sure your cables are color coded enabling you to identify both ends of the cable.
2. Wear eye protection and do not lean over the battery.
3. Be sure the vent caps are tight on the battery.
4. Be sure both batteries are the same voltage.
5. Be sure both cars are not touching each other and the parking brakes are on.

 

Then follow this sequence:

 

1.      Attach the red cable to the positive (+) terminal of the dead battery. The metal part of the cable may not touch the other cable or anything else metal.

2.      Attach the other end of the red cable to the positive (+) terminal of the good battery.

3.      Attach one end of the black cable to the negative (-) terminal of the good battery.

4.      Attach the other end of the black cable to any metal part of the disabled car. Do not attach this cable to the negative (-) terminal of the dead battery or any part of the carburetor line.

5.      Start the “good” car, run for several minutes, then start the disabled car. Stay away from the engine compartment as the cars are started.

6.      Once the disabled car is started, remove the cables in reverse order. Do not allow any clamp to touch any metal while the other end remains attached.

7.      Run or drive the disabled car for at least 15 to 30 minutes before shutting off. This should charge the battery enough so the car will start the next time.

Remember, during the holiday season, please be safe, and have a happy holiday!!