48 posts categorized "Current Affairs"

October 29, 2010

Beware of Cosmetic Contact Lenses for Halloween!

I got an e-mail from my son today.  His friend tried to get a pair of contact lenses on line for a party he is going to in South Beach.  Problem was he couldn't get the contact lenses without a Doctor's Rx!  He wanted to know if I could get him the lenses before the party...  This brings up an important point, contact lenses are not a costume, they are still medical devices that are applied to the eyes.  They need to be fit and cared for properly!  Unfortunately I needed more than a day's notice to get him the lenses, I guess a new costume in in the works..

It's good to know that he was unable to get his lenses without the Rx.  Several years ago, it would have been much easier, and riskier to get these lenses.  In fact I did an interview way back in 2004 with CBS News and Sapna Parikh (who is now on Fox.)  I love this interview.  Why?  Because my daughter Arielle and her friend Chelsea are both part of the story!  It is great to see them when they were so young, they are now 20!

Hope you all enjoy the story!


October 15, 2010

Blog Action Day: Water (and LASIK)

Today is Blog Action Day, an annual event that unites the world's bloggers in posting about the same issue on the same day. The aim is to raise awareness and trigger a global discussion around an important issue that impacts us all.  By doing so on the same day, the blogging community effectively changes the conversation on the web and focuses audiences around the globe on that issue. 


Since I have already blogged about water through our See:Water initiative, I felt it was important to be a part of this world bloggining community initiative.  The premis of our See:Water campaign was to increase awareness: almost a billion people on the planet don’t have access to clean, safe drinking water. That’s one in eight of us who are subject to preventable disease and even death because of something that many of us take for granted.  Access to clean water is not just a human rights issue. It’s an environmental issue. An animal welfare issue. A sustainability issue. Water is a global issue, and it affects all of us. 

We asked patients to contribute to the Charity:Water campaign, matched their donation, and rewarded them with a discount on their LASIK surgery!  Cause-related marketing is a win:  win:  win for all involved!  We raised over $5,000 for Charity:Water... 

This was so successful that we decided to partner with the Women’s Cancer Programs of the Entertainment Industry Foundation (EIF)  this month which is Breast Cancer Awareness Month.

So, Since I need to blog about water today, here are some interesting tidbits from the Blog Action Day Blog:

  • Bottled Water: Even though people in the US have access to clean water from their taps, they drink an average of 200 bottles of water per person each year. Over 17 million barrels of oil are needed to manufacture those water bottles, 86 percent of which will never be recycled. More Info »
  • Uninhabitable Rivers: Today, 40% of America’s rivers and 46% of America’s lakes are too polluted for fishing, swimming, or aquatic life. That’s not surprising considering the fact that 1.2 trillion gallons of untreated sewage, storm water, and industrial waste are discharged into US waters annually. More Info »
  • Fashion Footprint: That cotton t-shirt you’re wearing right now took 400 gallons of water to produce, and your jeans required an extra 1800 gallons. Not wearing cotton? The dyes and synthetic fibers used to make your clothes create waste that’s among the many contributors to water pollution. More Info »

OK, time to get involved, if nothing else, sign the following petition:


Change.org|Start Petition

October 05, 2010

After 22 Years FDA Continues to Drop the Ball on Eye Drop Packaging Mix Ups

22 Years ago I had a letter published in the Archives of Ophthalmology titled:  Corneal Abrasion From Accidental Instillation of Cyanoacrylate Into the Eye.  This letter described a 38-year-old woman was referred from a local emergency department to my office after accidentally putting instant nail glue into her left eye.  She had been taking gentamicin sulfate (antibiotics) drops to treat conjunctivitis, and had inadvertently mixed up the bottles, which looked similar to her.  I also stated that: There have been many accounts of accidental ocular instillation of cyanoacrylate adhesives. In 1982, a similarity in packaging of ophthalmic medications and the adhesive containers was noted to be a consumer safety problem. This case will illustrate that, five years later, this consumer safety problem still exists.

Well, this been 22 years since that letter, and the problem still exists today!  MyFox Phoenix did a story yesterday titled:   Woman Mistakes Superglue for Eye drops FDA to investigate medical mishap

She reached for eyedrops and instead used superglue -- and it happens a lot more often than you might think.

Irmgard Holm had cataract surgery last year. She mistakenly reached for what she thought was one of her half dozen eyedrop medications -- but the burning sensation that followed let her know something was seriously wrong.

It was superglue.

"The bottles are identical and I am not young anymore, but I am not senile," says Holm.

I guess the FDA is more concerned with the likes of Morris Waxler and his "LASIK-Bashing" than to concern itself with a true safety issue.  Its not too difficult to prohibit the bottling of substances toxic to the eye in similar containers! 

FDA, get with the program!!

October 04, 2010

The LASIK Debate Continues on CNN

Last week's LASIK debate aired on CNN.  It pitted ophthalmologist Stephen Slade vs former FDA official Morris Waxler.  While Dr. Slade did a great job in defending LASIK's clinical track record, I don't think he addressed some of Waxler's false claims adequately, including:

  • "only 60 percent can get rid of their glasses and contact lenses"
  • "There's -- the failure rate if you calculate a failure rate based on FDA data, and you can se it from the charts I sent to CNN, the failure rate is over 50 percent."
  • "18 percent or more suffer from glare halo, dry eyes and similar problems."
  • "some of the ophthalmologists who have been responsible for the military adopting these issues have a side business in which they conduct -- they perform Lasik surgery. So, they've profited mightily by this."
These statistics are simply wrong.  They need to be addressed and discredited!  Here are some of the statistics that I have previously quoted from USAEyes CORE survey:
  • 99% report quality of life as expected, better, or much better
  • 98% day vision as expected, better, or much better
  • 98% no complications or issues are seldom problematic
  • 98% would recommend surgery to family and friends.
  • 97% would have surgery again, knowing what they know now
  • 96% wear corrective lenses as often as expected, less, or much less than expected
  • 96% report post op vision without lenses as expected, better, or much better than expected when compared to preop vision with lenses
  • 96% report overall quality of vision as expected, better, or much better than expected
  • 91% no complications at any time
  • 91% night vision as expected, better, or much better
  • 7% complications seldom problematic
    – yet 91% of these same patients would have surgery again
  • 2% complications frequent or always problematic
    – yet 22% of f these same patients would have surgery again

LASIK is too successful a procedure to be tarnished by false claims.  Granted, theree are complications with LASIK, as there are with any surgical procedure, however, we need to dispute Waxler's claims and not let them go unchecked.  We also need to know what motives fuel Waxler's false accusations!

Here is a copy of the CNN transcript for those interested: Download Rethinking The Safety of LASIK

September 29, 2010

Balanced Reporting: CNN to Air LASIK Debate This Morning

I have received a large response to my post last week that criticized Diane Sawyer's one-sided coverage of LASIK.  I urge everyone to tune in, Tivo, or DVR this morning's CNN Newsroom

This morning, CNN’s Kyra Phillips will talk with Morris Waxler and Dr. Stephen Slade who performed the first Lasik surgery in the U.S. at 10:15am ET on CNN Newsroom. We want you to weigh in on this conversation… Do you think Lasik surgery is safe and effective? Tell us what you think and we’ll read some of your comments during the show.

Dr. Slade is a very respected LASIK surgeon, and should do a good job in providing a true assessment of the risks and benefits associated with LASIK.  I also hope some light can be shed into how Waxler came up with his "statistics", and his motivations.

I plan on commenting further on this issue after it airs and will hopefully have a link to share with you all.  In the meantime, I urge everyone to post a comment on the CNN link.

September 24, 2010

One-Sided Reporting: Diane Sawyer of ABC News Covers LASIK With Bias Reporting

In some of the most one-sided journalism that I have seen, Diane Sawyer and ABC's World News Tonight  reported on the safety of LASIK surgery.  The story was based on an interview with Morris Waxler, a former FDA official who was involved in the approval process of LASIK in the 1990's. 

I take exception with many points in this story, including:

  • Diane Sawyer introduces Waxler as the "official who led the drive to approve the procedure."  As an FDA official, he led no such drive, his job with the FDA would have been to review clinical results and either recommend or strike down LASIK's approval.  He was not involved in the clinical trial process itself.
  • The reporter asks Waxler if he would ever recommend LASIK surgery to anyone interested in the procedure. His response, "no, absolutely not."  Although he is introduced as "Dr. Waxler," he is not an MD, he has a PhD.  I would love to know what clinical experience he purports to have.
  • Waxler states that people don't understand that LASIK "is not like getting your nails done."  I agree, LASIK is not a manicure, it is surgery.  I think this is certainly conveyed to all of my patients!
  • The reports states that "compromised cornea can develop microscopic scar tissue and cause vision problems."  This is simply not true.
  • Waxler claims that 50% of LASIK patients have side effects and 33% continue to need glasses or contact lenses.  I do not know where he gets his data, this is simply not true!  If these claims were true, no one would opt for the procedure.

The FDA is in the process of reviewing long term LASIK results.  One study, USAEyes CORE survey, found:

  • 99% report quality of life as expected, better, or much better
  • 98% day vision as expected, better, or much better
  • 98% no complications or issues are seldom problematic
  • 98% would recommend surgery to family and friends.
  • 97% would have surgery again, knowing what they know now
  • 96% wear corrective lenses as often as expected, less, or much less than expected
  • 96% report post op vision without lenses as expected, better, or much better than expected when compared to preop vision with lenses
  • 96% report overall quality of vision as expected, better, or much better than expected
  • 91% no complications at any time
  • 91% night vision as expected, better, or much better
  • 7% complications seldom problematic
    – yet 91% of these same patients would have surgery again
  • 2% complications frequent or always problematic
    – yet 22% of f these same patients would have surgery again

These survey results makes one take pause and wonder where Waxler gets his statistics from and what his motivations might be.  Since retiring from the FDA, Waxler now runs Waxler Regulatory Consultancy, LLC, which "provide consultant services on Food and Drug Agency regulatory issues for the entire life cycle of your medical devices."  One wonders if one of his clients might be an anti-LASIK organization?

R. Doyle Stulting, MD, PhD, president of the American Society of Cataract and Refractive Sugeons (ASCRS) has also had something to say about Waxler in the past:

“In summary, your letter is filled with false statements, incorrect citations of the published literature, references that do not fairly represent the existing literature, mischaracterization of a study protocol you have never seen, incorrect reference to outcomes of PRK as if they were for LASIK, citation of results for a laser designed two decades ago as if were representative of modern lasers, mischaracterization of results from older lasers as “better than most,” reference of a graph that does not exist in the reference you cite, and misrepresentations of the actual performance of modern excimer lasers for the correction of refractive errors”

I am a little surprised at World News Tonight for reporting in such a biased manner.  Shame on you, Diane Sawyer!

Here is the story.

September 08, 2010

American Medical Care Continues to Lag: AcrySof® IQ ReSTOR® Multifocal Toric IOL Released Outside the USA

Alcon labs announced this week the release of the AcrySof® IQ ReSTOR® Multifocal Toric intraocular lens (IOL) outside the United State.  The AcrySof® IQ ReSTOR® Multifocal Toric IOL combines the technologies of the ReSTOR® +3 add multifocal IOL and the Toric IOL.  Data demonstrated that the AcrySof® IQ ReSTOR® Multifocal Toric IOL delivers similar quality of vision when compared to the AcrySof® IQ ReSTOR® +3.0 D IOL.

This lens will allow surgeons to offer their patients who have pre-existing astigmatism a lens that provides quality vision at all distances after cataract surgery or clear lens exchange. Up until now, I have treated these patients with the ReSTOR® Multifocal implanted at the time of cataract surgery.  Residual astigmatism is then treated about 1 month later with LASIK.  This new lens will allow me to treat both conditions at the same time, and use less surgery. 

There is only 1 problem:  this new lens is NOT AVAILABLE IN THE UNITED STATES!  Alcon plans to file a Pre-Market Application (PMA) for the lens with the U.S. Food and Drug Administration (FDA) in early 2012.  Once again, the draconian ways of our FDA have allowed medical care outside the US to out pace our own, we continue to provide third world medical technology to our patients...  Another part of our broken health care system in need of repair.

August 19, 2010

Brett Better Wear Those Safety Glasses: Favre Returns to NFL and Colbert Threatens to Poke Out His Eye!

Stephen Colbert, in discussing Brett Favre's most recent return to playing for the NFL, threatened to "stab him in the eye with a broken broom handle."  Although this was, of course, said in jest, it brings up an important point:  most eye injuries can be prevented.

According to Prevent Blindness:

Eye injuries in the workplace are very common. More than 2,000 people injure their eyes at work each day. About 1 in 10 injuries require one or more missed workdays to recover from. Of the total amount of work-related injuries, 10-20 % will cause temporary or permanent vision loss.

Experts believe that the right eye protection could have lessened the severity or even prevented 90% of eye injuries in accidents.

Common causes for eye injuries are:

  • Flying objects (bits of metal, glass)
  • Tools
  • Particles
  • Chemicals
  • Harmful radiation
  • Any combination of these or other hazards

There are three things you can do to help prevent an eye injury

  • Know the eye safety dangers at work-complete an eye hazard assessment
  • Eliminate hazards before starting work. Use machine guarding, work screens, or other engineering controls)
  • Use proper eye protection.

You should wear safety eyewear whenever there is a chance of eye injury. Anyone working in or passing through areas that pose eye hazards should wear protective eyewear.

The Colbert ReportMon - Thurs 11:30pm / 10:30c
Brett Favre Returns to Football
Colbert Report Full Episodes2010 ElectionFox News

Well Brett, welcome back to the NFL.  As a long time Packer Backer and fan of yours, I suggest you keep away from Colbert.  In the meantime, Brett, drop me a line at EyeCare 20/20, and I will send you a free pair of safety glasses!!

August 18, 2010

Our Broken Health Care System: 3 Years in the Hospital With No Way Out!

I had a friend down the shore this weekend who told me an amazingly sad story about a friend of his.

A 52 year old married man with a 7 year old son has been in the hospital for the past 3 years.  He has a rare disease called Pompe disease which has forced him to live on a respirator.  His doctors feel he is well enough to go home, however his medical insurance company, Aetna, will not cover his needed home health care.  His more expensive in-hospital care is being covered by Medicaid!  According to NorthJersey.com he is:

caught in an insurance quagmire — smack between inadequate coverage by Aetna and Medicare and ineligibility for standard Medicaid coverage.

This unfortunate story is but another example of the absurdity of our current health care system.  I have referred this to a lawyer friend who has gone up against the insurance industry very successfully in the past.

What do you think?

August 06, 2010

Going Green Preventing 22 Million Cataracts

There is no doubt that I have seen an increase in the severity of cataracts in younger patients for years.  This is purely anecdotal on my part, but I am definitely operating more and more on younger patients.  When I discuss these cataracts wIth these younger patients, they are very surprised, "cataract is a disorder of the elderly" is a frequent response I will hear from the 40 something year old suffering from the symptoms of a cataract.  My response has been that I believe the rise in incidence in cataracts of the young is probably caused by ozone depletion and UV exposure. Visual complaints that may signify cataracts include:

  • Blurred vision, double vision, ghost images, the sense of a "film" over the eyes
  • Lights seem too dim for reading or close-up work, or feeling "dazzled" by strong light
  • Changing eyeglass prescriptions often, and this change does not seem to help vision
  • Glare while driving at night
If the cataracts are small, I recommend full time UV protection for the eyes, if the cataracts are large, cataract surgery is discussed.

I have been proved correct:  A report was released this week by the EPA, Health and Environmental Effects of Ozone Layer Depletion.  For the first time, EPA has included data on cataract and UV exposure. All people, regardless of gender and skin type, are at risk for cataracts. It is recommended that both  adults and children use eyewear that absorbs UV rays and to wear a wide-brimmed hat to limit outside UV exposure. 

The EPA report estimates that the strengthening of the original Montreal Protocol through the Montreal Amendments of 1997 will avoid more than 22 million additional cataract cases for Americans born between 1985 and 2100.  The environmental treaty, signed by 196 countries, was designed to reduce and eventually eliminate ozone depleting substances. 

Obviously, going green is not just a good idea to protect the environment; it can also help to save sight thru cataract prevention!