Thursday, February 7, 2013
Our LASIK Blog has been relocated!
We have moved our LASIK Blog to our website. You can read our latest blog posts at: mandelvision.com/blog.
Wednesday, January 23, 2013
Monovision Laser Vision Correction: An Alternative to Reading Glasses
One of the most common questions we hear from prospective patients over the age of 40 is: “Am I a candidate for LASIK or PRK laser vision correction if I only need reading glasses?” The answer may surprise you: It's yes! The common misconception is that laser vision correction is only for patients who are lifelong glasses or contact lens wearers. However, with the advantage of the monovision approach, patients who only wear reading glasses can also benefit from the procedure. Even better news: For those patients who truly have 20/20 distance vision in each eye without corrective lenses, the laser vision correction procedure is half the price, since only one eye is corrected.
Monovision is a tried and true approach to avoiding or minimizing the need for reading or computer glasses, and is a laser vision correction procedure in which one eye is optimized for distance vision and the other for near vision tasks. With monovision correction, although both eyes are still working together, one eye is relied upon much more for distance, while the other eye is relied upon for near, which is why it’s called monovision (from the term monocular, meaning one eye). Your brain has neuroplasticity, so you can train your brain to automatically, and seamlessly, switch between the eyes as you change your focus from near to distant objects, and vice versa. Monovision is also commonly used as a customized option in LASIK and PRK laser vision correction procedures for those patients who are either nearsighted or farsighted and over the age of 40 who have lost their ability to see clearly up close.
In order to understand monovision, you need to understand how the visual system works, as well as some key ophthalmic terms. When a patient reaches their mid 40’s and loses the ability to accommodate, (or adjust their focusing power for near vision) they need bifocals or reading glasses. This condition is called presbyopia, and the lenses used to correct this condition are plus powered lenses which enable the patient to see clearly for near vision tasks. In a normal sighted eye, light rays from distant objects are focused directly on the retina to produce a clear image without the need for corrective lenses. In a nearsighted (myopic) eye, the eye is anatomically longer than that of a normal sighted eye. Therefore, light rays from distant objects come into focus before they reach the retina. This condition results in an eye that cannot see clearly in the distance, but can see clearly up close (without the help of corrective lenses). This is the concept that is employed in monovision correction.
All patients have a dominant eye, which is the eye that is preferred for visual tasks. In the monovision approach, the non-dominant eye is purposely made slightly nearsighted to optimize reading vision. This means that vision in that eye will be clearer up close for near vision tasks, but blurry when viewing distant objects. The degree of correction chosen for reading correction will be customized for each patient’s visual needs. The factors considered in choosing the amount of correction for reading vision include the refractive error (prescription) of the eye, the patients’ age, profession and hobbies. The goal for the dominant eye is for it to see clearly in the distance. If a patient is nearsighted or farsighted, the dominant eye also requires laser vision correction treatment to correct that eye for distance vision. If a patient has a normal sighted dominant eye, that eye does not require treatment, so only the non-dominant eye is corrected for near vision.
Is it possible to train yourself to adjust to this different type of vision? YES. Monovision takes advantage of brain plasticity to help you learn to automatically see both near and far objects. How motivated you are to adapt to this customized vision and take advantage of your brains plasticity, is the best predictor of success with monovision.
Not everyone is an optimal candidate for this type of laser vision correction procedure. Therefore, a consultation, including a thorough medical eye exam, is necessary to determine whether monovision is the right choice for you. This type of correction can also be simulated with a contact lens so that patients can see what monovision is like prior to having this procedure. Monovision correction can also be achieved with contact lenses, but is usually not successful in eyeglasses.
There is a slight compromise with monovision, as two eyes working together typically give you better vision than one eye working alone. There is also a learning curve to adapt to monovision. However, after an adjustment period, the motivation to avoid bifocals or reading glasses is usually strong enough to overcome this. Depth perception can be affected slightly, but usually not enough to affect daily activities. At Mandel Vision, we do recommend driving glasses until you comfortably adapt to monovision. Once the brain adjusts to monovision, most patients are very happy with their customized procedure. Moreover, they are ecstatic that they no longer have to reach for their reading glasses every time they attempt to read a restaurant menu!
Call Mandel Vision® today, at 888-866-3681, for your free laser vision correction evaluation, with corneal surgeon, Eric R. Mandel, M.D., to see if you qualify for this exciting alternative to reading glasses.
Thursday, December 27, 2012
The Customization of Laser Vision Correction
Recent WavePrintÒ technology has afforded eye surgeons the
benefit of customization in laser vision correction procedures. This is not a new concept to Eric R. Mandel, M.D.,
founder and medical director of Mandel VisionÒ. Having researched refractive surgery since
the mid 1980’s, he recognized very early in his surgical career the importance
of getting to know his patients as individuals.
The difference at Mandel Vision is that Dr. Mandel not only customizes
each surgical procedure using the latest WavePrint technology, but he also
calls on his years of experience to then personally customize the procedure
based on the specific visual needs of each patient.
Surgical Customization
The WavePrint technology in the AMO WaveScan Wavefront
System, utilized at Mandel Vision, leads the industry for outstanding wavefront
acquisition and diagnostic capabilities.[i] The WavePrint Map is derived from technology that
was first developed to correct distortions of light waves from space. This technology is now used as a diagnostic
and therapeutic tool to enhance our abilities to measure the visual system with
an accuracy that was previously unattainable.
The WaveScan™ captures the unique imperfections of each
patient’s eye using all of the available Hartmann-Shack™ data points
for more accurate wavefront error reconstruction.[ii] These data points then create a unique
fingerprint of your cornea. This
fingerprint is then programmed into the VISX Star S4Ò Laser for each eye of each
patient, individually. This technology
allows Dr. Mandel to correct for visual disturbances, such as spherical
aberration, that cannot be corrected with glasses or contact lenses. This means it may be possible to achieve
better vision following laser vision correction than was attainable with
glasses or contact lenses before the procedure.
Individual Customization ~ Dr. Mandel’s Personal Touch
A researcher in refractive surgery since 1984, Dr. Mandel understands the importance of getting to know his
patients, including their profession, their hobbies and their passions prior to
performing laser vision correction surgery.
Armed with this information, he’s able to customize their laser vision
correction procedure. Although two
patients may be the same age and have the same prescription for glasses, they
may require different types of laser vision correction treatments. For instance, two 44-year-old
patients with similar prescriptions may require completely different approaches
to their surgical correction. A
professional golfer, who will begin to lose focus on the logo of the ball which
is used for aligning putts, will have different future visual requirements than
a commercial pilot who spends the day monitoring multiple computer
screens. Dr. Mandel and our vision
correction team take the time to get to know each patient so that we can personalize
their projected final outcome.
Here at Mandel Vision, we not only want you to be happy with
your visual outcome now, we want you to be happy for life.
Monday, November 19, 2012
Dr. Mandel’s Reading and Computer Tips
Did you know that when you are working on the computer or reading, you blink 60% less than at other times? This lack of blinking exacerbates dryness, fatigue and discomfort that are often associated with office work. Poor indoor environments, with low amounts of humidity, are another contributing factor. Think of your eyes as a car’s windshield. If you have poor windshield wipers, or no windshield wiper fluid, your windshield will be dirty and difficult to see through. Similarly, you must remember to blink frequently and lubricate your eyes with artificial tear drops, when you are working on the computer or reading, to keep your eyes moist and clear. This is especially true during the first year after laser vision correction.
Following the simple steps below will make you feel more comfortable so that you can spend more time doing close work without discomfort:
1. For every half hour of reading or computer work, put a drop of artificial tears into your eyes and then close your eyes for 45 to 60 seconds. (Don’t just look away, but truly close your eyes.)
2. Put a post-it note on your computer, or near your reading material, with the word "BLINK" written on it. This simple reminder to blink really works!
3. Use good lighting for all near vision tasks. An incandescent light, with a rheostat to adjust illumination, is one of the best choices for comfortable reading.
4. Try to get out of the habit of holding reading material too close or moving too close to your computer monitor. This can strain your eye muscles and cause fatigue.
Happy reading!
Wednesday, October 24, 2012
How to Choose a LASIK Surgeon
Choosing a surgeon for any procedure can be a daunting task. This is especially true when choosing a
surgeon for laser vision correction, as there are few things more precious than
sight. LASIK is a surgeon dependant procedure. Akin to a master carpenter with master tools,
a highly skilled surgeon and the most advanced technological equipment are
required for an optimal result.
With that in mind, below are some important questions to
consider when choosing your laser vision correction surgeon:
Were
you told to discontinue the use of your contact lenses prior to your procedure?
Contact lenses, even the soft type, can distort the
wavefront reading of your cornea for a week or two after the contact lens is
removed. Because the treatment is so
precise and contact lens wear can distort that reading, it’s recommended that
patients discontinue their soft contact lenses for 1 to 2 weeks and toric and
gas permeable contact lenses for 2 to 3 weeks prior to laser vision
correction. This is to ensure that the
most accurate measurements can be obtained.
You want to be certain the measurements are obtained on the natural
shape of your cornea and not a cornea molded to the shape of a contact lens. New wavefront analysis measurements should be
taken on the day of your surgery.
Does
the surgeon personally examine you during your evaluation, educate and answer
your questions, and personally perform the procedure as well as your
post-operative care?
LASIK should be a procedure that is customized to each
patient’s individual needs. To achieve
this, a surgeon needs to get to know the patient, their profession, hobbies and
the specific goal they would like to accomplish with laser vision
correction. Additionally, there are
often adjustments that need to be made with post operative medications to
achieve an optimal result, so it’s important that the surgeon follow the
patient personally after laser vision correction.
Is
the surgeon using the most advanced pre-screening equipment available?
Pentacam analysis is one of the most sophisticated
screening technologies available. It is not necessary to perform on everyone, but
a significant number of patients are turned away as less than optimal
candidates because of findings that only this machine is able to uncover.
Is
the surgeon using the most advanced technology to perform refractive surgery?
iLASIK is the latest technology and the only advanced
all-laser procedure that NASA has approved for use on astronauts. This technology combines the VISX Wavescan
mapping technology with iris registration, the all-laser method of flap
creation with the IntraLase Femtosecond (FS) Laser and the CustomVue wavefront
guided vision correction procedure with the VISX excimer laser.
Did
you receive a thorough medical eye examination as a part of the laser vision
consultation?
The evaluation process should consist of a comprehensive
medical eye examination which includes an extremely precise refraction
(measured both before and after dilation), a glaucoma screening, dilation, as
well as extensive corneal curvature (topography) and corneal thickness
(pachymetry) measurements. This exam
should take a minimum of one hour to complete.
Is the
surgeon a corneal specialist?
LASIK is a corneal procedure. The corneal flaps created in LASIK are
thinner than a human hair. Surgeons who
are cornea-fellowship trained are best equipped to perform LASIK, as they are
specifically trained in microsurgical techniques of the cornea.
Is the
surgeon Board Certified by the American Board of Ophthalmology (ABO)?
The ABO was the first medical specialty board founded in
the U.S. and awards the only medical specialty certificate in ophthalmology
recognized by both the American Board of Medical Specialties (ABMS) and the
American Medical Association (AMA).[1] Board certification provides assurance to the
public that a physician has successfully completed an evaluation designed to
assess the knowledge, experience and skills requisite to the delivery of high
standards of patient care in ophthalmology.[2]
In summary, it’s important to get to know your laser
vision correction surgeon prior to undergoing this elective procedure. In the hands of a skilled corneal specialist, laser
vision correction is a safe and very effective procedure.
About
Dr. Mandel:
Dr.
Mandel has been a true pioneer in laser vision correction research since
1984. Dr. Mandel has been board
certified by the ABO, in good standing since 1988. Dr. Mandel is a Harvard trained corneal
specialist and is the author of the ophthalmic textbook entitled: Atlas of Corneal Disease. Dr. Mandel has performed tens of thousands of
refractive surgical procedures. At
Mandel Vision, Dr. Mandel personally examines you before and after your
procedure and will patiently answer all of your questions. Dr. Mandel is also the only exclusive laser
vision surgeon in New York named in America’s Top Doctors by Castle Connolly,
the most discriminating of the peer surveys, for eleven consecutive years.
Tuesday, September 11, 2012
Flexible Spending Accounts and Laser Vision Correction
If you have a flexible spending
account and are considering laser vision correction, now is the time to take
advantage of it!
A flexible
spending account (FSA) allows an employee to set aside pre-tax dollars to cover
qualified out-of-pocket healthcare expenses.
Qualified expenses include laser vision correction. These contributions are not subject to
payroll taxes, which can result in substantial savings. Here’s how it works. Employees are either given an FSA debit card
which they can use to pay directly for services using their FSA funds, or they
pay out of pocket and then submit a receipt to their employer for reimbursement
from their FSA account.
Currently,
there is no legal limit to what employees can contribute to their FSA and 78%
of large employers set it at $5,000 or higher.[i] Starting in 2013, when the Affordable
Care Act kicks in, the maximum annual FSA contribution for each employee will
be capped at $2,500.[ii] This cap goes into effect based on the
calendar year of your particular plan. Here’s
something else to think about: An
earlier version of the Affordable Care Act plan called for eliminating FSA’s
altogether, and this could come up again.[iii]
There is also a deadline for making contributions to an
FSA plan. For most plans that deadline
is between October and December for the following calendar year. This means you would have to contribute in
2012 in order to have access to the funds in 2013. Be sure to ask your plan’s administrator,
which would typically be your human resources director, what the deadline is
for your particular plan. Another
important aspect of an FSA is the “use-it-or-lose-it” rule. This means unused money left in the account
at the end of the calendar year for the plan is forfeited. This is especially important for those of you
who are considering using flex spending dollars for laser vision correction. If you deposit money into your FSA account
for LASIK or PRK, and are not a suitable candidate, you will either lose that
money or be forced to find creative ways to spend it on healthcare. Therefore, it’s best to have a consultation
to determine your candidacy for laser vision correction, or any elective
procedure, before making a contribution to your FSA plan.
The good news is our consultations at Mandel Vision are
FREE and extremely informative! So, you
have nothing to lose by scheduling your laser vision correction consultation
with Dr. Mandel. Better yet, you could
save yourself a very costly mistake!
Call our office at 212-734-0111 today to schedule your free consultation.
Thursday, May 31, 2012
Fear is one of the most common barriers patients face when
considering laser vision correction. Now,
thanks to former Navy Captain and ophthalmologist, Steven Schallhorn, MD,
patients can feel more secure. Dr.
Schallhorn performed LASIK on military personnel from the Army, Airforce,
Marine Corp., and Navy using the same advanced blade-free, Femtosecond and
Wavefront guided technology used at Mandel Vision. In an effort to determine the safety and
efficacy of LASIK, he then subjected these patients to some of the most extreme
and harsh conditions possible including high altitude, extreme G forces,
underwater pressures and blowing sand.
The results of the clinical trial were crystal clear. The visual results were excellent and the LASIK
flaps were stable, even after being subjected to the most extreme environments.
The LASIK flaps even proved to be stable in animal models that were exposed to
forces equivalent to those produced during ejection from a plane traveling at
400 knots.[i] Another concern, particularly for Navy Seals
who participate in many night maneuvers, is night vision following LASIK. Dr. Schallhorn found that night vision
actually improved[ii],
following LASIK with Femtosecond technology.
This is critical, as many of these maneuvers put these soldiers in life
and death situations. LASIK has enabled
soldiers previously ineligible for special forces, due to the need for contact lenses
and glasses, the opportunity to realize their full potential in the military.
Additionally, after careful review of Dr. Schallhorn’s data,
NASA, which previously banned any laser corrective eye surgery, approved LASIK
for its astronauts.[iii] This decision, made despite the physically
demanding, extreme zero-gravity conditions that astronauts endure, was not
taken lightly. Poor vision was the
number one factor that previously disqualified many NASA applicants.[iv]
LASIK, yet again, has opened the door to allow many more aspiring astronauts
the opportunity to realize their dreams of space travel.
Patients can take comfort in the knowledge that LASIK is
deemed safe in even the most extreme environments. AMO, one of the leading ophthalmic laser
companies, says it best: “Consumers
looking for proof that LASIK is safe, effective and advanced enough for them
need look no further; LASIK has proven it has ‘The Right Stuff’”.[v]
Click on the links
below to view the documentary, produced by Patient Education Concepts, entitled:
LASIK
on the Frontlines.
8 minute version: http://www.youtube.com/watch?v=4q-pbmLr46Q
28 minute version: http://www.youtube.com/watch?v=awBS2sxNCqU
[i]
Tanzer, David J.Laser Vision Correction in the US Military. Cataract &
Refractive Surgery Today. June 2008.
[ii]
Ciccone, John. LASIK: On the Frontlines.
ASCRS EyeWorld. February 2012.
[iii]
Rundle, Rhonda L. Want to Work in Space? Squinters Can Now Apply. WSJ, Sept. 21, 2007, Vol. CCI, No. 69.
[iv]Ibid
[v]
AMO, Inc., ©2007. NASA Approves Advanced
LASIK for Use on Astronauts
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