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In the past 25 years, Dr. Boshnick has participated in over 100 clinical contact lens studies for major contact lens manufacturers. In addition, Dr.Boshnick has lectured and presented papers at national and international conferences.
Our specialty contact lens practice is known as the Global Vision Rehabilitation Center. Dr. Boshnick and his staff have dedicated themselves to the restoration of quality vision to those patients who have suffered vision loss due to keratoconus, corneal transplant surgery, refractive eye surgeries such as LASIK, R-K surgeries, chronic dry eye, ocular trauma, auto-immune disease and corneal dystrophies such as Stevens-Johnson Syndrome and many other ocular conditions.
The Global Vision Rehabilitation Center is one of the first specialty lens practices in North America to focus it’s attention on this very special “high need” population. Patients who have suffered loss of quality vision and ocular comfort due to the conditions discussed above, can require a great deal of time to address. Our practice is dedicated to this special patient population and we are prepared to provide the time and effort needed to restore quality vision once again.
Thousands of keratoconus patients each year are advised by their eye doctors to get corneal transplant surgery (keratoplasty). The great majority of this patient population in reality would do quite well with properly fitted scleral lenses. Keratoplasty is not a “walk in the park.” There are real risks associated with this procedure. The following are the facts associated with keratoplasty:
1. Over 50% of those patients receiving corneal transplant surgery with need scleral lenses in order to achieve visual acuity greater than 20/50. Contrary to what one might think, these lenses are comfortable and very easy to wear.
2. It will take about 1 year for vision to stabilize.
3. There may be a limited lifespan to the transplanted cornea. Repeated corneal transplant surgery due to rejection and/or infection is the 2nd commonest indication for keratoplasty.
4. There is a risk of life-long rejection (this decreases after the first year).
5. There is a susceptibility to traumatic wound rupture.
6. During the first year after the corneal transplant surgery, anti-rejection eye drops will need to be used. The used of these eye drops may increase the risk of glaucoma and cataracts.
For the above reasons, I always recommend that patients with keratoconus and other corneal conditions consider every non-surgical alternative before getting involved with corneal transplant surgery.
A well designed and fit scleral lens serves 3 functions: A. Protect the compromised cornea from the environment and the blinking action of the eyelids. B. Keep the eye moist as most keratoconic corneas have a dry ocular surface. C. Provide excellent vision along with excellent comfort.
The photo below shows a transplanted cornea with sutures. Do you want to do this to your eye?
These photos are of two eyes that underwent corneal transplant surgery that resulted in corneal rejection followed by infection inside the eye( endophthalmitis )
Sadly the result was permanent blindness. While these events are rare they do occur.
Optical Coherence Tomography creates a series of 2-dimensional cross-sectional photographs of the eye running from the surface to the back of the cornea, thus measuring the complete anterior segment of the eye. The instrument is invaluable for fitting scleral lenses, since the characteristics and clearance of the lens can be isolated and measured in microns. This detailed profile assists in obtaining more perfectly fitting lenses that can be worn comfortably for many hours. Below are some recent photographs showing scleral lenses being worn and measured by the Visante OCT. Note how irregular the cornea is, and how the scleral lens is able to form a smooth prosthetic surface that restores vision.
Exam Room: We have some of the most advanced equipment in the Southeastern United States. Here’s a look at the exam room.
How we use digital imagery to help patients: The monitor to the left on the wall is showing the corneal topographies of 2 corneas damaged by Radial Keratotomy surgery. The monitor on the right is showing a digital photograph of an eye devastated by Stevens-Johnson Syndrome. We use these and other digital imaging technologies to explain to patients and their families the exact nature of ocular and vision disorders we are dealing with and to better explain the type of technologies that will be needed to restore vision and ocular comfort.
This Marine Captain served 2 tours of duty in Afghanistan while suffering from advanced keratoconus in both eyes. As his condition progressed he had Intacs (plastic intra-corneal rings) surgically inserted into both corneas. The Intacs did not improve either his comfort or his vision. He was scheduled for corneal transplant surgery but was asked to visit our office before undergoing this surgery. We fit him with GVR Scleral lenses which he has been wearing for several years now. His visual acuity is 20/20 in each eye and he is able to wear these lenses with all day comfort.
COMMENT FROM CARMEN MOLINA: Thank you so much Dr. Boshnick….our Captain is very valuable not only as a mentor but a friend to so many students and staff….glad to hear that you were the reason for his sight…GOD bless you and the staff
El respeto y afabilidad de un amigo lo hace resplandecer mas que oro.
Cuando pude encontrar a Dr Boshnick, y después de conversar un poco con el me di cuenta que no solo es un experimentado en la oftalmología sino también un ser humano que tiene la habilidad de inspirar confianza a sus pacientes.
LLegue a El con un keratoconos en ambos ojos de mas de treinta y cinco anos,transplante de cornea, y una progresiva perdida de visión ,soy de profesión relojero y amo lo que por cuarenta anos he hecho,desafortunadamente mi cuadro visual se deterioro a tal grado que mi previo oftalmólogo me comento en mas de una ocacion que aplicara al desability.
Asi llegue al consultorio de Dr.Bosnick, con el animo por el suelo y pocas esperanzas, y pareciera que el rápidamente lo noto,se tomo el tiempo para explicarme las opciones y me comenzó un procedimiento de restauración ocular utilizando un novedoso tratamiento con conchas proteticas oculares que nunca me había sido mencionado por otros oftalmólogos ;al principio me dijo: “esto va a ser como un viaje a Roma que haremos juntos ,ey todavía no hemos empezado el viaje”, asi fue que comenzó con el tratamiento en mis deteriorados ojos; al principio no fue fácil ,ni para El doctor ni tampoco para mi que usaba por primera vez este tipo de lentes tan grandes,con el correr de las semanas y varios cambios de lentes comencé a sentirme mas comodo y mi vista ha mejorado progresivamente,actualmente uso los lentes por trece horas diarias y no siento ni resequedad ni ningún tipo de molestias,todavía el Dr.no ha terminado su trabajo con mis ojos ,pero ya pude regresa a mi profesión y me siento mucho mas esperanzado. Creo que si algún día tengo el privilegio de visitar la hermosa ciudad de Roma,allí nada me será estrano! ,pues podré recordar a mi amigo medico Dr Edward Bosnick que me acompaño en un primer viaje imaginario,y quizás en una noche estrellada me dijo mira arriba a ver si puedes ver las estrellas,y yo con mi vista restaurada pude decir junto con el salmista David “Los cielos cuentan la gloria de Dios,y el firmamento anuncia las obras de sus manos”
Dr. Edward Boshnick
Snapper Creek Professional Center
7800 SW 87 Ave Suite B-270
Miami, Florida 33173
305.271.8206