Lasik followed by Retinal Detachment, then Pain

Over the years I have been asked about scleral lenses and eye pain many times. The 2 images below are of the same eye. This patient underwent LASIK surgery about 15 years ago. 3 years later this eye suffered a 360 degree retinal detachment which created a completely blind eye (no light perception). About 3 years ago this eye became so painful that this patient was contemplating having the eye removed. After visiting a number of eye care providers seeking relief from this pain without success this patient was referred to my office for help. In all my years of practice this was the most debilitated painful eye that I had ever seen. I fit this eye was a specially designed scleral lens with the intention of protecting the compromised cornea from the environment and the blinking action of the eyelids. Look carefully at the first photo and you can see the cloudy, scarred, blood vessel filled cornea with a scleral lens over it. The 2nd image is a cross section of the same cornea with the scleral lens over it. In this image, the top 2 curved lines are the front and back surfaces of the scleral lens. The thick curved grey structure is the compromised cornea. Again, look carefully and notice the split in the center of the cornea. This is the LASIK flap separating the anterior cornea from the underlying cornea. Also note that the outer layer of the cornea (the corneal epithelium) is coming "unglued" a condition known as "bullous keratopathy". This patient has been able to function pain free for the past 2 years with the scleral lens even though this is a blind eye. It is amazing that this patient was very happy with his vision for the 3 years following his LASIK procedure.

The Wavefront Scleral Lens

The corneal irregularities created by refractive surgeries, such as LASIK and RK, are responsible for ghosting, halos, starbursting, and loss of contrast sensitivity. These "higher order aberrations" may exist on both the anterior and posterior. With aberrometry, the defects of the entire optical system can now be corrected by a scleral lens.

The Wavefront Scleral Lens

Autologous Serum for Dry Eyes

Dry eye conditions are among the most challenging conditions faced by refractive surgery patients. With autologous serum, blood is spun down to plasma, forming an eye drop that helps rehabilitate the cornea.

Learn More about Autologous Serum

Dr. Boshnick on CBS This Morning


See Dr. Boshnick and Dr. Morris Waxler (former FDA chief research scientist on refractive surgery) talk about bad LASIK

Optimum Infinite Gas Permeable Material

I am happy to announce that our Global Vision Rehabilitation Center will be designing and fitting all of our “high need” patients with the Optimum Infinite gas permeable contact lens material. The Optimum Infinite material is the most oxygen permeable material ever to be approved by the FDA. In addition, this newly FDA approved material includes a UV lens blocker. Now for the first time, with certain patients, wearing a scleral lens made with the Infinite material under extended wear conditions can be considered.

SMAP 3D Scleral Lens Design

NEW: Powerpoint presentation on SMAP 3D

Last year we introduced an exciting piece of technology that has allowed us to custom design a scleral lens much more accurately. It is the SMAP 3D, which is a computer attached to a dedicated camera that allows us to obtain a 3 dimensional image of the entire front surface of the eye, including the cornea and the surrounding white portion of the eye (the sclera). Up until now there has not been any technology that would allow us to measure the ocular curvatures outside the cornea. The SMAP allows us to do this. Read More

Have Twitter?

Follow @Boshnick or check https://twitter.com/boshnick

Have Instagram?

Dr. Boshnick on Instagram

Check out EyeFreedom.com

EyeFreedom.com

The NEW YORK TIMES on LASIK

Blurred Vision, Burning Eyes: This Is a Lasik Success?

EyePrint Pro

EyePrintPro technology creates a scleral lens based on a mold of the cornea. The molding is accurate to 1 or 2 microns and fits perfectly because it exactly mirrors the irregularities of the individual corneal surface. The technology is well suited for post-Lasik, Keratoconus, RK, eye injury, and corneal transplant patients. Read More in this PDF about EyePrintPro Scleral Lens Technology

Watch Video at YouTube