Diabetic retinopathy is the most common diabetic eye disease and a leading cause of blindness in American adults. It is caused by changes in the blood vessels of the retina.

In some people with diabetic retinopathy, blood vessels may swell and leak fluid. In other people, abnormal new blood vessels grow on the surface of the retina. The retina is the light-sensitive tissue at the back of the eye. A healthy retina is necessary for good vision.

If you have diabetic retinopathy, at first you may not notice changes to your vision. But over time, diabetic retinopathy can get worse and cause vision loss. Diabetic retinopathy usually affects both eyes.

If you have diabetes get a comprehensive dilated eye exam at least once a year and remember:

• Proliferative retinopathy can develop without symptoms. At this advanced stage, you are at high risk for vision loss.
• Macular edema can develop without symptoms at any of the four stages of diabetic retinopathy.
• You can develop both proliferative retinopathy and macular edema and still see fine. However, you are at high risk for vision loss.
• Your eye care professional can tell if you have macular edema or any stage of diabetic retinopathy. Whether or not you have symptoms, early detection and timely treatment can prevent vision loss.

If you have diabetic retinopathy, you may need an eye exam more often. People with proliferative retinopathy can reduce their risk of blindness by 95 percent with timely treatment and appropriate follow-up care.

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A lot of the best analysis has been through Navy and Air force pilots.  Many individuals in the military would be rejected as pilots based on inadequate vision.  Although they may have good vision with contact lenses or glasses, in the intense environment of combat, the contact or glasses wearer is seen to be at a severe disadvantage.  As PRK and Lasik continued to advance and develop, eventually the military began to approve the newer methods for their personnel.

Eventually, even NASA approved the use of the advanced blade-free Lasik procedure (iLasik) for use in astronauts.  The physical and visual requirements for astronauts are very stringent and many individuals that were otherwise very qualified were previously rejected based on vision only.  The zero Gravity and other difficult space related environmental issues made it difficult for people wearing glasses or contact lenses to function decently.  Ultimately, there were so many people that wanted the chance to become astronauts that those with the “handicap” of nearsightedness were simply removed from consideration…they were out-competed by their luckier colleagues that were not “blind.”

It took the advances of the blade-free Lasik procedure to win acceptance by the military and NASA for their personnel.  This procedure is the same iLasik technique that we have used for quite some time at our surgery center.  I have had experience with the older diamond blade RK surgery which didn’t use a laser at all.  I’ve also had extensive experience with Lasik from its beginning when it originally used a high speed vibrating razor blade and now to the most advanced stage where the entire Lasik procedure is performed using only lasers with no blades whatsoever.  In many ways, the advancement to the blade free iLasik technology is as big a leap forward from old style Lasik as the excimer laser and PRK were over RK.  Prior to the development of the excimer laser, refractive surgery was actually somewhat of a small, almost fringe group within the eye surgery community.  RK surgeons were a tiny minority while the vast majority of ophthalmologists chose not to be involved with refractive surgery.  In general, it was the unpredictability and safety issues of blade based refractive surgery that turned so many surgeons away.  It was the availability of the highly precise and very safe excimer laser that spurred the rapid growth within the eye surgery community and it is predicted that within this generation, the majority of comprehensive ophthalmologists will be trained in and perform refractive surgery to some degree.  So it is ironic that many Lasik surgeons continue to cling to the old style bladed Lasik rather than embracing the more advanced, precise, and safe blade-free iLasik techniques.  Clearly, the US Military and NASA recognize the difference for their personnel and we do so for our patients also.  If you are a prospective refractive surgery patient considering Lasik, you should choose to use the highest standard available as well.

About the Author:  John D. Suson, MD - www.supereyes.com

     Dr. Suson holds a clinical faculty appointment in the Department of Ophthalmology at the Medical College of Wisconsin and is in private practice in Milwaukee, WI.  His focus in Ophthalmology is refractive surgery, cataracts, and treatment of glaucoma and diabetes.

     Dr. Suson is a preferred refractive surgeon for NewSight Laser Network, a network of over 100 Optometrists in southeastern Wisconsin.

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The obvious answer, which I think you already know, is that it can’t.  The ads are designed to get you in the door but are deceptive in many ways.  Certain chain centers have even received warnings or disciplinary action from the Federal Trade Commission for deceptive advertising.  To avoid FTC warnings, what often occurs is that the advertised price is a starting point to which thousands of dollars will be added to the price before surgery can actually proceed. 

One tactic that is commonly used is to have a low price available for an older, very limited technology which does not apply to most people.  In fact, in my practice, many of the people that might qualify for this cheap surgery, I discourage from having surgery because their vision is already so good that it’s not worth undergoing Lasik.  Everyone else with normal prescriptions is told they do not qualify for the $500 surgery because of their higher prescription and the cost ends up being $3000 more than expected.

They also use the sales tactic of up-selling the patient with “optional” benefits which are not truly optional.  The surgery itself is billed as one component, but the various parts of the preoperative evaluation and postoperative care are then added onto the price. It is impossible to perform the surgery without doing a complete examination beforehand and follow-up afterward, so the price skyrockets when everything is added up.  I had an anesthesiologist friend that used to have a joke: “The cost to put you to sleep for surgery is only $1, but if you want to wake up, the price goes up.”  It’s the same with these Lasik surgery chains, but the joke is really on the patient/consumer. 

Third, as I’m sure you all know, they use inferior, out dated technology.  In fact, the technology that is available for the extremely cheap $500 Lasik is usually VERY old and doesn’t apply to most people that truly need Lasik.  How else could it be offered at a price so close to what you already pay for a pair of glasses!!  But even the supposed “cutting edge technology” is not the latest available instrumentation, even though they may say it is.  These cheap centers continue to use the old razor blade flap cutting technology that all of the highest quality reputable Lasik surgeons abandoned years ago.  Why would you want a high speed vibrating razor blade cutting your eye if you could have a high precision, high safety laser do the same thing…only better!!? 

Unfortunately, by the time all of this is revealed to the patient, they have been charged a significant, nonrefundable consult fee for an evaluation.  If you do proceed with the surgery, the fee is applied to surgery, otherwise it is lost money.  Now you are forced to choose an inferior and potentially less safe technology at a much higher cost than you were lead to believe.  Wouldn’t it be better to work with a practice that doesn’t deal with shady sales tactics to trap you and that uses only the highest levels of technology?  The choice is yours, but you should definitely see somebody like us that will not force a financial commitment on you before you even know what your Lasik surgery choices are.

About the Author:  John D. Suson, MD - www.supereyes.com

     Dr. Suson holds a clinical faculty appointment in the Department of Ophthalmology at the Medical College of Wiscosin and is in private practice in Milwaukee, WI.  His focus in Ophthalmology is refractive surgery, cataracts, and treatment of glaucoma and diabetes.

     Dr. Suson is a preferred refractive surgeon for NewSight Laser Network, a network of over 100 Optometrists in southeastern Wisconsin. 

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     Of the 20 million children in the U.S. under age five, only 14% have had an eye exam.  So nearly 18 million children have not received an eye exam before entering school.  A report by the National Eye Institute indicates that visual impairment in children is associated with developmental delays and the need for special educatiional, vocational and social services into adulthood.

     Many of NewSight Laser & VisionCare doctors participated with a program managed by Optometry’s Charity - The AOA Foundation and the Wisconsin Optometric Association called InfantSee.  InfantSee is a program through which optometrists provide eye examinations for babies during their first year of life - a critical time when any findings may be treated proactively.

    Please visit http://www.newsightlaser.net/find-optometrist-wisconsin.php to find a participating optometrist near you.

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     The lens is made mainly of water and protein, arranged in a way that keeps the lens clear allowing light to pass through it.  As we age some of the protein may clump together and cloud areas of the lens.  This is a cataract.  As we age over time the cataract may grow larger and clound more and more of the lens reducing the quality of the images  we look at.  Research suggests there are several causes, such as smoking, exposure to ultra-violet light and diabetes, to mention a few.

Most cataracts are related to aging but there are other types:  traumatic cataract - cataracts can develop after an eye injury, sometimes many years later;  Congenital cataract - some babies are born with cataracts or develop them in childhood.  These may be so small they do not affect vision. If they do, the cataract is removed;  secondary cataracts - cataracts can form after surgery for other eye problems like glaucoma or diabetes;  radiation cataract - cataracts can develop after exposure to some types of radiation.

     Cataracts are detected through a comprehensive eye exam that includes: visual acuity testing, dilated eye exam, tonometry.  Your NewSight doctor of optometry can make a determination during your exam and offer clear alternatives for how you can best resolve your vision issues.  Our doctors can provide you professional care and guide you in making the best decision for your life style needs.

Stay tuned for additional follow ups on the surgical process and technologys available for those who have cataracts.

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• All branches of the US military and NASA recently allowed the treatment of Lasik for their servicemen and women, thanks to studies using the iLasik Technology.
• Doctors have been performing laser vision correction procedures for over a decade, and 31.4 million procedure have been performed worldwide to date,* making it the most common elective vision procedure in the US.
• Based on infection rates associated with wearing contact lenses, experts consider Lasik safer than wearing contacts.**
• Ninety-eight percent of mildly to moderately mearsighted patients participating in the CustomVue Clinical Trails submitted to the FDA could see 20/20 or better one year after treatment.***

For a free consultation to determine if you are qualified visit www.newsightlaser.net or call 877-602-1010.

* Market Scope Q1 2009 Quarterly Estimate.

** Oregon Health & Science University (OHSU) Caser Eye Institute.  Is Lasik Surgery Safer than Contact Lenses?

*** Data on file. AMO Development, LLC.  CustomVue Procedure Clinical Trails submitted to FDA: 2003, 2004, 2005, 2007.

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One possible reason?  Almost two-thirds of children under the age of six never had an eye exam by an eye doctor, the survey said.  Additionally the survey showed that one in four 6 to 11 year-olds wear prescription glasses, and that prevalence of eye conditions increases with the child’s age.

“The survey provides a clear example of why regular eye exams are so important as childern progress in school,” said Gary Brooks, VSP Vision Care’s president.  “The survey results reinforce the need for regular eye exams as kids’ eyes continue to change and adapt.”

Prevent Blindness America recommeds that all children have their vision checked at infancy and regularly through-out childhood, and that if a child fails a vision screening, or parents are concerned about an eye or vision problem, the child should have a complete eye exam by an optometrist or ophthalmologist…

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A total of 993 vision- corrected astigmatic patients completed an online survey.  15o patients had never worn contact lenses, and 178 had worn contact lenses in the past.  The results of the survey showed that seven out of ten of those who had never worn contact lenses would be highly interested to wear contact lenses if the were available and their eye doctor made the recommendation.

During the last few years several contact lens companies have develop better and new material that has led to many more astigmatic patients having very good success in wearing contact lenses.  Next time you see your NewSight eye doctor make sure you ask for a technology update. NewSight VisionCare optometrists are able to fit some of the most difficult to fit patients.

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Polarized.  Because they block light waves that align in horizontal patterns when reflecting off flat surfaces, they are useful for fishing, hunting, skiing, and driving.

Tint. Tint is mainly a matter of preference - for best color preception use lenses that are gray, amber, brown, or green.  Green offers the  best contrast with little or no color distortion.  Darker lenses don’t necessarily provide more UV protection.

Mirror coating.  It’s derived from thin layers of various metals coating and doesn’t automatically convey UVA/UVB protection.

Blue blocking.  Describes amber colored lenses that protect eyes from blue visible light.  There is some evidence that the retina might be more sensitive to that light.

ANSI.  The American National Standards Institute, oversees development of voluntary standards for sunglasses and other products.

Impact resistant.  The Food and Drug Administration requires all sunglasses to survive an impact test without fracturing but not to be shatterproof.

Polycarbonate.  A plastic that resists impact especially well.

Photochromic.  These lenses lighten or darken is response to sunlight.

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