I thought I’d devote a post to those common myths you always hear about the eyes.  I get questions about one of these at least once a week.  It’s hard to do something contrary to the old wives tales you grew up hearing, and sometimes I even have to stop myself from believing something which I know is not true!  My oldest son loves the show Mythbusters and I have to admit, it’s pretty cool, hence the Mythbuster approach to eye myths (without any of the experimentation!).

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So, let’s get started.  Common Eye Myths – which ones are true and which ones are not!

1.  It’s bad to read in the dark.

This is how my son loves to read at night.  All the lights in the room are off and he uses this little bedside Ikea light.

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It actually is not dangerous to read in the dark.  It doesn’t make you need glasses sooner.  It doesn’t tire the eyes out.  There was one study which showed that reading in the dark for adults did affect their comprehension and reading times.  So, it stands to reason, for young readers, it’s best to use high contrast reading material to make it easier for them to read faster and understand what they’re reading.  But, again, not unsafe for they eyes.

MYTH BUSTED

2.  Babies will outgrow cross eyes.

Very rarely, babies can have wandering or crossed eyes when they are born.  Just like they are learning how to use their arms and legs, they have to develop their eye muscles and vision.  However, by the time babies are 4-6 months old, they should be able to use their eyes to focus on faces and toys up close with straight eyes.  It’s actually common for babies younger than 6 months old to have eyes that wander out.  The problem that often happens, is that many babies have real crossed eyes, which do not improve with time, as in my patient below who needed surgery.

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Sometimes, the parents, and even the pediatricians, falsely reassure the parents that this kind of eye crossing will improve.  So, they wait to come to see a pediatric ophthalmologist. This kind of eye crossing, esotropia or strabismus, does not improve with time.  And, actually when babies have esotropia, it is best to operate sooner rather than later.  The sooner your perform surgery, the better the child’s change to maintain or restore their depth perception. Strabismus surgery in infants is not a cosmetic procedure.  There is a lot of misinformation about strabismus surgery.  I remember I was operating on the little baby above (she was 7 months old) and even the Harvard employed anesthesiologist at Boston Children’s was questioning the mom as to why she was having surgery at such a young age!  Thankfully, the mom was extremely well educated on the topic and could set the anesthesiologist straight.

MYTH CONFIRMED (with a caveat)

3.   Sitting too close to the TV is bad for the eyes

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Maybe about once a week, I get a parent in my office who hopefully asks “It’s bad to sit close to the TV, right?” looking meaningfully at Little John in the exam chair.  Except, that it really isn’t.  So, I truthfully answer that sitting close to the TV is not harmful to the eyes or the vision.  No studies have found that it makes kids need glasses faster.  But, your child might be sitting close to the TV because they cannot see it.  It might, in fact, be a sign of nearsightedness in a child.  Your children’s eyes have the ability to focus much better than an adult, so for them, sitting (or standing) close to the TV is comfortable.  I do always add that the American Academy of Pediatrics does recommend restricting screen time (TV, iPad, iPhone, etc) to a maximum of 2 hours a day and only for children older than 2 years of age.

MYTH: BUSTED

4.  A cataract needs to be “ripe” before it can be operated upon.

Using words like “ripe” is an old school way of describing the severity of the cataracts.  Older ophthalmologists wouldn’t operate on a cataract until the cataract was large enough.  But, bear in mind, this was back when you had to be admitted to the hospital for cataract surgery and use sand bags to immobilize your head post-operatively.  Cataract surgery was a big deal.  Nowadays, no one uses that terminology, because with lasers an new intraocular lenses, cataract surgery doesn’t carry the same risks as it did 30 or 40 years ago.  So, really, it comes down to if your cataracts are interfering with your ability to do things you love – drive at night, reading, painting, etc.  If so, then it might be time for you to talk to your ophthalmologist about cataract surgery.   There’s no hard and fast line about when your cataracts are ready to be removed.  It’s all about how they affect your activities of daily living.

MYTH: BUSTED

5.  Wearing glasses will make your eyes dependent on them.

This is the one I am currently struggling with.  As I approach 40, I find it hard to read my iPhone in low lighting conditions.  I have a pair of very low prescription reading glasses (+0.50 sphere).  But, even though they make my quickbooks accounting much easier, I am hesitant to wear them.  Why you may ask?  I love the look of them – in fact, growing up not needing glasses ever, I always wanted glasses.  I adore my Fendis.  But, it’s for the simple fact that even if it’s way deep down, I still succumb to the notion that if I start to wear the reading glasses more regularly, my vision will deteriorate.  That is just not true.  My need for reading glasses will increase every year whether or not I wear glasses now.  Same is true for kids. A lot of parents worry about this dependency as well.  Children’s need for glasses has nothing to do with whether or not they were their glasses.  Genetics, anatomy of the eye are what’s important.

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I don’t like taking selfies

 

MYTH: BUSTED

6.  Crossing your eyes make them stay that way.

An oldie, but a goodie.

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Nope – crossing your eyes will not make them stay that way.  So, kids, cross away to your heart’s content.  Esotropia, or eye crossing, has many different causes.  People can be born with it (congenital esotropia), it can be secondary to being really farsighted (accommodative esotropia), from a blind eye (sensory esotropia), or even from a nerve palsy.  But, not because you do it over and over again.

MYTH: BUSTED

7.  Carrots help prevent you from needing glasses.

I love carrots.  I ate a ton of them growing up.  It was my after school snack with French salad dressing.  And, I don’t wear glasses (well I didn’t for the first 39 years of my life).  But, though carrots are rich in Vitamin A, that doesn’t help you from being nearsighted, farsighted or having astigmatism.

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It is always a good idea to eat a diet rich in vitamins and antioxidants for the overall health of your eyes.  Click here for my blog post about anti-oxidants and your eyes (with recipes)

MYTH: BUSTED

 

Hope you enjoyed our fun mythbusters post!

 

 

 

I can’t believe it’s been 2 months since I posted last.  Now that  all of the kids are in school, I can get back to a regular posting schedule. This past weekend, we invited all of our patients to a talk entitled “Advances in Cataract Surgery” at our office.  I went to my new favorite place – fiver.com to find a graphic designer to help design the invitation.

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The hard part was convincing my husband, Dr. Jeff Wong to actually give the talk.  You may have noticed that I tend to be the one to do all the videos and talks for our practice.  I enjoy it and don’t mind being in front of an audience or a camera (guess I can credit my days as a pageant queen for that).  But, Jeff is another story.  He is actually very well spoken and gives wonderful, insightful presentations, but he is more reserved and doesn’t like being front and center.  However, I was surprised that he was actually up for giving this talk.  As he said at the beginning of the talk on Saturday “I love doing cataract surgery and I love talking to my patients about cataract surgery, so that they have all of the information they need to make an informed decision”

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We had a continental breakfast for guests.  The poi malasadas went fast!

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And, our 2 surgical coordinators, Ronnie and Kaui were on hand to help answer questions as well about the surgical scheduling process.

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We had a great turnout – it was just the perfect number of people to provide an intimate forum for everyone to ask their questions.  Joel, our optician even went around and cleaned all of the guests’ eyeglasses – now that’s service!

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My husband gave basic information first – what is a cataract?

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He then discussed laser cataract surgery, which most people have heard about.  We’re lucky that we’re part of the Eye Surgery Center of Hawaii.  They have a laser cataract surgery machine and my husband is able to offer this option to all of his patients   As much as we love operating at Queen’s Medical Center, Queen’s doesn’t have a laser cataract machine, so for the past few years, we’ve been doing all of our adult cataract surgery at the Eye Surgery Center.  Click here to see my previous post about laser cataract surgery

catalys2He then answered specific questions about all of the various types of intraocular lenses which can be inserted into the eye. At the end, we also received really wonderful feedback, so I think we will try to do this roundtable talk very few months.  Keeping it small really allowed for everyone to feel comfortable interrupting my husband if they didn’t understand something.

At the conclusion of the talk, all guests received little gift bags chock full of educational information about cataract surgery.

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And, the nice part was, even though we did the talk on a Saturday, we just brought the kids in with us (just like old times!)

Here are 2 hard workers heading home.

IMG_8042Come join us for our next talk.  We’ll post invites and updates on our social media – facebook, instagram and twitter.

 

Whenever I tell a patient that they have cataracts and start discussing surgery, many always ask “Is the surgery done with laser?”  Until the past year, I would say no, it’s not laser that removes the cataract.  Since the 1970’s, cataract surgery  has been done withphacoemulsifcation, or ultrasound power to break the cataract into tiny pieces.  Phacoemulsification utilizes the same ultrasound  that dentists use to clean your teeth and was actually developed by Dr. Kelman at the Manhattan Eye, Ear & Throat Hospital where my husband and I trained, met and fell in love (a subject for another post).

However, at the end of 2011, the FDA approved the CATALYS Precision Laser System, a next generation laser cataract machine.  Earlier this year, my husband, Dr. Jeffrey Wong, became one of the first cataract surgeons in Hawaii to offer laser cataract surgery with the CATALYS.  Using CATALYS, he can provide a gentle, highly customized cataract procedure with precision not achievable with traditional manual techniques.

How does it work?

Every eye has a unique size and shape. CATALYS’ advanced 3D imaging technology builds a 3D map of each eye and tailors the treatment to that map. This enables the surgeon to create a customized treatment plan that matches the uniqueness of each eye.

Next, the surgeon uses CATALYS to create a circular opening for accessing and removing the cataract.  Usually, the surgeon does this manually with a sharp instrument and small forceps.  However, the CATALYS machine can create this opening, or capsulorhexis,  for the surgeon using laser.  Clinical studies have shown that this opening is approximately 10 times more accurate when performed with CATALYS than what is achievable by hand.1,2  This opening is an extremely important part of cataract surgery, for it allows the surgeon access to the cataract.  If the opening is not perfectly circular, complications can occur with the placement of the artificial lens.  That’s not to say that an experienced surgeon has to use the CATALYS machine to make the capsulorhexis.  I’ve watched my husband perform cataract surgery numerous times and he has no trouble creating circular opening, however this laser machine does eliminate the chance that opening may be too large or too small, or not perfectly round.  After all, it’s a machine, so it makes the same 5 mm opening every time.  After creating the opening, CATALYS then softens and breaks up the hard cataract into tiny pieces, allowing for gentler, easier cataract removal.3  

Using the manual technique without the CATALYS machine, my husband would have to use the instrument pictured below along with the ultrasound probe to break the cataract into many pieces.

Again, in experienced hands, this technique often results in perfect 20/20 vision, but it does require additional ultrasound power.  With the CATALYS machine, since the laser divides up the cataract, the ultrasound power that is used to remove the cataract is less, which is better for the overall health of the eye.

Depending on the patient’s pre-operative vision and desired visual result, Dr. Wong, or whoever your cataract surgeon is, may recommend a tailored treatment plan that could include creating ultra-precise laser incisions in the cornea and a specific clear lens type, such as a multi-focal lens. This tailored treatment may reduce a patient’s need for glasses or contacts after surgery.

What are the benefits of Laser Cataract surgery?

  • A highly customized procedure using advanced 3D imaging
  • A treatment with little or no discomfort
  • A more precise treatment
  • A gentler and easier cataract removal – this means less trauma to the cornea (the front section of the eye)
  • Generally, a more rapid visual recovery due to reduced inflammation
  • The opportunity to receive tailored treatment with advanced technology multi-focal lenses, which may reduce the need for glasses or contacts after surgery

What is a patient’s experience like with CATALYS ?

Most parts of the surgery are the same with or without the laser.  You still have to check in to the surgical center an hour before the surgery and you can’t eat anything after midnight.  The main difference is the extra step of the laser.  Before going into the operating room where the actual cataract is removed, patients first go into a small room where the laser is located.  The laser machine is pictured below:

Patients like on the bed and the surgeon “docks” the machine on to your operative eye.  Then, he or she will enter the parameters into the machine and guides the machine in making the laser cuts for the capsule opening and sectioning the cataract into pie pieces.  Then, the patient is taken to the operating room, where the surgeon will use the phacoemulsification probe to completely remove the cataract and insert the artificial lens.

A Patient’s view of surgery with the CATALYS

One of the first patients, a nurse at Queen’s, who my husband performed laser cataract surgery on in the summer, was kind enough to record her experience.

Last year, I had the conventional cataract surgery done on my right eye, by Dr Jeff at Queen’s same day surgery. My pre and post op recovery was uneventful, painless, and successful.  This year, for my left eye, I chose to the computerized Optic procedure and the newest Laser Cataract Surgery with CATALYS. Nervous?  No, not at all. I had already researched on line, decided that the Laser Cataract Surgery with CATALYS, would be the most precise and present the fastest recovery. Preoperatively, Dr Jeff thoroughly explained the procedure, and I was ready! The morning of the surgery I arrived at the Surgical Eye Center, was warmly greeted and the preop procedure were started. The Surgical Eye Center has a very relaxed atmosphere. The staff was friendly, informative, very attentive and efficient.  I barely felt the IV start, and appreciated the fact that I did not have to change out of my clothes into a surgical gown. What I was unprepared for, was how painlessly simple the whole procedure would be! I was taken to the room with the Catalys machine, and lay comfortably down on the table.  Dr Jeff explained each step by step of the procedure. I was instructed to focus on the “red light”…and for me this became a light show and a kaleidoscope of red scales and textures. I was mesmerized by the moving lights! After a few seconds (or minutes, I am not sure) a beautiful green light branched out like tiny capillaries, covering the red scales.  Slowly all of the lights and colors faded, and I was assisted to sit up and walked back to the gurney. I was really amazed! I do not remember very much of the second part of the surgery which was the lens implant procedure.  It maybe the effects of the fentanyl or versed, but I think I was still thinking about my “personal light show”. The whole cataract and lens implant took less than 10-15 minutes.I went home, took a tylenol and watched netflix movies! By that evening I was already on the computer checking emails! The next morning I was able to drive to the Honolulu Eye Clinic.Today, I still find myself staring at the leaves of trees and at plants and flowers, as colors are brighter and more vibrant. Post operatively, and I continue to notice that my vision is sharper and I am able to see things more clearly.

The world is really beautiful! This was amazing! Thank you Dr Jeff!

If you are interested in learning more about laser cataract surgery with my husband, Dr. Jeff Wong, in Honolulu, please contact us at Honolulu Eye Clinic at 526-0030 or via email: ronnie@honolulueyeclinic.com and speak with our Surgical Coordinator, Ronnie Bradbury.
 

 

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