Shapiro Laser Eye Center: David Shapiro, M.D.

TWO TOP MASK PICKS TO HELP WITH GLASSES FOGGING Consumer Lab recently picked two masks as their top choices for helping with glasses fogging. The Gifington mask was given high marks for minimizing glasses fogging because the bridge of the mask rides high up on the nose, allowing glasses to sit below the rim of the mask. The Gifington mask was also noted to have a very moldable nose wire that allowed a a good seal as it contoured to the nose and cheeks. Finally, the ear loop...s were considered to offer excellent adjustability to optimize mask fit on the face to reduce glasses fogging. Consumer Lab noted that even with the Gifington mask, fogging could still occur of course. The other mask that Consumber Lab gave top marks to for helping with glasses fogging was the Atelier mask. Consumer Lab praised the nose wire on this mask for its excellent fit but felt that the ear loop design would be difficult for anyone with a hearing aid to wear. GO AHEAD FINALLY HAVE LASIK INSTEAD! We have seen a significant increase in the numbers of people seeking laser vision (LASIK and PRK) correction since COVID began. Frustratoin with glasses fogging up from masks is one of the main reasons patients mention as finally spurring them to have laser eye surgery. Others say they don’t like the idea of putting contact lenses in their eyes and risking contracting COVID. Perhaps for many people these are just excuses to push themselves over the line to finally have their poor vision fixed something they’ve always wanted to do anyway but had just put off. After LASIK or PRK, patients so many patients say, Why didn’t I do this sooner!!. Masks don’t fog your vision after laser eye surgery!! https://shapirolaser.com/masks-that-fog-your-glasses-less/

LASIK vs SMILE: safety, efficacy after 40 WHAT IS SMILE LASER VISION CORRECTION? SMILE (small incision lenticular extraction) is a relatively new laser vision correction procedure that is an alternative to LASIK and PRK. SMILE involves two steps: 1) a small incision is created with the laser at a similar diamter to where a LASIK flap edge would be and then 2) the laser is then focused within the cornea to sculpt out a disc shaped segment of tissue called the lenticle. The len...tical is then removed through the small incision creating a cavity in the cornea. The top of the cornea then sinks down to fill in that cavity, changing the shape of the cornea and correcting nearsightedness and astigmatism. NEW STUDY ON SMILE LASER EYE SURGERY A study published this month in the British Journal of Ophthalmology compared the safety and efficacy of SMILE in patients under age 35 versus those over age 40. 102 eyes of 53 patients were included in the study. Results were recorded at six months after surgery. In the words of the authors, Post-SMILE refractive outcomes in those patients over 40 years of age, although acceptable, are not as good as those obtained in younger patients, showing a significantly lower efficacy and safety indexes, and poorer astigmatic outcomes, with a tendency towards undercorrection. There is a theory that the human cornea becomes stiffer and biomechanically stronger with age. The authors felt that this increase in stiffness might be causing the lower safety and efficacy found in the older patient group. Ironically, this increase in corneal strength would in theory only help the results of LASIK or PRK, certainly not hinder them. https://shapirolaser.com/lasik-vs-smile-safety-efficacy-af/

NFL KANSAS CITY CHIEFS’ STAR CORNERBACK CHARVARIOIUS WARD HAS LASIK Kansas City Chief’s Cornerback Charvarious Ward had terrible eyesight his entire life and now he’s 20/20 thanks to having LASIK laser eye surgery. Ward thinks his new eyesight will help him become one of the best corners in teh game. A LIFETIME OF POOR VISION... Ward suffered from terrible eysight since kindergarten. In fact, he had to repeat kindergarten as his school thought he had a learning disability. In fact, he did not have any learning disabilities at all, he simply needed a pair of glasses and was fine in school after that. Ward even says of his life before LASIK, I couldn’t see a thing, man. I couldn’t see nothing. NFL STAR EVEN WHILE UNABLE TO SEE After high school, Ward joined the Kansas City Chiefs. As a testament to his raw talent, Ward eventually worked his way onto the starting roster even though he could not see the football once it was in the air. As Ward said, I could see a human body that’s right in front of me, but once that ball is in the air, who knows what’s going to happen? I could see it when it first got in the air, but once it starts traveling, I just lose track of it and have to pray I put my hands in the right spot. I just have to pray the ball comes back in my line of sight. Despite his poor vision, Ward posted impressive statistics, ranking first in passer rating and reception percentage allowed, but probably due to his poor eyesight only managed two interceptions. HAVING LASIK TO BECOME AN EVEN BETTER PLAYER Last season, Ward talked about wanting to take his game to the next level and he knew that would mean having better eyesight to get more interceptions. This past March, just before COVID-19 temporarily shut down elective surgery, Ward underwent LASIK surgery in both eyes. He now has perfect 20/20 vision. Ward now says, This year I’m trying to intercept everything. I’m not going to be scared to turn my head around. Because I know now I can see the ball and stay in contact with the receiver at the same time. So I feel like it’s going to make me a way better playmaker, which is what we need in the secondary: turnovers. I just want to take the next evolution in my game and become one of the top corners in the game. MANY PROFESSIONAL ATHLETES HAVE HAD LASIK TO IMPROVE THEIR GAME Many professional athletes, including many I have had the pleasure to help undergo LASIK and get to know, have found LASIK to be the magic ingredient that helps them take their game to the next level. LASIK can be lifechanging for most anyone wearing glasses or contacts, but athletes have a particular benefit in gaining that extra edge in their performance.

Is Your Face Mask Fogging Your Glasses? Many people who have not had LASIK are finding another inconvenience with using glasses: their face mask for the coronavirus keeps causing their glasses to fog up. This can make for dangerous vision impairment. Removing the glasses repeatedly to clean them can involve touching the face, which increases exposure risk for COVID-19. WHY WEAR FACE MASKS FOR COVID-19?...Continue reading

Teleconsults With Dr. Shapiro If you are at home during the COVID-19 crisis and would like to learn more about LASIK, we are offering teleconsultations with Dr. Shaprio at a time that is convenient for you. This teleconsult will help you deterine if you are a candidate, go over the the process in depth, and give you a chance to have all your questions answered. If you would like to schedule a teleconsult with Dr. Shaspiro, you can call our office at 805-339-0566 or schedule via our website at www.shapirolaser.com

NFL Quarterback Jameis Winston Has LASIK Ahead of His 2020 Free Agency Winston Has LASIK To Correct His Nearsightedness After Throwing League High 30 Interceptions Winston had been struggling with his nearsightedness (myopia) while playing as an elite quarterback since his college days. Last season, before having LASIK, Winston threw a league high 30 interceptions despite also throwing for a league-leading 5,109 yards. At the end of the season, Tampa Bay Buccaneers head coach... Bruce Evens commented about Winston, he can’t read the scoreboard but he can see the guys in front of him. Obviously very talented, Winston decided to have LASIK to improve his eyesight to improve his game. Winston’s spokesperson said of his decision to have LASIK: Jameis did not want to count out any options that he had that could possibly help him with the game he loves so much. He doesn’t want to miss out on any opportunity that presents itself. This is the game he loves and he wants to be the best at it and if there are any options that can improve his game he is willing to do it. Before announcing his decision publically, Winston gave a big hint to his fans by posting a picture of himself on Instagram in post-operative dark glasses. At the bottome of the picture he wrote: They Know!!!!. Many professional athletes from NFL to NBA to MLB players to race car drivers, including many I have performed laser eye surgery on, have chosen to have LASIK or PRK to be able to make their vision the very best possible and not have to rely on glasses or contact lenses during the demanding challenges of professional sports. I fully expect Winston to be an even more formidable and effective quarterback next season with his new and improved eyesight!

US Military Wavefront PRK Study Shows Superb Results Customized Wavefront PRK is an area of extreme interest to the military was how Captain Elizabeth Hoffmeister, MD put it after presenting superb results of customized wavefront PRK (flapless LASIK) at the American Academy of Ophthalmology annual meeting. Dr. Hoffmeister presented a recently completed US Military study of 334 eyes of 167 patients undergoing customized wavefront PRK using the VISX Star S4IR excimer laser. T...his 1 year study included 7 military centers and was the first of its kind in the military in that centers from the Army, Navy, and Air Force all participated. The results were truly outstanding: 100% of subjects saw 20/40 or better (vision good enough to pass a driver’s test without glasses or contacts), 99% saw 20/20 or better, and 92% saw 20/16 or better in other words, better than perfect vision! This is consistent with a customized wavefront PRK study I presented at the American Society of Cataract and Refractive Surgery, conducted at the Shapiro Laser Eye Center. Our study of 50 patients undergoing customized wavefront PRK at our center showed 100% of patients said they saw as least as well as with their glasses or contacts and 96% said they said they saw better than they had ever seen with glasses or contact lenses. The US military performs 30-40,000 cases of laser vision correction each year with 75% being PRK and 25% being LASIK. Given these truly amazing results, the US military finds customized wavefront PRK to be of extreme interest. https://shapirolaser.com/us-military-wavefront-prk-study-s/

LASIK Invented 30 Years Ago, FDA Approved 20 Years Ago In 1989, 30 years ago this year, the US Patent and Trademark Office awarded a patent for peforming LASIK to Gholam Peyman, MD. This patent represented nearly 100 years of evolution of eye surgery to correct vision. I had the opportunity to assist on the first case of LASIK in the Western United States, performed in 1992 by Charles Casebeer, MD, my fellowship mentor. Laser vision correction, in the form of PRK, was approv...ed by the FDA for use in the United States in 1995. LASIK itself recieved formal FDA approval in 1999, 20 years ago. Since the time that patent was awarded 30 years ago, and 20 years since FDA approval, an estimated 40 million cases of LASIK have been performed worldwide with a success rate of 99.5%. Over the past 20 years, LASIK has undergone incredible evolution. In 2003, the FDA approved the next generation of LASIK, customized wavefront LASIK, which incorporated NASA-derived technology to measure the optics of the eye and customize the laser treatment to an individual’s unique optical characteristics. Since that time, there have been three generations of customized wavefront technology: original cusomized wavefront LASIK, ultra-high resolution customized wavefront LASIK, and ultra-high resolution customized wavefront LASIK using iris registration systems for targeting and alignement of the laser on the cornea. We also now have the ability to peform topography guided LASIK in which a map of the cornea is used to direct the laser beam. Today’s latest generation customized wavefront and topography guidedl LASIK technology are incredibly precise and results are significantly improved from the already impressive results we achieved 20 years ago. Today, the lastest version of LASIK truly represents one of the miracles of modern medicine. https://shapirolaser.com/lasik-invented-30-years-ago-fda-a/

Eye Drops to Cure Reading Glasses (Presbyopia)? PRESBYOPIA: THE NEED FOR READING GLASSES FROM AGING Presbyopia or aging of the eye is the age-related loss of our ability to see up close. It happens to everyone eventually, typically starting around age 40 and progressing gradually until the early 60’s. It is caused by the lens inside the eye getting physically stiffer with age so it becomes less and less flexible and unable to adjust focus to different distances....Continue reading

What Causes Myopia (Nearsightedness)? Nature More Than Nurture? Genetics More Important Than Environment in Becoming Nearsighted? Previous studies have suggested that there is a strong genetic component to why children become nearsighted as they grow into adulthood. A study from 2003, for example, suggested that genes are the main factor in determining who developes nearsightedness (myopia). This study looked at 388 8th grade children. The results showed that the higher the n...umber of parents that have myopia, the greater the chance the child will become nearsighted, although the researchers were quick to point out that even having both parents being nearsighted does not guarantee the child will be nearsighted. Environmental factors did have a small role in determining who would become nearsighted in this study. Interestingly, in this study, nearsighted children performed higher overall than their non-nearsighted peers on reading and language skills testing. Nurture More Than Nature? Environment More Important Than Genetics in Becoming Nearsighted? Other studies have suggested that environmental factors are most responsible for determining which children will develop nearsightedness as they mature into adults. A landmark study from Taiwan showed that children who were required to spend recess outdoors in school were less likely to develop myopia than those who stayed indoors. This has led to speculation whether this is a direct effect of sunlight, physical activity, or even Vitamin D levels from sunlight. A New Study Links Low Physical Activity and Screen Device Time to Nearsightedness A new study adds support to theory that environmental factors play a large role in causing nearsightedness (myopia) to develop. This European study, conducted in Denmark, looked at 1,443 16-17 year old adolescent children, 45% boys and 55% girls, and found that those children who were physically active less than 3 hours a week had a doubling of their chances of developing nearsightedness! Those who used computer screen devices more than 6 hours per day also doubled their chances of developing nearsightedness. Unfortunately, it seems societal trends are toward less physical activity and greater time in front of computer screens and phone screens. An Epidemic of Nearsightedness? In 2000, 23% of the world’s population was nearsighted. By 2050, it is expected that 50% of the world’s population will be myopic. Given that the genetics of the human of the human population likely will not have changed in that time, this suggests that the enviromental factors of a less active, more computer screen oriented, more indoors world likely is the cause of so much nearsightedness. The good news, of course, is that with the latest generation of customized wavefront LASIK and customized wavefront PRK, we have outstanding ways to treat this growing epidemic of nearsightedness. https://shapirolaser.com/low-physical-activity-screen-devi/

LASIK and PRK vs REFRACTIVE LENS EXCHANGE (RLE) FOR VISION CORRECTION In patients who are in their mid-50s or older, the question often comes up whether to correct vision by LASIK or by refractive lens exchange (RLE). LASIK involves reshaping the outter side of the cornea with an extremely precise laser beam and does not enter into the inside of the eye. RLE, on the other hand, is essentially cataract surgery, but before there is an actual cataract. A cataract is a clouding u...Continue reading

New NASA Orbiting Telescope To Use LASIK Wavefront Tech NASA’s James Webb Space Telescope is scheduled to launch in 2021. It will incorporate advanced LASIK technology to help improve its optical systems in order to peer more deeply and more accurately into the far universe once in orbit. At the core of the James Webb Space Telescope’s optics are highly polished mirrors with incredibly precise tolerances. In order to maximize the optical quality of these mirrors, NASA technic...ians use a measurement sytems based on Hartmann Shack wavefront sensors, a technology I use on a daily basis when performing customized wavefront LASIK and PRK. With these laser eye surgeries for vision correction, an invisible and harmless infrared measurement laser is shined into the patient’s eye and bounced off the retina in the back of the eye. The reflected infrared laser light comes back through the eye as a returning wavefront of infrared light. As this infrared wavefront travels from the back of the eye all the way to the front and ultimately out of the eye, it is distorted by all the nuances of that person’s eye’s optics. When the distorted wave of infrared light leaves the eye (called the optical fingerprint), it is measured by a grid of sensors, the same Hartmann Shack sensors that NASA is using. These sensors can determine the angle at which the infrared light rays are coming toward them and provide information on how the cornea needs to be reshaped to optimize the patient’s vision with an accuracy that far exceeds the normal which is better one or two test. NASA is using a similar system, based on Hartmann Shack sensor measurements, to guide the polishing of the space telescopes mirrors to refine the optics to a degree which is impossible without wavefront technology. In a way, NASA is performing customized wavefront surgery on their most advanced telescope! https://shapirolaser.com/new-nasa-orbiting-telescope-to-us/

Sunlight's Beneficial Roles for the Eye Sunlight is being shown to have many surprising benefits to the eye, probably via vitamin D. Previous studies have shown that outdoor sunlight exposure during childhood may actually decrease the chances a child will grow up to become nearsighted. A new study published this week in the newsletter of the American Academy of Ophthalmology looked at the role of Vitamin D blood levels in assessing how well artifical tears treat patients with... dry eye syndrome. Vitamin D can be synthesized by the body from sunlight or from obtained from nutritional sources such as vitamin D supplements or injections. Given our indoor lifestyle, many people in the United States are Vitamin D deficient. This study showed that while artificial tears improved dry eyes in both patients who had good blood levels of Vitaimn D and in those who had low blood levels of vitamin D, tear quality and tear performance markers were only increased in those patients with good blood levels of Vitamin D. The researchers concluded that their study may show that vitamin D may act synergistically with topical treatments to harmonize components of the tear film. A note of caution though. Of course, while overall sunlight may have beneficial effects for the eye via blood vitamin D levels, I always remind patients that direct UV light exposure to the eye from sunlight can be harmful. Some researchers feel UV light exposure, for example, over time is linked to cataract formation. Other studies have suggested an association between UV light exposure and the development of macular degeneration. Fortunately, good quality UV-blocking sunglasses that are appropriately labeled do an excellent job of blocking UV light from entering into the eye. And, of course, too much sunlight exposure, particularly during the highest UV times of the day, can lead to skin cancer as well. Sunlight seems to be of most benefit in moderation. https://shapirolaser.com/sunlights-beneficial-role-for-the/

SMILE vs Custom LASIK and PRK SMILE, LASIK, and PRK are forms of laser vision correction that reshape the cornea, the main focusing structure of the eye. While each of these versions of laser eye surgery uses a laser, they are different in how they go about their goal of improving vision. In SMILE (Small Incision Lenticular Extraction), an ultra-short pulse laser called a femtosecond laser is used to sculpt a lenticle inside the cornea, beneath the corneal surface. A small s...Continue reading

New Study of LASIK Myths: LASIK and Dry Eye I just returned from our largest annual international professional conference, the annual meeting of American Society of Cataract and Surgery held this year in San Diego. Over 10,000 ophthalmologists from all over the world attended. I heard an interesting study presented by Julie Schallhorn, MD, MS, who is Assistant Professor of Ophthalmology at UC San Francisco Medical School (the medical school I attended). Dr. Shallhorn’s study ...Continue reading

New York Mets Catchers Love Their LASIK Laser Eye Surgery - And Getting Rid of the Problems of Contact Lenses! NY Mets catcher Tomas Nido was in his eighth major league game of his life, behind the plate catching 101 mph fastballs from Noah Syndergaard when a strong wind suddenly blew one of his contact lenses off his eye. It was not the first time that Nido had lost a contact at a critical time during a game. He realized at that point that he wanted to have LASIK laser eye s...urgery as soon as possible. Nido had LASIK in both eyes and was back playing for the Mets only two days later. His first day back he hit a double. Nido said he immediately could see the pitcher’s release and spin on the ball more cleaerly. It is normal to have fluctuations in vision and glare off of lights for approximately sixs weeks after LASIK and Nido did notice these, but still loved his vision even immediately after surgery through this healing process. His eyesight was so improved that he noticed a large spike in his batting average after returning from his surgery and he is thrilled he had LASIK! It turns out Nido is not the only catcher on the NY Mets to have LASIK. Three weeks before Nido had his LASIK surgery, the Mets signed two time All Star catcher Wilson Ramos to the team. Ramos, however, had only become an All Star after having LASIK. He had previously undergone LASIK eye surgery two years earlier, in 2016 while he was with the Washington Nationals. Ramos was frustrated at the time with his contacts drying out and he had to apply lubricant drops to his eyes between each inning to keep them moist. He waited a year to have the procedure because he was afraid before he finally decided to go ahead and he was very happy he did! Ramos’ batting average improved the next season by 78 points to .307 and he made it onto the All Star Team for the first time in his career. When he looks back on it it, Ramos describes the LASIK as, Not a hard surgery. That was quick and easy. Afterward, a couple of drops, go to hotel, take a few pills, sleep for three hours, see difference when you wake up and turn on television. Now the Mets have two catchers who have had LASIK! https://shapirolaser.com/lasik-a-lost-contact-and-the-ny-m/

Study: LASIK, PRK Big Help for US Military Most people do not realize that nearly 20% of all laser vision correction in the US is performed in the US Military. The US Military views the impressive improvements in vision with LASIK or PRK laser eye surgery as critical to helping its members carry out their combat tasks. A recent study conducted by the Warfighter Refractive Eye Surgery Program looked at the amount of impact of having LASIK or PRK laser vision correction was on ...specific visually demanding tasks. A survey of 360 active duy US military members who had undergone either LASIK or PRK was conducted in which each member was asked to rank how their vision affected their military preparedness for various tasks on a 1 to 5 scale with 1 being worst and 5 being best. Before surgery, using glasses or contact lenses, the average score was 3.6 out of a possible score of 5. Six months after laser vision correction, the average score had increased to 4.8 without glasses or contacts, showing military members were significantly better off with laser eye surgery. Some of the specific tasks the study evaluated included weapons sighting ability, functioning at night, ability to function in extreme weather, and use of personal masks such as hazardous materials masks. In my own practice, I have seen many patients who were not in the military, but whose job performance also benefited greatly from having LASIK or PRK rather than wearing glasses or contact lenses. Some examples would be firefighters who need to wear protective masks or law enforcement officers who need to sight a gun in a crisis or even world travelers who go to remote areas and are afraid of losing their contacts or glasses or worse yet, having a contact lens complication in an area where good eye care is not readily avaliable. For all of these patients, having LASIK or PRK is not just a way to avoid the nuisance of wearing glasses or contacts it actually can improve their job performance and safety! https://shapirolaser.com/study-lasik-prk-big-help-for-us-m/