Category Archives: Scleral lenses

Scleral contact lenses used to treat irregular corneas due to Lasik failures, RK complications, keratoconus, cornea ectasia, Pellucid Marginal Degeneration, and Stevens-Johnson Syndrome.

Treatment for RK complications

Treatment/correction (without further surgery) for RK side effects/complications scleral contact lenses, RGP lenses, hybrid lenses, soft contact lenses, glasses)
Radial Keratotomy is a procedure to reduce nearsightedness in which tiny cuts are made in cornea to flatten it. The procedure is used for treating nearsightedness and astigmatism both. However, the problem with RK is that the results are not accurately predictable and thus there are occasionally complications and side effects specially over-correction or under-correction.

The vision correction by RK may also be unstable and mostly result in farsightedness after 10 years or so, called hyperopic shift.

Treatment for RK complications

Radial Keratotomy is not done very often anymore because of other options like laser surgeries available these days with less complications. However if you’ve developed any complications of the RK procedure, consult your doctor and get an expert opinion regarding your specific case and what are best management options available for your post RK complications.

Common vision related side effects of RK can be solved by:

Eyeglasses

High definition eye glasses are helpful in correcting minor refractive errors after the RK procedure such as minor under correction or minor over correction resulting in minor post RK nearsightedness or farsightedness respectively.

Toric soft contact lenses

Toric soft lenses are helpful in post RK patients when regular astigmatism is present. However they are not helpful in patients with irregular astigmatism as they’re unable to mask an irregular corneal surface.

Hybrid contact lenses

Hybrid contact lenses consisting of rigid gas permeable center with a soft contact lens skirt in peripheries is helpful in patients with irregular corneal surface and irregular astigmatism.

Rigid Gas Permeable contact lenses

Rigid gas permeable contact lenses don’t come in contact with the corneal surface e and thus are helpful in solving the vision issues due to irregular cornea.

Scleral Contact lenses

Scleral contact lenses don’t rest on the corneal surface, rather they rest on the sclera due to their larger diameter. They’re gas permeable therefore corneal hypoxia is prevented.

Scleral contact lenses are helpful in solving various corneal surface related vision issues and also dry eyes or other issues due to corneal irritation with conventional lenses.

Treating Dry eyes

Following manipulation of cornea in RK or other eye surgeries, the nerves sensation and thus the tears production might get disturbed resulting in dry eyes. Dry eyes treatment is necessary even if temporary to have better vision during the recovery phase. Dry eyes can be managed using scleral contact lenses, eye drops, punctal plugs, etc.

Complications following RK are common. However before jumping to conclusions and starting self-remedies, always consult the specialist to get an expert opinion regarding your specific case for best post RK complications treatment. Contact Dr. Irwin Azman for a Free Consultation.

Treatment of Common LASIK Complications

Treatment/correction (without further surgery) for LASIK side effects/complications (scleral contact lenses, RGP lenses, hybrid lenses, soft contact lenses, glasses)

LASIK, along with other laser eye surgeries, has a high success rate and an excellent safety record. However, like every procedure, complications might occur and rarely result in complete or partial loss of vision and several side effects can occur.

LASIK common side effects include dryness, glares, halos, blurring of vision, double vision, loss of contrast and other visual disturbances.

Treatment of common LASIK complications

LASIK complications and side effects due to LASIK failure can occasionally be resolved with additional surgical procedure, however this can often worsen the symptoms instead of solving them.

Non-surgical treatment of common LASIK complications includes using various lenses and glasses.

Rigid Gas permeable contact lenses

For mild to moderate irregularities in cornea following LASIK surgery, gas permeable contact lenses are recommended. RGP or GP contact lenses are made of material that is permeable and allows gaseous exchange, so that the lens doesn’t stick to the underlying cornea. This helps in fixing the blurring or irregularities in vision due to irregular cornea. They are also helpful in fixing excessive glare in complicated post LASIK surgery vision.

Scleral contact lenses

If the corneal surface is bulged or inappropriate for conventional lenses as in keratoconus, the specialist might recommend scleral contact lenses.

Soft contact lenses

Soft contact lenses are recommended for people whose vision gets normal with gas permeable or scleral lenses but they can’t wear them because of their rigidity. These lenses are custom made for the patient and can also be worn for night or dim light environments.

Hybrid contact lenses

Hybrid lenses are large diameter lenses with rigid central gas permeable zone, surrounded by a soft peripheral zone.

Hybrid contact lenses are helpful for irregular shaped cornea. They are helpful in not only correcting errors in post LASIK complications but also in normal eyes. They are used for correcting nearsightedness, farsightedness and astigmatism.

Toric contact lenses

Toric contact lenses are available in both soft and rigid gas permeable materials. They are recommended for people with high degree of astigmatism, which isn’t completely solved with LASIK surgery.

Glasses for LASIK complications

Those patients who can’t use contact lenses, or probably don’t like wearing them can use glasses for the temporary or permanent post LASIK side effects. Glasses help to improve vision in patients experiencing disturbed vision, farsightedness, nearsightedness, glare, etc.

Management of post LASIK complications is possible but it’s important that you consult the expert in this field and discuss the best available option for your situation. Contact Dr. Irwin Azman today for a Free Consultation.

Post LASIK Complications

Lasik (Laser-Assisted in situ Keratomileusis), a type of eye surgery for correction of also errors of refraction is also known as laser eye surgery or laser vision correction.

LASIK provides a permanent solution for errors of refraction in most patients, getting rid of eye glasses or contact lenses. However, there are certain complications associated with the procedure too and should be known by the patients before getting LASIK procedure done.

Post LASIK complications:

Like every surgical procedure, there are certain side effects associated with LASIK too, which don’t develop in most of the patients, but there is a possibility of acquiring them as a complication. Please note that not all the complications are permanent. These complications are:

Correction errors

This can result as the error by surgeon. The procedure can result in undercorrection, overcorrection, residual astigmatism, etc. in some patients. This results in blurring of vision, imperfect vision as compared to expected vision after the LASIK procedure.

  • Undercorrections: this can result if too little tissue was removed from the eye during the procedure. This can be corrected by repeating the procedure easily. Undercorrection is common for people with nearsightedness.
  • Overcorrections: this can happen if too much tissue is removed from the eye. This is difficult to correct in most cases.

Astigmatism

Uneven tissue removal during the LASIK procedure results in uneven refraction of light entering the eye, resulting in astigmatism. It may require further surgical correction or else to be corrected by glasses and contact lenses.

Dry Eyes

Some patients might experience dry eyes after the surgery. This is a temporary side effect mostly, however it can develop into dry eye syndrome in few patients, specially those who suffer from underlying conditions with dry eyes.

Vision returning to previous condition

Due to conditions like abnormal wound healing, hormonal imbalances, pregnancy, etc. the vision can return to the pre surgical condition slowly over time.

Visual impairment or loss

Rarely, the patient might experience more impaired vision than it was before the procedure. Very rarely, vision loss can result as a complication too.

The patient might experience glare, halos or double vision after surgery, specially at night, even if the vision is better in good light conditions.

Oversized pupils

As a result of procedure, if the pupils end up being larger than they should ideally be, it results in halos, glare, etc.

Infection

Infection can result from any surgical procedure, specially if hygienic standards are not met. This can result in redness along with discharge from the eyes. Pain can also be present in patients with post operative infection.

Delayed healing

Certain factors might contribute to delayed surgical wound healing in some patients.

Is there any treatment for glare after LASIK surgery?

Glare after LASIK surgery:

A recent episode of the Dr. Oz Show, which aired on October 3rd, 2013, featured an investigative report about the potential life-long side effects of LASIK eye surgery. As a popular elective surgery, nearly 800,000 people get LASIK every year. FDA clinical data trial shows that every modern laser left 1 out of 5 patients seeing worse after LASIK. Side effects include dry eyes, double vision, halos or starbursts (especially at night), and blurry vision.

lasik problems

Investigative reporter Elisabeth Leamy has been investigating the harmful side effects of LASIK for over two years. During her undercover consultations with doctors, she discovered that the side effects were minimized and the procedure was treated like an easy, no-risk procedure. Morris Waxler, the former FDA official responsible for getting LASIK surgery approved, is now working to get it banned. He says that the side effects of LASIK are actually injuries and that LASIK harms 20% of patients.

While the investigation revealed the potential dangers and risk of LASIK eye surgery, it did not discuss what people can do if they are suffering from LASIK side effects.

Dr. Irwin Azman is one of the leading LASIK consultants with over 25 years of experience in the diagnosis and management of the Post LASIK patient with complications and side effects. Dr. Azman affirms that although patients may experience side effects due to pre-existing eye conditions, there are non-surgical treatments to help those with LASIK side effects. Together with his team of technicians, new technologies in instrumentation and new treatment modalities, Dr. Azman is able to prescribe each patient with the perfect solution in resolving their Post LASIK side effects without further surgery.

According to Dr. Azman: “While LASIK surgery can be successful under optimum eye conditions, unfortunately many patients do experience side effects due to pre-existing conditions. However, there is hope. Utilizing our vast experience and expertise, as well as an array of new technologies, we are able to treat these side effects with non-surgical techniques.”

Visit http://www.lasikfailures.com for more information about Treatment for LASIK complications and the services of Dr. Irwin Azman or call (240) 782-2020.

Dr. Oz Undercover LASIK Surgery Investigation

As reported on the Dr. Oz Show, “LASIK surgery promises to fix imperfect eyesight, but is it safe? Investigative reporter and consumer expert Elisabeth Leamy goes undercover to find out more about the potential life-changing side effects of this popular surgery.”

The Dr. Oz Undercover LASIK Surgery Investigation: 

Click her for full video segment: 

“LASIK surgery is an unnecessary procedure on a very necessary part of your body. Almost no one needs LASIK, though many want it. That’s why it’s important to know the possible risks as well as the potential benefits. You’ve heard about the benefits in countless LASIK commercials. The Dr. Oz Show wanted to balance out the picture, by presenting the risks.”

“More than 20 million people worldwide have had LASIK surgery and many report they are thrilled with the results. But our investigation found this eye operation isn’t the foolproof fix it’s often made out to be. LASIK can have bad results, from unclear vision to visual distortions, from excruciating eye pain to a weakened eye structure.”

“Every year, an estimated 600,000 people get LASIK, according to the FDA. Those people may be responding to advertising like this:

  • “Throw away your glasses!”
  • “You’re only minutes away from 20/20 vision!”
  • “No more need for expensive contact lenses!”
  • “Have your vision permanently corrected!”
  • “Your eyes will have high-definition vision clarity!”

According to FDA rules, eye centers are not supposed to overstate the benefits of LASIK or understate the risks and yet we easily found hyped up LASIK commercial claims with a simple YouTube search.

The LASIK advertising promises above are not necessarily true. So here’s what all patients need to know about some of the complications of the procedure to make an informed decision about LASIK.”

 

 

Prevention and Treatment of LASIK Problems

If you are experiencing contact lens intolerance and are thinking about LASIK, STOP!

Stop Sign

Before making this decision you need to know the truth:  LASIK surgery has side effects and can lead to permanent disabling complications affecting your lifestyle permanently. Proceed with caution. According to recent studies between 10-40% of LASIK patients experience symptoms of complications. Symptoms include dry eyes, glare, halos and star bursting.   Our own in-house experience, together with 10 other contact lens practices demonstrates the #1 reason patients seek LASIK is due to contact lens intolerance relating to dryness and blurry vision.

If you’ve had LASIK and are now experiencing problems, there is HOPE to get you back all day comfort with clear vision.

Prevention and Treatment of LASIK Problems

Dr. Irwin Azman maintains a contact lens specialty practice since 1977 with a special interest in the prevention and treatment of LASIK problems and restoration of vision and comfort lost as a result of refractive surgery: LASIK, PRK, RK, intacs, corneal transplant or keratoconus. Many of his patients travel from all parts of the United States and are referred by other eye care practitioners.

Unfortunately, most LASIK patients have some level of complication which has affected their lifestyle permanently. Some are out on total disability, while others suffer from depression.  Symptoms range from dry eyes, burning eyes, glare, light sensitivity, ghost images, star bursts, double vision, loss of contrast sensitivity, fluctuation of vision, eye pain, and loss of sight.

Many of Dr. Azman’s patients have seen several other eye doctors before seeking his expertise and were told “nothing can be done” or that they needed a corneal transplant. Dr. Azman says “there is HOPE for the majority of these patients and to hold off on corneal surgery.”

Each case is different. Each patient will go thru 2-3 evaluations including:  phone and in-person consultations, review of all previous eye records. Incorporating and using the latest technology to determine the exact problem and solution. Special tests range from: wavefront aberrometry, anterior and posterior OCT, tear scan, specular microscopy, meibography, tear osmolality, corneal evaluation, advanced refraction, refractive wavefront topography, and vital stainings.

Simple solutions can vary from a combination of dry eye treatment, prescribing of specialty soft lenses, to specialty post op LASIK rigid lenses.  More complex solutions vary from the prescribing of customized reverse geometry lenses, customized piggy back lenses, hybrid lenses, to the most complex lens called post refractive surgery scleral lenses. If a patient has a highly irregular and distorted cornea, and experiences halos, star bursts, double vision, and decreased vision scleral lenses are usually the best option that can minimize/eliminate all the symptoms.

Unfortunately, most practitioners have very little experience, if any, while Dr. Azman has treated 100’s of patients.

With over 25 years of LASIK experience, Dr. Azman is one of the pioneers in preventing LASIK complications and treating those with Post LASIK / PRK / RK patient. Together with his knowledge and experience, Dr. Azman and his team employ the newest technologies in instrumentation and treatment modalities. Dr. Azman is able to prescribe each patient with a solution in resolving their Post LASIK / PRK / RK difficulties.

If you are suffering from contact lens intolerance, or are thinking about LASIK surgery, or have any symptoms caused by refractive surgery please call
Dr. Azman personally for a free consultation. Call Today (240) 782-2020!

Post LASIK Dry Eye Treatment

According to the Eagle Vision-Yankelovich poll, one out of every five U.S. residents suffer from Dry Eye Syndrome; that’s 59 million Americans!
Dry eye is the most common complication of LASIK.  In fact, about half of all LASIK patients will have dry eye after LASIK. While the condition is usually temporary and mild, significant numbers of people continue to suffer from dry eye for months or even years after the procedure.
Many people who have had LASIK  had a previously undiagnosed dry eye issue, and the procedure actually exacerbated the problem. For example, contact lens wearers who find their contact lenses uncomfortable due to dry eye, may investigate LASIK as an alternative (since they do not want to wear eyeglasses).  They then, regrettably, proceed to LASIK without proper dry eye treatment. Fortunately, pre-LASIK procedure screenings have advanced, and dry eye detection is now a condition that is hopefully detected in advance. However, there are still many, many post LASIK patients who experience dry eye.

Post LASIK Dry Eye Treatment

Dr. Irwin Azman O.D.

Dr. Irwin Azman O.D.

Dr. Irwin Azman, who has been in practice for over 30 years, specializes in post LASIK complications and side effects. Dr. Azman, a PRK patient himself, has been involved in refractive surgery for over 20 year and is always committed to staying updated on the latest, most advanced researcheducation and technologies. Dr. Azman utilizes his knowledge, experience, and expertise to provide his patients with treatments for post LASIK complications and side effects, without further surgical procedures. Each dry eye patient is different, and Dr. Azman utilizes his vast knowledge to customize a treatment program that is tailored for each individual patient.

Treatment for glare after LASIK

Many patients have undergone radial keratotomy (RK), LASIK, PRK and other refractive surgeries with significant success. However, unfortunately, there are many people out there who have even had the newest LASIK procedures, but are still experiencing post Lasik side effects such as glare, starbursts, loss of night vision, and dry eye.

Glare after Lasik

Glare after Lasik

What can be done for post LASIK, PRK, and radial keratotomy (RK) complications and side effects?

Some doctors will continue to recommend additional surgical procedures, which inevitably exacerbate the problem

With over 30 years of experience, Dr. Irwin Azman, a PRK patient himself, utilizes his expertise with the newest technology to resolve and treat side effects from post LASIK, radial keratotomy (RK), PRK and other refractive surgeries.

Contact Dr. Irwin Azman for a free consultation at (240) 782-2020 | www.lasikfailures.com

New Treatment for Recurrent Corneal Erosion

What is Recurrent Corneal Erosion:

Recurrent corneal erosion is the failure of the cornea‘s outermost layer of epithelial cells to attach to the underlying layer. Due to loss of cells, and exposure of sensitive corneal nerves this condition is agonizing and painful. Recurrent corneal erosion may be due to corneal dystrophy or corneal disease, but is generally caused from a previous corneal injury. Some predisposing factors, such as diabetes or a corneal dystrophy, may be the underlying cause.

Cornea Abrasion

Cornea Abrasion (Photo credit: GogDog)

Signs and Symptoms

New treatment for Recurrent Corneal Erosion is now available at Global Complex Eye Care. Utilizing amniotic membrane tissue, PROKERA® has natural therapeutic actions that help damaged or inflamed eye surfaces heal faster. Eyes treated with PROKERA® have quicker healing, less pain, less scarring, and less inflammation.The amniotic membrane in PROKERA® is thin and clear like the tissue on the surface of your eye and protects your eye’s damaged tissue while inserted.

PROKERA® was developed to treat eye diseases such as recurrent corneal erosion, infectious/inflammatory keratitis, Herpes, superficial epithelial defects, severe dry eye syndrome, and other corneal diseases.s PROKERA® is a safe, effective treatment provided by a tissue bank regulated by the FDA. The tissue has passed many quality control tests before it is provided.

Correcting Radial Keratotomy (RK) Complications

Radial keratotomy (RK) is a refractive surgical procedure to correct myopia (nearsightedness) that was developed in 1974. It has been superseded by newer operations, such as photorefractive keratectomy (PRK), LASIK, Intra-Lasik, Wavefront Lasik, and others. Although rarely done now, millions of people underwent RK in the 80’s and 90’s around the world with over a million procedures done in the United States. In addition, many of these RK patients had LASIK in an attempt to undo damage caused by their initial RK surgery.

With the RK procedure, incisions are made on the cornea with a scalpel (knife). These tiny cuts flatten the surface of the cornea and reduce nearsightedness. The surgeon may make additional cuts to flatten the misshapen part of the cornea for those people who have both astigmatism and nearsightedness. The long term results of radial keratotomy (RK) complications have truly been horrific for many people. Numerous problems occurred years later. These include:

• Loss of Best Corrected Visual Acuity
• Severe Dry Eye
• Unstable or Fluctuating Vision
• Double or Triple Vision
• Irregular Astigmatism
• Halos, Glare, and Reduced Night Vision

Many RK patients also underwent additional RK procedures followed by one or more LASIK procedures. In every instance, the additional procedures only exacerbated the problem. In recent years, advances in specialty lenses including Scleral lenses and other unique advanced lens technologies have become available which will allow patients to see clearly and comfortably once again, without the risk of further surgery.

The images below show how one of our patients, Sharon B., sees at night after having RK surgery vs. how she now sees with a Scleral lens.

 Post RK Surgery with glasses                   Post RK Surgery Corrected with Scleral lens                                                                       Post RK Surgery Uncorrected and corrected