Zembla Documentary on Lasik, Pain, and Suicidality

This Lasik documentary was created by investigative journalists in Holland. The language is mostly Dutch, with English subtitles. The documentary focuses on corneal neuropathic path after Lasik and the suicidality it creates. Dutch physician Dr. Michael Brouwer and other Lasik sufferers in Holland are interviewed, as is Dr. Edward Boshnick in the United States (see EyeFreedom.com). The investigators ask: Is the experience of pain after Lasik really uncommon? What are the consequences when it occurs? Also interviewed are Dr. David Barsook and Dr. Morris Waxler. Dr. Barsook is Director of the Pain and Imaging Neuroscience (P.A.I.N.) Group at Boston Children’s Hospital, MGH ,and McLean Hospital at Harvard University. Dr. Barsook maintains that corneal pain after Lasik follows an established model of neuropathic pain. Dr. Morris Waxler is the FDA's former chief research scientist on Lasik. Dr. Waxler maintains at his website HelpStopLasik.com that "The FDA does not want to admit that millions of people have now had a surgery that never should have been approved by its own rules. The FDA is now engaged in covering-up a scandal and an epidemic, and its own corrupt practices. This should be exposed, and LASIK should end." He revisits these conclusions in the video.

Instruments

Meet our Instruments

Exam Room: We have some of the most advanced equipment in the Southeastern United States. Here's a look at the exam room.

We have some of the most advanced equipment in the Southeastern United States.

How we use digital imagery to help patients: The monitor to the left on the wall is showing the corneal topographies of 2 corneas damaged by Radial Keratotomy surgery. The monitor on the right is showing a digital photograph of an eye devastated by Stevens-Johnson Syndrome. We use these and other digital imaging technologies to explain to patients and their families the exact nature of ocular and vision disorders we are dealing with and to better explain the type of technologies that will be needed to restore vision and ocular comfort.



Radiuscope

The Radiuscope is an essential instrument for measuring the curvature of a contact or scleral lens to the second decimal place. In addition if a lens should have an slight irregular curvature, we can detect it with the use of this instrument. Every lens that comes into our office is checked and double checked to make sure that all of the lens specifications are exactly as ordered. In this photo, you see one of our student doctors examining a scleral lens to make sure that all of the lens curvatures are exact.

Zeiss Cirrus Optical Coherence Tomography

What you are seeing in this image is a cross sectional view of the macula and retina. Optical Coherence Tomography is the only technology that will allow us to study all of the ocular structures in the back portion of the eye in such great detail.

Zeiss Frequency Doubling Technology

Frequency Doubling Technology (FDT) provides a rapid method of detecting visual field abnormalities seen in ocular disease such as glaucoma, certain brain tumors and optic nerve disease. This instrument has a high level of sensitivity and specificity allowing us to detect visual field abnormalities at a very early stage.


Zeiss-Anterior-Segment-Ocular-Coherence-Tomography

This instrument allows us to visualize and measure the anterior structures of the eye including the cornea, anterior chamber, iris, and lens. We have found this technology invaluable in helping us design with great accuracy specialized contact and scleral lenses for patients suffering vision loss due to keratoconus, post refractive surgical complications such as LASIK and RK complications, corneal transplant surgeries, dry eyes and other ocular diseases and conditions.

Zeiss Anterior Segment Ocular Coherence Tomography allows the structures in the front section of the eye to be examined Zeiss Anterior Segment Ocular Coherence Tomography allows the structures in the front section of the eye to be examined

Zeiss Visual Field Analyzer

This instrument is used to detect and measure early visual field loss which may be indicative of glaucoma or neurological disease. This instrument has now become to universal standard for the detection and measuring of visual field loss. While the Zeiss FDT Visual Field Analyzer is used as a screening instrument, the Zeiss-Humphrey Visual Field Analyzer is used by us for an in-depth examination of the entire visual field. This instrument can help us diagnose early visual field loss which may be indicative of early glaucoma and/or neurological disease.

The Zeiss Visual Field Analyzer allows visual field loss to be measured.

The Zeiss Visual Field Analyzer allows visual field loss to be measured.

Zeiss Computerized Corneal Topography

Zeiss Computerized Corneal Topography: This technology allows us to map the front surface of the eye, the cornea. The computerized corneal topographer is used to measure the corneal contour and curvature of every point on the corneal surface. The instrument provides us with a corneal map which can help us diagnose early corneal disease and to help us design a specialty contact or scleral lens for a particular cornea. This map is much like an architectural plan. Every cornea is unique and different. The different colors that you see on the monitor on the wall indicated the “hills and valleys” of a cornea. Without these corneal maps, it would be very difficult to create the lenses we are now creating for our “high need” patient population. With this instrument we can detect at a very early stage corneal conditions such a Keratoconus, Pellucid Marginal Degeneration and a host of other corneal conditions. In addition, this instrument is invaluable in helping us to design specialty contact and scleral lenses.

Computerized Corneal Topography allows the surface of the cornea to be examined for hills and valleys.

Computerized Corneal Topography allows the surface of the cornea to be examined for hills and valleys.

Computerized Corneal Topography assists in creating scleral lenses.

Spectral Domain Optical Coherence Tomography

This unique technology allows us to view three dimensional in-vivo images of the retina, optic nerve and the nerve fiber layer. In addition, the individual layers of the retina can be virtually separated and studied. The result is the ability to detect retinal and optic nerve disease (such as macular degeneration and glaucoma) in the earliest stages. What you are viewing in the image shown on the monitor on the wall is a full detachment of the retina which required emergency surgery.



Spectral Domain Optical Coherence Tomography

Oculus Keratograph Topographer

The Oculus Keratograph Topographer allows us to measure and analyze the moisture level, both qualitatively and quantitatively of the corneal surface. In addition, this instrument allows us to image three dimensionally the corneal surface and the oil producing (Meibomian) glands of the eyelids. The dysfunction of the Meibomian glands is the most frequent cause of dry eye. A healthy tear layer not only helps promote long term contact lens comfort, it is also essential for healthy eyes.



The very special software of the Oculus Keratograph also provides us with a three dimensional image of the corneal surface. This three-dimensional ocular image helps us to create a more detailed scleral lens design than was previously possible.

Oculus Keratograph Topographer-1

Digital Retinal Camera

The digital retinal camera is used to analyze and examine the interior tissues of the eye. Many systemic diseases such as diabetes, hypertension, blood and neurologic disorders can be diagnosed with the use of this instrument. The image seen on the monitor is the ocular fundus, which is the most posterior structure of the eye. The red structure seen here is the retina. The small yellow-like structure is the optic nerve with blood vessels emanating from it.

Digital Retinal Camera and Analyzer

Specular Microscope

Specular Microscope

Specular Microscopy plays a significant role in evaluating the health of the cornea. The Specular Microscope is unlike any other microscope. It is used to evaluate the cells comprising the back surface of the cornea, the endothelium. With aging, trauma, disease and surgery, the endothelial cells can become compromised. The endothelial cells pump oxygen into the cornea. These cells don’t replicate. One they die, new cells are not created to take their place. These cells are responsible for the cornea maintaining its transparency. This instrument allows us to detect any disorders of the corneal endothelium in the earliest stages.



The Specular Microscope allows the cells of the endothelial layer to be examined in detail.

Forum Program, by Zeiss Optical

Our specialty practice recently installed a unique eye care management program known as Forum by Zeiss Optical (a records database, not a discussion forum). With this program we are now able to view all ophthalmic examination data ( ocular photos, visual fields, all corneal, retinal and optic nerve images etc.) in one location. All of this information can be displayed, reviewed and discussed with the patient right next to the doctor. In addition, we are now able to compare all of this information to images taken today to images taken months or years ago. This unique technology represents a quantum leap in our ability to detect and manage small changes that may be taking place in a given eye over a period of time. This Zeiss Forum soft ware also allows us to review all of this technology remotely from any place in the world. Click the thumbnail images below for a larger version.

Visante Optical Coherence Tomography

Optical Coherence Tomography creates a series of 2-dimensional cross-sectional photographs of the eye running from the surface to the back of the cornea, thus measuring the complete anterior segment of the eye. The instrument is invaluable for fitting scleral lenses, since the characteristics and clearance of the lens can be isolated and measured in microns. This detailed profile assists in obtaining more perfectly fitting lenses that can be worn comfortably for many hours. Below are some recent photographs showing scleral lenses being worn and measured by the Visante OCT. Note how irregular the cornea is, and how the scleral lens is able to form a smooth prosthetic surface that restores vision.

















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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