Saturday, October 22, 2016

New Progressives

This week I got my new tortoise shell Ray Ban glasses with Essilor progressives & Crizal coating, all custom measured by our Zeiss i-Terminal. Not only are they perfect but they were *instantly* perfect. No adaptation time, which is a 1st for me. This is my 4th pair of progressives and the previous 3 were weird at the beginning. Not these. These were immediately amazing. No headache, no eyestrain, excellent vision in all views. It's pretty amazing. I'm a new BIG FAN of the i-Terminal.

Tuesday, October 11, 2016

LASIK Regression

I had LASIK in one eye in 2007 for high astigmatism (about 4.75 diopters). I knew when I did it that it would probably not eliminate the full amount (it didn't), but it would greatly reduce it (it did). I have been fairly happy. Now I'm 44 and presbyopic (need bifocals) and the last 3 straight years my astigmatism has been getting worse again. It's "coming back" or regressing. It's my experience that a LOT of these high astigmatism cases regress, and my own situation has borne that out. Pre-treatment I was -4.75 diopters of astigmatism or "cylinder" (cyl). Immediately post procedure I was -1.00 cyl, a vast improvement! 3 years ago I was -1.25, 2 years ago -1.75, last year -2.00 and today -2.50. So I'm back to half of my original amount of astigmatism. I'm not too bothered by it. I wear progressive glasses almost all day anyway because I need them for the computer and reading, so adding in the extra cyl is easy. It is interesting tho that I'm regressing. I wonder how much more astigmatism I'll get? For the record it has not been my experience that nearsighted LASIK cases regress much. They're usually fine. And I don't refer many high cyl cases (or far sighted cases or high myopia cases) so I don't have many patients experiencing this because I'm pretty conservative.

Monday, September 12, 2016

GREENE EYES: Dr. Mindi Greene & Dr. Michael Prince Optometrists, Optical Bryan, TX

Optometrist Dr. Michael Prince is now at GREENE EYES in Bryan, TX

It has come to my attention that when patients call my old office in Huntsville, TX looking for me some of the staff say they don't know where I went when I left. No matter! here is all the info again! Michael Prince, O.D. 979-775-4900 979-775-4949 fax 725 E Villa Maria Road Suite 1500 Bryan, TX 77802 In the Bryan Tejas Shopping Center Next to HEB at the corner of Texas Ave & Volla Maria

Thursday, September 8, 2016

Sometimes I Think Optometry is "Glaucoma Crazy"

I cannot tell you how many patients I have had who said something like this: "my last eye doctor was VERY CONCERNED that I could have GLAUCOMA! Yeah they made me do all these tests and then sent me to a specialist!" OK fine. I do the eye exam. They have great corrected vision, no defects on a screen field, no defects on a screen OCT, 15 pressures and (here it comes) a 0.6 cup to disc ratio OU. BAM! GLAUCOMA! Right? Wrong. Physiologic cupping. I would have never, ever told any patient their 0.6 cups "could be" glaucoma in the absence of any other evidence. That's asinine. It really roll my eyes when the patient says that they were told it "could turn into" glaucoma. Come on. These are docs who either know very little about the disease or are just paranoid. This happens all the time! I just want to scream from the hilltops "PHYSIOLOGIC CUPPING! IT EXISTS! Come on, people. Stop freaking out.

Friday, August 12, 2016

The Story of the LASIK Boom & Bust

From the Review of Optometry article "Refractive Surgery in Retrospect" "In the early days of laser vision correction, just after LASIK was approved, its popularity exploded—from about 100,000 procedures in 1996 to 1.4 million in 2000—a 14-fold increase in just five years.1 LASIK had quickly become the most common refractive procedure in the world. But then in early 2000s, the dot-com bubble popped, and the volume of procedures dipped for a few years. In 2004, the number of laser refractive surgeries nearly recovered to that high water mark of the year 2000, but never surpassed it. The numbers plateaued just beneath 1.4 million for the following three or four years. Then in 2007-2008, the housing bubble burst. The economy took a nosedive and laser refractive surgery—typically an elective procedure—followed the plunge. The numbers bottomed out in 2011-2012 at about 600,000 procedures a year, less than half than that of its high point. The number of procedures has edged up a little bit since, but it’s clear that laser refractive surgery never fully took over the eye care world, as many people back in the late 1990s had expected it would."

Biennial "My Favorite Contact Lenses" List

Right now in Aug 2016 here are my go-to soft disposable contact lenses: BEST OVERALL LENS: Acuvue Oasys One Day. Supreme comfort, vision and safety. Its one knock is cost. A close second is Alcon's Dailies Total One (even more expensive!) BEST DAILY DISPOSABLE: See above (Acuvue Oasys One Day). BEST 2 WEEK LENS: Acuvue Oasys. Two week lenses are pretty much going the way of the Dodo. No longer big sellers. Most docs are moving away from this modality, probably because it's too hard for patients to remember their schedule and be compliant. BEST MONTHLY: Bausch & Lomb ULTRA. I am loving this lens right now. Very comfortable, very good optical quality, and currently has a great rebate, making it one of the least costly options. The new Acuvue Vita is a close second. BEST TORIC (ASTIGMATISM): Air Optix for Astigmatism. Still the best and most stable toric design out there. BEST DAILY TORIC: Dailies Aqua Comfort Plus for Astigmatism. Good lens, terrible name. BEST MULTIFOCAL: Bausch & Lomb ULTRA Multifocal. This is a great product for presbyopes (patients over 40 who need bifocals or reading glasses). The comfort of the ULTRA material in a multifocal design that works well. And that's it for now! Let me know what you think!