As many of you know, over the last few years I have become interested in doing an ophthalmology mission trip. A primary reason for this is to use my education and skills to assist those who have limited access to health care, but I also wanted to challenge myself to get out of my comfort zone. When the opportunity presented itself to participate with a Detroit-based ophthalmology team to serve in Kenya, Africa, I jumped at the chance.
After two 7.5 hour flights and an all-day drive from Nairobi, we arrived at Brittany’s House in Migori. Clinic began Monday morning with a huge line of patients. We spent 3 long days seeing over 500 patients and performing over 100 surgeries, the majority of which were cataract surgeries. Cataracts are the commonest cause of blindness worldwide due to lack of access to health care. The work was the most challenging of my career yet very rewarding.
We were fortunate to be able to restore vision to many patients who were completely blind from cataracts. I also saw many advanced cases of glaucoma, retinal detachments and other diseases where the vision was not easily correctable. These patients left a heaviness in my heart that we could not do more for them. It also served as a reminder of how lucky we are to live here in the USA with so many resources available to us from good nutrition and sanitation to access to medications and health care providers.
I returned home with a renewed spirit, ready to treat all of you with the best technology available. I am so grateful to my colleagues and Kenya Relief to have been given this opportunity. If you would like to learn more about the organization that sponsors the missions, check out www.kenyarelief.org.
In the Detroit area patients often have questions about LASIK, PRK or SMILE
For patients seeking to reduce their dependence on glasses and contact lenses, there are many options available which can be overwhelming. The commonest procedure is LASIK (laser-assisted in-situ keratomileusis). LASIK surgery has been performed extensively since it’s approval by the FDA in 1998, with over 19 million procedures performed. The results of many scientific studies done show that the vast majority of patients are very satisfied with their results and are happy they had the procedure.
PRK stands for photorefractive keratomileusis. The difference between PRK and LASIK is that in LASIK a partial thickness flap is made on the cornea. The flap is reflected out of the way and a laser is used to reshape the cornea. With PRK a flap is not created. The corneal epithelium is removed and the laser is then used to reshape the cornea. A bandage contact lens is placed to allow the cornea to heal. This procedure is often considered when the corneas are too thin for LASIK.
SMILE refers to small-incision lenticule extraction. In this procedure a small incision is made in the cornea with a laser and a small lenticule of the cornea is created with the laser and extracted through the incision.
There has been much in the news recently about complications related to these procedures. As with any procedure, the most important initial steps are to have a thorough examination by the eye surgeon who will be performing the procedure to ensure you are a good candidate. At Akler Eye Center, our screening examination takes approximately 2 hours. We will obtain a thorough medical history and perform various tests and examinations of the eyes. The testing includes measuring the contour of the front of the eye, the thickness of the cornea and the tear production of the eye. Multiple refractions (measurements of the prescription) will be done as well. Dr. Akler will review all the tests and examine your eyes to make sure they are healthy. Following this, we will have a detailed discussion about which procedure is best for you and what to expect during the procedure and recovery.
Like any procedure, LASIK has risks and possible complications. The commonest initial side effects are burning and tearing in the eyes which is usually much improved several hours following the procedure. You will be instructed to go home and have a nap following the procedure. Fluctuating and blurry vision is very common initially and for the majority of patients lasts 4-6 weeks but is most pronounced in the first 2 weeks following the procedure. Glare, halos and starbursts in low light conditions are common initially but usually resolve completely. They are much less common with the newest generation of laser that we currently use and are rarely permanent. Dryness, grittiness and feeling like something is in the eye is very common initially and is treated by placing artificial tears in the eyes. These symptoms are usually much better after 4-6 weeks but can last longer in some patients. For more information on LASIK, visit our LASIK FAQ’s.
It is normal to have some fear when contemplating a procedure such as LASIK. I have been perfoming LASIK since 1999 and have done many thousands of procedures. In my experience, my patients overall are extremely satisfied with their vision and are happy with their decision. I invite you to check out our online reviews to see what our patients have said about us and their LASIK procedure. It is a privilege to have had so many people entrust me with their most precious sense – their sight.
LASIK Eye Surgery Continue To Be The Leading Vision Correction Procedure in Michigan
The struggle of wearing glasses is enough to make anyone long for the day when they can experience great sight through LASIK or other laser eye surgery procedures. Those that don’t have this problem will never understand, they will never know the struggle is real! The constant adjusting, getting the right fit, cleaning, worried about scratching and/or the need to remove before bed and putting them on first thing in the morning. Most patients tell us the biggest benefit of LASIK eye surgery is that they are able to finally get rid of their glasses.
Many patients spend hundreds of dollars a year on exams, lenses, frames and contacts. Through LASIK, you can achieve great vision immediately and finally rid yourself of glasses and contacts. LASIK is the most commonly used laser eye surgery procedure. LASIK (or laser in-situ keratomileusis) is used to correct nearsightedness, farsightedness and astigmatism. People are selecting this surgery to treat their vision disabilities, and every year about 600,000 Americans get LASIK to treat farsightedness, nearsightedness or astigmatism resulting in clearer vision.
If you’re considering laser eye surgery, here are some of the benefits of LASIK eye surgery
LASIK is not painful. Oral valium and topical numbing drops are used to ensure you will be comfortable during your procedure. The straightforward and quick procedure along with the simple aftercare is the reason LASIK is the most popular way of correcting your vision.
While the vision is blurry the day of the procedure, by the following day most patients see well enough to drive themselves to their postoperative appointment and to go to work. We do recommend looking away from screens every 20 minutes to reduce eyestrain during the recovery process.
Though it may take a few weeks or a month for your vision to adjust completely, once it does, you can expect excellent vision. Nevertheless, your eye prescription can change with time and further follow-ups may be required later in life based on your eyes.
The results of the LASIK surgery are quicker and faster than other procedures such as PRK. Though you will be unable to drive yourself home after the LASIK eye surgery procedure, most people return to their daily lifestyles and routines after 24 hours.
It seems a little odd to hear that the LASIK surgery can save you money, but it does over your lifetime. Think about the annual cost of eye exams, frames, lenses and contacts; those add up over the years. With laser eye surgery, the cost is recovered over time and the improvement in lifestyle not having to wear glasses and contacts is priceless.
No more eyewear:
The relief cannot be described. Imagine the ability to wear those sunglasses you’ve always wanted! There will also be no need to put your glasses on before driving or getting into the pool. You can swim, drive or watch TV whenever you want without worrying to get those contacts or glasses on.
There are many job opportunities which require 20/20 vision, at first you were unable to be a potential candidate for those opportunities. Now you will have the capability to apply wherever you want, there will be no flaw left in you that you cannot improve.
Enhance sports freedom:
Imagine playing a sport while wearing glasses, it is quite difficult. You don’t want your glasses to break in the middle of the game or get hurt by it. LASIK will help you to get rid of these frustrating issues of sweat dripping on the glasses or wearing the sports goggles. You will have the freedom to be a part of any recreational activity you like because your vision is now sharper than ever before.
No More Contact Lens Problems:
Wearing contacts can lead to a number of eye irritations and problems. As there is a constant need of touching your eyes while putting on or taking off the contacts, you are at increased risk. Lots of people suffer from infections, red eyes, sore eyes, dry eyes and/or blurred vision from wearing contacts. These are all common problems related to improper care of your lenses, wearing them too long or simply wearing them.
No More Lost or Slipping of Contacts:
If you wear contacts, you probably have been met with the incident when you are unable to find your len, sometimes it’s slipped deeply behind your eye or has fallen out. Both cases are extremely frustrating and make you wish you just wore your glasses.
If you have been thinking about LASIK or any other laser eye surgery procedures, contact one of our two Detroit, Michigan area offices to schedule your free consultation. Akler Eye Center is one of Michigan’s top LASIK eye surgery centers. At Akler Eye Center you can say hello to clear vision with LASIK surgery.
Michelle Akler, MD Akler Eye Center Sterling Heights & Dearborn
Happy Holidays to all of you! For this Akler Eye newsletter, I will discuss which types of foods help your eyes to stay healthy!
As most of you know, aside from ophthalmology, my passions include reading and living a healthy lifestyle. Important habits include eating foods that are good for my body and staying active. In this article I will discuss some foods that will help keep your eyes healthy.
Here are 5 foods that should be part of your diet for healthy eyes:
Leafy green vegetables like kale and spinach, collard greens, broccoli and peas. These foods are high in lutein and zeaxanthin and may lower your risk for age-related macular degeneration. These nutrients are also found in eggs.
Citrus fruits like oranges and lemons are all high in vitamin C. This vitamin may delay cataract formation and age-related macular degeneration.
Beans of all kinds, for example lima and kidney beans, contain zinc which may help protect your eyes from exposure to light over a lifetime. Long-term light exposure is implicated in cataract formation (so wear your sunglasses when outdoors too!).
Cold water fish like salmon, tuna and sardines have a high concentration of omega-3 fatty acids, which may reduce the risk of developing age-related macular degeneration.
Orange fruits and vegetables – yes I would never forget carrots! These foods are high in beta-carotene which help with night vision.
It’s a challenge to stay on track during the holidays, but keep these foods in mind even when indulging in holiday treats! I wish all of you a very happy new year!
As both an ophthalmologist in Detroit and a parent, I often think about whether our society’s addiction to screens is healthy. The incidence of myopia, or nearsightedness, has nearly doubled in the US to 42%. Scientists are not sure if this is all related to increased use of cellphones or related to the increase in near work in general. Studies have shown that spending time outdoors in early childhood can slow the progression of nearsightedness.
Recommendations for children to avoid eyestrain when looking at phones, computers and tablets are similar to what we discuss with adults. The key recommendation is to look away from the device periodically, ideally out a window. Much of the eyestrain is related to the fact that we don’t blink as much when we are on the computer which causes dry eye. Ideally we should encourage our children to spend less time on these devices.
There is no evidence that buying special glasses for using on the computer is necessary or will protect the eyes.
If you have more questions about your eye care, contact us to Experience Excellence in Eye Care.
There have been so many exciting new developments in the technology of lens implants over the last 15 years, from implants that correct astigmatism to advances in multifocal implants that offer a range of vision from distance to near. One of the featured talks in the Innovator Session this year featured a laser that can adjust the features of ANY implant even if it was placed years ago.
This in-office laser is called The Perfector and can change the power of an intraocular lens and can even make a standard lens a multifocal lens. The effects can also be reversed with the laser if the patient does not like the vision. This will offer all of our patients with lens implants a chance to “try on” multifocal lenses and reverse if they dislike them. We will also be able to adjust the power of the lenses.
The laser is in the early stages of development; human trials have not yet begun. This is an exciting story to follow and I can’t wait to hear more about this potentially powerful tool to enhance our surgery results.
Winter has always been my least favorite season, despite my Canadian heritage! This month I will share the results of study that examined whether having cataract surgery affects the mortality of older women.
This large scale longitudinal study was designed to examine the association between cataract surgery and mortality in older women with cataract.
Of a total of 74,044 women over age 65 studied, 41,735 underwent cataract surgery. The group who underwent cataract surgery had a lower mortality for all causes including vascular, cancer, accidental, neurologic, pulmonary and infectious.
This study indicates that cataract surgery improves the health status and functional independence of women which lowers their risk of dying from various causes.
Diabetes affects more than 415 million people worldwide, or 1 in every 11 adults. About 45% of diabetic patients are likely to have diabetic retinopathy. Early detection and treatment of diabetic retinopathy can help reduce preventable vision loss.
Artificial intelligence is the use of computers to simulate human intelligence. Deep learning uses huge amounts of data paired with extensive neural networks to give computers new capabilities; training the computers to do what our brains do naturally. Researchers at Stanford University put deep learning to work in developing an algorithm that allowed them to identify which diabetic patients needed to be referred to an ophthalmologist.
The algorithm was created based on more than 7,500 images from a wide range of patients. These images were used to teach the computer to identify between healthy patients and those with any stage of disease from mild to severe. The computer was accurate 94% of the time. The program can be run on a personal computer or a smartphone, making it potentially accessible worldwide.
The team awaits approval from the FDA before it can be used outside of a research setting. So for now, patients will have to continue to visit their ophthalmologist for their annual diabetic eye exam. In the future – you may be able to get your screening diabetic retinal exam using your smartphone!
Source: Ophthalmology, July 2017
Michelle Akler, MD Akler Eye Center Sterling Heights & Dearborn
As a society, we are spending more time looking at computer screen in the form of monitors, tablets and smartphones than ever before. While long hours spent looking at screens can cause eye strain, this is related to decreased blinking which is associated with dry eyes. There is no evidence that the type or amount of light coming from the screens causes any permanent damage to the eyes.
Companies selling glasses that filter out the blue light from computers claim that overexposure to blue light causes disruption of the sleep-wake cycle, dry eyes and macular degeneration. Exposure to ultraviolet light from the sun is associated with cataract formation and other eye diseases. However, no measurable UVA or UVB radiation is emitted from computer monitors, tablets or smartphones. Special glasses are therefore not necessary.
Some simple measures are recommended to reduce eyestrain. The simplest is to look away from the computer every 20 minutes and to gaze far away (eg out of a window or down a long corridor). This will relieve the prolonged focusing. Further, when the eyes feel dry use artificial tears to moisten them.
Source: AAO EyeSmart
Michelle Akler, MD Akler Eye Center Sterling Heights & Dearborn
Happy Thanksgiving! I hope everyone has been enjoying the wonderful fall weather! Last month I attended the American Academy of Ophthalmology Annual Meeting in Chicago. I am going to share some exciting research being done overseas on novel approaches to reducing the dependence on reading glasses as we age.
PEARL Treatment for Presbyopia
Presbyopia refers to the gradual loss of the eye’s ability to focus on near objects. This occurs as the lens inside the eye grows more stiff as we age. There is much interest in developing treatments for this condition that would reduce dependence on reading glasses and bifocals.
There are currently two FDA-approved devices for surgically treating presbyopia, the Kamra inlay and the Raindrop inlay. These are both small rings made of synthetic material that are implanted in the cornea (clear window in the front of the eye). To qualify for this procedure, the patients need to have good distance vision without glasses or contacts and have healthy eyes. Potential complications of the procedure are inflammation and scarring around the synthetic device.
A novel treatment for presbyopia called PEARL was presented at the American Academy of Ophthalmology Annual Meeting last month. In this technique, donor corneal tissue is implanted in the cornea. Since the material is not synthetic, there is less loss of distance vision and reduced risk of severe inflammation in the cornea.
PEARL has only been performed on a small number of patients in India, but larger studies with longer term follow up may show this technique to work well and possibly even be combined with LASIK or other refractive procedures for full vision correction at distance and near.
Source: AAO Annual Meeting, Refractive Surgery Original Papers, Chicago IL October 2016
Michelle Akler, MD Akler Eye Center Sterling Heights & Dearborn