Refractive Surgery Blog

In my last blog posting (July 13, 2007), I mentioned that monovision correction had been around since the Johnson Administration. I have since learned that a form of monovision has been around since around the 13th century B.C. Pirates or Sea Peoples apparently used a form of monovision when they threatened the Aegean Sea during ancient times.

When you think of a pirate, the image of a peg-legged, hook-armed eye-patched sailor comes to mind. While one can understand how loss of a limb might have been very common on the high seas, it is hard to conceive of that many pirates losing an eye. In fact, according to pirate folklore, pirates covered one eye on purpose to keep it dark adapted for night vision. When a sailor went from being in the bright sun into the dark hold below, the patch would be switched to the fellow eye and there would be no delay in the time it took to recover his vision. Pirates moved about their ship freely and efficiently but did so with poor depth perception.

If you are interested in finding out more on this topic, an episode of Mythbusters recently aired on the discovery channel addressing this very subject. Part of the pirate episode is posted on the internet. Check it out on YouTube.

Stuart Lewis, MD

Labels: Monovision

The US Food and Drug Administration (FDA) finally approved a refractive technique that eye surgeons have commonly used to help presbyopic patients deal with their visual challenges at both distance and near (See my Blog entry "LASIK for Presbyopia," Feb. 13, 2007). Monovision, or the concept of correcting one eye for distance and the other (usually non-dominant eye) for near vision, was approved on July 12, 2007. I have been performing monovision laser refractive surgery on an off-label basis since 1996 and have been correcting patients that way with contact lenses and with intraocular lenses following cataract surgery since 1982. This approach has been widely utilized since the Johnson Administration.

"Monovision has been available off-label since approval of the first laser used for conventional laser eye surgery" according to the Executive Director of the Council for Refractive Surgery Quality Assurance. "This FDA approval is not likely to have any practical effect on the availability of monovision lasik in the United States."

According to the FDA, patients should have a contact lens trial of monovision correction prior to having surgical correction to make sure they tolerate having their eyes corrected to different focal points. The main draw back to to monovision correction is that depth perception may not be as acute as having both eyes corrected equally. Other problem areas arise in driving at night or reading extensively for long periods of time. Some patients elect to wear glasses for those tasks but don't use any additional correction for most daily activities. While we take care to make sure the decision to have monovision correction is the correct one, occasionally a patient will decide it is not what they really wanted. In those rare cases, additional laser treatment can be used to equalize the vision.

Stuart Lewis, MD

Labels: Monovision LASIK

Last month (June 2007), I was approved for fellowship in the American College of Surgeons. After the convocation ceremony later this year in New Orleans, my formal title will be Stuart A. Lewis, M.D., F.A.C.S. I am honored to be accepted into this prestigeous organization and look forward to being involved in carrying out its madate.

The American College of Surgeons is a scientific and educational association of surgeons that was founded in 1913 to improve the quality of care for the surgical patient by setting high standards for surgical education and practice.

Members of the American College of Surgeons are referred to as "Fellows." The letters FACS (Fellow, American College of Surgeons) after a surgeon's name mean that the surgeon's education and training, professional qualifications, surgical competence, and ethical conduct have passed a rigorous evaluation, and have been found to be consistent with the high standards established and demanded by the College.

It will be my goal to continue providing not only excellence in eyecare as has been the tradition in my office for over 50 years, but, to provide care in a state-of the-art, ethical manner in accordance with the American College of Surgeons.

Labels: American College of Surgeons