Uncle Sam Wants You . . . to Get Your Eyes Checked!

One of the interesting things about looking at publications from WWII is the way the whole country’s cultural apparatus geared itself up to be part of the war effort. And Popular Science was no exception.

In fact, practically the entirety of the magazine’s content in the February 1944 issue is directed at promoting the war effort, and its article on understanding vision is no exception. The article not only explains how our vision works, it tells us that “in wartime poor vision is more than ever a calamity. It not only can dull our minds, contort our faces, and even lead to total blindness: it also cheats our country of our best services.” Just like our minds, we have to get our “eyes right” if we’re going to win the war against fascism.

The article gives some shocking statistics that show us how prevalent neglected vision was at the time. According to a study by the Better Vision Institute profiled in the magazine, at least 7 million American war plant workers were neglecting their vision. A full 70% of workers were found to have defective vision, but only 30% of them had sought treatment. This was considered unacceptable. The Institute actually described neglecting your vision as “housing a saboteur.”

But criticism was not reserved only for the workers. Employers were also criticized. The article said that only 20% of plants recorded the eyesight of workers involved in accidents, and only 25% actually took the time to see if a person had the vision necessary to do delicate work before assigning him or her to the job. In the words of the article, “They, too, house potential saboteurs.”

The article then goes on to rhapsodize about the wonder of the eye, with its ability to regulate light and focus on different images, not to mention move independently and regulate its intraocular pressure.

The article gives some practical information as well, in the form of this easy test for astigmatism, and an explanation of how lenses correct nearsightedness and farsightedness.

If the patriotic language of the article seems a little jarring to modern readers, there is at least one part of the article that remains current. After chastising workers for their failure to seek eye care, it says:

There’s no excuse for this dangerous civilian laxity. Eye specialists in sufficient numbers, are available. They have the proper equipment and knowledge. And the benefits of eye care far exceed the efforts involved; for good vision, with our without the aid of glasses, is one of our greatest physical wonders.

How much more this is true now in the days of LASIK and refractive lens exchange.

You may not be a saboteur, but there’s still no excuse for avoiding routine eye care. Please contact a local ophthalmologist today to protect one of our nation’s most precious natural resources.

Femtosecond Laser May Reduce Risk of Myopic Regression after LASIK

A significant fraction of LASIK patients may experience myopic regression after LASIK. When this occurs, the results of LASIK will decline toward increased myopia (nearsightedness) after treatment. It’s not known exactly what is the frequency of this condition, but some studies have suggested it might be as high as 20% during the first six months and as high as 25% after a year. Patients with high myopia (at least 10 diopters) are at the greatest risk for this complication.

A recent study suggests that the use of the microkeratome may be partly to blame for this, and that LASIK patients may be more likely to retain the quality of their LASIK results if the procedure is performed using a femtosecond laser. The study, published in the Journal of Cataract and Refractive Surgery looked at the long-term results of 786 LASIK patients, 377 who had LASIK performed with a microkeratome, 409 performed with a femtosecond laser. Follow-ups were performed for both groups at one week and 12 months after surgery.

Researchers defined myopic regression as a combination of a myopic shift of 0.5 diopters (about 1 line on the Snellen chart) or more with residual myopia of 0.5 diopters or less. Using this definition, the risk for myopic regression after LASIK with a microkeratome was 67%, compared to 44% risk for femtosecond laser LASIK.

This study is part of the growing body of evidence that, although subtle, femtosecond lasers may actually result in significantly better LASIK results than microkeratomes.

To discuss a possible LASIK procedure with a doctor, please contact a local ophthalmologist.

SMILE Eye Surgery Offers an All-in-One Alternative to LASIK

Since LASIK is more than two decades old at this point and has several drawbacks despite its proven results, it should not be a surprise that people are always looking for a new alternative procedure. The new candidate is called SMILE surgery, which is short for Small-Incision Lenticule Extraction surgery, and it uses only a femtosecond laser to reshape the cornea.

This procedure hopes to remove flap complications associated with LASIK as well as the risk of dry eyes after the procedure, and maybe give a treatment alternative to many people who cannot benefit from LASIK.

In SMILE surgery, a small incision is made in the surface of the cornea using a femtosecond laser. The femtosecond laser is then used to cut out a lens-shaped section from the interior of the cornea. This section is then extracted using a small tool.

There have been a number of significant studies performed on this procedure. One of the earliest was performed in Germany and the results published in the Journal of Cataract and Refractive Surgery in 2008, using a slightly different version of the procedure called Femtosecond Lenticule Extraction (FLE, sometimes FLEX or reFLEX). This study treated ten myopic eyes, with 90% of them achieving +/- 1.00 D, approximately equivalent to 20/50 vision. The study showed no evidence of higher-order aberrations.

A more recent study published in the British Journal of Ophthalmology looked at 91 eyes of 48 patients. This multi-center 6-month prospective study showed even more positive results, with 95.6% of patients within 1.00 D, and 83.5% of eyes achieved an uncorrected visual acuity (vision without glasses or contacts) of 20/20 at 6 months, comparable to LASIK results. In the follow-up questionnaire, 93.3% of patients were satisfied and would undergo the procedure again.

The SMILE procedure is already being offered in Britain and India, and researchers are recruiting candidates for clinical trials here in the US. It’s hard to say just how long it will be before the procedure will be available.

To learn more about advanced vision correction alternatives, please contact a local ophthalmologist today.

Pentagon Orders Prototypes of Advanced Optic Contact Lenses

The US military is the first customer for an advanced optic contact lens designed to give soldiers a much better view of the battlefield while using heads up display (HUD) units. The two-part system is designed to replace the current HUD units which are bulky and are limited in effectiveness by the soldiers’ limited field of vision.

These advanced optic contact lenses, designed by Innovega, a Washington, DC technology company, are multifocal lenses, like the advanced IOLs ReZoom, ReStor, and Tecnis. But the IOLs work by bringing a plurality of images to the retina, only one of which will be focused and therefore seen by the user. The contact lenses, on the other hand, work by bringing a plurality of focused images to the retina, allowing the user to focus on multiple objects at different distances all at once. For this specific application, the lens allows a soldier to focus on the HUD as well as on the rest of the battlefield.

How It Works

These multifocal lenses are divided into two zones. The internal zone sends light from the HUD toward the middle of the pupil where it can be conveyed to the macula, the zone on the retina responsible for detailed vision. The outer filter focuses light from the surrounding environment to the pupil’s rim.

This dual-focus display allows people to focus on multiple things at once, something human beings are not normally able to do.

The Frontiers of Augmented Reality

In addition to the military application, executives at Innovega hope to begin marketing the lens to the public, potentially as soon as 2014. The lenses have a number of potential applications, such as allowing 3-D interfaces by allowing different images to be projected onto each lens. This could be used for movies, or for immersive gaming.

The lenses could also be a solution to distracted driving, allowing drivers to focus simultaneously on the road as well as their car’s instrument panels, allowing them to perform a wide variety of tasks without taking their eyes off the road.

The Innovega display system is also seen as a potential competitor to Google’s Project Glass, which would allow people to view personal HUDs while walking around city streets and automatically see information about businesses and other local services.

This could also be utilized by law enforcement and security if integrated with the new Ex-Eye system being implemented in Spain. The Ex-Eye system uses advanced facial recognition to scan up to 100,000 faces per second, flagging known criminals and suspected terrorists to stop them before they are able to execute their plans. This security technology will be implemented at the 2016 Olympic games in Brazil, and it may be able to be significantly more effective if combined with Innovega’s advanced contact lenses.

Cautious Optimism

Although Innovega is justifiably excited about their display units, we should be a little more skeptical. Previous experience with trying to impose multiple viewpoints has met with mixed success. LASIK monovision and multifocal lenses give good results for some people, but others experience disorientation, motion sickness, and a significant fraction of users are unable to adapt to their plural visual system.

To learn more about advanced lenses that may be able to help your vision today, please contact a local ophthalmologist today.