Author Archives: Nancy Fairbrother

Your Summer Eyes

Summer puts more demand on our eyes and vision than any other time of year. Because the days are longer and the sunshine a little brighter, most find themselves outside soaking up the rays, enjoying water activities and time with friends. You may not realize it, but all of this summer fun make vision correction, such as glasses and contact lenses, a challenge.


Oceans and Lakes and Pools, Oh My!

There is nothing like getting to the shore or pool to beat the heat of summer. Or surfing in the ocean, enjoying water skiing or other boating and water activities in lakes and rivers. But, if you wear contact lenses, you should know they shouldn’t be used in the water because of the risk of bacterial contamination that can lead to sight-threatening infections.


The reality is regardless of your need for vision correction, water poses a real threat to the health of your eyes. Between the chlorine in pools and pollution along the Great South Bay, you will want a pair of well-fitting goggles to help prevent any exposure that can lead to irritation or infection.


Working and Playing with Eye Safety in Mind

Summer is all about the art of spontaneity – a pick-up game here or a tennis game there. But having to think about your vision correction needs can put the brakes on last-minute plans.


Protective eyewear is a must, particularly for sports like baseball, paintball and tennis where the ball can cause significant eye injuries. While prescription sport goggles are available at specialty eyewear centers, if you have good vision or have had a corrective procedure like LASIK, you should pick up a pair at the local sporting goods store.


If your summer plans include tackling some big chores and projects around the house, even if it is just mowing the lawn, be sure to use safety goggles to protect your eyes from flying debris.


Eyes Need Sun Protection, Too

After you’ve slathered on some sunscreen to protect your skin from damaging UV rays, be sure to take the same precaution for your eyes. We know eyes can suffer from sun damage with vision-threatening results. Cataracts and macular degeneration are both linked to long-term sun exposure.


Sunglasses should have 100 percent protection against both UVA and UVB radiation, some labels have UV 400 – which covers both UVA and UVB rays. Just because the lenses are dark, doesn’t mean they offer sun protection. Dark lenses are designed to block visible light, which is great when you are at Long Beach on a bright sunny day, but UV rays are invisible. You want to be sure your sunglasses have the protection your eyes need.


Larger, wrap-around styles are best to ensure your eyes are adequately covered. You want to block any UV light from your eyes (as well as the skin around them). This is particularly true if you’ve had LASIK, you want to protect your investment in great vision. Some contact lenses offer UV blocking technology, but we strongly recommend wearing sun-protecting sunglasses as well. If you know you are going to be out in the sun for a while, put a wide-brimmed hat on for added sun safety.


Packing for Sightseeing

If travel is on the agenda this summer, your vision takes on a whole new meaning. Your eyes take in everything around you – especially if you are visiting a new destination or packing for an adventure of a lifetime.


Add to your packing list the items you need to enjoy the sights:

  • If you wear glasses or contact lenses, you won’t want to be caught without a back-up pair of prescription glasses. This is important in case you lose or break your regular pair or have a problem with your contacts while traveling.
  • Speaking of contacts, be sure to pack extra daily disposable lenses. Whether your travel plans change, your delayed for any reason or a pair gets damaged. Include plenty of solution, drops and an extra sterile case for your extended wear or rigid lenses so you can take great care of your contacts regardless of the water quality of your destination.
  • No matter what your vision correction, don’t forget the sunglasses (see above!)


There are No “Safe” Fireworks

As a final note, don’t be fooled by the labeling. Lighting off fireworks at home in inherently dangerous. Yes, even the seemingly benign sparklers can cause significant harm to the eyes, face and body. There is no need to take such chances with you and your loved ones when there are fantastic fireworks shows everywhere around the Fourth of July. In fact, Astoria Park is starting their celebration on June 29th – take a picnic and make an evening of it. Please protect yourself and your eyesight by leaving the firework displays to the professionals.


We hope you have amazing plans for this Summer and hope you find these tips valuable for making sure your eyes and vision help you make the most of it. If you find your glasses or contacts are getting in the way of your activities, rather than supporting them, we are here to help. Not everyone is a good candidate for LASIK but there might be other laser vision correction procedures that can help you achieve your best vision. Your first step in exploring your options is a thorough evaluation with your eye doctor so we can make the recommendations best suited for your eyes and vision.

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Don’t Ignore Dry Eye Symptoms

Nearly everyone’s eyes have felt dry or itchy at some point, and though it may be uncomfortable, most people brush it off because it doesn’t seem serious. According to eye experts like Dr. Eric Donnenfeld, the opposite is true: if ignored, chronic dry eye symptoms can cause serious complications. The trusted Long Island ophthalmologist explains more here. Continue reading

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How To Use Your Tax Refund To Invest In Yourself

Did you know most Americans receive a tax refund?  If you are among the 8 out of 10 expecting a refund this year, you may already have a plan for the money.  Many people take advantage of tax refunds to travel, build their savings, or to improve their overall quality of life. Following are some options you may want to consider.


Invest In Yourself

Investing in yourself is an opportunity that doesn’t come along very often. And investing in crisp, clear vision represents a smart way to spend that extra money while providing perhaps the healthiest return ever.


If you’ve considered LASIK but are worried about the price, the average tax refund of $2,800 can go a long way toward the health of your eyesight. And with LASIK qualifying as a medical expense, some taxpayers are able to achieve a double benefit with a tax deduction.


Improving your vision with LASIK offers several benefits.  Freedom from corrective eyewear, improved athletic performance, and eliminating the ongoing cost of glasses, contacts, solutions and drops are just a few. Today, LASIK is an extremely advanced procedure with the capability to correct a range of vision problems including nearsightedness, farsightedness and astigmatism, meaning more people and prescriptions can benefit than ever before.


Best of all, laser vision correction is a decision that can improve your quality of life.  Great vision is a terrific way to invest in yourself and the first step is a visit with a highly-qualified surgeon to determine if you are a candidate.


Pay Off Debt

Buying your financial freedom by using your return to reduce or eliminate high-interest debt can be very satisfying. It can also boost your credit rating and improve your monthly cash flow. Put that refund to work by paying down private student loans, car loans, or credit card debt.  You’ll be making a 13%-20% return on your investment, depending on your current APR. If you have several credit cards, pay down the one with the highest interest rate first.


Splurge On Your family

Many feel they’ve saved all year, and want to use their tax refund toward a vacation the entire family can enjoy.  Studies show that we value memories much more than we value material possessions.  So splurge a little — it can enrich your life and be a welcome reward for paying down debt and other expenses. But act responsibly – don’t use a $500 refund to take a $4,000 all-inclusive family vacation that results in running up additional debt.


It’s not often that we experience a windfall of extra cash, so it’s important to spend that tax return wisely. Whether you decide to pay off high interest debt, splurge on your family, or invest in clearer vision with LASIK, it terrific to have an option to invest in yourself and your quality of life.

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Laser Enhances Accuracy and Precision of Cataract Removal

Traditional cataract surgery is one of the most routine, predictable and safe procedures performed today. However, over the past few years, the best cataract surgeons have started performing the procedure with the help of a femtosecond laser. A femtosecond laser automates several steps of the procedure, further enhancing the predictability, safety and accuracy.

Here, Dr. Eric Donnenfeld explains why he recommends laser-driven surgery to individuals with cataract-related vision loss. Continue reading

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How Parents Can Benefit from LASIK

Parents have enough to worry about — everything from getting meals on the table to potty training to chauffeuring kids around to their activities. One thing they shouldn’t have to worry about is relying on glasses or contact lenses to see clearly.

Laser vision correction with LASIK is designed to give patients freedom from visual aids, which in turn makes everyday life a little easier. Read on to learn why Dr. Eric Donnenfeld feels that parents especially can benefit from LASIK. Continue reading

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What You Need To Know About PROWL

This post originally appeared in the ARSC Insight Blog.

What You Need To Know About the PROWL Studies


What You Need To Know About PROWL

Two new studies published online in the JAMA Ophthalmology shed new and important light on patient experiences after LASIK surgery.

What is PROWL?

The goal of the FDA’s PROWL (Patient Reported Outcomes with LASIK) studies was to validate a new questionnaire that gives patients an accurate and complete way to report their experience with vision and LASIK. The questionnaire – a first – provides a better, more consistent collection the patient’s reporting of visual symptoms, dry eye symptoms, as well as patient satisfaction after LASIK, overall satisfaction with vision, daily functioning and well being.

“The PROWL studies are important,” said American Society of Cataract and Refractive Surgery President Kerry D. Solomon, M.D. “This is the first scientifically validated patient questionnaire for LASIK and it has a lot of potential. It provides not only an entirely new set of data that we hope will provide more insights on LASIK outcomes for patients, but also a platform for better patient education and, ultimately, more educated decisions about vision correction. With time and use of the questionnaire, surgeons will get accurate and consistent information from the patient’s perspective.”

What was learned and why it matters?

First, the studies acknowledge the body of clinical evidence confirming the safety and effectiveness of LASIK. With that knowledge, the study’s authors wanted to further explore the patient experience with LASIK, including reports of visual and ocular symptoms and satisfaction with vision and LASIK. Their findings suggested that with a valid questionnaire, patients more accurately assess and report symptoms and satisfaction.

In order to test the performance of the questionnaire – validate it from a scientific perspective – two small sample populations of LASIK patients were given the survey of patient reported outcome (PRO) questions.

  1. PROWL-1 was conducted at a military center with 262 active-duty Navy personnel (ages 21-52 years of age).
  2. PROWL-2 had 312 civilian participants (ages 21-57 years of age) located at five private practice and academic centers around the country.

The observational study focused on the functionality of the questionnaire. However, as a result of the LASIK procedures being performed, some additional data was reported:

  • Both groups reported high satisfaction rates, between 96 and 99 percent
  • A small but significant subset of patients – those without symptoms prior to LASIK – experienced new visual symptoms such as glare, halos, or starbursts, or mild, moderate, or severe dry eye symptoms, 3 months after surgery.
  • Overall, the prevalence of visual symptoms and dry eye decreased after having LASIK and improved over time.
  • Through the questionnaire, very few patients reported their symptoms impacted their daily activities or well-being.

Has our understanding of LASIK side effects changed?

From a clinical perspective, absolutely not. LASIK side effects are well-known and understood through a huge volume of research. However, what is significant is that patient reported methods offer an entirely new set of data for clinicians and researchers to tap into. This helps to characterize the experience with LASIK more broadly and, perhaps, more accurately moving forward.

Side effects from LASIK are rare, recent studies suggest fewer than 2 percent of patients undergoing modern LASIK report symptoms. This relatively low percentage of patients experience side effects during the recovery and healing process and these include dry eye and visual symptoms such as glare, halos and starbursts.  Typically, these symptoms resolve with time or, occasionally, with additional treatment. In particular, those patients who choose to have the most advance treatment profiles with the latest technologies have been shown to have higher levels of satisfaction with the procedure.

“As we have said many times before, LASIK is surgery and can produce post-operative effects,” said Dr. Solomon. “Factors such as the patient’s expectations and understanding of LASIK have an important bearing on outcomes. It’s also true that not all people who undergo LASIK are good candidates for the procedure.  The ultimate key to steady improvement in LASIK outcomes is patient education, effective counseling before and after the procedure, and effective screening to make sure that people who undergo LASIK are good candidates.  LASIK is one of many vision correction options, and patients should choose and be guided toward the options that are right for them.”

Importantly, doctors want to thoroughly understand those patients who do experience symptoms and the PRO questionnaire may well represent an important advancement in accurately reporting and characterizing symptoms.

The Questionnaire

The PROWL survey instrument consists of more than 68 questions intended to help patients self-assess and report a range of issues including, satisfaction with current vision, satisfaction with LASIK surgery, and the existence, bothersomeness, and effect on usual activities of visual symptoms including: double images, glare, halos and starbursts. The questionnaire incorporates both written definitions of symptoms and images to help illustrate the symptom and severity levels. The baseline PROWL questionnaire took study participants on average of 20 minutes to complete.

So, what’s the bottom line?

The PROWL study affirms our ongoing commitment to careful, thorough patient counseling about the risks for side effects and symptoms from LASIK. Using validated questionnaires, such as the one created for the PROWL study, is an excellent vehicle for collecting accurate and consistent information from patients. LASIK practices will have access to the PROWL questionnaire (LINK) and should strongly consider incorporating its use as it may allow eye care professionals and patients to make more educated decisions about vision correction. If you are among the thousands of people considering vision correction options, you owe it to yourself and your vision to become as informed as possible about LASIK and other procedures. If you are reading this, you have found the ARSC Insight blog and we encourage you to subscribe.

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young optometrist

Earlier this year, a team of researchers wanted to determine if modern LASIK had improved patient outcomes when compared to when LASIK was first approved by the FDA. The team reviewed more than 4,400 clinical studies from around the world and concluded in a paper published in the Journal of Cataract and Refractive Surgery that LASIK is among the safest and most effective vision correction procedures. This vast data review on LASIK is the latest to be added to the library of more than 7,000 peer-reviewed, published studies.


There has never been a better time to have LASIK. The American Refractive Surgery Council recently wrote, “There are as many reasons [to opt for LASIK] as there are candidates. But all of them want what LASIK has to offer – superb vision correction without the hassle of glasses or contact lenses.”


Should I consider LASIK today?

LASIK today is the best it’s ever been. In addition to continuous improvements in technology and technique, surgeons also draw on an extensive base of knowledge to evaluate the patient and perform the procedure.


The scientific literature reports patient satisfaction rates (globally) of more than 98 percent. And, data from a recent three-year study showed contact lens wearers who chose LASIK were more satisfied with their vision than those who stayed in contacts, and that LASIK patient satisfaction also increased over time (while the satisfaction rate among contact lens users decrease).


Is LASIK for everyone?

No, and any reputable LASIK surgeon will use everything at their disposal to evaluate and determine if an individual is a good candidate.


Surgeons today will discuss the procedure in depth with you and will ensure you understand the risks as well as the benefits. A range of medical conditions, including thin corneas and other eye deformities, can mean that LASIK won’t work well for you.


(If you are told you are not a good or even excellent candidate for LASIK, do not be discouraged. It means you are working with a qualified surgeon who has your best interest at heart. There are likely other alternatives to help you achieve your vision goals.)


Opting for LASIK means understanding what the experience will be like – what happens in surgery, what you’ll experience afterward, how long until side effects disappear, and how your vision might continue to change over time.


Do your homework and ask questions.


Ultimately, and only after you have all of the information, you need to determine if LASIK is right for you. If you are a good candidate for LASIK, think about what you want out of the procedure, and be prepared with questions to ask. Articles like this can help you get ready for your consultation. Candidates who come to see us and discuss their vision correction options have done their homework. They have independently confirmed that LASIK is safe and effective, and they know the advantages it offers over other forms of vision correction. We are here to help and will answer any question you may have.



Avenova With Neutrox Is “Breakthrough” in Fight Against Contact Lens Intolerance

By Dr. Eric Donnenfeld,

Contact lenses are a wonderful invention. They enable people to see better, to shed cumbersome eyeglass, and feel better about how they look.

But contact lenses can also cause inflammation, pain and dry eyes. More than fifteen percent of people suffer from a problem called contact lens intolerance, where discomfort and dryness is so great they have to give up their lenses.

Moreover, contact lenses can also cause dangerous eye infections. A recent report from the Centers for Disease Control warns that 20 percent of infections linked to wearing contact lenses led to serious eye damage.

Many of my own patients are upset and frustrated because they can no longer wear contact lenses.

Fortunately, I can help them, thanks to several new approaches, including an innovative new eyelid cleanser called Avenova.

The most common cause of contact lens intolerance is dry eye, which occurs when the eye doesn’t have a sufficient film of protective tears. That problem, in turn, is caused or exacerbated by bacteria and tiny parasitic mites that live on the eyelids. The microbes not only irritate sensitive eye tissue, causing pain and inflammation (and sometimes, serious eye infections), they also make enzymes that break down a crucial oil layer that protects the tear film.

But we can now successfully tackle these problems. A new device called LipiFlow applies heat and controlled pressure to the inner eyelid, unblocking the glands that produce the crucial oil. Another device, named BlephEx, deep cleans the lid margins with a disposable sponge.

In addition, I’ve had great results with Avenova® with Neutrox from NovaBay Pharmaceuticals.   This has become first line therapy. Avenova uses a formulation of pure hypochlorous acid (named Neutrox) to remove the bacteria and mites, reducing chances of infections. It also inactivates the bacterial enzymes, helping to stabilize the tear film and improve comfort. So far, every single one of my patients suffering from contact lens intolerance or other chronic eye conditions has been helped by simple twice-daily wipes with Avenova. It truly is a breakthrough.


ericdonnenfeldmdA leader and innovator in eye care, Eric D. Donnenfeld, MD, FACS, is a board-certified ophthalmologist, clinical professor of ophthalmology at NYU and past president of the American Society of Cataract and Refractive Surgery




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Questions I Want You To Ask Me About LASIK (Part One)

Focus on letters I and C.  Eye chart and glasses.I spend most of my day talking with patients about their vision; how to protect it and make it better. It’s what I love to do. The very best conversations I have with patients include lots of questions – particularly important for those who are considering an elective procedure such as LASIK. I decided I wanted to write about the top questions I want you to ask me about LASIK. Here are the first five:


How safe is LASIK?

The safety of LASIK is proven by a tremendous amount of scientific evidence gathered by hundreds of clinical researchers. Based upon all this data, and it has one of the largest data sets ever compiled concerning a medical procedure, that LASIK is considered extremely safe.


Am I a good candidate and if so why?

This should be determined by a thorough evaluation of your vision and eyes in a comprehensive consultation with your LASIK surgeon. Being a good physical candidate is important, but it is also necessary to include your personality and lifestyle in making the decision to move forward.


What are the chances I will obtain the vision I desire?

As with the data supporting the safety of LASIK, there is a vast amount of research supporting the effectiveness of the procedure. The latest lasers and diagnostic technologies have further refined the performance of LASIK to deliver visual outcomes that are better than ever with more than 95 percent of patients achieving 20/20 vision and nearly 100 percent of patients achieving at least 20/40. The most recent review of the LASIK research worldwide shows that more than 96 percent of patients are satisfied with their vision.


Will I need to ever wear glasses again in the future?

Most patients no longer need to rely on glasses or contacts, and the ones that do see their dependence on corrective eyewear drastically reduced. While the results from LASIK surgery are considered to be permanent, you will still be susceptible to age-related eye conditions such as presbyopia and cataracts. Should you develop one of these conditions, you may need to use reading glasses or additional treatment.


What can I do to improve my results prior to, during, and following the procedure?

Having a thorough understanding of the procedure, what to expect during the recovery and carefully following the post-operative medication and activity regimen are all essential to a successful outcome.


When can I go back to doing normal activities?

Typically, patients return to work the next day and are back to their normal routine within a week or two.


We strongly recommend, once you’ve had a thorough LASIK evaluation and it is determined you are a good or even excellent candidate for LASIK, you get information from a variety of sources. We are here to answer your questions and want to help you with this decision in any way we can. We also understand the need to do some independent research. In addition to talking with your friends and family who have had LASIK, the American Refractive Surgery Council offers a lot of information about vision correction procedures and is a good resource.

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Do You Love Your Contacts as Much as You Used Too?

A Japanese woman puts in a contact lens.

Let’s face it, most people who wear contact lenses have a love-hate relationship with them.

Ah…the exhilaration of that first pair of contact lenses when for the first time you, who have known the struggle with glasses, are able to see without anyone knowing that, in reality, you can’t. But, that sense of freedom can be fleeting once you realize that contacts, too, have limitations. And, for many, the disappointment sets in when signs of contact lens intolerance appear. It begins with a slight irritation or dry eye; but over time, it can become a sight-threatening issue.

What is contact lens intolerance?

Contact lens intolerance happens when a person’s eyes get irritated when they put in their contacts – becoming bothersome enough that they want to take them out and stop wearing them. Symptoms can be temporary and range from a mild gritty or stinging sensation to more serious issues such as chronic dry eye, abrasions, infections and even corneal ulcers. And for some, these complications are sight-threatening – for up to 1 in 500 contact lens users per year – according to the Centers for Disease Control and Prevention, citing a study published in 2008.

What causes contact lens intolerance?

There are several possible factors. It could be that the fit isn’t right. Perhaps age or hormone changes are contributing factors.  Certainly the over-wearing of lenses and the resulting deposits developing on the surface of the lens is as issue, as is not cleaning lenses properly, or sensitivity to lens cleaning solutions; all are associated with the spectrum of symptoms in contact lens intolerance. Whatever the cause, people with contact lens intolerance are better off looking for alternative solutions, such as switching to glasses or having LASIK eye surgery to correct their vision permanently without needing corrective lenses of any type.

Even people who don’t suffer from contact lens intolerance eventually find that the appeal of contacts begins to fade. All types of contact lenses reduce the amount of oxygen reaching the cornea – the front of the eye where the contact resides.  Even with proper care and meticulous hygiene, this can lead to an increased risk of eye problems.

A recently published study of long-term (<5 years) contact lens users showed that, over a 3-year period, their level of satisfaction with using contact lenses decreased significantly: from 63 percent down to 54 percent. The study also showed that people who used to use contacts, but then chose to have LASIK eye surgery, had a much higher level of satisfaction with their vision that only improved over time.  Importantly, LASIK has a much lower risk of sight threatening infection – 1 in 10,000 according to clinical research.

If you wear contacts and experience symptoms such as red, irritated eyes, ongoing dry eye symptoms, pain or swelling, it’s vital you don’t ignore any of these symptoms. To protect the health of your eyes and vision, please schedule a consultation with Dr. Donnenfeld at Long Island LASIK immediately as you may be contact lens intolerant. It may be time for you to consider other forms of vision correction, such as LASIK.


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