Lewis LASIK

01/09/2021

08/11/2020

There were a lot of firsts last week. One of which was Dr. James Lewis who implanted the first Light Adjustable Lens (LAL) in Pennsylvania. Congratulations...

05/06/2020

Our practice will start seeing patients again on Monday, May 11th in full compliance with all local, state, and federal guidelines. This includes masks, social distancing, and the disinfection of all common surfaces. Elective surgeries are also being rescheduled. Care will be taken to avoid office congestion and minimize exposure to COVID-19.

We require: ➡️ You do not have fever, chills, shaking, muscle pain, headache, sore throat, or a loss of taste or smell ➡️ You have not had exposure to anyone with a flu-like illness within the past two weeks ➡️ You wear a mask or equivalent facial covering over both your nose and mouth ➡️ You agree to maintain social distancing ➡️ You avoid touching your eyes, nose, mouth, and face ➡️ You enter the office alone if possible

Expect to hear from our staff shortly. You may contact us at your convenience from links at jameslewismd.com

05/01/2020

Chorioretinal folds are a known finding following penetrating glaucoma surgery, as in these two cases who underwent Ahmed valve tube shunt placement. Prevalence is estimated between 10-50% of incisional glaucoma surgeries.

Pic 1.) several linear chorioretinal folds throughout the posterior pole. Intraocular pressure was 4mmHg at the time of this photo. The fundus and visual acuity returned to baseline within a week as IOP leveled at 10mmHg.
Pic 2.) Small choroidal folds can be seen distributed temporal to the macula. This image also demonstrates a large hemorrhage consistent with ocular decompression retinopathy.
Pic 3.) shows complete resolution of the choroidal folds and hemorrhage after 4 weeks in patient 2.

@ Lewis LASIK

04/25/2020

Inflammation of the anterior chamber can create fibrin plaques that are readily seen within the pupil. The second and third images demonstrate an almost completely occluded pupil with synechia formation. The fourth image demonstrates an ultrasound biomicroscopy image of a patient in angle closure following complete pupil occlusion from fibrin (blue arrow). Aggressive corticosteroid therapy can ‘melt’ the fibrin and cycloplegics can mechanically disrupt it. Nd:YAG laser can also instantly disrupt total occlusion.

04/22/2020

Descemet stripping endothelial keratoplasty (DSEK) is a corneal transplant procedure that replaces only the innermost cells of the cornea. It is readily combined with cataract surgery to improve refractive outcomes. This is a one day post operative visit of a DSEK showing faint edema and remaining air bubble. The air bubble will typically dissolve over the first 48-72 hours.

04/17/2020

Iris cysts are benign. If suspected, they should be imaged with ultrasound biomicroscopy (UBM) to confirm the diagnosis and rule out other causes of iris elevation.

04/15/2020

Corneal infection! This series of images highlights a case of pseudomonas aeruginosa microbial keratitis (corneal infection) related to contact lens wear. Keep in mind the cornea is about 0.5 millimeters thick! Not much room to allow an infection to move deeper.
Pic 1. The resultant scar after the infection cleared.
Pic 2. At presentation, the eye is injected (red) with a large central infiltrate (immune response) and necrotic stromal tissue (dying cells).
Pic 3. There was extensive inflammation in the anterior chamber including fibrin strands
Pic 4. Note the presence of a hypopyon (accumulation of white blood cells at the bottom of the anterior chamber).
Pic 5. This is two days after initiating treatment with fortified antibiotics. The pupil is intentionally dilated (for comfort) and anterior chamber inflammation is improving. There is a small unrelated fiber present that was subsequently removed.
Pic 6. A closer look at the scar and the shadow it casts. These scars disrupt the vision permanently. Fortunately this patient has achieved good acuity, yet blur, glare and haze can be persistent.
(Sorry for poor photo quality in pictures 2/3/4)

It is important to work quickly to identify the organism responsible for these infections to tailor treatment appropriately. If left untreated infection can spread to devastating results.

@ Lewis LASIK

04/14/2020

Diabetic retinopathy (diabetes affecting the blood vessels of the retina) can cause permanent vision loss in severely affected individuals. The first retinal image of the left eye is more advanced proliferative diabetic retinopathy (PDR) compared to the second image of the right eye. This means new blood vessels have grown to compensate for diseased ones. Unfortunately these new blood vessels are also diseased and can leak blood and fluid or create scar tissue that can lead to retinal detachment. In these images, you’ll see peripheral laser scars (black marks), scar tissue (fibrovascular), new blood vessels (neovascularization), pre-retinal hemorrhage, and scattered exudate and intraretinal hemorrhage. @ Lewis LASIK

04/13/2020

Inflammation of the eye can take many forms, all of which are best seen with the magnification of a biomicroscope (higher magnification in second image). These images show white blood cells and inflammatory proteins mixed into the normal clear fluid of the anterior chamber. Often related to trauma, autoimmune disease, inflammatory conditions, or previous surgery, this anterior chamber inflammation is painful and requires medication to improve. @ Lewis LASIK

04/12/2020

Wishing you a joyful 🐣 .
From all of us at 🐰
LewisLASIK / CataractPhiladelphia

04/10/2020

The same virus that commonly causes cold sores can affect ocular tissue, often the cornea. This herpes simplex dendrite is stained with sodium fluorescein dye and illuminates with cobalt blue light.

04/10/2020

After cataract surgery, the anterior capsule can contract and affect vision. Sometimes a refractive shift is observed and in this case, the visual axis is blocked by the capsule causing cloudy vision. A 1-2 minute, painless laser procedure in the office restores clarity.

03/20/2020

In response to Coronavirus Disease 2019 (COVID-19) and in support of our shared public health responsibilities, beginning March 14, 2020, our offices will remain open for emergencies only. All elective lasers and surgeries (including LASIK, Cataract Surgery, Cataract/Hydrus, and Corneal Transplants) are canceled through at least March 31, 2020. Exceptions include patients with uncontrolled glaucoma, trauma, sight-threatening conditions, and other emergencies.

To allay any concerns, we have implemented a HIPAA compliant telemedicine protocol accessible from any connected, camera-equipped device (phone or computer). Virtual visits can be scheduled by going to https://jameslewismd.com. There is no cost for these emergency online consultations.

Following this crisis, we will augment our surgical and clinic hours to expedite your ophthalmic surgical needs.

A questionnaire, a thermometer, and social distancing are insufficient weapons against COVID-19. Elective health care must be halted by both doctors and patients to quash this pandemic. The American Academy of Ophthalmology just announced (March 18, 2020, 8 PM) these same recommendations.

08/16/2019

Dr. Lewis is a top Philadelphia cataract surgery provider who uses premium IOLs.

CataractPhiladelphia.com

03/17/2019

Happy St. Patrick’s Day 🍀