W Andrew Cies MD

11/28/2023

New Drop for presbyopia (the need for reading glasses)

Qlosi (pronounced CLOTH-see) is the second drop approved by the FDA to reduce the need for reading glasses. The first is Vuity, which has been quite successful, but Orasis Pharmaceuticals states that Qlosi has fewer side effects (irritation and headaches) than Vuity. Qlosi will be available in early 2024 and give patients another option to help with reading. As with Vuity, your correction may not be suitable for either drop and the drops require a prescription. So, come in for a visit to see if you are a good candidate for this medication.

The preservative-free, low-dose eye drop will be commercially available in 2024.

11/28/2023

Eye Transplant!
Many people have heard the news of the world’s first eye transplant. This news can be confusing. Ophthalmologists have transplanted corneas for many years, replacing the clear outer dome of the eye to repair corneal injury or certain corneal diseases. Until now a complete eye transplant has not been performed. But surgeons at NYU Langone Health recently performed a partial face and complete eye transplant. Face transplants themselves are incredibly complicated but a blessing to people with serious face injuries.
It is important to understand what is really going on with the eye transplant. The surgeons at NYU were able to connect blood vessels to permit survival of the eye. The nerve was also reconnected and stem cells were injected to promote return of visual function. Thus far in the patient’s recovery, no vision has been restored and the eyelid cannot fully protect the eye.
What has been accomplished?
1) A major step in cosmetic reconstruction of the face including an eye for the first time
2) A demonstration that it is possible to transplant a whole eye and have it survive with good blood supply and rejection prevention
3) An open look into the future of possible sight restoration
What has not been achieved
1) Return of vision, so far!
Other transplants: Stem cell transplants to the back of the eye, the retina, are being actively researched. Thus far, as with total eye transplants, vision loss due to retinal disease, such as macular degeneration, has not been achieved, But, the research is promising
So, be encouraged by this major advance, but medicine is not at the point where a whole eye transplant is successful in restoring vision. . It great that there are ophthalmologists with the lofty goal of functional vision restoration via an eye transplant are out there, working for all of us. Stay tuned….

Surgeons in New York have performed the first-ever whole-eye transplant in a human, they announced on Thursday, an accomplishment being hailed as a breakthrough even though the patient has not regained sight in the eye.

10/30/2023

We have received numerous calls regarding possible dangerous eye drops. There have been a few isolated cases of severe health problems after use of these drops. You may note that most of these are generic drops for dry eyes or eye whitening. Most have been recalled but please shop carefully. Note that these drops may still be available online.

Eye Drop Retailers and Product Information Recall 2023

CVS Health
CVS Health Lubricant Eye Drops
CVS Health Multi-Action Relief Drops
CVS Health Mild Moderate Lubricating Eye Drops

Rugby (Cardinal Health)
Rugby (Cardinal Health) Lubricating Tears Eye Drops
Rugby (Cardinal) Polyvinyl Alcohol 1.4% Lubricating Eye Drops

Leader (Cardinal Health)
Leader (Cardinal Health) Dry Eye Relief
Leader (Cardinal Health) Lubricant Eye Drops
Leader (Cardinal Health) Dry Eye Relief
Leader (Cardinal Health) Eye Irritation Relief

Rite Aid
Rite Aid-Lubricant Eye Drops
Rite Aid-Gentle Lubricant Gel Eye Drops
Rite Aid-Lubricant Gel Drops
Rite Aid-Multi-Action Relief Drops

Target
Target - Up&Up Dry Eye Relief Lubricant Eye Drops
Target - Up&Up Extreme Relief Dry Eye

Velocity Pharma LLC
Velocity Pharma LLC-Lubricant Eye Drop

Walmart
Walmart-Equate Hydration PF Lubricant Eye Drop

To access information from the American Academy of Ophthalmology - click on link below:
https://mail.google.com/mail/u/0/ /FMfcgzGwHVKqHxTcvwkSvcvhZwPJbqCN

To access the actual report from the FDA, click on the link below:

Eye Drop Recall

08/02/2023

Clear Lens Extraction (CLE)

Vision Correction That Eliminates the Need for Cataract Surgery
If you wish to reduce or eliminate your need of glasses or contact lens, but have been told that you are not a candidate for LASIK, PRK or cataract surgery; clear lens extraction (CLE) may be an option for you. This procedure, also called refractive lens exchange, is quite similar to cataract surgery. However the lens is clear: there is no cataract. The goal of CLE is to reduce or eliminate your need for glasses. It can correct nearsightedness (myopia), farsightedness (hyperopia), astigmatism, and loss of near vision (presbyopia). People with a strong distance correction and the need for reading correction as well are the best candidates for this surgery. People with good eye health in their 40s to 60s and need reading glasses may consider this surgery.

The Process
We perform in-depth, personalized assessments to determine if CLE is the best choice for you.
A Complete Eye Evaluation
You will undergo a complete evaluation of your eyes. A technician will perform a basic eye exam, imaging, and diagnostic testing and will take measurements of your eyes. Then your eyes will be dilated, and the doctor will examine them to determine whether CLE surgery is an option for you.
CLE and Insurance
Because CLE surgery is an elective procedure; it is not covered by most insurance plans. The cost covers the surgery and one year’s follow up. . We follow you closely, especially the year after surgery, to ensure the results meet your expectations.

The procedure
CLE is basically identical to cataract surgery. It is an outpatient surgery performed with a combination of sedation and numbing drops to insure your comfort. To “recalibrate” your eye the clear lens is removed. Then one of several possible lens implants are placed in the eye, replacing the human lens and re-calibrating the eye at the same time.

Replacement Lens Options
Recent advances in lens technology and design allow us to offer several choices to improve your vision with CLE. We will discuss the results of your eye exam, what you hope to achieve, and the options for the surgery. This will help determine which replacement lens is right for you. Depending on the lenses you and your doctor select, CLE can correct nearsightedness, farsightedness, astigmatism, and presbyopia...
Monofocal Lenses
These lenses correct distance vision, but you will need glasses for near-work activities like reading.
Monofocal and Astigmatism-Correcting Lenses
Toric lenses correct astigmatism and distance vision. Glasses will still be required for near work.
Presbyopia-Correcting or “Lifestyle” Lenses
These lenses are designed to correct whatever distance correction you have and due to their special design, the lenses can correct reading and computer needs as well. The goal is elimination of all glasses. It may still be necessary to wear reading glasses for very small print or in low-light and sometimes for night driving.

What to Expect with CLE
Long-Term Results
The replacement lenses are intended to remain in place permanently. The results of CLE should last a lifetime unless there is a medical change in your eyes. Because your natural lenses are removed during the procedure, you will not need cataract surgery.

Consultation
If Clear Lens Extraction sounds interesting to you, please call for an appointment.

See illustration below

08/02/2023

Myopia Control in Children and Adolescents
Myopia is a common cause of poor vision. In the USA between 30 and 40% of the population will have myopia. Aside from the poor vision associated with myopia, there are also some serious problems associated with nearsightedness that can damage vision. Stable myopia in adults is corrected with glasses or contact lenses. Children at risk for myopia can be treated to lessen the impact of this condition. Addressing myopia in children, especially before the growth years of adolescence can benefit the youth by reducing the chance of stronger correction and thicker glasses. Severe myopia is associated with retinal degeneration so myopia control is a worthwhile goal.

What Is Myopia
Myopia, or nearsightedness, is a condition in which individuals are able to see objects that are close to them but have difficulty distinguishing things at a distance without glasses or contact lenses. In significant myopia the eye is unusually long and thick glasses are needed to focus on objects in the distance. The risk of progressive myopia increases for children with near sighted parents, excessive time indoors, and overuse of computers and reading,

How is a youth evaluated for myopia?
We take a family history, looking for a genetic tendency for myopia. The child’s vision is tested, and a refraction (glasses check) is performed. A refraction is the process of identifying and quantifying the myopia. An important measurement is the axial length: a computer measures how long the eye is. There are reliable charts of normal eye growth patterns which we program with the child’s measurements. If the amount of myopia and axial length are outside the normal growth pattern, then we may recommend treatment.

Types of Myopia Control
Control of myopia in children and adolescents has become an area of intense interest and study. There are several treatments for myopia that have proven to be helpful in a number of studies. Myopia cannot be cured but during the developing years the condition can be controlled.
Basic recommendations
Progressive myopia is associated with heavy computer use, reading, and not enough outside time. The near tasks require focusing and excessive game playing on computers doesn’t give the focusing muscles time to relax. So game playing on computers should be controlled and necessary homework and reading broken up by taking breaks. More outdoor time is possibly felt to be related to the differing wavelengths of natural light, or just getting the child away from the computer.

Ortho-K | Ortho-K or Orthokeratology is one practice being used to slow down the progression of myopia. Ortho-K utilizes special gas-permeable hard contact lens that is placed on the eyes just before bedtime. This lens helps to gently hold your eye in the proper shape throughout the night. The lens is not worn during the day as the eye tends to hold the desired shape achieved by the night time treatment. This approach more often used in stable myopia in adults but can be employed in children to slow the progression of myopia...

Atropine Eye Drops | One of the theories about the progression of myopia, is that it is associated with eye strain. The additional stresses that are placed on the eye when straining tend to cause abnormal elongation of the eye. Atropine drops are placed in the child’s eyes at bedtime. The drops dilate the pupils but more importantly relax the focusing muscles during sleep. This relaxation reduces msscl tone of the focusing muscles and therefore the tendency for the eye to elongate with worsening myopia as a result. The dilation and impact on focusing are usually gone the next morning.

Multifocal Eyeglasses or Contact Lenses | These specialty glasses or contact lenses are designed to help reduce strain on the eyes. They provide correction for near vision to reduce excessive eyestrain and spasm of the focusing muscles. The eyeglasses are not currently available in the USA but can be ordered in Canada. Either approach has shown great promise in slowing the progression of myopia in youth.

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Overview
If either parent has significant myopia, the child should be checked. If you notice that your child is having a difficult time seeing objects that are far away or squinting, he or she may need treatment. Many parents notice changes in their children with their behavior or grades at school, their ability to play sports, or that they may even be pulling back from playing with friends. It is important for all kids to have periodic vision checks but especially those who seem to underperform or have difficulty with school, games or sports.

We are quite involved in this developing discipline of myopia control. Please call and make an appointment for your child and we will evaluate the need for glasses and/or treatment.

05/23/2023

Voyage: A Story about Vision

This is a Voyage of a place in time not travel. None the less, this trip explores the mind, the heart and the joy of modern technology enhancing vision. W. Andrew Cies, M.D. opened doors of technology which enhanced my eyes to the potential of vision I found hard to believe. The story unfolds as I was struggling to live with eyes that had lost clarity and perception in a haze of hopeless smoke.

My youth was a joy. My vision was clear and flexible; I could see details and colors that were clear at 20 feet that normal vision was perceptible a 10 feet. As the voyage through time passed the erosion of vision was slow yet inevitable. As an Architect, Engineer and Photographer; the required details had to be refined for clarity. Glasses grew thicker, variable focuses were a must. None the less, age twisted my vision into a haze.

I am embracing this technology as a babe suckling the magic emerging from a list into light and clarity. The voyage has a story that may benefit those considering the potential vision.

This was not a flash of clarity.

Once again, I had to adjust my vision like a youth with eyes open yet anticipating the limits of an old man.

Being a surfer, my vision was a key to enjoying the ocean. To enhance my experience there were a number of techniques to fulfill these goal. For example, Dr. Cies removes pterygiums from my eyes to clear my vision.

The Eyes are the Windows into the Mind
(Post Cataract Surgery)

The transition was in a flash. The adjustments were steps taken slowly over time. Careful thought informed the new normal. The flexible dances of youth had no place in discovering the new path.

These eyes have settled into form. Natural light dances thru my new eyes opened windows illuminating my mind manifesting a clarity recalling my youth. I can only imagine the potential insights blossoming in the days, months, and years ahead

CB