Services provided at our office include:
	Comprehensive Eye Examinations		Contact Lenses
	Optical Dispensing		Laser Vision Correction
	Surgery Co-Management		Eye Infections, Eye Injuries, Dry Eyes
	Eye Diseases; Cataracts, Glaucoma, Diabetes		Low Vision Services
	Vision Therapy

As one of our patients, you may expect the following:

Doctors with experience and expertise unsurpassed in the contact lens field

As extensive a contact lens offering as any office in the world

Highly trained technical and administrative personnel to make your experiences with us not just successful, but comfortable as well

State of the art ophthalmic instrumentation

An office significantly involved in research and development allowing for new contact lens products, often years in advance of their general introduction

A large inventory of contact lenses that often allows for same day prescribing as well as emergency lens replacements

A 24 hour answering service with doctors on call for ocular emergencies

Extensive office and doctor hours (six days a week during all months except summer)

Our commitment is to maintaining the highest level of quality eyecare for both initial contact lens fits and follow-up care. This is essential for continued contact lens wearing success.

WHY?

Good vision is more than scoring 20/20 on a school screening or passing the vision test at the motor vehicle department, and, vision problems are more than the obvious symptoms of needing more light to see. VISION SCREENING SHOULD NOT BE CONFUSED WITH A COMPREHENSIVE VISION ANALYSIS BY A PROFESSIONAL VISION SPECIALIST.

Quality vision care can help ensure clear, comfortable binocular vision throughout a lifetime of changing visual demands...and abilities.

Periodic, preventative examinations are essential to continued ocular health and efficient binocular performance without stress or strain. Timely detection and diagnosis of visual and ocular disorders may be vital to successful remediation.

WHEN?

Children should undergo their first formal visual evaluation on or around their third birthday. Pediatric vision analysis will reveal whether there is a tendency toward nearsightedness, farsightedness, crossed eye, astigmatism, or amblyopia. Perhaps more importantly, it will determine whether the many visual skills that your child will need are beginning to develop as they should.

Proper focusing and eye muscle coordination assures your youngster the visual efficiency and comfort he or she needs for optimal academic and athletic performance. Periodic reevaluation will be recommended usually every one or two years), depending upon your child's individual case.

Adults between the ages of 18 and 40 should undergo routine evaluation every two years. Certain ocular and systemic conditions such as high myopia, glaucoma, diabetes, and high blood pressure, necessitate more frequent exams to monitor retinal health.

The incidence of age related visual and ocular changes such as presbyopia and glaucoma significantly increases after age forty. Because certain sight threatening disorders are "silent" (without symptoms) in their early stages, it is advisable to undergo annual examinations beginning at this time.

Ocular changes affecting older adults, such as cataracts macular degeneration, can also be diagnosed earlier through routine preventative check-ups.

HOW?

The examination procedure will take approximately one hour. We ask that you allow for some flexibility in your schedule on the day of your exam in the event that slightly more time is needed to complete the testing and address all of your questions. We also ask that you bring your most recent eyeglasses and/or contact lenses and a list of any ocular or oral medications you may be taking.

Because many ocular and visual changes are hereditary or influenced by other health problems, the first step in the examination procedure is a thorough personal medical and ocular history.

Testing will then be performed to determine the eyes' refractive status in order to derive the appropriate distance and/or reading correction. Focusing and eye coordination skills will then be assessed.

An external ocular examination is performed using a binocular microscope. Glaucoma testing (intraocular pressure) is also done at this time.

Finally, the doctor will use a hand held direct ophthalmoscope to view the interior structures of each eye. This instrument permits observation of the central retina, including the optic nerve and macula. It allows for screening of any abnormalities in these vital areas.

At the conclusion of this examination your vision will be unaffected and you will be able to immediately resume your normal activities.

A detailed pamphlet is available. To get this information or to schedule an exam please call us at (212)355-5145 or (516)365-4500 or e-mail us at: doctors@eyewise.com.

We specialize in hard-to-fit contact lens patients and employ over 300 types of contact lenses on a regular basis. Below is a brief guide to the types of contact lenses we offer:

Soft Lenses (Hydrogel): Soft lenses require almost no physical adaptation. For most individuals, full-time wear is achieved quickly and effortlessly. They have, in addition, become the standard for contact lens wear in sports, since these lenses are difficult to dislodge and don't easily allow for dust to get underneath. Available in dozens of materials and even more designs, soft lenses can correct the vast majority of eye prescriptions. They are available in both daily and extended wear (overnight) options.

Rigid Lenses (Gas Permeables): As the name implies these lenses are firm and do not contain water. Hard materials take a somewhat longer time to adapt to than soft, but once that is accomplished, they can be worn with comfort and safety by most individuals. Rigid lenses offer the benefits of maximum optical performance and ease of care. They can be designed in virtually any size, shape, and prescription. We currently employ well over a dozen materials in our unlimited array of gas permeable lens designs, selecting each based on our patients needs.

Hybrid Lenses: These lenses have a hard lens center attached to a peripheral soft skirt. The concept is one of rigid lens optics with soft lens comfort.

"Disposable" Contact Lenses: Since 1986 our office has been involved in the development and introduction of disposable lenses. Disposability is mostly a soft lens concept, since hydrogel lens types generally soil and deteriorate more rapidly than rigid lenses. Many designs and materials are now available with "disposability" options. We currently offer daily, weekly, bi-weekly, monthly, bi-monthly, quarterly, and semi-annual contact lens replacement programs.

Specialty Lenses: We offer many other contact lens options including bifocal contact lenses, custom designed lenses, cosmetic (or colored) lenses, Orthokeratology (myopia control) lenses, aphakic contact lenses for cataract patients, and color deficiency lenses.

Special Effect Theatrical Cosmetic Contact Lenses: Custom made contact lenses are available for actors to enhance eye color or to substantially alter the color or shape of an eye. We can provide technical support "on set" to supervise the insertion, removal, and care of these devices.

A more detailed pamphlet on contact lenses is available by calling us or sending e-mail to: doctors@eyewise.com.

Our optical laboratory has the latest in equipment to not only fabricate your glasses, but to maintain and repair them should they become broken or damaged. We are able to tint, coat, harden and edge spectacle lenses. We are able to provide you with any frame or lens design available. Our highly qualified optician and staff are able to adjust and fit your glasses to you for extended comfort and vision.

Laser vision correction is the most technologically advanced method available today for reducing your dependence on glasses and contact lenses. We're excited to be able to offer you pre-operative and post-operative care in association with TLC Laser Centers to offer you the finest in laser vision correction.

Laser vision correction is an out-patient surgical procedure that corrects vision problems using an Excimer laser to recontour and alter the surface of the cornea. Laser vision correction is a treatment for a wide range of vision problems (nearsightedness, farsightedness, and astigmatism).

Is Laser Vision Correction for Me?

Although this can only be definitively answered after we have conducted a thorough pre-operative exam, if all or most of the following statements are true for you, then you may be a good candidate for laser vision correction:

My dependence on eyeglasses and/or contact lenses has always felt like a handicap.

I am an avid sportsperson, and I feel my performance would be enhanced without my corrective lenses.

My career opportunities would be improved if I did not have to rely on eyeglasses or contact lenses for distance vision.

I prefer the way I look without glasses.

I adapt well to change.

If laser vision correction can reduce the hassles of contact lenses or glasses, and improves the quality of my life, it is worth the investment.

What is LASIK?

LASIK is an extremely effective outpatient procedure that is suitable not only for higher prescriptions but also for patients with moderate to low prescriptions. LASIK dramatically reduces your recovery time. The procedure takes only a few minutes to complete and involves minimal discomfort. LASIK requires more technical skill and training than other laser procedures. For this reason, our patients are treated only by the most experienced surgeons at TLC. These surgeons are center medical directors who have performed thousands of LASIK procedures with impressive results.

The LASIK procedure involves two basic steps. The first is the creation of the corneal flap. The surgeon utilizes a microkeratome (an automated microsurgical instrument) to create a flap from the very top layer of the clear covering of the eye (cornea). The excimer laser utilizes a cool beam to gently reshape the layer underneath and the flap is then closed.

Each pulse of the layer can remove 39 millionths of an inch of tissue in 12 billionths of a second. This enables surgeons to achieve remarkable accuracy while maintaining excellent control throughout the procedure.

What are the advantages of LASIK?

Brief recovery time

Very low infection risk

Relatively quick procedure to complete

Very low risk of scarring

Minimal discomfort

High degree of predictability

Reduced need for re-treatment

Excellent ocular integrity post-treatment

Widest range of correctable prescriptions

What is PRK?

PRK or Photorefractive Keratectomy uses a cool, ultra violet excimer laser beam to reshape the outer surface of the cornea, which is the most accessible way to modify refractive imperfections. Close to 95% of typical PRK patients achieve 20/40 or better vision after one treatment; excellent vision stability is reported more than 5 years after treatment; corneal strength is preserved. It should also be noted that the healing of the eye involves a careful regimen by the patient and close monitoring by the doctor for several months following PRK, a minor degree of over or undercorrection may be present, "night glare" may occur in low light, and some patients experience post-operative discomfort or pain (which varies greatly from individual to individual and disappears completely in just a few days).

Will the procedure be painful?

The actual procedure itself is painless as local anesthetic eyedrops are instilled before the surgery begins. After the anesthetic wears off, you may feel some discomfort. This might consist of a mild gritty sensation accompanied by watering. This usually lasts only 3 to 4 hours. Most patients benefit from a short nap after the procedure.

How soon after the procedure will my eyes reach their level of correction?

Most patients see 20/40 or better by the next day. Patients can usually resume driving by the second or third day. Most patients return to work after 2 days.

Will my vision be hazy or foggy?

Almost everyone experiences a trace degree of corneal hazing during healing, although most patients are not aware of it. It is usually only visible to the doctor under microscopic examination and permanently clears in almost all patients by their one week check-up.

Will my nearsightedness return?

Regression, or a shift back toward myopia after laser vision treatment, occurs to a small degree in all individuals and therefore the computerized laser is programmed to adjust for this. This process generally stabilizes within 3 months. Small variation of under or overcorrection may be expected. Part-time or full-time corrective lenses or a subsequent laser procedure may be needed to further enhance vision. More than 10 years of investigative trials with laser vision treatment show excellent eye stability years later.

What are the office procedures?

The first visit, the screening visit, will last approximately 30 minutes and will determine whether or not laser vision treatment is suited to the condition of your eyes and lifestyle. It will also provide extensive education on the procedure. The pre-operative visit, lasting about 2 hours, is devoted to gathering detailed and precise measurements of your refractive error, corneal shape, and internal and external ocular health. This evaluation involves the use of dilating drops which blur vision for several hours after the exam. It is recommended that you bring sunglasses, and if possible, a friend or relative, should driving be required. The laser treatment is the next step and you arrive before your procedure for an additional consultation with the surgeon. A final map of your eye is made to calibrate the laser's computer. A medical assistant will begin a series of drops to anesthetize your eyes and a speculum will be used to restrict eyelid movement. After the procedure, the eye(s) will be fitted with a clear shield to be worn overnight. You will be seen in our office the next day and then again 1 week later. You will return to our office for ongoing follow-up visits at regular intervals, typically 1 month, 3 months, 6 months, and 12 months. Thereafter, yearly eye examinations will help to ensure your continued visual and ocular well-being.

How much will it cost?

Please call our offices for full details on the cost of this procedure which includes pre-operative exam, the laser procedure, one year follow-up care, and any future enhancements if necessary. Financing plans are available.

For more information about this procedure, please call our office at (212) 355-5145 or (516) 365-4500 or e-mail us at doctors@eyewise.com. An informative pamphlet on this procedure is available.

Our office provides many of the surgical services such as Cataract surgery, Laser surgery, Refractive surgery and Strabismic surgery. We offer this in conjunction with the hospital and local eye surgeons.

Additionally, we have working arrangements established with other specialized eye care doctors to manage such things are retinal detachments, retinal tears and hemmorhages.

Our office provides emergency services for eye infections and eye injuries. Please call our office at 212-355-5145 during office hours, after hours or on weekends. Our staff will work with you to schedule an appointment as soon as possible. State of the art microscopes allow us to examine the front surface of the eye and facial areas around the eye for infection or injury. After assessing the extent of the injury or infection a treatment plan will be formulated and explained to you. Treatment may include medications and supportive care. Follow-up visits to monitor your recovery will be scheduled as needed.

Dry Eyes: Symptoms include scratchy eyes, burning, mild redness and gritty feeling eyes. Oral medications, reading, computer tasks and dry environments may aggravate marginally dry eyes. Dry eyes can be diagnosed by using dyes to observe tear patterns, evaluation of the amount of tears on the front of the eye and from review of your symptoms. Treatment may include artificial tears; eye drops for treating allergies; and/or punctal plugs inserted in the tear drainage canals.

Cataracts: The natural lens in the eye gradually becomes less clear as we get older. When opacities develop in the lens and the lens gets too hazy, vision will be impaired. Our office can diagnose and manage cataract care. When the cataract affects the vision to the extent that you cannot read or see distant objects comfortably, we will recommend cataract surgery. Our office co-manages with cataract specialists that are proven experts in cataract surgery. Cataract surgery can provide you with a bright new world of vision.

Glaucoma: Glaucoma gradually destroys the optic nerve tissue in the back of the eye. The greatest danger of glaucoma stems from the fact that the disease is painless and without obvious symptoms until significant damage has occurred. The most common cause is from pressure being too high inside the eye, but vascular disease and other diseases can also cause glaucoma. We always monitor for glaucoma during routine eye examinations. Tests include checking the pressure of the eye, screening for peripheral vision defects and analyzing the appearance of the optic nerve. If you are diagnosed with glaucoma, we typically prescribe medications that lower the eye pressure. Most forms of glaucoma are successfully treated with eye drops. Laser treatments and eye surgery are secondary treatments that offer alternative ways to treat more advanced glaucoma.

Diabetes: Diabetic patients should have a dilated retinal examination each year. Laser treatments have proven to slow the progression of retinal eye disease for many patients. Diabetes often stimulates the growth of new blood vessels in the back of the eye, which ultimately leak and damage the retina. If this condition is discovered early, laser treatment can destroy these vessels. We have the latest instruments used to detect changes in the back of the eye. If we discover advancing diabetic eye disease that can be treated or needs further evaluation, we will refer you for consultation and further testing to a board certified retinal specialist.

People who have lost eyesight due to injuries or eye disease need special types of products to help them function as independently as possible. We offer a full range of these products through our office. Our paraoptometric staff is trained to demonstrate the use of some of these devices. They range all the way from a simple hand magnifier to a closed circuit TV system.

In addition, we can direct those who have low vision problems to products that will help them carry on the day-to-day tasks that they need to perform. In some cases we can set up a program for the low vision patient with the National Library of Congress to receive "books on tapes", which is a service for the blind.

Seeing clearly is not enough. For many people, reading and hand-eye coordination tasks can be very difficult. The act of sight not only includes ones eyes, but it also includes the neurological activity that processes the visual information. Throwing a ball or skiing down a hill, is a learned activity; to do either well takes practice. Those who do it best are those who started learning at the earliest age. Sight plays an important role in the learning of these activities. Sight is the steering mechanism; it is the main activity that provides feedback regarding what really is happening. We provide Vision Therapy to help individuals learn how to process visual information and develop better hand-eye coordination skills.