Ocular Surface Temperature and Lipid Layer Thickness

The aim of this study was to establish the relationship between ocular surface temperature (OST), tear film stability as assessed by noninvasive tear break-up time (NIBUT) and subjective evaluation of the lipid layer thickness in a young, asymptomatic, sample group (n=29). NIBUT and tear lipid layer structure were evaluated through a slit-lamp mounted Tearscope Plus. A self-calibrating infrared thermography camera was used to record two OST values (one immediately post-blink and one immediately pre the subsequent blink).

The most common lipid layer pattern observed was the amorphous pattern (48.3%). Differences between post- and pre-blink OST values were observed. Significant differences of pre-blink OST values were observed between the closed marmoreal group with that from the amorphous and flow groups. There were no differences of NIBUT values between each lipid layer thickness.

A non-significant tendency for higher OST in eyes with increased NIBUT was observed. This study suggests that higher OST values could be associated with thicker tear lipid layer in normal subjects. The lack of significant results in relation with tear film stability may be due to only normal subjects were included.

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NASA Study of Cataract in Astronauts

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The NASA Study of Cataract in Astronauts (NASCA) is a 5-year longitudinal study of the effect of space radiation exposure on the severity/progression of nuclear, cortical and posterior subcapsular (PSC) lens opacities. Participants include 171 consenting astronauts who flew at least one mission in space and a comparison group made up of three components: (a) 53 astronauts who had not flown in space, (b) 95 military aircrew personnel and (c) 99 non-aircrew ground-based comparison subjects. Continuous measures of nuclear, cortical and PSC lens opacities were derived from Nidek EAS 1000 digitized images. Age, demographics, general health, nutritional intake and solar ocular exposure were measured at baseline. Astronauts who flew at least one mission were matched to comparison subjects using propensity scores based on demographic characteristics and medical history stratified by gender and smoking (ever/never).

The cross-sectional data for matched subjects were analyzed by fitting customized non-normal regression models to examine the effect of space radiation on each measure of opacity. The variability and median of cortical cataracts were significantly higher for exposed astronauts than for non-exposed astronauts and comparison subjects with similar ages. Galactic cosmic space radiation (GCR) may be linked to increased PSC area and the number of PSC centers. Within the astronaut group, PSC size was greater in subjects with higher space radiation doses. No association was found between space radiation and nuclear cataracts.

Cross-sectional data analysis revealed a small deleterious effect of space radiation for cortical cataracts and possibly for PSC cataracts. These results suggest increased cataract risks at smaller radiation doses than have been reported previously.

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Increase in ocular melanoma rates to use of tanning booths.

NBC Nightly News reported about the tanning bed industry. "While the risk of skin cancer is well known, [a] dire warning...compared the effects to cigarette smoking and arsenic. Chief medical editor Nancy Snyderman, MD, explained that according to the World Health Organization, an exponential increase in skin cancer can be linked to the use of indoor sun and tanning booths. For people who start using the booths before the age of 30, their risk goes up 75 percent."
        The Tampa Tribune reports that the declaration by the WHO's International Agency for Research on Cancer (IARC) that tanning booths emitting ultraviolet radiation are carcinogenic simply echoes what dermatologists say they've suspected for years. The declaration, published in the August issue of The Lancet Oncology, ranked tanning beds right up there with tobacco smoke and mustard gas. Dermatologist Neil Alan Fenske, MD, of the University of South Florida, pointed out that for some time, tanning beds that use ultraviolet rays were suspected of causing skin cancer. He stated that the members of the American Academy of Dermatology have been fighting this battle for a number of years, adding that patients who have received abundant amounts of light via tanning beds have developed extraordinary numbers of skin cancers.
        The Detroit Free Press reports that IARC made its announcement after finding enough evidence in people and mice that UVA and UVB rays damage skin-cell DNA, sometimes in cancer-blocking genes. The damage may result in three types of skin cancer: the less dangerous basal and squamous cell skin cancers and melanoma, explained dermatologist Darius Mehregan, MD, of Wayne State University. The Free Press notes that the American Academy of Dermatology had no comment on the international decree, and calls to the Indoor Tanning Association were not immediately returned.
        According to MedPage Today , citing evidence from case-control studies and a meta-analysis, the IARC monograph working group 'raised the classification of the use of UV-emitting tanning devices to Group 1, 'carcinogenic to humans.' In addition, the working group also cited case-control studies showing 'consistent evidence of an association between the use of UV-emitting tanning devices and ocular melanoma.' In fact, the IARC reclassified all forms of ultraviolet radiation as a single carcinogenic entity. Historically, mutations caused by exposure solar radiation had been attributed to UVB, but the same mutation was identified in UVA-induced skin tumors in mice. In its update, the IARC moved UV radiation as a whole into the highest-risk category, eliminating distinctions between UVA, UVB, and UVC.
        The Philadelphia Inquirer quoted John Overstreet, executive director of the Indoor Tanning Association, as saying, Because tanning beds produce the same UV light as the sun, overexposure and abuse of our product -- just like overexposure to sunlight -- is associated with an increased risk for some types of skin cancer.
        USA Today faults industry promotion of questionable health benefits of tanning. USA Today editorializes, Despite mounting evidence linking tanning beds and cancer, the Indoor Tanning Association, which represents the industry, has shamelessly promoted questionable health benefits instead. In fact, its most recent campaign has been to convince people that tanning beds are beneficial because they are a source of Vitamin D. A few years ago, the tanning industry encouraged now-disproven claims that the mainly UVA ultra-violet rays emitted by sun beds do not do the same damage as the sun's. In 2008, its director termed assertions of a link between tanning beds and melanoma 'irresponsible.' USA Today argues, It's the industry that appears irresponsible, much as Big Tobacco once was as it tried to refute science. The paper calls for better education about tanning dangers, along with stronger warnings and action against misleading health claims.

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River blindness can be stopped by drugs: WHO

River blindness may be eradicated through long-term ivermectin use.



New studies, published Tuesday in the journal PLoS Neglected Tropical Diseases, suggest river blindness can be wiped out with a long enough course of ivermectin. The World Health Organization (WHO) said the studies demonstrated that treatment with the drug ivermectin stopped further infections and transmission of the disease in three areas of Africa in Mali and Senegal.

The drug ivermectin, developed in 1987 by Merck, kills the larvae of the parasite that causes the disease, but not the adult worms, so scientists thought treatments were needed every six months or year to keep it under control. Researchers found, however, that after 15 to 17 years of regular treatment, only a few infections remained after treatment was stopped in...three test areas, leading them to conclude that river blindness can be wiped out with a long enough course of ivermectin. AFP notes that main funding for the studies came from the Bill & Melinda Gates Foundation.

BBC News reports that currently, at least 37 million people are infected with the disease, which causes sufferers to lose their sight and also to develop painful skin complaints. River blindness is endemic in many parts of Africa, primarily in poor, rural communities. The disease is caused by a parasite that is transmitted to people through the bite of the black fly. The worms spread through the body and when they eventually die, our immune system reacts fiercely. That reaction destroys living tissue -- especially the eye. While doctors have known for years that drugs can control the disease, they now believe it can be eliminated.

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Half a brain girl recovers vision

According to research published in the Proceedings of the National Academy of Sciences, researchers from the UK's University of Glasgow say they have solved the mystery of how a girl with half a brain has near perfect vision in one eye.

The 10-year-old girl was born missing the right side of her brain, whose job it is to map the left field of vision. Magnetic resonance imaging scans showed that the girl's brain rewired itself during development when she was still  in utero. In spite of having some seizures as a toddler, which were successfully treated, and slight weakness on her left side, the girl has had a normal medical history, attending school and taking part in regular activities. Amazingly, her left and right field vision is almost perfect in one eye.

Dr Lars Muckli, of the university's Centre for Cognitive Neuroimaging, said: "The brain has amazing plasticity but we were quite astonished to see just how well the single hemisphere of the brain in this girl has adapted to compensate for the missing half.

"Despite lacking one hemisphere, the girl has normal psychological function and is perfectly capable of living a normal and fulfilling life. She is witty, charming and intelligent."

Scans revealed that retinal nerve fibers carrying visual information from the back of the eye which should have gone to the right hemisphere of the brain diverted to the left.

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Intra-oral device helps blinded Marine to discern shapes.

Washington Post reports that a special 'lollipop,' a device that uses the tongue to stimulate the visual cortex and send sensory information to the brain, is helping Marine Cpl. Mike Jernigan, who lost both of his eyes in a roadside bomb attack in Iraq, to discern shapes.

The intra-oral device, or IOD...is an inch-square grid with 625 small round metal pieces that is connected by a wire to a small camera mounted on a pair of sunglasses and to a hand-held controller about the size of a BlackBerry. Images are sent by the camera to the IOD, which transmits a low-voltage pulse to Jernigan's tongue. With training, Jernigan has learned to translate that pulse into pictures.

Optometrist Amy Nau, OD, who is researching the effectiveness of the device at the University of Pittsburgh, explained, It's kind of like Braille that you use with your fingers. Dr. Nau added, Instead of symbols, it's a picture, and instead of your fingertips, it's your tongue. The IOD, called the BrainPort vision device...is manufactured by Wicab.

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Glaucoma biggest cause of blindness in New Zealand

Glaucoma NZ chairwoman Helen Danesh-Meyer has highlighted the biggest cause of blindness in New Zealand. It is estimated that 68,000 people have glaucoma in New Zealand. The Dominion Post has an excellent article highlighting this issue.

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Glaucoma surgeries up while Medicare reimbursement down

According to a study published in the July issue of the Archives of Ophthalmology, the number of glaucoma surgeries is on the rise, but Medicare reimbursement for the procedures has been decreasing.

For the study, researchers from Exponent, Alcon Research, and the Bloomberg School of Public Health analyzed Part B Medicare data for 100,000 beneficiaries from 1997 to 2006. The team found that from 1997 to 2001, there was an overall decrease in both the number of procedures and the amount of annual payments, but there was an increase in the number of procedures in the following years, reaching a total of 414,980 in 2006. The investigators attributed the increase to advancements in technology and a change in calculating the global period for reimbursement purposes.

The authors also noted that payments for trabeculectomies decreased over time, while annual payments for newer procedures, such as cyclophotocoagulation and shunt-related procedures, have increased.

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A new paradigm for understanding glaucoma has emerged

Glaucoma isn't simply an eye disease, experts now say, but rather a degenerative nerve disorder, not unlike Alzheimer's or Parkinson's disease.

While researchers still recognize high pressure within the eye as a leading risk factor for glaucoma, it is becoming clear that the condition begins with injury to the optic nerve as it exits the back of the eye. The damage then spreads, moving from one nerve cell to adjoining nerve cells.

Neeru Gupta, MD, PhD, of the University of Toronto, explained, In glaucoma, we've shown that when your retinal ganglion cells are sick, the long axons that project from the eye into the brain are also affected, resulting in changes that we can detect in the vision center of the brain. This phenomenon, called transynaptic damage, occurs in Alzheimer's and Parkinson's disease, as well.

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About 200,000 new cases of advanced, age-related macular degeneration (AMD) are identified each year in the United States, many older Americans with more severe or "wet" forms of AMD endured inevitable, gradual loss of central vision.
Lucentis in clinical trials has been shown to stop and, in many cases, reverse at least some vision loss in most people with advanced AMD. Another drug closely related to Lucentis, known as Avastin (bevacizumab), also has been shown to be a highly effective and far cheaper alternative for lower-income individuals with advanced AMD.
The problem is that Avastin is FDA-approved only for treatment of colon and other cancers, but not for macular degeneration. As an alternative, many eye doctors have been using Avastin as an "off-label" treatment.
Pharmaceutical companies are driven by financial intersts, while physicians with patient care. Here is an excellent article that summarizes it.

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Does your employer care about your vision

Charlotte, NC has seen many things change over the course of the last years financial crisis. Both financial institutions Bank of America and Wachovia (now, Wells Fargo) have seen major shifts in how they do business.

From my perspective as an optometrist, the most notable has been the change in vision insurance plans especially for BofA. They moved from VSP considered a better partner to private practice optometrist to Eyemed (who also run the chain Lenscrafters).

The question that's raised is: how much shall companies bear for the employees eye care?.

It surely is no secret that if your vision is impaired, it affects practically every sphere of your life. Yet, we find that one place most organizations cut back is in vision and related service. It enrages me to see some plans that restrict eye exams to 24 months! Especially when they are kids! I spend considerable amount of time explaining to parents the need for annual eye exams.
Recently, a study of the eye care policies of the UK's top 250 companies revealed considerable confusion among employers over their responsibilities for the eye care of their employees. The results also showed that 59 per cent of the UK's leading 250 companies believe that they are only required to make a contribution towards the cost of glasses, while a further 20 per cent believed contributions are entirely voluntary.

I hope there is an independent study of the top 250 companies in the US, where the Human Resource officers are surveyed about their responsibilities to employees vision.

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Laser treatment may help reverse effects of dry AMD

A ground-breaking laser treatment may help reverse the effects of age-related macular degeneration (AMD). In early proof-of-concept trials involving about 50 people, the laser technique, which was developed by pioneering eye expert Professor John Marshall of King's College London, appeared to return the back of the eye to its youthful state.

In the technique, a painless 'short pulse' laser boosts the release of the enzymes to clean away natural waste materials, but without damaging the cells that enable vision. The researchers now plan further studies in patients already suffering from AMD in one eye with the aim of saving the sight in their better eye for as long as possible.

Professor Marshall said that he hoped the treatment would be available within two to five years. There is currently no treatment for the most common form of AMD -- known as 'dry' AMD -- which the new laser technique could prevent.

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Recent estimates by the World Health Organization (WHO) calculate at least 171 million people worldwide suffer from diabetes and expect this figure to more than double, to reach 366 million, by 2030

According to Sanofi-Aventis SA, its long-acting Lantus [insulin glargine] drug didn't increase the risk of blindness for diabetics compared to an older type of insulin in a five-year study of more than 1,000 patients. In addition, there was...no 'observable trend' showing a difference in the risk of serious side effects including cancer, the drugmaker said in a statement.

"This 5-year study is the longest randomized controlled study with insulin glargine versus NPH human insulin," said lead investigator Julio Rosenstock, MD, Director of the Dallas Diabetes and Endocrine Center at Medical City and also Clinical Professor of Medicine, University of Texas Southwestern Medical Schoo.

The study results were published in the online edition of the Diabetologia medical journal.

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Lucentis met late-stage trial goal in patients with macular edema due to BRVO

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Genentech, Inc. announced that its macular degeneration drug Lucentis [ranibizumab] met its goal in a late stage trial, improving the vision of patients with macular edema due to branch retinal vein occlusion.

Currently, Lucentis is approved to treat neurovascular, or 'wet,' age-related macular degeneration. Genentech is now trying to get the drug approved for macular edema due to branch retinal vein occlusion, a condition in which the macula, or central part of the retina, swells because fluid leaks or builds up.

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Light-sensing worms provide a new tool for the study of vision

A team from the University in Michigan, led by Shawn Xu, has discovered that tiny worms can sense light.

They discovered that the chemical reactions used by the C. elegans ( a 1mm sized worm which is one of the most commonly used model animals in genetic research) are rather similar to the ones in humans. This discovery means that from now on the worm can be used for the research of building blocks of human vision, as well as how disrupting the phototransduction pathway can lead to eye disease.

This discovery may lead to further breakthroughs in the research of vision, helping researchers understand the basis of human vision diseases and promote the understanding of the evolutionary development of eyes in various species.

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Experiment seeks to head off Type 1 diabetes

Researchers at Children's Hospital of Pittsburgh are hoping to control type 1 diabetes by curbing the rogue immune cells that cause it, before patients become completely dependent on daily insulin injections tosurvive.

About 3 million Americans have Type 1 diabetes, where the body mistakenly attacks and destroys cells in the pancreas that produce insulin, the hormone crucial to converting blood sugar to energy.

This novel vaccine -- made from patients' own blood blocks the '911 call' that dendritic cells send to direct T cells to the pancreas. Just altering three communication molecules on their surface basically confuses and paralyzes the T cells. In mice and monkeys, the reprogrammed cells ended the vicious cycle of a pancreas attack that in turn attracts more T cells to attack again.

In human trials, the team has used donated blood to filter out immature dendritic cells and then reprogram them. Animal experiments have shown that after the cells have been re-injected just inside the skin over the pancreas...the cells somehow find their way back to that organ to start working.

Two competing teams - MacroGenics Inc. and Eli Lilly, and Tolerx Inc. and GlaxoSmithKline - have advanced tests under way

Currently, 15 adult diabetics [are] being injected to make sure there are no unexpected side effects before researchers test if reprogrammed cells might really protect children's pancreas cells

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UAW retirees swamping optometry offices in Indiana

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The Indianapolis Star reported that, in Indiana, optometry offices have been swamped with United Auto Workers retirees who want to squeeze in one last visit before the coverage evaporates.
According to Bill Matthews, of UAW Local 23, Indiana is home to about 100,000 hourly UAW retirees & all of them have been affected by the change.
The Star described the plight of one retiree who has diabetes and needs regular eye examinations. David Ehman had his eyes checked in the past year, so he cannot make one more covered visit to his optometrist. The last visit he and his wife made to the eye doctor, with coverage, she left with new eyeglasses and he with a fresh set of contact lenses for a combined bill of nearly $800. Now, he said, he will have to shop around. Ehman stated, “The insurance thing really puts a bind on you. You start having to decide, how much is your health worth? “

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ವೀಡಿಯೊ ಗೇಮ್ ಟು ಟ್ರೀಟ್ ಲಜ್ಯ್ ಎಯೇ

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Amblyopia, otherwise known as lazy eye, is a disorder of the visual system that is characterized by poor or indistinct vision in an eye that is otherwise physically normal, or out of proportion to associated structural abnormalities. It has been estimated to affect 1–5% of the population.

Treatment consists of correcting the optical deficit and forcing use of the amblyopic eye, either by patching the good eye, or by instilling topical atropine in the eye with better vision. This, according to the researchers, can lead to social stigma during a formative part of childhood
A review was published recently in Vision Research of a new computer based therapy developed by researchers from Tel Aviv University.

Dr. Uri Polat, Tel Aviv University's eye and brain specialist has developed a computer therapy that could spare kids from the ugly eye patch, letting them enjoy themselves during therapy.
And, this treatment, currently available only for adults, corrects the activity of the neurons in the brain, the main operator of eye function. The study showed that twenty hours in front of Dr. Polat's computer treatment had the same effect as about 500 hours of wearing an eye patch. In this treatment methodology, special and random objects appear, keeping the patient constantly alert and expecting the unexpected.

Researchers from Tel Aviv University have now collaborated with gaming specialists from Rochester University for developing a version of the therapy for kids.
"You see these poor kids in kindergarten wearing the patch. Everyone hates it, especially the parents who know what it's doing to their kid's self-esteem," said Dr. Polat. "As far as I know this is really a one-of-a-kind, non-invasive and effective way to treat lazy eye, without the use of an embarrassing eye patch.
"This is probably the first treatment that attempts to correct lazy eyes in adults, something that doctors had previously given up on. Doctors don't suggest intervention after the age of nine, because it usually doesn't work," he Polat added.

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Human organ and tissue transplantation has become an important and growing part of modern medical practice. Advances in medical technology have resulted in millions of Americans receiving these life-saving or life-enhancing gifts. Eye banks can provide the most precious gifts of the world that is the gift of vision.

N.C. Eye Bank has the distinction of being the provider of most corneas in the world. Eye Bank Association of America reports that the NC based organization provided corneas for 3,440 transplants in 2008; the most of any eye bank in the world.

Eye banks make these transplants possible by processing donated corneas and supplying them to surgeons. According to Bob Russ, the eye bank's director of human resources, the expansion of opportunities to sign up for organ donation is one of the reasons why more people have agreed to be donors.
When a potential donor dies, the eye bank's clock starts ticking.
According to a recent report from Donate Life America people can sign up to be donors through the N.C. Division of Motor Vehicles when getting or renewing their driver's license.
Under the new State Law that passed last year the heart symbol on someone's driver's license is considered binding consent to donate organs, including eye tissue. Before the law was passed, such groups as the eye bank had to get permission from the family to get eye tissue.

How to donate?
• In North Carolina, people can sign up to be organ donors through the N.C. Division of Motor Vehicles. The licenses of those who are donors are marked with a heart.
• Donors should tell their family members about their wishes.
• Corneas to be used in a transplant, must be stored within 24 hours of the donor's death.
• In eye-tissue donations, disease, injury or infection in eyes disqualifies them for transplantation, but they can still be used for education and research purposes.
For more information about eye donation, you may call or visit the N.C.Eye Bank at 765-0932 or go to www.nceyebank.org

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Relationship between omega-3 fatty acids, risk of AMD

According to a study published online June 9 in the British Journal of Ophthalmology, the association between omega-3 fatty acids and lower risk of age-related macular degeneration (AMD) appears to be modified by other dietary supplements and disease stage.
For the study, researchers from Tufts University performed an analysis of data from 2,924 patients participating in the Age-Related Eye Disease Study, an eight-year supplementation trial. Dietary intake was assessed using food-frequency questionnaires.
The investigators found that a high intake of the omega-3s docosahexaenoic acid (DHA) and eicosapentaenoic acid...was associated with a lower risk of progression to advanced AMD. The team also found that patients who had low glycemic index diets and high consumption of the omega-3 fatty acids had lower risks of progression to advanced AMD than patients with high intakes alone, but patients in the early stages of AMD...only derived a benefit from consuming large amounts of DHA if they were not taking additional supplementation as part of the study.

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Optometric vision therapy described as life-transforming

In an opinion piece in the Los Angeles Times Susan R. Barry, professor of neurobiology in the department of biological sciences at Mount Holyoke College and the author of Fixing My Gaze: A Scientist's Journey Into Seeing in Three Dimensions, writes, Children are still not routinely tested for binocular vision deficits because the standard school vision exam (reading the eye chart with one eye at a time) doesn't screen for defects in eye coordination or stereovision. As a result, many children with vision problems may be labeled learning disabled, or if they misbehave in frustration, diagnosed with attention-deficit hyperactivity disorder.
At age 48, Barry, who suffered from crossed eyes and stereoblindness since childhood, consulted a developmental optometrist who prescribed a program of optometric vision therapy, which taught her how to coordinate her eyes so she could see things in three dimensions. Wishing she had had this therapy as a youngster, she concludes, Detecting these problems early and then seeking proper treatment can improve a child's vision and transform a child's life

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Red Meat Linked To Blindness in Old Age

A new study from Australia suggests that eating lots of red meat is linked to a higher risk of developing age-related macular degeneration (AMD), a leading cause of blindness in old age.

The study was the work of first author Dr Elaine Chong, who is from the Centre for Eye Research Australia based at the University of Melbourne, and colleagues, and is published on 1 April in the advance access issue of the American Journal of Epidemiology.

The results showed that:

* At follow up, 1,680 participants had early stage AMD and 77 had late stage AMD.

* Higher red meat intake was positively associated with early AMD (ie more red meat linked to higher chance of having early AMD).

* The odds ratio for eating meat ten times a week or more versus eating it less than 5 times a week was a significant 1.47 (ie eating meat 10 times a week gave a person 47 per cent higher risk of AMD than if they ate it less than 5 times a week).

* Conversely, eating chicken 3.5 times a week or more was linked to 57 per cent lower risk of late AMD compared to eating it less than 1.5 times a week.

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Blind Man Navigates Obstacle Maze Unaided

Researchers have demonstrated for the first time that people can successfully navigate an obstacle course even after brain damage has left them with no awareness of the ability to see and no activity in the visual cortex, a region of the brain's cortex that is primarily responsible for processing visual inputs.
The findings reported by NY Times published in the December 23rd issue of Current Biology, a Cell Press publication, reveal the importance of alternative routes in the brain, which are active in both those who have suffered severe brain damage to the visual cortex and in all of our everyday lives, according to the researchers.
See a video here
Earlier studies had shown a similar ability in monkeys with comparable brain lesions. The new study was possible only because of the participation of an unusual patient known as TN, who was left blind after selective damage to the visual cortex in both hemispheres of his brain following consecutive strokes.

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opical anti-inflammatories may be effective in keratoconus

While the etiology of keratoconus remains unclear, Albert Jun, MD, PhD, reviewed new research indicating that an inflammatory component can be measured in altered concentrations of inflammatory molecules such as IL 6, IL 10, TNF-alpha and matrix metalloproteinases.

This evidence may support the study of topical anti-inflammatory drops for treating and preventing disease advancement, he said at the symposium, which was jointly sponsored by Wilmer Eye Institute and the Maryland Optometric Association.

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Homeless, but with clearer vision

My school has always played a significant role in the Boston community. During my training and residency I worked at many of the sites belonging to the New England Eye network.



New England College of Optometry has a program that benefits the homeless and is run by Ceida Chan, OD. This free program offers eye exams administered by students in the third year of the 4 year course as part of their clinical rotation. Many in the homeless community suffer from Diabetes and infectious disease and eye trauma. So this service meets two important needs - in providing medical care and helping in training students to see patients in a 'non clinical' environment, sometimes completing exams with portable equipment.

Boston newspaper covered this here

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Experimental stem-cell therapy for blindness

MIT's Technology Review reports that a new treatment for eye disease, developed by Advanced Cell Technology (ACT) uses human embryonic stem cells to re-create retinal pigment epithelium (RPE) cells in the retina that support the photoreceptors needed for vision.

RPE cells are often the first to die off in age-related macular degeneration and other eye diseases, which in turn leads to loss of vision. Now, the experimental therapy has proved safe and effective in animal studies, and may begin early human trials in the next few months if it receives approval from the Food and Drug Administration.

According to Robert Lanza, ACT's chief scientific officer, not only does the RPE treatment avoid the problem of immune rejection, but the cells themselves are relatively easy to create, as embryonic cells tend to spontaneously differentiate into RPE cells and can be easily maintained in that state. ACT plans to focus first on patients with Stargardt's disease, and then move eventually to those with age-related macular degeneration.

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TV segment features device designed to restore some vision to the blind

NBC Nightly News reported that a new device offers the enormous promise of restoring sight for those who don't have it. Chief science correspondent Robert Bazell interviewed Kathleen Blake, once totally blind, but now able to see, thanks to a tiny TV camera mounted on her sun glasses that sends images to electrodes placed on the back of her eye.

For 20 years, Dr. Mark Humayun and his team at the University of Southern California (USC) have been working toward the amazing goal of restoring vision to the blind. Not long ago, the USC researchers achieved great improvement in the device, going from 16 electrodes to 60, enabling better sight. According to Bazell, Soon, the glasses will go. Armand Tanguay, an electrical engineer, is developing cameras to be implanted directly in the eye lens in a system many scientists believe will restore better and better sight to millions.

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Prevalence of Dry Eye Disease Among US Men

According to a study published in the June issue of the Archives of Ophthalmology, after age 50, approximately 4% of males develop dry-eye disease.
For the study, researchers from Brigham and Women's Hospital analyzed data on 25,444 men, who were asked if they had ever been diagnosed with dry-eye disease and also whether they had symptoms, including dry or irritated eyes. The team found that about three percent reported a previous diagnosis of dry eye, while 6.8 percent said they had constantly or often experienced at least one symptom, such as dryness or irritation. Nearly 2.2 percent reported both symptoms constantly or often. The authors explained that increasing age, high blood pressure, benign prostatic hyperplasia, and the use of antidepressants increase the chances of developing dry-eye disease.

Related articles by Zemanta

• Cost-effective eye drop to treat "Dry Eye Syndrome" (eye.taragana.net)

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According to a study published in the British Journal of Ophthalmology, people with age-related macular degeneration (AMD) should eat oily fish at least twice a week, because omega-3 fatty acids found in abundance in oily fish appear to slow or even halt the progress of both early and late stage disease.

BBC reports that, for the study, researchers at Tufts University examined data on almost 3,000 people taking part in a trial of vitamins and supplements. The team found that progression to both dry and wet forms of advanced AMD disease was 25 percent less likely among those eating a diet rich in omega-3 fatty acids. In addition, people with advanced AMD who also consumed a low glycemic-index diet and who took supplemental antioxidant vitamins and minerals like vitamin C and zinc appeared to reduce their risk of disease progression by...up to 50 percent. The authors suggested that eating two to three servings of fatty fish...every week would achieve the recommended daily intake (650mg) of omega-3.

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Researchers associate intermittent exotropia with mental illness in early adulthood.
MedPage Today reported that, according to a study published in the June issue of Archives of Ophthalmology, children with intermittent exotropia, which is a form of strabismus in which the eyes deviate outward, may have a nearly threefold increased risk of developing mental illness by early adulthood.

For the study, researchers from the Mayo Clinic followed 183 patients who were diagnosed with intermittent exotropia, 118 of whom were female. The cohort, plus age- and sex-matched controls, was followed to a mean age of 21.9 years. The investigators found that overall, a psychiatric disorder, including depression or anxiety, was diagnosed in 97 (53 percent) of the 183 patients, compared with 55 (30.1 percent) of the controls. In fact, children with the ocular problem were 2.7 times more likely to develop a psychiatric disorder than were age- and sex-matched controls, with rates of psychiatric disorders being significantly higher in boys, for reasons that remain unclear, the authors said.

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HealthDay reported that, according to a survey conducted by the American Optometric Association (AOA), even though people who wear eyeglasses or contact lenses constitute 81 percent of the population, approximately one of every five of them hasn't seen an eye doctor or eye-care specialist in more than two years, the recommended period between eye checkups. Three of every five of those who don't use corrective lenses said that they had not had a vision exam in more than two years.

Some eye doctors believe this is because most vision problems aren't readily apparent, and because people have enough on their plates. AOA spokesman and optometrist Kerry Beebe, OD, said that the problem with these perceptions is that most eye diseases come on subtly. Once someone recognizes vision loss, it's usually too late to have pursued many avenues of treatment. Dr. Beebe added that people don't realize a lot of eye diseases don't have any symptoms in the early stages, which is where you'd like to treat those kinds of problems.

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ಸುರ್ಗೆರಿ ಫಾರ್ ರೆದಿಂಗ್ ಗ್ಲಸ್ಸೇಸ್

Pennsylvania's Times Leader reported that with the insertion of the Tecnis multifocal lens, patients with presbyopia, a visual condition that becomes apparent especially in middle age and in which loss of elasticity of the lens of the eye causes defective accommodation and inability to focus sharply for near vision, will regain the ability to see more clearly and not need to rely on reading glasses or bifocals again. Notably, 88 percent of those who received the Tecnis in both eyes reported never wearing glasses four to six months after surgery, and more than 90 percent never needed glasses for distance activities, such as driving, or near activities, such as reading, according to Frank Bucci, MD, who was one of 12 surgeons in the US to use the lens in trial cases with the Food and Drug Administration. The cost of the surgery is about $4,400.

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MedPage Today (6/1, Neale) reported that, according to a study published in Ophthalmology, common bacteria found on the eye were susceptible to newer-generation fluoroquinolones. For the study, researchers from Korea's Yonsei University College of Medicine obtained samples from 105 patients using conjunctival swabs immediately before refractive surgery.

Coagulase-negative staphylococci (CNS) were found in 84.9 percent of the cultures; nearly one-third of those (31.4 percent) were methicillin-resistant. Also found were Staphylococcus aureus (2.3 percent), Streptococcus pneumoniae (1.2 percent), and gram-negative bacilli (4.8 percent). Next, the investigators treated the cultures with three newer-generation fluoroquinolones -- gatifloxacin, moxifloxacin, and gemifloxacin -- and two older-generation antibiotics in that class -- ofloxacin and levofloxacin. While the minimum inhibitory concentrations of the antibiotics required to stop the growth of 90 percent of the methicillin-susceptible CNS indicated that all five drugs were effective, the team found that the three newer-generation antibiotics as a group were significantly more effective against methicillin-resistant CNS than the two older ones.

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Only 17% of US employers offer vision insurance!

Mississippi's Clarion-Ledger  reports that only 17 percent of US employers report offering vision insurance. They report that  the lack of vision insurance leaves millions...vulnerable to neglecting eye problems. For children, neglected vision problems can lead to poor performance in school. According to the American Optometric Association, children face increasing demands on their visual abilities, noting the size of print in schoolbooks becomes smaller, and the amount of time spent reading and studying increases significantly. Poor vision may also lead to poor work performance, dangerous driving, and diminished quality of life for adults. Experts now estimate that approximately "11 million Americans" may "have untreated refractive errors" which could "easily be corrected to restore perfect, or near-perfect, vision."

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Our eyes are constantly making saccades, or little jumps. Yet the world appears to us as a smooth whole. Somehow, the brain's visual system "knows" where the eyes are about to move and is able to adjust for that movement. In a paper published online this week in Nature, researchers at the University of Pittsburgh and the National Eye Institute (NEI) for the first time provide a circuit-level explanation as to why.

"This is a classic problem in neuroscience," says Marc Sommer, assistant professor of neuroscience at Pitt, who coauthored the paper with Robert Wurtz, senior investigator at NEI, one of the National Institutes of Health. "People have been searching for a circuit to accomplish this stability for the last 50 years, and we think we've made good progress with this study."

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Australian bionic eye researchers say they are likely to start clinical tests of a bionic eye within two years.

As part of the Government's response to last year's 2020 summit, $50 million will go to bionic eye research.

The director of Bionic Vision Australia, Professor Anthony Burkitt, says an implant is likely to be trialled on patients within two years and commercially available in five years.

"We'd imagine that very much like the development of the Cochlear implant it became better and better over time, so that eventually within five to seven years people would be able to read large print, recognise faces, do that sort of thing," he said.

"So that's the sort of - at least in the initial phase - is the sort of quality of vision that we're looking at."

He says the bionic eye will be initially for people who are completely blind or suffering age-related vision loss.

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Possible cure for macular degeneration

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There is new hope for people who suffer from macular degeneration.

Macular degeneration causes the center of your vision area to blur and deteriorate, but researchers say replacing cells in the filling wall of the retina could cure the condition.

"You're actually giving them a cell. This is a whole entity if you want to call it anything, and that's just a different way of looking at treating people. It truly is regeneration in terms of putting something back that is gone, so it's a major step forward," said Peter Coffey at the University College London.

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MSNBC reports that, according to Carmen Bunde, program director with Prevent Blindness Nebraska, blurry vision in a child can cause brain damage if the vision is not corrected. In some cases, amblyopia is to blame. It's often called 'lazy eye,' because weak eye muscles make the eye drift to the side, eventually disrupting vision.

Amblyopia is responsible for more vision loss in people age 45 and younger than all other eye disorders combined. The article details how trained volunteers with Prevent Blindness Nebraska screen more than 3,000 low income children a year, many of them...preschool age, for eye disorders. Children who fail the eye exams are sent to their doctors for follow-up care. Approximately one in 20 preschoolers are referred to eye doctors after the screenings. Experts point out that the best time to catch eye disorders is between the ages of three and five years old.

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Folic acid, B vitamins may reduce AMD risk in some women

Following a USA Today story, Nicholas Bakalar writes in the New York Times Vital Signs column that, according to a study published Feb. 23 in the Archives of Internal Medicine, vitamin B supplements may reduce the risk for age-related macular degeneration (AMD), at least in women with cardiovascular disease or at risk for it.

For the study, researchers from Harvard University followed 5,205 female healthcare professionals with cardiovascular disease or three or more risk factors for it, who were randomly assigned to take either a placebo or a combination of folic acid and vitamins B6 and B12. After about seven years of follow-up, the investigators found 55 cases of AMD in the treatment group, and 82 among those who took a placebo. Specifically, the authors found that those who took the vitamins had a 41 percent reduced risk for significant degeneration, and theorized that the vitamins may reduce blood levels of the amino acid homocysteine, which has been implicated in vision loss.

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Imaging-analysis technique allows diagnosis of diabetes-related eye problems over the Internet.

Wired News reports that an imaging-analysis technique developed by researchers at the University of Tennessee for finding defects in semiconductors is now being used to diagnose the eye problems associated with diabetes over the Internet. Pictures of the retinas of patients with diabetes are uploaded to a server that compares them to a database of thousands of other images of healthy and diseased eyes.

Algorithms can assign a disease level to the new eye image by looking at the same factors, mainly damage to blood vessels, that an eye doctor would. Currently, more than 25 million Americans suffer from diabetes, which, if left untreated, can cause blindness, among other physical problems. This new technology could help reduce the cost and increase the availability of screening for the eye problems that impair the vision of thousands of patients each year.

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Illinois' Belleville News Democrat (2/12) reported that a new device called the Trabectome speeds glaucoma operations and post-surgical recovery.

The device works by reducing pressure in the eye without the need for the filtration or shunts used in traditional glaucoma surgery, allowing surgeons to remove tissue so fluid more easily drains out of the eye. While traditional glaucoma surgery usually means several weeks of recovery with no lifting or bending, the recovery with the Trabectome normally takes about a week. But, not all glaucoma patients...are good candidates for the new device. According to glaucoma researcher Carla J. Siegfried, M.D., patients in the early to moderate stages of the disease are the best candidates

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Antioxidants & degenerative eye diseases.

According to findings published in the Feb. 2 advance online edition of the Journal of Clinical Investigation, antioxidants may help preserve vision lost in degenerative eye diseases, and a new cell-based gene therapy technique...could eventually offer another option for arresting vision loss from these diseases.
A team from the Scripps Research Institute found that debilitating eye damage in rodents is caused by increased oxidative chemical activity sparked by...new blood vessel growth, rather than simply by the new blood vessel growth itself.
Next, the team was able to identify two remarkably effective treatments. One of these options is simply giving the mice doses of antioxidants orally in order to counterbalance the oxidative damage to neurons, blocking further deterioration in the eyes of treated mice. Then, by using a novel twist to standard gene therapy techniques, the researchers were able to deliver directly to the neurons in question a protein that protects neurons, effectively fortifying them against the onslaught of oxidants.

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Spectacle Power adjusted by injecting fluid into the lenses

On its website, BBC News (2/10) reports that a retired Oxford University physics professor has designed adjustable glasses that can be used by people in the developing world. The glasses are altered by injecting tiny quantities of fluid into the lenses, which means that people can have glasses that suit their eyes without the need for a prescription. According to BBC News, the invention should enable millions of people in poorer parts of the world to get glasses for the first time.

Get more info from http://www.adaptive-eyewear.org/home/

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Cataracts are the most common age-related eye disease, with more than 17 percent of Americans age 40 and over affected. The main cause, aside from plain old aging, is exposure to ultraviolet B radiation in sunlight. People can reduce their risk and delay the need for surgery to remove a clouded lens by wearing sunglasses and brimmed hats while outside.

At present, cataract surgery has been refined so that the super small incisions are self-sealing. Besides cataracts, eye conditions such as glaucoma and macular degeneration also affect seniors, although they are more insidious. Typically, medications are used to slow the damage caused by glaucoma. Meanwhile, high doses of supplements, including vitamins C and E and beta carotene and the mineral zinc, have been found to slow the progression of AMD in several trials.

This report was published in the US News and World Report

It was also noted that people with diabetes have added reason to worry: Diabetic retinopathy affects some 40 percent of people with the disease, with 8 percent of all diabetics facing significant vision loss. Keeping your blood sugar levels under control reduces the risk of harm.

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Glaucoma Associated With Reading Impairments in Elderly

A study by the Johns Hopkins University’s Wilmer Eye Institute found people with glaucoma in both eyes (bilateral) read 29 words per minute slower than those without glaucoma. They also were almost twice as likely to have reading impairment.

Those with glaucoma in one eye (unilateral) had rates about on par with those without the condition, which can cause eye damage and vision loss.

The findings were published in the January issue of Archives of Ophthalmology.

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On the front of its Style section, the Washington Post reports that after losing an eye in a car accident, Tanya Vlach, of San Francisco, CA, wants a new computer eye to replace the natural one she lost. After she put a request for help out on the Internet, Vlach was deluged by tons and tons of responses from hundreds of young techies, some of whom wanted to fit a cell phone camera...into Vlach's beautiful but merely decorative blue acrylic orb.

Vlach settled upon Frank Oliver, 37, whose start-up company, Artisan Robotics, focuses on cutting-edge materials science and power systems for aerospace and military robots. Oliver believes it may take two or three years to develop the eye.

James Weiland, a retinal prosthesis researcher at the University of Southern California's Artificial Retina Project, said the project is not insurmountable, but so many components have to come together that it would be...a challenge.

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Stem cells to treat corneal blindness

On its website, BBC News reported that researchers at Scotland's Princess Alexandra Eye Pavilion in Edinburgh, working with the Gartnavel General Hospital in Glasgow, will work together using an innovative technique involving adult stem cells to treat patients with corneal blindness. Approximately 20 patients will take part in the initial tests, using cells cultivated before being transplanted onto the surface of the cornea. But, unlike the more controversial embryonic stem-cell research, the technique takes stem cells from dead adult donors. Not long ago, in trials at the University of Pennsylvania, subjects with inherited blindness experienced dramatic improvements in vision after a corrective gene was injected into the eye. The Scottish researchers hope to emulate the success of this previous study.

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Choices for Presbyopia Correction

Presbyopia is the slow deterioration of close vision and is most commonly attributed to aging. The condition is caused by a loss of elasticity of the crystalline lens, the structure behind the iris that enables the eye to focus on objects at various distances. People with presbyopia have the choice of correction their vision with reading glasses, monovision contact lenses (one eye is corrected for distance, one for up close), or laser surgery.

In the New York Times SSkin Deep column, Camille Sweeney observed that as the population ages, experts in the eye-care industry say the potential for the presbyopia correction market is huge.

In early trials is a treatment called the transscleral light therapy system, pioneered by a company called Oculatek: in which a laser device emits a low level of light aimed at strengthening the ciliary muscle...under the whites of the eyes. Another option is refractive lens exchange, an outpatient surgical procedure which involves 'replacing the natural crystalline lens with an artificial one'.

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Scientists working on next generation of artificial retinas

McClatchy reported that researchers at the Doheny Eye Institute at the University of Southern California are testing artificial retinas that they hope can restore partial sight to people who've lost their vision to the most common causes of blindness, retinitis pigmentosa (RP) and macular degeneration.

RP ruins peripheral vision, while macular degeneration causes a blurred or blind spot in central vision. Both conditions irreparably damage the retina, the light-sensitive patch at the back of the eye that converts images into signals and relays them the brain.

Scientists now aim to create sensitive devices that can be implanted in the eye and will let previously blind people recognize faces and read large print. These artificial retinas are still experimental and won't be available for commercial use for years, however. Currently, the Argus Two artificial retina is being tested on 17 blind people in the U.S. and Europe. In the meantime, scientists at the Energy Department's National Laboratories are creating a third-generation artificial retina, and hope to begin human trials in 2011

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Artificial corneas and retinas

The Miami Herald reports that in developing countries, the need for donor corneas largely exceeds the supply, making the laboratory-developed artificial cornea all the more important.

Researchers from Miami's Bascom Palmer Eye Institute have been at the forefront of its development. Eduardo Alfonso, M.D., interim chair of the institute, explained that doctors prefer donor corneas, because artificial ones are still in the testing phase, though results in the past few years have been good. And, like the human cornea, the synthetic cornea is made in the same curved shape.

Even though artificial corneas are not yet perfect, Alfonso and his team are also starting new projects, including development of an artificial retina and artificial vision technology, in which images processed by the brain would use information that doesn't come from the eyes -- especially useful for those who are completely blind.

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Blind and dream

I have been asked this question before and have struggled to give a rational answer.

In the New York Times Really? column, Anahad O'Connor raised the question of whether people who don't see images during the day might see them when they shut their eyes at night.

According to studies led by a psychologist at the University of Hartford...people born without the ability to see report no visual imagery in their dreams. Instead, they experience a heightening of taste, touch, and smell. They also report a higher percentage of dreams that involve mishaps related to traveling or transportation, perhaps reflecting one of their biggest daytime concerns: safely finding their way around.

Researchers also say that people who go blind before age five rarely experience visual imagery in their dreams. Those who lose their vision after age five, however, often continue to see in their dreams, though the frequency and clarity diminish over time.

In regards to dreams, my favorite quote is by a former President of India, Dr Abjul Kalam “Dreams are not what you see in your sleep, but dreams are that, which do not allow you to sleep”. Fantastic!

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Patch versus Drops in treating Lazy eye

In the New York Times Well blog, Tara Parker-Pope wrote that a study published in the Archives of Ophthalmology compares patch therapy for amblyopia with .a weekly regimen of medicated eye drops that essentially work as a patch by blurring vision in the stronger eye.

Mitchell M. Scheiman, O.D., FCOVD, of the Pennsylvania College of Optometry in Philadelphia, (now called Salus University) and colleagues, conducted a randomized study of nearly 200 children, and found that giving the eye drops on the weekend worked about as well as wearing a patch for two hours a day. The eye drops, which contain atropine, work by preventing a muscle in the stronger eye from constricting. As a result, when a child tries to read or focus on something close, the good eye is blurred. The child's weaker eye is forced to focus and work harder, which helps it strengthen over time.

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Diabetes-related eye diseases may skyrocket over next four decades

The New York Times reports that, according to a study published Dec. 9 in the Archives of Ophthalmology, diabetes-related eye diseases will skyrocket over the next four decades, with elderly Hispanics and blacks hit hardest because of higher rates of Type 2 diabetes.

In particular, the report projects that the number of adults 40 and older with diabetic retinopathy -- the leading cause of blindness among working-age adults -- will reach 16 million in 2050, up from 5.5 million in 2005. In addition, the study estimates that the number of diabetics with glaucoma will quadruple to 1.4 million, while the number with cataracts will more than triple to 10 million. Study author Jinan B. Saaddine, M.D., M.P.H., of the Centers for Disease Control and Prevention (CDC), said the findings are a call for to do more to prevent diabetes to start with.

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Childrens eye exam

A neat video on Fox that describes problems an eye exams detects in children...

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news no parent wants to hear!

Optometrist finds no evidence computer use by children leads to myopia.

Canada's Canwest News reports that the Internet abounds with articles allegedly written by eye-care professionals stating that many ophthalmologists believe increased computer use by children puts them at risk for early development of nearsightedness, or myopia.

In fact, these same articles draw little or no difference between myopia, in which far vision is permanently diminished and must be corrected with lenses or laser surgery, and a temporary condition called computer vision syndrome (CVS).

Optometrist Eric DesGroseilliers, O.D., of the Ottawa Optometric Clinic, pointed out that, in over 12 years of practice, during which he has examined the eyes of four to five children a day, he has been unable to attribute any increases in myopia to computer use. Instead, he believes any recent increase in myopia diagnoses is likely because parents are better educated about eye health, and children receive professional eye care earlier. CVS, however, is a temporary discomfort caused by prolonged computer use. Eye strain, headaches, temporary blurred vision, and other complaints make up the symptoms of CVS, but in general they are not considered that serious.

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