How do blind people ski?

Visually impaired ski racer Danelle D'Aquanni Umstead:

My guide, Rob, always will ski in front so he can tell me what is coming up in the course, and what I may feel as we are skiing down it. We wear headsets that are an open line of communication between the two of us. This allows Rob to continue speaking to me and coaching me as we race down

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Latino Americans Have Higher Rates Of Blindness, Diabetic Eye Disease, Cataracts

According to four papers published in the May issue of the American Journal of Ophthalmology, "Latino Americans have higher rates of visual impairment, blindness, diabetic eye disease, and cataracts than whites in the United States."

In analyzing data from more than 4,600 participants in the Los Angeles Latino Eye Study (LALES), researchers found that the Latinos' rates of visual impairment and blindness were the highest of any ethnic group in the country, compared to other US studies of different populations.

"These data have significant public health implications and present a challenge for eye care providers to develop programs to address the burden of eye disease in Latinos," Dr. Paul A. Sieving, director of the National Eye Institute, said in the news release.

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Systems To Help Blind See Again

Venture Capital Dispatch blog of the Wall Street Journal reported that two companies are working on vision systems to help some blind people see again.

Second Sight Medical Products, Inc. based in Sylmar, Calif. is developing special eyeglasses that transmit pictures to a receiver embedded on the retina. The images are transferred by the optic nerve to the brain. The device is targeted to patients who have lost most of their vision as a result of retinal degeneration and whose nerve connections are still intact.

Israel's Nano Retina Inc. is also developing a similar device. The devices are priced from $50,000 to $100,000. Both companies are now working with insurance companies to have them pick up the costs for patients in need of such devices.

A third company, Optobionics Corp is pursuing a trickier and more costly approach: restoring function to the damaged retina by using the device to stimulate the rods and cones, rather than using the system as an adjunct to the retina. They are looking for funds to enter Phase III trials.

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• Trial of human retinal implants quite successful (news.cnet.com)
• Two high-tech approaches to restoring sight (healthzone.ca)
• Technology Behind Second Sight Retinal Prosthesis (medgadget.com)

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VA Rehab Center For Blinded Veterans To Be Named After Fallen Optometrist

A new rehab center for blinded service members will be named after Maj. Charles Robert Soltes Jr who was killed by a suicide bomber in Iraq.
The center is scheduled to be open in Long Beach next spring.
The bill to authorize that name was introduced by Rep. John Campbell, R-Irvine. Last month, it passed the House 417-0 and on Monday, April 19, it passed the Senate without the need for a roll call vote.
On Monday evening, Sen. Daniel Akaka, D-Hawaii, chairman of the Veterans Affairs Committee, spoke up for the measure.

"Major Soltes was a dedicated Army officer and an outstanding clinician, educator and military optometrist,'' Akaka said. "And naming the Long Beach VA blind rehabilitation center in honor of him will be a fitting tribute to his lasting memory.''

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Early Screening For Type 2 Diabetes Cost Effective

According to a study published online March 30 in The Lancet, early screening for type 2 diabetes is cost effective and prevents diabetes-related complications, including myocardial infarction and blindness.

By using mathematical modeling to assess several screening strategies, researchers determined the most cost-effective approach is to begin screening patients for type 2 diabetes between ages 30 and 45, with follow-up every three to five years. They arrived at this conclusion by studying a simulated population of 325,000 non-diabetic 30-year-olds using the National Health and Nutrition Examination Survey data from 1999 through 2004.

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Monitoring May Be Enough For Some Patients At Risk For Glaucoma

Dallas Morning News reported that most patients who are at risk of developing glaucoma because of high eye pressure may just require monitoring.

In a 15-year study presented at the American Glaucoma Society's annual meeting and published in the Archives of Ophthalmology, participants with elevated eye pressure but no evidence of glaucoma were randomized to eye drops or were simply monitored.

In the second part of the study, during which all participants received eye drops, researchers found that in lower-risk patients there was not much difference between those taking drops the whole time and those who got drops seven years later.

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You thought contact lenses are to correct vision?

The UK's Daily Mail reports that thanks to advances in technology, contact lenses have been "transformed...into valuable health tools" that do more than just correct vision.
For example,

Red-tinted contact lenses have been developed to relieve the agony of migraines. They work by filtering out wavelengths of light that over-stimulate retinal receptors - lightsensitive tissues lining the inner surface of the eye - which results in head pain.

Researchers at the University of Western Ontario, Canada, have created lenses that chemically react to glucose found in tears as a means of monitoring glucose levels in diabetics.

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Ipad = Eyestrain

The much awaited ipad is out this weekend. There has been lavish praise for it. The Wall Street Journal reports that experts are now debating which e-reader device is easier on the eyes.
While some e-readers provide printed book-like black text on a white background, others use a computer-like color screen that is backlit and uses a liquid crystal display. Although the choice of an e-reader may come down to personal preference, one eye expert maintains that all of the devices, no matter what their technology, may cause eyestrain. The solution to that, he recommends, is for people using the devices to take frequent breaks to rest their eyes.

Some people can have trouble with an e-paper screen, like the Kindle, where text looks like a dark shade of gray on top of a light shade of gray, says Mary Lou Jackson, director of vision rehabilitation at Harvard's Massachusetts Eye and Ear Infirmary. For those people, Dr. Jackson says "hands down I would vote for the iPad."

Our office dispenses a new lens that is aimed at relieving the stress on your visual system - Essilor Anti-Fatigue lenses are a patented design advanced single vision lens specially designed to relieve the symptoms of visual fatigue.
The lenses support the wearer's accommodation efforts with an additional plus power at near vision (+ 0.60 D) and with instant adaptation. This provides a greater level of comfort for the wearer as the natural accommodation pattern is retained.

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Home saliva test tells risk of AMD

Canadian company ArcticDx Inc. has introduced the availability of a test specifically designed to determine one's inherited risk for Age-Related Macular Degeneration.

The president of ArcticDX, Greg Hines has stated “This will be the first time that clinicians will be able to diagnose the eye condition macular degeneration before symptoms arise. This provides the opportunity for targeted patient education and routine eye examinations that offer early detection and disease management. Macular degeneration is a disease that can be arrested but it is not reversible. It is important to offer early treatment regiments that may arrest the eye disease before significant loss occurs.”

There is now a website dedicate to this product: Macula Risk

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WV Bill Would Allow Optometrists To Perform Laser Surgeries For Glaucoma

Reported in the Charleston Gazette: As amended in the" West Virginia Senate on Feb. 22, SB230, a controversial bill to allow optometrists to perform specified surgical procedures, would let optometrists perform three types of laser surgery to treat glaucoma.

While opponents of the bill such as Sen. Ron Stollings, D-Boone argued Monday that's three procedures too many.

Stollings, a physician in Madison, said he became ill undergoing one of the laser surgery procedures for glaucoma, and considers himself fortunate he was under the care of an ophthalmologist -- a medical doctor with advanced training in treatment of eye diseases -- rather than an optometrist.

Senate Judiciary Chairman Jeff Kessler (D-Marshall), who offered the amendment on the Senate floor, said there are safeguards built into the proposed legislation.

The bill went through the Government Organization Committee, but bypassed the Health and Human Resources Committee. The Register-Herald quotes optometrist David Holliday, OD, saying, "Optometrists are performing these procedures in certain states. We're not the exception by any means. We feel comfortable with those procedures and fully qualified to do those jobs

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Australia's Sydney Morning Herald reports that Australian scientists have identified one of the genetic causes of long-sightedness, a breakthrough that could lead to the development of a drug to treat vision loss. Long-sightedness - an inability to see things clearly when they are up close - affects about 10 per cent of the population.

Researchers led by Dr Paul Baird of CERA (affiliated with the University of Melbourne and is located at the Royal Victorian Eye and Ear Hospital). identified changes in the hepatocyte growth factor (HGF) gene which...are now suspected of playing a disruptive role in the proper development of the eye.

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Massachusetts would require vision tests for elderly drivers.

In a front-page story, the Boston Globe reports that "key" Massachusetts state lawmakers, facing public concern over a raft of highly publicized accidents involving older drivers, yesterday proposed requiring vision tests for drivers over 75 years old seeking to renew their licenses, and granting legal immunity to doctors who report that their patients are not competent to drive.

The Globe notes that the new bill does not require healthcare professionals to report patients, and says they would be immune from lawsuits in cases in which they decline to report incompetent drivers. The measure would also ban text messaging while driving and forbid all drivers under age 18 from using cell phones while behind the wheel.

The legislation is scheduled for a vote tomorrow in the House.

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Epimacular brachytherapy now used to treat AMD

Macular degeneration is an aggressive condition in which abnormal blood vessels form in the part of the eye called the macula. These blood vessels are very fragile and often leak blood and fluid, causing scar tissue to form.

This affects central vision, which is essential for everyday tasks such as reading and driving.

Sufferers struggle to recognize faces at a distance, have a blurred or blind spot in the centre of their vision, and straight lines can appear wavy.

A new treatment procedure called Epimacular brachytherapy, when used to treat patients requiring chronic anti-VEGF therapy, may reduce the burden of treatment for neovascular age-related macular degeneration.

According to results from a study presented at the joint meeting of the American Academy of Ophthalmology and Pan-American Association of Ophthalmology, a single procedure of epimacular brachytherapy can further improve visual acuity in a majority of this patient population while decreasing the number of injections required. Most important, 63% of patients enrolled in the study experienced improvement in their visual acuity while 50% of patients gained five or more letters of visual acuity at 6 months.

Preliminary results indicate that epimacular brachytherapy may help reduce treatment burden in a population of patients that are at high risk for visual decline, even if they are undergoing sustained anti-VEGF monotherapy, according to Pravin U. Dugel, MD, of Retinal Consultants of Arizona.

Eye experts in the UK are using epimacular brachytherapy to treat the wet form of age-related macular degeneration (AMD). During outpatient surgery, surgeons place a "radioactive pellet" that travels down the inside of a probe into the eye, where it gives the macula a high dose of radiation designed to burn the abnormal blood vessels growing behind the retina

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According to a study published in the January issue of the Archives of Ophthalmology, high caloric and sodium intake appear to be associated with the progression of diabetic retinopathy (DR) among African American patients with type 1 diabetes.

In a study population of 469 individuals at risk for the progression of DR, researchers found that baseline total caloric intake was significantly associated with a six-year incidence of vision-threatening Diabetic Retinopathy (either proliferative DR or macular edema [ME]) and of severe hard exudates, while high sodium intake at baseline was a significant, independent risk factor for six-year incidence of ME.

Limitations of this study include single measurement of nutrient intake, failure to adjust for multiple comparisons, and lack of generalizability to other populations.

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Researchers question causes of myopia

On its "Morning Edition" program, NPR reports on the search for the causes of myopia. Epidemiologist Susan Vitale, of the National Eye Institute, explained that a study she coauthored in December's Archives of Ophthalmology found about a 66 percent increase in myopia over 30 years.


NPR notes that near-work the things you do close up with your eyes, like reading or watching television, has been suspected as contributing to nearsightedness, but a study by researchers at the College of Optometry at the Ohio State University found that near-work had no influence. They did discover, however, that the amount of outdoor activity a child had an influence the development of myopia.

Now, researchers are studying whether outdoor light somehow changes the way the eye grows

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Image via Wikipedia

The New York Times reported that the decline of written language has become a reality for only the blind, as fewer and fewer visually impaired people learn Braille, many preferring instead to rely upon synthetic voice technology and computer-screen-reading software.

In fact, a report released last year by the National Federation of the Blind, an advocacy group with 50,000 members, said that less than 10 percent of the 1.3 million legally blind Americans read Braille. The report found that while approximately half of all blind children learned Braille in the 1950s, today that number is as low as one in 10.

Increased number of blind children born with additional physical or mental handicaps, often the result of premature birth. And a large percentage of these students were partly sighted. There is a wonderful article explaining this so well in the Arizona Republic June 1, 2006 . The reporter interviewed Arielle Silverman President of the Arizona Association of Blind Students.

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Statin use is not associated with risk of developing advanced, age-related macular degeneration (AMD), according to a study published in the Dec. issue of Ophthalmology.

In a study of 744 patients, researchers from the University of Pennsylvania found that among patients who had bilateral large drusen, use of the cholesterol-lowering medications was not associated with a higher or lower risk of progressing to advanced disease.

At baseline, all patients were at risk for advanced AMD but had not yet progressed to that stage.

At the end of the study, 39.8% of the participants reported using statins; about two-thirds starting taking the drugs during the trial.

The investigators theorized, however, that a protective effect may have been obscured because patients who are taking statins for cardiovascular disease are also at high risk for developing AMD.

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AMD treatment with NeoVista system

Wet AMD occurs when abnormal blood vessels behind the retina start to grow under the macula, where they leak blood and fluid, causing scar tissue to form and vision to become impaired. With wet AMD, vision loss may occur faster and be more noticeable than with dry AMD. The longer the abnormal vessels leak or grow, the more detail vision will be lost. The earlier wet AMD is diagnosed, the better the patients' chance of preserving some or much of their central vision.

The first European patients have been treated for wet age-related macular degeneration with NeoVista's Vidion ANV Therapy System, an epimacular brachytherapy device that delivers a single dose of therapeutic radiation, the manufacturer announced in a press release.

Stanislao Rizzo, MD, of S. Chiara Hospital, Pisa, Italy, treated the initial group of patients with the Vidion ANV Therapy System. Unlike previous radiation therapies for wet AMD, NeoVista's innovative device delivers the peak dose of strontium-90 beta ionizing radiation directly to the lesion minimizing exposure to the surrounding tissue. The minimally invasive procedure utilizes a device similar in size to a needle, to deliver a highly targeted dose of radiation directly to the area of the retina affected by wet AMD. Importantly for patients, the systemic radiation exposure is minimal, as the effective dose to the entire body from NeoVista's epimacular brachytherapy device is less then a routine chest x-ray.

The Vidion system is undergoing phase 3 clinical trials for U.S. Food and Drug Administration marketing approval. The device proved safe and effective in preliminary clinical trials, the release said.

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Blood test to identify retinopathy in Type 1 Diabetics

A routine blood test may identify juvenile-onset diabetic patients at heightened risk for proliferative retinopathy.

In a multivariate analysis of data on 426 people followed over 18 years from Pittsburgh Epidemiology of Diabetes Complications Study, researchers found that each increment of 1 g/dL in hemoglobin was associated with a linear 29% increase in risk for retinopathy in men with type 1 diabetes (95% CI 8% to 54%), and a quadratic 10% risk increase in women (95% CI 0% to 20%).

Notably, only diastolic pressure and glycated hemoglobin were predictive of retinopathy in multivariate analysis for both sexes, while systolic pressure predicted retinopathy in women (HR 1.03 per mm Hg), but not in men.

The researchers noted that the difference in the nature of the relationship between hemoglobin and retinopathy risk between sexes -- linear in men, quadratic in women -- may just be a statistical fluke, arising from the small number of men with hemoglobin levels below 13.5 g/dL.

A U-shaped relationship, indicating increased retinopathy risk for both low and high levels of hemoglobin, is likely to apply to both sexes, they said

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Combined drug to treat nasal and ocular allergies

Image by aarrgh via Flickr

A study published in the Annals of Allergy, Asthma, and Immunology and presented at an allergy conference, showed that the combination of azelastine (Astelin or Astepro) and fluticasone propionate (Flonase) gave significantly better nasal symptom relief than placebo or either drug alone.
Azelastine is an antihistamine and mast cell stabilizer that is also sold as eye drops for allergic conjunctivitis under another brand name. Fluticasone is a synthetic glucosteroid that is used as an anti-inflammatory.

Investigators enrolled 610 patients with moderate-to-severe allergic rhinitis, randomly assigning them to get either azelastine, fluticasone, the combination nasal spray, or a placebo nasal spray twice a day for two weeks. They discovered that the combination was significantly better than either drug alone or placebo at relieving nasal symptoms, but the two drugs delivered together -- a combination dubbed MP29-02 -- were not significantly better than either drug as monotherapy for ocular symptoms

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