Friday, July 31, 2009

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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Wednesday, July 22, 2009

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.

Tuesday, July 21, 2009

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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Monday, July 20, 2009

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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Thursday, July 16, 2009

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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Wednesday, July 15, 2009

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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Tuesday, July 14, 2009

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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Tuesday, July 07, 2009

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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Monday, July 06, 2009

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

The same view with age-related macular degener...Image via Wikipedia

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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Tuesday, June 30, 2009

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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Monday, June 29, 2009

UAW retirees swamping optometry offices in Indiana

A phoropter in use.Image via Wikipedia

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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Tuesday, June 23, 2009

ವೀಡಿಯೊ ಗೇಮ್ ಟು ಟ್ರೀಟ್ ಲಜ್ಯ್ ಎಯೇ

This image shows many of the characteristics c...Image via Wikipedia

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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Monday, June 22, 2009

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

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.

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

Thursday, June 18, 2009

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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