Dr. Jay's blog

Increase in myopia found among college students

2016-08-02T09:45:00.002-07:00

Increase in myopia found among college students

Researchers saw a rise in myopia among first-year college students, from 23.4% in 2002 to 41.3% in 2014, according to a study in Optometry and Vision Science.
Researchers believe the increase in myopia prevalence in these Portuguese students from the University of Minho could be related to the lifestyle changes of the academic population.

http://www.healio.com/optometry/optics/news/online/%7B8e88df34-4d1a-47e4-b1e9-8a4a4f913974%7D/increase-in-myopia-found-among-college-students?utm_source=maestro&utm_medium=email&utm_campaign=optometry%20news

Gene Therapy Treatment For Inherited Retinal Dystrophies Succeeds In Late-Stage Clinical Trial.

2015-10-06T07:15:00.003-07:00

Gene Therapy Treatment For Inherited Retinal Dystrophies Succeeds In Late-Stage Clinical Trial.

The New York Times (10/5, B3, Pollack, Subscription Publication) reports that Spark Therapeutics has announced that its SPK-RPE65 “gene therapy” treatment for “certain so-called inherited retinal dystrophies” succeeded in a late-stage clinical trial, allowing patients “to more easily maneuver in dimmer light than they could before” treatment. Spark “said it planned to apply to the Food and Drug Administration next year for approval to sell the product.” Should the FDA approve the product, it could “become the first gene therapy to win approval” in the US, the Times points out.

http://www.nytimes.com/2015/10/05/science/eye-treatment-closes-in-on-being-first-gene-therapy-approved-in-us.html?ref=health&_r=0

‘Smart’ contacts green-lighted for human tests

2015-09-10T12:03:00.004-07:00

‘Smart’ contacts green-lighted for human tests

Ready or not, here come smart contacts.

"Doctors of optometry will need to be a part of the team if smart lenses are to succeed."

Swiss pharmaceutical company Novartis publicly revealed plans to roll out human trials of its prototype smart contact lens technology in 2016 with an eye on consumer market ubiquity within five years, according to a September 5, 2015 Reuters report. This initial prototype smart lens is purportedly designed to help with presbyopia, though the company eyes other applications, as well.

In July 2014, Novartis penned a collaborative agreement with Google, Inc., to bring the tech giant's blood-glucose monitoring smart lenses to market. The technology could redefine the way patients with diabetes track their glucose levels, offering a painless, more continual tracking method versus the tried-and-true finger-stick blood test.

Although Google provided a peek at how its proposed smart lenses would work—using miniaturized sensors imbedded in the hydrogel lens to collect tear fluid and transmit data to a handheld monitor—Novartis has not revealed designs for its accommodative vision correction smart lenses.

Alcon, Novartis' eye care division, will have the opportunity to in-license and commercialize the technology.

Contact lenses of the future, today
Turning science fiction into science fact, smart contact lenses look to be the latest in a line of wearable technology that marries digital connectivity with bio-sensing capabilities to clue in consumers about their personal health and wellbeing.

In the July/August 2014 edition of AOA Focus, AOA members discussed the rise of contact lens technology and the possibilities on the horizon, including:

Drug-eluting lenses for common ocular complications
Blood-glucose monitoring smart lenses
Intraocular pressure-monitoring lenses
Augmented-reality lenses designed for military and future consumer use

"This is a great opportunity for optometry to strut its stuff," said Thomas Quinn, O.D., AOA Contact Lens & Cornea Section immediate past chair, in the 2014 AOA Focus story. "Doctors of optometry will need to be a part of the team if smart lenses are to succeed."

Currently, about 1 in 10 U.S. adults have diabetes, a number projected to grow to 1 in 3 by 2050, according to the Centers for Disease Control and Prevention. Just as ever-increasing diabetes rates proved a catalyst for Google's smart lenses, those climbing numbers also serve as a constant reminder that doctors of optometry play a key role in the multidisciplinary care of patients with diabetes.
http://www.aoa.org/news/clinical-eye-care/smart-contacts-green-lighted-for-human-tests?sso=y

Report: In Past Three Years, Eye Injuries Caused By Fireworks Have More Than Doubled.

2015-07-07T07:24:00.002-07:00

Report: In Past Three Years, Eye Injuries Caused By Fireworks Have More Than Doubled.

USA Today (7/3, Bowerman) reported that “in the past three years, eye injuries caused by fireworks have more than doubled, according to the annual fireworks injury report issued...by the US Consumer Product Safety Commission.” US emergency departments “ treated 1,300 eye injuries caused by fireworks over a one-month period in 2014 compared to 600 eye injuries over the same timeframe in 2011.”

http://www.usatoday.com/story/news/nation-now/2015/07/02/fourth--july-independence-day-firework-injuries-eye-emergency-room/29612657/

Johns Hopkins Researchers Investigating Potential Link Between Vision Deficiencies And Literacy.

2015-05-27T06:11:00.001-07:00

Johns Hopkins Researchers Investigating Potential Link Between Vision Deficiencies And Literacy.

The Baltimore Sun (5/27) reports that Johns Hopkins Hospital Wilmer Eye Institute researchers have been “trying to answer a basic but overlooked question: Are students struggling to read because they can’t see?” They have been conducting screenings and prescribing glasses to Baltimore students “to produce a first-of-its-kind study that attempts to link vision deficiencies and literacy in a school-based population.” The pilot program will include 300 students from 12 schools.

[it is about time!]

http://www.baltimoresun.com/news/maryland/education/bs-md-ci-hopkins-glasses-study-20150526-story.html#page=1

Medieval Remedy For Eye Infections Found To Kill Superbug MRSA.

2015-03-31T08:03:00.002-07:00

The Telegraph (UK) (3/31, Knapton) reports that research presented at the Annual Conference of the Society for General Microbiology reveals that a “medieval remedy for eye infections which was discovered in a manuscript in the British Library has been found to kill the superbug MRSA.” The 1,000-year-old “‘eyesalve’ recipe calls for two species of Allium (garlic and onion or leek), wine and oxgall (bile from a cow’s stomach).” No single ingredient on its own “had any measurable effect, but when combined according to the recipe,” not only “did the salve clear up styes, but it also tackled the deadly superbug MRSA, which is resistant to many antibiotics.”

http://www.telegraph.co.uk/news/science/science-news/11504166/Anglo-Saxon-cow-bile-and-garlic-potion-kills-MRSA.html

Study: Natural Outdoor Light May Help Nearsightedness.

2014-12-01T05:50:00.004-08:00

Study: Natural Outdoor Light May Help Nearsightedness.

It's long been thought kids are more at risk of nearsightedness, or myopia, if they spend hours and hours in front of computer screens or fiddling with tiny hand-held electronic devices.
Not true, say scientists. But now there is research that suggests that children who are genetically predisposed to the visual deficit can improve their chances of avoiding eyeglasses just by stepping outside.
Yep, sunshine is all they need -- more specifically, the natural light of outdoors -- and 14 hours a week of outdoor light should do it.
Why this is the case is not exactly clear.
"We don't really know what makes outdoor time so special," said Donald Mutti, the lead researcher of the study from Ohio State University College of Optometry, in a press release. "If we knew, we could change how we approach myopia."
What is known is that UVB light, (invisible ultraviolet B rays), plays a role in the cellular production of vitamin D, which is believed to help the eyes focus light on the retina. However, the Ohio State researchers think there is another possibility.
"Between the ages of five and nine, a child's eye is still growing," said Mutti. "Sometimes this growth causes the distance between the lens and the retina to lengthen, leading to nearsightedness. We think these different types of outdoor light may help preserve the proper shape and length of the eye during that growth period."
The scientists are also studying whether visible light outdoors, not just UVB, might contribute to healthy eyesight. Even on an overcast day, outdoor light is at least 10 times brighter than indoor light, they said. When a person is outdoors, certain specialized cells in the retina control pupil dilation, letting in more of less light.
"Our initial research suggests that the pupil responds more if these cells have been exposed to a lot of sunlight in the previous few days."
Ultimately, there are more questions to be answered, says Mutti, but he believes his team's findings are already contributing to finding those answers.
"I think the research we are doing now will help us finally solve the mystery of the outdoor effect, and maybe help some people avoid a lifetime of wearing glasses," he said. "In the meantime, I tell parents don't worry about reading, get their kids outside, but don't forget ... sunscreen."

http://www.washingtonpost.com/news/to-your-health/wp/2014/11/28/go-play-outside-kids-natural-light-reduces-risk-of-nearsightedness-in-children-scientists-say/

Symptoms of eyeglass related issues. Shaw lenses usually solve these issues.

2014-10-07T09:19:00.004-07:00

Here are the symptoms which are associated with image size issues and other binocular issues. Normal eyeglasses do not address these issues.
Shaw lenses do!

There's a reason you haven't liked your glasses

The basic problem with current lens design is that it doesn’t take into consideration how the eyes work together. The SHAW lens uses doctor measured motor fusion (vergence) limits and sophisticated math to create lenses that take into account how your eyes move together as it balances the image sizes. This solves many distortion problems. As a result, many patients report better vision comfort and fewer headaches.

You really should ask us about these lenses.

Adults over age 45 should be screened for diabetes

2014-10-07T09:17:00.002-07:00

By Deborah Kotz

Primary care physicians should screen all adults over age 45 for diabetes, according to new recommendations proposed Monday by a government-sponsored panel of experts. The US Preventive Services Task Force, composed of primary care providers, base their new advice on evidence suggesting that diagnosing elevated blood sugar levels before people develop full-blown diabetes can reduce their risk of getting the condition and also developing heart disease.

Evidence from several recent large clinical trials suggest that those who have moderately elevated blood sugar, a condition called prediabetes, detected on a routine blood test and treated through a diet and exercise program have a 47 percent reduced risk of developing diabetes over the next several years.

The Task Force’s previous recommendations from 2008 only recommended diabetes screening in those at increased heart disease risk due to high blood pressure because studies were lacking to show benefits for screening the general population. “More evidence has emerged since then on the benefits of lifestyle interventions,” said Task Force member Dr. Michael Pignone, a professor of medicine at the University of North Carolina at Chapel Hill School of Medicine. “Our feeling is that you need to have an effective intervention available for people that you screen.”

People who are overweight, have a family history of diabetes, or are African-American, Asian, or Latino, likely need to be screened earlier than 45, the Task Force recommended, because they’re at higher diabetes risk. Women who have polycystic ovarian syndrome or who developed gestational diabetes during pregnancy also fall into the high-risk category.

“We didn’t specify an age for screening those high-risk groups,” Pignone said. “That’s something patients should discuss with their doctors.” The group also didn’t advise how frequently adults should be screened.

Diabetes experts supported the new recommendations, which agree with the latest advice from other medical organizations.

Both the American Diabetes Association and the Centers for Disease Control and Prevention urge doctors to consider performing screening every three years in adults age 45 and older, especially for those who are overweight. Screening tests include a blood glucose test which requires fasting for eight hours beforehand, a glucose tolerance test which checks blood sugar both before and after drinking a sweetened beverage, or a blood test to measure the marker hemoglobin A1C, which measures average blood glucose for the past 2 to 3 months.

About 86 million American adults have elevated blood sugar levels, and an additional 29 million have diabetes, which is up from 26 million in 2010. But more than one-quarter of those with diabetes are unaware that they have the condition because they don’t recognize the symptoms, like frequent urination, weight loss, and fatigue, and aren’t getting screened, according to a 2014 CDC report.

Dr. Osama Hamdy, medical director of the obesity clinical program at Joslin Diabetes Center, said the Task Force’s guidelines, aimed at primary care physicians, will likely lead not just to earlier diabetes diagnoses but to a greater detection of high blood sugar levels at a point when diabetes can still be prevented.

“We need to focus on prevention rather than just treating a problem,” Hamdy said.

Doctors, however, need to do more in terms of prevention than simply telling patients to quit junk food and soda and increase their physical activity, Pignone said. “The type of prevention program found to be effective in studies we reviewed typically involved 16 educational sessions, access to a health coach, and achievement of 150 minutes of activity each week,” he said. “Primary care practices don’t usually have the resources” to get patients to make drastic lifestyle changes.

Most of the lifestyle intervention programs offered at Joslin, Hamdy said, are only covered by insurance companies once a patient has been diagnosed with diabetes -- not for prevention.

“I hope this new recommendation will set the stage for reimbursements at an earlier stage when diabetes can be prevented,” he added.

In the meantime, the CDC offers a National Diabetes Prevention program that teaches nutrition and exercise classes at more than a dozen health centers and YMCA’s in Massachusetts at little or no cost to participants.

Deborah Kotz can be reached at dkotz@globe.com. Follow her on Twitter @debkotz2.

https://www.bostonglobe.com/lifestyle/health-wellness/2014/10/06/adults-over-age-should-screened-for-diabetes-task-force-recommends/jvzO5zz6y1cNgvSmmmrwuK/story.html

Like a bad habit: Patients’ 6 common contact lens mistakes

2014-07-24T07:48:00.004-07:00

Like a bad habit: Patients’ 6 common contact lens mistakes

Acanthamoeba keratitis is not a virus, but it spread like one recently in a horrifying Internet tale of optometrists' warnings come true.

A Taiwanese student reportedly went blind after she left a pair of disposable contact lenses in her eyes for six months straight, allowing the infectious amoeba to eat away at her corneas.

"All these bad habits are due to a lack of understanding on the part of patients."

It's a rare circumstance, but the proof is in the cornea, so it seems. Contact lenses are among the safest forms of visual correction, but if not used as directed, there can be serious consequences.

Thomas Quinn, O.D., AOA Contact Lens and Cornea Section (CLCS) chair, says now is the time to talk with patients about the importance of proper contact lens wear. And through an informal query of other practitioners, he highlights six of the most common mistakes made by contact lens patients.

Bad news practices

Overstayed welcome. Studies have indicated around half of disposable and frequent replacement lens users wear lenses longer than their recommended schedule. What barometer do patients use to change their lenses? They wait until the lenses become bothersome. "That's like saying, 'I'm going to wear my underwear until they start to bother me,'" Dr. Quinn says. "No, you change them before they start to bother you."
Caught dirty-handed. The cleanest, daily disposable lenses are all for naught if wearers do not wash their hands before handling their lenses. Dr. Quinn recalled a teenage patient with daily disposable lenses who persistently would be treated for corneal infiltrative events (CIEs). He learned the teen's hands were never washed before handling lenses.
Damp digits. The flip side of the coin: Although most patients do think to wash their hands, sometimes they forget to dry their hands before handling contact lenses. Water can harbor harmful microorganisms that can be transferred onto the lens and subsequently onto the eye if wearers fail to dry their hands with a clean surface.
No respect for the system. Not all contact lens care systems are created equal, in terms of disinfection, and chemical sensitivities and incompatibilities with lens materials. Patients might opt for a cheaper, generic solution as opposed to the care system specifically designed for their lenses. "The cheapest solution isn't always the best solution," Dr. Quinn says.
A case of grimy cases. Proper contact lens care extends to storage cases, as well. The AOA recommends wearers replace lens cases at least every three months, and cases should be cleaned and disinfected periodically in between. But Dr. Quinn says that information tends to be lost on patients, and optometrists are partly to blame—how to care for cases is the overall top question submitted to contactlenssafety.org. Dr Quinn: "People aren't caring for their cases, but partly because they don't know how to do it."
Dozing dangers. And finally, people snoozing in contact lenses that are not designed to be slept in are at a five times higher risk of developing CIEs, according to some studies.Even extended wear lenses carry some risk of infection as compared to daily wear lenses.

But what should optometrists do about these? Dr. Quinn urges continued education, but also highlights the benefits of daily disposable lenses as a way to eliminate several of these bad habits.

"All these bad habits are due to a lack of understanding on the part of patients," he says.

http://www.aoa.org/news/inside-optometry/like-a-bad-habit-patients-6-common-contact-lens-mistakes?sso=y

Noninvasive Eye Exams May Someday Detect Alzheimer’s In Earliest Stages.

2014-07-14T09:56:00.003-07:00

Noninvasive Eye Exams May Someday Detect Alzheimer’s In Earliest Stages.

The CBS Evening News (7/13, story 4, 2:00, Glor) reported that researchers have “announced the promising result of a study on a new test to pick up” signs of Alzheimer’s disease “years, if not decades, in advance. And they’re looking for the sign in an unusual place, the eye.”

The Washington Post (7/13, Kunkle) reported that according to two studies presented at the Alzheimer’s Association International Conference in Denmark, “noninvasive eye exams...might offer a way to identify Alzheimer’s in its early stages.” Researchers “investigated a possible link between levels of beta-amyloid in the eye — as detected by a new, relatively inexpensive imaging technology — and levels of the same protein in the brain, as seen through PET scans.” A second study “also found a link between levels of beta amyloid in the eye’s lens and inside the brain.”

The NBC News (7/14) website reported that by staining beta amyloid with “curcumin, a component of the common spice turmeric,” researchers “could detect it in the retina even before it began to accumulate in the brain.” The ability to detect Alzheimer’s years in advance may “mean earlier treatment, and could give people a chance to plan, said Maria Carrillo, vice president of medical and scientific relations at the Alzheimer’s Association.” Some medications for Alzheimer’s “work best early in the disease process,” Carrillo explained.

Also covering the studies are the Wall Street Journal (7/14, Wang, Subscription Publication), and the CBS News (7/14, Dahler) website.

http://wpost.com/national/health-science/alzheimers-researchers-hunt-for-new-tools-to-identify-diseases-onset/2014/07/12/d458222e-092a-11e4-bbf1-cc51275e7f8f_story.html

They Can't Always Get What They Want

2014-07-09T07:49:00.004-07:00

Patient Satisfaction and Quality of Care: Are They Linked?

An Expert Interview With Joshua J. Fenton, MD, MPH

They Can't Always Get What They Want

Medscape: In your original paper, you mentioned the possibility that too much emphasis on patient satisfaction measures could lead to "unintended adverse outcomes." There has been a lot of discussion about overtreatment,^[20] such as overprescribing of antibiotics,^[21] and ordering unnecessary tests. Patients ask for these things, even when they aren't necessary, and are more satisfied when they get what they think they need. Do providers modify their behavior based on patient satisfaction scores?
Dr. Fenton: That was one of our concerns about the results of our study. We observed an association between higher patient satisfaction and higher healthcare utilization, and yet there was also an association between higher satisfaction and patient mortality. It was an observational study, so is it impossible to determine whether the associations were causal. It does raise some concern that the high utilization among the more satisfied patients may not have been for high-value care.
Ours was not the first study to point to the problem of low-value care in healthcare. The studies from the Dartmouth Atlas of Health Care have been widely cited for pointing out, for example, that approximately 30% of healthcare expenditures in the United States are probably wasteful and for either discretionary or inappropriate care.^[22] So there is a dynamic in US healthcare that drives excessive healthcare utilization, and we are concerned about that. An overemphasis on patient satisfaction could make this worse.
Most primary care providers are concerned about the perverse incentives that satisfaction metrics could introduce into the clinical encounter. I'm particularly wary about the push to maximize satisfaction, as if the goals should be to get every patient to rate every encounter as "excellent."
Some encounters are bound to be challenging for both the patient and the clinician. When difficult issues are raised, such as a patient's ability to drive, a possible substance abuse issue, or perhaps poor exercise habits, patients may have an affective response that leads to lower satisfaction. Yet compensation schemes that unduly award maximum satisfaction would discourage these important conversations.
There is a major difference between the doctor/patient relationship and the relationship between a business and a customer. Of course, many primary care encounters, as well as those in other settings, are driven at least to some extent by consumerist behavior on the part of patients. Patients ask for this or that test, treatment, or referral, or a brand-name drug advertised on TV. Perhaps they want an antibiotic when in fact they have a common cold. In these situations, the doctor would ideally respond to patients' requests empathetically in a manner that addresses their concerns. But a denial of patients' requests, even if respectful and empathetic, obviously risks dissatisfying the patient. In essence, we want physicians to care about satisfaction, but not too much.

http://www.medscape.com/viewarticle/826280_4

Improving Visual Acuity In Amblyopes

2014-05-06T07:20:00.004-07:00

Patching, Atropine Eye Drops May Both Provide Durable Improved Visual Acuity In Amblyopia.

Medscape (5/2, Hackethal) reports that according to the results of a study published online May 1 in JAMA Ophthalmology, “patching or atropine eye drops both improved visual acuity” over the long term. The study included 419 youngsters with amblyopia who were randomized “to six hours per day of patching or 1 drop per day of 1% atropine sulfate.” When the kids reached 15 years of age, researchers could find “no differences in visual acuity between subgroups based on initial treatment with atropine or patching (P = .44 and P = .43, respectively).”

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Patching or atropine eye drops both improved visual acuity in a long-term follow-up of a randomized controlled trial (RCT) in children with amblyopia, according to new results from the Pediatric Eye Disease Investigator Group (PEDIG).
The long-term results from the PEDIG trial, which both had a high proportion of children followed-up to the end of the study and used standardized measurement throughout, add to the study's previous findings.
The new PEDIG results, published online May 1 in JAMA Ophthalmology, show that visual improvement is durable. The new findings contrast with previous reports from retrospective case series that have suggested regression is common after stopping treatment, first author Michael X. Repka, MD, MBA, professor of ophthalmology and pediatrics at the Johns Hopkins School of Medicine, Baltimore, Maryland, told Medscape Medical News.
The multicenter PEDIG trial included 419 children with amblyopia who were younger than 7 years when enrollment began in 1999. The researchers randomly assigned participants to 6 hours per day of patching or 1 drop per day of 1% atropine sulfate. They conducted masked outcome exams at 6 months and 2 years, after which treatment was at the discretion of investigators. Results at 6 months found a 3 logMAR improvement in visual acuity in both groups. From 6 months to 2 years, visual acuity improved in both treatment groups. About 50% of amblyopic eyes were 20/25 or better at 2 years.
At the 2-year exam, 188 of the children were enrolled in long-term follow-up. The researchers conducted visual testing (acuity, manifest and cycloplegic fractions, ocular alignment, and stereoacuity) again at 10 and 15 years in this group. At age 10 years, about 46% of amblyopic eyes were still 20/25 or better.
At age 15 years, mean visual acuity in 59.9% of amblyopic eyes was 20/25 or better, whereas in 33.3%, mean visual acuity was 20/20 vision or better. Mean interocular acuity difference was about the same at 10 and 15 years of age (2.0 and 2.1 logMAR lines, respectively; P = .39).
Visual acuity at age 15 years was better among those younger than 5 years at the time of enrollment compared with those between the ages of 5 and 6 years at trial entry (about 20/25 and 20/32, respectively; P < .001). At age 15 years, there were no differences in visual acuity between subgroups based on initial treatment with atropine or patching (P = .44 and P = .43, respectively). Stereoacuity testing looking at whether treatment for amblyopia affects binocular vision was similar at 15 years for the treatment groups (P = .44 for all and P = .85 for those with no ocular deviation at 15 years).
The authors write that their study could have been limited by selection bias, as participants had better visual acuity in the amblyopic eye when they were enrolled in the long-term follow-up group compared with nonparticipants. This could have biased the 15-year results toward better visual acuity in the amblyopic eye.
The better outcomes detected in children who initiated therapy at a younger age might be explained, according to the authors, if plasticity decreases over time or if shorter exposure to untreated amblyopia decreases damage to the visual system.
"Amblyopia therapy improves the vision of the eye in most cases, and that improvement appears to be durable," Dr. Repka emphasized, "Many children do have some residual amblyopia, [although] the initial choice of therapy does not appear to impact the final outcome."
This study was by the National Eye Institute. The authors have disclosed no relevant financial relationships.
JAMA Ophthalmol. Published online May 1, 2014.

http://www.medscape.com/viewarticle/824466

Two Antioxidants In Kale Tied To Lower Risk Of Chronic Eye Diseases.

2014-02-26T05:22:00.003-08:00

Two Antioxidants In Kale Tied To Lower Risk Of Chronic Eye Diseases.

The Boston Globe (2/25, Kotz) “Daily Dose” blog reports that kale contains two antioxidants, “lutein and zeaxanthin,” which “have been associated with a lower risk of chronic eye diseases, including age-related macular degeneration and cataracts, according to the American Optometric Association.” The blog entry provides tips on how to prepare kale. It also warns people with “certain thyroid conditions...to avoid eating raw kale more than three times a week since eating excess amounts of the raw green could interfere with iodine absorption in those with an underactive thyroid.”

http://www.boston.com/lifestyle/health/blogs/daily-dose/2014/02/24/how-work-more-kale-into-your-diet/RX63XKM48ZW534FACvW7qN/blog.html

Laser Toys May Cause Serious Eye Damage.

2013-11-22T07:33:00.003-08:00

Laser Toys May Cause Serious Eye Damage.

HealthDay (11/22, Preidt) reports that, according to a case report published online Nov. 4 in the journal Ophthalmology, high-powered blue laser toys may “cause serious and potentially permanent eye damage.” Researchers reported “on 14 cases of laser-caused eye damage” that “were caused by high-power blue laser gadgets and included four cases of perforations of the retina.” The injuries were sustained by boys and men ranging in age from 11 to 30. Two patients suffered lasting damage to the retina.

http://consumer.healthday.com/kids-health-information-23/adolescents-and-teen-health-news-719/zapped-by-laser-toys-eyes-damaged-682199.html

Long-Term Oral Contraceptive Use Tied To Higher Glaucoma Risk.

2013-11-21T05:31:00.000-08:00

Long-Term Oral Contraceptive Use Tied To Higher Glaucoma Risk.

The New York Daily News (11/19, Miller) reports that, according to research presented at an ophthalmology meeting, long-term oral contraceptive use may “increase women’s risk for a leading cause of blindness.” After examining data on some 3,400 women, researchers found that “taking oral contraceptives for more than three years appears to double a woman’s risk of glaucoma.”

The Newark (NJ) Star-Ledger (11/19, O'Brien) reports, “The study results held consistent no matter which kind of oral contraceptives were used.” Previous research has indicated that “estrogen may play a significant role in the development of glaucoma.” The majority of oral contraceptives “contain synthetic forms of both estrogen and progestin.”

On its website, CBS News (11/19, Jaslow) quotes the study’s lead author, who said in a statement that “women who have taken oral contraceptives for three or more years should be screened for glaucoma” and monitored by an eye doctor, particularly if they exhibit other risk factors. According to the National Eye Institute, “people with a history of eye pressure, those with a family history of glaucoma, black people over the age of 40 or Mexican Americans older than 60 years of age” all may be at increased risk for glaucoma.

Also covering the story are the Fox News (11/19) website, the CNN (11/18, Wadas-Willingham) “The Chart” blog, the Huffington Post (11/18), the Time (11/19, Sifferlin) “Healthland” blog, the NPR (11/19, Shute) “Shots” blog, and HealthDay (11/19, Preidt). Foreign sources covering the story include the Daily Telegraph (UK) (11/19, Collins), the Daily Mail (UK) (11/19, Innes), and AFP (11/19).

http://www.nydailynews.com/life-style/health/pill-long-term-linked-higher-risk-glaucoma-article-1.1520783

Educational Campaign Promotes the Need for Access to High Quality Eye Care in States

2013-11-14T13:29:00.002-08:00

American Optometric Association Launches "See Clearly, America" Campaign

Educational Campaign Promotes the Need for Access to High Quality Eye Care in States

PR Newswire

ALEXANDRIA, Va., Nov. 6, 2013

ALEXANDRIA, Va., Nov. 6, 2013 /PRNewswire/ -- The American Optometric Association (AOA) today announced that it has launched the "See Clearly, America" public education campaign to highlight how Doctors of Optometry possess the education, skills, and training to provide quality eye care and help meet America's rising eye care needs.
The President of the American Optometric Association, Dr. Mitch Munson, said, "We launched the 'See Clearly, America' campaign because we want everyone to know that no matter where they live – rural, suburban or urban setting – that access to world-class quality eye care can be found in the office of their nearest optometrist."
As part of this campaign, the AOA determined that Americans were not aware of the extensive clinical training and education that the approximately 36,000 doctors of optometry have received.
Said Dr. Deanna Alexander, past recipient of the national Optometrist of the Year award, "People are surprised to learn that doctors of optometry have as much professional training in eye care and treatment as dentists have in oral care."
For aspiring optometrists, that means that after graduating from a college or university with a Bachelors' Degree they must attend optometry school for four years, earning their Doctor of Optometry Degree. At their college of optometry, students concentrate on the eye, vision, and associated systemic disease—including courses that focus on a patient's overall medical condition in relation to the eyes.
After graduating with the degree, Doctor of Optometry, individuals must pass a national licensure exam and a comprehensive exam before practicing in a state. Throughout their careers, doctors of optometry participate in extensive, ongoing training in the latest treatments and technological advancements to ensure they are able to deliver the highest quality eye care utilizing the most recent medical and scientific developments possible.
Dr. David Cockrell, AOA President-Elect, said, "Unfortunately, there is a misunderstanding that optometrists don't do much more than evaluate vision and prescribe eyewear. Doctors of Optometry have an advanced education, extensive skills training, and a breadth of experience in diagnosing and treating medical conditions as well."
Added Cockrell, "At a time when our country faces growing eye care and health care demands, we need to change that mindset, and individual state laws, to ensure that all highly trained, skilled and qualified Doctors of Optometry can help Americans see clearly."
The centerpiece of the "See Clearly, America" campaign is a new website, www.AmericasEyeDoctors.com. The website provides information about optometrists, issues of importance and ways to get involved.
SOURCE American Optometric Association

New York Girl Loses Sight After Buying Illegal Contacts

2013-09-18T18:48:00.000-07:00

A New York girl needs a cornea transplant after she illegally purchased a pair of colored contacts at a local beauty store, WPIX.com reported.
Erica Barnes reportedly bought the $20 contacts at a store on Jamaica Avenue in Queens, N.Y., because she wanted to be like singer Rihanna – and all her friends were doing it, too. She wore the lenses for one day and fell asleep with them in her eyes.
“For $20, she lost her eye,” said Erica’s step-mother, Trina Swain. “Every parent should know their girls are in danger. They are dangerous eye candy that our children can buy anywhere.”
Under federal law, you need a prescription from a doctor to purchase contact lenses – and they should be purchased from a licensed health care provider, who can teach you how to use them and take care of them.
Erica was told she could clean them with tap water – not saline solution.
Dr. Jules Winokur, a corneal specialist in New York City, said contact lenses purchased from beauty stores often don’t fit properly and the salespeople who sell them don’t give proper advice on how to take care of them or how to use them.
He said he sees several people come to his office with infections because they use such lenses, and he advises it’s not a good idea.

Diversity Of Gut Bacteria Could Be Factor In Obesity Risk.

2013-08-29T09:16:00.002-07:00

Interesting

Diversity Of Gut Bacteria Could Be Factor In Obesity Risk.

In its “Shots” blog NPR (8/29, Stein) reports a study published in the journal Nature has found that the diversity of the bacteria in a person’s gut can play a role in determining if they will “gain weight, become obese and develop risk factors for serious health problems.” The study analyzed the microbes in the guts of 292 participants, 169 of whom were obese and 123 of whom were lean. The researchers found the lean participants “had higher microbial diversity than the obese,” and the obese participants with lower bacterial diversity had a greater likelihood of weight gain over time.

The Huffington Post (8/28) adds that the researchers also found that the makeup of gut bacteria in obese people “may be provoking mild inflammation,” that could increase the risk for developing chronic conditions including heart disease and diabetes.

HealthDay (8/29, Dotinga) notes that a second study published in the same issue of Nature involved the analysis of gut bacteria in 49 obese and overweight participants trying to lose weight on “diets that were low-fat and low-calorie but high in protein plus fiber-rich foods like vegetables and fruits.” According to the researchers, “the diet appeared to actually change the bacterial makeup in the guts of the participants.” The Daily Mail (UK) (8/29, Innes) also reports on the studies’ findings.

http://consumer.healthday.com/vitamins-and-nutritional-information-27/dieting-to-increase-fiber-health-news-194/your-gut-bacteria-may-be-key-to-obesity-risk-679637.html

Children's Eye Injuries Peak in Summer, Expert Says

2013-06-27T04:55:00.002-07:00

Children's Eye Injuries Peak in Summer, Expert Says

Swimming pool accidents top the list

FRIDAY, June 21 (HealthDay News) -- Swimming pools are a major reason why children's eye injuries increase in the summer, according to an expert.
Eye injuries among youngsters start to rise in May and June before peaking in July. They then fall off in September after school begins, according to Gerald McGwin Jr., a professor in the epidemiology and ophthalmology departments at the University of Alabama at Birmingham.
"Overall, the leading cause of eye injury in children 15 and younger is sports, specifically swimming," he said in a university news release.
Pool chemicals, which can cause eye irritation, are a common cause of eye injuries.
"Ensuring that a pool's pH level is within normal range is one way to reduce these injuries," McGwin said. "Goggles and swim masks are another way by providing a barrier between eyes and water."
Other causes of pool-related eye injuries include being hit by water toys or by elbows and feet.
Household chemicals and cleaners are another cause for concern and account for 30 percent of eye injuries suffered by children younger than age 2. "The obvious solution for parents and caregivers is to keep dangerous chemicals and substances locked up or out of the reach of children at all times," McGwin said.
Other ways to reduce eye injuries include having children of all ages wear eye protection when playing sports and keeping children away from sparklers, firecrackers or any other types of fireworks.
The good news is that the number of eye injuries among children 15 and younger in the United States is declining, McGwin said. Reported eye injuries fell from a high of more than 80,000 in 1992 to a low of about 50,000 in 2010.

Computer vision syndrome can devastate sight

2013-06-06T05:05:00.002-07:00

Computer vision syndrome can devastate sight

It's a story millions of modern American workers know well: hours typing and staring at a computer screen, accompanied by neck pain and dry eyes. But health experts are just discovering the devastating effects it can have on your vision.
Like many people with a desk job, Linda Totanes said she stares at a computer screen 10 hours a day. Over the last few years at work, she has watched her eye prescription deteriorate.
"It just started out like -1.00, -2.00, -2.50, -3.75 and it eventually got to -4.50, and I'm like, 'Oh my God, I really can't see anything,' " said Totanes. "Without help, I literally can't see you sitting in front of me."
Now, at just 39 years old, Totanes said her night vision is gone. She said her failing vision, combined with the blinding halos of light she sees around headlights, has made her stop driving in the dark.
"I don't trust myself with my son in the back seat," said Totanes. "I never thought at this age this would happen. But I think, 'What if I hurt someone, what if I crash?' It's not worth it."
Totanes was diagnosed with computer vision syndrome, and she's not alone.
According to the National Institute of Occupational Safety and Health, up to 90 percent of Americans who use a computer for more than three hours a day have symptoms. The American Optometric Association lists the symptoms as eyestrain, fatigue, headache, dry eyes, neck and back pain, double vision and blurred vision.
Experts say what's startling is how young people are seeing some of the most severe symptoms.
Melissa Banila is 30 years old. After working 16-hour days behind a computer screen, she said she has narrowly avoided several car accidents, swerving through lanes to pull over, completely unable to see.
"After a long day at work, my contacts would fuse to my eye," said Banila. "I couldn't see; I didn't see someone next to me. I could have gotten in an accident. That was really scary for me."
Dr. Sandy T. Feldman, medical director at Clearview Eye and Laser Center in California, said one in six patients who come to see her have symptoms of computer vision syndrome.
"It's amazing; it's a growing, growing problem," Feldman said. "We consider this a public health emergency."
She said computer vision syndrome is of particular concern for children, many of whom spend hours staring at phones, tablets, computers and television screens.
"We should think about our child's eyes. They are growing and we want to reduce the potential for nearsightedness," Feldman said.
Perhaps related to the effects of screen time, nearsightedness is on the rise. According to the National Eye Institute in Bethesda, Md., in the U.S., 42 percent of 24- to 54-year-olds are nearsighted, compared to just 25 percent in that age group 30 years ago.
Meanwhile, research from the Department of Health Management at I-Shou University in Taiwan reveals nearsightedness in the current Chinese population stands at an alarming 86 percent. The study's authors point to reading small screens on smartphones.
So what can you do? Feldman says you should wear the right prescription at the computer or have special computer glasses. You can also tilt the screen 15 degrees down and make sure it sits 20 inches away from your eyes. She emphasizes reducing glare on the screen and adjusting the brightness in different environments. But, most importantly, follow the "20-20-20" rule.
"Every 20 minutes you're staring at the screen, look 20 feet away for 20 seconds," said Feldman. "It's easy to remember and it works."
Both Totanes and Banila recently underwent eye surgery, hoping for a cure to their vision woes. Both said they are recovering well and can't wait to see results.
"You hear about people in their 60s and 70s with eye problems, but at my age? And from my computer? I never thought," said Totanes. "It's kind of sad. I mean, vision is everything."
(Reach Natasha Zouves at natasha.zouves@10news.com. Distributed by Scripps Howard News Service, http://www.shns.com.)

http://www.naplesnews.com/news/2013/jun/04/computer-vision-syndrome-can-devastate-sight/

Want to halt the progression of near sightedness in children?

2013-05-22T06:27:00.001-07:00

Want to do something about your nearsightedness increasing every year. Corneal molding is showing a growing body of evidence that it slows/halts nearsighted progression.

"Researchers have reported positive first-year results from a clinical trial that is testing whether specialized contact lenses can slow or halt the progression of near sightedness in children."

http://www.prweb.com/releases/2009/07/prweb2612144.htm

https://www.facebook.com/SMARTTrial

We are training physicians to take care of the 1%

2013-05-13T14:25:00.002-07:00

Food for thought

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We are training physicians to take care of the 1%

Andrew Morris-Singer, MD | Education | May 10, 2013

“That makes no sense!” a friend recently blurted out to me after I finished helping her understand how the vast majority of internal medicine residents are trained in this country. Her incredulousness was less about the “how,” and more about the “where.”
No doubt. When you consider that the overwhelming majority of practitioners will ultimately be practicing almost exclusively in the outpatient environment, and that cost-conscious healthcare reform efforts are specifically trying to replace hospital-based, predominantly late, “sick care” with proactive and preventative ambulatory care, it’s remarkable that future physicians spend so much of their time training on the wards of academic hospitals. The research supports what so many of us avidly question.

For some time, a number of primary care advocates have been trying to call attention to the imbalance between ambulatory and hospital-based training in this nation. They have grown impatient with the manner in which inpatient, largely reactive care, is prioritized in curriculum while primary care is treated as an afterthought, at best, or superfluous at worst. And these advocates have grown increasingly frustrated watching this phenomenon drive unnecessary health spending tied to overprovision of expensive tests, overutilization of inpatient services, and a lack of commitment to basic prevention and coordination activities.
But while primary care advocates are tuned in to these problems, the typical patient has no idea of the level of dysfunction. And honestly, I can’t help but wonder if they would even see the current situation as problematic. Americans are in love with technology. They view specialization as progress. Many patients would voluntarily go for the full body CT scan (much to the horror of their primary care practitioners), as they’ve been taught to believe that more information and tests are better. The academic hospital, housing the most cutting-edge technology, biomedical science, and specialized medical professionals, therefore, becomes the Promised Land.
Yet only 1% of American patients will be treated in these super-specialized institutions in any 3-month period. The vast majority of us have a set of healthcare needs requiring treatment approaches that can’t be found within most of these institutions. “We don’t carry that,” would be the honest response an average American would hear if they approached the academic hospital information desk to find out where in the hospital they could go to get help to lose weight non-surgically, control their blood pressure and other chronic diseases, find resources to treat their depression and anxiety, or meet health coaches to help them manage their overall health. “But that’s what I need,” they’d say. “That’s what the vast majority of us need!”
So if that’s what your average American needs to promote and protect their health, and those things are frequently absent from the basic services of the academic hospital, why do almost all of our trainees spend the preponderance of their medical training confined to these halls, taking care of the 1%? You’re probably thinking, “This is partly due to our collective desire to prepare them to be able to identify and care for the sickest of the sick and manage difficult diagnostic dilemmas.” But does that require that they spend two-thirds of their time in the hospital? Is it possible that our predominantly hospital-based approach to training is leaving the next generation of practitioners relatively ill-prepared to care for the other 99% of us?
“Let me make sure I understand this,” my friend continued after I laid this all out for her. “It’s as if we took all of the veterinary students in the US, sent them off to the Galapagos Islands for 3 years to care for swimming lizards and flightless birds, and then brought them back to the US and expected them to figure out what’s wrong with our cats and dogs. They wouldn’t know where to start! They’d probably think my cat, Sprinkles’, purr was pathological or something…and they’d end up ordering a billion tests to figure out if she was dying! They might even stick a needle in her.”
Precisely.
Andrew Morris-Singer is an internal medicine physician and president and co-founder, Primary Care Progress.

http://www.kevinmd.com/blog/2013/05/training-physicians-care-1.html?utm_content=buffer7b9c6&utm_source=buffer&utm_medium=twitter&utm_campaign=Buffer

Symptoms of eyeglass related issues. Shaw lenses usually solve these issues.

2013-05-02T06:33:00.000-07:00

Here are the symptoms which are associated with image size issues and other binocular issues. Normal eyeglasses do not address these issues.
Shaw lenses do!

There's a reason you haven't liked your glasses

Increase In Nonrefractive Visual Impairment In US Tied To Diabetes.

2013-05-02T05:05:00.000-07:00

This is precisely why yearly [or as directed by your eye doctor] diabetic eye examination is critical.

Increase In Nonrefractive Visual Impairment In US Tied To Diabetes.

Print media covered a study suggesting that an increasing percentage of Americans are losing their eyesight due to the complications of diabetes. Because diabetes rates are on the rise, so are the complications of the illness, including those that affect eyesight.

USA Today (12/10, Szabo, Today) reports, "The nation's twin epidemics of obesity and diabetes are beginning to rob more Americans of their sight," according to a study published Dec. 12 in the Journal of the American Medical Association. "The percentage of American adults suffering from uncorrectable vision loss spiked 21% in only about six years, rising to nearly 1.7% of the population, according to an analysis of the years 1999-2002 to 2005-08." However, "rates of visual impairment doubled among poor people and those who had had diabetes for a decade or more," the study found.

The Los Angeles Times (12/11, Brown) "Booster Shots" blog reports that investigators, "led by Dr. David S. Friedman of the Johns Hopkins University School of Medicine in Baltimore, gathered survey and physical examination data collected from 9,471 US adults over the age of 20 in 1999 to 2002 and from another set of 10,480 Americans in 2005 to 2008." Then, "after analyzing a series of variables, including age, sex, race, schooling, income, obesity, diabetes diagnosis and amount of time since diabetes diagnosis, as well as visual impairment, they found that most of the risk factors for visual impairment had decreased or remained stable between the two time periods. The exception was prevalence of diabetes diagnosed at least 10 years previously, which climbed."

Bloomberg News (12/12, Ostrow) reports that "the rate of non-refractive visual impairment jumped 21 percent in 2005-2008 from 1999-2002," the study found. "About 2.15 million people in the US ages 20 and older suffer from non-refractive visual impairment, which can take surgery or lasers to repair, said" Friedman. "Based on today's findings, more effort is needed to prevent diabetes and ensure that those who have the disease get yearly eye exams, he said."

The Huffington Post (12/11) points out, "Non-Hispanic white people between ages 20 and 39 had a 40 percent increase in nonrefractive visual impairments, with the prevalence going up from 0.5 percent in 1999-2002 to 0.7 percent in 2005-2008." The study authors "reported that factors such as poverty, diabetes and lower education level are all linked with these kinds of visual impairments, but that only diabetes has actually increased between the two time periods -- suggesting that it could play a role in the increased rates."

According to MedPage Today (12/12), an accompanying editorial "concluded that the study findings should 'stimulate funding for new and ongoing efforts to prevent the underlying causes that lead to diabetes and its complications, such as obesity-prevention programs aimed at children and adolescents.'" MedPage Today notes, "The study was supported by a grant from the CDC, the David Friedman Research Grant Award, the National Eye Institute, and the National Center for Health Statistics."

Also covering the story are Reuters (12/12, Pittman), HealthDay (12/12, Gordon), WebMD (12/12, Mann), and Medscape (12/12, Brown).

http://www.usatoday.com/story/news/health/2012/12/10/diabetes-obesity-vision-loss/1759777/