A short discussion on treatments of macular degeneration

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Macular degeneration is a common eye condition referring to the slow and painless deterioration of the central potion of the retina (macula). There are many types of macular degeneration, although the most common is known as AMD, or age-related macular degeneration. As the name suggests, this eye condition affects the elderly and is considered the leading cause of vision loss among Americans 60 years and older. AMD typically affects both eyes, though the appearance and severity of the condition could vary between the two eyes.

Currently, there is no cure for AMD, although several treatment options may be considered, depending on the type of age-related macular degeneration an individual has.

Dry AMD: This is the most common form and its onset is very slow. Individuals usually do not go completely blind and peripheral vision is rarely affected. Treatment plans usually revolve around minimizing the effects of dry AMD and involve low vision clinics. These health facilities would typically recommend corrective suggestions such as magnifying lenses, buying large print books, and using intensive reading lights.

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Wet AMD: This is less common but more aggressive and can result in severe central vision loss. There are two main treatment options for this. The first is Anti-VEGF (vascular endothelial growth factor) which prevents the growth of new blood vessels in the eye. This medication is injected into the eye using a very fine needle. This treatment, however, is still under research as not everyone reacts to the medication the same way. The other treatment option is laser surgery, which destroys abnormal blood vessels in the eye. While this stops the spread of wet AMD for a while, this is not a cure and should only be a last resort.

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Scientists and health professionals are still working on developing a cure for either type of AMD, although to date, there are only options for managing them. Ophthalmologists are, therefore, encouraging preventive measures to minimize the risk of acquiring such a debilitating condition.

Dr. Hitesh K. Patel is a renowned ophthalmologist in Edison, New Jersey. Learn more about eye health by following this Twitter account.

REPOST: Washington County woman lost her eyesight, not her 'vision'

Natalie Ruschell shares her “walk from darkness to light” story and the journey that has helped her develop many personal mantras, including “It’s alright to be blind as long as you never lose your vision” and “people helping people.”

Natalie Ruschell of Midway, Washington County, talks about the day she lost her vision. Ruschell lost her eyesight in 1987 when she was in law school. She went on to pass the bar exam and became an attorney. | Image Source: triblive.com

This time, opening her eyes did not help.

Natalie Ruschell awoke in her bedroom and saw nothing but impenetrable darkness. When she heard the sound of morning rush hour traffic outside her window, she knew she was in trouble.

“I rolled over to my right side so I could face the window and there was nothing, nothing there,” said Ruschell, 55, of Midway, Washington County. “I rolled back over to my left side to see the clock, but I couldn't see the digital display, I couldn't see it. I tried to see my nightstand — nothing. I tried to focus in on my desk, because it's a lot bigger; I couldn't see my desk. Finally, I tried to just see the walls, and I couldn't.

“I leaned back, took a deep breath and thought, ‘How do I get out of this room?' ”

Ruschell had feared this day.

When doctors told her she had diabetes at age 12, they explained the potential life-altering or even life-ending complications associated with the disease. Among them was the loss of sight. So she began closing her eyes for long stretches, trying to figure out if she could navigate her world in complete darkness.

“I wanted to understand that sensation because it really scared me,” she said. “They told me about kidney disease, heart disease — I didn't care about that stuff. But blindness? I never wanted to be there.

“When I closed my eyes, it was uncomfortable, very uncomfortable, but I could always open them. It was still frightening, but I always knew that I could open my eyes.”

Not this time.

Ruschell slowly got out of bed. She took short steps to her desk, followed the edge until it led her to the door, then stepped into the hallway. With her hand on the wall, she passed her roommates' doors and approached the dining area. She reached out for the kitchen table, found it, then eased into a chair.

For close to an hour she sat there, figuring out what to do next.

Ruschell was a third-year law school student in 1987 at Western New England College in Springfield, Mass. She needed to call someone back home in Midway, but who? Her parents were on vacation. One of her sisters was off at college and the other sister, a flight attendant, was on a plane.

That left her best friend, Debbie. She reached for the phone and carefully dialed.

“I just went blind,” Ruschell said calmly.

There was a long silence, followed by: “What?”

“I lost my sight,” Ruschell said. “I've gone blind. And I have to get home.”

Her roommates helped her onto the plane. When they left and the plane roared into the sky, terror set in.

“I was in this little tube and I was going very, very fast and I didn't know where the exit doors were and I didn't have any idea what I'd do in the event of an emergency,” she said. “I was totally by myself. I didn't know anybody on either side and nobody offered to help. I was by myself and just praying that I'd get there.”

Doctors did what they could. There were long hospital stays. Ruschell had multiple surgeries. Hopes for a recovery soared.

“Then one day the doctor squeezed my hand and said, ‘I'm sorry. We can't save your eyesight.' ”

So Ruschell went home.

And she studied.

She could not read Braille yet, so her mother read to her every morning. After lunch, her father, sister or a friend took over until supper.

When the day came to take the bar, she went to Soldiers & Sailors Memorial Hall & Museum in Oakland. Proctors gave Ruschell extra time; they let her mother accompany her to read aloud the questions. Ruschell dictated her answers.

Weeks later when the envelope arrived, Ruschell wondered: What if I failed?

“Then we'll try again,” her mother said, and she opened the letter.

Her mother began to scream, You passed, you passed!

“I was weak,” Ruschell recalled. “I just started to cry.”

Today, Ruschell, a lawyer, is the founding member of Ruschell & Associates LLC, which has law offices in Midway and the South Side. She is licensed to practice in Ohio and West Virginia as well.

Sitting in her office recently, she considered the things she once saw.

“At least I had the opportunity to see the beauty of a day.”

And she recalled a boy she met in a hospital. He had leukemia and had gone blind from chemotherapy. They were playing bingo in a room full of sick children. The boy won. But when staff handed him his award, he broke into tears.

He said he wanted to see what he had won. But he never would.

“I used to pray, please don't let me lose my vision,” Ruschell said. “I didn't. I lost my eyesight. ... I knew what I wanted to do, I knew how to do it, and I knew I could do it. I realized that I would always have the vision to see what I was winning.”

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REPOST: Superman contact lenses will help pensioners with bad eyesight see like Clark Kent

Initially developed for military use,  prototype contact lenses could give wearers a superhero-like vision. This article gives us more insight about this revolutionary lenses.

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Telescopic contact lenses made to help elite military forces could give the elderly superhero vision.

Scientists have been developing ­miniature binoculars that soldiers can pop on in the blink of an eye. Experts now say this technology can be adapted to aid OAPs with fading sight.

Dr Eric Tremblay of the Swiss Federal Institute of Technology, Lausanne, said yesterday the lenses “hold a lot of promise” for people suffering age-related macular degeneration and could help pensioners with tasks such as driving.

The super-lenses have an inner area that offers normal vision and an outer zone which magnifies by three times. They use sensors and polarised light to switch from normal to magnified vision with the aid of electronic glasses.

Dr Tremblay, who led the research, said: “People with AMD use their ­peripheral vision to see to the side of their blind spot. When they try to read it’s difficult because your visual acuity falls off away from the centre.”

The lenses could be rolled out to help the elderly within two years.

Trials have taken place with funding from the US Defence Advanced Research Projects Agency.

Scientists are now trying to make the lenses more comfortable to wear.

Dr. Hitesh K. Patel is an ophthalmologist specializing in the prevention, diagnosis, and treatment of cataracts. Visit this Facebook page for more discussion on eye care.

Different ways pregnancy can cause eyesight problems

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When a woman is pregnant, it’s not just her belly and feet that undergo changes. Shifting hormones and fluid retention may also affect the eyes, resulting in temporary vision impairment.

Water retention is thought to be the main cause of this slight change in eyesight; the body is holding so much water during pregnancy that it causes an increase in the thickness and curvature of the cornea and changes the shape of the eyeball. This results in blurred vision, double vision, and sensitivity to light. In some cases, women could see spots or flashes of light, or even temporary vision loss.

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Those with existing eye conditions may also experience changes – for better or for worse. Women with diabetes may experience diabetic retinopathy which worsens eyesight, while those with glaucoma may see notice an improvement in their condition. It is not recommended though that pregnant women get new eyeglasses or contacts, since the change is only temporary and will go back to normal after a few months after delivery.

Vision is not the only thing affected by pregnancy and breastfeeding. Some women experience dry eyes (caused by lack of lubrication and moisture), causing their eyes to become red and have that itchy and burning sensation. Applying artificial tears usually helps relieve dry eyes as long as their physicians deemed it is safe for pregnant women to use.

However, changes in vision during pregnancy should not be ignored. Even if it’s just a slight change, it may be an indication of problems like high blood pressure or preeclampsia. A trip to the doctor when any changes in eyesight become evident is highly recommended.

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Dr. Hitesh K. Patel of Edison, New Jersey, is the founder of Patel Eye Associates and Patel Eye Care and Rehabilitation Foundation. Follow this Twitter account for more eye care tips and articles.

REPOST: Common glaucoma drug reduces risk of vision loss

A new study supports the benefits of widely used glaucoma drug. This article has the details.

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A pressure-lowering eye drop has been found to greatly reduce the risk of vision loss in people with open angle glaucoma (OAG), one of the leading causes of blindness.

The trial to assess the vision-preserving effect of prostaglandin analogue eye drop, which is already in common use for treatment of glaucoma, confirmed its efficacy.

"Our findings offer solid proof to patients and practitioners that the visual deterioration caused by glaucoma can be reduced using this treatment," said lead author David Garway-Heath from UCL (University College London) Institute of Ophthalmology.

OAG currently affects around 45 million people worldwide.

Vision loss from glaucoma occurs when the optic nerve is damaged. In most cases, increased pressure inside the eye (intraocular pressure), is thought to contribute to this damage.

"Medication to lower raised eye pressure has been used for decades as the main treatment for OAG to delay progressive vision loss," Garway-Heath explained.

"But, until now, the extent to which the most frequently prescribed class of pressure-lowering drugs (prostaglandin analogues) have a protective effect on vision was not known," Garway-Heath added.

The study recruited 516 newly diagnosed, previously untreated individuals with OAG in Britain.

Half were randomly assigned to daily pressure-lowering eye drops and the other half to a matching placebo.

The risk of visual deterioration was over 50 percent lower in the group treated with daily pressure-lowering eye drops compared to those using placebo drops over 2 years.

The study was published in the journal The Lancet.

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REPOST: Games and apps help to improve student's vision

Gaming has always been seen as something that eads to poor eyesight, but the same cannot be said to some games and apps today. This article from Hillsdale Daily News talks about Carson McVey, a first-grader who plays games to improve his eyesight.

With a smile on his face Pittsford Elementary School first-grader Carson McVey plays Bingo with Lisa Pelc, Hillsdale Intermediate School District impaired-orientation and mobility specialist. Image Source: hillsdale.net

With a big smile on his face Pittsford first-grader Carson McVey, 6, yelled "Bingo!" after covering all of his numbers.

With the "Bingo!" McVey received a high-five from Lisa Pelc, Hillsdale Intermediate School District impaired-orientation and mobility specialist. Pelc, who has worked with McVey since preschool, said the game helps McVey with his scanning and number recognition.

The Bingo game is just one of the many exercises the two work through during their weekly sessions to help improve McVey's eyesight.

McVey had cataract surgery last year to improve his vision. Before the surgery he was forced to use a magnifying globe to read and he couldn't see things far away.

"He is getting so good with his reading," Pelc said.

Since the surgery McVey, who now wears bifocals, can read letters from across the room and up close.

Pelc said she is amazed by the changes she has seen in his vision.

Using an iPad outfitted with several apps dedicated to improving vision, Pelc helps McVey work on his reading, sight words, spelling and color recognition.

With a nod McVey said he enjoys using the iPad for learning.

Pelc said all of the new apps for the iPad have been very beneficial to the students she works with on a daily basis. Several of the apps are also aligned with Michigan's Common Core requirements.
Pelc works with approximately 13 students on a weekly basis at several of the schools in the county. She also checks-in on other students who use vision tools in the classroom.

Pelc stressed the importance of catching vision problems at an early age in children to get them corrected. Early detection and treatment can improve a child's learning as they enter school.


Edison-based ophthalmologist Dr. Hitesh K. Patel founded the Patel Eye Associates to treat various  eye conditions. Follow this Facebook page for more information on eye care and treatment.

REPOST: Stem Cells Show Potential Benefits for Eye Diseases

A Massachusetts biotech firm reported that a treatment based on embryonic stem cells might help restore vision. This article from the Wall Street Journal further explains this study.

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Vision Improves for Some Patients in Clinical Trial

Researchers have used stem cells from human embryos to treat patients suffering from severe vision loss, the first time the technique has been shown to be both safe and potentially effective in a sustained way.

The clinical trial, done in 18 U.S. patients, is an important advance in the quest to get the controversial treatment to the clinic—a road marked by years of ethical concerns and legal and political battles.

The latest trial was designed to test whether the stem-cell approach was safe and didn’t lead to tumors or other serious side effects. On that score, the trial was successful.

“It has come through with flying colors,” said Chris Mason, professor of regenerative medicine at University College London, who wasn’t involved with the study.

Given the small number of participants and lack of controls, it is harder to ascertain whether the treatment is broadly effective. Nonetheless, some participants seemed to benefit.

One patient was a 75-year-old rancher from Kansas whose eyesight improved to the point where he could ride a horse again. Another patient went to the mall for the first time. Another traveled to the airport by herself.

“We’ve been hearing about embryonic stem cells for a long time,” said Robert Lanza, chief scientific officer of Advanced Cell Technology Inc., ACTC +3.31% of Marlborough, Mass., and co-author of the study, published Tuesday in the journal Lancet. “We needed some news to show this technology is indeed safe and can help people.”

Embryonic stem cells are master cells that can become all the other cells in the body. The hope is that they can be manipulated to create fresh tissue to transplant into patients and thus treat a range of ailments, from Alzheimer’s to strokes.

It is a controversial approach. Some people oppose removing stem cells from a human embryo because it gets destroyed in the process. They believe that is tantamount to destroying a life.

The stem cells in the trial were used to treat two debilitating eye diseases. One, dry age-related macular degeneration, or AMD, is responsible for more than 80% of the blindness in the developed world. The other, Stargardt’s disease, is the most common form of juvenile blindness and afflicts more than 25,000 people in the U.S. alone.

Both involve the retina—a layer of tissue inside the eye that houses two kinds of light-sensitive cells, rods and cones. There is another layer called the retinal pigment epithelium, or RPE.

The job of RPE cells is to nourish and support the rods and cones. When either of these diseases strikes, the RPE cells stop functioning properly, causing the rods and cones to deteriorate and leading to a progressive loss of vision.

In their trial, Dr. Lanza and his colleagues first obtained an eight-cell embryo from a fertility clinic. (The embryo was left over from fertility treatments and was destined for destruction.) They extracted a single cell, multiplied it in a lab dish and converted some of the resulting cells into RPE cells. The lab-made RPE cells were then injected into the eye.

Transplanted cells appear as a dark spot on the retina of a person with macular degeneration. | Image Source: technologyreview.com

 Half the patients suffered from dry AMD, and half had Stargardt’s. For each patient, the lab-made cells were injected in the eye with the poorer vision. The median follow-up period was 22 months. The trial demonstrated that even after several months, the transplanted cells remained in place and didn’t trigger adverse immune reactions or tumors.

Vision tests suggested that 10 of the 18 treated eyes had improved sight, with eight patients reading more than 15 additional letters on a reading chart in the first year after transplant. Visual acuity remained the same or improved in seven patients, though it decreased by more than ten letters in one patient.

Overall, “we’re seeing a visual improvement,” said Dr. Lanza of Advanced Cell, which funded the study. “That was not what we were expecting—it’s frosting on the cake.”

What could account for the apparent change in vision? Dr. Lanza suggests that some rods and cones in the eye might remain dormant and the lab-made RPEs recharge them so that they function properly.

The research still has a long way to go. Because there were no controls, such as placebo injections in the patients’ eyes that weren’t treated, it isn’t clear whether the improved vision was because of the treatment or some other factor. To help answer that question, the scientists plan to launch a larger trial by the end of the year involving 100 Stargardt’s patients and several dozen who suffer from dry AMD.

Dr. Hitesh K. Patel established Patel Eye Associates to different eye conditions, including myopia, hyperopia, and glaucoma. Visit this Facebook page for more updates.