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.

Image Source: opticianonline.net

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.”

Receive up-to-date information about the latest in eye health by liking this Dr. Hitesh K. Patel Facebook page.

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.

Image Source: mirror.co.uk

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

Image Source: eyecorrectionsydney.com.au

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.

Image Source: dailymail.co.uk

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.

Image Source: parentdish.co.uk

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.

Image Source: thehealthsite.com

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.

Image Source: ft.com

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.

Eye care through healthy eats: Three nutritious foods for optimal vision

Just like any other part of the body, the eyes need proper nourishment, too. Apart from carrots, there are several other common foods that promote healthy eyesight. The following are some examples:

Kale

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It's common knowledge that carrots contain beta-carotene, a carotenoid that easily converts into Vitamin A for good vision and overall health improvement. However, Kale and other leafy vegetables such as spinach and collard greens also contain carotenoids, specifically lutein and zeaxanthin. These two carotenoids are the only ones found naturally in the lens and retina of the eye. Studies show that eating food rich in lutein and zeaxanthin helps prevent the onset and slow the progression of cataracts and age-related macular degeneration (AMD) by preventing light-induced damage to the eyes.

A plus: kale also provides vitamins C, K, and B-6; calcium, magnesium, iron, and protein.

Salmon

Image Source: greenretaildecisions.com

Salmon contains large amounts of Omega-3 fatty acids. Studies suggest that the fish helps prevent macular degeneration and dry eye syndrome, as well as decreases the risk of glaucoma and ocular hypertension, a condition that causes abnormal pressure in the eyes which, if left untreated, leads to permanent vision loss in some people.

Those who don't like salmon can try substituting with fish oil supplements.

Almonds

Image Source: healthmag.ir

Almonds are a good source of vitamin E, which has been shown to reduce the risk of advanced AMD by 25 percent for those already exhibiting the beginning symptoms. Other studies suggest that vitamin E prevents or delays the formation of cataracts. It can also be found in vegetable oils, peanut butter, and sweet potatoes.

Eating a diet rich in the aforementioned foods and using preventative measures, such as wearing sunglasses in the daytime and limiting time in front of the computer, can help keep the eyes healthy and injury free.

Dr. Hitesh K. Patel is an Edison-based opthalmologist who specializes in the diagnosis, prevention, and treatment of cataracts. Learn more about eye care by subscribing to this blog.

REPOST: Eye Care Experts Stress the Importance of Annual Pediatric Vision Screenings

Dr. Norman Saffra, Director of the Division of Ophthalmology at Maimonides Medical Center, stresses the importance of annual pediatric vision screenings in this article on The Jewish Voice.

Dr. Norman Saffra, Director of the Division of Ophthalmology at Maimonides Medical Center, performs an eyesight screening. | Image Source: jewishvoiceny.com

Annual vision screenings are an essential part of preparing your child for Back-to-School. A child suffering from vision problems is at a disadvantage in the classroom, in sports, at home studying, and more.

“A child’s vision is constantly developing,” notes Dr. Norman Saffra, Director of the Division of Ophthalmology at Maimonides Medical Center. “It is even more important for children currently wearing glasses to be re-evaluated annually as their prescriptions may change as they grow.”

Parents should rely on their pediatricians for initial vision screenings. These screenings will detect common vision problems such as nearsightedness, farsightedness, blurred vision, and other eye abnormalities. If a problem is detected, the next step is to make an appointment with a pediatric eye care specialist for further evaluation and treatment.

“If parents notice a vision issue in between annual check-ups, they should be sure to schedule an appointment as soon as possible,” says Dr. Saffra. “When in doubt, check it out.”

Throughout the school year, take note of symptoms of developing vision problems. Signs may include: difficulty seeing the blackboard or reading books, excessive eye rubbing and increasing headaches. Take special note of children squinting or blinking frequently, or closing one eye when reading. If one eye seems droopy or drifting, your child may be developing a “lazy eye.”

“Not all vision problems are lifelong reasons to wear glasses,” points out Dr. Roman Polishchuk, Pediatric Optometrist at Maimonides Medical Center. “Sometimes as children develop, their eyesight needs minor corrective assistance, after which, your child can stop wearing glasses.”

The Maimonides ophthalmology team strongly urges parents not to miss their child’s annual vision screening.

The Maimonides Infants & Children’s Hospital is Brooklyn’s first and only fully-accredited children’s hospital, offering the full array of pediatric sub-specialties. The inpatient units feature an aquatic theme with fish tanks maintained through a partnership with the New York Aquarium. For more information on the outstanding clinical services provided at the Maimonides Infants & Children’s Hospital, visit our website at http://www.maimonidesmed.org/Pediatrics/MICH.aspx

Edison-based ophthalmologist, Dr. Hitesh K. Patel established the Patel Eye Associates for people in need of eye treatments. Subscribe to this Facebook page to learn more about eye care.

REPOST: Novartis-Google team on lens for diabetes, vision issues

 Among the new technologies in eye care that is in development is the "smart contact lens". Read this article from USAtoday.com for more details.

Image Source: usatoday.com

Google is teaming up with pharmaceutical giant Novartis to develop a "smart" contact lens intended to replace reading glasses for people who can't read without them and glucose monitors for those with diabetes.

For people with vision problems, the device would work like the autofocus of a camera, allowing them to focus on close-up things like the words in a book. It will be designed to work as a contact lens that is changed out regularly, or as an intra-ocular lens, permanently inserted into the eye during cataract surgery.

For diabetics, the lenses would replace regular finger sticks designed to read out a person's blood glucose level. Instead, the lens will "read" glucose levels in tears, sending information wirelessly to a handheld device that will warn patients when they need to eat or lower their glucose levels.

"These are issues that have been unmet medical needs for quite some time," said Novartis CEO Joseph Jimenez.

Novartis' eye-care division Alcon, based in Texas, inked the deal today to do the development work, along with Google X, an innovation lab at the information company's Mountain View, Calif., headquarters, which had previously announced plans to make "smart" contacts.

Jimenez, said he hopes the contact will be the first of many technologies the two companies develop together.

"It was very clear that there could be a very nice synergistic value between bringing high tech together with biology to solve some of the biggest health care issues that we're facing," Jimenez said.

The work is still preliminary, he said, with testing in people expected to begin next year. It will be a few years before the lens can be considered for regulatory approval and reach customers.

He said a price had not been decided for the lenses, and would not disclose how much the two companies will be investing in the project other than to say that it will be "commensurate with the business opportunity."

More than 1.7 billion people worldwide have presbyopia, the medical term for eyes that lose their ability to focus up-close with age, and more than 380 million have diabetes, he said.

Diabetes experts said they see two potential problems with glucose-monitoring lenses.

First, it's not clear whether glucose in tears, which the device would measure, changes in sync with the glucose in blood.

"There are no available data to show any reliability of this sensor," said Robert Ratner, chief scientific and medical Officer of the American Diabetes Association. "Is this going to be a situation where you have to change the contact once a day, once a week or once an hour? All of these are unknowns."

Second, diabetics are most at risk for crashing blood sugar levels at night while they're sleeping. But that's also when most people take out their contacts.

"Any type of contact device is going to need to be something that can be worn overnight if it's going to be able to realize the benefits people need, which is to get warning alarms when their glucoses are going out of range overnight," said Howard Wolpert, director of the Joslin Institute for Technology Translation at the Harvard-affiliated Joslin Diabetes Center in Boston.

For aging eyes, there are also many other alternatives to the contacts, from glasses to low-tech contacts to LASIK surgery, said Kerry Assil, an ophthalmic surgeon in Los Angeles.

But still, he said, if the "smart" contacts can be made to work, it would be a boon to patients. "Any new thing that can provide people with a slightly enhanced visual clarity, reduced side effects and so forth, tremendously elevates their sense of well being and their sense of confidence."

Dr. Hitesh K. Patel is an Edison-based opthalmologist and founder of the Patel Eye Associates. Follow this Twitter account to learn more about the latest trends in eye care.

Age–related macular degeneration: Family history is a factor

Image Source: optegra.com

 It is important to know your family history, particularly when it comes to eye diseases such as age-related macular degeneration (AMD). Studies have suggested that family history is a significant determinant in the development of eye diseases particularly in AMD. The risk increases if the person has an immediate family member, for instance, a parent or a sibling, who already has the disease.

Image Source: hollows.org.au

Macular degeneration is one of the leading causes of vision loss among those aged 50 and above. As the name suggests, it is the degeneration or loss of the macula, which is a small spot near the center of the retina. The macula is the part of the eye needed for sharp, central vision. This allows people to see objects that are before them. Damage to the macula would blur the image. Over time, the blurred image may get larger and the person could develop blank areas in their central vision. Objects also do not appear as bright as they used to be.

 The development of AMD varies from person to person. Some people may not suffer from vision loss until after a long period of time. AMD does not lead to complete blindness. Nevertheless, the loss of central vision in AMD will affect how the person goes through everyday activities, such as driving, reading, writing, and cooking.
 


Image Source: aoa.org

 Unfortunately, early and intermediate stages of AMD are often without symptoms and go undetected. Only by using a comprehensive dilated exam can a person determine whether one has AMD. Still, AMD may be prevented through the use of proper lifestyle changes. It is also highly recommended to take a thorough audit of one’s family history to surmise potential risks.


Maintaining good eye health and treating eye-related diseases is the mission of ophthalmologist Dr. Hitesh K. Patel of Edison, New Jersey, and the primary reason behind the establishment of Patel Eye Associates. Receive up-to-date information about the latest in eye health by liking this Facebook page.

New studies asses patient’s adherence to glaucoma medication

A new study reveals that a fairly large number of patients suffering from glaucoma did not regularly use their prescribed eye drops.

Image source: www.atlanticeyeinstitute.com

The research, which was conducted at university-based glaucoma clinic, recruited 407 patients who were undergoing treatment that required daily prostaglandin eye drops. Aimed to measure their medical adherence, the patients were given a container with an electronic cap that recorded each time it was opened.

It was revealed later on that 82.8 percent of the participants took their medication properly on at least 75 percent of days, while the remaining 17.2 percent were not able to adhere to their prescribed medication.

Image source: www.oregoneyecenter.com

Furthering the study, the researchers made their second intervention by including text or voice messages to assist the patients with their eye drop medication.

As the experiment concluded, the researchers found that the adherence rate among those who failed to take their medication in the first batch increased from 53 percent to 64 percent.

Although the barriers to patients’ medication adherence were considered complex, the researchers concluded that the inclusion of text or voice messages can help patients adhere to their eye drop medication.

Image source: www.glaucoma.org

Given these results, the researchers noted that telecommunication-based reminders can help patients and doctors track one’s daily glaucoma medications. They further stressed that this latest discovery is essential because it can potentially support today’s ophthalmology practice.

Dr. Hitesh K. Patel is an Edison, New Jersey-based ophthalmologist. Read more about glaucoma and other vision problems at www.pateleyeassociates.com.

REPOST: Off with your glasses: Visual crowding linked to retina, brain processing

Tel Aviv University researchers discovered a link between sharp vision and brain's processing speed. Find out how the brain integrate visual formation from this ScienceDaily.com article.

 

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Middle-aged adults who suddenly need reading glasses, patients with traumatic brain injuries, and people with visual disorders such as "lazy eye" may have one thing in common -- "visual crowding," an inability to recognize individual items surrounded by multiple objects. Visual crowding makes it impossible to read, as single letters within words are rendered illegible. And basic cognitive functions such as facial recognition can also be significantly hampered. Scientists and clinicians currently attribute crowding to a disorder in peripheral vision.


Image Source: en.wikipedia.org

Now Prof. Uri Polat, Maria Lev, and Dr. Oren Yehezkel of Tel Aviv University's Goldschleger Eye Research Institute at the Sackler Faculty of Medicine have discovered new evidence that correlates crowding in the fovea -- a small part of the retina responsible for sharp vision -- and the brain's processing speed. These findings, published in Nature's Scientific Reports, could greatly alter earlier models of visual crowding, which emphasized peripheral impairment exclusively. And for many adults lost without their reading glasses, this could improve their vision significantly.

"Current theories strongly stress that visual crowding does not exist in the fovea, that it's a phenomenon that exists only in peripheral visual fields," said Prof. Polat. "But our study points to another part of the eye altogether -- the fovea -- and contributes to a unified model for how the brain integrates visual information."

 A trained eye

According to Prof. Polat, vision is dynamic and changes rapidly, but it takes time for the brain to process this visual information. Rapidly moving tickers on TV, or traffic signs seen as the driver speeds past, are difficult for anyone to read. However, given enough time, someone with excellent vision can fully recognize the words. Those with slower processing speeds -- usually the result of poor perceptive development or age -- may not be able to decipher the tickers or the traffic signs. In the study, Prof. Polat employed his expertise in improving vision by retraining the brain and the foveal part of the eye, using exercises in which speed is a key element.

 
Image Source: flickr.com

"Training adults to reduce foveal crowding leads to improved vision. A similar training we conducted two years ago allowed adults to eliminate their use of reading glasses altogether, using a technology provided by the GlassesOff company. Other patients who had lost sharp vision for whatever reason were also able to benefit from the same training and improve their processing speed and visual capabilities," said Prof. Polat. Maria Lev, who performed the study as a part of her doctoral thesis, said one young subject had experienced significant limitations in school for years and had been unable to obtain a driver's license due to severe visual impairment from foveal crowding. After undergoing training that emphasized a foveal rather than a peripheral focus, he was able to overcome the handicap.

 
Image Source: zmescience.com

 "He finally managed to learn to read properly and found his way forward," said Lev. "I'm proud to say that today he is not only eligible for a driver's license, he's also been able to earn his master's degree."  

Follow this Dr. Hitesh K. Patel Twitter page to get more updates on vision care.

REPOST: New eye layer has possible link to glaucoma, study shows

How will the new layer that's discovered in the human eye affect eye diseases like glaucoma? Read the answer from this ScienceDaily.com article.
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A new layer in the human cornea -- discovered by researchers at The University of Nottingham last year -- plays a vital role in the structure of the tissue that controls the flow of fluid from the eye, research has shown.

Image Source: foxnews.com

The findings, published in a paper in the British Journal of Ophthalmology, could shed new light on glaucoma, a devastating disease caused by defective drainage of fluid from the eye and the world's second leading cause of blindness.

The latest research shows that the new layer, dubbed Dua's Layer after the academic Professor Harminder Dua who discovered it, makes an important contribution to the sieve-like meshwork, the trabecular meshwork (TM), in the periphery of the cornea.

The TM is a wedge-shaped band of tissue that extends along the circumference of the angle of the anterior chamber of the eye. It is made of beams of collagen wrapped in a basement membrane to which trabecular cells and endothelial cells attach. The beams branch out randomly to form a 'meshwork'.

Pressure within the eye is maintained by the balance of aqueous fluid production by eye tissue called the ciliary body and drainage principally through the TM to the canal of Schlemm, a circular channel in the angle of the eye.

Defective drainage through the TM is an important cause of glaucoma, a condition that leads to raised pressure in the eye that can permanently affect sight. Around 1 to 2% of the world's population yearly have chronic glaucoma and globally around 45 million people have open angle glaucoma which can permanently damage the optic nerve -- 10% of whom are blind.

The latest research by Professor Dua and colleagues in Academic Ophthalmology at The University of Nottingham sheds new light on the basic anatomy of Dua's Layer, which is just 15 microns thick but incredibly tough. Comprised of thin plates of collagen, it sits at the back of the cornea between the corneal stroma and Descemet's membrane.

By examining human donor eyes using electron microscopy, the researchers were able to look at Dua's Layer beyond the central part of the cornea to shed more light on its features at the extreme periphery of the cornea. They discovered that the collagen fibres of Dua's Layer also branch out to form a meshwork and that the core of TM is in fact an extension of Dua's Layer.

It is hoped the discovery will offer new clues on why the drainage system malfunctions in the eyes of some people, leading to high pressure.

Professor Dua said: "Many surgeons who perform lamellar corneal transplant recognize this layer as an important part of the surgical anatomy of the cornea. This new finding resulting from a study of the microanatomy of the periphery of the layer could have significance beyond corneal surgery."

The breakthrough discovery of Dua's Layer was first revealed in a paper in the academic journal Ophthalmology in June last year and was widely covered by the world's scientific and lay media. The paper became the number one downloaded ophthalmology paper from the website ScienceDirect between July and September 2013 and was ranked the 11^th most downloaded from the website for the whole of medicine and dentistry.

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Dr. Hitesh K. Patel is the founder of the Edison-based eye center, Patel Eye Associates. Know more about him by following this Twitter account.

REPOST: Cause of destructive cascade of diabetic retinopathy

This MedicalNewsToday.com article discusses the roles  and effects of excessive ROS or reactive oxygen species in our body and how will it affect our vision.


The retina can be bombarded by reactive oxygen species in diabetes, prompting events that destroy healthy blood vessels, form leaky new ones and ruin vision.

Now researchers have learned that those chemically reactive molecules must come from both the bone marrow as well as the retinal cells themselves to cause such serious consequences.

"It's a cascade that requires two players to signal the next event that causes the damage," said Dr. Ruth Caldwell, cell biologist at the Vascular Biology Center at the Medical College of Georgia at Georgia Regents University.

The good news is the finding also provides two new points for intervention, said Dr. Modesto Rojas, MCG postdoctoral fellow and first author of the study in the journal PLOS ONE.

Excessive glucose in the blood prompts excessive production of reactive oxygen species, or ROS, and the light-sensitive retina is particularly vulnerable. Caldwell's research team had previously documented that ROS from white blood cells produced by the bone marrow as well as from retinal cells were the major instigators in diabetic retinopathy, a leading cause of blindness worldwide. But they weren't sure which mattered most.

So they looked as several different scenarios, including mice lacking the ability to produce ROS by either the retinal or white blood cells, and found that if either were lacking, future damage was essentially eliminated. "One alone can't do it," said Caldwell, the study's corresponding author. "They did not develop the early signs of diabetic retinopathy that we were measuring."

While blocking ROS production by retinal cells could be difficult, drugs already exist that reduce activation of white blood cells. Those cells not only make ROS, but also adhere to blood vessel walls in the retina that become sticky in diabetes, Rojas said. In fact, a study published in October 2013 in PLOS ONEshowed that neutrophil inhibitory factor could block the vascular lesions that are a hallmark of diabetic retinopathy without hurting the immunity of diabetic mice. The MCG scientists note that decreased activation does not impact the immune protection white blood cells also provide.

Next steps include studying those drugs in their animal models and learning more about how ROS causes the collateral damage that can destroy vision. "All of this is some sort of wound-healing response gone wrong," Caldwell said.

ROS, a natural byproduct of the body's use of oxygen, has healthy roles in the body, including cell signaling, but is destructive at high levels that result from disease states such as diabetes.



Dr. Hitesh K. Patel, an ophthalmologist, serves Edison, New Brunswick and all areas of Middlesex County, NJ. LASIK surgery is one of his specializations.Get more updates by following this Twitter page.

Research: Birth control use could increase risk factor for glaucoma

Research shows that long-term birth control use could be a risk factor for glaucoma, a blindness-causing ocular disorder that affects nearly 60 million people worldwide. The study, which was conducted by University of California, San Francisco, Duke University School of Medicine and Third Affiliated Hospital of Nanchang University, Nanchang, China, reveals that females who had used any kind of oral contraceptives for longer than three years are twice as likely to suffer glaucoma.

Image Source: nymag.com

The research is the first to establish a connection between long-term birth control use and increased risk of glaucoma. Researchers surveyed 3,406 female participants aged 40 years and older from across the United States using a vision and reproductive health questionnaire and eye exams.

Image Source: jama.com

The researchers advise gynecologists and ophthalmologists to be conscious that oral contraceptives might be a contributing factor in glaucomatous diseases, and that they should inform their patients to have their eyes screened for the blindness-causing disease if have other risk factors. Considered one of the leading causes of blindness, glaucoma is a condition that brings damage to a person’s optic nerve and gets worse over time. It is often associated with a buildup of pressure inside the eye and usually occurs in adults over age 40, but it can also manifest in young adults, children, and even infants.

Image Source: glenmorevisioncenter.com

Ophthalmologist Dr. Hitesh K. Patel of Edison, New Jersey is the founder of Patel Eye Associates, an eye care center that provides treatment and diagnosis of various vision problems such as cataracts, nearsightedness, and astigmatism. Know more about his expertise by visiting this website.

REPOST: Climate may play a role in the distribution and prevalence of trachoma

According to researchers, climate change can influence the transmission of the active stages of trachoma. This MedicalNewsToday shares the findings.

High temperatures and low rainfall are important factors which influence the occurrence and severity of the active stages of trachoma - the most common cause of infectious blindness - according to a new study published in PLOS Neglected Tropical Diseases.

Researchers from the London School of Hygiene & Tropical Medicine and Sightsavers carried out the first systematic review to explore links between climate and trachoma. They found temperature and rainfall appear to influence the transmission of the infection in Africa, possibly because the eye-seeking flies which spread trachoma are more active at higher temperatures and are more abundant in areas with low rainfall.

Trachoma affects more than 40 million people, but it is estimated that 1.2 billion people worldwide live in areas where trachoma is found and are at risk of going blind. The bacterial infection is either passed from person to person by contact with infected secretions from the eyes or nose on hands and clothing, or by flies that land around children's eyes. Repeated infection in childhood can lead to blindness later in life.

The World Health Organization has resolved to eliminate blinding trachoma by 2020 and is working with governments and partners to roll out the SAFE strategy*, which includes surgery to distorted eyelids, antibiotics for active infection, facial cleanliness and environmental improvement to reduce the spread of the infection.

However to ensure the disease can be eliminated on schedule, a greater understanding of all factors that affect the incidence of the disease is needed. This study brings together the evidence on the role climate factors have to play for the first time.

Study co-author Dr Sari Kovats, Senior Lecturer at the London School of Hygiene & Tropical Medicine, said: "Our findings will assist international efforts to map where trachoma occurs as we now have a clearer understanding of the role that altitude, temperature and rainfall can play. We need to increase research on the environmental determinants of blinding trachoma in order to make control measures more effective now and in the future."

Dominic Haslam, Director of Policy at Sightsavers and co-author of the study, said: "This review underlines the urgent need for organizations such as Sightsavers to step-up global efforts to eliminate trachoma, before regional climate shifts make the current situation worse. The blinding disease already causes devastating suffering to millions around the world, and yet we know that by promoting face washing, better hygiene and sanitation, we can help manage the spread of trachoma in endemic communities."

Founder of the Patel Eye Associates and Patel Eye Care and Rehabilitation Foundation, Dr. Hitesh K. Patel has served countless of clients in Edison, New Jersey, and beyond. Visit this Facebook page for more updates.

REPOST: New Laser Provides Cutting-Edge Treatment for Diabetes, Retinal Diseases

This ScienceDaily.com article shares the new laser, named Supra Scan Multi-spot Laser, which is said to prevent blindness for patients with severe conditions.


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A new laser is helping experts at the Truhlsen Eye Institute at the University of Nebraska Medical Center provide better treatment for eye diseases. This advanced laser can prevent blindness for some patients with serious conditions.

"This new laser with yellow light is currently the only one of its caliber in the U.S., and there's only one other being used in the world right now," said Quan Dong Nguyen, M.D., the McGaw Memorial Endowed Chair in Ophthalmology and director of the Eye Institute.

On July 22, the first patient received treatment from the laser for proliferative diabetic retinopathy, the most severe stage of eye disease caused by diabetes.

"This laser is the most cutting-edge laser device available today," said Diana Do, M.D., associate professor of ophthalmology and director of the Carl Camras Center for Innovative Clinical Research at the Truhlsen Eye Institute and the retina specialist who performed the first treatment.

"It allows us to apply a large number of laser spots in a variety of patterns," Dr. Do said. "Overall, it is more effective, efficient and may be safer than traditional lasers."

Traditional lasers are limited in the number of patterns and pulsing they can accommodate, whereas the new laser allows for more nuanced and problem-specific targeting, Dr. Do said.

The laser provides treatment for various rare eye diseases, including retinal vein occlusion, neovascular glaucoma, and retinal tears. In addition, with micropulse application capability, it also can be combined with other therapies to treat diabetic macular edema, the most common cause of moderate vision loss for diabetes patients.

"With diabetes rates on the rise nationally and in Nebraska, more and more patients will be able to benefit from the superior treatment that new technology like this can bring," Dr. Do said.

The full name of the laser is the Supra Scan Multi-spot Laser. It is manufactured by Quantel Medical, which is headquartered in Paris, France.

The Truhlsen Eye Institute, which opened in two months ago at 3902 Leavenworth St., is the newest building on UNMC's campus and offers state-of-the-art eye care in many eye subspecialties as well as routine prescription and optical shop services.

To make an appointment at the Truhlsen Eye Institute, please call 402-559-2020.

Through world-class research and patient care, UNMC generates breakthroughs that make life better for people throughout Nebraska and beyond. Its education programs train more health professionals than any other institution in the state. Learn more at unmc.edu.

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This Dr. Hitesh K. Patel blog site contains more articles on the latest on eye care. 

Preventing cataracts by living a healthy lifestyle

A cataract is an eye condition that causes a clouded vision, which is why people affected by it feel like looking at the world from behind a translucent glass pane. This condition can be resolved through surgery, but many people still become blind because they don’t have enough resources to have the procedure. Although there are still no proven studies on the prevention of cataracts, doctors believe that living healthy does help.

Image Source: acs.org

The Mayo Clinic lists some things that can be done in order to prevent or at least minimize the risk of acquiring cataracts:

• Having regular eye examinations. Regular eye examinations can help detect early-stage cataracts and their symptoms.

• Quitting smoking. A study published on Investigative Opthalmology & Visual Science found that adult smokers are at “an increased risk of age-related cataract.”

Image Source: stayhealthyla.org

• Reducing alcohol consumption. Although there are no studies that can conclusively say that alcohol causes cataracts, a study found that drinking more than two alcoholic beverages a day increases one’s risk factor for cataracts.

• Wearing sunglasses. Sunglasses can protect the eyes from UV damage, which may contribute to the development of cataracts.

• Managing other health conditions. Other medical conditions, like diabetes, can also increase one’s risk of acquiring cataracts. Managing those medical conditions can lessen cataract risk.

Image Source: drgeorgewaringiv.wordpress.com

• Maintain a healthy weight by exercising and eating a healthy diet that consists of fruits and vegetables. Fruits and vegetables have antioxidants that can help maintain or improve eye health.

It is important to understand that while a study how to actually prevent the onset of cataracts has yet to be proven, making these lifestyle changes early on can come a long way when one reaches a certain age where his or her risk of acquiring cataracts increases.  

Dr Hitesh K. Patel offers cataract treatment at Patel Eye Associates in Edison, NJ. This website contains more information about its services.

REPOST: Disparities in Eye Care Could Cost Some Their Sight

This report from USNews.com shares data from a recently published study on the relationship between social standing and age-related eye diseases: 


Americans with low incomes and education levels are less likely to get eye care, a new study finds.

Researchers examined data from nearly 3,600 people, aged 40 and older, who took part in the 2002 U.S. National Health Interview Survey, and 3,100 who took part in the 2008 survey. In 2002, people with low incomes were much less likely than those with higher incomes to say that they'd visited an eye doctor, about 63 percent versus 80 percent.

The investigators found that people with less than a high school degree were less likely than those with at least a college education to say that they'd visited an eye doctor (nearly 63 percent versus 81 percent, respectively) or to have had a dilated eye examination (just under 65 percent versus just over 81 percent, respectively).

"There is a need for increased awareness about the relationship between social circumstances and [age-related eye disease], and for more research to determine how income and educational inequalities affect health-seeking behavior at the community and individual level over time," Dr. Xinzhi Zhang, of the U.S. National Institutes of Health, and colleagues wrote in the report.

The study was published online July 18 in the journal JAMA Ophthalmology.

In recent years, there have been many medical advances in the treatment and prevention of age-related eye diseases, including macular degeneration, diabetic retinopathy and glaucoma. And, in the case of cataracts, vision loss many even be reversible. However, to benefit from these interventions people must have access to eye care, the researchers noted in a journal news release.



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