Eye / Vision Problems
Eye-opening research provides important diagnostic tool for major childhood killer
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The eye can provide a very reliable way of diagnosing cerebral malaria, researchers in Malawi have shown. By looking at the changes to the retina, doctors are able to determine whether an unconscious child is suffering from this severe form of malaria or another, unrelated illness, leading to the most appropriate treatment.
Because malaria is so common in Africa, children may have an incidental malaria infection whilst actually having another life-threatening illness. This can confuse the diagnosis in an unconscious child. Doctors hope that widespread use of eye examination could greatly reduce the number of children dying from this major childhood killer.
Cataract Surgery to Eliminate Reading Glasses?
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Improvements in the lenses implanted in the eye during cataract surgery have led to a new - and controversial - surgical option for people with presbyopia, a common form of farsightedness that typically develops in middle age. But a new report from Harvard Medical School urges people considering this operation to weigh its risks, as well as its benefits.
The recently developed implantable variable-focus lenses, which enable people to see objects at varying distances by shifting their eyes slightly, are currently FDA-approved only for patients undergoing cataract surgery. But some ophthalmologists are also implanting them into the eyes of people without cataracts in order to correct presbyopia. This requires removing the eyes’ natural lenses, as is done in cataract surgery.
The Aging Eye: Preventing and Treating Eye Disease urges consumers to keep two things in mind before undergoing this surgery for presbyopia. First, it will not be covered by insurance unless you also have cataracts, and the cost can be $5,000 or more for each eye. Second, many ophthalmologists are reluctant to perform this procedure in people without cataracts because of the risks involved in any eye operation, as well as lack of information about long-term safety and effectiveness.
Glaucoma can worsen during pregnancy
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For women with glaucoma, pregnancy usually has no effect on their eye condition, but in some cases it does.
Glaucoma is characterized by increased pressure within the eyeball, which can lead to vision loss or even blindness if it’s left untreated.
A study of what researchers call the largest group of pregnant glaucoma patients ever compiled is reported in the Archives of Ophthalmology. “We found that although many glaucoma patients did quite well during pregnancy, some had a significant worsening of their disease,” senior investigator Dr. Cynthia L. Grosskreutz told Reuters Health.
Scientists slow vision loss with vitamin E, alpha-lipoic acid and other antioxidant chemicals
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Scientists at Johns Hopkins have successfully blocked the advance of retinal degeneration in mice with a form of retinitis pigmentosa (RP) by treating them with vitamin E, alpha-lipoic acid and other antioxidant chemicals.
“Much more work needs to be done to determine if what we did in mice will work in humans,” said Peter Campochiaro, the Eccles Professor of Ophthalmology and Neuroscience at The Johns Hopkins University School of Medicine. “But these findings have helped to solve a mystery.”
In patients with RP, rod photoreceptors die from a mutation, but it has not been known why cone photoreceptors die. After rods die, the level of oxygen in the retina goes up, and this work shows that it is the high oxygen that gradually kills the cones. Oxygen damage is also called “oxidative damage” and can be reduced by antioxidants. So for the first time, scientists have a treatment target in patients with RP, added Campochiaro. His team’s findings appeared in the July online edition of the Proceedings of the National Academy of Sciences.
New Hope for Wet Macular Degeneration Patients
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New imaging technologies for the eye pioneered at The New York Eye and Ear Infirmary, coupled with advanced medical treatments, are rapidly changing the outlook for many patients with macular degeneration, a retinal disease that in its worst form is a major cause of blindness in the United States.
“OCT-SLO in an innovative imaging technology that vastly improves our ability to manage the care of patients with ‘wet’ macular degeneration, the worst form of the disease,” said Richard Rosen, MD, a retina specialist at the Infirmary. “This leap in diagnostic capabilities, combined with the recent success of anti-angiogenic drugs, such as Avastin, which halt the progression of ‘wet’ macular degeneration, and in many cases improve eyesight, heralds new opportunities for treating a devastating disease.”
OCT-SLO, in addition to exceptionally high-resolution images of the retina, provides a way to precisely localize aberrant blood vessels which cause the disease. As a result, treatments can be localized and better monitored, as well. (Colorful diagnostic images are available).
A Possible Diagnosis for Dry Eyes and Mouth
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Most everyone can relate to an occasional bout of dry eyes or dry mouth. But if you live with both every day, it could be Sjo’gren’s (SHOW-grins) syndrome.
Typical signs and symptoms include dry, gritty or burning eyes, intermittent blurry vision, a dry mouth that causes difficulty swallowing, dental cavities and enlarged parotid glands. The parotids are a pair of salivary glands behind your jaw and in front of your ears. Other signs and symptoms may include dry skin or vaginal dryness in women, joint pain and stiffness and fatigue.
Genetic testing can improve newborn screening tests for hearing defects
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Researchers have identified several changes that could be made to existing newborn screening tests for hearing defects that could advance the standard of care in detecting deaf infants, according to an article in the New England Journal of Medicine.
Walter E. Nance, M.D., Ph.D., professor of human genetics in Virginia Commonwealth University’s School of Medicine, and Cynthia C. Morton, Ph.D., a professor of human genetics at the Harvard Medical School, have summarized four important criteria to be considered for screening programs throughout the country for newborn hearing defects. These include the prompt confirmation of abnormal results from screening tests; adoption of an etiologic focus to determine the cause of the deafness; initiation of molecular genetic testing for all newborns; and better recognition of infants at risk for late-onset hearing loss occurring prior to speech and language development.
Plasminogen activator inhibitor type 2 may play role in infection and dry eye
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Plasminogen Activator Inhibitor Type 2 (PAI-2), a protein found in various cell types including the skin, has been discovered in the tissue covering the eye and may have future clinical implications in various pathologies of the ocular surface such as eye infection or dry eye, according to researchers at the University of Pennsylvania and Temple University.
The researchers, led by Mina Massaro-Giordano, M.D., of the University of Pennsylvania’s Scheie Eye Institute, and Marcella Macaluso, Ph.D., of the Sbarro Institute for Cancer Research at Temple University, published their study,
“Cytoplasmic and nuclear interaction between Rb family proteins and PAI-2: a physiological crosstalk in human corneal and conjunctival epithelial cells,” in Cell Death and Differentiation (http://www.nature.com/cdd).
Glaucoma eye pressure higher in sleep: study
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Some patients with glaucoma may have greater pressure in their eyes during sleep, meaning that the severity of the disease can go unrecognized during exams that only involve daytime office visits, a study said on Monday.
Higher intraocular pressure, the force within the eyeball, and greater daily fluctuation in pressure may increase the risk that glaucoma will develop or worsen, according to the report in the February issue of Archives of Ophthalmology.
Researcher identifies key to macular degeneration progression
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Dr. Jayakrishna Ambati UK HealthCare physician and Associate Professor and Vice Chair of the Department of Ophthalmology and Visual Sciences, announced a discovery by his research team that will impact how physicians and patients approach treatment for macular degeneration.
Age-related macular degeneration (AMD) is the leading cause of permanent vision loss among the elderly in many industrialized countries, including the United States. Approximately 15 million people in the U.S. have the early “dry” form of macular degeneration. Of those patients, about ten to 20 percent go on to develop the late-stage or “wet” form of the disease. The earliest clinical indicator of macular degeneration is the presence of drusen, or extracellular deposits that accumulate beneath the retinal pigmented epithelium.
Patients may see scary lights during eye surgery
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Patients who are awake while undergoing surgery on the gel-like vitreous inside the eye often report seeing frightening lights, similar to what is experienced by cataract surgery patients, a new study shows. As a result, many patients say they would opt for general anesthesia the next time around, despite the greater risk.
About three fourths of patients perceived light during the surgery, Dr. Colin S. H. Tan of the Eye Institute at Tan Tock Seng Hospital in Singapore and colleagues report, and a significant minority reported being frightened by their visual experiences.
Vision Risk From ED Medications
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Men with a history of heart attack who use the popular erectile dysfunction medications Viagra or Cialis may be at increased risk for vision loss, according to new UAB research published in the British Journal of Ophthalmology. The study draws a link between the medications and non-arteritic anterior ischaemic optic neuropathy (NAION), which can cause vision loss in one or both eyes. “We found a strong link between use of Viagra or Cialis and NAION in men with a history of heart attack,” said Gerald McGwin, Ph.D., associate professor of ophthalmology.
“We found similar results in men with hypertension that, while not as dramatic, are substantial enough to indicate that men with a history of heart disease should be warned of the risks of NAION before use of these medications.”
Scientists Link Another Gene to Degenerative Blindness
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Researchers have labored for decades to understand blindness-inducing neurodegenerative diseases such as age-related macular degeneration (AMD) and retinitis pigmentosa (RP).
It has been a painstaking scientific journey as AMD and RP each belong to a complex family of disorders, in which every disorder has many forms and each form is encoded with a distinct genetic recipe. Even AMD, a major cause of vision loss in people over 60, is actually a collection of more than 50 diseases.
Elevated homocysteine levels may be a biomarker for increased risk of AMD
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People who have elevated homocysteine in their blood, an amino acid that is a known biomarker for cardiovascular disease, may also be at an increased risk of developing age-related macular degeneration (AMD), according to a study in the January issue of the American Journal of Ophthalmology.
This research was conducted at the Massachusetts Eye and Ear Infirmary and Devers Eye Institute in Portland, Ore.
National Glaucoma Awareness Month
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Glaucoma is an important public health problem in the United States, affecting at least 2 million people. It is the second leading cause of blindness and the leading cause of blindness among African-Americans. Yet it is estimated that half of those suffering from the disease in this country remain undiagnosed. The Department of Veterans Affairs urges everyone over 40 to seek screening for glaucoma during January which is National Glaucoma Awareness Month. People with a higher risk than others of getting the disease include:
