February Is Age Related Macular Degeneration Month

pexels-photo-902194.jpegAge Related Macular Degeneration (AMD) is one of the leading causes of vision loss in patients over the age of 60 in the United States.  Since February is AMD awareness month let’s talk a little about the detection, diagnosis, and treatment of this potentially visually devastating condition. The macula is the central part of the retina and if it is damaged central vision becomes impaired. There are two types of AMD, one is “dry” and one is “wet”. Dry AMD comprises roughly 90% of AMD patients and is characterized by thinning of the central retina and deposition of yellow spots (called drusen) in the macula. Although dry AMD is slow to progress and vision loss may be minimal, it can progress to a more intermediate or advanced form of dry AMD which can then progress to wet AMD. Wet AMD happens when abnormal and fragile blood vessels grow underneath the retina and then bleed (this is why it is called ‘wet’) causing destruction of the central vision. Dry AMD has no treatment per se, however there are lifestyle changes that can be taken in order to deter the progression from dry to wet. These lifestyle changes include smoking cessation, UV protection such as sunglasses, and ingestion of nutrients such as lutein and zeaxanthin in foods such as spinach or kale or in a vitamin supplement. Wet AMD is treated with drugs that are delivered into the vitreous (inner jelly like portion of eye) and go under the the broad umbrella term of “anti-VEGF” agents. Laser treatments and PDT (photodynamic therapy) are other treatments utilized in wet AMD.

blur-close-up-focus-906055Symptoms of macular degeneration include blurry vision, darkening of vision, loss of color vision and visual distortion. Once the central vision is lost, there is no way to restore it and low vision devices such as telescopes and magnifiers can be helpful to maximize the remaining vision. Early detection of AMD is crucial in order to preserve central functional vision which is why yearly eye exams are so important.

How many pairs of glasses do you have?

One of the biggest perks of being in the optical business is that I have a million pairs of glasses (only a slight exaggeration). While multiple pairs of glasses definitely contribute to a stylish wardrobe,  there are more important reasons to have more than one pair. The same way that you wear different shoes for different activities, you need different types of glasses for different visual tasks. High heels don’t work for marathons, flip flops don’t work for an interview, and when was the last time you saw someone wearing snow boots at the beach?

The most important second pair of glasses should be a quality pair of sunglasses – these are available in both prescription and plano (fancy word for non-prescription) as well as in single vision and progressive (for reading at the beach). Many of us who are on the computer for extended periods of time benefit from a specific pair of computer glasses which would incorporate an anti reflective coating with a blue light filter to help mitigate fatigue. I always tell patients to measure the exact distance between their eyes and the computer screen so we can come up with the optimal prescription. There are also special progressive designs for people who use multiple computers at multiple distances. People with hobbies sometimes have very specific needs as well. The musicians in my practice bring in their instruments and music stands and we calculate in real space what the perfect prescription should be (we have often been treated to impromptu concerts!) Crafters like myself who enjoy knitting and watching TV at the same time often need a specific pair of glasses as well. Fashion is another reason to have multiple pairs of glasses.

Going back to my shoe analogy, certain styles are intrinsically casual and would not work well at a formal event (like sneakers with a ball gown). Different colors and shapes as well as the addition of details such as crystals or interesting hardware elevate a frame from merely functional to spectacular. Building a glasses wardrobe is a creative as well as practical way to express your individuality. Our well trained staff will help you select the perfect pair(s) of glasses which will harmonize fashion, function, and fun!

Is Diet Soda Bad For Diabetics?

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We know that excess sugar is bad for diabetics so patients with diabetes turn to foods with artificial sweeteners to get that burst of sweetness without the dangers of sugar. A recent study in the journal Clinical and Experimental Ophthalmology has reported a linkage between diabetics who drink more than four cans of diet soda and the development of the blinding complications of diabetic retinopathy (severe leakage of blood vessels in the eye). It was not associated with the development of the less severe eye complications of diabetes or macular edema which is swelling in the central part of the eye.

This study is pretty scary. Diabetics rely on these artificial sweeteners on a daily basis to keep them safe from sugar and here is a study that says that these sweeteners can cause severe eye complications. Now what? This research is very new and the results have to be repeated in order to make definitive decisions about cutting sweeteners out of a diabetics diet. A confounding factor in the research also notes that people who consume a lot of artificial sweeteners also have a higher body mass index (they weigh more) as well as a worse cardiovascular profile. In other words, more studies are needed.

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So if I am diabetic and drink a lot of diet soda what do I do now? Admittedly this is a tough call. It would probably be wise to cut down the consumption of diet soda and try to switch over to water and stay tuned for further studies to be done.

‘Tis the season… for toy buying

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As a mom and an eye doctor I always tried to buy toys for my kids that were not just fun but that also helped develop their visual skills. One of the most important things to remember when buying gifts for kids is to keep it age appropriate. Nothing is worse than a kid who receives a toy or game that is frustrating to play because it is above the child’s skill set. Most toys have age levels printed on the front so it’s easy to stick to the age guidelines. Although iPad games and electronic devices may seem like super hot gifts, they actually can overstimulate young minds and experts recommend sticking to “classic” toys as gifts.

Dr. Mary Gregory (Omni Vision and Learning in Minnesota) and Dr. Kellye Knueppel (Vision Therapy Center in Wisconsin) are optometrists who specialize in developmental optometry and each has created her own list of toys that helps nurture specific visual skills. Here is an abridged list of my favorites.

  • Eye/hand coordination – toys like Lincoln Logs, Tinker Toys and Legos
  • Visual Memory – remember the game Simon with the colored flashing lights? Oldie but goodie.
  • Visual Perceptual skills – there are a lot of toys out there that fit into this category, including jigsaw puzzles, Battleship, Go Fish, Bingo, Old Maid , dominoes, and Bop It.
  • Visual Motor Integration and Fine Motor skills – finger painting, bead stringing, Lite-Brite (love this one) and Spirograph.
  • Imagination – any toy that allows you to play “pretend” falls in this category – current toys such as Fingerlings, Polly Pocket (yes, they are back!), and these adorable plushy pets called Pomsies are all on the Good Housekeeping’s list of top toys of 2018.

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No matter what toys you buy for the little ones in your life this holiday season it’s the time you spend face to face with your child that is the most rewarding present of all.

Happy Holidays!

National Diabetes Month

20739543558_58dae0d23b_cNovember is National Diabetes Month and this gives me the opportunity to get up on my soapbox and shout through my megaphone about the importance of yearly eye exams. For patients who know they have diabetes, dilated eye exams are crucial in order to ensure that there is no diabetic retinopathy in the back part of the eye which if not treated can lead to blindness.

So what is diabetes and how does it affect your eyes? Diabetes is a disease which according to the CDC affects more than 100 million Americans and interferes with the body’s ability to store and utilize sugar. Very often patients who are unaware that they are diabetic will experience scary fluctuations in vision which will bring them into my office to see what’s going on. At this point I will refer them out for blood work and a visit with the primary doctor to check for diabetes. Changes in blood sugar can cause these wild changes in the prescription which will stabilize once the glucose (sugar) levels are under control. Once someone has had diabetes for many years and/or has poor control of their sugar levels, the risk of having diabetic retinopathy skyrockets. Diabetic retinopathy happens when the small blood vessels on the back surface of the eye weaken and leak blood and fluid into the retina. If this progresses further without blood vessels shutting off and the creation of new abnormal blood vessels creating scarring which can cause vision loss and/or blindness.

How do you prevent this? The key is keeping blood sugar levels under tight control. This is accomplished by paying attention to diet, exercising, keeping blood pressure and cholesterol under control and not smoking – in other words – maintaining a healthy lifestyle. One important number to be aware of when you come in for your eye exam is your HA1C (or glycosylated hemoglobin) which reflects the overall blood sugar levels over a three month period. Generally this number should be under 7.

All diabetic patients get a letter sent to their primary doctor after their eye exam with the results of the retinal evaluation. If there is retinopathy the primary doc may have to tinker with the meds in order to achieve better glucose control. Above all, be vigilant about any vision changes that are scary or unusual. As I always tell my patients, nothing is stupid or trivial and I’d rather check you and find nothing than have you ignore something serious.