When I was eight, my eye doctor prescribed glasses for me to see the blackboard. The truth was, my vision was so bad I should have worn glasses all the time, but my mother told me that wearing glasses would make my vision worse so I walked around in a blurry haze for ten years until I got my first pair of contact lenses. When my own daughter needed glasses at the age of six (bad genetics from her dad) I made sure she wore them all the time so she would not miss out on seeing the beautiful details in the world around her the way I did (love you mom). One thing that concerned me however was how quickly her prescription changed, sometimes every six months. Back then the idea of slowing the progression of nearsightedness was not even in its infancy and according to the conventional wisdom of the time I had her wear bifocals. Fast forward almost twenty years and controlling the progression of nearsightedness is now a reality.
There are a couple of options out there such as Ortho K (wearing hard lenses overnight to reshape the cornea), atropine eye drops, and soft multifocal lenses with specific parameters to help blur certain parts of the vision and attenuate others. Although these modalities are FDA approved, they are not necessary FDA approved for myopia (nearsightedness) control. A few days ago CooperVision announced that they came out with a daily disposable soft multifocal lens called MiSight which is specifically approved by the FDA for myopia control. This is a very exciting addition to our arsenal of myopia control tactics and one that I believe will be embraced by both parents and eye care professionals alike due to its ease of use and availability. As soon as I get more information on the accessibility of the lens I will post a little more on how the technology works and who would be a good candidate for this treatment.
Age 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.
Symptoms 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.
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