January Is Glaucoma Awareness Month

Glaucoma is one of most misunderstood eye diseases that eye doctors treat. Most people have heard of glaucoma and know they don’t want to have it, but I’ve found that most of my patients aren’t really sure how it damages vision or how it gets treated. 2.7 million people in the United States have glaucoma and it is the second leading cause of blindness.

Certain types of glaucoma are painless, which gives the disease the dubious distinction of being called “the sneak thief of vision”. It is a disease that damages the optic nerve in the eye causing progressive loss of peripheral vision, and by the time someone notices that they have lost portions of their visual field it is too late, and that visual loss is irreversible. One of the variables that causes the optic nerve to sustain damage is elevated intraocular pressure. If the pressure in the eye is extremely high, the eye will be painful, but the majority of patients only have moderately elevated pressure and will not know it is high until it is detected on a routine eye exam. Factors that increase the risk of developing glaucoma include being African American, having a family history, hypothyroidism, being over 60, and previous eye trauma. Typically, the initial treatment modality is using eye drops that lower the intraocular pressure,  but more advanced or complicated cases may need laser or surgery.

A disease such as glaucoma is a perfect example of why everyone needs routine eye care, even if they have 20/20 vision, since evaluation of the optic nerve, peripheral vision, and eye pressure measurements in the office are key to preventing devastating and permanent vision loss. 

New Contact Lenses Prevent Sight From Worsening!

asphalt road between trees

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.

Don’t Blame The French Fries!

bowl of french fries

Last month a story came out of England about a teenager who went blind from eating only junk food. I found this very interesting and bookmarked the article so I could blog about it when I had the time. Well oopsie, September passed by in a blur and the email I had saved with the link to the article got buried in my inbox until yesterday when in a frantic attempt to organize my life by starting with my work emails I encountered the article I had saved. After doing a little research on the story I was glad I waited to share the information because the initial story that most of the media outlets shared left out certain details that misrepresented the real lesson to be learned from this young man’s tragic vision loss.

The basic story is that a teenager in the UK whose diet consisted of Pringles, white bread, french fries and occasionally some ham lost his eyesight to a condition called nutritional optic neuropathy which like it sounds, develops due to the lack of the proper nutrients that the eyes need in order to function. Many of the articles used this story as a cautionary tale, admonishing junk food eaters and parents of picky eaters that this is what could happen if you don’t eat a healthy diet. Turns out the young man who went blind was not a “picky eater” but rather , he had an eating disorder called ARFID (Avoidant Restrictive Food Intake Disorder) which led to various nutritional illnesses. The media however jumped on the bandwagon of the evils of junk food and fad diets instead of using the story as an opportunity to bring awareness to the importance of detecting mental health disorders in children and teenagers. Does poor nutrition due to a diet limited to french fries lead to blindness? Absolutely that can happen, but this story was way more complex than simply blaming Pringles and fries. 

June = Cataract Awareness Month

pexels-photo-902194.jpegContrary to popular belief, a cataract is not an eye disease, rather it is a natural age related change to the lens of the eye which causes it to become opaque and difficult to see through. Generally cataracts are very slow growing and most commonly develop in people over the age of 55. Signs and symptoms can be subtle at first, ranging from blurry vision, glare from headlights, difficulty driving at night and frequent eyeglass prescription changes. Most people come into the office complaining that their glasses are not working when in reality they are experiencing blurred vision from cataracts.

So what exactly is a cataract? There is a part of the eye called the lens which is located behind the iris, the colored part of the eye and it functions to focus light on the retina. When we are young the lens is clear and flexible but as we age the lens becomes opaque or cloudy and consequently images on the retina become blurred. Cataracts can also form in patients with diabetes, smokers, and those on certain medications like steroids. There is no proven way to prevent cataracts but UV protection, smoking cessation and a healthy diet that includes antioxidants can help prevent their premature development.

pexels-photo-690887.jpegHow do we treat cataracts? When cataracts start to interfere with quality of life and ability to function, surgical removal of the cataract is indicated. The lens of the eye is removed and replaced with an artificial lens which greatly improves vision. The most common comment I get on the first day after the operation is how bright and beautiful colors look. As with any surgery there are risks, but we co-manage surgery with the best cataract surgeons in order to ensure the best possible outcomes.

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.