Smoking and Your Eyes

Smoking is the single largest preventable cause of eye disease.
smoking and your eyes
On the third Thursday of November each year, smokers across the nation take part in the Great American Smokeout, sponsored by the American Cancer Society. This might be the ideal time for you to stop smoking and ACS has information and resources you may find helpful.

Here are some things you should know about smoking and your eyes.

  • Smoking at any age, even in your teens or twenties, increases your future risk for vision loss.
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  • The more you smoke, the higher your risk for eye disease.
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  • If you quit smoking, your risk for these eye diseases decreases considerably.
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  • Smoking increases your risk for cardiovascular diseases that indirectly influence your eyes’ health.
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  • Women who smoke during pregnancy increase their chance for a premature birth and a potentially blinding eye disease called retinopathy of prematurity (ROP).
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  • A smoker is two times more likely to develop macular degeneration compared with a nonsmoker.
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  • Smoking double your chance of forming cataracts and the risk continues to increase the more you smoke.
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  • Smoking doubles your diabetes risk which can lead to the blinding eye disease, diabetic retinopathy.
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  • Smokers are more than twice as likely to be affected by dry eye syndrome as a non-smoker.
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  • Second-hand smoke also makes dry eye worse, especially for contact lens wearers and post-menopausal women.
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  • If you smoke you can have a three-fold increase in the risk of developing AMD compared with people who have never smoked.
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  • Smoking appears linked to the development of uveitis with smokers having more than twice the risk of non-smokers.

If you are looking to stop smoking you may also want to check out Smokefree.gov which provides free, accurate, evidence-based information and professional assistance to help support the immediate and long-term needs of people trying to quit smoking.

11/19/15

Susan DeRemerSusan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

Creating Cybrids to Study Age-Related Diseases

DEF Research Director Dr. M. Cristina Kenney’s research has shown that the mitochondrial DNA from different ethnic/racial populations may play a key role in determining that population’s resistance or susceptibility to disease (see previous article on 11/12/15 – Mitochondria and Age-Related Macular Degeneration). In order to study these effects, Kenney has developed the cybrid model using mitochondria from subjects of different ethnic/racial groups (Figure 1). The comparison of an individual’s mitochondria with that from other ethnic/racial groups (African, European, Asian or Ashkenazi Jewish) allows us to determine if their mitochondria determine that population’s susceptibility or resistance to disease and to response to drugs.

cybrids to study age-related disease
Figure 1 – Cybrids are cell lines with identical nuclei but the mitochondrial DNA from individuals of different ethnic/racial groups.

Personalized cybrids
Kenney’s cybrids are made with mitochondria from the blood taken from individual living donors. Looked at individually they are all really “personalized cybrids” because each cybrid test system has the mitochondria from the original donor and reflects the responses of that donor.

Using Cybrids to Study Age-Related Diseases

How is Kenney using these personalized cybrids?
Kenney is partnering with Dr. Pinchas Cohen, dean of the University of Southern California, Leonard Davis School of Gerontology, to explore how novel, small proteins produced from mitochondria might be used to treat a variety of age-related diseases such as age-related macular degeneration, Alzheimer’s, Parkinson’s, stroke and cholesterol. Cohen’s laboratory has discovered and characterized many of these new, small proteins called “mitochondrial derived peptides” (MDPs). His work has shown that these MDPs can protect brain cells from damage and early death, such as occurs in Alzheimer’s disease. Cohen and Kenney are now testing these MDPs in the K and H cybrids to assess their protective effects to stop retinal cell death, such as seen in AMD.

Kenney explains her approach:
“Our cybrid system represents a very powerful technique. We are now using the Ashkenazi Jewish population as an excellent model to learn how the mitochondria, with their unique mtDNA, influence the risk factors for AMD. We plan to extend the study to investigate Ashkenazi Jewish people’s susceptibility to Alzheimer’s disease, heart disease and stroke. Eventually, we believe the findings for the K haplogroup mitochondrial DNA will be applicable to other groups, as well.”

11/17/15

Anthony B. Nesburn, MD  FACSAnthony B. Nesburn, MD, FASC
President/Medical Director
Discovery Eye Foundation

Mitochondria and Age-Related Macular Degeneration

Research on mitochondrial DNA shows promise for treating AMD

For the past few years, DEF Research Director Dr. M. Cristina Kenney has been researching the relationship of mitochondria and age-related macular degeneration (AMD). She found that damaged mitochondria from people with AMD send signals that can cause retinal cells to die at an increased rate, compared with people who had healthy mitochondria and no AMD. That research led to the exploration of stimulating mitochondria to support retinal cell health in an effort to retain or restore vision for people with AMD.

Mitochondria in Cells
Cells are the basic building blocks of all living things. The human body is composed of trillions of cells. They provide structure for the body, take in nutrients from food, convert those nutrients into energy and carry out specialized functions. Cells also contain the body’s hereditary material (DNA) and so they can make copies of themselves.

Mitochondria are tiny structures inside cells whose function is to produce energy, like a battery in a flashlight, to keep cells alive. Each cell contains hundreds to thousands of mitochondria, which are located in the fluid that surrounds the nucleus. Although most DNA is packaged in chromosomes within the nucleus of a cell (nuclear DNA), mitochondria also have a small amount of their own DNA, known as mitochondrial DNA or mtDNA.

Because only egg cells contribute mitochondria to a developing embryo, only females can pass on the mitochondrial DNA to their children.

Mitochondrial Haplogroups
The mtDNA can be classified into categories called haplogroups, which represent different ancient, geographically separated groups of people. For example, African-Americans and people of ancient African lineage have inherited L haplogroup mitochondria from their mothers no matter where they currently live.
mitochondria and age-related macular degeneration
Similarly, most Ashkenazi Jewish populations (primarily those Jews whose families originated in Eastern or Central Europe) possess mitochondria of the K haplogroup. People with this haplogroup of mtDNA seem to be susceptible to a variety of age-related diseases, including age-related macular degeneration (AMD).

The incidence of AMD varies a lot among different ethnic/racial populations. For example, in the United States, the likelihood of losing vision from AMD is very low for a person with an African maternal background but it is much higher in people of European descent. Similarly, in an Israeli eye clinic, of the people who had AMD, 96% were Jewish while only 4% were of Arab descent. This suggests that European mtDNA in retinal cells of Caucasians may be the reason they are more susceptible to AMD.

Mitochondria and Age-Related Macular Degeneration
Figure 1

It has been recognized that AMD is a very complex disease with many factors involved (Figure 1). There are more than 30 genes associated with AMD, representing many different biological pathways. In addition, mitochondrial damage and specific mtDNA haplogroups have been associated with AMD. Finally, it is recognized that environmental factors, such as smoking and obesity, increase the risk to develop AMD.

Although millions of dollars and thousands of man-hours have been invested in finding the causes and treatments for AMD, we still do not understand how to prevent the most common form of AMD. One major difficulty has been that when we study a diverse group of individuals, each with hundreds of different nuclear and mitochondrial genes, it is very difficult to identify the causes and pathways involved with developing AMD and determining effective treatments. One drug may not help everyone and different people develop different types and severities of AMD.

Mitochondria and Age-Related Macular Degeneration
Figure 2

Kenney’s approach to this dilemma has been to SIMPLIFY THE TESTING SYSTEM (Figure 2). In her research with different ethnic/racial groups, Kenney has found that the Ashkenazi Jewish population (K haplogroup) is an excellent group in which to study age-related diseases. This group has very well characterized nuclear and mitochondrial genes, the population tends to relatively homogenous and to marry within their community. Finally, the Ashkenazi Jewish population has longevity, which increases the likelihood that they will develop aging diseases, such as AMD.

Kenney’s laboratory has created a “cybrid” test system, which are cell lines with identical nuclei and nuclear DNA, but different mitochondrial DNA so that the differences in the cell behavior can be attributed to the different mitochondrial DNA (see the following cybrid story on 11/17/15). Using the cybrid system, Kenney has compared cell behavior of mitochondria from subjects with the K (Ashkenazi Jewish) haplogroups and the mitochondria from people of the H haplogroup (Figure 3), the most common European haplogroup.

Mitochondria and Age-Related Macular Degeneration
Figure 3

There are:

  • Major differences in production of cholesterol and lipid molecules
  • Altered levels of inflammation
  • Differences in their responses to toxic effects of amyloid-? (a toxic protein associated with AMD and Alzheimer’s disease)

These differences are important contributors to AMD and other age-related diseases.

Significance of the Findings
Maternally inherited mitochondrial DNA can influence how a person’s cells respond to stress and this can contribute to age-related diseases. This is a completely new way of thinking about common aging diseases and offers new approaches to treatment and prevention of those diseases.

Future Studies
Kenney’s laboratory will continue to use the K haplogroup cybrid model to study the mitochondrial DNA, with the goal of blocking the harmful events that cause early retinal cell death, such as that seen in AMD. An additional advantage of cybrids is that they are unique to the donor whose blood was used to make them. Therefore with these “personalized cybrids,” Kenney can test the responses of the personalized cybrids to drugs that are currently being used for AMD (Lucentis™, Avastin™ and Eylea™). They can also be used to identify novel, new drugs that can protect the cells from early cellular death, a major event in the dry form of AMD. This research shows great promise in developing personalized treatments for AMD and other age-related diseases.

11/12/15


Anthony B. Nesburn, MD  FACSAnthony B. Nesburn, MD FACS
President/Medical Director
Discovery Eye Foundation

Technology for Vision

In just over 10 years, the technology that has been developed to help people see has been amazing. While medical research continues to move forward to find treatments and potential cures of the future, those with the technological know-how have created ways for people to see NOW. Here is a very brief look at some of these technologies.

Technology for Vision

Second Sight and the Argus II

One of the pioneers in the field of vision technology, Second Sight started in 1998, and they are now currently producing the second version of their device. It is made up of two parts:

The Implant: Requiring a 4-hour surgery, a device is surgically implanted in the eye on top of the retina, and along the outside of the eye. It includes an antenna, an electronics case, and an electrode array.
technology for vision
The External Equipment: It includes glasses, a video processing unit (VPU) and a cable.
technology for vision
In a healthy eye, photoreceptors (rods and cones) in the retina convert light into tiny electrochemical impulses that are sent to the brain, where they are translated into images. If the photoreceptors don’t function correctly your brain can’t produce images. The Argus II Retinal Prosthesis System (“Argus II”) is designed to bypass the damaged photoreceptors.

A miniature video camera housed in the patient’s glasses captures an object. The video is sent to the small VPU that the patient wears. It is then processed and transmitted back to the glasses via a cable. This information is sent wirelessly to the antenna in the implant and signals are sent to the electrode array, which emits small pulses of electricity. These pulses bypass the damaged photoreceptors and stimulate the retina’s remaining cells. The visual information is then sent to the brain to create the perception of patterns of light which patients can learn to interpret as objects. Significant training is required to use the system.

The implant is designed to give you a visual field of about 3.5 inches by 6.5 inches at arm’s length; however, the actual size of light you see may be larger or smaller. Since it is strictly based on light, there is no color perception.

eSight

Another system that relies upon the user wearing glasses is eSight which started in 2012. While the Argus II is for people that have very little or no vision, the eSight is for people with low vision or that are legally blind. eSight glasses require the individual to have a certain degree of sight remaining to be successful. If you can only see shadows you probably don’t have enough remaining sight for the glasses to work for them.

This system is also composed of two parts, but it does not require any surgery:

The Headset: It contains a high-definition camera, OLED screens, and the ability to capture and display a real-time video feed. The headset is mounted on carrier frames, which enables eSight’s “bioptic tilt” feature so the user can shift between viewing modes and engage their peripheral vision.
technology for vision
The Controller: A small, lightweight processing unit that adjusts every pixel of the video in real time. It also houses the battery, which powers eSight.
technology for vision
Because most legally blind individuals retain limited sight concentrated in their peripheral vision, their eyes do not receive an adequate signal for the brain to recognize what is being seen. This can create blind spots, blurriness, inability to detect contrast, and other symptoms that reduce vision. eSight is able to significantly corrects these issues by using a high-speed camera, video processing software, a computer processor and the high quality video OLED screens to project a real-time image on the inside of the glasses, allowing people to see.

eSight requires considerably less training than the Argus II. It is intuitive, but as with learning anything new, the more you use it the easier it is to use. It is best to practice on a daily basis.

CentraSight from VisionCare Ophthalmic Technologies

The CentraSight uses a tiny telescope that is implanted inside the eye. The telescope implant was created to improve for people with end-stage age-related macular degeneration (AMD). The tiny telescope – about the size of a pea – is implanted inside one eye, behind the iris and is barely noticeable in your eye.
technology for vision
In end-stage AMD, the macula, where central vision occurs, is degenerated in both eyes without any healthy macular areas left for detailed central vision. There is no way for the individual to see around the central blind spot in their vision. It does not affect peripheral vision, which is blurry so you can’t use it to read, but you can use it to detect objects and movement.
technology for vision
Once implanted inside the eye, the tiny telescope works like a telephoto lens of a camera. It magnifies images onto the healthy areas of the retina to help improve central vision. Because the image is enlarged it reduces the effect the blind spot has on central vision. The surgical procedure is only performed on one eye because the peripheral (side) vision will be restricted in the eye with the telescope implant. This means the peripheral vision in the untreated eye will need to work in conjunction with the implanted eye. “A person uses the eye with the telescope implant for detailed central vision (such as reading “WALK” signs at a crosswalk). The other eye is used for peripheral vision (such as checking to see if cars are coming from the side).

Training with a CentraSight low vision specialist will be needed to develop the skills you need to use your new vision, such as how to switch your viewing back and forth between the eye with the telescope implant and the eye without the implant. You will still need to wear eye glasses and may need to use a hand-held magnifier with the telescope-implanted eye to read or see fine details clearly. However, in general, less magnification will be needed.

Ocumetics Bionic Lens

After eight years of research, a Canadian optometrist, Dr. Gareth Webb, has invented a tiny bionic lens that is able to enhance eyesight so that an individual can see three times better than the sharpness of 20/20 vision. The Ocumetics Bionic Lens is a button-shaped lens that can be injected into the eye in eight minutes in a procedure identical to cataract surgery.

As people get older, the lens inside the human eye becomes cloudy over time, causing blurred vision, known as cataracts. The Bionic Lens would be inserted, replacing the person’s clouded lens, similar to the intraocular lenses currently used in cataract surgery.

The Bionic Lens features a patented Ocumetics camera optics system, which is a tiny bio-mechanical camera that is able to shift focus from a close range object to optical infinity – as far as the eye can see – much faster than the human brain.

This device is still not available to the public, but Webb is hopeful that clinical trials will start soon. Depending on regulatory processes in each country, Webb hopes the Bionic Lens will be commercially available by 2017.

11/10/15


Susan DeRemerSusan DeRemer, CFRE
Vice President of Devlopment
Discovery Eye Foundation

The Importance of An Eye Exam

Why You Need An Eye Exam

The end of the year is fast approaching – when was the last time you had an eye exam? Was it a comprehensive eye exam?
eye exam
To keep your eyes healthy and maintain your vision, the American Optometric Association (AOA) recommends a comprehensive eye exam every two years for adults ages 18 to 60, and annual exams for people age 61 and older. However, if you have a family history of eye disease (glaucoma, macular degeneration, etc.), diabetes or high blood pressure, or have had an eye injury or surgery, you should have a comprehensive exam every year, unless otherwise indicated by your doctor.
Also, adults who wear contact lenses should have annual eye exams.

An important part of the comprehensive eye exam is the dilated eye exam to look inside your eye. Drops are placed in each eye to widen the pupil and allow more light to enter the eye. This gives your doctor a clear view of important tissues at the back of the eye, including the retina, the macula, and the optic nerve. This allows for early diagnosis of sight-threatening eye diseases like age-related macular degeneration, diabetic retinopathy, glaucoma, etc.

To better understand the importance of the dilated eye exam, here is a video from the National Eye Institute (NE) that explains what to expect.

At the end of your comprehensive eye exam your doctor should raise any concerns he has with you. But it is up to you to be prepared to react and ask questions for peace of mind and to help save your vision.

Questions To Ask After Your Eye Exam

It is always important to know if anything about your eyes have changed since your last visit. If the doctor says no, then the only thing you need to know is when they want to see you again.

If the doctor says the have been some minor changes, you need to know what questions to ask, such as:

  • Is my condition stable, or can I lose more sight?
  • What new symptoms should I watch out for?
  • Is there anything I can do to improve or help my vision?
  • When is the next time you want to see me?

If the doctor sees a marked change in your vision or give you a diagnosis of eye disease, you would want to ask:

  • Are there treatments for my eye disease?
  • When should I start treatment and how long will it last?
  • What are the benefits of this treatment and how successful is it?
  • What are the risks and possible side effects associated with this treatment?
  • Are there any foods, medications, or activities I should avoid while I am undergoing this treatment?
  • If I need to take medication, what should I do if I miss a dose or have a reaction?
  • Are there any other treatments available?
  • Will I need more tests necessary later?
  • How often should I schedule follow-up visits? Should I be monitored on a regular basis?
  • Am I still safe to drive?

Your vision is a terrible thing to lose, but with proper diet, exercise and no smoking, along with regularly scheduled eye exams, you improve your chances of maintaining your sight.

11/5/15

Susan DeRemerSusan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

Carrots For Healthy Eyes

Carrots forHealthy Eyes
Lately we have heard quite a bit about carrots and the positive effects they can have on your vision, such as slowing the progression of age-related macular degeneration (AMD). This is because carrots contain pigments called carotenoids. These pigments also give vegetables their colors, in this case orange. But carrots weren’t always orange.

The beginnings of carrots can be tracked back to the dry, hot lands of Iran and Afghanistan in 3000 BC, when the root vegetables were black, white, red and purple. They were bitter and used as a healing remedy for many illnesses, as well as an aphrodisiac.
carrots for healthy eyes
The vegetable grew in popularity because it was still edible even after months of being stored in a variety of conditions. Carrot seeds were soon picked and sold to neighboring Middle Eastern, African and Asian populations. This is when the crossbreeding started and new types of carrots were created.

Across centuries and continents, the carrot evolved, improving the composition, look, flavor and size. After years of selective breeding, in the 17th century a Dutch yellow carrot was engineered to get rid of the bitterness, increase sweetness and minimalize the wooden core. This appears to be the origin of the orange carrot we enjoy today.

Americans didn’t fully use carrots until after World War I when soldiers returning home told about French and other European cuisine which included the carrot. However, it didn’t really become popular until World War II, when England actively encouraged home growing of carrots while the US was engaged in cultivating “Victory Gardens.”

Today the carrot is found around the world in temperate regions. They have a high nutrition value, presence of ?-carotene, dietary fiber, antioxidants, minerals and ability to be prepared in a wide variety of recipes. They have become a staple in many countries.

Currently, the largest producer and exporter of carrots in the world is China. In 2010, 33.5 million tons of carrots and turnips were produced worldwide, with 15.8 million tons from China, 1.3 million tons each from the US and Russia, 1 million tons from Uzbekistan and less than a million from Poland, the United Kingdom and Ukraine.

Because of the popularity and health benefits of carrots, they are now enjoyed in a variety of ways – beyond the simple salad. Here are some recipes you might find interesting to try:

carrots for healthy eyesCrab Toast with Carrot and Scallion – Forget your traditional bruschetta, wow your guests with the appetizer.
 
 
 
 
 

carrots for healthy eyesPotato-Carrot Latkes with Lemon-Raisin Topping – Seems perfect with Hanukkah just around the corner.
 
 
 
 
 

carrots for healthy eyesRoasted Carrot, Squash and Sweet Potato Soup – This is a more traditional carrot recipe, it is not that hard to find a carrot soup, but this one also has squash and sweet potatoes which are also eye healthy!
 
 
 
 
 

carrots for healthy eyesCarrot Farfalle Pasta with Lemon and Herbs – Not only are carrots good for flavor, but they add a nice color to this pasta that could be the base for any number of pasta dishes.
 
 
 
 
 

carrots for healthy eyesCarrot Ginger Layer Cake with Orange Cream Cheese Frosting – Most carrot cakes have no frosting or a traditional cream cheese frosting. The idea of an orange frosting makes this cake special.
 
 
 
 
 

carrots for healthy eyesCarrot, Ginger, and Lime Juice – Refreshing and healthy.
 
 
 
 
 

10/22/15

Susan DeRemerSusan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

Increased Awareness for Saving Vision

The following is a survey done by Essilor (a French company that produces ophthalmic lenses along with ophthalmic optical equipment) and a large marketing research firm in the UK, YouGov. While the focus in on people living in the UK, the results would probably be similar to the US population. Even with increased access to the Internet, many people are still not aware of the risks associated with eye disease and what they can do to help retain their vision. Increased awareness of informational resources are important for saving vision.
saving vision
There are a number of websites with easy to understand information about taking care of your vision that I have listed under Resources to Help Save Vision at the bottom of this article. And while there are eye diseases that are hereditary, you can slow the onset and progression by making good lifestyle choices about smoking, diet and exercise. Your eye care specialist is also an excellent source of information about what you can to do reduce your risk of vision loss, at any age.

Increased Awareness for Saving Vision

A YouGov poll conducted with Essilor reveals that most Britons are unaware of damage to their eyes by surrounding objects, activities, and devices. This widespread lack of awareness means fewer people seeking methods of prevention and avoidance, and for those that are aware of risks, most are not informed of existing preventative measures.

The poll has shown* that many British people remain uninformed about the various ways in which eyes are damaged by common daily factors, despite evidence that eye health is affected by blue light, UV rays (reflected from common surfaces), diet, obesity, and smoking.
Of the 2,096 people polled, the percentage of respondents aware of the link between known factors affecting and eye health were:

  • Poor diet – 59%
  • Obesity – 35%
  • Smoking tobacco – 36%
  • UV light, not just direct from the sun but reflected off shiny surfaces – 54%
  • Blue light from low energy lightbulbs and electronic screens – 29%

More than one in ten people were completely unaware that any of these factors could affect your eyesight at all.
saving vision
72% of respondents own or wear prescription glasses but only 28% knew that there were lenses available (for both prescription and non-prescription glasses) to protect against some of these factors; specifically, blue light from electronic devices and low energy light bulbs, and UV light from direct sunlight and reflective surfaces.

76% admitted they haven’t heard of E-SPF ratings – the grade given to lenses to show the level of protection they offer against UV.

Just 13% have lenses with protection from direct and reflected UV light, and only 2% have protection from blue light (from screens, devices, and low energy bulbs).

Poll results showed that younger people were most aware of the dangers of UV and blue light, yet least aware of how smoking tobacco and obesity can affect your eye health. Within economic sectors, middle to high income people are more aware of the effects of smoking & obesity on eyesight than those with low income –

  • 39% of people with middle to high income compared to 33% of people with low income are aware of the impact of smoking tobacco.
  • 38% of people with middle to high income compared to 31% of people with low income are aware of the impact of obesity.

Awareness of the impacts of smoking and obesity on eye health is significantly higher in Scotland (47% & 49% respectively) than anywhere else in the UK (35% & 33% in England and 40% & 38% in Wales).
Essilor’s Professional Relations Manager, Andy Hepworth, has commented: “The lack of awareness about these common risks to people’s eyes is concerning. Not only would many more glasses wearers be better protected, but also many people who do not wear glasses would likely take precautions too, if made aware of the dangers and the existence of non-prescription protective lenses.”

To see the full results of the poll, please visit the Essilor website.

For more information on the protection offered from blue light and UV through specialist lens coatings, for both prescriptions and non-prescription glasses, please see here for UV & Blue Light Protection options.

*All figures, unless otherwise stated, are from YouGov Plc. Total sample size was 2,096 adults. Fieldwork was undertaken between 21st and 24th August 2015. The survey was carried out online. The figures have been weighted and are representative of all GB adults (aged 18+).

Resources To Help Save Vision
All About Vision
Macular Degeneration Partnership
National Eye Institute (NEI)
Prevent Blindness

10/16/15


Susan DeRemerSusan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

Vision Loss and Depression

On Tuesday, September 29, 2015, the National Eye Institute (NEI) hosted a Twitter chat on vision loss and depression. Here are some highlights of that discussion, along with some great resources to learn more about dealing with vision loss and depression.
vision loss and depression

  • Many studies show that people with vision loss or low vision are at risk for depression, although not everyone with vision loss gets depressed.
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  • A person with low vision is defined as someone who finds it difficult to do daily tasks even with regular glasses, contacts, medications or surgery.
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  • The number of Americans with low vision will increase over 70% by 2030. Broken down by ethnicity, African Americans with low vision will increase 93% and Hispanics with low vision will increase 190% during the same period. This is due to the rapidly aging Boomer population. 88% of Americans with low vision are age 65 and older.
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  • Symptoms of depression include persistent feelings of sadness, anxiety, irritability and fatigue. It is a common and serious illness that interferes with daily life. Each year, about 6.7% of American adults experience major depressive disorder. Women and men experience depression differently, with women 70% more likely to experience depression than men.
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  • People 65 and older are at particular risk for developing serious depression related to vision loss and yet it is often underdiagnosed and undertreated. Older adults may have other, less obvious symptoms of depression or they may not be willing to talk about their feelings. Many overlooked because sadness is not their main symptom. It is important to remember that while depression is a common problem among older adults, it is not a normal part of aging.
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  • An estimated 29-58% of those who suffer significant vision loss have major depressive disorder one year later. People with vision loss are 2x more likely to be depressed than someone without vision loss. Depression can be very disabling and may reduce the effectiveness of low vision rehabilitation interventions.
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  • A recent study confirmed age-related macular degeneration (AMD) is a big contributor to depression risk, as it accounts for about 45% of low vision cases.
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  • Older adults w/ vision loss are also 3X more likely to report difficulty in 1) walking, 2) managing medications, and 3) preparing meals. In fact about 39% of people with severe vision loss experience activities of daily living ADL limitations, compared to 7% of those with better vision. ADLs include eating, bathing, dressing, toileting, walking and continence.
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  • A link between depression and vision loss was also found in people as young as 20 according to a recent study. It looked at over 10,000 adults in the US and found they were approximately 2x more likely to be depressed.
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  • A decline in vision can also be associated with lower emotional, physical, and social functioning. To help those with low vision avoid depression it is important that they remain active and engaged in the world around them. And while people may become depressed because of vision loss, other causes of depression may also be present.
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  • An integrated approach to depression management in older adults with impaired vision may be the best course of action. Behavioral activation helps people recognize that loss of the activities they enjoyed that have led to depression and encourages them to find ways to re-engage with these activities. After 4 months, behavioral activation reduced the risk of depression by 50% compared to the control group. Behavioral activation can be used alone, or as part of psychotherapy called cognitive-behavioral therapy (CBT).
  •  

  • Cognitive behavioral therapy (CBT) helps people with depression restructure negative thought patterns and to correct distorted thinking that is often part of depression. But it is important to remember that the best approach to treating depression is to personalize it for each individual.
  •  

  • Often, the combination of pharmacotherapy and psychotherapy is a very effective option for depression treatment. Other time-limited psychotherapies, including interpersonal therapy (IPT) are effective in treating depression in people of all ages.
  •  

  • Collaboration between eye care and mental health professionals can help people with vision loss improve their quality of life.

Resources
Understanding depression

How to live with low vision

Living with Low vision – How you can help webinar

Update on depression and AMD

Association of vison loss and depression in those over 20

Sadness impairs color perception

Rehab helps prevent depression from age-related vision loss

10/6/15

Susan DeRemerSusan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

Pumpkin Season

A sure sign that fall is here is that Starbucks is offering their Pumpkin-Spiced Lattes. Since pumpkins begin to ripen in September, this makes sense. But there are so many other ways to enjoy pumpkins, which can be good for your vision.
pumpkin season
They contain an abundance of antioxidants, vitamins, fiber and phytonutrients that are good for your skin, eyes and heart, and they may also decrease your risk of cancer.

When shopping for your pumpkin you need to look for the sugar or cheese pumpkins varieties that are good for cooking and baking, because of their dense, sweet flesh. A traditional field pumpkin that you use for decoration and carving jack-o’-lanterns has watery, stringy flesh and is not recommended for eating.

You can keep an un-cut pumpkin at room temperature for up to a month. Stored in a cool cellar or refrigerator, they can last up to three months. However, once you cut the pumpkin, pieces should be wrapped tightly and refrigerated and used within five days.

Pumpkin Season Recipes

Here are a variety of tasty recipes that will let you enjoy pumpkins beyond the traditional soup and pie (but we have included those two as well).

Breads and Muffins

pumpkin season
Pumpkin-Cranberry Muffins

Pumpkin-Cranberry Muffins from My Recipes by Heather McRae

Pumpkin Biscuits from Country Living

Pumpkin-Cranberry Breadsticks from Recipe Girl

Pumpkin and Cream Cheese Muffins from Country Living

Pastas

pumpkin season
Chicken, Bacon & Pumpkin Gnocchi

Chicken Bacon Pumpkin Gnoochi from Nutmeg Nanny

Ravioli with Pumpkin Alfredo Sauce from Taste and Tell

Soups

pumpkin season
Pumpkin, Beef & Black Bean Chili

Pumpkin, Beef and Black Bean Chili from Country Living

Roasted Pumpkin Soup from Martha Stewart

Breakfast Treats

pumpkin season
Fresh Pumpkin Pancakes

Fresh Pumpkin Pancakes from A Sweet Pea Chef

Pumpkin-Ginger Waffles from Country Living

Desserts

pumpkin season
Pumpkin Whoppie Pies with Cream Cheese Filling

Pumpkin Whoopie Pies with Cream-Cheese Filling from Martha Stewart

Ginger Pumpkin Pie with Toasted Coconut from My Recipes by David Bonom

Pumpkin Chiffon Pie with Gingersnap Pecan Crust from Epicurious

Extras

pumpkin season
Pumpkin French Fries

Baked Pumpkin Fries from Kirbie’s Cravings

Pumpkin Salsa from Little Figgy

Pumpkin Pie Shake from My Recipes by Vivian Levine

As the days get shorter and the temperatures cool off, these recipes will hopefully get you geared up for autumn, and the holidays that are around the corner. Let us know which recipes are your favorites in the comments below.

9/29/15

Susan DeRemerSusan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

Vision Rehabilitation Services

The term “vision rehabilitation” covers a wide range of services that can help you learn how to remain active with vision loss while maintaining your independence and quality of life.
sorting meds - vision rehabilitation

Vision Rehabilitation Services

The following are different vision rehabilitation services you can access in addition to the information and help you will receive from your ophthalmologist or optometrist.

  • Communication skills: These help you with reading, writing and assistive computer technology. In some cases you may even want to learn braille.
  • Counseling: This can be beneficial, not only to you, but and family and/or friends that want to better understand or help you with your vision loss.
  • Independent living skills: These skills can be a simple as learning how to cook safely, take care of your personal appearance, manage your finances, keep exercising, or enjoy hobbies. The people that come to your home to help you keep your independent may also suggest home modifications to make life easier and help ensure your safety.
  • Independent movement and travel skills: These skills are important not only to help with your independence, but also to keep you from isolating yourself. Isolation is a common problem with vision loss as you may not want people to know you are losing your vision, or you are afraid of falling or embarrassing yourself. However, isolation can lead to depression.
  • Low vision evaluations and training: There are a variety of hand-held and desktop magnifiers, special reading glasses, lighting sources and other devices that help you make the most of your remaining vision.
  • Vocational rehabilitation: Loss of vision does not necessarily mean you can no longer work. Vocational evaluation and training, along with job modification and restructuring, can keep you enjoying the work you have enjoyed and depend on.


laptop help - vision rehabilitation

Vision Rehabilitation Service Providers

When looking for vision rehabilitation services, what should you know? You are best looking for a specially trained person including low vision therapists, vision rehabilitation therapists, and orientation and mobility specialists. They each have completed a standardized certification process that will let them help guide you as you work toward your vision goals.

  • Certified Low Vision Therapists (CLVTs): These therapists work with you to use your remaining vision with various devices and assistive technology. They also help you determine what modification you might need at home or work to remain independent and safe.
  • Certified Vision Rehabilitation Therapists (CVRTs): These therapists teach special adaptive skills that will allow you to confidently carry out a range of daily activities.
  • Certified Orientation and Mobility Specialists (COMS or O&Ms): These specialists teach skills that help you navigate safely and confidently when you are home, in the community or traveling far from home. This can include the use of a cane, GPS devices or public transportation. They also include guide dog instructors, but this training is more intense and takes place at a guide dog facility for several days.

To remain active and independent may require learning new skills, but it is important to find the right person to help you learn those skills. By finding the best person to suit your needs, the process can be a fun and positive experience.

9/17/15

Susan DeRemerSusan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation