Age-Related Macular Degeneration & Alzheimer’s

Similar Diseases, Different Locations, Possible Common Treatments

There are many similarities between two age-related diseases (Age-related Macular Degeneration and Alzheimer’s disease) that can affect thousands of people world-wide. In the United States there are 11 million people that have some form of AMD and it is estimated to grow to 22 million by the year 2050. Furthermore, in 2016 it was estimated that the cost to care for those with AMD was $512 billion. Worldwide it is estimated that by 2020, there will be 96 million people with AMD. National Eye Institute 

The second aging disorder that causes high degree of damage is Alzheimer’s disease. Presently, in the United States there are 5.4 million people with Alzheimer’s disease and this will increase to approximately 13.8 million by 2050. In 2016, the cost for caring for these patients was $236 billion. Worldwide the numbers of Alzheimer’s patients are estimated to be 44 million and the global cost is $605 billion. Alzheimer’s Association

Similar Risk Factors

The risk factors for both AMD and Alzheimer’s disease are very similar to each other. These include aging, smoking, and high cholesterol. Both diseases are found more frequently in women than men and in approximately 5% to 15% the diseases are found in more than one family member. There is also a genetic risk factor of a lipid transport protein called Apolipoprotein E (ApoE) that provides elevated risk in AMD patients if they carry the allele 2 variant and higher risk in Alzheimer’s patients if they carry the allele 4 variant.

In AMD and Alzheimer’s disease there are 3 events that make the pathologies very similar except that they are found in different locations, either the retina or the brain.

1. Amyloid beta is a protein that is not present in normal tissues but larger quantities accumulate in the brain for Alzheimer’s patients and are identified to be plaques by MRI scans. The presence of these plaques is defining (pathognomonic) for Alzheimer’s disease. In AMD patients amyloid-beta deposits are found to accumulate underneath the retina and form small clumps of protein-lipid materials called drusen. This is significant because the amyloid-beta is very toxic and harmful to the surrounding cells and when it is accumulating in tissues, it causes the cells to be damaged and loss their abilities to function.

2. A second feature of both AMD and Alzheimer’s disease is that there are high levels of tissue damage, loss of function and a lot of cell death in the retina and brain.

3. Finally, both diseases have damage to the mitochondria, which are small units within the cells that are critical to keeping the cells alive. The mitochondria are the “batteries” of the cell providing energy to keep the retina and brain cells functioning. Mitochondria are similar to the batteries in a flashlight. You can have a very expensive flashlight but if you do not have good batteries, the flashlight will not work. It is a similar situation to the cell. As long as the mitochondria are healthy and providing energy the cells can function. However, when the mitochondria start to die, then the cells will lose their functions and cell death will occur. This is true for all types of cells in the body, such as nerve cells, muscle cells, retinal cells, heart cells, etc. In other words, healthy mitochondria are critical to keep cell alive and functioning well.

Future Treatments

Using a novel in vitro model called cybrids (cytoplasmic hybrids), Dr. Cristina Kenney’s laboratory has shown that when mitochondria from patients with AMD are placed into specialized human retinal cells, the AMD mitochondria will cause the cells to die more rapidly than normal because they are so damaged. With this important discovery, the goal of the research group has been to identify drugs and proteins/peptides that can rescue the damage AMD mitochondria and protect the retinal cells. Their research is moving forward very quickly and testing drugs is the top priority for Dr. Kenney’s group. By rejuvenating the mitochondria from ‘old-damage’ to ‘new-healthy’ will prolong the health of the retinal cells and protect vision loss from AMD. What is learned in these studies will have long reaching applications to other aging-diseases such as Alzheimer’s and Parkinson’s diseases.

Low Vision and Smart Phones

Many of us just use the basics on our smart phone and never personalize them for our own needs. It is worth taking the time to adjust our phones to take advantage of the special services that may be available and unused. Making a phone call or sending a text message with a smart phone can be challenging, however, with simple modifications, keeping in touch with the world can become a snap. Getting comfortable with your smart phone will make staying in touch with your loved ones very easy.

If you’ve used a smartphone these past several years you already know that a great deal of voice command capabilities come built in to most current models, so you can verbally instruct your smartphone to “Call my wife,” or “Read my last text message.” The smart phone has been a wonderful addition to the world of technology; with built-in accessibility features these phones have provided individuals with visual impairments the ability to carry out several activities that have been difficult without the use of a magnifier or other assistive device.

One way to make it easier to see the names in your contact list is to magnify the text on the screen. After tapping the “SETTINGS” icon on your home screen, you will find “ACCESSIBILITY” features under General Settings or Personal Set-up. Accessibility features can be used to visually enhance the use of your smart phone. Adjusting the size of the text, under the “LARGER TEXT” selection can magnify the print in your contact list so that names are easier to see. Simply sliding the prompt on the larger text screen to the right will enlarge print throughout your smart phone: phone contacts, text messages and emails.

Despite enlarging text, you still may find it difficult to see contacts on your screen. That is where tools called “VOICE ASSISTANTS” or “TEXT-TO-SPEECH” can make it less stressful for you. After you have enabled the settings, you can engage them by speaking into your unit’s microphone. On most phones, this feature can be turned on by holding down the home button. Once you hear a beep, you say the name of a person or business. You can access your contact list by asking your voice assistant to call people from your contact list or by reciting the phone number you are trying to connect to.

Tips for a Better Low-Vision Phone Experience

Whether you use some or all of the low-vision phone features described in this article, there are still more things you can do to improve phone usability that don’t require a trip to Accessibility settings. Some involve choosing hardware and software, others are simple, and cost nothing.

  • Right-size your phone: How much magnification you need depends on your vision, of course, but also on the size of the phone you choose. If you need a high level of zoom, or larger text, you might want to pick a phone with a larger screen, which will allow more of the screen contents to remain visible when you zoom or crank up the font size. You’ll find Android and iOS phones with screens up to 5.7 inches. Tablets are bigger. The challenge of a large phone for some low-vision users is the need to hold the device close to your eyes to view it. Before you choose a phone, be sure to handle and use the model you’re planning to buy.

  • High-contrast wallpaper: You can change the background of your Home screen by turning any photo into wallpaper, or picking from wallpapers already available on the device. Using a solid color, rather than a busy photo that obscures your app icons and the text on the Home screen can make it much easier to locate text and icons. If a solid background seems boring, try a starry sky or snowy scene, for a dark or light look, respectively.

  • Apps with dark mode and/or font size options: Apps that focus on reading and navigation often have their own accessibility-enhancing options. Apple’s iBooks and Amazon’s Kindle app allow you to change font size, and even typeface, as well as changing the background or text color of what you’re reading. Seek out apps that compensate for what might be missing in your phone’s operating system, or that simply offer a better experience.

Get the Most from your Phone

The good news about smartphones is that they all provide features to support those with low-vision or whose eyesight has simply changed due to age. Your challenge is to try out as many of these features as possible, and decide which ones are right for you.

For tips and instruction on how to use smartphone (Iphone/Android) if you have low vision:

How a visually impaired person can use a smartphone

How To Set Up An Android Phone/Tablet For Low 

How I Use My iPhone 7 Plus | Life, Legally Blind 

Back to School – Why Eye Exams are Important!

Summer is almost over and it’s back to school season. As parents, many of us are busy ensuring our kids are ready and prepared for the new year; worrying about school supplies, new clothes, and new haircuts. There is always a long list of things to do before school starts. But something that often gets overlooked is getting your child’s eyes examined annually.

Early eye examinations are crucial to make sure children have normal, healthy vision so they can perform better at schoolwork and play. Early identification of a child’s vision problem can be crucial because children often are more responsive to treatment when problems are diagnosed early.

Early eye exams also are important because children need the following basic skills related to good eyesight for learning:

  • Near vision

  • Distance vision

  • Binocular (two eyes) coordination

  • Eye movement skills

  • Focusing skills

  • Peripheral awareness

  • Hand-eye coordination

Parents also need to be alert for the presence of vision problems such as ‘crossed’ eyes or ‘lazy’ eye. These conditions can develop at a young age. ‘Crossed’ eyes or strabismus involves one or both eyes turning inward (towards the nose) or outward. Amblyopia, known as ‘lazy’ eye, is a lack of clear vision in one eye, which can’t be fully corrected with eyeglasses. ‘Lazy’ eye often develops as a result of ‘crossed’ eyes, but may occur without noticeable signs. Lazy eye can be treated if caught early.

In addition, parents should watch their child for indication of any delays in development, which may signal the presence of a vision problem. Difficulty with recognition of colors, shapes, letters and numbers can occur if there is a vision problem. Children generally will not voice complaints about their eyes, therefore parents should watch for signs that may indicate a vision problem, including:

  • Sitting close to the TV or holding a book too close

  • Squinting

  • Tilting their head

  • Constant eye rubbing

  • Extreme light sensitivity

  • Poor focusing

  • Poor visual tracking (following an object)

  • Abnormal alignment or movement of the eyes (after 6 months of age)

  • Chronic redness of the eyes

  • Chronic tearing of the eyes

  • A white pupil instead of black

Scheduling Eye Exams for Your Child

If eye problems are suspected during routine physical examinations, a referral should be made to an eye doctor for further evaluation. Eye doctors have specific equipment and training to assist them with spotting potential vision problems in children.

When scheduling an eye exam for your child, choose a time when he or she usually is alert and happy.

Glasses and Contacts

Keep these tips in mind for kids who wear glasses:

  • Plastic frames are best for children younger than 2.

  • Let kids pick their own frames.

  • If older kids wear metal frames, make sure they have spring hinges, which are more durable.

  • An elastic strap attached to the glasses will help keep them in place for active toddlers.

  • Kids with severe eye problems may need special lenses called high-index lenses, which are thinner and lighter than plastic lenses.

  • Polycarbonate lenses are best for all kids, especially those who play sports. Polycarbonate is a tough, shatterproof, clear thermoplastic used to make thin, light lenses. However, although they’re very impact-resistant, these lenses scratch more easily than plastic lenses.

  • Your eye doctor can help you decide what type of vision correction is best for your child.

Specialists state that 80% of what your youngster learns in school is taught visually. Untreated vision troubles can put children at a substantial disadvantage. Be certain to arrange that your child has a complete eye exam before school starts.

View Video

The Do’s and Don’ts of Proper Lens Care

If you’ve ever slept in your contact lenses, worn disposable lenses past the prescribed replacement schedule, rinsed your contact lenses with tap water or gone for a dip in the community pool without removing contacts from your eyes first, it’s time to rethink your habits.

lensMost problems associated with contact lenses cause minor irritation, but serious eye infections from poor lens hygiene can be extremely painful and may lead to permanent vision loss. About 80 to 90 percent of contact lens-related eye infections are bacterial. A type of infection you can get is called pseudomonas aeruginosa, a fast-growing bacterial infection that can lead to a hole in your cornea. Unfortunately, patients who get this infection have a high chance of permanent scarring and vision loss. Beyond bacteria, fungal infections are also potential threats to your vision.

Do:

  • Always wash and thoroughly dry your hands before handling contact lenses.
  • Carefully and regularly clean contact lenses as directed by your eye care specialist. If recommended, rub the contact lenses with your fingers and rinse them thoroughly before soaking the lenses overnight in multipurpose solution that completely covers each lens.
  • Store lenses in the proper lens storage case, and replace the case at least every three months. Clean the case after each use, and keep it open and dry between cleanings.
  • Use only fresh solution to clean and store contact lenses. Never reuse old solution—it loses its effectiveness. Change your contact lens solution according to the manufacturer’s recommendations, even if you don’t use your lenses daily.
  • Always follow the recommended contact lens replacement schedule prescribed by your eye care specialist.
  • Remove contact lenses before swimming or entering a hot tub.Avoid tap water to wash or store contact lenses or lens cases.
  • See your eye care professional for your regularly scheduled contact lens and eye examination.

Don’t:

  • Use cream soaps. They can leave a film on your hands that can transfer to the lenses.
  • Use saliva to rinse or lubricate your contact lenses
  • Use homemade saline solutions. Improper use of homemade saline solutions has been linked with a potentially blinding condition among soft lens wearers.
  • Put contact lenses in your mouth or moisten them with saliva, which is full of bacteria and a potential source of infection.
  • Use tap water to wash or store contact lenses or lens cases.
  • Use products not recommended by your eye care specialist to clean and disinfect your lenses.
  • Use saline solution and rewetting drops not designed for contact lenses.
  • Sleep in contact lenses. The contact lens and your eyelid act as a double barrier, potentially trapping bacteria on the lens directly on your eyes.

How to Protect Your Eyes During Allergy Season

protect your eyes during allergy seasonIt seems like every season is allergy season. In the spring, it’s the tree and flower pollen. Summer adds grass pollen. In the fall, it’s weed pollen. People who have allergies have symptoms such as sneezing, sniffling, and nasal congestion, but allergies can affect the eyes, too. They can make your eyes red, itchy, burning, and watery, and cause swollen eyelids.

Here are 8 tips on how to get relief from Eye Allergies:

1. Get an early start. See your eye doctor before allergy season begins to learn how to reduce your sensitivity to allergens.

2. Try to avoid or limit your exposure to the primary causes of your eye allergies. In the spring and summer, pollen from trees and grasses are the usual suspects. Ragweed pollen is the biggest culprit in late summer and fall. Mold, dust mites and pet dander are common indoor allergens during winter.

3. Protect your eyes from airborne allergens outdoors by wearing wraparound-style sunglasses.

4. Don’t rub your eyes if they itch! Eye rubbing releases more histamine and makes your allergy symptoms worse.

5. Use plenty of artificial tears to wash airborne allergens from your eyes. Ask your eye doctor which brands are best for you.

6. Cut down your contact lens wear or switch to daily disposable lenses to reduce the build-up of allergens on your lenses.

7. Shower before bedtime and gently clean your eyelids to remove any pollen that could cause irritation while you sleep.

8. Consider purchasing an air purifier for your home, and purchase an allergen-trapping filter for your heating/cooling system.

If you’re curious about the current pollen count in your area, or are going on a trip and want to find out if you need to pack the eye drops, visit www.pollen.com.

Issues That Could Affect Your Child’s Vision

boy-with-glassesVision loss is feared more than the loss of any other sense and is considered to affect the quality of life more than most other issues. When it comes to children, even partial vision loss can be damaging because it can affect the way that your child learns and develops. There are several different types of issues that may affect your child’s vision. Awareness is key to prevention and treatment.

Refractive Errors

Refractive errors such as nearsightedness, farsightedness, and astigmatism are the most common types of issues that affect children’s vision. Since children are working to constantly adapt to their surroundings, they may not realize that they have a vision problem and the issue may manifest as an inability to focus, chronic headaches, or poor eye-hand coordination. In most cases, these issues can be corrected with glasses or contacts, but extreme cases may require surgery.

Alignment Disorders

Alignment disorders are generally more obvious than other types of issues. One eye may drift to the side, an eyelid may droop, or the surface of an eye may appear cloudy, affecting the vision. In some cases, however, the condition may be intermittent, so it is important to continually look for these symptoms and alert an eye doctor to any concerns. Alignment disorders may be corrected with surgery, an eye patch, eye drops, or a combination depending on the cause.

Pediatric Retinoblastoma

Pediatric retinoblastoma is a type of kid’s eye cancer that usually affects children under six years of age. About 95 percent of children diagnosed in the US are able to be treated successfully and a majority of these children retain most or all of their sight. The prognosis for retinoblastoma improves greatly with early diagnosis and treatment. One of the most common warning signs that you can look for is a white glare on the pupil when it is directly exposed to light.

Diseases and Infections

Diseases and infections such as conjunctivitis, styes, and blocked tear ducts are usually minor problems that are easily resolved. However, these issues may develop into larger problems that affect the vision if care is not taken. Conjunctivitis may resolve on its own depending on the cause, but the child should be kept away from others during the healing process to avoid infecting others or being exposed to other contaminants while the eye is sensitive.

Blocked tear ducts may be opened up using massage techniques recommended by a pediatrician or ophthalalmogist. Allowing the eyes to dry out may be dangerous for the vision, so drops may be needed to keep the eye moist while the tear ducts are blocked. Styes are caused by an infection in the eyelash follicle, so it is important to keep the area clean so that the infection can clear without causing damage.

By working to spot potential issues, you can help to preserve your child’s eye health and vision.

 

amanda-duffyAmanda Duffy
Freelance blogger

How to Lessen Computer Vision Syndrome

Your eyes are your window to the world – but your eyes get a lot of extra strain thanks to the advent of new technology. Especially at work, we’re looking at screens of all different sizes and types all the time. And what happens to our eyes can be more than just a case of tired muscles; in fact, it’s got a name – computer vision syndrome.

The cause of that is obvious – lots of screens, as we said, and often multiple screens. In addition to computer vision syndrome, sufferers can feel headaches and eye fatigue among other symptoms. Luckily there are steps you can take to reduce or mitigate the chance of eye strain. Setting up a work station properly can help, as can anti-glare screens or placement of technology in relationship to sources of natural light.

If you’re focused on the health of your eyes, this graphic is an absolute must-read.

How to Protect Your Eyes in the Digital Age

thumbnail_eugene
Eugene Feygin
Program Manager at Quill.com

How Your Eyes May Have Evolved

Lens manufacturer and eyewear giant Essilor has produced the short video below to explain the complexity behind the human eye and how your eye may have evolved. Explore the components that make-up a human eye, from light sensitive stigma used by single-celled organisms to the lens you’re using to read this article. They have also written an article about the “Top Modern Eye Dangers and How to Prevent Them” to help you take care of your remarkable eyes.


essEssilor UK

There Is Something In Your Eye – Now What?

It is never planned. You could be putting on makeup, gardening, or even just running errands on a windy day, but all of a sudden you have something in your eye and it hurts. What do you do?
something in your eye

Small Foreign Objects

First and foremost – DON’T RUB your eye!! This could scratch your cornea and make things much worse.

  • Wash your hands thoroughly with soap and water.
  •  

  • In a well-lighted area, look in a mirror to try and find the object in your eye.
  •  

  • If you wear contacts, remove them before trying to remove the object or flushing your eye.
  •  

  • Try blinking and letting your natural tearing flush out the object.
  •  

  • If the object is on the colored part of the eye or under the upper lid you can try to flush it out gently with clean cool or lukewarm water in one of three ways:
     

    1. Completely fill an eyecup or small juice glass with water and put your open eye into the container to flush out the object. Do this standing over a sink as the water will overflow.
    2.  

    3. Use a clean eyedropper and fill with water. Be careful to not touch the tip of the eyedropper to the eye.
    4.  

    5. Turn your head so your eye is down and to the side, then hold your open eye under a faucet.

     

  • If the object is in the corner or on the white part of the eye you can try flushing the eye using one of the methods listed above or a using wet cotton swab or twisted piece of tissue to lightly touch the foreign object. Make sure to not apply pressure to the eye.
  •  

  • If it is under the lower lid you can use any of the methods above by gently pulling down on your lower lid to access the object, but be careful to not push the object further down.
  •  

  • A scratchy feeling of slight discomfort may continue for a short time after removing a small object. I discomfort continues after 24-48 hours, your eye becomes red or your vision becomes blurred, immediately seek medical attention.
  •  

  • Never use tweezers, toothpicks or other hard objects to remove an object as these could damage your eye.

Never try to remove a piece of metal, anything that has punctured your eye or an object that will not come out after flushing with water. Cover both eyes to help prevent eye movement and there is no pressure on the eyes. Have a friend drive you to eye doctor immediately.

Chemicals

Do not touch your eye, but IMMEDIATELY flush your eye with clean running water from a faucet.

  • Flush your eye for a minimum of 15 minutes holding your eye open and at an angle so the runoff water does not run into the other eye. If both eyes are affected or the chemicals are on other parts of the face or body, you need to do the flushing in a shower.
  •  

  • If you wear contact lenses, leave them in and start flushing immediately. If they do not fall out from the flushing process you can try to remove them. Then repeat the entire flushing process.
  •  

  • Seek medical attention immediately upon completing the flushing process, regardless of how your eyes feel.

Prevention

The best way to protect yourself from getting anything into your eyes is to protect them.

  • Never use chemicals without wearing goggles that completely surround and protect the eyes.
  •  

  • Wear specially designed goggles when swimming.
  •  

  • Wear goggles when participating in sports where you could get hit with any flying object like a ball or bat. Also in any sport where you could get an opponent’s elbow or hand in your eye.
  •  

  • Wear protective eyewear when using power tools or striking tools like hammers.
  •  

  • When you are cycling, in dusty areas or it is windy, also protect your eyes with sunglasses or other protective eyewear.

 
Susan DeRemer

Susan DeRemer, CFRE
Discovery Eye Foundation

Can You Get Sunburned Eyes?

You know to slather on lots of sunblock before going out in the sun, and to keep applying it throughout the day. What about your eyes? Do you always wear a brimmed hat and sunglasses? Even on cloudy days? Can your eyes get sunburned?

The short answer is yes, you can get sunburned eyes, and just like you skin, it could come back and haunt you in the future.
 

eyes get sunburned
photo courtesy of Sarah DeRemer

Severely sunburned eyes, known as photokeratitis, is a result of prolonged exposure to the sun’s ultraviolet rays and can cause a burning sensation and blurred vision. Realize that these damaging UV rays do not just come directly from the sun, but also from the reflection of these rays from water and sand.

Symptoms of sunburned eyes include:

  • Eye pain
  • A  gritty feeling
  • Burning sensation
  • Red eyes
  • Swollen eyes and/or lids
  • Watery eyes
  • Blurred vision
  • Sensitivity to light
  • Glare and halos around lights
  • Headaches

These symptoms are temporary and should resolve on their own within 24 to 48 hours. If the symptoms last longer, see your eye doctor immediately.

While waiting for your eyes to recover you might want to:

  • Stay indoors and wear sunglasses to help with your increased light sensitivity.
  • Keep your eyes moist with preservative-free artificial tears.
  • Use OTC pain relievers to help with the pain and follow the recommended dosage.
  • DO NOT rub your eyes.
  • If you wear contact lenses, remove them immediately and stop wearing them until your eyes have returned to normal.
  • You may find that placing a cool, damp cloth over your closed eyes is soothing.

Just like with your skin, the UV rays do have a long-term effect on your eyes.  Sunlight can cause a slow deterioration of the cells in your eyes that could lead to eye diseases such as age-related macular degeneration and cataracts. Therefore it is best to limit you exposure to both direct and reflected UV rays.

The best ways to protect your eyes include wearing sunglasses that block 100% of the UV rays and a hat.  Not all sunglasses have UV protection, so make sure the ones you select do, and wear them whenever outdoors. Even on a cloudy day as UV rays penetrate clouds. For maximum protection consider wrap-around glasses to protect you from direct and indirect sunlight.  If you are participating in sports, goggles or glasses designed for your specific sport might be the best option. And don’t forget to wear a brimmed hat. It will not only protect you from indirect sunlight, it will also protect your face from sunburn.

Susan DeRemer

Susan DeRemer, CFRE
Discovery Eye Foundation