Last week we reviewed the rainbow of fruits and vegetables you can eat to help with eye health. But you don’t need to limit yourself – enjoy a rainbow of nuts, whole grains and beans as well.
Photo by zcool.com.cn
A reason some people avoid nuts is the number of calories found in nuts. However, a report published in the American Journal of Clinical Nutrition found that adults who incorporate nuts into their diets don’t have to limit their consumption. A review of 31 studies about eating nuts found that people who added nuts to their diets and who replaced other foods with nuts lost more weight, an average of almost one and half pounds. Nuts have also been shown to be beneficial for stress reduction, heart health, various cancers, cholesterol, brain health and eye health.
Eating more whole grains makes your diet healthier because they are filled with nutrients including protein, fiber, B vitamins, antioxidants, and trace minerals (iron, zinc, copper, and magnesium). A diet rich in whole grains has been shown to reduce the risk of heart disease, type 2 diabetes, obesity, and some forms of cancer.
Beans, lentils and other nutritious legumes are the best sources of lean vegetarian protein. They made up of high-quality carbohydrates that are rich in fiber, zinc, vitamin B6, folate, magnesium, iron, and potassium. These protein-packed, low-fat nutrients can help with osteoporosis; improve heart-health, colon and bowel health; reduce the risks of cancer and age-related macular degeneration; control blood sugars, fight free radicals and even help with weight loss.
RED
Red adzuki bean
Pinto beans
Kidney beans
Pecans
Buckwheat
Amaranth
Quinoa
Barley
ORANGE/YELLOW
Almonds
Cashews
Millet
Chickpeas
Butter beans
GREEN
Lentils
Mung beans
Pistachios
Pumpkin seeds
Lima beans
Edamame
Sunflower seeds
BLUE/PURPLE
Flaxseeds
Walnuts
Chestnuts
Black beans
Quinoa
Black and wild rice
Rye
WHITE
Soy beans
Garbanzo beans
Rice
Barley
Sesame seeds
Navy beans
Oats
Quinoa
To learn more about the benefits of specific nuts, whole grains and beans, go to The World’s Healthiest Foods. The site is filled with nutritional information, history and recipes for a wide variety of foods from around the world.
Susan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation
During a trip to the optometrist or ophthalmologist, a patient will encounter the process of subjective refraction. This technique involves the clinician asking the patient to make a series of judgments (which is better, one or two?) about the clarity of their vision when looking through a series of lenses. The choices that the patient makes guide the clinician in identifying an optical prescription which is typically made up of sphere, and potentially, cylinder lenses.
Why is it that glasses don’t always work for patients with keratoconus?
In many instances, individuals with keratoconus do not achieve excellent visual performance with spectacles or traditional soft contact lenses. One cause for the failure of these corrections is that the changes in corneal shape that accompany keratoconus induce refractive errors which traditional spectacles simply cannot correct. So, even when sphere and cylinder in the keratoconic eye are well-corrected, these “other refractive errors” or “other aberrations” remain uncorrected and can lead to a blurred retinal image and blurred vision. Collectively these other aberrations can be referred to as higher order aberration, while the aberrations that are typically corrected with spectacles and soft contact lenses are referred to as lower order aberration.
What kinds of higher order aberrations are present in keratoconus:
Pantanelli et al. have stated that the level of higher order aberration present in an eye with keratoconus is, on average, approximately 5.5 times higher than the level experienced in a control group. In an effort to visualize higher-order aberration data, they are commonly represented graphically as shown in the figures below. Examples of higher order aberration measured in one normal eye are shown in figure A, while an example of higher order aberration from one keratoconic eye are shown in figure B. The circular nature of the map denotes the boundary of the measurement, which is defined by the round pupil of the eye. A majority of the higher order aberration map in figure A is green (denoting a relative absence of higher order aberration). However, the map in figure B displays a much larger variation in color, indicating the presence of higher order aberration in this individual keratoconic eye in a greater quantity than the normal eye shown in figure A.
Figure A – normalFigure B – keratoconus
A wavefront aberration map of the “other aberrations” or higher order aberrations of two eyes. Figure A is an example of data for a normal eye and figure B is an example of data for an eye with keratoconus.
If refraction is not capable of quantifying higher order aberrations, how are they measured?
One method for obtaining the information regarding higher order aberration shown above is with a wavefront sensor. The wavefront sensor objectively (without patient feedback) collects information on the optical performance of the eye that can be used to calculate the amount of both lower and higher order aberration present.
Laboratory-based research related to custom contact lenses:
Several investigators in the laboratory (e.g. Katsoulos et al., Sabesan et al., Chen et al., Marsack et al.) have reported on work that attempts to further reduce higher order aberration by targeting the eye-specific higher order aberration seen in a given keratoconic eye. The general philosophy behind these customized lenses is that the aberration pattern measured with the wavefront sensor is a more complete optical prescription for implementation of a custom contact lens. Figure C demonstrates, in principle, the optical properties of a contact lens designed to correct the higher-order aberration in figure B. Where the map of the eye (figure B) is red, the map of the correction (figure C) is blue, and vice versa. When the lens is worn, the net effect as light propagates through the lens-eye system is the cancellation of the higher order aberration in a targeted manner.
Figure C -keratoconus correction
In principle, this figure pictorially represents the higher order optical properties of a contact lens designed to fully correct the higher-order aberration of the eye represented in figure B.
What is next:
Investigators continue to push the technology behind custom contact lenses for keratoconus towards clinical relevance. However, like every novel intervention strategy, we must manage our expectations. Complexity in measuring keratoconic eyes, a need for specialized equipment and expertise to design and manufacture the lenses, the infrastructure needed to coordinate the clinical exam and manufacture efforts and cost associated with the process are a subset of the barriers that must be removed if this type of correction is to become more mainstream. For this reason, it is my opinion that if/when these corrections become commonly available in the clinic, they will likely add to, and not replace, existing forms of corrections that patients and clinicians now utilize to correct vision.
Jason Marsack, PhD
Research Assistant Professor
University of Houston, College of Optometry.
Dr. Marsack’s work focuses on the relationship between visual performance
and optical aberration in individuals with highly aberrated eyes.
When planning what to eat, think of a rainbow. Eating brightly colored fruits and vegetables helps to give your body the nutrients it needs. These same nutrients are the disease-fighting components that give fruits and vegetables their array of colors.
by Sarah DeRemer
Eating a variety of colors can help –
Strengthen your immune system
Lower risk for certain cancers
Help ward off type 2 diabetes
Maintain heart heath
Improve memory
Reduce the risk for some eye diseases
Red
The pigments that make some foods red are known as anthocyanins and lycopene. These are the compounds that fight free radicals and prevent oxidative damage to cells, important to preserving eye health, keeping our hearts healthy and helping to fight cancers. Heat concentrates lycopene levels so cooked tomatoes and tomatoe sauces have higher concentrations than raw fruit.
Add red to your meals by tossing a handful of raspberries, strawberries, goji berries or pomegranate seeds into your cereal, slicing roasted beets or red bell pepper into a salad, or adding cooked red adzuki or kidney beans to a rice dish.
Here are examples of red fruits and vegetables:
Red apples
Adzuki beans
Beets
Red cabbage
Cherries
Cranberries
Goji berries
Pink grapefruit
Red grapes
Red peppers
Pomegranates
Red potatoes
Radishes
Raspberries
Rhubarb
Strawberries
Tomatoes
Watermelon
For a recipe filled with lycopene, try a zesty Orange and Tomato Salsa, one of three salsa crudas using brightly colored fruits.
Orange & Yellow
Orange fruits and vegetables contain beta-carotene, a powerful antioxidant that promotes eye health, can delay cognitive aging and protect the skin from sun damage. Beta-carotene also converts to vitamin A, which is important for night vision and the health of your immune system. Orange foods also contain vitamin C, another antioxidant that boost the immune system, but also protects against cardiovascular disease. Yellow fruits and vegetables contain lutein, another nutrient important for healthy vision.
Some of the sources you can enjoy include:
Sweet potatoes
Carrots
Pumpkin
Apricots
Cantaloupes
Summer squash
Citrus fruit
Papayas
Peaches and nectarines
Sweet corn
Yellow peppers
Mangoes
Pineapple
Yellow tomatoes
To incorporate more orange/yellow foods into your diet, replace French fries with crisp, baked sweet potato slices, keep dried apricots, pineapple or mangoes handy for a ready-to-eat snack or add sweet potatoes to black beans or chili for a color and texture boost.
Green fruits and vegetables are colored by natural plant pigment called “chlorophyll” and are rich in lutein and zeaxanthin, pigments that may help your eyes filter damaging light rays, thus protecting against macular degeneration, the leading cause of vision loss in people over 65. Green fruits and vegetables are also a good source of vitamins C & K, fiber, folate and magnesium which contain anti-cancer properties as well as helping promote strong bones and teeth.
Blue and purple fruits and vegetables are rich anthocyanins, lutein, zeaxanthin, resveratrol and vitamin C. These nutrents help protect cells and heal your body. Research suggests they play active roles in promoting eye and heart health, preventing premature aging, reducing inflammation, decreasing cancer cell growth and improving memory.
Foods such as blueberries, figs, eggplants, plums and grapes get their gorgeous hue from the phytochemical anthocyanin (also found in red foods). Anthocyanins act as powerful antioxidants that protect cells from damage and may help reduce the risk of heart disease, stroke and cancer. Studies have even shown that eating more blueberries is linked with improved memory function and healthy aging.
Be sure to help yourself to plenty of blue/purple foods, such as
White fruits and vegetables are colored by pigments called anthoxanthins, which may help lower cholesterol and blood pressure. Onions also have the flavonoid quercetin, known for its anti-inflammatory properties and cardiovascular health benefits. As we know, being heart-healthy is also being eye-healthy.
Some members of the white group, such as bananas and potatoes, are also a good source of potassium, while the hard-shelled coconut is considered a “superfood” because its natural water is loaded with vitamins, minerals, and electrolytes, while the raw coconut meat (flesh), which is found around the inside of a coconut shell contains high levels of lauric acid, for helping reduce cholesterol and promoting brain health.
Some examples of the white group include:
Bananas
Cauliflower
Coconut
Garlic
Ginger
Jicama
Mushrooms
Onions
Parsnips
Pears
Potatoes
Radishes
Shallots
Turnips
This recipe for Dark Chocolate Fondue, not only has cream of coconut, but is wonderful when dipping bananas!
Susan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation
“Dr. S., my eyes are red and burning at the end of my work day.”
“Patient, what sort of work do you do? Tell me something about your work conditions.”
“I am a computer graphics artist. I sit and stare at my twenty-seven inch HD screen for hours on end gently adjusting the composition of each pixel. My studio is air-conditioned but not humidified, so after some hours of work, I feel dry as a bone.”
“One more question…can you cry tears? Say, when you peel and slice an onion?”
The need to blink
Blinking is a complex function of the eyelids that when completed results in a clean, refreshed, re-wetted corneal surface. The tears that are washed across the outside of the eye with each blink bring oxygen and other nutrients to the outer cell layer aiding in the rebuilding and revitalizing of the surface tissue.
Blinking is characterized by a full sweep of the upper lid over the eye to meet the lower lid. The completion of this motion is performed gently without squeezing. And, to be effective full eye closure needs to be repeated fairly often. Blink rates vary according to investigators but most sources report an average of between six and ten full blinks per minute under normal viewing circumstances.
The anti-blink problem of our generation
In olden times – say the years between 1750-1950 – the most aggravating problem to the ocular surface was a good book or intense study. The reader would concern himself with the text at hand and slowly his eyes would dry until a “rest break” was necessary.
Environmental or vocational changes to our lifestyle over the generations have promoted reduced blink rates. Most recently in this negatively developmental progression is the effect of the television screen, the CRT, the LED screen, the handheld and pocket computer on the blink rate. It appears that as attention level increases, blinking suffers. First the eyes close less, then incompletely, and finally rarely only when surface dryness drives the individual to desperate measures. He must blink or (so he feels) his eyes will pop out of their sockets.
Adding insult to injury increasingly over the decades is air conditioning – both heating and cooling – when not humidified. Staring at console screens in dry environs speeds the desiccation of the cornea and results in discomfort.
The surface of the eye is a biological system. Living systems require some degree of moisture. If the cells of the eye – or any biological surface — are permitted to dry out, they will die. Dead corneal cells fall off the cornea and float in the tears on the surface of the eye until washed away with a blink. Until the surface is cleaned the dead cells are considered by the eye to be foreign bodies with the consequent irritation and induced reflex to blink.
When cells die and fall off, the underlying nerve endings send pain signals to the nervous system. The sensation can be felt as pain, burning, or mere irritation or itching depending upon the severity of cell loss.
How to handle environmentally induced dry eye
After the ocular surface is dry most treatments will seem to make matters worse: to cause burning and stinging, perhaps, even more than the dry eye itself. Any tear substitute, any amount of blinking will be irritating at first. But, that is really all that can be done at this stage: wetting and blinking.
Prevention
As in many conditions, the best treatment, in fact a cure, for recurrent environmentally induced dry eye is prevention. For the eye that has a naturally flowing tear supply, the act of blinking is the surest prevention to stinging and burning after a day’s work at the computer. Additionally, many sources recommend using the ‘rule of 20’: after each twenty minutes of work, look up from the text or away from the screen; blink and refocus on the page twenty times. This repetitive exercise simultaneously re-wets the eye and relaxes the focusing mechanism of the eye.
The result is relaxed and comfortable eyes that can continue to provide important and high quality information for longer hours of work.
Bezalel Schendowich, OD
Chairperson and Education Coordinator, JOS
Fellow, IACLE
Member, Medical Advisory Board NKCF
Sha’are Zedek Medical Center, Jerusalem, ISRAEL
Working long hours in front of the computer requires a fairly unchanging body, head and eye position which can cause discomfort. Correct working position, periodic stretch breaks, frequent eye blinking, artificial tears for lubrication are all very important. However, it’s not always easy to remember this when you are engrossed in work. Here are a few fun, free and easy-to-install “break reminders” to help:WorkSafe SamWorkSafe Samis a desktop tool that provides stretching tips to help reduce eye and muscle strain for office workers (clicking on this link will open a file on your computer because this is a zip file).
Workrave is break reminder program that alerts you to take “micro-pauses” and stretch breaks.
Take Your Break is another break reminder designed to prevent or minimize repetitive strain injury, computer eye strain and other computer related health problems. It has a friendly interface and a tray icon status indicator. It runs quietly in the background, monitoring your activity and reminding you to take regular breaks.
And remember to blink. Blinking cleans the ocular surface of debris and flushes fresh tears over the ocular surface. Each blink brings nutrients to the eye surface structures keeping them healthy. The flow of tears is responsible for wetting the lower third of the cornea. This is very important in KC, since this area is generally below the bulge of the cone and in many cases irritated by wobbly RGP lenses. Maybe your job requires hours of work at a computer. Maybe you like to spend your free time surfing the internet. Whatever the reason, your body is probably feeling the effects of spending too much time staring at a computer monitor, which could result in Computer Vision Syndrome (CVS). The most common symptoms are: eye strain, dry or irritated eyes,redness in eyes,difficulty in refocusing eye,neck pain,double vision,blurred vision, fatigue, and headaches.
Please join us on Thursday when Dr. Bezalel Schendowich will be providing a detailed insight into the importance of blinking, going beyond computer usage.
Cathy Warren, RN
Executive Director
National Keratoconus Foundation
A symposium was held in Bethesda, Maryland at the National Institutes of Health on March 6, 2014. The purpose was to bring together clinicians and researchers from a wide variety of background to discuss the recently discovered differences in the function of the immune system in patients with age-related macular degeneration (AMD) and how it relates to aging. These differences are important to understand because they may lead to new therapeutic approaches to treat people which are high risk for AMD.
Courtesy of National Eye Institute, National Institutes of Health
Three researchers associated with the Discovery Eye Foundation attended the one-day conference. Cristina Kenney, MD, PhD, has worked in the field of AMD for over twelve years and is a leading expert on the genetics and molecular changes in the mitochondria as it related to the retinal cell death associated with AMD.
Lbachir BenMohamed, PhD, is an expert immunologist with a tremendous understanding of how the immune system responds to infections and stress.
Anthony Nesburn, MD, has been involved in AMD research at both the clinical and research levels.
By attending this meeting, all three researchers gained insight into the importance of the immune system with respect to maintaining a healthy retina and slowing the progression of AMD.
The highlights of the meeting were the following:
1. Emily Chew, MD (National Eye Institute) reviewed the clinical aspects of the disease stressing that there are many stages of AMD.
The early stage of AMD is diagnosed based upon the medium-size drusen (about the width of an average human hair) that can be seen underneath the retina. There may not be any visual changes in these patients.
The intermediate stage of AMD is when subjects have larger drusen and some degree of retinal pigment epithelial cell drop out. These patients may not have vision loss or other symptoms.
The late stages of AMD which can be categorized into the dry form (geographic atrophy) which has significant loss of the retinal pigment epithelial cells and overlying photoreceptor cells. Presently there in no treatment for this type of AMD.
These individuals can have changes that cause decreased vision. The second form of late AMD is the wet form (neovascular), which has growth of abnormal blood vessels beneath the retina that can cause significant loss of vision. The treatments for this type of AMD are anti-VEGF medications that block the growth of these vessels and help maintain good visual acuity.
2. Anand Swaroop, PhD (National Eye Institute) reviewed the genetics of AMD and summarized the work of numerous laboratories. It is now recognized that there are over 20 different genes associated with AMD. These genes fall into the categories of those involved with Complement Activation, Cholesterol Pathway, Angiogenesis, Extracellular Matrix and Signaling Pathways. Many of these genes have additive effects, meaning that if a patient has more than one high risk gene, then the likelihood of developing AMD increases. While we have learned a lot about the genes that are important, we still do not have any gene therapies that can be used to treat AMD.
3. Six different speakers presented their data related to animal models of AMD and it was agreed that there is not a “perfect” model because most of the animals do not have a macula, the region of the retina that is affected the most by AMD. However, there is still a lot to be learned by using the models that we do have because if we can better understand the basic pathways involved, then we can block or modify the pathways to prevent the damage.
4. Jayakrishna Ambati, PhD (University of Kentucky) presented data showing that there is a deficiency of an enzyme called DICER1 in the retinal pigment epithelial cells which leads to increased activation of inflammation via a protein complex called the inflammasome. He described some of the signaling pathways which are involved in the inflammasome activation. This is important because these pathways can become targets for treatment of the dry form of AMD.
5. Jae Jin Chae, PhD (National Human Genome Research Institute) also talked about the role that inflammation plays in the development of AMD. The data presented reviewed the pathways involved with activation of the inflammasomes which is the first step in a cascade of events that result in inflammatory diseases. They have identified a calcium-sensing receptor (CASR) which triggers the activation of the NLRP3, a key component of the inflammasome. Understanding how this series of events works allows researchers to develop medications to block or interfere with the pathway and therefore decrease the levels of inflammation.
M. Cristina Kenney, MD, PhD
Professor and Director of Ophthalmology Research
School of Medicine, Dept. of Ophthalmology
University of California, Irvine
Last week a study that appeared in the Annals of Internal Medicine (AIM) showed that fish oils such as omega-3 don’t reduce the risk of heart disease. It caused quite a stir, as we have been told for years, by organizations like the American Heart Association that we needed to increase our intake of omega-3. For some people that meant taking supplements instead of eating flax seeds, walnuts, sardines or salmon, just a few of the sources of omega-3.
In May of 2013 the results of the AREDS II study on eye supplements found that while lutein and zeaxanthin may be helpful in helping vision, omega-3 did not have a positive effect over five years.
In both of these studies they are referring to omega-3 supplements. This does not mean you should give up eating fish, or other sources of omega-3. To derive the benefits of omega-3 you need to get it from the source – directly from the food you eat, so it is still advised you eat fish as part of a healthy diet.
If you do use supplements check with your doctor to make sure they are right for you. A doctor can help you determine what, if anything you might need, making a decision based on your diet, medical history and any medications you might be taking.
What to do when “There’s nothing more that can be done.”
“I’m sorry, but there’s nothing more that can be done. There is no cure for your eye condition.”
In your work as healthcare professionals and health educators, it’s likely you’ve encountered a significant number of adults and older adults who have been on the receiving end of this devastating news.
When an eye care provider says, “There’s nothing more that can be done,” what he or she likely means is, “There’s nothing more I can do for you surgically.” But instead of saying, “There’s nothing more that I can do,” the discouraging message delivered to the patient is, “There’s nothing more that can be done.”
Thus, in many cases, the discussion ends there. Patients will either exhaust their resources searching for an elusive cure or become resigned to a life that is restricted and defined by incurable vision loss.
When receiving a diagnosis of vision loss, many adults who have managed to overcome a host of obstacles in their lives may now believe they are facing an obstacle with no viable solution. A natural, and understandable, initial reaction is to focus instead on the devastating losses that are seen as an inevitable accompaniment to blindness and low vision such as:
Loss of independence: “How will I prepare meals, clean my home, or shop? Will I become a burden to my family and friends?”
Loss of confidence and self-worth: “All my life I’ve been physically active and self-reliant. Has my life as an independent person come to an end?”
Loss of privacy: “I won’t be able to handle my finances independently. Will I have to surrender control of my life to someone else?”
Loss of employment: “I’ll have to quit my job. How will I earn a living?”
It’s important to let your clients and patients know that there is indeed hope—and life—after vision loss. A wide range of vision rehabilitation services enable adults who are blind or have low vision to continue living independently. The term “vision rehabilitation” includes highly trained professionals and comprehensive services that can restore function after vision loss, just as physical therapy restores function after a stroke or other injury.Patient working with a low vision therapist
Orientation and mobility specialists, who teach safe and independent indoor and outdoor travel skills, including the use of a long cane, electronic travel devices, public transportation, and sighted guide, human guide, and pre-cane skills.
Additional vision rehabilitation services can include:
Peer support and counseling: talking with peers, sharing common concerns and frustrations, and finding solutions to vision-related problems.
Vocational rehabilitation: vocational evaluation and training, job training, job modification and restructuring, and job placement.
Veterans’ services: vision rehabilitation and related support services for blinded veterans of all ages.
There are many resources available to help your patients and clients locate vision rehabilitation services. For example, the VisionAware Directory of Services allows you to browse by state and type of service, including counseling resources, support groups, low vision services, independent living skills, and orientation and mobility. The VisionAware “Getting Started” Kit provides tip sheets on specialized services and products that can assist with everyday life after vision loss.
The National Eye Institute’s National Eye Health Education Program (NEHEP) also has low vision education resources. The video, Living with Low Vision: Stories of Hope and Independence, explains how, as a health professional, you can help your patients make the most of their remaining vision and improve their quality of life by referring them for vision rehabilitation services. Share it with your colleagues, too. You can find additional resources and ideas for promoting vision rehabilitation on the NEHEP Low Vision Program page.
Maureen A. Duffy, CVRT
Social Media Specialist, visionaware.org
Associate Editor, Journal of Visual Impairment & Blindness
Adjunct Faculty, Salus University/College of Education and Rehabilitation
The Macular Degeneration Partnership, a program of the Discovery Eye Foundation, has received numerous questions about the implantable miniature telescope (IMT) since it was approved by the FDA in 2010. Implantable Miniature TelescopeThe IMT is becoming more widely available now. The IMT is a tiny telescope implanted inside the eye that may benefit older adults with advanced AMD. Smaller than a pea, this device is proven to restore sight and quality of life in eligible candidates. Unfortunately, the inclusion criteria to be eligible for the device are narrow. Most importantly, the IMT can only be implanted into an eye that has not had a cataract removed yet. We encourage you to review the below information to see if you or a loved one might be a candidate for this procedure. Approximately 2 million Americans have advanced forms of AMD, which is the leading cause of blindness in people over the age of 65. When an individual has severe wet macular degeneration, or dry AMD with geographic atrophy, it is sometimes called “end-stage AMD”. Patients with end-stage AMD have a central blind spot or missing area in their vision. But, despite the availability of drug treatments that slow the progression of AMD, the number of people with end-stage AMD is expected to double by the year 2050.
Specifically, the telescope implant uses micro-optical technology to magnify images which would normally be seen in your “straight ahead,” or central, vision. The images are projected onto the healthy portion of the retina not affected by the disease, making it possible for patients to see straight ahead. The procedure is performed on one eye only, and involves removing the eye’s natural lens and replacing it with the tiny telescope implant. This is similar to the surgery performed to remove a cataract, which is a clouding of the natural lens. The other eye remains as is to preserve peripheral vision, which is important for balance and orientation. The surgery is done in an outpatient setting by a specially-trained ophthalmologist called a cornea/cataract surgeon. The telescope implant is FDA approved and available through Medicare.
Although the telescope implant is not a cure for AMD, studies showed that in general patients were able to see 3 to 4 lines better on the eye test chart and demonstrated improved quality of life on the National Eye Institute Visual Functioning Questionnaire. Two multi-year clinical studies enrolled over 225 patients to evaluate the safety and efficacy of the telescope implant used in the CentraSight treatment program. To be considered a candidate for the telescope implant, an ophthalmologist must first confirm that you:
• Have irreversible, End-Stage AMD resulting from either dry or wet AMD
• Are no longer a candidate for drug treatment of your AMD
• Have not had cataract surgery in the eye in which the telescope will be implanted
• Meet age, vision, and cornea health requirements
Some people with end-stage AMD may not be a candidate for a telescope implant. Patients and their physicians will assess if the benefits of the procedure outweigh the potential risks to decide if this treatment option is right for them.
CentraSight is the program that guides people with end-stage AMD through the telescope implant evaluation, surgery and rehabilitation process. While the out-patient procedure is quick, patients also must commit to a comprehensive occupational therapy program to learn how to use their new vision (and way of seeing) in daily life. Click here to watch a video that shows how the implantable telescope works.
“After surgery, one of the most important aspects of the telescope implant procedure is the rehabilitation,” said Dr. Marjan Farid, Associate Clinical Professor of Ophthalmology at the University of California-Irvine School of Medicine. “Specially trained optometrists and occupational therapists work with patients to teach them how to use their new vision because there are different techniques involved when you are sitting still (for example, reading or watching TV) than when you are moving around, such as walking or cooking.”
The CentraSight treatment program is coordinated by retina specialists who treat macular degeneration and other back-of-the-eye disorders. Before deciding to have the surgery, a special vision test is given in the office. A device simulates what a person may expect to see once the telescope is implanted to determine if the potential improvement will meet the patient’s expectations. Once the telescope has been implanted by an eye surgeon, the patient will need to work with vision rehabilitation specialists (approximately 6 to 12 weeks) to learn how to use their new vision in their everyday activities. Risks include all those associated with cataract surgery, such as postoperative inflammation, raised intraocular pressure, corneal swelling, and the potential for comprised corneal health.
“The first patient whom I implanted with this telescope over a year and a half ago states that she can now recognize the faces of her children and grandchildren,” said Dr. Farid. “For patients with AMD, face recognition of loved ones is a major improvement in the overall quality of their life.”
CentraSight treatment centers are available across the nation. Patients can call 1-877-99-SIGHT to find one in their area.
Judith Delgado
Executive Director
Macular Degeneration Partnership
Lighting is the most essential element for vision. Without light, we cannot see. Conversely, too much light causes glare and eye discomfort. People with macular degeneration, diabetic retinopathy, glaucoma, retinitis pigmentosa, and other vision conditions require specific levels and colors of light to maximize their vision. For each person, the lighting requirements are specific and one should consult with a low vision optometrist or ophthalmologist and find out the best color temperature of light, the best brightness of light, and the best type of light bulb to maximize vision.
There are many different forms of lighting for indoor use. The incandescent light bulb has been the most popular light bulb for decades but it will soon be discontinued because there are new light bulbs that use less energy, produce less heat, and produce a brighter light of different colors. OTT task lamp
Compact Fluorescent Lights
The most frequent replacement for the incandescent light bulb is the compact fluorescent light bulb, sometimes abbreviated as CFL. The CFL bulb consists of a tube slighter larger than the diameter of a pencil that is swirled to produce a bulb approximately the same size as a conventional light bulb. The base of the bulb has threads to allow the bulb to be screwed into most all light fixtures and this will enable people to keep their older lamps.
LED Bulbs
Another common replacement for the incandescent light bulb is the LED bulb, also called the light emitting diode. LED bulbs are very efficient and use less energy that the CFL bulbs. There are many varieties of LED bulbs with various color temperatures. Although the price of an LED bulb is higher than the CFL, the overall cost savings makes them an excellent choice if your eyes respond best to the LED bulb.
How to shop for replacement bulbs
One of the easiest ways to purchase replacement light bulbs for your lamps at home is to go to a light bulb store or to a home improvement store. Take the information provided by your low vision eye doctor and ask a clerk to help you to find the bulb that you need. The following information is the features to search for on the package:
Lumens: Lumens inform you about how much light the bulb will produce. The higher the lumens, the brighter the light.
Temperature: The package of the bulb will describe the Kelvin temperature of the bulb. 2800 degrees will produce a white light with a reddish tint. 3500 degrees will be a whiter light while the 5000 degree bulb will be white with a tint of blue. Ask your doctor about the best temperature color because some bulbs with a temperature over 5000 degrees contain blue light which can be hazardous to the retina of some people’s eyes.
Watts: The watts only tell you how much energy the bulb uses. The lower the wattage, the less energy it consumes.
Base: A medium base is the standard base of the typical incandescent light.
Task Lighting
Task lights are designed to provide the recommended lighting for the specific activity that you are performing. A desk lamp is the most popular task light for reading, writing, paying bills, arts and crafts, and eating. The lamps are small and easy to move from one location to another. The table lamp has a cover that will direct the light from the light bulb directly on the items you want to see. This is very important because light will not shine into the eyes of the user and cause glare. Desk lamps are also positioned close to the table and this increases the amount of light that illuminates the item. The closer the light is to the reading material, the brighter the illumination. Too many times, people with low vision attempt to improve their lighting by installing a brighter bulb in the ceiling. However, the distance between the bulb and the reading materials is too large and one will not be able to see maximally. Some of the most popular desk lamps for people with low vision are the Ott desk lamp and Veralux desk lamps. These lamps are very easy to turn on and off and they provide a wide area of illumination for reading and desk-work.
Track lightingSome people require task lighting at different locations in the home, such as above the stove, kitchen counter, or in the living room. The most effective solutions for this type of task lighting are track lights. A track light consists of a metal strip that is mounted to the ceiling. Light fixtures can then be connected to the metal strip. Low voltage halogen light fixtures with a MR-16 bulb provide users with the largest variety of lighting needs. The MR-16 bulbs do not use much energy, they are available in different color temperatures, and they are very bright. Many people will install a track light above their lounge chair to read in the living room. Similarly, they can be installed over the stove or kitchen counter. The bulbs come in a spot light design and a flood design to spread the width of the light to a level that works best for the person. Track lights are very elegant and work very well in dining rooms and in conference rooms.
Bill Takeshita, OD, FAAO, FCOVD
Chief of Optometry, Center for the Partially Sighted
Consulting director of low vision education, Braille Institute
Susan DeRemer, CFRE
Bezalel Schendowich, OD
